Organisationsklimat för högt luftfartsskydd vid flygplatsarbete. Utveckling av Airdrome Security Climate Questionnaire (ADSECQ)

En viktig förutsättning för att flygtrafiken ska kunna bedrivas säkert är att personer och farliga, förbjudna föremål som kan hota luftfartsskyddet inte ges tillträde till flygplatsens behörighetsområden eller till flygplanen eller utrustning eller funktioner som är betydelsefulla för flygplanens säkerhet. För att säkerställa detta finns säkerhetsledningssystem på flygplatserna. Dessa system omfattar såväl tekniska delsystem för säkerhetskontroll, som rutiner och procedurer för upprätthållande och utveckling av hög nivå på luftfartsskyddet. De anställda på flygplatsen har därmed en avgörande betydelse för luftfartsskyddet, och alltså blir inte bara tekniska och strukturella utan även individuella och sociala fenomen viktiga att beakta. De sociala förutsättningarna handlar om hur sociala normer med betydelse för luftfartsskyddet ser ut och utvecklas på arbetsplatsen. Sådana normer utvecklas på basis av vad de anställda uppfattar som viktiga värden i organisationen och gruppen, och dessa bedömningar baseras i hög grad på perceptioner (det man kan uppfatta med sina sinnen) och erfarenheter från det dagliga arbetet. Här blir fenomen som organisationskultur och organisationsklimat betydelsefulla. En förutsättning för att kunna arbeta med att utveckla organisationsklimatet så att det än bättre stöder en hög nivå på luftfartsskyddet vid flygplatsarbetet är att man kan skaffa sig en uppfattning om karaktären på säkerhetsklimatet för luftfartsskydd. Är det högt eller lågt? Vilka är de svaga punkterna, som behöver utvecklas? Och vilka är de starka sidorna, som man bör gynna ytterligare? Ett sätt att mäta säkerhetsklimat är genom enkät. Denna rapport ger en teoretisk bakgrund till begreppet säkerhetsklimat och beskriver utvecklingen av ett enkätinstrument för att mäta luftfartsskyddsklimat vid flygplatsarbete; Airdrome Security Climate Questionnaire, ADSECQ.Projektet har genomförts på uppdrag av Swedavia, som även finansierat det. Fullskalestudien administrerades av Maria Bergh och Anette Wedin, COWI AB, som även bidragit med viss text om fullskalestudien i denna rapport

Just like a virus, change is spreading - A qualitative study exploring how continuous change within a logistic company is perceived and executed by managers

Purpose: Together with a large logistic organisation, this paper investigates a change, called project S. This study explores the perspectives of the managers within the chosen case company, how they perceived, executed the change and how they experienced the effectiveness and sustainability of project S. Based on previous research, the various factors and the complexity of change, organisational change is vital to explore in order to pursue a better understanding of the processes. The purpose of this study is to provide a deeper understanding of how the managers perceived the change by exploring their lived experiences. Theory: This study applies Røvik’s (2011) virus theory providing six different stages of change in the phases of infectiousness, immunity, replication, incubation, mutation and dormancy. Røvik’s approach on organisational change provides a deeper understanding of the processes of change through different stages and the various challenges it might face. Method: The method used is a qualitative one, being 16 semi-structured interviews with managers at the logistic company. After collecting the empirical data, coding using thematization was used in order to discover patterns that can relate to the theory. Results: The main findings resulted in a thematic analysis creating themes connected to leadership in transition, communication through change and closure of continuous change. Within these themes, sub-themes were discovered and used to gain both a deeper understanding and a more elaborative result. The concise conclusion of the managers experiences, of project S with its sustainability and effectiveness, show connection to enhanced leadership style and adjusted communication techniques

The weekend matters: Relationships between stress recovery and affective experiences

Non-work experiences during the weekend provide opportunities to recover from work demands and to replenish lost resources. This longitudinal study examined how specific recovery experiences during the weekend (relaxation, mastery, control, and detachment), as well as non-work hassles, were associated with specific positive and negative affective states during the following workweek. Participants (N 1⁄4 229) completed surveys before the week- end, during the weekend, and during the following workweek. Hierarchical regression analyses revealed that after controlling for affective states the previous week, recovery experiences during the weekend significantly explained variance in affective states at the end of the weekend and during the following workweek. Suggestions for future research include a closer examination of the role of individual differences, self-regulation, and specific work demands in employee stress recovery

Early restorative rehabilitation of children and adolescents with amelogenesis imperfecta

Amelogenesis imperfecta (AI) is a rare, genetically determined defect in enamel mineralization. Patients with (AI) can present with rapid tooth loss or fractures of enamel and dental sensitivity as well as alterations in enamel thickness, color, and shape. These factors may compromise esthetic appearance and masticatory function. Existing treatment recommendations suggest using resin composite restorations until adulthood, although such restorations have a limited longevity. The main aims of this thesis were to compare oral health and the quality and longevity of dental restorations in a group of young patients with AI to a control group. Second, this work aimed to compare the quality and longevity of two crown types, Procera and IPS e.max Press, in adolescents and young adults with AI and to document any adverse events. A third aim was to study oral health-related quality of life (OHRQoL), dental fear, and dental beliefs before and after early prosthetic crown therapy. Finally, we aimed to explore the experiences and perceptions of adolescents and young adults living with AI and receiving early prosthetic therapy. Study I examined the oral health and the quality and longevity of dental restorations in 82 patients with AI, 40 boys and 42 girls, 6 to 25 years old (mean age 14.5±4.3 years) and a control group matched in age, gender and area of residence. Annual mean number of dental visits in the AI group was 2.9±1.7 compared to 1.9±1.2 in the control group (p<0.001). The number of decayed, missing and filled surfaces was 8.1±15.6 in the AI group compared to 1.0±2.0 in the control group (p<0.001). The longevity of dental restorations was significantly lower in the patients with AI, with 24.7±35.1% of the AI group requiring replacement of fillings during the observation period compared to 9.2±23.7% in the control group (p<0.001). Patients with hypomineralized/hypomatured AI had restorations of shorter longevity than those with hypoplastic AI (p<0.01). Porcelain crowns had significantly longer survival than composite resin materials in the AI group (p<0.001). Study II included 27 patients with AI 11 to 22 years of age and in need of crown therapy in a randomized controlled trial using a split-mouth technique. After placing 119 Procera crowns and 108 IPS e.max Press crowns following randomization, we recorded longevity, quality, adverse events, and tooth sensitivity. After 2 years, 97% of the crowns in both groups had excellent or acceptable quality. We found no significant differences in quality between Procera and IPS e.max Press crowns. Tooth sensitivity decreased significantly after crown therapy (p<0.001). Endodontic complications occurred in 3% of crowns. Study III asked patients to complete three questionnaires measuring oral health related quality of life (OHRQoL) (OHIP-14), dental fear (CFSS-DS), and dental beliefs (DBS-R). We included 69 patients with AI, 6 to 25 years old, 33 males and 36 females (mean age 14.5±4.3) as well as healthy controls (n=80), patients with cleft lip and palate (CLP; n=30), and patients with molar incisor hypomineralization (MIH; n=39). All groups were matched in age and gender, and all but the CLP group in socioeconomic area. Patients with severe AI between the ages of 9 and 22 received crown therapy and completed the questionnaires both before and after therapy. OHIP-14 scores were significantly higher among patients with AI (7.0±6.7), MIH (6.8±7.6) and CLP (13.6±12.1) than among healthy controls (1.4±2.4) (p<0.001). After crown therapy, OHIP-14 scores in patients with severe AI decreased significantly from 7.8±6.1 to 3.0±4.8 indicating an improved OHRQoL. Early prosthetic therapy did not increase dental fear or negative attitudes toward dental treatment. In Study IV, seven patients with severe AI aged 16 to 23 years who underwent porcelain crown therapy participated in one-on-one interviews. The interviews followed a topic guide consisting of open-ended questions related to experiences of having AI. We analyzed transcripts from the interviews using thematic analysis. The analysis process identified three main themes: Disturbances in daily life, Managing disturbances, and Normalization of daily life. Experiences included severe pain and sensitivity problems, feelings of embarrassment and shame, and dealing with dental staff who lacked knowledge and understanding of their condition. The patients described strategies to manage their disturbances, reduce pain when eating or drinking, and for meeting other people. After definitive treatment with porcelain crown therapy, they described feeling like a “normal” patient. These results show that the quality of resin composite restorations in patients with AI is of inferior quality compared to controls. We also found the longevity of resin composite restorations to be shorter than for controls and that prosthetic crown therapy had significantly better quality and longevity than resin composite restorations in patients with AI. Resin composite restorations cannot be recommended for patients with severe forms of AI. After 2 years 97% of the crowns of both Procera and IPS e.max Press crowns had excellent or acceptable quality and no significant difference between the two crown types were found. Crown therapy also resulted in decreased sensitivity problems in young AI patients. We found it possible to perform crown therapy without adverse effects in young patients with AI and concluded that early permanent crown therapy can be recommended in patients showing severe forms of AI. Patients with AI rated their OHRQoL lower than healthy controls but improved significantly after crown therapy. Extensive therapy did not increase dental fear or negative attitudes towards dentistry. It is evident that orofacial appearance and orofacial pain are factors that need to be addressed and taken into account in the treatment plan. Patients with AI described a profound effects of AI in daily life with severe pain and sensitivity problems and feelings of embarrassment. After definitive treatment with porcelain crown therapy, they described feeling like a “normal” person. Patients with AI were met with lack of knowledge and lack of understanding of their situation in dental care. Continuing education on rare conditions is important as well early referral if the situation cannot be handled in general dentistry

OMFATTANDE GERIATRISK BEDÖMNING En litteraturöversikt över användning och effekter av omfattande geriatrisk bedömning i Sverige

Bakgrund: Den äldre befolkningen ökar i population och i takt med detta ökar även kraven på samhället och sjukvården att tillmötesgå populationens komplexa vård och omsorgsbehov. Det krävs anpassningar i hälso- och sjukvården med en gynnande vårdstruktur i form av en omfattande geriatrisk bedömning (Comprehensive Geratric Assessment [CGA]) för att utföra en helhetsinriktad bedömning för äldre personer som är i riskzonen för skörhet. Syfte: Syftet med studien är att beskriva användningen och effekterna av omfattande geriatrisk bedömning inom svensk hälso- och sjukvård. Metod: Studien är en litteraturöversikt baserad på Fribergs modell, med en sammanställning av senaste vetenskaplig granskade och publicerade studier om användning och effekterna av CGA för äldre (≥65 år) inom svensk vård. Sökningen resulterades i nio artiklar varav en kvalitativ och åtta kvantitativa studier som analyserades och sammanställdes utifrån en induktiv innehållsanalys i tre kategorier och sex underkategorier. Resultat: Litteraturöversikten visade att CGA används inom svensk vård (primärvård/öppenvård och slutenvård) för sköra äldre personer och ger varierande resultat beroende på om patienterna får CGA baserad vård jämfört med sedvanlig vård. Positiva effekter ses på fysisk kapacitet, ADL och dödlighet. CGA kan förbättra hälsorelaterad livskvalitet och ge ett mer holistiskt synsätt på patienters hälsa. Ekonomiskt kan CGA minska kostnader genom färre akutinläggningar och sjukhusvistelser, även om den totala vårdbelastningen varierar. Slutsats: CGA medför positiva effekter i hälso- och sjukvården och kan förbättra vården för sköra äldre genom att erbjuda ett helhetsperspektiv och stödja en personcentrerad vårdprocess. Användning av bedömningsunderlaget kan främja kommunikation och samarbete, sätter individens hela livssituation i fokus och stämmer väl överens med sjuksköterskans roll att värna om värdighet, autonomi och evidensbaserade beslut. Implementering av CGA kan hjälpa vårdpersonal att hantera komplexiteten hos äldre patienter på ett säkert och holistiskt sätt