Syftet med denna bok är att placera in forskarna vid den sociologiska institutionen i Chicago 1892–1965 och deras idéer i sitt historiska sammanhang. Boken redogör för såväl hur institutionen konstituerades och utvecklades till Chicagoskolan mellan 1915–1935 som vilka idéströmningar som i huvudsak influerade och utvecklades av William I. Thomas, Robert E. Park och Ernest W. Burgess. Vidare visar boken på de numera klassiska stadsdelsstudierna The Hobo (1923), The Gang (1927), The Ghetto (1928) och The Gold Coast and the Slum (1929) placering i ett övergripande urbant ramverk, idéinfluenserna mellan sociologi och antropologi samt Howard S. Beckers, Erving Goffmans och William F. Whytes plats i Chicagotraditionen.

Oscar Andersson redogör i denna rapport om öppenvårdsprogrammet Hållplats 8 på ett ingående sätt hur individ- och familjeomsorgen i stadsdelen Rosengård försöker förebygga och motverka att ungdomsbrottsligheten blir etablerad i stadsdelen. Det är dock ännu allt för tidigt att dra några långtgående slutsatser om hur väl öppenvårdsprogrammet har lyckats med denna grannlaga uppgift sedan starten i januari 2005. Samtidigt finns det tendenser som tyder på att ungdomar som har varit inskrivna vid Hållplats 8 har påbörjat en livsstilsförändring. Från att tidigare ha varit ungdomar som enbart varit upptagna med att umgås med sina kriminella kamrater börjar de successivt efter inskrivningen att allt mer tänka på hur deras normbrytande beteende påverkar deras familj och framtidsutsikter. Oscar Andersson lyfter även fram frågor som går bortom interventionens omedelbara inverkan på ungdomarnas kriminella beteende och tänkande. Han pekar bl.a. på betydelsen av att placera in socialtjänstens insatser i ett övergripande socialpolitiskt sammanhang, där grundläggande välfärdsfrågor om fritid, skola, sysselsättning och trångboddhet diskuteras. Centrala teman i rapporten är interventioner för kriminella barn och ungdomar, förhållandet mellan sluten- och öppenvård, socialt nätverksarbete, evidensbaserad praktik, manualbaserade metoder, verksamhetsutveckling och inte minst ungdomarnas egna berättelser.

Nels Andersons bok The Hobo (1923) är en socio logisk klassiker. Med denna bok inledde Univer sity of Chicago sin sociologiska serie om grupper av människor, institu tio ner, livsstilar och stadsdelar i 1920- och 1930-talets Chicago. Nels Andersons studie handlar om den kringvandrande och tillfällighetsarbetande hemlöse man nen, hobon, om hans bakgrund och erfarenheter och om det strapatsfyllda livet i Chicagos Ho bohe mien. Anderson hade själv under många år levt som en hobo, och hade därför en unik inblick i den värld han beskriver. Det fi nns fl era skäl till varför boken fortfarande är aktuell. Ett är att Anderson på ett nästan oöver träff at sätt visar hur man genom deltagande observation kan fånga ett socialt fenomen inifrån. Läsaren förs på ett raffi nerat sätt in i hobons sociala värld med dess arbete, sjukdomar, språk, sånger, moral, äventyrliga resor och in tellektuella liv. Beskrivningar utifrån hobons subjektiva livshorisont ger lä sa ren insikt i en tillvaro och en kultur som är okända för de flesta som inte lever på gatan. Boken skild rar också en historisk brytningstid som innebar att pionjärtidens hobo blev överflödig.

The purpose of this article is to outline how Nels Anderson’s (1889–1986) social heritage as a hobo was related to the creation of his sociological classic The Hobo: The Sociology of the Homeless Man (1923) and his marginalized position within the academic environment. The focus here is on Anderson’s social heritage, The Hobo, and his marginal position in society in relation to the pioneering era of the The Chicago School of Sociology. Based on the texts on and of Anderson and to some extent archival sources, the article knit together different parts of Anderson’s life with Robert E. Park’s and Everett V. Stonequist’s concept the marginal man. Anderson’s social heritage as a traveling workman made on the one hand his doctoral colleagues at University of Chicago assume that he was as unreliable as the homeless men he had studied, and on the other hand made him particularly well equipped to make the study that perhaps more than any other has become seen as a classic in the tradition of the Chicago School of Sociology.

Social scientists have mostly taken it for granted that William Foote Whyte's sociological classic Street Corner Society (SCS, 1943) belongs to the Chicago school of sociology's research tradition or that it is a relatively independent study which cannot be placed in any specific research tradition. Social science research has usually overlooked the fact that William Foote Whyte was educated in social anthropology at Harvard University, and was mainly influenced by Conrad M. Arensberg and W. Lloyd Warner. What I want to show, based on archival research, is that SCS cannot easily be said either to belong to the Chicago school's urban sociology or to be an independent study in departmental and idea-historical terms. Instead, the work should be seen as part of A. R. Radcliffe-Brown's and W. Lloyd Warner's comparative research projects in social anthropology.

William Foote Whytes Street Corner Society från 1943 är en levande klassiker. Den handlar om socialt samspel, nätverk och vardagsliv bland unga män i den italiensk-amerikanska stadsdelen North End i Boston under 1930-talets depres sion. Whyte bodde själv i stadsdelen under åren 1936–40 och umgicks flitigt med de män, vilkas relationer och grupprocesser han studerade och som han fi ck kontakt med genom en person som han i boken kallar för Doc. En av Whytes uppmärksammade slutsatser är att North Ends problem inte är dess brist på organisering, ”utan att den egna sociala organiseringen inte stämmer överens med det omgivande samhällets struktur” – en uppfattning som gick stick i stäv med Chicagoskolans syn på slum som desorganiserade enklaver.

Elisabet Apelmo tittade på trailrar för de Paralympiska spelen – men det var ett helt annat tv-program hon kom att tänka på.

Hur är det att vara en ung idrottande kvinna och leva med funktionshinder? På vilka sätt är det möjligt att visa sin femininitet och vilka strategier mot diskriminering och negativa attityder kan utvecklas? I avhandlingen "Som vem som helst – kön, funktionalitet och idrottande kroppar" utforskar Apelmo unga kvinnors erfarenheter av en kropp som å ena sidan betraktas som avvikande – den fysiskt funktionsnedsatta eller rörelsehindrade kroppen, å andra sidan betraktas som presterande – den idrottande kroppen.

The aim of this article is to explore how young, sporting women with physical impairments experience physical education (PE), drawing on research on PE as well as on disability studies. The questions posed are the following: How do the young women handle the two subject positions that emerge as a result of the perception of them as respectively deviant and accomplished, and what are the strategies of resistance they develop. The research fields within which the article is situated are the Sociology of the Body, Feminist research, Pedagogical research, and Disability Studies. With this paper I wish to contribute to greater insight in Social Science research regarding the disabled body as well as the able body. By studying what exists at that margin, insight into the centre can be gained; through the study of the Other (the body which is regarded as deviant), the normal body can be made visible.

This report deals with everyday habits and their environmental impacts in relation to the use of information and communication technology (ICT, colloquially referred to as IT). We addressed the following questions in the context of sustainable urban development: a) how to identify environmentally promising and problematic practices in urban everyday life and b) how to assess and utilize the potential to transform these practices through the use of ICT. We addressed these questions by reviewing case studies, reports etc. Case study examples showed how ICT is used, e.g. to streamline and inform, or to share resources, vehicles and other products. We discussed if it is possible, from an environmental sociology perspective, to assess when and how ICT serves as an enabling technology that enhances or replaces previous patterns of action. Morevoer, we addressed phenomena defined from a more general sustainability science point of view, e.g. substitution and rebound effects. An important starting point was that social structures both enable and limit specific patterns of action. Social structures are maintained by people's actions and through their experience. Change occurs as a result of the dynamics between people's actions and the structures created by past actions. Social practices are constantly being reproduced, with additions of new elements, e g when ICT applications are put to new uses. Then patterns of social relations and systems might change, for example in how we use energy, travel, consume or socialize during both work and leisure time. Our review indicates that the knowledge that partners of Centre for Sustainable Communications (CESC) currently have access to is substantial but fragmented and with a bias towards certain types of sectors, and patterns of action. Environmentally promising practices have been more researched than problematic ones. Furthermore, use of ICT for e.g. commuting and monitoring household energy use is more researched than most other patterns of action involving use of ICTs. For example research has indicated that leisure and entertainment through use of ICTs is related to significant environmental impacts, but practice-oriented research on this is very much absent from today’s body of knowledge (as it is defined and delimited in this report). As for how everyday practices might change towards increased environmental sustainability by the use of ICT, we have found the knowledge situation even more incomplete. This means, however, that it is worthwhile for CESC researchers and partners to carry on developing knowledge regarding this. Concerning what should be viewed as more promising respectively more problematic urban patterns of action, we have to some extent illuminated this by exemplifying international environmental sociological research that is useful for discussing social practices in relation to environmental impacts. We have exemplified how this can shed light on some of the case studies we found among the CESC researchers and partners. Based on environmental sociology we discussed in what ways city dwellers with high income account for the most environmentally problematic practices. Correspondingly, we discussed how inhabitants with low income – out of necessity–account for many promising practices. In relation to this we also briefly discussed how rebound effects should be seen as related to socio-economic position. Another kind of problematic aspect highlighted is that players responsible for introducing, trying out etc., new ICTs, seem to have a tendency to do this in own networks or among the urban middle class. This is problematic from a democratic point of view. In 2012, 1.2 million people in Sweden did very rarely, or not at all, use the internet in their homes. Detailed knowledge about this group's ICT related practices seems to be largely missing. If representatives for these groups are not represented in environmental research there is a danger that they also become less visible in public debate of environmental and ICT issues. This means that different social positions imply different opportunities and constraints. What patterns of actions people take more or less part in is influenced by social structures, norms and regulations, the historical and the immediate context, but also by the individuals' previous experiences and knowledge. The understanding of how a change towards a more sustainable society could come about through use of ICT therefore requires knowledge of practices among the full socio-demographic range of city dwellers.

Rationale and aims: This study focuses on the development of an instrument for the evaluation of clinical practice guidelines and is one part of a research project about the implementation and use of such guidelines among hospitals in the southern region of Sweden. The aim of the present paper was to investigate the test-retest reliability of a questionnaire. Method: A questionnaire was designed to gather data about guidelines that have been implemented as well as information about factors, which, according to the Promoting Action on Research Implementation in Health Service (PARIHS)-model, influence the success of implementation. Thirty-nine professionals at one of the hospitals included in the survey completed the questionnaire on two occations within a mean time of 5.5 weeks. The test-retest reliability was analyzed by means of Cohen's Kapps and percentage concordance. Results: Eight items had good agreement in terms of strength and high percentage concordance. With regard to the Kappa values 13 items show moderate and two fair agreement. Conclusions: The test-retest reliability scores show mainly acceptable results indicating a reasonable stability, thus suggesting the possibility of further developing the instrument. The factors described in the PARIHS-model seem relevant for use in evaluating implementation and use of guidelines. The instrument could benefit from a revision of the language in order to enhance clarity and make it less abstract.

Trots att vi lever i ett välfärdssamhälle, där kunskap och resurser inte borde vara något problem, ser vi en bestående ojämlikhet i hälsa och en ökande psykosocial ohälsa bland ungdomar. Hur är detta möjligt och vad kan man göra åt det? Genom vilka sociala interventioner och andra insatser kan unga människors reella delaktighet, egenmakt, välfärd, livskvalitet och hälsa främjas på ett hållbart sätt? Denna rapport från en pilotstudie genomförd i Simrishamn presenterar de teoretiska och empiriska bevekelsegrunderna för hur och varför en deltagarbaserad aktionsforskningsansats skulle kunna vara ett bra sätt att arbeta för att förbättra villkoren för ungdomars hälsa. Rapporten förespråkar dels ett ökat tvärvetenskapligt och professionsöverskridande samarbete mellan forskare och beslutsfattare, dels ett nära samarbete med ungdomarna själva. Det handlar om att få till stånd ett mer jämlikt utbyte av kunskap målgrupper och makthavare emellan – och därmed förhoppningsvis ett i längden mer jämlikt inflytande över användningen av samhällets resurser.

The main aim with this report is to increase the knowledge about and the understanding of disability and ethnicity as a combined phenomena. The empirical part of the project focuses the experiences of immigrant and refugee families of different ethnic background who have disabled children. From the point of view of these families, how are their conditions of life in Sweden? In the project I have made 18 interviews with parents whose children get support and service by the District habilitation organisation in the Region Skåne. The parents represent ten different nationalities in and outside Europe Most of the children are multi-handicapped. Important areas of question in the interviews deal with the migration process, the families' own views of their background, cultural and ethnic identity and concepts of disability, health, illness and disease. The parents' experiences of having a disabled child, about the support and services around them and the strategies families use to cope with their situation are discussed.

The purpose of this study is to highlight experiences of living in a relationship where BDSM is being exercised. The acronym is an umbrella term for bondage/discipline, dominance/submission and sadomasochism. The study is based on interviews with persons who define themselves as BDSM practitioners. The overall questions of this study are: How does the BDSM practice appear in everyday life? How did the practice start and how has it developed over time? What is included in the sexual BDSM practice? The empirical material has been analyzed with interactionism as the theoretical framework. The picture that emerges is complex. To define oneself as a BDSM practitioner might mean different things for different people where the extent of the practice, what it consists of and how integrated it is in the lives of people might vary from person to person. But despite differences there are also recurring, common patterns in the stories of the informants. All of them describe the practice in positive terms. To a great extent the practice has to do with sexuality where an explicit power exchange, an assuming of dominant and submissive roles and an everyday life filled with rituals, rules and agreements are described as being key elements. Punishment, in the form of physical pain or humiliation, is common when the rules are not obeyed. All the interviewees use safe words to make sure both are comfortable about what's happening. Some sorts of tools are utilized by all. The most common are whips, bonds, chains and locks, paddles, clamps/clothespins, knives, butt plugs and ropes. There is a concern among the informants to find and to form strategies to cope and to adapt the BDSM role to other roles and here the parental role is the most apparent. Also an ambition to create a balance between the personal norms and the norms of the BDSM culture and those of the overall society can be seen. The interviewees express a search for answers to why one practices BDSM. In this process they return to experiences, almost exclusively of a destructive nature, and they wonder if these experiences have affected their sexuality and their preference for BDSM. Even though the attitude in society actually has become more accepting, for example with the help of media, recent research and the fact that BDSM no longer is considered a disorder in Sweden.

This report examines the ways in which socioeconomic (SE) factors affect educational disadvantage. As a starting-point SE could be understood as a set of structural factors that influence education and could cause disadvantages for groups of children, youths and adults. Since socioeconomic disadvantage (SED) is a very complex concept, we will present a more extensive working definition. Official perceptions of SED as well as research perspectives will be discussed. SED has intersectional dimensions and these are explored here and in the other thematic reports1. There are several different factors used to measure socioeconomic conditions. Common ways of assessing SED can include parents’ educational level, social background, living conditions and social heritage. In Eurostat, parents’ educational level, living conditions, and income are measured together with other variables such as gender and ethnic group, in a multi-dimensional structure, in order to compile a comprehensive definition of SE. Although socioeconomic circumstances have an important effect on young people’s school careers, the concept of SE is not formally and uniformly defined in relation to education in EU reports and statistics.

The report examines educational disadvantage in primary and secondary school and educational policies in Denmark in relation to seven factors: gender, disability, ethnic minority status, indigenous minority status, language, religion, and socio-economic conditions.

Collaboration on children at risk is essential, but our knowledge about interprofessional collaboration between social workers and educators is limited. The aim of this study is twofold: (1) to describe French and Swedish teachers’ social representation of social workers; and (2) to compare these social representations. The French sample group is composed of 77 secondary school teachers (of students from 11 to 18 years old), and the Swedish sample group is composed of 94. The method used was a ‘free association task’, commonly used to access the semantic content of social representation. Two different social representations of social workers were revealed, one for the French and one for the Swedish teachers. The French representation is characterised by highly positive aspects such as support, listening and competence. Swedish teachers’ social representation of social workers is completely different: negative associations were common (44%), and among these, professional secrecy and law and regulations dominated. One plausible explanation is the difference of French and Swedish teachers’ roles regarding collaboration with social workers.

In this paper, we present an initial effort in the creation of a generic instrument for measuring the performance of collaboration across organisational and professional boundaries. Based on the literature and previous research on collaboration, a three-dimensional instrument for measuring the preconditions for and the performance of collaboration has been constructed. Validity and reliability have been tested, and the instrument has been used in more than 100 projects. It has been demonstrated that the instrument can serve a number of purposes: to consecutively measure and assess the performance of collaboration; to identify weak parts of the collaboration; to reveal if there are different preconditions for the involved partners’ full engagement in the collaboration; and to relate the performance to other similar collaboration projects. The outcome of the use of the instrument indicates that it can serve as an interactive tool for promoting a learning organisation in the context of collaboration and for building innovative network structures.

Personal assistance is a user-directed service that was founded by a section of the disability movement, namely the American Independent Living movement, in the late 1960s. Today, the concept and ideology of personal assistance services (PAS) has spread worldwide, and constitutes a part of the support system for people with disabilities in many countries. The service differs from several other publicly financed services since users of personal assistance are given the opportunity to employ and supervise the staff providing the service. Organizing services in this way is presumed to enhance self-sufficiency of persons with disabilities and improve their chances of so-called independent living. This dissertation deals with personal assistance services (PAS) in the Swedish context. The aim is to illuminate and understand how personal assistance is carried out socially. To explore this, an ethnographic field study was conducted. The field study focused on face-to-face interaction of adult users with physical impairments and their personal assistants. Analysis and interpretation of the empirical material was primarily guided by Goffman’s dramaturgical perspective and concepts. Results show that the users and their personal assistants balance and shift between different modes of interacting with and approaching each other; by doing so they create and withhold definitions of the situations that are crucial for carrying out personal assistance services. “Preparedness” refers to their passivity, but also readiness, in situations when the users and personal assistants are idle. “Initiative” refers to their negotiations, but also agreements, concerning how the practical help of the personal assistance should be carried out. “Friendliness” refers to their small talk but also to the informal way of approaching each other.

BACKGROUND: It is increasingly acknowledged that satisfaction with sexual relations forms an important aspect of people's lives, but little is known of factors associated with this phenomenon among people with mental illness. AIM: This study aimed to investigate how demographic, social, clinical, and health-related factors were related to satisfaction with sexual relations. METHODS: Patients with persistent mental illness (N = 103), recruited from an outpatient unit, were assessed regarding the target variables. RESULTS: No clinical variable, and only one demographic factor, namely being a cohabitant, was found to be important to satisfaction with sexual relations. Several social factors, pertaining to how everyday occupations were valued and how the social network was perceived, were shown to be of importance. General quality of life, but not self-rated health or interviewer-assessed psychopathology, was also important for satisfaction with sexual relations. A multivariate analysis showed that the most significant factor for satisfaction with sexual relations was how everyday activities were valued, and being a cohabitant explained some additional variation. CONCLUSION: Previous research indicates that the mental health care services largely neglect sexual problems among people with mental illness, and the findings may provide additional knowledge that may be used in the support of this target group.

New times need new rules. As time has made society more complex the managing of society has encountered new obstacles and new problems. The old ways to manage behavior by casuistic laws are long gone since complexity creates complexity. Laws that are vague and pass on the "ought" from the political system to the administrative represent the new path. As a result of this new form of legislation, participation has become the word of today.

Purpose – This study aims to illuminate self-perceived health-related quality of life (HRQoL) among newly-arrived Arabic-speaking refugees in Malmo¨ , Sweden participating in a specific group Health Promotion activity. Design/methodology/approach – Data consist of questionnaires, observations and oral evaluations in groups. Questions about HRQoL was measured by EQ-5D self-assessment containing five dimensions and three response options of severity, including a visual analog health rating scale. Participants’ sleep patterns were measured by a sleep and recovery questionnaire with questions about sleep quality and sleep quantity. Findings – The results show that disturbed sleep relates to EQ-5D variables and to health rating scores. Moreover, there are changes over time and participants’ perceptions of their health and quality of life in most EQ-5D variables have significantly increased after the end of activity. In the variables pain and depression an improvement remains even at second follow up and health rating scores are higher at both follow ups relative to what it was originally. Sleep and recovery problems were perceived as less difficult at the course completion and second follow up. Research limitations/implications – Because of practical and ethical reasons there is an absence of a control group in this study. Practical implications – The paper includes implications for education in medicine, health care and social work, for the design of the refugee reception programs and for the inter-professional collaborations. Originality/value – The paper shows that health promotion interventions in group setting in the first stage of resettlement turn out to be useful according to HRQoL and knowledge of the health care system. Keywords Health promotion, Refugees, Arabic-speaking, Health-related quality of life, Sweden, Immigration, Health care

This article aims to understand how burn-out became an object of thought, through the study of certain processes of legitimization. It traces the genealogy of the burn-out concept from the initial article from 1974, via its confirmation as a “disease” in the 1980s, to its appearance as a legitimate diagnosis in Sweden in 1997. The theoretical framework is that of applied metaphysics, which means a study on how a specific phenomenon came into being. Consequently, I take departure from ontology in motion with an approach that concerns the legitimization processes. The conclusion will show the underlying processes of legitimization in relation to the making of a psychiatric object of thought in Swedish society.

Aims and objectives: To describe and analyse to what extent the goals of the education in promoting culturally competent nursing care have been achieved from a student perspective. Background: As Sweden has transformed into a multicultural society over the past 50 years, there is a need to specify, at all levels of the nursing programme, transcultural concepts for the success of integration. A research-based didactic model was designed for the nursing programme at Malmö University and this was followed by investigations of its outcome. Design and methods: The study is a prospective cohort study with an outcome analysis. A descriptive research study with a longitudinal design was performed, with the focus on Swedish nursing students' experiences of transcultural nursing knowledge and their attitudes before and after implementation of the didactic model. The students evaluate highly their competence to meet demands of multicultural health and medical service. Additionally, their ability to recognise and understand the consequences of international migration on health also received a high mean. Conclusions: The study revealed the knowledge and experience acquired by Swedish students in transcultural nursing. The assumption was that a visible development of knowledge should occur during the three years of education. Interpreting the findings, such effectiveness can be found and hopefully the students will be able to give holistic nursing care based on a person's individual culture.

I kapitlet fokuseras unga personer med funktionsnedsättning och frågan om huruvida förändrade villkor på arbetsmarknaden är försvårande för gruppen när det gäller etablering i arbetslivet. Inledningsvis beskrivs för sammanhanget relevanta delar av arbetsmarknads- och funktionshinderspolitiken i Sverige. Därefter riktas intresset mot den flexibla arbetsmarknaden och de förändringar som skett över tid. Även den växande bemanningsbranschen beskrivs och diskuteras. Vidare förs en diskussion om hur dessa förändringar och nya krav kan påverka sysselsättningsvillkoren för personer med funktionsnedsättning.

Delaktighetsmodellen skapar en dialog på lika villkor mellan personal och brukare. I boken görs en genomgång av centrala begrepp för självbestämmande, delaktighet, empowerment och inflytande utifrån teoretisk och vardagsnära kunskap.

This report examines the ways in which socioeconomic (SE) factors affect educational disadvantage. As a starting-point SE could be understood as a set of structural factors that influence education and could cause disadvantages for groups of children, youths and adults. Since socioeconomic disadvantage (SED) is a very complex concept, we will present a more extensive working definition. Official perceptions of SED as well as research perspectives will be discussed. SED has intersectional dimensions and these are explored.

Twenty educational projects, each intended in some way to address the educational needs of a specific group of disadvantaged people

The general objective of this dissertation was to study the putative underutilisation of mental health services in a multicultural context. The method followed a qualitative interview-based naturalistic approach, and the interview format was primarily semi-structured. Special attention in the method section has been given to the role of the interpreter in research. For some time the research areas of underutilisation of mental health care among immigrants, and that of children of immigrant parents suffering from mental illness, have been dominated by a vulnerability approach. Results from the present thesis show that this one-dimensional picture of immigrants as a category associated with psychopathology ought to be balanced with that of strength and resilience. It was also found in the studied group that underutilisation of mental health care is partly due to the perception of mental conditions as normal life crises, rather than illnesses. Thus, instead of focusing on health care resources, interviewees conveyed their need for greater social and financial support. The results of this study suggest that there is a lack of extended possibilities, for both adults and children of immigrant background, to express their own needs outside a predefined context. Investigating aspects of resilience in future research on mental ill health in multicultural contexts would challenge the focus on vulnerability, and perhaps so promote resilience.

Background: According to a survey from 2005 the population of Rosengård, a cultural heterogeneous borough of Malmö, Sweden, utilizes half as much psychiatric health services as expected in relation to estimated needs. Aim: To examine perceptions of mental illness trying to find possible reasons behind the low utilization. 206 Method: Unstructured interviews were conducted with 30 people living and/or working in the area. Result: Mental illness health was associated with insanity and shame. Numerous conditions were considered as “normal life crises” rather than medical states and are consequently taken care of in other ways than seeking mental health care. Conclusion: Several reasons behind low utilization of psychiatric health services among inhabitants in Rosengård were detected. Explanations are to be found both in different perceptions of mental illness, in the social situation in the area but also in the assumptions made in the survey this study was based upon. Despite that Sweden, with its developed welfare system, frequently is described as the country that has coped best with the growing number of immigrants and their various needs, it seems as if the needs are still unexplored, and there is no service for “normal life crises”.

Tysta(de?) Röster Vem lyssnar på Rosengårdsbarn som lever med en psykiskt sjuk förälder? Forskning visar att föräldrars psykiska ohälsa kan påverka livet för deras barn avsevärt, både direkt och indirekt. Det är även välkänt att dessa barn inte får tillräckligt stöd och att deras behov sällan tillgodoses. Trots att det finns en mängd studier kring dessa barn i allmänhet, saknas forskning om barn till föräldrar med psykisk ohälsa och invandrarbakgrund. Vi vet att psykisk ohälsa är ett känsligt ämne och nära förknippat med galenskap och skam. Vi vet också att personer med invandrarbakgrund i större utsträckning undviker att söka psykiatrisk vård. Därmed kan vi anta att det finns en hel del barn som lever med föräldrar som lider av psykisk ohälsa, utan att barnen är kända och därmed kan få möjligheten att prata om det och motta särskilt stöd. Syftet med studien var att undersöka situationen för invandrarbarn som lever med en förälder med psykisk ohälsa. Planen var att intervjua barn i åldern 10-18 år och göra barnens egna röster hörda. Syftet kunde emellertid inte uppfyllas då starka ”gate keepers” hindrade oss från att få kontakt med barnen. Svårigheterna med att rekrytera barn för studien är fokus för detta paper.

BACKGROUND: : The literature concerning interpretation in research primarily concentrates on rigorous techniques to eliminate bias. This article analyses other significant issues that arise when interpreters participate in research. MATERIAL: : Empirical examples are drawn from a research project concerning mental ill health in a multicultural neighbourhood. DISCUSSION: : Interpreters influence interview data in ways commonly unnoticed by researchers. One often-overlooked factor is that languages are dynamic and interpreters are not instruments. CONCLUSION: : Research conducted with an interpreter is a complex undertaking. Solely relying on checklists to improve methodological rigour can result in a false sense of the material's validity.

According to a 2005 survey, the people of Rosengård, a culturally heterogeneous borough of Malmö, Sweden, utilise considerably less mental health services in relation to their estimated needs than the rest of the city’s population. A study based on interviews with people living or working in the area revealed several possible reasons. Most important was their perception of what constitutes mental illness. If the cause of one’s disturbed mental state is viewed as a normal life crises rather than an illness, one does not seek medical treatment. The aim of this article is to illustrate how under-utilisation of mental health services by an immigrant population can be explained by their different perceptions of what constitutes mental illness. Interventions should add concerns regarding a client’s socio-economic and psychosocial needs, rather than solely follow a medical model.

Overweight and obesity in younger children could better be brought in focus through a deeper understanding of how Child Health Care nurses (CHC-nurses) perceive their work with the problems of overweight at the CHC Centers. The aim of this study was to elucidate the CHC-nurses conceptions of their preventive work with childhood overweight and obesity in Child Health Care. A qualitative study, based on open-ended interviews, involving 18 CHC-nurses strategically selected from 17 CHC Centres in the southern part of Sweden using a phenomenographic approach. Two categories of description emerged from the data: (i) Internal obstacles to the CHC- nurses' work with overweight in children and (ii) External obstacles to the management of overweight in children. The CHC-nurses conceived their work with overweight in Child Health Care to be complicated and constrained by several obstacles depending on the nurses' personal priorities, knowledge, responsibility and the absence of resources and cooperation, as well as the lack of uniform guidelines for preventing and managing childhood overweight and further a deficient management organisation. Nurses' attention to monitoring overweight in children, and their initiative for prevention, is based on their conceptions of the obstacles that hinder them in their efforts. An increased awareness of the CHC-nurses conceptions of the priorities, their sense of responsibility and prevention practices is warranted. If measures in this direction are not taken there is a growing risk that overweight children will pass through the CHC without any formal recognition of their situation. There is an indication that the present level of the CHC-nurses' preventive work with childhood overweight has room for improvement in several areas. It is suggested that the specialist education of these health care professionals should be supplemented and that organisation of the management of childhood overweight should be also revised at the primary health care level.

Abstract Background: Registered Sick Children’s Nurses and District Nurses employed at Child Health Care centres are in a position to help prevent childhood overweight and obesity. Prevention of this challenging public health threat could be improved through having a better understanding of how this group of nurses perceives childhood obesity. The aim of this study was to elucidate the conceptions of childhood overweight, including obesity, among nurses working in Child Health Care. Method: A qualitative study using a phenomenographic approach, based on open-ended interviews with 18 Child Health Care nurses (CHC-nurses) strategically selected from 17 Child Health Care Centres in the southern part of Sweden. Results: Four categories of description emerged from the data: Perception of childhood overweight changes, Overweight in younger children a neglected concern, Overweight a delicate issue and Importance of family lifestyle. The participating CHC-nurses conceived overweight in children, primarily obesity in children to be an extensive and serious problem which affects children, families and the surrounding society. Overweight in children was further perceived as a consequence of their parent’s lifestyle and their awareness of the problem, which was considered by the CHC-nurses as a sensitive and a provoking issue. It was also perceived that overweight in children is not taken seriously during the pre-school period and that concerns regarding overweight in younger children were mainly about the appearance and not the health of the child. The CHC-nurses perceived that the proportion of overweight children has increased, which Swedish society and the CHC-nurses have adapted to. This adaptation makes it difficult for CHC-nurses to define those children who are overweight. Conclusion: CHC-nurses provide a comprehensive and complex picture of childhood overweight, which includes several difficulties dealing with this issue. Attention to CHC-nurse’s conceptions of overweight in children is important since it can affect the parent-nurse relationship and thereby the nurse’s, as well as the parent’s efforts to influence the children’s weight. It is suggested that CHC- nurses should work with person centered counseling and empowerment concerning parent to child relations in cases involving overweight. Keywords: Child, Conceptions, Nurses, Overweight, Perceptions, Primary health care, Qualitative research

Syftet med denna avhandling har varit att försöka avslöja omständigheter och faktorer som hänger samman med att kvinnor fortsätter respektive slutar att röka och att bidra med kunskaper om vilka rökare som är mest sårbara när det gäller risken för att drabbas av hjärtinfarkt.I den officiella sjuk- och dödsorsaksstatistiken framgår det att risken för hjärtinfarkt minskar bland män och kvinnor, både i Sverige och andra industriländer. Eftersom bruket av tobak har minskat skulle man kunna tro att det finns ett samband mellan den sjunkande risken för hjärtinfarkt och samhällets satsningar på att minska tobaksbruket. Under motsvarande tid har risken för lungcancer ökat, inte minst bland yngre kvinnor, och det finns därför anledning att undersöka om den sjunkande risken för hjärtinfarkt gäller för både yngre och äldre kvinnor. I det första delarbetet som handlar om risken för hjärtinfarkt i Malmö från 1986 till 2002 framgår det att infarktrisken successivt gått ner de senaste tjugo åren bland män och äldre kvinnor. Denna positiva trend gäller inte för kvinnor under 65 år, i den gruppen är risken oförändrad. Den mest troliga förklaringen till detta är den höga andelen rökare i den här åldersgruppen.Många studier har dokumenterat rökningens samband med hjärtinfarkt. Dessa studier bygger på en jämförelse av incidensen av hjärtinfarkt, dvs andelen som under en viss tidsperiod insjuknar i hjärtinfarkt, bland rökare och icke-rökare. Rökarna drabbas i större utsträckning än icke-rökarna men många rökare klarar sig. Varför en del rökare är mer sårbara än andra har varit syftet med det andra delarbetet. I detta, som bygger på en uppföljning av de 10 619 kvinnorna som kom till hälsoundersökningen 1977-91 på avdelningen för förebyggande medicin i Malmö, är slutsatsen att många av hjärtinfarkterna bland rökare orsakas av högt blodtryck, höga blodfetter, övervikt och diabetes och att kombinationen av rökning och dessaandra riskfaktorer, främst högt blodtryck leder till en extra riskökning.Risken för hjärtinfarkt varierar i Malmö mycket mellan olika bostadsområden. För att kunna arbeta med förebyggande insatser behövs det mer information om vad detta kan bero på. Delarbete tre, som bygger på de 17 319 kvinnorna som deltar i den sk Kost&Cancer studien i Malmö, har haft som syfte att studera i vilken utsträckning dessa skillnader i hjärtinfarkt beror på rökning och vilken utsträckning bruket av tobak i ett bostadsområde samvarierar med områdets socioekonomiska omständigheter. Slutsatsen är att bruket av tobak, framförallt bland yngre kvinnor, starkt hänger samman med områdets socioekonomiska karaktär, i områden med sämst förutsättningar röker man mest och här har man också flest fall av hjärtinfarkt. Den här typen av studier är av värde för att kunna rikta samhällets preventiva insatser.Risken för biverkningar i samband med medicinsk och kirurgisk behandling diskuteras ofta. Det är däremot ovanligt att man kommenterar detta i samband med förebyggande insatser. I det fjärde delarbetet handlar det om och hur vikt och blodtryck förändras i samband med att man slutar röka. I studien ingår 3 931 kvinnor som deltog i hälsoundersökningen på avdelningen för förebyggande medicin och som i genomsnitt 9 år senare ställde upp som deltagare i Kost&Cancer studien. Trehundra åttio åtta av de ursprungligen 1550 rökarna hade då slutat röka. Rökarn, som från början vägde 2-2.5 kg mindre än icke-rökarna, gick i genomsnitt upp 3.2 kg, de som slutade 7.6 och icke-rökarna 3.7 kg. Att sluta röka var förenat med en måttliga ökning av både det systoliska och diastoliska blodtrycket och det var fler av dem som slutade röka som vid uppföljningen hade högt blodtryck.Det femte delarbetet handlar om former för uppföljning och utvärdering av de många olika förebyggande insatser som görs på det tobakspreventiva området. Rökvanornas utveckling följs och kommenteras i de undersökningar som görs av Folkhälsoinstitutet. Men vem det är som trots dessa preventiva insatser fortsätter att röka och vem som slutar har rönt liten uppmärksamhet. Detta har varit syftet med delarbete fem, som igen bygger på de drygt 17 000 kvinnor från Malmös olika bostadsområden som deltar i den sk Kost&Cancer studien. Slutsatsen är att de som slutade röka oftare var gifta kvinnor med lång utbildning, stressfri arbetsmiljö och bra ekonomi, kvinnor som i mindre utsträckning exponeras för passiv rökning och som tycker att de mår bra. Och omvänt gäller att i grupper med sämst socioekonomiska och psykosociala omständigheter och i grupper som exponeras för passiv rökning där fortsatte kvinnorna att röka.

The last-decade incidence of myocardial infarction (MI) has diminished dramatically in most age groups but not in middle-aged women in Sweden. There has been a large influx of immigrants and it has been shown that immigrant wom en have a higher BMI and are less physically active than Swedish women. Thereby they have a higher risk for heart disease. The aim of the study was to examine post-migration diet ary changes, and knowledge about risks for heart diseases among Somali women. Furthermore, to examine the women’s perceptions of body image, self-esteem, and their knowledge about the positive effect of physical activity. The qualitative research method was used and eight Soma li women aged 40 years or more, who have lived in Sweden longer than ten years, were in terviewed with the help of a semi- structured questionnaire. The study revealed that S omali migrated women in Sweden had changed their diet and experienced weight increase. They reported low self-esteem and little motivation for physical activity. They understood t hat they had a higher risk for heart disease as compared to Swedish women and they had, in gener al, a preference for big body size. The women of this study are, in combination with other risk factors, at a high risk of myocardial infarction. They all revealed a general knowledge a bout the relationship between obesity and inactivity and enhanced risks for heart disease. Th ey had a preference for a larger female body image. They expressed low self-esteem, loneliness, and alienation from society. It is important to address the health issue among migrant Somali wo men in Sweden, but since this study had few informants, larger studies and more science is needed to further investigate the problem.

Background The relationship between smoking and an increased incidence of cardiovascular diseases is well known. Whether smokeless tobacco (snuff) is related to myocardial infarction (MI) or stroke is still controversial. Aim of this study was to explore whether snuff users have an increased incidence of MI or stroke. Methods A total of 16 754 women and 10 473 men (aged 45-73 years), without history of cardiovascular disease (CVD), belonging to the population-based “Malmö Diet and Cancer” study were examined. Incidence of MI and stroke were monitored over 10.3 years. Results Snuff was used by 737 (7.0 %) men and 75 (0.4%) women, respectively. Among men, snuff was significantly associated with low occupation level, single civil status, high BMI and with current and former smoking. In women, snuff was associated with lower systolic blood pressure. A total of 964 individuals (3.5 %), i.e.544 men (5.3%) and 420 (2.5%) women suffered a MI during the follow-up period. The corresponding numbers of incident stroke cases were 1048, i.e. 553 men (5.3%) and 495 (3.0%) women, respectively. Snuff was not associated with any statistically significant increased risk of MI or stroke in men or women. The relative risks (RR) in male snuff users compared to non-users were 1.05 (95% confidence interval (CI): 0.8-1.4, p=0.740) for incident MI and 0.97 (0.7-1.4, p=0.878) for stroke, after taking age and potential confounders into account. In women none of the 420 women who were snuff users had a MI and only one suffered a stroke during the follow-up. Conclusion Several life-style risk factors were more prevalent in snuff-users than in non-users. However, the present study does not support any relationship between snuff and incidence of cardiovascular disease in men.

In this paper, we discuss traditional Somali concepts of mental ill health.Qualitative interviews were conducted with some 20 Swedish Somali interviewees about factors causing mental ill health, traditional classification, strategies to deal with mental ill health, and attitudes to the mental health care services in Sweden. Social mobilisation and religious healing are cornerstones of traditional Somali measures to deal with mental suffering. Traditional Somali views of mental ill health stand in stark contrast to classification of mental ill health in the western biomedical model. These views deserve attention since they may have an impact on health-seeking behaviour among Somali immigrants in western countries. Yet a too strong focus on cultural aspects may over-shadow the fact that much mental suffering among Somali migrants must be understood within social, economic, and political contexts.

Objectives: Relatives of people with mental illnesses are affected in many different areas of life, and are often concerned that their ill family members might be of danger to themselves or others. The aim of this presentation is to report some results from Swedish studies of relatives focusing on stigma, family burden, participation in care, and attitudes towards coercive treatment. Methods: In three different data collection periods in a longitudinal project, in all 455 relatives of committed and voluntarily admitted patients were interviewed, using a semi-structured questionnaire. Results: A majority of relatives experienced psychological factors of stigma by association. Relatives‘ burden and participation in care were not found to be associated to violent behaviour by the patients or to the patients‘ diagnoses, but relatives of patients with suicide attempts scored higher on some of the burden and participation items than other relatives. Relatives reported stronger support for coercion in order to protect the patient than for easing family burden and protecting others. Conclusion: The results indicate that relatives of psychiatric patients experience stigma by association and low participation in care, but in general support the need for compulsory psychiatric care in specific situations. However, despite a heavy burden due to the patients‘ mental illnesses, relatives do not primarily call for coercion in order to ease the family burden. There is a need for the psychiatric services to involve and support relatives of patients with suicidal behaviour.