Purpose -- This study investigates the inefficiencies in warehouse outbound logistics,

focusing on how lean tools and strategic planning can improve efficiency. Identifying

the main issues in the loading process and ways to make the operations more sustainable

and more effective.

Method -- The study has chosen a major electronics retailer central warehouse in the

Nordic region as a case study. The required data for this research will be collected

using qualitative methods like interviews, observations, and document analysis. Lean

tools were used to identify inefficiencies and analyze the process to answer the paper's

research questions.

Findings -- The study found warehouse inefficiencies such as truck conditions,

packaging, and communications, would be improved by implementing Lean tools such

as 8 wastes, 5S, and Standard Operating Procedures. Better strategic planning has shown

potential improvement for last-minute orders and quality checks.

Implications -- The study has presented some solutions regarding the inefficiencies

that would help the warehouse improve planning for variation of truck conditions

and packaging issues, and enhance collaboration. The study outcome would help improve

productivity and the efficiency of the operation.

Limitations -- The study was conducted in one case company with a major warehouse

which would require more data collection especially quantitative that would add more

accuracy of the inefficiencies. The inefficiencies and recommendations given in the

study might not apply to a similar-sized enterprise.

The purpose of this thesis is to explore the role of supply chain practices and integration inreducing plastic usage. Based a two-phased single case study approach the firm level supplychain practices involved in plastic usage and waste is examined through triangulation of threedata collection methods and analysed using process maps. Secondly, a supply chain wideperspective of supply chain practices and integration is explored through semi-structuredinterviews and primarily coded using a deductive reasoning. The study shed light on thenecessity for supply chain collaboration to reduce sub-optimisations on a firm-level basis forreducing plastic usage and waste. Further findings included the importance for companies toadopt both a top-down and bottom-up approach when tackling issues of environmentalsustainability and encourage information sharing throughout the company and their partners toalign their initiatives vertically, but also horizontally across the supply chain. The studycontributes to the knowledge of supply chain practices for reducing plastic usage and waste andoffers a glimpse into the dynamics of these practices on a supply chain wide perspective.Offering practitioners and researcher with a selection of recommendations for combating suboptimisations and a compass for green supply chain efforts. Reducing plastic, which this studyattempts to explore through supply chain practices, has implications on a societal andenvironmental level. Lastly, the study attempts to contribute with a degree of originality byexploring green supply chain practices through a firm-level approach.

This paper aims to clarify how public digital user interfaces discursively enable and constrain interaction between citizens and the welfare state, both digitally and offline, and the potential implications of these interfaces and interactions for older citizens. An analysis of four digital welfare user interfaces in Sweden shows that information gathering is at the core and their multimodal nature and personal language usage can foster a welcoming environment for citizens. Additionally, the study suggests that the design of these interfaces shapes the structuring of citizenship, as they not only demand specific actions from citizens to access the right information but also require knowledge about what to look for. Consequently, citizens bear the burden of work and responsibility, potentially contributing to the low use of online public services among older people and serving the renegotiation of welfare provision altogether. One way to mitigate this rigid structuring of citizenship is to offer offline interaction, a notion that is discursively promoted in some interfaces but pushed back in others. User interfaces that enable offline interaction may be beneficial for digitally vulnerable social groups, such as the older ones among citizens over 65. However, those interfaces that are predominantly rooted in a digital-only approach risk excluding such groups.

​Teachers’ beliefs about grammar teaching theories and practices affect and influence their practices in the classroom. Teachers should therefore be encouraged to examine the beliefs and assumptions underlying their teaching, in order to engage in critical reflection on their teaching practices. The aim of this study is threefold. Firstly, it aims to investigate the beliefs held by eight Swedish EFL teachers regarding grammar teaching. Specifically, the study seeks to determine the extent to which these teachers believe that grammar teaching is beneficial for language learning. Secondly, the study aims to investigate the teachers’ beliefs regarding the effectiveness of various grammar teaching methods and approaches. Thirdly, the study aims to gather insight into the personal and social factors that may give reason to these beliefs. Teacher cognition is employed as the theoretical framework for this study. The study also follows a descriptive and interpretative design, making a distinction between conceptual and evaluative elements of beliefs. Semi-structured interviews were conducted to gain a deeper understanding of the teachers’ beliefs concerning grammar teaching. The data were then analysed using a qualitative approach. The findings indicate a consensus among the teachers that grammar teaching is important for language learning. However, the belief to which extent grammar teaching is beneficial varies among the teachers. The teachers also vary in their opinions concerning the purpose of grammar teaching, as well as how and when it should be practiced. The respondents hold various opinions on the effectiveness of explicit and implicit grammar teaching for language learning. Some of the teachers favour explicit grammar teaching for its provision of structure and aim which they find provides a sense of clarity to the learner. Conversely, some of the teachers view implicit grammar teaching as an effective tool for helping students acquire grammar in a more subtle and inspiring way. Furthermore, the findings seem to support that teachers’ own experiences of grammar teaching affect their instructional choices. However, their instructional choices may not always reflect their own experiences of grammar teaching as learners. Further findings suggest that the respondents’ practices in the classroom are experimental and practical rather than based on second language acquisition theories.  

Att olika perspektiv, kulturer och ideologier konfronteras med varandra i en litterär text är exempel på hur en läsning kan ge underlag för en diskussion om föreställningar om den samiska kulturen i den svenska skolan. Svenskämnets litteraturundervisning kan i förhållande till gymnasieskolans värdegrundsarbete stärka elevers kunskap om Sveriges kulturarv. Denna uppsats undersöker den didaktiska potentialen i Ann-Helén Laestadius roman Stöld (2021), med syftet att visa hur samisk skönlitteratur kan användas i undervisning för att öka förståelsen för olika kulturer, identitetsskapande och minoritetsgrupper. Genom en tematisk innehållsanalys med teoretiska redskap från kulturstudier har tre aspekter av kultur framträtt som de viktigaste identitetsmarkörerna: språkanvändning, traditioner och levnadsvanor, samt mötet med samhällsstrukturer. Analysen visar att romanen erbjuder en rik källa för diskussioner om kultur och kulturarv. Romanen gestaltar både traditionella och moderna aspekter av den samiska kulturen och illustrerar hur identiteter formas och utmanas genom språk, assimilation och samhälleliga normer. 

I relation till gymnasieskolans läroplan kan Stöld användas för att uppnå målen om förståelse för de nationella minoriteternas språk, kultur, religion och historia, samtidigt som elever får möjlighet att reflektera över egna identiteter och erfarenheter av kulturella skillnader. Romanen öppnar för etiska diskussioner om tolerans, mångkultur och respekt för olikheter, vilket stämmer väl med skolans demokratiska uppdrag. Metoddiskussionen framhåller att den kulturteoretiska ansatsen har varit effektiv för att analysera hur kulturella identiteter formas och utmanas i romanen. Genom att kombinera litteraturvetenskap, kulturstudier och didaktik har uppsatsen visat på den stora potentialen som skönlitteratur har för värdegrundsarbete i skolan, men också öppnat upp för vidare forskning om hur romanen kan omsättas i praktisk undervisning. 

Studier visar att fattigdom påverkar människors livskvalitet och möjligheter till full delaktighet i samhället, och kan ge upphov till ohälsa och skamkänslor. Fattigdom är ett komplext fenomen som kan definieras på olika sätt beroende på tid och plats. Resultat i denna studie baseras på data och definitioner av fattigdom från Statistiska Centralbyrån (SCB). Två definitioner används som utgår ifrån att fattigdom är brist på resurser som leder till att man inte når en allmänt accepterad levnadsstandard. Relativ fattigdom som innebär att hushåll har inkomster lägre än 60 % av medianinkomsten och absolut fattigdom som innebär att inkomsten inte täcker nödvändiga levnadskostnader. I fokus för rapporten är att undersöka barnfattigdom, fattigdom bland ensamstående med och utan barn, fattigdom bland unga vuxna, samt fattigdom bland äldre.

Sammantager visar rapporten att fattigdom utifrån de valda definitionerna i Jönköpings län varierar mellan olika grupper och kommuner. Bland barn i länet lever i genomsnitt 19,5% i relativ fattigdom, vilket är något högre än riksgenomsnittet på 18,3%. När det gäller låg inkomststandard, är den lägsta andelen 1,8%, och den högsta nivån 10,6%. Rapporten visar också att barn med utländsk bakgrund löper en betydligt högre risk för fattigdom.

För ensamstående föräldrar finns också stora variationer mellan kommuner, där kvinnor med barn löper högre risk för fattigdom än ensamstående män. Yngre ensamstående kvinnor utan barn har högre risk att leva i fattigdom i några kommuner. Rapporten visar vidare att unga vuxna (20–29 år) med utländsk bakgrund har en betydligt högre risk för låg inkomststandard än de med svensk bakgrund i alla kommuner.

När det gäller äldre (65–79 år) visar resultatet att ensamstående kvinnor har högre nivåer av fattigdom jämfört med män, men risken är betydligt lägre för sammanboende äldre.

Rapporten visar också att generellt sett har sammanboende äldre lägre risk för fattigdom, och skillnaderna mellan könen är tydliga men mindre framträdande jämfört med ensamstående med hemmaboende barn i åldersgrupperna 20–29 år och 30–49 år.

Slutsatsen av rapporten är att fattigdom i Jönköpings län varierar avsevärt mellan olika kommuner, utrikesfödda och ensamstående mödrar med hemmaboende barn utgör grupper med ökad risk för ekonomisk utsatthet. Fattigdom är ett komplext fenomen som påverkar flera aspekter av livet, från utbildning och hälsa till socialt välbefinnande. För att effektivt bekämpa fattigdom behövs omfattande strategier som fokuserar på olika faktorer, såsom utbildning, bostad, och vård. Fortsatt forskning är nödvändig för att undersöka långvarig fattigdom och de faktorer som bidrar till socioekonomiska skillnader i regionen.

Background: Screen use is a central role in adolescents' daily lives. While high screen time is linked to decreased physical and mental health, views differ on the extent and type of screen use causing these effects. Limiting screen time among adolescents can promote both their physical and mental well-being.

Aim: The aim was to describe adolescents' screen use and analyze the relationship between screen use, physical activity, and self-rated health among students in grade 9 and second-year high school students.

Method: A quantitative design based on a cross-sectional survey from the "Folkhälsoenkät Ung". Statistical analyses (chi-square test and logistic regression analysis) were performed using SPSS.

Result: Significant differences in screen use were found based on gender, living arrangements, country of birth and family's financial situation. The result showed that high screen use was associated with lower levels of physical activity and poorer self-rated health. 

Conclusion: The amount of time adolescents spend in front of screens impacts their physical activity levels and self-rated health. However, it also depends on what they are doing on the screen. No cause-and-effect relationship could be established from the results, but it provides a clearer understanding of the topic and can serve as a basis for further research. 

Background: As the population ages, there is an increasing reliance on home care services, where home care nurses play a crucial role in patient management during transitions between inpatient and home care settings.

Aim: This study explores district nurses' experiences and management of specific incidents that arise during interactions between home care and inpatient care.

Method: Employing a qualitative design with an inductive approach, the research utilized the Critical Incident Technique (CIT). Data were collected through 24 interviews with district nurses in the south of Sweden, yielding 67 specific incidents for analysis. The analysis focused first on the nurses' experiences and then on the handling of these incidents in practice.

Results: The findings reveal significant gaps in communication between hospital and home health care, particularly in patients' discharge, which underlined the importance of well-functioning collaboration. District nurses reported challenges with incomplete medication information and absent care plans, which made their work difficult and put patient safety at risk. Despite these difficulties, there were also positive examples when communication was effective and contributed to a smoother transition and improved patient care.

Conclusion: The study highlights critical deficiencies in communication, care planning, medication management, and role clarity, which jeopardize patient safety. Addressing these gaps is essential for improving care transitions and ensuring safer outcomes for patients. 

Bakgrund: Patienter med kroniska sjukdomar upptar en stor del av hälso- och sjukvårdens resurser där patientens delaktighet är av stor vikt, vilket egenmonitorering kan bidra till. Egenmonitorering innebär att patienten mäter sina värden själv där de befinner sig som distriktssköterskan på vårdcentralen tar del av, vilket är ett nytt arbetssätt som gör det betydelsefullt med kunskap inom området.

Syfte: Studiens syfte var att beskriva distriktssköterskans erfarenheter av egenmonitorering vid kroniska sjukdomar på vårdcentral. 

Metod: Kvalitativ metod med induktiv ansats där ändamålsenligt urval tillämpades och datainsamling skedde via tio stycken semistrukturerade intervjuer som analyserats med Graneheim och Lundmans innehållsanalys.

Resultat: Första kategorin; Digital hälsa som system och verktyg innehöll underkategorierna Egenmonitorering som hjälpande verktyg, patientgrupper som använder egenmonitorering, faktorer som påverkar användandet av egenmonitorering som plattform. Andra kategorin; Egenmonitoreringens påverkan på distriktssköterskans arbetssätt innehöll underkategorierna Effektivisering av vårdprocesser, Ökad tillgänglighet genom nya kommunikationsvägar. Tredje kategorin; Egenmonitorering främjar till egenvård innehöll underkategorierna Följsamhet och bättre sjukdomskontroll, Gemensamt ansvar för vård och hälsa. Fjärde kategorin; Vård i hemmet och vardagen innehöll underkategorierna Egenmonitorering skapar frihet, Digital vård, komplement till fysiska besök.

Slutsats: Egenmonitorering leder till delaktighet, ansvar, sjukdomsinsikt och följsamhet för patienterna. Det underlättar och effektiviserar distriktssköterskans arbete. 

Background: The health centre is a central part of primary care and serves as the patient's first contact with health care. The main tasks of the district nurse include planned nursing interventions, but there are also emergency situations that require rapid intervention to ensure survival or prevent serious harm. Assessment tools and standardised systems are in place to ensure evidence-based and safe care. Research shows significant gaps in the competences and skills of health professionals in managing emergencies in health centres. Work environment is important for safe care.   

Aim: The aim of the study was to describe district nurses' experience of preparedness in emergency situations at health centres.  

Method: Ten district nurses from six different health care centres participated in interviews that formed the basis for a qualitative study with an inductive approach.  

Results: The results are presented in three categories: The health care centre as a caring unit, structural conditions and the feeling of preparedness. The district nurse's perception of preparedness for emergency situations was influenced by several factors, where access to education and training was a central part. Teamwork and the degree to which staff were available were important. The practical working environment in the form of equipment and facilities and having functioning routines were also emphasised.  

Conclusion: Education and training, together with the various aspects of the work environment, are key factors in the district nurse's perception of preparedness in emergency situations. 

Bakgrund: RLS är en vanligt förekommande neurologisk sjukdom som kan förekomma i alla åldrar men framförallt hos äldre. Symtomen påverkar individen i sin vardag med uttalad sömnstörning och dagtrötthet som påverkar hela livssituationen för både individen och anhörig. Vilket påverkar parets situation och sannolikt den anhörigas stöd till personen som har RLS. Det saknas studier kring RLS och anhörigstöd varav ett behov av ökad kunskap om hur anhöriga erfar sin situation sågs.  

Syfte: Syftet var att bestämma faktorer som anhöriga erfar underlättar eller försvårar socialt stöd till personer med RLS.  

Metod: En kvalitativ intervjustudie med 25 strategiskt utvalda anhöriga, (13 män/12kvinnor medelålder 65 år, range 39-82år) till personer diagnostiserade med RLS genomfördes. Informanterna rekryterades via en rikstäckande patientförening för RLS. Kvalitativ innehållsanalys genomfördes med en deduktiv ansats utifrån socialt stödteorin. 

Resultat: Anhöriga erfor känslor av maktlöshet som kunde försvåra det sociala stödet medan att acceptera sjukdomen kunde underlätta. Kunskapsbristen om RLS erfors som stor och utgjorde en svårighet för den anhörige att kunna ge sitt sociala stöd, för att underlätta fick den anhöriga lyssna och bekräfta symtomen. Att hitta på gemensamma aktiviteter och samtidigt behöva offra egna aktiviteter ansågs som svårt. 

Slutsats: Anhöriga erfor både möjligheter genom acceptans och svårigheter i form av maktlöshet och ensamhet särskilt kopplat till kunskapsbrist och uteblivet stöd från vården vilket medförde svårigheter i att ge sitt sociala stöd.

This thesis in health and care sciences focuses on factors related to working in the ambulance service and their association with health.

For patients in need of emergency medical care outside healthcare facilities, ambulance personnel are, following the dispatch centre, the first link in the chain to providing good health and care on equal terms for the entire population, in accordance with the Health and Medical Services Act. Registered nurses and emergency medical technicians in the ambulance service provide advanced prehospital care that is available around the clock. The job includes several factors that may negatively affect health, such as shift work, long work hours, heavy lifting, sedentary work, stress, and the risk of exposure to threats and violence. Previous research suggests that this occupational group may be at increased risk of cardiovascular disease, mental health issues, and musculoskeletal disorders; however, the evidence is limited.

The overall aim of this thesis was to describe and analyse work- and leisure-related factors and their association with health among ambulance personnel.

To achieve the overall aim of this thesis, four studies with quantitative designs were conducted (Papers I-IV). Ambulance personnel from an ambulance service in the south of Sweden were invited to participate. Paper I (n=106) described work-, lifestyle-, and health-related factors among ambulance personnel, using health examinations, blood samples, questionnaires, and physical capacity tests. Paper II (n=79) analysed hair cortisol levels as an indicator of long-term stress and their relationship to work factors, using hair samples and questionnaires. Paper III (n=63) described and analysed patterns of physical behaviours using accelerometry and questionnaires. Paper IV analysed blood pressure variation using ambulatory monitoring and questionnaires. Additionally, Papers I, II, and IV described and analysed differences between women and men, and Papers III and IV analysed associations with different work shifts.

The main findings in this thesis indicate that ambulance personnel were exposed to several work-related factors which could negatively impact health, such as physically demanding work, psychosocial demands (for example work stress and risk of threats and violence), and shift work. Despite this, the participants reported overall good self-rated health, high self-rated work ability, high physical capacity, a high level of physical activity during leisure time, and few other lifestyle-related risk factors. However, the findings identified a high prevalence of hypertension, elevated cholesterol levels, and high body mass index among the ambulance personnel. A larger proportion of women, compared to men, reported physically demanding work; however, women performed better in the physical capacity tests and had lower ambulatory blood pressure than men. Different shift types did not appear to affect the pattern of physical behaviours.

The findings in this thesis can be related to the World Health Organization’s (WHO) framework for healthy workplaces comprising the physical and psychosocial work environment and personal health resources. Indirectly, the thesis also relates to the fourth area, which includes interaction with the surrounding society.

In conclusion, this thesis presents a multifaceted picture in relation to health for personnel working in the Swedish ambulance service.

Introduction: Nursing staff have faced various challenges during the global pandemic of COVID-19 such as nursing shortages. The great number of COVID-19 patients requiring hospitalization placed heavy demands on healthcare staff to maintain patient safety and to work according to constantly changing guidelines to prevent the spread of infection.

Objective: The objective was to describe nurses’ experiences of caring for patients with suspected or confirmed COVID-19 in the initial phase of the pandemic.

Methods: The study has a qualitative design. Semi-structured interviews were conducted with seven nurses in primary care and hospital care during the initial stage of the pandemic. Qualitative content analysis with an inductive approach was used.

Results: The nurses expressed that the working routines changed very quickly at the onset of the pandemic. A triage system was implemented to care for patients with symptoms of COVID-19 to prevent transmission between patients. A major change was the constant use of personal protective equipment in patient care. The nurses also experienced a sense of inadequacy regarding the care of the patients and became emotionally affected and exhausted.

Conclusion: The nurses experienced that many patients worsened clinically, leading to exhausting and difficult nursing care situations. They also experienced increasing responsibility since new protective equipment and procedures needed to be quickly implemented according to frequently changing recommendations, causing the nurses to feel uncertain about how to maintain patient safety. Support from colleagues was crucial to cope throughout the initial stage of the pandemic.

Background: Adolescent pregnancy is a global health problem. In Uganda, the rate of teenage pregnancies is approximately 25% and these are associated with both poor maternal- and perinatal health outcome.

Objective: This qualitative case study aimed to examine health workers’ experiences of promoting sustainable health and well-being for pregnant adolescent girls in Uganda.

Method: A qualitative study design was used. Data was collected through semi-structured interviews of four health workers working for a Non-Government Organization (NGO) based in Uganda. Data was inductively analyzed by content analysis.

Result: Three categories emerged: social structure, organization’s work – rehabilitation and therapy, and outcome. Healthcare workers worked with health promotion using a person-centered approach, emphasizing therapies and empowerment strategies and an overall faith-based approach. Furthermore, the result showed that girls were abandoned by their families when entering the center, but with help from the NGO they increased their understanding of the girls situation, due to resettlement of plan and follow up made by the health workers.

Conclusion: Health workers can promote health and well-being among pregnant adolescent by applying person-centered care, including therapies and empowerment strategies by a faith-based approach. Social structures and families should be encouraged to provide support to pregnant adolescent girls.

Background: Research show that fibromyalgia has low credibility in healthcare, leading to poor treatment, lack of knowledge and disinterest. Therefore, people with fibromyalgia feel frustration, fear, anxiety and disappointment.

Objective: The aim of this study was to explore the experiences of people with fibromyalgia in their encounters with healthcare personnel in Sweden.

Method: A cross-sectional design, where 409 people with fibromyalgia answered an anonymous online patient-reported experience measure, developed specific for the study, with six closed questions and one open-ended question. Descriptive statistics were analysed by response frequencies. Correlation analysis were performed between demographic and clinical variables with the answers from the closed questions. Free-text answers were analysed with content analysis.

Results: A third experienced the treatment as bad (34%) and that they were not being taken seriously (30.5%). Almost half (47%) always or mostly felt fear of seeking healthcare related to fibromyalgia and that the health care personnel did not understand their diagnosis (46%). The majority (54%) experienced that the health care personnel did not understand how fibromyalgia affected them or how they could help them. The findings were confirmed in the free-text answers that were categorized into: Scepticism and disregard, Ignorance and disinterest and Professionalism and empathy. There were positive significant correlations between age and five of the questions (ρ = .105–.181, p < .05–p < .01), indicating that lower age is correlated with a worse experience. Furthermore, the duration of fibromyalgia showed a significant correlation with feeling afraid of seeking healthcare because of fibromyalgia (ρ = .144, p < .01), the shorter duration, the greater was the fear of seeking healthcare.

Conclusion: As a third of patients with fibromyalgia had bad experiences with healthcare, especially younger patients, knowledge about fibromyalgia needs to be increased and the patients should be taken seriously and treated respectfully, as well as given adequate support.

This compilation thesis contributes to a deeper understanding of perceived safety in human-robot interaction (HRI) with a particular focus on social robots. The current understanding of safety in HRI is mostly limited to physical safety, whereas perceived safety has often been neglected and underestimated. However, safe HRI requires a conceptualization of safety that goes beyond physical safety covering also perceived safety of the users. Within this context, this thesis provides a comprehensive analysis of perceived safety in HRI with social robots, considering a diverse set of human-related and robot-related factors.

Two particular challenges for providing perceived safety in HRI are 1) understanding and evaluating human safety perception through direct and indirect measures, and 2) utilizing the measured level of perceived safety for adapting the robot behaviors. The primary contribution of this dissertation is in addressing the first challenge. The thesis investigates perceived safety in HRI by alternating between conducting user studies, literature review, and testing the findings from the literature within user studies.

In this thesis, six main factors influencing perceived safety in HRI are lifted: the context of robot use, the user’s comfort, experience and familiarity with robots, trust, sense of control over the interaction, and transparent and predictable robot behaviors. These factors could provide a common understanding of perceived safety and bridge the theoretical gap in the literature. Moreover, this thesis proposes an experimental paradigm to observe and quantify perceived safety using objective and subjective measures. This contributes to bridging the methodological gap in the literature.

The six factors are reviewed in HRI literature, and the robot features that affect these factors are organized in a taxonomy. Although this taxonomy focuses on social robots, the identified characteristics are relevant to other types of robots and autonomous systems. In addition to the taxonomy, the thesis provides a set of guidelines for providing perceived safety in social HRI. As a secondary contribution, the thesis presents an overview of reinforcement learning applications in social robotics as a suitable learning mechanism for adapting the robots’ behaviors to mitigate psychological harm.

The aim of the study presented in this paper is to develop a quantitative evaluation tool of the sense of safety and security for robots in eldercare. By investigating the literature on measurement of safety and security in human-robot interaction, we propose new evaluation tools. These tools are semantic differential scale questionnaires. In experimental validation, we used the Pepper robot, programmed in the way to exhibit social behaviors, and constructed four experimental conditions varying the degree of the robot’s non-verbal behaviors from no gestures at all to full head and hand movements. The experimental results suggest that both questionnaires (for the sense of safety and the sense of security) have good internal consistency.

This research aims to develop an autonomous social robot for elderly individuals. The robot will learn from the interaction and change its behaviors in order to enhance the interaction and improve the user experience. For this purpose, we aim to use Deep Reinforcement Learning. The robot will observe the user’s verbal and nonverbal social cues by using its camera and microphone, the reward will be positive valence and engagement of the user.

This paper examines whether social cues, such as facial expressions, can be used to adapt and tailor a robot-assisted training in order to maximize performance and comfort. Specifically, this paper serves as a basis in determining whether key facial signals, including emotions and facial actions, are common among participants during a physical and cognitive training scenario. In the experiment, participants performed basic arm exercises with a social robot as a guide. We extracted facial features from video recordings of participants and applied a recursive feature elimination algorithm to select a subset of discriminating facial features. These features are correlated with the performance of the user and the level of difficulty of the exercises. The long-term aim of this work, building upon the work presented here, is to develop an algorithm that can eventually be used in robot-assisted training to allow a robot to tailor a training program based on the physical capabilities as well as the social cues of the users.

For many applications where interaction between robots and older people takes place, safety and security are key dimensions to consider. ‘Safety’ refers to a perceived threat of physical harm, whereas ‘security’ is a broad term which refers to many aspects related to health, well-being, and aging. This chapter presents a quantitative evaluation tool of the sense of safety and security for robots in elder care. By investigating the literature on measurement of safety and security in human–robot interaction, we propose new evaluation tools specially tailored to assess interaction between robots and older people.

The development of sheet metal stamping tools is shaped by various challenges, including shifting customer demands, technological advancements, and the drive for shorter lead times. These factors suggest that reusing design knowledge could improve efficiency and quality and reduce costs. However, many companies rely on the tacit knowledge of experienced designers, which limits the formalization and systematic reuse of past designs. This thesis examines the current state of design knowledge reuse within the toolmaking industry and introduces an approach using case-based Reasoning (CBR) to support this process.

Through semi-structured interviews with industry professionals, literature reviews, and the development and demonstration of the principles of a system incorporating CBR and genetic algorithms (GA), this research investigates how past tool designs might be retrieved and adapted more effectively. The research follows a design research methodology framework involving data collection, analysis, and solution development. The findings indicate some challenges in formalizing knowledge reuse and suggest that existing design data and tools are not always fully utilized.

The proposed CBR method is developed to help tool designers systematically find and adapt relevant previous designs, which may lead to improvements in design efficiency. While the method is focused on specific tasks in stamping tool design, similar approaches could also be applied to other areas where design knowledge reuse is important. The results indicate that this approach could enhance the tool design process, though further testing in practical settings is necessary. Future work will explore the system’s potential through field testing and examine the role of additional technologies, such as simulation and artificial intelligence, in further supporting the tool development process.

The 2019 Chiquitanía wildfires in Bolivia marked a significant environmental disaster with profound ecological and socio-political implications. This research explores how indigenous communities and elite groups were represented in selected news media coverage during August-September 2019, examining the plurinational imaginaries, power dynamics of blame, racialized regimen of news and polarization within the context of the 2019 presidential election. Through Critical Discourse Analysis (CDA) using Teun A. van Dijk's sociocognitive approach, and qualitative thematic text analysis of 25 national and international media articles, this research uncovers how media narratives are constructed and how they reinforce existing power structures. The findings indicate that indigenous communities were often tokenized and portrayed either as victims or as contributors to the fires, thus stripping them of agency and reinforcing historical discrimination patterns. Conversely, elite groups involved in agribusiness were depicted more positively. This dichotomy reflects a broader societal bias that favours industrial growth over ecological and social sustainability. The media's portrayal of former President Evo Morales, particularly in the politically charged pre-electoral context, simplified complex policy issues into direct criticisms. This research underscores the necessity for a more inclusive and equitable media approach that integrates indigenous perspectives and knowledge into national conversations on environmental sustainability and policy. By addressing these biases, media can better reflect the diverse realities and contributions of all societal groups, promoting a more balanced and just representation.

Tooth agenesis is a common disorder. Agenesis of the maxillary lateral incisor is found in 1.5%–2% of the population. Based on the prevalence and the approximate amount of children born every year in Sweden, there are presumably 1650–2400 children born every year who will have missing maxillary lateral incisors. The condition is known to cause significant aesthetic, psychosocial and financial burdens for the individual. Although missing maxillary lateral incisors and the treatment thereof have been widely studied through quantitative research, the choice of treatment is still controversial among professionals. The overall aim of this thesis was to increase the understanding of two different treatment methods, orthodontic space closure (SC) and implant replacement (IR), in patients with one or two missing maxillary lateral incisors with respect to the aesthetic outcome, the clinical outcome, the treatment costs and how the treatment alternatives are experienced by the patients. Qualitative and quantitative methods were employed to achieve this aim.

Paper I assessed the aesthetic outcome after treatment with either SC or IR. Three groups of people – laypeople 20–30 years of age (n = 26), laypeople 50–70 years of age (n = 26) and orthodontists (n = 25) – evaluated 44 cases treated with SC or IR. The assessments showed that the gingival colour adjacent to the replacing tooth was rated as having better aesthetics in the SC cases (p 0.000). Furthermore, the orthodontists preferred the aesthetics of the dentition in the SC cases (p 0.042). The younger laypeople were more dissatisfied with the colour of the tooth replacing the missing lateral incisor in SC cases (p 0.043).

In paper II, the focus changed to analysing the costs of treatment arising during and after treatment. Cost analysis was used to compare the societal costs of SC and IR. The records of 32 patients treated with SC (n = 18) or IR (n = 14) due to missing maxillary lateral incisors were retrieved from the archives. These patients had completed treatment between 2001 and 2008. To enable comparisons, the time horizon was set to 12 years since treatment completion. Short- and long-term direct and indirect costs were analysed using cost analysis from a societal perspective. SC was least costly when comparing direct short-term costs. There was no difference between SC and IR in direct long-term costs. There was a difference between SC and IR, in favour of SC, when comparing patients’ loss of productivity (p 0.007), short-term societal costs (p < 0.001), long-term societal costs (p 0.037) and, consequently, total societal costs (p < 0.001).

Paper III focused on the experiences of patients receiving the two different treatments. Semi-structured interviews with 13 individuals who had completed treatment with either SC or IR due to missing maxillary lateral incisors (MMLI) at least six month earlier were performed. The data were analysed based on grounded theory and resulted in the main category of being different during treatment and three associated subcategories. The first subcategory, being different due to missing teeth, refers to when a person experiences being different because of anterior spacing. The second subcategory, being different due to fixed appliance, refers to when the appliance itself makes a person different. These two categories exemplify being different in terms of appearance. The third subcategory, being different due to treatment appointments, refers to the need to spend time differently due to having appointments at the clinic for treatment.

Treatment techniques change and improve over time, and it is of interest to know whether these improvements differ between IR and SC. Thus, paper IV aimed to compare the aesthetic outcome and other clinical findings in patients with missing maxillary lateral incisors treated with either IR or SC at two different times 10 years apart. A total of 88 patients were included in the study. Cohort I (n = 44) was treated between 2001 and 2008, and cohort II (n = 44) was treated between 2011 and 2018. Each treatment was compared between the two cohorts concerning long-term clinical and aesthetic outcomes. Of the 16 analysed variables, there was an improvement regarding crown length, bleeding on probing (BoP), the papilla, the inclination of the incisors and the general appearance of the dentition when comparing IR cases. When comparing the SC cases, there was an improvement in the overbite and the colour of the replacing tooth. However, bleeding on probing and crown length deteriorated over time for the SC cases. There were no significant differences for the remaining variables.

Overall, the laypeople rated the aesthetic outcome of both treatments as equally good. The orthodontists had a slight preference for the aesthetic outcome in the SC cases. Patients treated with SC had lower societal costs compared with patients treated with IR. Patients with missing maxillary lateral incisors considered that their treatment started at the time of their diagnosis. Furthermore, they experienced feelings of being different irrespective of the type of treatment. Among cases treated with IR, there has been an improvement over time, while in SC cases the change has been somewhat ambiguous. The improvement in IR cases did not include the gingival colour adjacent to the replacing tooth, which was of concern in IR cases when comparing the two treatments.

In summary, in those cases where both treatment alternatives are possible, SC is preferable.

Syfte: Att beskriva tandhygienisters perspektiv med att använda visuellt stöd vid munhälsorelaterad information.

Metod: Kvalitativ intervjustudie med induktiv ansats och analysering med tematisk analys. I studien deltog 13 legitimerade tandhygienister. Inklusionskriterierna var anställning som tandhygienist inom folktandvård eller privat tandvårdsklinik i minst 6 månader, med regelbunden patientkontakt och erfarenhet av någon form av visuellt stöd vid munhälsorelaterad information minst 1 gång/veckan.

Resultat: Användning av visuellt stöd underlättar för tandhygienister att ge tydlig munhälsorelaterad information till patienter, vars intresse kan väckas och motivera till samarbete. Tre teman framkom utifrån intervjuerna, vilka var: Den pedagogiska visualiseringen: sanningens ögonblick på gott och ont, Visuellt stöd: en nyckel till framgång i behandlingen och Tid är pengar.

Konklusion: Tandhygienister upplevde att användning av visuellt stöd gav en trygghet vid munhälsorelaterad information. Hjälpmedlet bidrar till att förtydliga detaljer från det visuella och gav möjlighet att stämma av om patienten har förstått innebörden från given information. Genom att använda visuellt stöd kan återbesöken hos tandhygienisten bli mer tidseffektiva, eftersom patienterna har fått en förbättrad förståelse för sin munhälsa.

Implikation: Visuellt stöd är ett värdefullt verktyg för tandhygienister för att främja den patientcentrerade kommunikationen och för att underlätta hälsofrämjande dialog med patienter i tandvården.

Although patients with chronic heart failure (CHF) often experience psychological distress, psychosocial aspects are not an integral part of their treatment and care. The aim is to describe the adaptation of Coping Effectiveness Training for patients with CHF and the participants? reported experiences. The intervention workbook and manual were translated into Swedish and adapted for patients with CHF. Patient-reported experience from 33 of 35 participants, that had completed the psychosocial intervention, was measured with an evaluation form consisting of closed and open-ended questions. Most participants thought they benefited from the intervention, were pleased with the structure and did not want to add anything to the program. The benefits experienced were learning how to cope with the illness and meeting other people to share and discuss experiences. There was a variation concerning the group process of how much direction should be given during the discussions. Overall, unique data from patient-reported experience measure showed that the participants were satisfied with the psychosocial intervention, applied for the first time to patients with CHF.

Background: Internationally, there are very few guidelines regarding how near relations can be taken care of on a children’s intensive care unit. Despite knowledge about the positive effects of parental presence, staff frequently reject parents out of insecurity. This study aimed to investigate health professionals’ understanding of letting parents be present throughout critical situations. A qualitative method with semi-structured interviews was used to answer the aim of his study. Nine persons participated in the study, both physicians and nurses. The result showed that health professionals’ main view is that parents’ presence is positive. However, their presence often has lower priority than the medical focus of the child and the health professionals’ concern of failure.

Conclusion: Health professionals have the power to decide if parents can be present in critical situations. Only when a parent demands to be present does that demand beat the decisions made by health professionals. Lack of resources within the team and fear of parents becoming a disturbance or a distraction are cited as the primary reasons not to let parents be present.

BACKGROUND: The nursing profession has undergone several changes in the past decades, and new challenges are to come in the future; patients are now cared for in their home, hospitals are more specialized, and primary care will have a key role. Health informatics is essential in all core competencies in nursing. From an educational perspective, it is of great importance that students are prepared for the new demands and needs of the patients. From a societal point of view, the society, health care included, is facing several challenges related to technological developments and digitization. Preparation for the next decade of nursing education and practice must be done, without the advantage of certainty. A training for not-yet-existing technologies where educators should not be limited by present practice paradigms is desirable. This study presents the design, method, and protocol for a study that investigates undergraduate nursing students' internet use, knowledge about electronic health (eHealth), and attitudes to technology and how experiences of eHealth are handled during the education in a multicenter study.

OBJECTIVE: The primary aim of this research project is to describe the design of a longitudinal study and a qualitative substudy consisting of the following aspects that explore students' knowledge about and relation to technology and eHealth: (1) what pre-existing knowledge and interest of this area the nursing students have and (2) how (and if) is it present in their education, (3) how do the students perceive this knowledge in their future career role, and (4) to what extent is the education capable of managing this knowledge?

METHODS: The study consists of two parts: a longitudinal study and a qualitative substudy. Students from the BSc in Nursing program from the Blekinge Institute of Technology, Karlskrona, Sweden, and from the Swedish Red Cross University College, Stockholm/Huddinge, Sweden, were included in this study.

RESULTS: The study is ongoing. Data analysis is currently underway, and the first results are expected to be published in 2019.

CONCLUSIONS: This study presents the design of a longitudinal study and a qualitative substudy. The eHealth in Nursing Education eNursEd study will answer several important questions about nursing students' attitudes toward and use of information and communications technology in their private life, their education, and their emerging profession. Knowledge from this study will be used to compare different nursing programs and students' knowledge about and relation to technology and eHealth. Results will also be communicated back to nursing educators to improve the teaching of eHealth, health informatics, and technology.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/14643.

Background: In the last decade, research has highlighted the importance of interprofessional approaches to education and practice. Collaboration between medical practice and engineering has been identified as particularly relevant to developing accountable models for sustainable healthcare and overcoming increased specialization leading to professional barriers. This study aims to analyze insights and understanding expressed by nursing students and biomedical engineering students following a joint learning activity regarding a medical device used in the hospital setting.

Method: A qualitative approach deriving from a phenomenological view examined an interprofessional learning activity where the focus was on active integration and knowledge exchange.

Conclusion: The activity was expressed as a positive opportunity for getting insights into perspectives from other professional groups as well as insights into the importance of a system perspective in patient safety. The learning and insights listed in the evaluations included ideas about how the two professional groups could collaborate in the future.

Background: Meeting with health care gets short before and after the operation. The difficulty at the day surgery is that preparation and information take place in close proximity to the operation. Health professionals must not only take care of the child during the medical visit, but also of the accompanying parent, too. Parents’ participation in the perioperative care, sometimes unable to attend.

Aim: This study aims to investigate how parental involvement in the perioperative a process can be facilitated.

Method: A qualitative design based on observations and interviews with semi structured questions with open answers. Results: The results conveyed involvement in the child’s perioperative process in diverse ways and to a different depth. This is highlighted in the theme Allowed with the under themes Security and Being accepted. However, the theme Exclusion with the under-theme Rejection revealed a non-caring approach where no caring relation could be established. Quotes from the transcribed material are used to highlight the results.

Conclusion: The study’s findings confirm earlier studies in the perspective that information is of central importance in enabling parents to be involved in the perioperative process. The results showed that parents’ involvement in the perioperative process is a prerequisite for creating safety in the child and reducing concerns in connection with the operation. Parental involvement may be hindered by a conventional approach that does not include the child’s perspective.

The use of Central Venous Catheters (CVCs) commonly results in complications. Coatings with silver or metal alloys can reduce the risk associated with the use of CVC. We have evaluated the durability of a noble metal coated CVC (the Bactiguard Infectious Protection, BIP CVC) and compared with an uncoated CVC for clinical tolerability (Adverse Events, AEs) and performance, in order to create a baseline for a large future study. Patients undergoing major surgery, randomised at a 2:1 ratio to BIP CVC (n = 22) or standard CVC (n = 12), were catheterized 9 - 12 days, respectively. Adverse events, microbial colonization and metal release were measured.

FINDINGS: There were no AEs in the BIP CVC-group, but 5 AEs occurred in 4 patients (1 patient had 2 AEs) in the standard CVC-group, p = 0.011 (whereof 3 were catheter related). The BIP CVC showed an initial release of coating metals in blood (gold, silver and palladium), which rapidly decreased and were far below Permitted Paily Exposure (PDE) for chronical use. The levels of silver concentration were far below those needed to develop microbial resistance. The performance was equal, and there was no difference concerning microbial colonization, for the two CVCs.

CONCLUSION: In this pilot study the BIP CVC had significantly lower AEs and showed a comparable performance to the standard CVC. The coating was durable throughout the study length (up to 16 days) and toxicological evaluation showed good safety margins. Larger studies are needed.

AbstractPurpose – Linear industrial packaging (LIP) is regarded as a major contributor to theenvironmental impact of products and supply chains. The field of research has identified threethemes that facilitate the utilization of circular industrial packaging (CIP), advocating itsimplementation to reduce environmental impact of the packaging process. Research hashowever only presented the desired objectives regarding each theme, leaving gaps in examiningfactors that facilitates the transition from LIP to CIP. Therefore, the purpose of this study is toinvestigate factors facilitating the transition from LIP to CIP, focusing on the already identifiedthemes.

Method – This study is of exploratory nature, based on a qualitative single case study withquantitative features. The case study was conducted at a Swedish engine manufacturingcompany where the unit of analysis was to investigate factors facilitating the transition fromLIP to CIP, focusing on the pre-identified themes. The primary data for this study was collectedthrough interviews, which was complemented and affirmed by a document study which servedas a secondary source of data. Collected data was transcribed and analysed via a thematicanalysis.

Findings – The findings presented the empirical data from three perspectives. How each subtheme was addressed when operating LIP, how each sub-theme is addressed when operatingCIP, and what changes were implemented during the transition from LIP to CIP, regarding eachsub-theme. Analysing the changes made eventually led to the identification of facilitatingfactors.

Limitations – The study posed several limitations, the transition from LIP to CIP has spannedseveral years. Therefore, it proved challenging to find interview participants who had been withthe case company since the start of the transition. Consequently, most interviewees have onlybeen part of some stages in the transition. A single case study was conducted which limit thegeneralisability of the results. Additionally, addressing each pre-identified theme consequentlyinvolves a somewhat broad investigation of their implications.

Keywords – Linear industrial packaging (LIP), Circular industrial packaging (CIP), facilitatingfactors, recycling, transition.

With the escalating scarcity of raw materials, the significance of material recovery and circular economy has become more pronounced than ever. This thesis will investigate the implementation of circular material flows on an organizational level, aiming to mitigate the environmental impact. Furthermore, it examines the influencing impacts of environmental and economic aspects, respectively, and what opportunities and challenges can be associated withsuch implementation. Through a combination of interviews and action research, both qualitativeand quantitative data were received. The authors realized a matrix of combined methods for analyzing the economic and environmental data to present the findings of the action research and emphasize the influential impacts. The results demonstrate a practical investigation by implementing reused material at a luminaire manufacturing company and analyzing the environmental and economic aspects. The findings of the action research show that manufacturing has a critical impact on the internal economic and environmental aspects. The results from interviews and action research address theidentified challenges and opportunities for the processes of implementing reused material. This study contributes partly through the frameworks developed for concept evaluation based on economic and environmental aspects that can be used in future concept evaluations. It also contributes to the ongoing sustainable development within the luminaire industry. The findings can further be used for the development of circular material implementation strategies for the collaborating company. Moreover, the thesis work will contribute to the overall enhancement of the implementation of circular material flows by utilizing reused components and materials. 

Inclusive education and teachers' perceptions of inclusive education is a relatively widely researched topic. In Sweden, research is focused on government-owned institutions. Private or independent schools make up a significant, yet little-studied element of the Swedish education system. The purpose of this study was to investigate the perception and experiences of the teaching staff regarding inclusive education in a Swedish independent English-speaking school. Members of the teaching staff working at the school were interviewed and the results were analysed. The analysis of the interviews resulted in 3 main themes: Teaching staff’s perceptions of inclusive education; Challenges and limitations experienced by the teaching faculty; and Advantages and benefits of inclusive education. The results were presented and discussed with previous literature and The Ecosystem of Support for Inclusive Education model. The results showed that the teachers had a positive perception towards inclusive education and stated various advantages of it. However, many areas needing improvement were highlighted such as professional development, and human and material resources. The results obtained during the present study are similar to the results obtained in the government-founded schools, underlining that it is necessary to think about inclusive education as a complex system.

Global warming gives rise to climate changes that affect, among other things, the windand snow climate in Sweden. The indications of changing wind and snow conditionsmeant an impact on buildings needed to be studied.The work was carried out through literature and document studies as well as loadcalculations on an HEB column and a diagonal brace for a fictitious hall building. Thefictional hall building was theoretically located in seven Swedish cities; Hemavan,Luleå, Örnsköldsvik, Örebro, Jönköping, Varberg and Trelleborg. The building wasinvestigated for each location to see how the building was affected by the changed loadsbased on extremes obtained from systematic literature studies. The different scenariosexamined were: increased wind and increased snow, increased wind and decreasedsnow, decreased wind and increased snow and decreased wind and decreased snow.The literature study indicated scattered conclusions about future wind conditions withresults showing a change between -8% to +16% in extreme wind speed, as well asforebodings of both decrease and increase in frequency. In contrast, the literature studyshowed that research on future snow conditions agreed on a general reduction in snowload in southern parts of the country. The exception was northwestern Sweden wheresnow loads can increase up to 1 kN/m2. Research also agreed on the reduction in snowduration and snowfall frequency.The results of the calculations indicated a change in utilization rate and deformation forthe diagonal brace and the column respectively for all the scenarios investigated. Thescenarios that resulted in the elements' increased utilization rate mean a risk for existingstructural elements that are used more. The indications of changed wind and snow loadsand their impact on the elements argued for the necessity to adjust the Swedishdimensioning standard.