Background

The main aim was to examine whether patients with persistent upper quadrant pain have higher end-point variability in goal directed pointing movements than pain-free controls when the pointing task is performed in total darkness and under full vision. An additional aim was to study associations between the magnitude of end-point variability and a clinical movement control test battery and self-rated functioning among patients.

Methods

Seventeen patients and 17 age- and gender-matched pain-free controls performed a pointing task that evaluated end-point variability of repetitive shoulder movements in horizontal adduction and abduction with full vision, and abduction with no visual information, completed a movement control test battery of neck and shoulder control tests and answered questionnaires.

Results

Patients had higher end point variability for horizontal abduction when performed with no visual information. For horizontal adduction the variability was higher, but only when it was controlled for movement time. No significant correlations were found between end-point variability and self-rated functioning, nor between end-point variability and neuromuscular control of the glenohumeral joint.

Conclusions

This study provides preliminary evidence that patients with persistent neck/shoulder pain can partly compensate proprioceptive deficits in goal-directed arm movement when visual feedback is present.

Objectives: The aim of the present study was to assess physiological and subjective stress markers during a 24-h ambulance work shift and during the next two work-free days, and relate these parameters to self-reported health complaints. Methods: Twenty-six ambulance personnel were followed during a 24-h work shift and during the next two work-free days with electrocardiogram, cortisol assessments and diary notes. The ambulance personnel also performed tests of autonomic reactivity before and at the end of the work shift. The subjects were categorized into two groups according to their number of health complaints. Results: In general, stress markers did not show differences between the work shift and leisure time. However, a modest deviation in heart rate variability pattern and higher morning cortisol values during work in comparison with work-free days were observed in personnel with many health complaints. Conclusions: Subjective and physiological characteristics of ambulance personnel did not indicate distinctive stress during the 24-h work shift. Relationships between frequent health complaints and specific work-related factors require further prospective studies.

The aim of the study was to evaluate the effects of individually prescribed physical exercise programmes on development of fatigue during the carrying of a loaded stretcher up and down the stairs. Nineteen ambulance personnel performed the training for 1 year. Testing occurred before and after 1 year of the training. Both the training group (n = 19) and the control group (n = 15) were assessed for physical capacity and lactate concentration in blood and ratings of perceived exertion during carrying a stretcher on the stairs. When comparisons were made between those who had been training three times/week for 1 year and the control group, lactate concentration was significantly decreased. In conclusion, markers of fatigue during stretcher carrying can be reduced by the use of individually prescribed physical exercise programmes.

The overall aim was to study transgender persons’ experiences of, and reactions upon, attitudes and social norms in relation to their gender identity. Another question that was relevant to answer was how transgender persons are affected by the hetero norm. The method used to collect data was through questionnaires published on the internet. The only requirement to participate was to be a transgender over 18 years old, and when the survey closed, 35 respondents had answered it. The questionnaire consisted of both quantitative and qualitative questions. Collected data were analyzed using descriptive statistics and content analysis.

The results indicate that transgender persons living conditions are largely affected by norms, and that they encounter a considerable amount of negative attitudes due to their gender identity. To "pass" as either man or woman turned out to be something that made it easier for transgender people to evade negative attitudes.

One hope is that this study can provide knowledge to different instances in the community to open up to be more open to critical thinking around norms.

The conclusion was that persons with a transgender identity are affected by societal norms and by heteronormativity. It takes a lot of courage to be able to be one self but everything boils down to how strong a person are and the availability of support and role models in the surrounding society. 

Syftet med studien var att få en djupare förståelse om på vilket sätt läshunden kan bidra till att förbättra barns läsförmåga. Studien använder sig av en metainspirerad innehållsanalys. Metaanalys användes för att samla in information till studien samt att kunna dra slutsatser om tidigare forskning. Innehållsanalys användes för att skapa teman och kodning, med hjälp av innehållsanalys kan man skapa en djupare mening med textens innehåll. Artiklarna från resultatdelen samlades in från vetenskapliga databaser där alla artiklar är peer-reviewe.

Studien undersöker på vilket sätt kan en läshund bidra till att positivt påverka barns läsförmåga? Är det hunden i sig som påverkar barnets läsförmåga eller är det miljön? Resultat visar på att läshunden påverkar barn positivt både psykiskt, fysiskt och socialt. Resultatet visar även på att det är läshunden som påverkar barnen positivt och inte miljön de vistas i under lästiden. Slutsatsen man kan dra av denna studie är att läshunden visar på en positiv påverkan på barn och har givit oss förståelse om på vilket sätt läshunden påverkar barnen.

BACKGROUND: Socioeconomic status (SES) can greatly affect the clinical outcome of medical problems. We sought to assess the in-hospital mortality of patients with the acute coronary syndrome (ACS) according to their SES.

METHODS: All patients admitted to Tehran Heart Center due to 1(st)-time ACS between March 2004 and August 2011 were assessed. The patients who were illiterate/lowly educated (≤5 years attained education) and were unemployed were considered low-SES patients and those who were employed and had high educational levels (>5 years attained education) were regarded as high-SES patients. Demographic, clinical, paraclinical, and in-hospital medical progress data were recorded. Death during the course of hospitalization was considered the end point, and the impact of SES on in-hospital mortality was evaluated.

RESULTS: A total of 6246 hospitalized patients (3290 low SES and 2956 high SES) were included (mean age = 60.3 ± 12.1 years, male = 2772 [44.4%]). Among them, 79 (1.26%) patients died. Univariable analysis showed a significantly higher mortality rate in the low-SES group (1.9% vs. 0.6%; P < 0.001). After adjustment for possible cofounders, SES still showed a significant effect on the in-hospital mortality of the ACS patients in that the high-SES patients had a lower in-hospital mortality rate (odds ratio: 0.304, 95% confidence interval: 0.094-0.980; P = 0.046).

CONCLUSIONS: This study found that patients with low SES were at a higher risk of in-hospital mortality due to the ACS. Furthermore, the results suggest the need for increased availability of jobs as well as improved levels of education as preventive measures to curb the unfolding deaths owing to coronary artery syndrome.

Background

Diverse ethnic groups may differ regarding the risk factors and severity of coronary artery disease (CAD). This study sought to assess the association between ethnicity and CAD risk and severity in six major Iranian ethnic groups.

Methods

In this study, 20,165 documented coronary artery disease patients who underwent coronary angiography at a tertiary referral heart center were recruited. The demographic, laboratory, clinical, and risk factor data of all the patients were retrieved. The Gensini score (an indicator of CAD severity) was calculated for all, and the risk factors and severity of CAD were compared between the ethnical groups, using adjusted standardized residuals, Kruskal–Wallis test, and multivariable regression analysis.

Results

The mean age of the participants (14,131 [70.1%] men and 6034 [29.9%] women) was 60.7 ± 10.8 years. The Fars (8.7%) and Gilak (8.6%) ethnic groups had the highest prevalence of ≥4 simultaneous risk factors. The mean Gensini score was the highest for the Gilaks (77.1 ± 55.9) and the lowest among the Lors (67.5 ± 52.8). The multivariable regression analysis showed that the Gilaks had the worst severity (β 0.056, 95% CI 0.009 to 0.102; P = 0.018), followed by the Torks (β 0.032, 95% CI 0.005 to 0.059; P = 0.020). Meanwhile, the Lors showed the lowest severity (β −0.087, 95% CI −0.146 to −0.027; P = 0.004).

Conclusions

This study found that there was heterogeneity in CAD severity and a diverse distribution in its well-known traditional risk factors among major Iranian ethnic groups.

Background: Current evidence shows inequality in the outcomes of rural and urban patients treated at their place of residence. This study compared in-hospital mortality between rural and urban patients with acute coronary syndrome (ACS) to find whether there were differences in the outcome and received treatment.

Methods: Between May 2007 and January 2018, patients admitted with ACS were included. The patients’ demographic, clinical, and laboratory data, as well as their in-hospital medical courses, were recorded. The association between place of residence (rural/urban) and in-hospital mortality due to ACS was evaluated using logistic regression adjusted for potential confounders.

Results: Of 9088 recruited patients (mean age =61.30±12.25 y; 5557 men [61.1%]), 838 were rural residents. A positive family history of coronary artery disease (P=0.003), smoking (P=0.002), and hyperlipidemia (P=0.026), as well as a higher body mass index (P=0.013), was seen more frequently in the urban patients, while the rural patients had lower education levels (P<0.001) and higher unemployment rates (P=0.009). In-hospital mortality occurred in 135 patients (1.5%): 10 rural (1.2%) and 125 urban (1.5%) patients (P=0.465). The Firth regression model, used to adjust the effects of possible confounders, showed no significant difference concerning in-hospital mortality between the rural and urban patients (OR, 1.57; 95% CI, 0.376 to 7.450; P=0.585).

Conclusion: This study found no significant differences in receiving proper treatment and in-hospital mortality between rural and urban patients with ACS.

Background: Given gender differences in the risk of coronary artery disease (CAD), the present study sought to investigate these dissimilarities amongst patients who underwent angiography at a major, tertiary heart hospital in Iran. Methods: Between 2005 and 2010, 44,820 patients who underwent coronary angiography were enrolled in a registry. Pre-procedural data such as demographics, CAD risk factors, presenting symptoms, and laboratory tests, as well as postprocedural data were collected. The data were, subsequently, compared between the men and women. Results: Out of the 44,820 patients (16,378 women), who underwent coronary angiography, 37,358 patients (11,995 women) had CAD. Amongst the CAD patients, the females were not only significantly older, less educated, and more overweight than were the males but also had higher levels of triglyceride, cholesterol, low-density lipoprotein, highdensity lipoprotein, and fasting blood sugar (P< 0.001). Of all the risk factors, hypertension and diabetes mellitus showed the strongest association in our female CAD patients (OR=3.45, 95%CI: 3.28-3.61 and OR=2.37, 95%CI: 2.26- 2.48, respectively). Acute coronary syndrome was more prevalent in the men (76.1% vs. 68.6%, P< 0.001), and chronic stable angina was more frequent in the females (31.4% vs. 23.9%, P< 0.001). With respect to post-procedural recommendations, the frequency of recommendations for non-invasive modalities was higher in the females (20.1% vs. 18.6%, P< 0.001). Conclusion: Hypertension and diabetes mellitus had the strongest association with CAD in our female patients. In the extensive CAD patients, medical treatment was recommended to the women more often.

Objective:

Sedentary behavior in children is positively associated with an increased risk of both obesity and insulin resistance. Children spend a considerable portion of their awake time in sedentary behavior; however, the pattern of accumulation is not known. Thus the objective of this study was to describe the patterning of sedentary behavior of children at and away from school.

Design and Methods:

The patterns of sedentary time in a sample of 53 children (28 girls) aged 10-12 years during school-term time were examined. Children wore an accelerometer for 1 week. Total sedentary time, prolonged sequences (bouts) of sedentary time, and frequency of active interruptions to sedentary were examined on school days and weekends and within school time and non-school time on school days.

Results:

The data did not support our hypothesis that children accumulated more sedentary time on school days when compared with weekend days (mean [SD]: 64.4% [5.3] vs. 64.9% [9.0], P = 0.686). However, when comparing school time with non-school time on school days, children accumulated more sedentary time at school (66.8% [7.3] vs. 62.4% [5.2], P < 0.001) and spent more time at school in sustained sedentary sequences, that is, uninterrupted sedentary time for 30 min or more (75.6 min [45.8] vs. 45.0 min [26.8], P < 0.002). The children also recorded less breaks per sedentary hour within school time when compared with non-school time (8.9 h⁻¹ vs. 10.2 h⁻¹, P < 0.001).

Conclusion:

Reducing total sedentary time spent both in and out of school remains an important challenge. Interrupting sedentary time more often in the “working” (school) day could also reap important musculoskeletal and metabolic health rewards for children.

Aim To study the leadership and management skills of first-line managers (FLMs) of elderly care and their work environment in Egypt and Sweden. Background FLMs in Egypt and Sweden are directly responsible for staff and quality of care. However, FLMs in Sweden, in elderly care, have smaller units/organizations to manage than do their colleagues in Egypt. Furthermore, family care of the elderly has been the norm in Egypt, but in recent years institutional care has increased, whereas in Sweden, residential living homes have existed for a longer period. Methods A convenience sample of FLMs, 49 from Egypt and 49 from Sweden, answered a questionnaire measuring leadership and management skills, structural and psychological empowerment, job satisfaction and psychosomatic health. Results In both countries, FLMs' perceptions of their leadership and management skills and psychological empowerment were quite high, whereas scores for job satisfaction and psychosomatic health were lower. FLMs had higher values in several factors/study variables in Egypt compared with in Sweden. Conclusion and implications The work environment, both in Egypt and Sweden, needs to be improved to increase FLMs' job satisfaction and decrease stress. The cultural differences and levels of management have an effect on the differences between the two countries.

Meal at school is a part of the school studies and it is important for health, but is also a prerequisite for both learning and enjoyment.  The school meal can provide students an opportunity to recover from their studies but sometimes students perceive the meal situation as stressful. It is important that the food environment at school works well for school children, so they do not have to rush during the meal and they can get the opportunity to eat in peace. The purpose of this study was to investigate how students perceive lunch break at school. If they feel they get enough time to eat and how they feel during the meal situation in the school restaurant. The research approach of this study was qualitative and the method of data collection was focus groups. Data were analyzed as a content analysis. The aim of the study were secondary school students in grade 7 and 9, one class from each grade was selected. The study was conducted at a secondary school in a municipality in Sweden with approximately 210 000 inhabitants. The results of the study show that students at secondary school feel they have enough time to eat lunch, but the lunch break is too short. The meal environment in the school restaurant is perceived as very messy and stressful. The meal situation was experienced as more stressful at grade 7 students than 9th grade students.  The conclusion was that students need longer lunch break and meal environment is perceived as stressful.

Bakgrund: Psykisk ohälsa ökar i Sverige och innefattar oika psykiska diagnoser och ohälsotillstånd som påverkats av samhällets olika uppfattningar om psykisk ohälsa. Schizofreni är en psykossjukdom som hör till psykisk ohälsa och de vanligaste symtomen för schizofreni är vanföreställningar och hallucinationer. Patienter med schizofreni behöver vård och stöd. 

Syftet: Syftet med studien var att beskriva sjuksköterskor inom psykiatrisk verksamhets attityder och erfarenheter i mötet med patienter med schizofreni samt att beskriva de inkluderade artiklarnas undersökningsgrupper.

Metod: En litteraturstudie med deskriptiv design innehållande tolv vetenskapliga artiklar som söktes i databaserna Cinahl och PsycINFO.

Huvudresultat: Resultatet visade att sjuksköterskor beskrev att de hade positiva och negativa attityder mot patienter som har schizofreni. Sjuksköterskorna beskrev att de hade fått nya erfarenheter av att se hur patienter med schizofrenis vardag såg ut och hur självständiga patienterna kan vara. Andra sjukksöterskor menade att patienter med schizofreni bör vårdas på sjukhus för att de ska få den vård och behandling som de kan behöva. Undersökningsgruppen i studien var sjuksköterskor inom den psykiatriska verksamheten. I studien diskuteras de inkluderade artiklarnas undersökningsgrupps ålder, kön samt yrkestitel.

Slutsats: Sjuksköterskorna i de inkluderande artiklarna hade delade meningar om attityder till patienter med schizofreni. Majoriteten av sjuksköterskorna menar att patienter med schizofreni behöver rätt vård,utbildning och stöd från sjukvårdspersonal och familj för att kunna hantera sin livssituation och fullfölja sin behandling.

Syfte: Syftet med denna studie är att genom en litteraturstudie undersöka hur transpersoner upplever inkludering inom fysisk aktivitet och idrott.  Metod: Litteratursökning i databasen Discovery och manuella sökningar av valda källors referenslista resulterade i tio artiklar som publicerats inom de senaste elva åren. Alla artiklar har analyserats, kvalitetsgranskats och sedan sammanställts.   Resultat: De mest framträdande resultatet för fysiska hinder angående transpersoners upplevelse av inkludering var; svårigheterna med offentliga rum och omklädningsrum samt problematiken med träningskläder. De vanligaste psykosociala hindren för transpersoner inom inkludering i fysisk aktivitet och idrott var; förnekad identitet, missnöje med kroppen, diskriminering, mobbning och utanförskap vilket ledde till depression, ångest och rädslor. De främsta fysiska möjligheterna som framkom i resultatet var fördelen med individuella idrotter och könskorrigerande behandling i kombination med fysisk aktivitet. Det centrala resultatet för psykosociala möjligheter påvisades vara socialt stöd och att fysisk aktivitet och idrott bidrog till minskad ångest och ökad glädje hos transpersonerna.   Slutsats: Det går att konstatera att många transpersoner blir diskriminerade på grund av sin sexuella läggning, köns uttryck och könsidentitet. Detta medför att många transpersoner lämnar idrotten och slutar vara fysisk aktiva. Denna studie kom fram till att många av de problem som presenterades i artiklarna grundar sig i idrottens men framförallt samhällets okunskap. Det framkom även att utvecklingen av transpersoners inklusion och deltagande inom fysisk aktivitet och idrott är ett växande område för idrottsrörelsen att ta i tu med. Riksidrottsförbundet bör arbeta mer aktivt med hbtq- frågor för att öka kunskapen och för att få en djupare förståelse för dagens problematik. Detta skulle kunna bidra till att fler transpersoner kan känna trygghet i idrotten, vilket i sin tur skulle medföra att idrottens värdegrund uppfylls.

Background: In 2021, it was estimated that 12.9 percent of Sweden's population had an alcohol or drug-related substance use disorder. Alcohol and drugs cause various harmful effects that pose a danger to health and can also result in economic and social damages. Nurses play a significant role in the recovery and treatment of patients with substancerelated disorders. Nurses may encounter this patient group across all healthcare settings. Previous studies showed that patients experienced a lot of stigmas and negative attitudes during their care. Purpose: This study aimed to describe nurses' experiences of caring for patients with substance-related disorders in inpatient care. Method: A descriptive literature study was conducted, using the PubMed-database to search for articles. The results were based on ten primary studies with a qualitative approach. Main results: Nurses faced challenging caregiving experiences when treating patients with substancerelated disorders. Nurses found it particularly difficult to treat pain. Caring for patients with substance-related disorders was also described as mentally demanding due to increased workloads. The results also highlighted the presence of threats and violence, stigma, and lack of knowledge. Nurses expressed a need for further education and increased support. Conclusion: Nurses´ lack of knowledge and experience were central factors behind the challenges they faced. To improve the quality of care and promote person-centered nursing, further education and support is required. Reducing stigma around substance-related disorders is also crucial in creating a supportive care environment for patients. By increasing knowledge and comprehension, nurses can better address the challenges that arises.

OBJECTIVE: The aim of this study was to investigate the association between presenteeism and absenteeism during the previous year and the current levels of exhaustion and impaired work performance in a Swedish university setting.

METHODS: In a study of 3525 employees, an ordinal logistic regression and general linear model was used to examine the association between presenteeism and absenteeism during the previous year and the current exhaustion and impaired work performance, respectively.

RESULTS: Presenteeism, but not absenteeism, during the previous year independently increased the risk of having moderate or severe exhaustion. Presenteeism, absenteeism, and exhaustion remained positively associated with impaired work performance when health status and other confounders had been adjusted for.

CONCLUSIONS: Presenteeism, but not absenteeism, was associated with exhaustion. Both presenteeism and absenteeism were the salient correlates of impaired work performance.

OBJECTIVE: To examine the associations between SP reported as number of days with SP reported as number of times and to evaluate their responsiveness.

METHODS: The study population (n = 454) consisted of employed individuals, at risk of long-term sickness absence. Correlation analyses were performed to examine associations between the two SP measures and external constructs such as work performance, general health and registered sick leave. Both SP constructs were measured several times to examine responsiveness.

RESULTS: The SP measures are moderately correlated. They moderately correlated with work performance and health status measures. SP reported as number of times seem to be more sensitive than number of days in detecting changes after rehabilitation.

CONCLUSIONS: Numerical or categorical constructs are valid sources of data on SP. However, categorized SP seem to be more responsive.

The purpose of this review was to investigate the association between publication performance and the organizational and psychosocial work environment of academics in a university setting. In 2018 we conducted database searches in Web of Science, Medline and other key journals (hand-searched) from 1990 to 2017 based on population, exposure and outcome framework. We examined reference lists, and after a title and abstract scan and full-text reading we identified studies that were original research and fulfilled our inclusion criteria. Articles were evaluated as having a low, moderate or high risk of bias using a quality assessment form. From the studies (n = 32) identified and synthesized, work-environment characteristics could explain the quality and quantity aspects of publication performance of academics. Management practices, leadership and psychosocial characteristics are influential factors that affect academics’ publication productivity. Most of the reviewed studies were judged to be of moderate quality because of issues of bias, related to the measuring of publication outcome. The findings in the studies reviewed suggest that highly productive research academics and departments significantly tend to be influenced by the organizational and psychosocial characteristics of their working environment. The practical relevance of this review is that it highlights where academics’ performance needs support and how the work environment can be improved to bolster publication productivity.

Background

Low back and neck pain are the most common musculoskeletal disorders worldwide, and imply suffering and substantial societal costs, hence effective interventions are crucial. The aim of this study was to evaluate the cost-effectiveness of manual therapy compared with advice to stay active for working age persons with nonspecific back and/or neck pain.

Methods

The two interventions were: a maximum of 6 manual therapy sessions within 6 weeks, including spinal manipulation/mobilization, massage and stretching, performed by a naprapath (index group), respectively information from a physician on the importance to stay active and on how to cope with pain, according to evidence-based advice, at 2 occasions within 3 weeks (control group). A cost-effectiveness analysis with a societal perspective was performed alongside a randomized controlled trial including 409 persons followed for one year, in 2005. The outcomes were health-related Quality of Life (QoL) encoded from the SF-36 and pain intensity. Direct and indirect costs were calculated based on intervention and medication costs and sickness absence data. An incremental cost per health related QoL was calculated, and sensitivity analyses were performed.

Results

The difference in QoL gains was 0.007 (95% CI − 0.010 to 0.023) and the mean improvement in pain intensity was 0.6 (95% CI 0.068–1.065) in favor of manual therapy after one year. Concerning the QoL outcome, the differences in mean cost per person was estimated at − 437 EUR (95% CI − 1302 to 371) and for the pain outcome the difference was − 635 EUR (95% CI − 1587 to 246) in favor of manual therapy. The results indicate that manual therapy achieves better outcomes at lower costs compared with advice to stay active. The sensitivity analyses were consistent with the main results.

Conclusions

Our results indicate that manual therapy for nonspecific back and/or neck pain is slightly less costly and more beneficial than advice to stay active for this sample of working age persons. Since manual therapy treatment is at least as cost-effective as evidence-based advice from a physician, it may be recommended for neck and low back pain. Further health economic studies that may confirm those findings are warranted.

Trial registration Current Controlled Trials ISRCTN56954776. Retrospectively registered 12 September 2006, http://www.isrctn.com/ISRCTN56954776.

A plant bioreactor has enormous capability as a system that supports many biological activities, that is, production of plant bodies, virus-like particles (VLPs), and vaccines. Foreign gene expression is an efficient mechanism for getting protein vaccines against different human viral and nonviral diseases. Plants make it easy to deal with safe, inexpensive, and provide trouble-free storage. The broad spectrum of safe gene promoters is being used to avoid risk assessments. Engineered virus-based vectors have no side effect. The process can be manipulated as follows: (a) retrieve and select gene encoding, use an antigenic protein from GenBank and/or from a viral-genome sequence, (b) design and construct hybrid-virus vectors (viral vector with a gene of interest) eventually flanked by plant-specific genetic regulatory elements for constitutive expression for obtaining chimeric virus, (c) gene transformation and/or transfection, for transient expression, into a plant host model, that is, tobacco, to get protocols processed positively, and then moving into edible host plants, (d) confirmation of protein expression by bioassay, PCR-associated tests (RT-PCR), Northern and Western blotting analysis, and serological assay (ELISA), (e) expression for adjuvant recombinant protein seeking better antigenicity, (f) extraction and purification of expressed protein for identification and dosing, (g) antigenicity capability evaluated using parental or oral delivery in animal models (mice and/or rabbit immunization), and (h) growing of construct-treated edible crops in protective green houses. Some successful cases of heterologous gene-expressed protein, as edible vaccine, are being discussed, that is, hepatitis C virus (HCV). R9 mimotope, also named hypervariable region 1 (HVR1), was derived from the HVR1 of HCV. It was used as a potential neutralizing epitope of HCV. The mimotope was expressed using cucumber mosaic virus coat protein (CP), alfalfa mosaic virus CP P3/RNA3, and tobacco mosaic virus (TMV) CP tobacco mild green mosaic virus (TMGMV) CP as expression vectors into tobacco plants. Expressed recombinant protein has not only been confirmed as a therapeutic but also as a diagnostic tool. Herpes simplex virus 2 (HSV-2), HSV-2 gD, and HSV-2 VP16 subunits were transfected into tobacco plants, using TMV CP TMGMV CP expression vectors.

Background: Schizophrenia is a form of psychosis, it is rare but a very serious disease and the lifetime risk of becoming sick is 0.8% in Sweden. People with schizophrenia experience altered perception of reality because of symptoms such as hallucinations and delusions. Many relatives of people with schizophrenia argue that there is a lack of knowledge that leads to distorted view of themselves and the environment. The diagnosis of schizophrenia is based on symptoms, which consequently means that nurses have an important role which should include plenty hospitality, communication and understanding of patients' quality of life.

Aim: The aim of this study is to describe how people with schizophrenia experience their quality of life and to describe the method of selection of the articles included.

Method: The present study has a descriptive design and contains a total of 12 articles with qualitative and quantitative effort. The majority of the articles that have been used has the qualitative approach. Data collection has been conducted via PsycINFO.

Main Results: The diagnosis of schizophrenia contributed to confusion and difficulties to accept their disease. Symptoms and side effects of the medicine were the most conspicuous factors that resulted in the loss. Experiences of stigmatization and rejection by the environment were also a contributing factor for a poorer quality of life. The 12 included articles have mainly used the interviews to reach people's subjective experiences of living with schizophrenia.

Conclusion: Schizophrenia affects people's daily lives and relationships with other people negatively which led to the suffering and poorer quality of life. Knowledge of how people with schizophrenia experience their quality of life is important information for nurses that can lead to greater understanding, better reception, care and treatment.

Background: Human error and deficient non-technical skills (NTSs) among providers of ALS in helicopter emergency medical services (HEMS) is a threat to patient and operational safety. Skills can be improved through simulation-based training and assessment. Objective: To document the current level of simulation-based training and assessment of seven generic NTSs in crew members in the Norwegian HEMS. Methods: A cross-sectional survey, either electronic or paper-based, of all 207 physicians, HEMS crew members (HCMs) and pilots working in the civilian Norwegian HEMS (11 bases), between 8 May and 25 July 2012. Results: The response rate was 82% (n=193). A large proportion of each of the professional groups lacked simulation-based training and assessment of their NTSs. Compared with pilots and HCMs, physicians undergo statistically significantly less frequent simulation-based training and assessment of their NTSs. Fifty out of 82 (61%) physicians were on call for more than 72 consecutive hours on a regular basis. Of these, 79% did not have any training in coping with fatigue. In contrast, 72 out of 73 (99%) pilots and HCMs were on call for more than 3 days in a row. Of these, 54% did not have any training in coping with fatigue. Conclusions: Our study indicates a lack of simulation-based training and assessment. Pilots and HCMs train and are assessed more frequently than physicians. All professional groups are on call for extended hours, but receive limited training in how to cope with fatigue.

Background: Obesity is now a growing problem in the world and as a result, several do gastric bypass surgery for weight loss. It is important that the experiences from a physical, mental and social approach is illuminated to provide a better understanding and to help them to right direction.

Aim: To describe the experience situation of life a one person after doing a gastric bypass surgery from a physical, psychological and social perspective.

Method: A descriptive study of eleven scientific articles.

Results: After a gastric bypass, the people have a more positive attitude towards life according the three perspectives. They experienced that they fit into society and could participate in the social and physical context in a better way than before. Sometime after the surgery, the participants experienced that they were back into the old habits which gave them a worse quality of life. They ment that the operation was a tool but the hard part remained and they expected a challenge, as some managed better than others.

Conclusions: It is important to give people good support, and information to enable them to preserve their new lifestyle. They are making a great mental effort, therefore they are indeed of psychotherapy and guidence to find a suitable copingstrategy to handle different situations.

Background: Diabetes mellitus is a chronic metabolic disease that has risen from 108 million to 422 million between 1980 and 2014. The disease is caused by elevated levels of glucose in the bloodstream related to insulin deficiency or insulin-resistant tissue cells. The disease requires lifelong medical treatment and adherence to healthy lifestyles. Health professionals have an important role in the development of the person's ability to coexist with the disease.

Purpose: to describe person's experiences of living with diabetes mellitus. 

Method: a descriptive literature review based on 15 qualitative studies relevant to the purpose of the study. Databases PubMed and CINAHL were used when searching for relevant scientific studies. 

Main result: Coexistence with diabetes mellitus requires an approach to healthy lifestyles and follow-up of medical recommendations, which affects the person's quality of life and well-being in different ways. Person with diabetes saw health professionals and family have a supporting role in managing diabetes. 

Conclusion: Diabetes mellitus is a chronic disease that affects a person's state of health and quality of life. Person`s experience a lack of knowledge related to lack of information and guidance from caregivers. In order to achieve good quality of life and well-being in patients, it is important that nurses carry out their work based on person-centered nursing.

Background: Health-related infections (HRI) are the most frequent occurring care damages in inpatient care. HRI’s does not only impact the individual patient, but it also creates high costs and causes high levels of stress at the organization, as well as the community level. Nurses’ application of and compliance with evidence-based guidelines regarding basic hygiene routines is the most effective way to prevent HRI. An examination of the various factors that contributes to the lack of compliance with the different guidelines are crucial in order to increase the theoretical and practical knowledge amongst nurses. This automatically leads to the performing of a safer patient care.

Aim: The purpose of this literature study was to identify and describe the various factors that may impact the nurse's compliance with basic hygiene routines in the prevention of healthcare related infections and to describe the data collection methods in the academic literature.

Method: A descriptive literature study with results from 12 scientific articles. The literature research was performed in the databases PubMed and Cinahl. The articles were also reviewed based on their data collection method.

Main results: Several factors contributed to how the nurses followed evidence-based guidelines regarding basic hygiene routines. The accessibility that nurses had to hygiene products was a primary cause. Lack of knowledge, time shortage, and high workload were additional causes as to why the basic hygiene routines were not properly performed. Contrary to this, good colleagues, good communication, and a safe workplace proved to be factors with a positive impact on preventive work. Surveys, observations and combined data collection methods were used in the included scientific articles.

Conclusion: There are several factors that affect nurses compliance with guidelines regarding basic hygiene routines. By creating awareness among nurses regarding these factors, they are given the possibility of improving the preventive work against HRI.

Syfte:

Syftet med föreliggande litteraturstudie var att beskriva patienters skattade livskvalitet

med SF-36, i väntan på levertransplantation samt efter levertransplantation.

Metod:

En beskrivande litteraturstudie med 11 kvantitativa artiklar, som efter sökning i

databaserna PubMed och Cinahl inkluderats.

Huvudresultat:

I fyra av åtta kategorier i SF-36 ligger samtliga patienters skattningar i

väntan på levertransplantation under 50 av 100 möjliga poäng. Social funktion var den

kategorin i SF-36, där livskvaliteten skattades högst hos patienter i väntan på

levertransplantation.

I fem av åtta kategorier ligger samtliga patienters skattningar efter levertransplantation över

50 av 100 möjliga poäng. Fysisk- och social funktion är de kategorier i SF-36, där patienter

efter levertransplantation skattar sin livskvalitet högst.

Slutsats:

Föreliggande litteraturstudies resultat kan ge en förståelse av livskvalitet hos

patienter i väntan på levertransplantation och efter levertransplantation. Detta kan

sjuksköterskan använda för att stötta patienter som skattar sin livskvalitet lågt. Tillsammans

med kvalitativ forskning kan sjuksköterskan få djupare kunskap i och med patienternas egna

upplevda livskvalitet. Detta är viktigt för att sjuksköterskan ska kunna individualisera

omvårdnadsarbetet.

Bakgrund: Sverige var det första landet i världen att förbjuda våld mot barn. Trots denna lag har idag vart sjunde barn någon gång blivit utsatt för våld av en vuxen. Flera undersökningar visar att den vanligaste platsen där barn blir utsatta är i hemmet där förövaren är en vuxen i familjen. När barnet förövats sin trygghet i familjen är det statens skyldighet att skydda och stödja barnet. All hälso- och sjukvårdpersonal har enligt lag skyldighet att anmäla vid misstanke om ett barn far illa, där sjuksköterskan är en nyckelperson i mötet med familjen och barnet. Att agera på misstanke om misshandel är avgörande för att säkerställa barnets välbefinnande och framtida trygghet, dessvärre visar statistik på att bara en liten del av alla misshandelsbrott mot barn rapporteras.

Syfte: Att beskriva sjuksköterskan upplevelser av att hantera situationer där våld mot barn misstänks i familjen. 

Introduction: Tens of thousands of children die every day across the world, some of which die at hospitals. Nurses form relationships with mutual influence to children they care for. Caring relationships are also formed with adult patients. When adult patients die, nurses experience negative emotions and use coping. They consider elders' deaths to be easier to cope with than those of younger patients. Method: A narrative literature review based on the results of 11 articles with qualitative data. Identified data units have been translated, coded and organized thematically. Results: Nurses experienced negative feelings such as helplessness, sadness, grief and guilt. The emotions could be exacerbated by attachment to the child and to the dead child’s family, as well as professional experience. The death of a child could be perceived as a professional failure and nurses felt unprepared by their earlier education. They used cognitive and behavioral strategies to cope with feelings and situations that related to the death of children. Conclusion: Nurses experienced the death of children as negative and painful. To cope with the incident, nurses use coping strategies. They felt unprepared to face and cope with the death of children and should therefore be offered education regarding this.

Introduction: Statistics show that 8% of all licensed nurses do not work in healthcare. Causes are high workload and work-related stress. Previous research presents that workplaces proactively work for the well-being of staff have more prosperous employees. Without the feeling of well-being of the nurse, patient safety and the quality of care will be worse.

Aim: Aim to describe the primary care nurse’s assessment of the psychosocial work environment and well-being and study the relationship between these variables.

Method: A quantitative cross-sectional study with descriptive and correlational design. A total of 170 questionnaires were sent out to nurses and district nurses working in regionally managed and privately owned primary care in Central Sweden. Response rate: 58%. Instrument used; Factors perceived stress symptoms, Thriving Scale, Copenhagen Psychosocial Questionnaire Version III.

Result: Strong correlation between high work-privacy conflicts and higher stress symptoms were seen, this means the variables co-vary negatively. High work pace correlates negatively with stress symptoms. Positive correlation was seen between feeling pride in the organization and well-being, vitality, learning and thriving at the workplace. Vitality and learning were rated high, which indicates high levels of thriving.

Conclusion: Several statistically significant relationships between psychosocial work environments and well-being were found. This implies that psychosocial work environment affects primary care nurse’s well-being. It underlines the importance of organizations prioritizing creating a sustainable work environment for the well-being to be preserved and improved.

Background Diabetes mellitus type 2 is a condition that is increasing in the world and targets the youth. There is much that the patients can do themselves to influence the disease in form of self-care, for example through physical activity. Aim The aim was to describe the effect of physical activity on adult patients with type 2 diabetes mellitus. Method This was a literature study in which 11 original articles with a quantitative approach had been reviewed and analyzed. Results Physical activity improved both bodily functions, biomedical markers and patients’ quality of life. The results were influenced by the type of exercise and intensity of physical activity they practiced. Hypoglycemic drug inhibited the good results of physical activity. Conclusion Physical activity was a effective form of treatment where the most favorable results were shown. The effect depended on the form of exercise, intensity and the patients’ compliance. As a nurse it can be important to motivate, inform and support the patients towards a healthier lifestyle.

Background:

Stroke is an endemic disease, which in Sweden approximately 30 000 persons yearly are taken by and is estimated to cost society around 18 billion Swedish kronor (SEK). Dysphagia (eating difficulty in swallowing) is a common and known disorder in stroke patients. Dysphagia is not a disease itself, but rather a symptom of something underlying for example stroke. Dysphagia can lead to malnutrition and the risk of increased mortality.

Background. It is well known that socioeconomic indicators, such as income and education, predict both stroke incidence and stroke mortality. This means that persons in lower socioeconomic positions are less likely to survive their stroke, and there will be a selective survival in the group discharged from hospital after their first stroke. Question. Does socioeconomic position continue to predict mortality, stroke specific, or from other causes, among patients surviving their first stroke in spite of this selective survival? Methods. All persons in Sweden aged 40–59 years who were discharged after a first hospitalization for stroke in 1996–2000 were included (n = 10,487), then followed up until the end of the fourth calendar year after discharge. Data were analysed with Cox regressions controlling for age, sex, and stroke type. Results. Persons with high socioeconomic position, measured by education and income, have lower mortality than those of low position. Education was not significant when adjusted for income, however. The risk of dying was similar for stroke-specific mortality and all-cause mortality, for those with cerebral infarction as well as for all patients. Conclusions. Socioeconomic position predicted stroke-specific mortality also in the selective group of persons who survived their first stroke.

Aim: The aim of this literature study was to describe the nurse experience and coping strategies working with cancer ill children and to analyze the included articles data collection method.

Method: A descripted literature study with qualitative approach. Eleven articles were included, nine qualitative, one quantitative and one with a mixed method. The articles were found through the database PubMed and Cinahl between the years 2005 to 2015.

Result: Five main themes were found: The nurse experience of working with cancer ill children, communications difficulties with the children and their families, difficulties about the work, and palliative care and death, the nurse coping strategies of working with cancer ill children. The nurses handled it with different coping strategies such as talking with colleges about their experiences. The nurses also had to take control over their own emotions. The data collection methods the included articles used were; semi-structed-, unstructed-, depth- and focus- groups interviews, surveys. One method, participants were responding to one question.

Conclusion: The nurse in pediatric oncology unit, daily faces seriously ill children. Emotional stress is something that the nurse must manage as he/she often faces difficulties and sad situations. The nurse manages these pressures by making use of different coping strategies. Despite these difficulties, the nurse experiences a lot of happiness and thankfulness in her profession.

Introduktion: Sömn är en viktig bidragande faktor för människans återhämtning och välmående. Sömnproblem är vanligt förekommande hos personer med ASD och ADHD och kan orsaka ökade svårigheter med koncentration, psykisk ohälsa och funktionsförmåga. Personer med ASD och ADHD behöver förutsättningar och verktyg för att bättre kunna hantera sin sömn genom egenvård.

Syfte: Att beskriva egenvård för att främja sömn hos tonåringar och vuxna med ASD eller ADHD. 

Metod: En litteraturstudie med deskriptiv design grundades på 11 vetenskapliga artiklar som söktes fram i databaserna Pubmed, Cinahl och PsychINFO.

Huvudresultat: Resultatet visade flera alternativ till egenvård för att främja sömn hos tonåringar och vuxna med ASD eller ADHD. Egenvård genom sömnhygien och tyngdtäcken visade en övervägande positiv inverkan på personernas sömn, men även andra egenvårdsåtgärder så som mindfulness, fysisk aktivitet och sensoriska intryck via bland annat kläder, mat och familjära ljud, dofter eller föremål hade en sömnfrämjade effekt för en del av personerna. Undersökningsgrupperna bestod av personer från den generella befolkningen, slutna vårdavdelningar och öppenvårdsmottagningar som varierade i ålder, kön och diagnoser.

Slutsats: Vilka egenvårdsåtgärder som fungerar för personer med ASD och ADHD varierar för varje enskild person. Hjälpsamma åtgärder kan exempelvis innefatta förbättrade sömnhygiensvanor, användning av tyngdtäcken eller sensoriska stimuli samt olika aktiviteter innehållande bland annat fysisk aktivitet, rogivande kvällsaktiviteter eller mindfulness. Individanpassat egenvårdstöd och eventuell närståendeutbildning inom egenvårdsstöd är värdefullt för att skapa och upprätthålla en fungerande handlingsplan för att främja sömn.

The purpose of the study was to describe what attitudes there were among recipients and donors about the guiding principles that should comply with oocyte- and sperm donation. The purpose was also to investigate if there were any differences within the groups of recipient women and men and the donor group considering disclosure to the child about their origin.

The study became a part of a national project. Data were collected with questionnaire that included earlier described aspects. It was formed with statements to take stands towards in form of “agree” or “disagree”. Number of participants were 333 and data were collected from April 2005 until spring 2008.

The main results found that among donors and the attitudes toward the child’s right to get knowledge about their origin showed that women was significantly more positive in several aspects then the men. The results also showed that considering the guiding principles that should comply with gametes donation the recipients and donors had just about similar attitudes. For the recipients there was only the women who had a significant difference in one of the statements, otherwise there was no difference in either of both groups for the attitudes about disclosure to the child.

Venepuncture and the insertion of peripheral venous catheters are common tasks in health care, and training in these procedures is included in nursing programmes. Evidence of nursing students’ knowledge and skills in these procedures is limited. The main aim of this study was to assess nursing students’ knowledge and skills when performing venepuncture and inserting peripheral venous catheters. Potential associations between level of knowledge and skills, self-training, self-efficacy, and demographic characteristics were also investigated. The assessment was performed by lecturers at a university college in Sweden using the two previously tested instruments "Assess Venepuncture"€ and "Assess Peripheral Venous Catheter Insertion". Between 81% and 100% of steps were carried out correctly by the students. The step with the highest rating was "€œUses gloves", and lowest rating was "€˜Informs the patients about the possibility of obtaining local anaesthesia"€™. Significant correlations between degree of self-training and correct performance were found in the group of students who registered their self-training. No associations between demographic characteristics and correct performances were found. Assessing that students have achieved adequate levels of knowledge and skills in these procedures at different levels of the nursing education is of importance to prevent complications and support patient safety.

Purpose: Performing venepuncture is one of the most routinely performed invasive procedures in nursing care. The aim of this study was to develop instruments for the assessment of nursing students' knowledge and skills when performing venepuncture and inserting a peripheral venous catheter. 
Methods: Two instruments were developed using the following steps. 1) Assessment items of importance for the procedures (venepuncture 48 items and peripheral venous catheter 51 items) were collected from focus groups including nurses, lecturers and patients. 2) The number of items was reduced using a method based on the Delphi method. Experts (n=51) reviewed the instruments in two rounds. The revised versions included 31 items for venepuncture and 33 items for peripheral venous catheter insertion. 3) Usability tests were conducted by nurses who tested the instruments to confirm that items were possible to assess. 4) Inter-rater reliability was assessed by twelve lecturers who in pairs, but independently of each other, used the instruments to assess 50 nursing students. 
Results: Proportion of agreement and Cohen's kappa coefficient were calculated for each item to determine inter-rater reliability. Among the tested items for both instruments, the median proportion of agreement was 1 (range 0.66-1) and the median kappa was 0.52 (range 0.22-1). 
Conclusions: The instruments developed for assessing nursing students' knowledge and skills of venepuncture and peripheral venous catheter insertion showed satisfactory inter-rater reliability.

Background: About 50 years ago, self-injurious behavior was considered rare, a symptom associated with psychosis or suicidal thoughts. In today's society, self-injurious behavior is a widespread phenomenon, especially among adolescents and adults dealing with mental illness in different ages. 

Aim: The aim of this literature study was to describe and compile nurses' experiences of caring for patients with self-injurious behavior. 

Method: A descriptive literature study made up of ten scientific articles.

Main results: Nurses in the care of patients with self-injurious behavior described experiences of relationship-building care, the importance of specific knowledge, empathy and professional distance, and the support from colleagues. 

Conclusion: The results of the literature study showed that several different components were important, these were; relationship-building care, lack of time and staff, the support of colleagues, the importance of specific knowledge as well as empathy and professional distance. These components form the basis for the nurse, to the best of her ability, to care for patients with self-injurious behavior in an adequate way of working. 

The aim of this study was to investigate how professionals in nature-based interventions work to promote mental health. The study focused on how professionals find that nature-based interventions are a complement to the traditional therapy for preventing mental illness and promoting mental health. It also addresses what challenges exist in maintaining   of nature-based interventions. Methods: This is a qualitative, inductive study where semi-structured interviews were used. The interviews with five professionals were recorded to facilitate transcription and after that a systematic thematic analysis was started to find patterns and codes in the respondents' answers. The results from this study showed the importance of having both preventive and promotional interventions and that the activities performed are meaningful. Gardening, nature and animalassisted therapy were central activities. It is a stress-free environment, focusing on the  individual in the group. The challenges for the businesses are lack of support from society and traditional health care. Many people have been helped by nature-based interventions as a  complement to traditional therapy.  Conclusion: Mental health is an important issue to tackle and therefore supplementary treatment is needed. Nature-based interventions are needed as a complement to traditional therapy to prevent mental illness and promote mental health. 

Pain is a phenomenon which not only affects patients physically but also mentally. Women who have undergone mastectomy feel that pain affects their quality of life. Mood swings, poor sleep, depression, anxiety and physical impairments are common symptoms that result in postoperative pain. The purpose: The purpose of this study was to illustrate what different treatments and nursing treatments the nurse can give in pain after mastectomy. Method: The study was conducted as a literature study where the authors examined sixteen scientific studies. Results: The results of the study showed that good communication, information, and the nurse's knowledge are vital to be able to provide adequate pain treatment. Concern reinforces the post-operative pain, and through early secures the patients anxiety and depression can be avoided. Concrete treatment methods with good effect on the pain that emerges in this study are individual rehabilitation, PCA pump, and that early outcomes in many cases contributes to a better quality of life. What also emerged in the study was the lack of research into practical treatments, despite high demand.

Background Managers’ work, working conditions and wellbeing are important determinants of occupational health in organizations. Nevertheless, little research has investigated these factors in the context of small growing businesses, which are known to contribute to employment, economic growth and social stability. The aim of this thesis was to explore managers’ work, working conditions and wellbeing in the context of small businesses with profitable growth. 

Methods Study I used a cross-sectional design to assess patterns in managerial work activities and leadership behaviours. Studies II–IV used qualitative interviews with managers (II–IV) and employees (II) to explore the effects of managers’ wellbeing on their leadership (II), their working conditions (III), and changes in their working conditions and wellbeing in the context of growing small businesses (IV).

Results Managers worked long hours, posing risks for occupational health, but also adopted work practices that bolster occupational health. Firm size matters for managerial work. Managers’ wellbeing reflected in their mood and energy levels and influenced their leadership behaviours and performance, and the company’s work environment. Managers were more constructive when they felt well, and more passively destructive when they felt unwell. Certain factors mitigated the consequences of their negative behaviours in the organization. Five types of managers’ demands and resources (daily managerial work; achievement of results; and social; organizational; and individual factors) were identified, where the specificity of the small business context revealed unique characteristics. Company growth changed managers’ experiences of working conditions and wellbeing.

Conclusions The specific context of small growing businesses shaped managers’ work, working conditions and wellbeing and the interplay between them. Dynamism in the organizational context due to growth had implications for managers’ work, working conditions and wellbeing.

Purpose

Given the importance of small businesses for society, and the significance of managers’ wellbeing for employee health, leadership, and business performance, more knowledge is needed on the sources of managers’ wellbeing. This study explored factors within the small business context that were perceived by managers to hinder or enable their wellbeing.

Methods

Data were collected through qualitative semi-structured interviews with 20 managers from 12 small companies, and analysed with content analysis.

Results

The factors that these managers in small businesses experienced as enhancing or hindering their personal wellbeing covered five categories: demands and resources in the daily managerial work, achievement of results, social factors, organizational factors, and individual factors.

Conclusions

The specific context of managerial work in small companies encompasses unique factors. For instance, the small company managers’ wellbeing was affected by vulnerability due to the smallness of the business and the absence of available resources. Simultaneously, a small company context provided a strong social climate and close relationships with employees and customers that strengthened the managers’ wellbeing. The findings suggest that the availability of financial, personnel, and organizational resources varies between small companies of different size, which may have implications for small business managers’ work and wellbeing.

BACKGROUND:There is a growing interest in managers’ wellbeing due to the observed associations between their wellbeing and leadership behaviours, and between leadership behaviours and employees’ wellbeing. However, it is still unclear how managers’ wellbeing influences their practiced leadership across different workplace contexts, which specific behaviours are affected, and how this varies across time.

OBJECTIVE:The purpose of this study was therefore to explore managers’ and employees’ experiences and perceptions regarding the consequences of managers’ wellbeing for their leadership behaviours in small businesses.

METHODS:Semi-structured interviews were conducted with 37 participants (19 managers and 18 employees) working at 12 Swedish small firms, and analysed using content analysis.

RESULTS:The findings show that managers were more constructive when they felt well, and more passively destructive when unwell. Variations in managers’ wellbeing influenced their mood, energy level, and performance, as well as the company’s working climate. However, these destructive leadership variations did not have a substantial impact, because several protective factors were present.

CONCLUSION:This study shows that the wellbeing of managers in small businesses has perceptible consequences for their leadership behaviours. The study also shows that sustained leadership behaviours may coexist with temporary variations of these behaviours on a constructive-destructive continuum depending on the leader’s wellbeing. Overall, the findings contribute to a more nuanced and dynamic understanding of how the interaction between managers’ wellbeing and their behaviours unfolds in the particular context of small companies.

Purpose

In view of the importance of managers’ wellbeing for their leadership behaviour, employee health, and business effectiveness and survival, a better understanding of managers’ wellbeing and working conditions is important for creating healthy and sustainable businesses. Previous research has mostly provided a static picture of managers’ wellbeing and work in the context of small businesses, missing the variability and dynamism that is characteristic of this context. Therefore, the purpose of this study is to explore how managers in small companies perceive their working conditions and wellbeing in the context of business growth.

Methods

The study is based on qualitative semi-structured interviews with 20 managers from twelve small companies. Content and thematic analysis were applied.

Results

The findings indicate that a manager’s working environment evolves from its initial stages and through the company’s growth, leading to variations over time in the manager’s experiences of wellbeing and work–life balance as well as changes in job demands and resources. Managers’ working situation becomes less demanding and more manageable when workloads and working hours are reduced and a better work–life balance is achieved. The perceived improvement is related to changes in organizational factors (e.g. company resources), but also to individual factors (e.g. managers’ increased awareness of the importance of a sustainable work situation). However, there were differences in how the working conditions and wellbeing changed over time and how organizational and individual resources affected the studied managers’ wellbeing.

Conclusions

This study shows that, in the context of small business, managers’ working conditions and wellbeing are dynamic and are linked to growth-related changes that occur from the start of organizational activities and during periods of growth. In addition, the findings suggest that changes in managers’ working conditions and wellbeing follow different trajectories over time because of the interaction between organizational and personal factors.