Audulv A.,Mid Sweden University
BMC Public Health | Year: 2013
Background: There currently exists a vast amount of literature concerning chronic illness self-management, however the developmental patterns and sustainability of self-management over time remain largely unknown. This paper aims to describe the patterns by which different chronic illness self-management behaviors develop and are maintained over time. Method. Twenty-one individuals newly diagnosed with chronic illnesses (e.g., diabetes, rheumatism, ischemic heart disease, multiple sclerosis, chronic renal disease, inflammatory bowel disease) were repeatedly interviewed over two-and-a-half years. The interviews were conducted in Sweden from 2006 to 2008. A total of 81 narrative interviews were analyzed with an interpretive description approach. Results: The participants' self-management behaviors could be described in four different developmental patterns: consistent, episodic, on demand, and transitional. The developmental patterns were related to specific self-management behaviors. Most participants took long-term medications in a consistent pattern, whereas exercise was often performed according to an episodic pattern. Participants managed health crises (e.g., angina, pain episodes) according to an on demand pattern and everyday changes due to illness (e.g., adaptation of work and household activities) according to a transitional pattern. All of the participants used more than one self-management pattern. Conclusion: The findings show that self-management does not develop as one uniform pattern. Instead different self-management behaviors are enacted in different patterns. Therefore, it is likely that self-management activities require support strategies tailored to each behavior's developmental pattern. © 2013 Audulv; licensee BioMed Central Ltd.
Danielski I.,Mid Sweden University
Energy and Buildings | Year: 2012
This study examines possible causes for variations in specific final energy use in new apartment buildings. The analysis is based on case studies of 22 new apartment buildings that were constructed as part of the 'Stockholm program for environmentally adapted buildings'. The buildings in the study were chosen because they share similar construction characteristics and similar energy systems but display unexpected large variations in specific energy use. Three causes were found to contribute to variations in monitored specific final energy use in the studied apartment buildings: (1) the time interval between the completion of construction work and the actual energy measurements, (2) the shape factor of the building and (3) the relative size of the common area. In addition, the buildings that participated in the Stockholm program failed to achieve the requirements for the specific final energy use, to a large extent, because of expectations based on the simulated values. The simulated specific final energy use predicted by the energy simulations were on average 19% lower than the monitored values, giving the impression that the buildings would fulfill the program's energy requirements. The reasons for the low simulated values were determined to be large uncertainties in the input data. © 2012 Elsevier B.V. All rights reserved.
Landstedt E.,Mid Sweden University
Scandinavian journal of public health | Year: 2011
Deliberate self-harm (DSH) in young people is an important public health issue. To prevent DSH, more knowledge is needed about its prevalence and associated contextual factors in community samples of adolescents. To determine the prevalence of deliberate self-harm in 17-year-old Swedish students and to explore the association of demographic variables, psychological distress, experiences of violence, and school-related factors with DSH. Data were derived from a cross-sectional study in which 17-year-old students completed questionnaires during school hours (n = 1,663; 78.3%). The variables used in this analysis are as follows: deliberate self-harm, demographic variables, psychological distress, experiences of violence, and school-related factors. Data were analysed using chi-squared statistics and logistic regression. The lifetime prevalence of DSH was 17%, and it was more common among girls (23.3%) than boys (10.5%). There were considerable socioeconomic differences in reports of DSH. Psychological distress was strongly associated with DSH in both boys and girls, as were experiences of bullying, sexual harassment, physical violence and sexual assault. Social support, safety and academic factors in school were related to reports of DSH in both girls and boys. There were some gender differences with respect to which factors were associated with DSH. Deliberate self-harm is common and more frequently reported by girls than boys. Psychological distress, experiences of different types of violence, and school-related factors (academic, social and safety-related), should be considered risk factors for DSH in young people. Findings can be applied to health-promotion policy and interventions in various contexts, for example schools.
Israelsson M.,Mid Sweden University
European Addiction Research | Year: 2012
Purpose: The study explores international trends in law on compulsory commitment to care of substance misusers (CCC), and two subtypes - civil CCC and CCC within criminal justice legislation - as well as maximum length and amount of applications of such care. Method: The time period covers more than 25 years, and a total of 104 countries and territories. The study is based on available data in three times of observation (1986, 1999 and 2009). Applications of CCC in number of cases are studied on European level for the years 2002-2006. Trends are analyzed using nonparametric tests and general linear models for repeated measures. Findings are discussed from contextual analysis. Result: There is a trend towards decrease in the number of countries worldwide having civil CCC legislation after the millennium, while CCC under criminal law has increased since the mid-1980s, resulting in some total net decrease. The shift results in longer mean duration of CCC and an increase in the number of cases sentenced. Conclusion: There is a risk that the shift from civil CCC to penal CCC implies more focus on young out-acting males in compulsory treatment and that the societal responsibility for more vulnerable persons might be neglected. Copyright © 2012 S. Karger AG, Basel.
Isaksson P.,Mid Sweden University
Engineering Fracture Mechanics | Year: 2010
The plasticity behavior of fiber networks is governed by complex mechanisms. This study examines the effect of microstructure on the macroscopic plastic behavior of two-dimensional random fiber networks such as strong-bonded paper. Remote load is a pure macroscopic mode I opening field, applied via a boundary layer assuming small scale yielding on the macroscopic scale. It is shown that using a macroscopic classical homogeneous continuum approach to describe plasticity effects due to (macroscopic) singular-dominated strain fields in planar fiber networks leads to erroneous results. The classical continuum description is too simple to capture the essential mechanical behavior of a network material since a structural effect, that alters the macroscopic stress field, becomes pronounced and introduces long-ranging microstructural effects that have to be accounted for. Because of this, it is necessary to include a nonlocal theory that bridges the gap between microscopic and macroscopic scales to describe the material response in homogeneous continuum models. An implicit stress gradient small deformation plasticity model, which is based on a strong nonlocal continuum formulation, is presented here that has the potential to describe the plasticity behavior of fiber networks on a macroscopic scale. The theory is derived by including nonlocal stress terms in the classical associated J2-theory of plasticity. The nonlocal stress tensor is found by scaling the local Cauchy stress tensor by the ratio of nonlocal and local von Mises equivalent stresses. The model is relatively easy to implement in ordinary finite element algorithms for small deformation theory. Fairly good agreements are obtained between discrete micromechanical network models and the derived homogeneous nonlocal continuum model. © 2010 Elsevier Ltd.