This thesis is focused on the mechanisms for corrosion andhydriding of Zircaloy. Special attention is paid tomicrostructural characterisation by cross sectionaltransmission electron microscopy of the oxide layer formed.Three main topics have been treated in this work: (i)Pre-transition oxides were investigated with the purpose ofevaluating if it is possible to predict post-transitionbehaviour of different alloys. (ii) The reason for the commonlyobserved accelerated corrosion of Zircaloy in the presence oflithium hydroxide was investigated by studying the phasetransformation of differently stabilised zirconium oxides andby corrosion studies. (iii) Pre-hydrided Zircaloy-2 was studiedto investigate the influence of hydrogen on the oxidationbehaviour. Characterisation of pre-transition oxides formed onzirconium alloys, has been accomplished with the aim ofdetermining if there are any differences in the properties(morphology, pores, cracks and phases) of the oxide layersformed which might explain the differences in corrosionbehaviour later in life. Four Zircaloy-2 versions and oneZircaloy-4 version were tested in an autoclave at 288° Cfor 20h and 168h and at 360˚C for 96h. Based on thecharacterisation of pre-transition oxide layers only small orno differences were found between the different alloycompositions, thus it is not possible to predict long-timecorrosion behaviour by studying pre-transition oxides. However,large differences were found between the two test temperatures.The higher oxidation temperature results in increased oxidationrates and larger oxide grains, the columnar grains are a factorof 3-4 longer, and the equiaxed grains have an almost doubledmaximum diameter. The fraction of columnar grains andtetragonal phase also increases with temperature. The reasonfor the difference in morphology between the two temperaturesis not fully understood, but the results show that acceleratedtesting at elevated temperatures may be a questionableapproach. One of the Zircaloy-2 samples was also anodicallyoxidised. The oxide layer formed only contains equiaxed grainsand phase analysis shows both monoclinic and tetragonal phasesare present. Oxidation tests of Zircaloy-2 and Zircaloy-4 in water andlithiated water at 360 ° C show that the pre-transitionoxidation rate is not affected by the presence of LiOH, but thetransition occurs earlier and the post-transition oxidationrate is increased. The oxidation rate correlates with thedensity of cracks in the oxide layer and the morphology of theoxide grains. The oxides formed have a layered structure andfor samples oxidised in LiOH solution the inner protectivelayer is thin. The effect of LiOH is suggested to be the resultof partial dissolution of the oxide and subsequentincorporation of lithium ions during adissolution-precipitation process. Newly formed oxide isprobably more hydrous, and the grain boundaries areparticularly liable to dissolution. The increased concentrationof LiOH within cracks and pores could reach the detrimentallevels necessary for dissolution. This is supported by theinsensitivity in the pre-transition region to both thecompositions of the alloy and to the environment. The alloycomposition influences the microstructure of the oxide layer,and thereby the resistance to accelerated corrosion rate inlithiated water. The hydrogen pickup ratio follows the weightgain, not the oxidation rate, up to the second transition. Whenthe protective oxide layer is degraded the hydrogen pickupratio increases markedly. To evaluate if hydrogen is a cause for or a consequence ofaccelerated corrosion, pre-transition oxidation tests ofZircaloy-2 have been performed with hydrogen present in threedifferent states: i) Hydrogen in solid solution in thezirconium alloy, corresponding to the initial oxidation priorto precipitation of hydrides. ii) Uniformly distributedhydrides simulating a situation in whish hydrides starts toprecipitate and iii) Massive surface hydride claimed to be themain cause of accelerated oxidation. Based on the resultsobtained, it is concluded that the oxidation of massivezirconium hydride resembles the oxidation of zirconium metal.This fact clearly shows that accelerated oxidation of zirconiumalloys cannot be due solely to the presence of a massivehydride layer, but also requires a combined effect offorexample interfacial roughness and hydride precipitation. <b>Keywords:</b>Zircaloy, Zirconium alloys, Oxidation, Oxidelayer, Pre-Transition, Hydriding, Pre-Hydrided, Hydrides,Lithium Hydroxide (LiOH), Lithiated Water, Dissolution, CrossSectional TEM

General and reproductive health and reproductive outcome were described in rural women of childbearing age (15-44 years) during 1992-93 in a cross-sectional study in Zimbabwe. Through a two-stage sampling procedure twelve villages were selected at random, and 79% of the women in the villages accepted to participate (n=1213). In a structured interview women¡¯s self-reported morbidity, socio-economic conditions, use of health care and fertility regulation methods, reproductive outcome and infertility problems were assessed. The prevalence rates of anaemia, malaria and syphilis were investigated. Retrospectively, HIV serology was anonymously assessed and associations with socio-economic conditions and morbidity were analysed. The mean age was 28 years. Family planning was currently used by 37%. Primary and secondary infertility was reported by 0.9% and 4.4%, respectively. The perinatal mortality rate for all completed pregnancies (n=3601) was 23/1000. During the latest completed pregnancy 94% had attended antenatal care and 85% had delivered in hospitals or clinics. The self-reported complications during delivery seemed to have been cared for within the health care system. Women perceived their health as being generally good. Mean haemoglobin (Hb) was 13.5 g/dl and only 3.4% were anaemic (Hb ¡Ü11.0 g/dl). Malaria prevalence was 5.4%, but a positive malaria test was not associated with anaemia. Syphilis prevalence was 2.2%, and a positive syphilis test increased the risk of being HIV positive three-fold (OR=3.0; 95% CI: 1.4-6.2). The prevalence of HIV was high (22%). Women aged 15-19 had the lowest prevalence (7.6%), while the highest was found in married women aged 20-29 years (30%). The differences in HIV prevalence between the villages ranged between 8.4% and 33%. HIV positive women reported no more morbidity than HIV negative women. The low morbidity found at the time of the study indicates a fairly short duration of the HIV epidemic.

Small firms often have inadequate access to the capital necessary for sucessful management. The Swedish Government introduced in the mid-1990s allowance rules that facilitate retention of profit for sole proprietorships and partnership firms. The tax credits arising from the allowances give certain benefits as a source of financing compared to traditional forms of credits. Among the more essential benefits are that the payment for some parts of the tax credit can be put on hold almost indefinitely, or alternatively never be paid. The firms are free to use these means, and the responsibility of future payment of the postponed tax debt stays with the individual firms. The comprehensive purpose of the dissertation may be stated as to increase the understanding of small Swedish firms, especially sole proprietorships, utilizing possibilities for allowances for income smoothing and internal financing. At the beginning the dissertation describes case studies, comprising a smaller selection of microfirms. With a starting-point from the accounted and reported income-tax returns, alternative calculations are made where additional positive tax and finance effects appear possible to obtain. One purpose of these studies is to increase the insight regarding the possibilities of income smoothing and internal financing that arise from utilizing these allowances. These studies also illuminate, to what extent and in what way they are being used in reality. Another objective of these studies is to give a more substantive insight into the technics behind the different allowances, appropriation to positive or negative interest rate allocation appropriation or dissolving of tax allocation reserve appropriation or dissolving of “expansion fund” Theories regarding the creation of resources, through building of capital, and theories on financial planning and strategy are studied. The purpose is to find support for the choice of theoretical grounded underlying independent variables that can be used in cross-sectional studies to explain the use of the possibilities of appropriations. Theories of finance that are of greatest interest, in the operationalisation of these variables, are theories that discuss the choices of different financing alternatives for small firms. The “pecking order theory”, describes the firm’s order of priority when choices of finance alternatives are made. The concept of “financial bootstrapping” expands the frame for different forms of financing choices that especially very small firms have at their disposal. The last part of the theoretical frame deals with the phenomenon of “income smoothing,” which can be translated as leveling out profits/losses. A number of financial and non-financial variables are supported by and operationalised from these financial theories e.g., return on sales, capital turnover, quick ratio and debt-to-equity ratio, respectively age, gender and line of business. Cross-sectional studies are implemented for the taxation years of 1996 and 1999, on databases that have been extracted from Statistics Sweden. The group of 87,276 sole proprietorships included in the study were required to complete tax returns and pay taxes for the business activity according to the supporting schedule, N2, information from the sole proprietorships’ income statement and balance sheet in an accounting statement that comes with the income tax return form. The possibilities of allowances are considered as dependent variables. The intention of the cross-sectional studies is to survey and describe the utilization of possible allowances, with the support of the financial and non-financial independent variables. The connection of these variables to the decision of sole proprietorships to appropriate to the tax allocation reserve is also summarized in a logistic regression model. A number of theoretically based propositions are made for the purpose of observing how the variables are connected to the chances that sole proprietorships actually appropriate to this form of allowance. Appropriation to the tax allocation reserve stands out as the most practiced form of allowance. The studies also clarify that utilization varies among different forms of allowances, but that not all firms that have the prerequisites to utilize the possibilities really do so to the full. A further utilization of the different possibilities of allowances is often conceivable. For the sole proprietorships that are not utilizing these possibilities, the allowances should be considered eligible as a contribution to internal financing and to increase access to capital.

The purpose of this study is to examine the geothermal potential, sustainability, and reinjection possibility of Edremit geothermal field. In order to investigate this, a numerical model consisting of a hot and cold water aquifer system is established. A two dimensional cross sectional model is set to simulate this geothermal system. Different pressure and temperature values are applied to the nodes at the boundaries to perform a steady state calibration which minimizes the computed results and observed values obtained from the near well logs. After the calibration, three alternative scenarios are proposed and the response of the pressure and temperature to these conditions is evaluated. At first the water is pumped from the wells of Yagci, Derman, Entur and ED-3 seperately at a mass rate of 5 kg/s and energy rate of 4.182 x 105 J/s. Then, in scenario 2 the water is pumped at the same rate from all the wells mentioned in the first scenario together. For the third scenario another well is opened to the geothermal system and 80% of the pumped water (temperature being 200C) is injected to the system from the wells while all the wells mentioned are working. The results of these scenarios are utilized to evaluate the reservoir in terms of its response to different production and reinjection conditions. Interpretation of the reservoir response in view of the pressure and temperature declines emphasize that such a simulation study can be applied to assess potential and sustainability of the geothermal systems.

Both spinal pain and temporomandibular disorders (TMD) commonly occur in the general population. Previous studies demonstrate neurophysiologic and biomechanical couplings between the trigeminal and cervical regions. This investigation tested the null hypothesis of no relationship between spinal pain (neck, shoulder and/or low back) and TMD, by using questionnaires and clinical examinations of the jaw function. In an age- and sex-matched case-control study, the specific aim was to compare the prevalence of signs and symptoms of TMD among cases with long-term spinal pain and controls without spinal pain. The results showed that subjects with spinal pain had signs and symptoms of TMD significantly more often than did controls. The associations remained after excluding all participants with jaw pain. Furthermore, the comorbidity pattern was similar, regardless of location of spinal pain. In a cross-sectional study, the specific aim was to test whether there is a reciprocal cross-sectional dose-response-like relationship between spinal pain and TMD. Two different designs were used, one with frequency/severity of spinal pain as independent variable, and the other, with frequency/severity of TMD symptoms as independent variable. The analysis showed increasing odds for presence of TMD symptoms with increasing frequency/severity of spinal pain, and increasing odds for presence of spinal pain with increasing frequency/severity of TMD symptoms. In a case-control study within a 2-year prospective cohort, the specific aim was to test whether there is a reciprocal temporal relationship between signs and symptoms in trigeminally, and symptoms in spinally, innervated areas. Incidence of symptoms in these areas was analyzed in relation to presence of spinal pain, headaches, and signs and symptoms of TMD at baseline. The main findings were that presence of signs of TMD at baseline increased the onset of spinal pain and symptoms in the trigeminal area, and that spinal pain increased the onset of symptoms in the trigeminal area. An augmentation effect between the significant baseline variables was observed for the incidence of headaches and jaw pain. In conclusion, the investigation demonstrated a cross-sectional and temporal relationship between spinal pain and TMD; thus, the null hypothesis was rejected. The results indicate common pathophysiological mechanisms in the development of spinal pain and TMD. The comorbidity and reciprocal influence that were found call for an integrated and multidimensional approach in the management of individuals with long-term spinal pain and TMD.

Background Affective disorders are poorly defined and studied in sub-Saharan Africa despite their substantial public health impact. Objectives Overall objective: To describe the epidemiology of selected affective disorders in rural Ethiopia. Specific objectives 1. To describe the validity and utility of the concept of minor depressive disorder (mD). 2. To describe the manifestation, prevalence and the short-term clinical and functional course and outcome of bipolar disorder. Subjects and methods Population: Zay community residents (age ≥16), and residents of Butajira (ages 15-49), in Southern Ethiopia. Study design: Population-based cross-sectional and longitudinal studies Case identification: For the identification of cases with bipolar disorder, a two stage process was employed. An initial screen used key informants and interview with the Composite International Diagnostic Interview (CIDI) to identify cases with probable bipolar disorder. A second confirmatory diagnostic assessment stage employed the Schedules for Clinical Assessment in Neuropsychiatry (SCAN). For the identification of cases with mD, data from the CIDI was used. Follow-up: 312 cases with bipolar disorder from Butajira were followed up for a mean of 2.5 years (ranging 1-4 years) through monthly clinical assessments and annual symptom and functional ratings. Results The CIDI was administered to 1714 adults among the Zay and to 68, 378 adults among the Butajira residents. The prevalence of mD among the Zay and Butajira was 20.5% and 2.2% respectively. Up to 80% of cases with mD had used services for their symptoms, while a third to a half of cases had thought about self harm. Up to a sixth of cases had attempted suicide. Age, marital status, education and somatic symptoms were independently associated with mD. The prevalence of bipolar disorder among the Zay was 1.8%. During a 2.5-year follow-up of 312 cases with bipolar disorder from Butajira, 65.9% relapsed (47.8% manic, 44.3% depressive and 7.7% mixed episodes) while 31.1% experienced persistent illness. Female gender predicted depressive relapse whereas male gender predicted manic relapse. Only being on psychotropic medication predicted remission (OR=3.42; 95% CI=1.82, 6.45). Disability was much worse among bipolar patients than in the general population and was predicted by symptom se3verity. Conclusions This is the largest study on mD and bipolar disorder in Africa. mD appears to have potential clinical utility in this setting given its association with service use and risk. The identified risk factors for mD also suggest potential aetiological continuity with major depression. The relatively high prevalence of bipolar disorder among the Zay may be related to genetic predisposition perhaps mediated through a founder effect, but other factors need exploring. In relation to the outcome of bipolar disorder, this study indicates that, contrary to previous assumptions, the course of bipolar disorder is characterised by both manic and depressive relapses in a relatively proportionate fashion. Bipolar disorder also leads to significant levels of disability. This is the only prospective outcome study of bipolar disorder in Africa where cases were monitored systematically at short assessment intervals. Therefore, findings are likely to be more robust than previous reports.

Previous research and patient complaints to the Swedish Patient Support Committee shows that there is a lack of substance in the patient-nurse relationship. This may suggest that it can be difficult for health care to live up to health-care law which requires it to be of good quality, based on dignity and respect and designed so that the patient is an active participant and can make their own decisions when it comes to their health care. For a better understanding of what a dignified patient-nurse relationship is, this study aims to clarify what the patient values as good patient-nurse relationship and describe how they have experienced the patient-nurse relationship during their stay at an emergency care department. The study is a descriptive cross-sectional study with a quantitative approach, where the population consisted of patients who were cared for at an emergency care department in the County of Västmanland, Sweden during 2007. The sample consisted of 93 patients which were asked to answer a questionnaire. The results show that patients who were cared for, answered positively in terms of the patient-nurse relationship, when they felt welcome to the department (62,1 %), when they were treated with deference and respect (59,3 %) and when the nurses showed they cared (57 %). A total of 11 % of the patients experienced a violation of their integrity and a sense of powerlessness towards health care. The results confirm previous research which emphasizes the importance of paying attention to patients' needs and requests before the dissatisfaction and lack of good patient-nurse relationship has arisen. This is necessary in order to improve and develop the positive experience of caring for the patient, and thus raise the quality of care. / Klagomål till patientnämnden visar på att det finns brister i bemötandet vilket också styrks av tidigare forskning. Det förefaller att det kan vara svårt för sjukvården att leva upp till hälso- och sjukvårdslagen som kräver att vården ska vara av god kvalitet, grundas på respekt, värdighet och utformas så att patienten själv får vara med och ta beslut. För att bidra till mer kunskap om ett värdigt bemötande avser denna studie att belysa vad patienten värderar som ett gott bemötande. Syftet var att beskriva hur patienter värderar bemötandet och hur de beskriver att de blivit bemötta av personalen under sin vårdtid på en akutvårdsavdelning. Studien är en deskriptiv tvärsnittsstudie med en kvantitativ ansats där populationen bestod av patienter som vårdats på akutvårdsavdelningar i Landstinget Västmanland under 2007. I studien ingick 93 patienter som vid slutet av vårdtillfället tillfrågats om de ville besvara en enkät. Resultatet visar att det som patienterna skattade att de var mest nöjda med (stämmer precis) ifråga om bemötandet var det välkomnande de fick när de kom till avdelningen (62,1 %), att de blev bemötta med aktning och respekt (59,3 %) samt att vårdarna brydde sig om dem (57 %). Trots det upplevde 11 % av patienterna kränkning av integritet och vanmakt i vården. Resultatet bekräftar tidigare forskning och poängterar vikten av att uppmärksamma patientens behov och begär innan ett missnöje har uppstått. Detta för att kunna förbättra och även utveckla en positiv upplevelse av bemötande för patienten och därmed höja vårdkvaliteten. / Axelina

Bakgrund: Andelen äldre i befolkningen ökar nationellt och internationellt, och med ökande ålder ökar både fysisk och psykisk ohälsa. Äldre personer med ohälsa i form av kognitiv svikt (oftast demenssjukdom) kan bli beroende av vård och omsorg i särskilda boenden för äldre för att kunna känna trygghet och välbefinnande samt ha ett gott liv, i gemenskap med andra. Dock visar utvärderingar av särskilda boenden för äldre att vården ofta kan vara uppgiftscentrerad och inte motsvara de äldres individuella behov och önskemål. Personcentrerad vård är en vårdmodell som beskrivs kunna tillgodose äldre personers multidimensionella behov och önskemål, genom att personens livshistoria, personlighet, kapacitet och perspektiv uppmärksammas, respekteras och inkluderas i vården. Den vetenskapliga litteraturen inom området visar dock att det finns begränsad kunskap om förekomsten av personcentrerad vård i särskilda boenden för äldre i Sverige och internationellt, liksom om vilka faktorer som är mest betydelsefulla för att särskilda boenden för äldre ska bedriva en personcentrerad vård. Syfte: Syftet med denna avhandling var att beskriva faktorer som samvarierar med förekomst av personcentrerad vård i särskilda boenden för äldre i Sverige. Metod: Samtliga delstudier var tvärsnittstudier och data samlades in genom enkäter till äldre med kognitiv svikt och personal i särskilda boenden för äldre i Sverige. I studie I bestod insamlad data av skattningar av personcentrerad vård från vårdpersonal (n=1465) i 182 särskilda boendeenheter. I studie II insamlades data i form av vårdpersonalens (n=1169) skattningar av personcentrerad vård och proxyskattningar av de äldres (n=1261) livskvalitet, ADL-förmågor, smärta, depressiva symtom och agitation i 151 särskilda boendeenheter. Delstudie III baserades på data i form av personalskattningar (n=1169) av personcentrerad vård, tillfredställelse med arbete och vård, samvetsstress, arbetsbelastning och psykosocialt klimat i samma 151 särskilda boendeenheter. Även delstudie IV baserades på data från de 151 särskilda boendeenheterna och inkluderade skattningar av de äldre och vårdpersonal, men också skattningar av organisation och miljö vid dessa enheter (n=151). Samtliga studiernas data analyserades med hjälp av statistiska analyser, beskrivande, bivariata och multivariata analysmetoder. Resultat: Studie I visade att enkätinstrumentet The Person-Centred Care Assessment Tool (P-CAT) har tillfredställande psykometriska egenskaper för intern konsistens och test-retest-reliabilitet. Instrumentet består av två subskalor: Individualisering av vården och Stöd från organisation och miljö. Delstudie II visade att de boendes ADL-förmågor och livskvalitet skattades bättre vid enheter som kan beskrivas som mer personcentrerade. Delstudie III visade att en mer personcentrerad vård har samband med att personalen upplever ett positivt psykosocialt klimat, mindre samvetsstress, lägre arbetsbelastning samt högre tillfredställelse med vård och arbete. Studien visade också att personcentrerad vård var positivt relaterat till i vilken omfattning vårdarna hade vidareutbildning i demensvård. Delstudie IV visade att vårdmiljön var mest betydelsefull för förekomsten av personcentrerad vård vid boendeenheterna och att en gynnsam vårdmiljö innebar att personal upplevde att det var ett positivt psykosocialt klimat på enheten, att de hade tid att prata med eller bara vara med de boende samt att de upplevde sig ha en gemensam värdegrund, låg arbetsbelastning och en fysisk miljö som var anpassad till de boendes behov. Slutsatser: Resultaten i avhandlingen visar att den svenska versionen av P-CAT kan användas för valida och reliabla utvärderingar av personcentrerad vård samt att den kan rekommenderas för fortsatt forskning och vårdutveckling inom särskilda boenden för äldre. Resultatet visar också att den vård- och arbetsmiljö som omger de äldre och vårdpersonal i särskilda boenden för äldre är betydelsefull för förekomsten av personcentrerad vård. Dessa aspekter behöver fokuseras ytterligare för att kunna erbjuda en personcentrerad vård. Vidare är det psykosociala klimatet och förekomsten av en upplevd gemensam värdegrund viktig att förstå och prioritera om vården ska utvecklas mot en ökad personcentrering. Fortsatt forskning och kliniskt utvecklingsarbete behövs för att operationalisera och implementera de komponenter som bidrar till ett positivt psykosocialt klimat och en personcentrerad värdegrund på särskilda boenden för äldre. Dessutom behövs en ökad förståelse för hur en sådan värdegrund kan omsättas i personcentrerade interaktioner, handlingar, aktiviteter och prioriteringar. Det vore alltså önskvärt att äldrevården utvecklades mot ett mer personcentrat förhållningssätt, eftersom avhandlingens resultat visar att högre grad av personcentrerad vård i särskilda boenden för äldre var positivt relaterat till välbefinnande och tillfredställelse för såväl de äldre som för vårdpersonal. / Introduction: The proportion of older people in the population increases nationally and internationally, with a declining physical and mental health often accompanying older age. Older people with health issues such as cognitive impairment or dementia often become dependent upon residential aged care to feel safe, experience well being and a good life with others. However, it has been shown that residential aged care can largely be taskoriented and not tailored to residents' needs and wishes. Person-centred care is a contemporary best practice model of care that can meet the multidimensional needs and preferences of older people dependent on care, by acknowledging, respecting and including each person’s life story, personality, capacities, and perspective in care. Nevertheless, the research literature indicates a limited knowledge on the extent to which residential aged care units are person-centred in Sweden and internationally, as well as a limited knowledge into factors of importance for person-centred care in residential aged care units. Aim: The overall aim of this thesis was to describe factors that associate with person-centred care in Swedish residential aged care units. Methods: The thesis consists of four studies with cross-sectional designs, and data was collected through resident and staff surveys in Swedish residential aged care units. Study I collected data consisting of ratings of person-centred care from staff (n=1465) in 182 residential aged care units. Study II collected data consisting of staff (n=1169) ratings of person-centred care and proxy ratings of resident (n=1261) quality of life, ADL-capacity, pain, depressive symptoms and agitated behaviours, in 151 residential aged care units. Study III was based on staff (n=1169) ratings of person-centred care, satisfaction with care and work, job strain, stress of conscience, and perceived psychosocial climate in the same 151 residential aged care units as in study II. Study IV was also based on data from the 151 residential aged care units as described in study II and III, and included ratings of resident and staff variables, as well as variables related to the organization and environment at the units. Data was analyzed using statistical analyses such as descriptive, bivariate, and multivariate methods. Results: Study I showed that the Person-Centred Care Assessment Tool (PCAT) has satisfactory psychometric properties relating to internal consistency and test-retest reliability. The tool consists of two subscales: Extent of personalizing care and Amount of organizational and environmental support. Study II showed that residents were rated as having higher quality of life and better ability to perform activities of daily living in units described as being more person-centred. Study III highlighted that person-centred care was associated with higher staff satisfaction, less job strain, less stress of conscience, and a positive psychosocial unit climate. Person-centredness of care was also positively associated with the extent to which staff had continuing education in dementia care. Study IV showed that the environment is the most influential factor for person-centred care, and that an environment facilitating person-centred care consists of a positive psychosocial unit climate, where staff perceives having time to spend being with residents, where staff perceives a shared philosophy of care, a low job strain, and a physical environment adapted to residents’ needs. Conclusions: The results of the thesis show that the Swedish version of the P-CAT can be used for valid and reliable assessment of unit personcentredness, and that it can be recommended for further research and practice development in residential aged care. The results of the thesis also show that the environment of care and work that encapsulates residents and staff in residential care units is important for person-centred care. These aspects need further focus to enable person-centred care in residential aged care units. Furthermore, the psychosocial climate and the presence and content of a shared philosophy of care are important to understand and prioritize if care is to move towards increased person-centredness. Further research and practice development work is needed to operationalize and implement the components that contribute to a positive psychosocial climate and a person-centred philosophy in residential aged care units, as well as to increase the knowledge of how such a philosophy of care can be translated into person-centred actions, interactions, activities and priorities. strive towards developing person-centredness further within aged care is desirable, as the results in this thesis indicate that residential aged care units

En viktig faktor för människans förmåga att arbeta är hälsa. På arbetsplatsen tillbringar människan mer än en tredje del av sina liv, vilket gör arbetsplatsen till en betydande arena i skapandet av hälsa. Kommuner har som arbetsgivare i Sverige generellt en sämre hälsa samt högre sjukfrånvaro bland sina anställda än andra arbetsgivare. De som jobbar inom vård och omsorg har generellt dåliga psykosociala arbetsförhållanden. Den psykosociala arbetsmiljön i form av höga krav, bristande kontroll och dåligt socialt stöd kan påverka hälsan negativt, vilket kan öka rörligheten på arbetsmarknaden i form av att fler tenderar att byta jobb på grund av dåliga arbetsförhållanden. Syftet är att undersöka samband mellan självskattad psykosocial arbetsmiljö, självskattad hälsa och övervägandet att byta jobb bland kommunanställda inom äldre- och handikappomsorgen i Sverige. Studien har genomförts som en deduktiv tvärsnittsstudie och är en del av en störres studie.  Den baseras på 9 270 kommunanställda inom äldre- och handikappomsorgen i Sverige. Studien teoretiska referensram är krav/kontroll/stöd modellen. Analys skedde genom univariata, bivariata och multivariata metoder.    Resultatet visar att det fanns signifikanta bi- och multivariata samband mellan att kommunanställda som upplever den psykosociala arbetsmiljön som god även skattar hälsan bättre samt i mindre utsträckning överväger att byta jobb än de som upplever sämre psykosocial arbetsmiljö. Ålder och antal år på arbetsplatsen hade betydelse för övervägandet att byta jobb. Detta i form av att ju äldre de anställda är samt ju längre de arbetat på arbetsplatsen desto mindre är övervägandet att byta jobb. Slutsatsen är att den psykosociala arbetsmiljön hade betydelse för den upplevda hälsan och övervägandet att byta jobb bland kommunanställda inom äldre och handikappsomsorgen. / Health is an important prerequisite for the ability to work. In the workplace, the human being spends more than a third of their lives. This makes the workplace a major arena for health promotion. Municipalities have as employers in Sweden generally poorer health and higher rates of sick leaves among the employees than other employers. Those who work in health care have bad demanding working conditions. Psychosocial work environment in the form of high demands, lack of control and poor social support may affect health negatively. This can increase labor market mobility in the form of more tend to change jobs due to poor working conditions. The aim of this study is to investigate the relationship between self-rated psychosocial work environment, self-rated health and occupational mobility among municipal employees in the elderly and disabled care in Sweden. The study is implemented as a deductive cross sectional study and is a part of a major study. It is based on a sample of 9 270 municipal employees in the elderly and disabled care in Sweden. The theoretical frame of reference of study is the demand / control / support model. The analyses were done by univariat, bivariat - and multivariate methods. The results show that there were significant correlation between municipal employees who experience the psychosocial work environment as good rated health better and lesser extent considering changing jobs than those who experience poorer psychosocial work environment. Age and number of years in the workplace was relevant to the consideration of changing jobs. This is in the form of the older employees are and the longer they worked in the workplace, the less is the consideration of changing jobs. The conclusion is that the psychosocial work environment was important for the perceived health and the consideration to change jobs among municipal employees in the elderly and disabled.

The frequently studied concept of social capital has often been related to health, but theconceptualisationand measurement of the conceptisanon-goingdebate. The main aim of this thesis is to study the relationship of four different indicators of social capital; informal social capital, formal social capital, trust towards institutions and trust towards others, with self-rated physical health and self-rated mental health in Iceland in 2009, shortly after a harsh economic crash. Insomnia symptoms will be studied as a possible mediator or moderator in the relationship. Furthermore, longitudinal data on informal social capital will be used to see the causal effect of social capital on health and to see if informal social capital decreased after the economic collapse. Population-based panel data from Iceland in 2007 and 2009 will be used to perform both cross-sectional analysis (n = 3,243) and longitudinal analysis (n = 3,131). The main results are that the four indicators of social capital all relate differently to physical and mental self-rated health, and insomnia symptoms seem to mediate the relationship between social capital and health, especially physical health. Surprisingly, informal social capital did increase during the economic collapse. The panel analysis further suggests that having poor informal social capital has causal effects on poor self-rated mental health when adjusted for symptoms of insomnia, age, gender, family status, education and smoking.