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Sweden can be considered a relatively liberal European country when it comes to research, for example, it allows creating embryos for research purposes; yet, the question of human germline genome modification has been approached with great caution. With the adoption of the Genetic Integrity Act in 2006, the Swedish legislature intended to enable some research relating to gene editing technology while simultaneously placing bans on its use in clinical trials and clinical care, and providing criminal sanctions if these bans are violated. In this way, Swedish law is also aligned with its external commitments, and in particular, the EU Clinical Trials laws. While arguably the Genetic Integrity Act could have effectively functioned prior to the advances in gene editing technology, today it may be regarded as ambiguous and outdated. Hence, risks that ethically contested practices could emerge cannot be excluded. This chapter examines the national laws and policies relating to human germline genome modification in research and in clinical care in Sweden, with due regard to Sweden’s external commitments. Importantly, in light of the ongoing regulatory discussions at the national, European and international fora, it is not obvious that, should European laws become more permissive, and enable human germline genome modification, so would Swedish national law.
The objective of this study was to examine young adults’ healthcare utilisation and its possible association with health literacy.
Many countries struggle with insufficient accessibility at emergency departments (EDs) and primary healthcare centres (PHCs). Young adults, aged 20–29 years old, account for a substantial number of unnecessary doctor visits where health literacy could be an explanatory factor.
This study incorporated a combined retrospective and cross-sectional study design with analysis of registry data, including all registered outpatient doctor visits between 2004 and 2014 (n = 1 086 432), and strategic sample questionnaire data (n = 207), focusing on socio-demographics, symptoms and information-seeking behaviour. Mean differences between first-year and last-year doctor visits for each age group were calculated using registry data. Fischer’s exact test was applied to questionnaire data to analyse group differences between ED and PHC visitors as well as between patients with sufficient health literacy and insufficient health literacy. Binary logistic regression was used to investigate covariation.
Healthcare utilisation has increased among young adults during the past decade, however, not comparatively more than for other age groups. ED patients (n = 49) compared to PHC patients (n = 158) were more likely to seek treatment for gastrointestinal symptoms (P = 0.001), had shorter duration of symptoms (P = 0.001) and sought care more often on the recommendation of a healthcare professional (P = 0.001). Insufficient/problematic health literacy among young adults was associated with having lower reliance on the healthcare system (P = 0.03) and with a greater likelihood of seeking treatment for psychiatric symptoms (P = 0.002).
Young adults do not account for the increase in healthcare utilisation during the last decade to a greater extent than other age groups. Young adults’ reliance on the healthcare system is associated with health literacy, an indicator potentially important for consideration when studying health literacy and its relationship to more effective use of healthcare services.
The Swedish Twin Registry functions as research infrastructure containing information on 216,258 twins born between 1886 and 2015, of whom 86,199 pairs have zygosity determined by DNA, an intrapair similarity algorithm, or being of opposite sex. In essence, practically all twins alive and currently 9 years or older have been invited for participation and donation of DNA on which genomewide single nucleotide polymorphisms array genotyping has been performed. Content, management and alternatives for future improvements are discussed.
The Nordic societies share liberal social values, generous welfare states, sunny hedonism as a kind of secular faith, efficient public institutions, greater equality among classes than in most other Western democracies, high ratings in global surveys of popular happiness, and, until recently at least, a kind of cosmopolitan idealism baked into their respective national identities. Also until about the 1990s, they were more or less culturally homogenous. But in public and electoral attitudes toward Global South, largely Muslim migrant families, they diverge. In Denmark the governing coalition includes a far-right party, and particularly since the notorious affair of Danish cartoons satirizing Muhammad, the government has strongly discouraged asylum-seekers from approaching its doors and does not exert itself to make the settled Muslim population feel at home. In proportion to its population, Sweden took in far more refugees even than Germany during the great surge of 2015, but, despite a well-funded effort, has encountered serious integration problems recorded by liberal and conservative observers. Discourse and policy have become less welcoming. In Norway, smaller and more economically buoyant, the political backlash to Muslim migration is more muted, but integration remains a work in progress.
Chapter 5 – Localizing transformations – discusses sense-making regarding societal transformations in selected local arenas: Praia in Cabo Verde, Guangzhou in China, the city of Nadi and a village in the Yasawa Islands in Fiji, Boulder in the USA, and Östergötland region in Sweden. Chapter 5 presents the case study contexts, including their social, cultural, economic, and geopolitical circumstances of societal transformation and how transformation has been addressed in policy documents. The chapter also present the stories of transformation emerging from 20 focus groups with citizens of these five countries treating, for example, the goals of transformation, engines of social change, the role of top–down versus bottom–up initiatives, and the role of values.
Maintaining good cognitive function with aging may be aided by technology such as computers, tablets, and their applications. Little research so far has investigated whether internet use helps to maintain cognitive function over time.
Two population-based studies with a longitudinal design from 2001/2003 (T1) to 2007/2010 (T2).
Sweden and the Netherlands.
Older adults aged 66 years and above from the Swedish National Study on Ageing and Care (N = 2,564) and from the Longitudinal Aging Study Amsterdam (N = 683).
Internet use was self-reported. Using the scores from the Mini-Mental State Examination (MMSE) from T1 and T2, both a difference score and a significant change index was calculated. Linear and logistic regression analysis were performed with difference score and significant change index, respectively, as the dependent variable and internet use as the independent variable, and adjusted for sex, education, age, living situation, and functional limitations. Using a meta-analytic approach, summary coefficients were calculated across both studies.
Internet use at baseline was 26.4% in Sweden and 13.3% in the Netherlands. Significant cognitive decline over six years amounted to 9.2% in Sweden and 17.0% in the Netherlands. Considering the difference score, the summary linear regression coefficient for internet use was −0.32 (95% CI: −0.62, −0.02). Considering the significant change index, the summary odds ratio for internet use was 0.54 (95% CI: 0.37, 0.78).
The results suggest that internet use might play a role in maintaining cognitive functioning. Further research into the specific activities that older adults are doing on the internet may shine light on this issue.
It is important to recognize that macroeconomic conditions and dynamics were important for the design of Swedish energy policy and that the transformation pressure on the Swedish energy system was exceptionally high by international comparison. Historic decisions, which were governed by a rationality fostered by the circumstances in the 1940s and early 1950s, came to form important structures which affected the outcome of the energy policy in the 1970s and 1980s. The perhaps most striking consequence of this was the emergence of an Environmental Kuznets Curve for carbon with few international counterparts. The transformative change of the Swedish energy system included several steps, which in retrospect seem accidental. The challenge today is to copy the sequence, while at the same time realizing that the structures and historical circumstances that brought about a sequence that was historically determined and of a contingent nature cannot easily serve as a ‘copy and paste’ learning example.
In this chapter, we discuss the evolution of the field of ‘ethics of nuclear energy’, regarding its past, present and future. We will first review the history of this field in the previous four decades, focusing on new and emerging challenges of nuclear energy production and waste disposal, in light of several important developments. Four of the most pressing ethical challenges will be further reviewed in the chapter. First, what is a morally ‘acceptable’ nuclear energy production method, if we consider the existing and possible new technologies? Second, provided a new tendency to consider nuclear waste disposal with several countries, what would be the new ethical and governance challenges of these multinational collaborations? Third, how should we deal with the (safety) challenges of the new geographic distribution of nuclear energy, tilting towards emerging economies with less experience with nuclear technology? Fourth, nuclear energy projects engender highly emotional controversies. Neither ignoring the emotions of the public nor taking them as a reason to prohibit or restrict a technology – we call them technocratic populist pitfalls respectively – seem to be able to guide responsible policy making.
Sweden is often considered a forerunner in family change and developments towards less gendered family production patterns. In this study, we focus on recent developments towards more gender-equal sharing of parental leave in Sweden. We explore how fathers’ use of parental leave has changed over time before and since the turn of the century. As the parental leave benefit is individual and earnings-based, we examine how fathers’ individual socio-economic and demographic characteristics are associated with their parental leave uptake over time, to determine whether there are forerunners and laggards in recent family change. Multinomial logistic regression models were applied to data from national registers. Our study demonstrates a bifurcation in trends in recent decades. This is associated with the extension of reforms that reserve part of the leave for fathers, the so-called “daddy months”, but stretches beyond the impact of any such reforms. Taking a long leave of over two months was pioneered by better-educated residents of metropolitan areas and surrounding suburbs, as well as Swedish-born fathers. Young fathers, low-income earners and foreign-born fathers lagged behind in these developments. We regard the unstable labour market situation of the latter as a contributing factor in widening social inequalities in family-related behaviour.
Patient and public involvement (PPI) is framed as beneficial for individuals and for the health system. However, little is known about the extent of involvement, or of its impact. Based on data from Sweden, we show that apart from voting in regional elections (76%), more people reported involvement as individual patients (23%) than part of collective activities (5%) or activities relating to a citizen perspective (4%). There was no correlation between how many people participated and the estimated impact – which was generally low. More extensive involvement is thus not linked to the potential to influence decisions. We argue that to achieve the benefits associated with PPI it is crucial to understand more about people's motivation for being involved and what underlies low estimates of impact. This requires a more systematic approach to involvement, how it is evaluated and its results communicated to participants and the society. We also argue that a future challenge for the Swedish health system, and for other similar health systems, is to support long-term collective involvement in the midst of growing individualization of health services and involvement opportunities primarily intended for patients.
Whilst much has been written about the opportunities and perils of Green participation in national coalition governments, analysis of Greens supporting minority governments is less common and has not focused on comparative-historical trends as this article does. We look beyond single case studies of Green-supported minority governments in order to establish historical party trajectories and policy impact over time in three countries with different political systems. The extent of the comparative work here has never previously been undertaken and establishes that repeat instances of such support can provide the basis for more stable and effective future interparty governing relationships. However, we argue that, whilst trust can build between parties to minority government arrangements over decades, it is not assured, and, whilst Green parties may achieve ministerial control after repeat instances of supporting minority governments, the benefits of doing so are not guaranteed.
The warrior woman has long been part of the Viking image, with a pedigree that extends from the Valkyries of Old Norse prose and poetry to modern media entertainment. Until recently, however, actual Viking Age evidence for such individuals has been sparse. This article addresses research showing that the individual buried at Birka in an ‘archetypal’ high-status warrior grave—always assumed to be male since its excavation in 1878—is, in fact, biologically female. Publication, in 2017, of the genomic data led to unprecedented public debate about this individual. Here, the authors address in detail the interpretation of the burial, discussing source-critical issues and parallels.
A central argument in theories on women's political interests has been that the sexual division of labor, inter alia, gives women greater experience of responsibility for the care of others, especially children, which in turn influences their political attitudes. However, the specifics of this claim have not been sufficiently examined in prior literature. By applying unique data on Swedish legislators’ subjective policy preferences and use of their parental leave over time, this article explores empirically whether the personal roles of members of parliament (MPs) in reproduction affect their political preferences, regardless of their sex. The analysis reveals that men's interest in social policy tends to increase after being on parental leave while in office, whereas women's interest in social and family policy remains strong, regardless. This finding might indicate a care experience mechanism at work, pertinent also to men, but with a possibly shallower content. The analysis raises the question: are care issues, previously seen as women's issues, now becoming human issues? It further contributes to the discussion on ways to measure gender other than using sex as proxy.
Objectives: The aim of this study was to assess the psychometric properties of a Swedish version of the Hayling test (HT-S) and its clinical utility in a group of patients with different frontotemporal dementia (FTD) syndromes. Early diagnosis of FTD is a challenge and requires a broad arsenal of assessment methods, neuropsychological tests not the least. The Hayling test assesses executive functions including initiation, efficiency and response inhibition. Methods: Seventy-six healthy controls were included as well as patients with the behavioral variant FTD (bvFTD; n = 17), semantic dementia (SD, n = 6), and progressive supranuclear palsy (n = 12). The Color Word Interference Test was administered to examine the construct validity. Results: Age showed a correlation with better performances in younger participants whereas the importance of sex and education were less evident. The split half reliability and internal consistency were equal to, or better, than reported for the original version. The interrater reliability was excellent. The construct validity was supported, nevertheless indicating partly different processes behind the performances of the two tests. The FTD group performed significantly worse than healthy controls on efficiency and response inhibition and there were also significant differences in performances between the syndromes despite small samples. Conclusions: The psychometric properties and clinical utility of the Swedish version are satisfactory for measuring efficiency and response inhibition with results indicating dissimilar profiles in the performances in the different syndromes. These results need to be corroborated in larger samples. (JINS, 2019, 25, 195–203)
The study explored the lived experiences of people with injury events in their residential environment. Participants were 65 people with disabilities and chronic diseases in Sweden with residential living injuries (females = 40 (61.5%), men = 25 (38.5%), age range 20–90 year old). They completed qualitative interviews on their experiences of injury events in their residential environment. Thematic analysis of the data yielded evidence to suggest the following issues: (1) individual coping resource preferences; (2) support services; and (3) family engagement needs. Participants coped utilizing positive reframing of their living with injury and the incidents they experienced. Social support functions were important for safety in the housing environment. Rather disconcerting is the fact that participants would not always tell their social network about the risks and injuries they experienced.
The use of tar and resinous substances dates back far into Scandinavian prehistory. How it was produced, however, was unknown until recent excavations in eastern Sweden revealed funnel-shaped features—now identified as structures for producing tar. A new way of organising tar production appeared in the eighth century AD, leading to large-scale manufacture within outland forests. Intensified Viking Age maritime activities probably increased the demand for tar, which also became an important trade commodity. The transition to intensive tar manufacturing implies new ways of organising production, labour, forest management and transportation, which influenced the structure of Scandinavian society and connected forested outlands with the world economy.
Human burials from the cemetery at the Rounala church, northern Sweden, were radiocarbon (14C) dated to shed light on the use of the cemetery. Carbon, nitrogen and sulfur stable isotope analysis of bone collagen from 19 distinct individuals indicated that these individuals had a mixed diet consisting of freshwater, marine and terrestrial resources. Dietary modeling using FRUITS was employed to calculate the contributions of the different resources for each individual. These data were then used to calculate individual ΔR values, taking into account freshwater and multiple marine reservoir effects, the latter caused by Baltic and Atlantic marine dietary inputs, respectively. 14C dating of tissues from modern freshwater fish species demonstrate a lack of a freshwater reservoir effect in the area. Two OxCal models were used to provide endpoint age estimates. The calibrated data suggest that the site’s cemetery was most likely in use already from the 14th century, and perhaps until at least the late 18th century.