Introduction       Hypertension is the leading cause of cardiovascular disease, which is responsible for 9.4 million death per year. The characteristics of the physical environment of the workplace may influence exposure to the risk of hypertension. The aim of this study is to increase the knowledge of to what extent of physical workplace environment is associated with hypertension. Method A cross-sectional study was conducted using UK Biobank data including 256,617 participants, aged 39-71 years. The exposure variable included information about the physical aspects of the workplace environment. The outcome variable was hypertension, defined by the average of two blood pressure measurement, systolic blood pressure >140 mmHg and diastolic blood pressure >90 mmHg. The association was calculated using logistic regression. Result Both crude (OR 1.21, CI 1.14-1.28) and adjusted analysis (OR 1.07, CI 1.01-1.12) showed an association between exposure to chemicals in the workplace and hypertension. This association was constant when controlling for possible confounders in three models. Other physical aspects of the workplace environment did not show any statistically significant association with hypertension. To assess whether this association was modified by job satisfaction, the analysis was further stratified by work/ job satisfaction, but it was concluded that work/ job satisfaction does not act as an effect modifier of the association between workplace environment and hypertension. Conclusion Chemical exposure may increase the risk of hypertension in the workplace among the workers. This knowledge emphasizes the importance to formulate preventive measures in the workplace for better health outcome of workers.

<p>Ongoing structural and financial changes in the health care sector have resulted in increased risks for ethical dilemmas and moral distress. It is purported that increased ethical competence will help staff manage ethical dilemmas and hence decrease moral distress. To enhance ethical competence several approaches may be used – theoretical education, and methods focusing on reflection and decision-making abilities.</p><p>Ethics rounds are a widespread systematic method hypothesized to improve ethical competence, nurture a reflective climate, and help in ethical decision-making. Despite its popularity, its effects on moral distress have hitherto never been evaluated in a controlled study.</p><p>The purpose of this thesis was to evaluate the impact of an intervention, including ethics rounds; the hypothesis being that the intervention would decrease perceived moral distress. An additional aim was exploring the concept of moral distress in various health care establishments, including pharmacies.</p><p>Focus groups were conducted to explore the concept of moral distress. To evaluate the intervention a scale assessing staff-perceived moral distress was designed, validated, and implemented.</p><p>Results showed that moral distress is evident in diverse health care settings. Some factors associated with this were lack of resources, conflicts of interest, and rules that are incompatible with practice. An expanded definition of moral distress was presented.</p><p>The training program was much appreciated by participants. However, no significant effects on perceived moral distress were found. Reasons could be that the intervention was too short or otherwise ineffective, there is no association between ethical competence and moral distress, the assessment scale was not sensitive enough, or management was not sufficiently involved.</p><p>There is a need to further refine the various aspects of ethical dilemmas in clinical settings, and to evaluate the most efficient means to enhance skills for dealing with ethical dilemmas, for the benefit of staff, patients, institutions, and society.</p>

Ongoing structural and financial changes in the health care sector have resulted in increased risks for ethical dilemmas and moral distress. It is purported that increased ethical competence will help staff manage ethical dilemmas and hence decrease moral distress. To enhance ethical competence several approaches may be used – theoretical education, and methods focusing on reflection and decision-making abilities. Ethics rounds are a widespread systematic method hypothesized to improve ethical competence, nurture a reflective climate, and help in ethical decision-making. Despite its popularity, its effects on moral distress have hitherto never been evaluated in a controlled study. The purpose of this thesis was to evaluate the impact of an intervention, including ethics rounds; the hypothesis being that the intervention would decrease perceived moral distress. An additional aim was exploring the concept of moral distress in various health care establishments, including pharmacies. Focus groups were conducted to explore the concept of moral distress. To evaluate the intervention a scale assessing staff-perceived moral distress was designed, validated, and implemented. Results showed that moral distress is evident in diverse health care settings. Some factors associated with this were lack of resources, conflicts of interest, and rules that are incompatible with practice. An expanded definition of moral distress was presented. The training program was much appreciated by participants. However, no significant effects on perceived moral distress were found. Reasons could be that the intervention was too short or otherwise ineffective, there is no association between ethical competence and moral distress, the assessment scale was not sensitive enough, or management was not sufficiently involved. There is a need to further refine the various aspects of ethical dilemmas in clinical settings, and to evaluate the most efficient means to enhance skills for dealing with ethical dilemmas, for the benefit of staff, patients, institutions, and society.

The purpose of the study is to investigate midwife's work towards pregnant women.  The method of the study had a qualitative approach and the data collection was done using semistructured interviews. Three phoneinterviewes and an interview face to face.    The method used had a qualitative approach and semi structured telephone interviews as well an interview with a personal meeting was the results implementation. The participants in the survey were four midwives recruited by telephone. The interviews were recorded, transcribed and analyzed with a manifest thematic content analysis, with a phenomenological element.   The Result gave four different themes: The health call - a good foundation for maternity health care, trust and trust, diet and exercise, insufficient knowledge and midwives experience of support. The result showed that midwives work on the same guidelines, that is the BAS program. They felt short of time and wished that the visits with the women could be a bit more flexible.   The conclusion is that more time for each visit would be necessary and that cooperation with other actors would make the work more efficient and fair.

Background: HIV drug resistance is presumed to be inevitable due to the error-prone nature of the virus. However, poor adherence to the antiretroviral drugs is proven to be an impending factor for HIV drug resistance development. Of these two explanations, which is the most common reason for HIV drug resistance?Method: A total of 40 published studies about HIV drug resistance, were retrospectively collected in Pubmed (May 2017), from 36 different countries for this paper. From each study was participants, percentage of HIV drug resistance and HIV-1 subtype extracted for analysis. All studies were than classified by either high-income, middle-income or low-income, based on a country income status, defined by the World Bank. HIV drug resistance was tested against: continents, HIV-1 subtypes, number of study participants, income levels, GDP per capita and EWI’s. All statistical analysis was performed in R: The R project for statistical computing.Result: This paper show, that HIV drug resistance primarily is caused by poor adherence which is closely associated with drug stock out. Highest HIV drug resistance levels was found in middle-income countries. However, number of participants enrolled per study was important for the outcome and this indicates that HIV drug resistance would be higher in low-income countries if larger studied had been carried out in these settings. This means that there is a large unrecorded prevalence of HIV drug resistance in low-income countries.

Introduktion: I Sverige tar 1500 människor sitt liv varje år, en tiondel av dem tillhör gruppen unga. Regeringen menar att unga bör prioriteras i arbetet mot självmord och Folkhälsomyndigheten arbetar för att motverka självmord. Syftet med litteraturöversikten var att beskriva möjligheten att med skolbaserade interventioner förebygga självmord bland ungdomar 14-19 år.  Metod: Metoden som använts är systematisk litteraturöversikt. Artiklar har sökts i Pubmed och har systematiskt analyserats och bearbetats för att ge en relevant bas till studien. Femton vetenskapliga artiklar har använts som grund till resultatet. Resultat: Artiklarna genererade tre teman: screening, gatekeeper-program och utbildning för elever. Screening används för att identifiera elever i riskzonen för självmord och remittera dem vidare för vård..Gatekeeper-program innebär att lärare, skolpersonal och/eller elever utbildas i att identifiera elever som mår psykiskt dåligt. Utbildning syftar  till att öka elevers hälsolitteracitet.. Diskussion: Regeringen har slagit fast i en proposition att unga bör vara av prioritet i folkhälsoarbetet mot självmord men det finns inom Folkhälsomyndighetens åtgärdsområden ingen direkt fokus på unga människor. Litteraturöversikten visar att utbildning för elever kan reducera självmordstalen bland unga människor,och liknande litteraturöversikter visar att en kombination av olika program kan vara effektivt. Därför föreslås att utbildningsprogram används för att förebygga självmord bland unga. / Introduction: In Sweden, 1500 people take their lives every year, one tenth of them belonging to the group of young people. The government believes that young people should be prioritized in suicide prevention efforts and the Public Health Agency is working to counter suicide. The purpose of the literature review was to describe the possibility of preventing suicide among young people aged 14-19 years with school-based interventions.  Method: The method used is systematic literature review. Articles have been searched in Pubmed and have been systematically analyzed and processed to provide a relevant base for the study. Fifteen scientific articles have been used as the basis for the result.  Results: The articles generated three themes: screening, gatekeeper programs and education for students. Screening is used to identify students at risk of suicide and to refer them further for care. The gatekeeper program means that teachers, school staff and / or students are trained to identify students who are mentally ill. Education aims to increase students' health capacity.  Discussion: The government has stated in a proposition that young people should be a priority in public health work against suicide, but there is no direct focus on young people in the area of ​​public health authorities. The literature review shows that education for students can reduce suicide among young people, and similar literature reviews show that a combination of different programs can be effective. Therefore, it is proposed that education programs be used to prevent suicide among young people

Inledning: Äldre utgör den största gruppen som drabbas av depression och är också den snabbast ökande gruppen i världen som lider av depression. Det råder en brist på forskning inom området och det finns indikationer på att äldre inte svarar på samma sätt som yngre vid behandling. Syftet med litteraturstudien är att undersöka metoder för behandling av depression i den äldre befolkningen. Metod: En systematisk litteraturstudie med tematisk innehållsanalys av kvantitativa data. Resultat: Femton artiklar inkluderades för analys. Analysen utmynnade i fyra teman: Fysisk aktivitet, Terapi, Social interaktion, Medicinsk behandling. Slutsats: Det finns indikationer på behandlingsmetoder med god effekt, men heterogeniteten inom studiepopulationen är stor och försvårar eventuella kliniska implikationer. Det behövs fler studier inom området med fokus på undergrupper. / Background: The older population makes up the largest group of people struck by mental depression. Meanwhile it is also the most rapidly increasing population group suffering from depression. There is a lack of research in this field and there are indications that older people do not respond to treatment in the same way as the younger population. The aim of this literature review is to examine methods of treatment for depression in the elderly population.Method: A systematic literature review with thematic content analysis of quantitative data.Results: Fifteen articles were included. The analysis resulted in four themes: Physical activity, Therapy, Social interaction, Medical treatment. Conclusion: There are indications of treatments with good effect, but it is difficult to identify possible clinical implications due to heterogeneity within the study population. More studies in the field focusing on subgroups are needed.

Under dem senaste åren har allt fler ungdomar av olika skäl slutat med lagidrott. I samtidigt med detta har den fysiska hälsan minskat bland våra ungdomar. Problematiken har uppstått för att ledarskapet och föreningarna fokuserar på fel delar som resultat och prestation, istället för att utveckla våra ungdomar. Syftet med denna studie är att undersöka ledarnas uppfattningar om vilken betydelse ledarskapet inom föreningslivet har för att vidmakthålla ungdomars deltagande i lagidrott högre upp i åldrarna. Ämnet har avgränsats till bollsporter i Västerås. En kvalitativ ansats har valt att tillämpas som metod, för att samla in materialet från fem intervjuer. Urvalet bestod av ett ändamålsenligt urval av ledare som hade kännedom om ämnet och deltagarna var av både män och kvinnor med varierande åldrar. Vid datainsamlingen gjordes semistrukturerande intervjuer och analysen gjordes utefter en manifest innehållsanalys. Resultatet visade tre olika faktorer som ledare beaktar för att främja deltagandet bland unga. Hälsofrämjande ledarskap där det sociala och det pedagogiska förhållningssättet samverkar för att skapa struktur och tydlighet. Delaktighet som bidrar till att alla ska kunna vara aktiva och få sin röst hörd, samt bli inkluderade i planeringar och möten. Den sista faktorn är gemenskap och socialt stöd, som verkar för att öka sammanhållningen och meningsfullheten.

Spel om pengar respektive alkoholbruk är två folkhälsoproblem som bidrar till flertalet sjukdomar och omfattande samhällskostnader. Ungefär 58 procent av befolkningen hade 2015 spelat om pengar under senaste året. I Sverige har ungefär 80 procent av den vuxna befolkningen brukat alkohol under den senaste månaden. Att vara aktiv inom lagidrott har visat sig vara en potentiell faktor för att bruka alkohol och spela om pengar. Syftet med studien var att kartlägga pengaspelande och alkoholbruk bland lagidrottande män i Västmanlands län och huruvida det finns något samband mellan spel om pengar och alkoholbruk. Studien var av kvantitativ metod och en tvärsnittsdesign användes. Kvantitativa data insamlades genom enkäter från 100 respondenter med en svarsfrekvens på 97 procent från åtta föreningar i Västmanlands län. Data analyserades genom deskriptiv analys och chi-2 tester i statistikprogrammet SPSS. Resultatet påvisade att de flesta hade spelat om pengar någon gång under det senaste året. Det framkom också att de flesta hade brukat alkohol senaste året. Resultatet påvisade även att det fanns samband mellan spel om pengar och alkoholbruk. Social kognitiv teori har använts för att djupare förklara möjliga motiv till varför lagidrottare börjar spela om pengar och hur beteendet tas efter från en individ till en annan.

INLEDNING Depression är en vanligt förekommande folksjukdom som växer globalt och kan innebära stort lidande för den drabbade. SYFTE Ge en översikt av effekterna av fysisk aktivitet vid depression. METOD En litteraturöversikt genomfördes genom att tio vetenskapliga originalartiklar valdes ut som studerade effekterna av fysisk aktivitet på depression. Dessa sammanställdes och analyserades fram till fyra gemensamma teman. RESULTAT Majoriteten av studierna visade signifikant förbättring av depressionsnivå efter intervention jämfört med kontrollgrupp. Fysisk aktivitet som komplement till antidepressiv medicinering har positiv effekt på depressionens svårighetsgrad och kan även minska behovet av höga doser antidepressiv medicin. Placeboeffekt kunde uteslutas. Enbart en studie observerade ingen påverkan på depression, hos vilken resultatet bör tolkas med hänsyn till ett begränsat studiedeltagande. DISKUSSION Fysisk aktivitet kan vara mer effektivt än traditionell behandling av antidepressiv medicinering. Den praktiska tillämpningen av att rekommendera fysisk aktivitet inom vården kan däremot vara komplex. Vinstintressen, okunskap och gamla vanor kan eventuellt försvåra en praktisk tillämpning av fysisk aktivitet som behandling. SLUTSATS Slutsatsen är att effekten av fysisk aktivitet på depression är behandlande och lindrande. Fysisk aktivitet står stark som effektiv behandlingsmetod mot depression såväl i sig eller i kombination med traditionell behandling, beroende på svårighetsgrad. Mer studier behövs för att identifiera de mest effektiva kombinationerna av fysisk aktivitet med andra behandlingsmetoder i förhållande till depressionsnivå och målgrupp.