Problem In Sweden Research Articles

Experiences of managers and staff working in community-based mental health with people ageing with severe mental health problems.

Existing research shows that older people with severe mental health problems need different forms of support in daily life and in the community to lead an active and meaningful life. A common form of support for people with severe mental health problems in Sweden is attendance at community-based day centres (DCs). However, knowledge of staff and managers' experiences of how people ageing with severe mental health problems are supported in DCs is scarce. The aim was to explore DC staff and managers' experiences of how people ageing with severe mental health problems are supported in DCs during the retirement process. Telephone interviews were conducted with managers in 27 municipalities in southern Sweden. In addition, focus groups were held with personnel from a total of nine different DCs. The material was analysed using content analysis. The results showed that older people who receive support in community-based mental health care were viewed as a neglected group with complex needs, and the informants (managers and staff) had few policies to guide them when providing support. This made the informants desire more knowledge about best practices to support the target group. One theme emerged, Minding the gap between ideal and reality while working with a neglected group with complex needs, with three categories: Reasoning around unmet needs, Navigating in a muddled organisation, and Wishing for an enriched service. Together with previous research, the results can contribute to increase awareness about an overlooked group at risk of being neglected and the pitfalls that impact the possibility to guide this target group in their recovery journey. Further research focusing on the target group's own experience of their everyday life situations is also needed.

Use of Prescribed and Non-Prescribed Treatments for Cluster Headache in a Swedish Cohort.

Cluster headache (CH) is a debilitating condition, but current therapies leave CH patients in pain. The extent of this problem in Sweden is unknown. An anonymized questionnaire was sent to 479 Swedish CH patients to investigate patterns and perceived effects of treatments. Three hundred fourteen answers were analyzed. The population was representative regarding age of onset and sex. Less than half (46%) were satisfied with their abortive treatments, 19% terminated functioning abortive treatments due to side effects. Additionally, 17% of chronic CH patients had not tried the first-line preventive drug verapamil. A small subset had tried illicit substances to treat their CH (0-8% depending on substance). Notably, psilocybin was reported effective as an abortive treatment by 100% (n = 8), and with some level of effect as a preventive treatment by 92% (n = 12). For verapamil, some level of preventive effect was reported among 68% (n = 85). Our descriptive data illustrate that many Swedish CH patients are undertreated, lack functional therapies, and experience side effects. Further studies are warranted to search for new treatment strategies as well as a revision of current treatment guidelines with the aim of reducing patient disease burden to the greatest extent possible.

Can psychosocial risk factors mediate the association between precarious employment and mental health problems in Sweden? Results from a register-based study.

The aim of this study was to examine the mediating effect of the psychosocial work environment on the association between precarious employment (PE) and increased risk of common mental disorders (CMD), substance use disorders and suicide attempts. This longitudinal register-study was based on the working population of Sweden, aged 25-60 years in 2005 (N=2 552 589). Mediation analyses based on a decomposition of counterfactual effects were used to estimate the indirect effect of psychosocial risk factors (PRF) (mediators, measured in 2005) on the association between PE (exposure, measured in 2005) and the first diagnosis of CMD, substance use disorders, and suicide attempts occurring over 2006-2017. The decomposition of effects showed that the indirect effect of the PRF is practically null for the three outcomes considered, among both sexes. PE increased the odds of being diagnosed with CMD, substance use disorders, and suicide attempts, among both men and women. After adjusting for PE, low job control increased the odds of all three outcomes among both sexes, while high job demands decreased the odds of CMD among women. High job strain increased the odds of CMD and suicide attempts among men, while passive job increased the odds of all three outcomes among women. The results of this study did not provide evidence for the hypothesis that psychosocial risks could be the pathways linking precarious employment with workers` mental health. Future studies in different social contexts and labour markets are needed.

Drug use and the constitution of homo politicus in Swedish politics 1966–1979

BackgroundThe emergence of the drug user as a political problem in Sweden during the 1960s presented politicians with the problem of how to fit this new character into the existing democratic order. The aim of this article is to examine how Swedish politics sought to regulate democratic participation by establishing norms that conditioned who is recognized as a political subject as well as what counts as political speech and action. MethodsThe analysis is based on a close reading of parliamentary debates, political motions, and public reports and covers the period 1966–1979. ResultsDuring the examined period, Swedish politics constituted the ideal subject of democratic politics, homo politicus, as a subject embedded in a community of active and politically conscious citizens endowed with the capacity to cooperate and engage in the collective formulation of the common good. Drug use therefore posed a threat to the democratic order due to its passivizing effects that inhibited the cooperation needed to uphold the democratic polity. ConclusionThe perceived individualism, passivity, and inability of the drug user to engage in cooperation within a politically conscious community of citizens positioned the drug user as a threat to the democratic order. The drug user thereby became a useful figure in the political regulation of the democratic sphere and the constitution of homo politicus, the ideal subject of democratic politics.

From research to routine care: A historical review of internet-based cognitive behavioral therapy for adult mental health problems in Sweden.

This narrative historical review examines the development of internet-based cognitive behavioral therapy (ICBT) in Sweden, describing its progression within both academic and routine care settings. The review encompasses key publications, significant scientific findings, and contextual factors in real-world settings. Over 25 years ago, Sweden emerged as a pioneering force in internet-delivered treatment research for mental health. Since then, Swedish universities, in collaboration with research partners, have produced substantial research demonstrating the efficacy of ICBT across various psychological problems, including social anxiety disorder, panic disorder, generalized anxiety disorder, and depression. Although research conducted in clinical settings has been less frequent than in academic contexts, it has confirmed the effectiveness of therapist-supported ICBT programs for mild-to-moderate mental health problems in routine care. Early on, ICBT was provided as an option for patients at both the primary care level and in specialized clinics, using treatment programs developed by both public and private providers. The development of a national platform for delivering internet-based treatment and the use of procurement in selecting ICBT programs and providers are factors that have shaped the current routine care landscape. However, gaps persist in understanding how to optimize the integration of digital treatment in routine care, warranting further research and the use of specific implementation frameworks and outcomes. This historical perspective on the research and delivery of ICBT in Sweden over two decades offers insights for the international community into the development and broad dissemination of a specific digital mental health intervention within a national context.

Individually Tailored and Culturally Adapted Internet-Based Cognitive Behavioral Therapy for Arabic-Speaking Youths With Mental Health Problems in Sweden: Qualitative Feasibility Study.

Most forcibly displaced refugees in Sweden originate from the Arab Republic of Syria and Iraq. Approximately half of all refugees are aged between 15 and 26 years. This particular group of youths is at a higher risk for developing various mental disorders. However, low use of mental health services across Europe has been reported. Previous research indicates that culturally adapted psychological interventions may be suitable for refugee youths. However, little is known about the feasibility, acceptability, and efficacy of such psychological interventions. This study aimed to explore the feasibility, acceptability, and preliminary efficacy of an individually tailored and culturally adapted internet-based cognitive behavioral therapy for Arabic-speaking refugees and immigrant youths in Sweden. A total of 17 participants were included to participate in an open trial study of an individually tailored and culturally adapted internet-based cognitive behavioral therapy targeting common mental health problems. To assess the intervention outcome, the Hopkins Symptom Checklist was used. To explore the acceptability of the intervention, in-depth interviews were conducted with 12 participants using thematic analysis. Feasibility was assessed by measuring treatment adherence and by calculating recruitment and retention rates. The intervention had a high dropout rate and low feasibility. Quantitative analyses of the treatment efficacy were not possible because of the high dropout rate. The qualitative analysis resulted in 3 overarching categories: experiences with SahaUng (the treatment), attitudes toward psychological interventions, and personal factors important for adherence. The findings from this study indicate that the feasibility and acceptability of the current intervention were low and, based on the qualitative analysis, could be increased by a refinement of recruitment strategies, further simplification of the treatment content, and modifications to the cultural adaptation.

Helping or Controlling? Choice of Coping Methods When Dealing with Violent Clients in Statutory Social Work

Client violence in social work is a workplace problem in Sweden and internationally. Frontline workers in public agencies have the discretion to decide how they deal with clients to cope with challenges like violence and threats. The coping methods may favour some clients while disadvantaging others. Ultimately, the coping practices may become de facto policy, which may not match official organisational policy. This article explores coping methods statutory social workers use to manage violence and threats in their day-to-day dyadic interactions with clients. The article is based on qualitative interviews with social workers (n = 19) who, according to their perception, were victims of client violence. Theory on street-level bureaucracy and frontline workers’ discretion is used. Based on thematic analysis, the results show that social workers draw from four groups of coping methods depending on their moral and normative dispositions. These include (1) the forced helper, (2) the compassionate helper, (3) the distanced helper, and (4) the authoritarian helper. Social workers oscillate between different dispositions depending on situational needs, striving to find the appropriate balance between helping and controlling clients. Studying social workers’ day-to-day dyadic interactions with clients highlights how coping methods could shape social work policy and practice.

Method and evaluations of the effective gain of artificial intelligence models for reducing CO2 emissions

Nowadays, there is an increasing use of digital technologies and Artificial Intelligence (AI) such as Machine Learning (ML) models that leverage data to optimize the performances of systems in almost all activity sectors, including ML models for optimizing solutions related to CO2 capture from the atmosphere or CO2 emissions reduction from human activities. However, on the other hand, the use of AI models is leading to an increasing energy consumption that also raises environmental issues (in terms of CO2 emissions) which are less studied in the literature. This then raises the new question of a more realistic estimate of the carbon footprint (CO2 emissions in particular) of AI models in general, and particularly AI models aimed at reducing CO2 emissions. Thus, in this paper, for an AI model in this latter context, we propose a method to quantify both his negative impacts (quantity of CO2 emissions emitted by the training and use of the model) and his positive impacts (quantity of CO2 emissions saved when the model is used). The method is evaluated with three state-of-the-art AI models: (i) an artificial neural network model for managing the energy demand of Brazilian households, (ii) an adaptive neuro-fuzzy inference system for photovoltaic power forecast in Tunisia, (iii) and a Bayesian regression model for the electric vehicle routing problem in Sweden and Luxembourg. Results show that, if only the positive impacts are considered, the reduction of CO2 emitted due to the usage of the models is significant, but depends on each context (34%, 73%, and 9%, respectively). However, when both positive and negative impacts are considered, the negative impacts are sometimes higher than the positive impacts (the first and the third model) for a nominal use (1 user). Nevertheless, the balance becomes highly positive again, when these two projects are scaled up (realistic projections with many users). The second model cannot be scaled up, but the balance remains positive, even if the gains are much smaller. More generally, the CO2 emissions gain metrics provided by our method can be used as new metrics for comparing the efficiency of AI models (for reducing CO2 emissions) beyond predictive capacity-based traditional ML evaluation metrics. Based on the lessons learned from our study, we also provide seven global recommendations that can contribute to the reduction of the carbon footprint of ML models in general.

Hybrids between Rubus caesius and Rubus sect. Corylifolii (Rosaceae) and their relation to R. cyclomorphus, R. tiliaster, R. glauciformis, R. slesvicensis and R. firmus

Using flow cytometry and microsatellite DNA analysis (MSDA), we studied hybrids between Rubus caesius and various other Rubus species, with an emphasis on Sweden. We show that hybrids between Rubus caesius and Rubus sect. Corylifolii arise easily. They show a large variation in morphology, but can normally be recognised by a number of characters. They are typically hexaploids, but ~13% of the hybrids are pentaploids and ~8% tetraploids. With MSDA, they are harder to identify than hybrids with R. idaeus, partly because all Corylifolii species have themselves arisen from R. caesius hybrids and therefore share many alleles with R. caesius, partly because hybridisation with R. caesius seems to give rise to some variation in microsatellite regions. Hybrids with species of R. sect. Rubus are much rarer in Sweden and we have only identified one such case. We show that R. cyclomorphus and R. tiliaster are not proper apomictic species, at least not in Sweden, but rather a collection of genetically unrelated hybrids between R. caesius and R. raduloides or R. camptostachys. MSDA analysis of R. slesvicensis and R. firmus shows that these species are problematic. We identify two distinct taxa, one from Skåne in Sweden, which we describe as a new species, R. ruboculus and another from the neighbourhood of Viborg and Schleswig, although the latter is probably not identical with R. slesvicensis s.s. All the other samples form a diverse group of putative R. caesius hybrids at three different ploidy levels. Rubus glauciformis is uniform in Småland, Öland and Blekinge, but becomes harder to distinguish from various hybrids in Skåne. We conclude that once R. caesius and R. idaeus hybrids are properly identified, along with a small number of new apomictic species (often with a local distribution), the genus Rubus does not pose any serious taxonomical problems in Sweden.

Exploring the sustainability of the teaching profession: A thematic analysis of teachers' perspectives

Teacher shortage and turnover is a growing problem in Sweden, yet little is known about the organisational factors associated with these problems. The current study explores teachers’ experiences of organisational processes and aims to identify relevant job demands and resources linked to professional sustainability for teachers. In this study, semi-structured focus group-interviews were conducted with five groups. In total, 44 teachers (33 women and 11 men) working in southern Sweden participated. The interviews were analysed using thematic analysis. Three key themes illustrating aspects of teachers’ perceptions were identified: Hindrances, Culture, and Leadership. The findings indicate that the participants experienced poor organisational structures effecting both their professional and personal lives. The results contribute to a deeper understanding of what impacts professional sustainability for teachers in Sweden.

Criminality among Young People With Substance Use Problems in Sweden: A One-Year Follow-Up Study

Criminality among Young People With Substance Use Problems in Sweden: A One-Year Follow-Up Study

Criminality among Young People With Substance Use Problems in Sweden: A One-Year Follow-Up Study

Swedish drug policy has a strong focus on minor drug violations. This longitudinal study analyses the association between criminality and substance use problems among young people who have received outpatient treatment and risk factors that predict continued problems with criminality. Research on this target group is under development in Sweden, but there are few follow-up studies. The study indicates that about one-quarters of the young people who begin outpatient treatment have been convicted of crimes at 1-year follow-up. Most of them who had been convicted with offences also have ongoing problems with substance use and three-quarters of the young people had been charged with a drug-related offence. More than five risk factors give an elevated risk of continued criminality. Interventions meeting the needs of young people, moving away from the current emphasis on penal law principles, may also contribute to reduced criminality in this target group.

Representing a Fading Welfare System that Is Failing Young People in \u2018NEET\u2019 Situations: a WPR Analysis of Swedish Youth Policies

The situation of young people who are neither in employment, education nor training (referred to in political, scientific and public discourses as ‘NEETs’) has received widespread attention during the last decade. However, while policy responses to young people’s work- and school-related marginalisation have been analysed by international scholars in a variety of contexts, to the best of our knowledge, no study to date has scrutinised problem representations of ‘NEET’ young people in youth policies in Sweden. To bridge the current knowledge gap and uncover taken-for-granted assumptions about the otherwise largely unchallenged Nordic welfare model, the aim of this research was to explore how the ‘problem’ of ‘NEET’ young people is represented in Swedish policies and policy proposals. To facilitate this, a discursive approach to policy analysis was adopted, following Bacchi’s ‘What’s the Problem Represented to be?’ (WPR) methodology. By focusing on the solutions that have been proposed to reduce the size of the ‘NEET’ group in two selected policies, four problem representations were developed. These connect the ‘NEET’ problem in Sweden, at the general level, to the ‘vulnerability’ of young people on the margins of education and employment (especially certain sub-groups) and, more specifically, to the failure of a fading welfare system to provide services and support for these ‘vulnerable’ subjects. Beyond representing the ‘problem’ along these lines, the identified problem representations may contribute to silencing young people’s agency and ignoring the consequences of a growing labour-market precarisation in Sweden, while failing to provide a basis for equity and social justice.

‘Anxiety, frustration and understanding’. Swedish personal social service workers’ cognitive appraisals of encounters with violent clients

ABSTRACT Workplace violence and threats from social service users towards social workers (client violence) is a problem in Sweden and internationally. This article explores the circumstances that make client violence stressful to social workers who exercise public authority in Swedish individual and family social services. The empirical data are based on qualitative interviews with social workers (n = 19) who, according to their own perception, have been threatened or assaulted by a client in relation to work. Theory on cognitive appraisal of threat and harm is used. The results, analysed by Inductive Thematic Analysis, show that client violence is stressful because it poses a threat to social workers’ professional identity and private life, and occurs in uncertain and repetitive ways. The results suggest that a negligent safety culture in social service agencies, characterized by normalization of client violence and limited organizational support, may contribute to stress related to client violence. The results are discussed in light of how social workers and social service agencies transact and affect each other.

Youth intimate partner violence: prevalence, characteristics, associated factors and arenas of violence

ABSTRACT Internationally, it is established that many youth experience violence within their romantic intimate relationships (youth intimate partner violence, Youth IPV). In Sweden, however, despite a well-developed research field on domestic violence and violence against children, knowledge about the prevalence of Youth IPV remains lacking. Therefore, taking its starting point in a mixed-method study on youth IPV in Sweden, this study presents incidence rates of Youth IPV victimization in a sample of Swedish youth, as well as associated factors to such victimization. Arenas of violence – i.e. settings where the violence takes place – are also addressed. In total, 59.7% (n = 526) of study respondents reported having experienced some form of IPV either once or multiple times. The results suggest gender differences: girls reported higher rates of victimization, especially for multiple experiences of violence. Markers for IPV victimization are presented. It is shown that Youth IPV happens in arenas to which adults have access. Viable markers for victimization are suggested; furthermore, the belief that ‘only at-risk youth experience IPV’ is challenged. It is critical that Youth IPV be considered a social problem in Sweden, deserving of specific attention and interventions. Youth IPV does not happen behind closed doors, but under the same roof as adults who have the obligation to protect them (i.e. parents and school staff) and this offers unique opportunities to respond and help. Further research should investigate the support offered to IPV-exposed youth, thereby shifting the focus to how this social problem is tackled.

How Adolescents Think When Responding to Alcohol-Related Questionnaires: A Think-Aloud Study

Self-report questionnaires on alcohol use are commonly used in both research and in clinical work with adolescents, but little is known about how adolescent responders perceive and interpret them. This study explores how adolescents think while responding to two alcohol-related questionnaires. It also investigates whether the instruments can initiate self-reflective processes on alcohol use. Data were collected among adolescents visiting a center for young people with substance use problems in Sweden. The participants found the questionnaires easy to complete and widely relevant, and the questionnaires commonly initiated a process of self-reflection. Results support the use in clinical settings.

Mental health problems among young people in substance abuse treatment in Sweden

BackgroundYoung people with substance use problems face a high risk of co-occurring mental health problems, something that may involve a more difficult life situation, social problems as well as worse treatment outcomes. The aim of this study is to analyse self-reported mental health problems among young people receiving outpatient treatment for substance use problems in Sweden. We explore what types of mental health problems are more or less predominant, and whether there are significant differences between boys and girls. In addition, we analyse how various mental health problems covary with indicators of substance abuse severity.MethodsThe study is based on structured interviews with 1970 young people enrolled at outpatient clinics in 11 Swedish cities. The data was analysed through frequency- and averages-calculations, Chi-square tests and multivariate logistic regression analyses.ResultsSelf-reported mental health problems were common among the young people in the study. A relatively large percentage of the total group (34–54%) reported problems such as concentration difficulties, sleeping difficulties, anxiety and depression. At the same time, many of the young people did not report any symptoms and only a small group, about 20%, reported diagnosed mental health disorders. The results show substantial gender differences, with girls reporting significantly higher levels of mental health problems.Multivariate logistic regression analyses demonstrated significant associations between severity of drug use problems and anxiety, concentration difficulties, aggression, hallucinations and mental stress caused by experiences of trauma.ConclusionsTreatment needs are diverse within this group of young people who use drugs. Since girls report higher levels of all mental health problems, and a larger burden of psychosocial risk factors than boys, they are likely to require more comprehensive treatment interventions. The link between more severe drug problems and mental health problems points to the importance of exploring this relationship in treatment. A multidisciplinary approach, in which co-occurring problems can be addressed simultaneously, may be the best treatment form for many young people with drug problems.

School Ethos and Recurring Sickness Absence: A Multilevel Study of Ninth-Grade Students in Stockholm.

School absence has been identified as a severe problem in Sweden, both at the individual level and for society as a whole. Despite the multitude and complexity of reasons behind school absence, health-related problems are likely to be one important determinant. This indicates that knowledge about factors that may contribute to preventing health-related absence among students is relevant. The aim was to investigate whether a higher level of teacher-reported school ethos was associated with less recurring sickness absence among students. Data from four cross-sectional surveys performed in 2014 and 2016 were combined. The Stockholm School Survey was carried out among 9482 ninth-grade students (ages 15–16 years) in 150 school units, and the Stockholm Teacher Survey was performed among 2090 teachers in the same units. School ethos was operationalised by an index of 12 teacher-reported items that was aggregated to the school-level. Recurring student sickness absence was captured by self-reports and defined as absence on >10 occasions during the current school year. Two-level logistic regressions were performed. The results show that about 9.5% of the students reported recurring sickness absence. Students attending schools with higher levels of teacher-rated school ethos were less likely to reporting recurring sickness absence than those attending schools with lower levels of ethos, even when adjusting for potential confounders (OR 0.79, 95% CI 0.65–0.97). In conclusion, recurring sickness absence was less common among students attending schools with higher levels of teacher-rated ethos. The findings suggest that schools may contribute to promoting student health.

Investigating the presence of mold in wood treated with chlorophenol

A common moisture-related problem in Sweden and other countries, is mold odor indoors. The general perception is that mold odor indicates hazardous hidden mold. However, some grey literature studies indicate that the source of mold odor might not be substantial amounts of mold, but rather chloroanisoles (CAs) which are biomethylated from chlorophenols (CPs) in moist conditions. Products containing CPs were commonly used world-wide as wood preservatives in the 1960-70s and problems with indoor mold odor have been reported in buildings where such products have been used. In Sweden, one of the main uses of CPs in buildings was in wooden constructions exposed to big moisture loads, such as sill plates and crawl space ceilings. Here we aimed to determine the potential presence and level of mold growth on wood treated with CPs in one school building with reported odor problems built in the stated time period. Odorous wooden samples were taken and analyzed for mold growth. No mold was detected by the naked eye, but some growth was seen using a microscope. We presently investigate more schools and samples, but so far our results question that mold odor depends on substantial amounts of mold.

Benefits of Investigating the Thermal Component for Moisture Safety in Ventilated Attics

Cold ventilated attics often have mould problems in Sweden. This is valid both for old and sometimes newly built attics. Increased insulation on the attic floor is assumed to increase the problem. To investigate this, numerical 1D models like WUFI or WUFI+ are typically used. These models give results but the physical processes are not so transparent for the user due to the complex numerical techniques involved and takes a long time to simulate. The problem is mainly related to the temperature in the attic, the ventilation rate and possible of leaks from the living space. All exposed surfaces in the attic will buffer moisture variations. But if this buffering is neglected and the leakage is treated as a constant the moisture content in the attic is only dependent on the ventilation with outside air and the assumed leakage. This would make a pure thermal investigation meaningful. An analytical model for the thermal problem was developed that took into account radiation between the interior surfaces and the different boundary conditions at the outside and inside surfaces. Using this model a parameter study of exterior roofing insulation was done using a moisture transport model that only took into account convection exchange. The results were compared with WUFI Pro and WUFI+ simulations which included the moisture exchange between air and internal surfaces. The comparison showed that the pure thermal model gave, as expected, larger variations in relative humidity, but that the results were qualitatively very similar. This indicates that analytical solutions of thermal problems can be used as a base in qualitative investigations of certain combined heat and moisture problems.