Abstract. The increased consumption of alcoholic beverages by young people must be viewed with great concern, particularly as regards prospective parents. A study was therefore started at four Maternal Health Clinics to develop methods for the early detection of maternal alcohol abuse and for treatment of the women concerned. The study involved 464 consecutive pregnant women. A systematic drinking anamnesis was obtained from all patients. Attention was also paid to additional indicators of maternal alcohol abuse. Four per cent of the women were classified as alcohol abusers, and a further 7% as excessive drinkers. The majority of the mothers reduced their drinking altogether or stopped after receiving information about alcohol. The alcoholic women, on the other hand, needed intensive counselling. Most women welcomed the opportunity to obtain an accurate assessment of the risks of alcohol consumption during pregnancy. One infant was given a diagnosis of fetal alcohol syndrome at birth and another neonate had a partial fetal alcohol syndrome. The antenatal staff identified significantly more women with excessive alcohol consumption, compared with the situation the year prior to starting the program. Family guidance provided by a multi‐disciplinary team in pregnancy may result in lifelong benefits to both the mother and her child.
The aim of the present study was to develop a theoretical understanding of quality of care from a patient perspective, using a grounded theory approach. Thirty-five interviews were conducted with a sample of 20 adult hospitalized patients (mean age: 60 years) in a clinic for infectious diseases. Data were analysed according to the constant comparative method. A model was formulated according to which quality of care can be understood in the light of two conditions, the resource structure of the care organization and the patient's preferences. The resource structure of the care organization consists of person-related and physical- and administrative environmental qualities. The patient's preferences have a rational and a human aspect. Within this framework, patients' perceptions of quality of care may be considered from four dimensions: the medical-technical competence of the caregivers; the physical-technical conditions of the care organization; the degree of identity-orientation in the attitudes and actions of the caregivers and the socio-cultural atmosphere of the care organization. The model is discussed in relation to existing theories in the field.
This study investigates the relationship between moral stress reactions and resulting coping efforts in severely morally challenging situations. Long-term positive reactions and post-traumatic stress disorder (PTSD) indicators following morally challenging situations are also studied. The sample consisted of cadets and officers (n = 332) from Norway and Sweden. Long-term positive reactions were found to be associated with limited moral stress reactions during the challenging episode and frequent use of acceptance and positive reappraisal coping strategies. Long-term high scores on a PTSD indicator scale covaried with high scores on Openness, a strong moral stress reaction, and frequent use of instrumental coping strategies. The main conclusion is that the immediate moral stress reaction and coping strategies following morally challenging situations appear to be related to both positive long-term reactions and to indicators of PTSD.
The impact of behavioral research on military systems design is often limited. Typically, military, technical, economic, and political systems designers are more influential. The implementation of a new leadership model—developmental leadership—in the Swedish Armed Forces may constitute an exception. The aim of this article is to describe and evaluate the implementation process and its effects. The new leadership model is now well on the way to full-scale implementation. The conclusion is that an interplay between structural aspects (limited organization size and the formal authority of the supreme commander) and behavioral and attitudinal aspects (internal and external change agents) contributed to this outcome.
Purpose The purpose of this study is twofold. First, to compare the self-rated leadership behaviors, leadership-related competencies and results of the leadership of younger, mid-aged and older leaders; and second to compare these aspects among younger leaders in different kinds of the work environment and between men and women. Design/methodology/approach Data was collected using the developmental leadership questionnaire from a sample of Swedish leadership course participants ( N = 7,743). Findings The results showed that the younger group of leaders (29 years old or younger n = 539), rated themselves more negatively than the mid-aged (30–50 years, n = 5,208) and older (51 years or older, n = 1,996) leaders. Analysis of the group of younger leaders showed that those working in the private sector scored most favorably. The gender comparison revealed that young male leaders scored higher on negative conventional (transactional) and destructive leadership behaviors. A logistic regression analysis of the younger group showed that social competence, developmental leadership and destructive leadership (negative) influenced self-rated results of leadership. Research limitations/implications The study is based on leaders’ self-ratings only. Practical implications The results can be used in leadership development contexts and in individualized coaching or mentoring programs. Originality/value The results have new implications for leadership theory related to self-confidence, stereotypes, selection and organizational culture.
People with Rett syndrome have deficient central autonomic control, which may interfere with walking. We have limited knowledge regarding the effects of exertion during physical activity in Rett syndrome. The aim was to investigate the autonomic responses during walking on a treadmill in Rett syndrome. Twenty-six females, 12 with Rett syndrome and 14 healthy females were included. All individuals started on the treadmill by standing still, followed by walking slowly with progressive speed until reaching maximum individual speed, which they kept for 6 min. Heart rate (HR), systolic (SBP), diastolic (DBP), mean arterial blood pressures (MAP), cardiac vagal tone (CVT), cardiac sensitivity to baroreflex (CSB), transcutaneous partial pressures of oxygen (pO2), carbon dioxide (pCO2), and breathing movements were recorded simultaneously and continuously. Autonomic responses were assessed by MAP, CSB and CVT during walking at 3 and 6 min. The changes in CSB and CVT in people with Rett syndrome compared to controls indicated more arousal, but only when the treadmill was started; as they continued walking, the arousal dropped to control level. People with Rett syndrome exhibited little changes in pCO2 whereas the controls showed increased values during walking. This suggests poor aerobic respiration in people with Rett syndrome during walking. Five people with Rett syndrome had Valsalva type of breathing at rest, three of those had normal breathing while walking on the treadmill while the remaining two started but soon stopped the Valsalva breathing during the walk. Our results show that individuals with Rett syndrome can walk for up to 6 min at their own maximum sustainable speed on a treadmill. Energy production may be low during walking in Rett syndrome, which could cause early tiredness. A treadmill can be used in people with Rett syndrome, but must be introduced slowly and should be individually tailored. We propose that walking promotes regular breathing in Rett syndrome.
