Background: The concept of distributed leadership has been addressed in previous research, but few studies link their analysis to current and comparative empirical studies on processes and conditions enabling or hindering the development of distributed leadership. This specific study aims to identify and analyze mechanisms that enable or hinder the development of distributed leadership among employees in eldercare.

Methods: This is a case study based on six specific workplaces in eldercare in Sweden in different ways aiming to work toward an organization that emphasizes trust and distribution of power. A realistic evaluation framework was used to understand the different workplace program theories regarding distributed leadership. Key mechanisms and how they interact with contextual factors in each case were analyzed. Comparative analyses were performed, identifying key processes in terms of realizing distributed leadership.

Results: Analyzing the program theories in the respective cases showed that they have different orientations influenced by different motives for distributed leadership, which also interact with how distributed leadership was manifested and realized. The results point specifically to the importance of the mechanism formalization processes, participatory approaches to implementation, vertical sense-making, and horizontal sense-making for the development of distributed leadership.

Conclusions: The result points to that regardless of the path for achieving distributed leadership adopted by the various workplaces studied, the common denominator for those succeeding in distributing leadership is the development of a relational agency based on shared visions, a shared understanding of roles, and responsibilities, a learning approach and a dialogue-oriented relationship between management and employees. Another critical aspect is having sufficient resources to make taking on more responsibilities attractive.

In this article, work in Swedish pharmacies is examined. With the Nordic concept of co-workership as a frame, the aim is to examine how employees in pharmacies view and handle their work situations and the reasons behind them. Data were mainly collected with 20 qualitative semistructured interviews in five different pharmacies. The data were organized and analyzed by using the content analysis process. In the studied pharmacies, it can be summarized as work was carried out in a self-propelled way. Employees take an overall responsibility for the workplace, have ambition to help others and to be a part of a good team, while most of the work is carried out individually and independently.

PURPOSE: As the group of technology-dependent children with long-term tracheostomy continues to expand, we aimed to explore parents' lived experience of everyday life with a child dependent on long-term tracheostomy.

MATERIALS AND METHODS: Six parents of four children were interviewed and the transcripts analyzed using Giorgi's descriptive phenomenology.

RESULTS: All aspects of everyday life, parent-child interaction, and interaction with the surrounding outside world were affected by technology dependency. Parents played an active role by acting both as a protective shield between the outside world and the child and as an enabling bridge to help the child interact with the outside world. The active and involved role of parents is interwoven in all aspects, levels, and directions of interaction and everyday life. The lived experiences can be described in four themes: caution and risk awareness due to technology, meeting the demands of technology dependence, strained and constrained by technology dependence, and conflicted feelings about technology dependence.

CONCLUSIONS: Long-term tracheostomy and technology-dependency affect and shape everyday life. Practical implications from the study suggest that re-design and co-design between all stakeholders involved are needed to support parental well-being, coping and enhance patient safety for this growing population and their parents.

BackgroundCommunity pharmacies in Sweden merge a state-funded professional community service with a retail business. While previous research has recognized its challenges, less attention has been paid to the potential conflict of interest it could result in regarding the work of pharmacists. This study aims to increase understanding of how pharmacists in Sweden combine their healthcare ambitions and obligations with those concerning being employees in a retail business.MethodsSemi-structured interviews were conducted with 28 pharmacists employed by pharmacy chains in Sweden. The data were thematically analysed.ResultsIn the analysis, three themes were formulated: Different interests, The conflict between professional work & business work, and Strategies to manage the conflicts. The analysis of the data reveals that pharmacists in Sweden experience a conflict of interest. They grapple with balancing being healthcare professionals with a focus on patient care and being valued retail employees that also focus on financial results. This conflict manifests in various situations, such as time management, communication focus, preferred behaviours, and different tasks. The different strategies applied by individual pharmacists to manage the work are results of job crafting. Pharmacists employ strategies such as compromise, mandate stretching, avoidance, and acceptance to manage the conflict. However, these strategies lead to compromises in their work.ConclusionThis study aimed to understand how pharmacists combine their healthcare ambitions and obligations with those of being employees in a retail business. The study demonstrated that Swedish community pharmacists need to perform a juggling act to be both professional healthcare workers and viewed as valuable retail employees. In situations when the conflict of interest occurs, the pharmacists use different strategies when determining how to prioritize between the professional work and the business work. The conflict of interest in the pharmacists' work need to be taken into consideration when discussing pharmacists practices, the profession, or role it's in the healthcare system.

Introduction A growing number of parents are navigating parenthood influenced by medical complexity and technological dependency as the group of children with long-term tracheostomy grows. However, little is known regarding the parental experiences of parenthood for this heterogeneous group of children now surviving through infancy and intensive care.Objective This study aimed to analyze how parents of children who have received a tracheostomy adapted to parenthood.Methods Interviews were conducted and analyzed following a constructivist grounded theory approach. Ten parents of seven children living with a tracheostomy in Sweden were recruited via the long-term intensive care unit (ICU).Results The core variable of parenthood "Stuck in survival" was explained by two categories and six subcategories. The category "Unaddressed previous history" describes the experiences from being in the ICU environment and how the parents are not able, due to insufficient time and resources, to address these stressful experiences. The category "Falling through the cracks of a rigid system" describes how the parents found themselves and their children to be continuously ill-fitted in a medical system impossible to adapt to their needs and situation. Parents placed the starting point of parenthood with the birth of the child, whilst the tracheotomy only constituted a turning point and would lead to the loss of any previously held expectations regarding parenthood.Conclusion This study identified a previously undescribed period prior to tracheostomy placement, which may have long-lasting effects on these families. The care provided in ICUs following the birth of a child who will require tracheostomy may not be tailored or adapted to accommodate the needs of these families leading to long-lasting effects on parenthood.

Job crafting kan definieras som medarbetares sätt att själva forma och förändra sina arbeten, för att optimera tillgängliga resurser och hantera utmaningar i arbetet. Job crafting har tidigare kopplats till många positiva effekter för individer, till exempel arbetsengagemang och arbetstillfredsställelse. Ett stödjande ledarskap, autonomi i arbetet och samarbete mellan olika professionsgrupper är exempel på vad som kan främja job crafting i vården. Men kunskap om hur individuella förutsättningar, så som exempelvis arbetserfarenhet, bidrar till medarbetares strategier att försöka forma och förändra sina arbeten är ännu begränsad.

Övergripande syfte i denna pågående studie är att undersöka hur individuella förutsättningar samspelar med hur individer job craftar på sätt som främjar deras hälsa. Studien kommer särskilt fokusera hur arbetserfarenhet samspelar med job crafting, men även samspel mellan familjeliv och professionstillhörighet kommer att analyseras.

Djupintervjuer har genomförts med sexton medarbetare med olika professioner på fem olika vårdenheter. Respondenternas erfarenhet i det nuvarande arbetet varierar mellan sex månader och 43 år.

De preliminära resultaten indikerar olika job crafting strategier och motiv till dem bland respondenter med längre och kortare arbetserfarenhet. Med kortare arbetslivserfarenhet fokuseras att lära sig sitt nya yrke samt att bygga relationer med kollegor för stöd och erfarenhetsutbyte. Mer erfarna respondenter fokuserar mer på att vårda sina sociala relationer och på meningsskapande förändringar i arbetet, för att trivas och må bra i arbetet snarare än att utvecklas professionellt. Respondenter med familjer fokuserar förändringar de gör i arbetet på att få en bra balans mellan arbete och privatliv. Gemensamt för respondenterna, oavsett profession och hur mycket arbetserfarenhet de har, är att de förändringar de gör i arbetet oftast är kopplade till att deras patienter ska ha det så bra som möjligt.

Building Information Modelling (BIM) is a process, often mentioned as an enabler of various benefits within Architecture – Engineering – Construction (AEC), of creating and managing information for a built asset. Despite the potential benefits associated with BIM, the use seems to have been relatively inefficient. One explanation may be the lack of system perspective in the implementation and use of BIM. The aim of this study was to map critical factors influencing the use of BIM based on existing research, including interactions among the three subsystems human, technology and organization. A scoping review was performed analyzing 46 included articles. The results showed that BIM is a holistic and social system, that the technology itself is insufficient, and that the acceptance of BIM is a significant critical factor for its efficient implementation and use. The research on how humans interact with the technology of BIM, and how the organization can facilitate those interactions, is however limited. Relevance to industry: Learnings from this study include that the AEC industry, by approaching BIM as a holistic and social system and recognizing the role of the individual user, can add another piece of the puzzle to achieving the effective use of BIM.

The current state of work-life transformation will see more white-collar work being performed remotely using digital management systems. There is, however, a lack of research on factors and resources contributing to sustainable work when working remotely using digital management systems. The aim of this study was to study the conditions and resources connected to digital management systems and remote work, and their associations with sustainable work, in terms of process quality, trust, and sense of coherence, when working remotely during the COVID-19 pandemic. An analytical cross-sectional study was performed. Questionnaire data from white-collar employees (n = 484) in two private companies were analyzed with regression models, focusing on the importance of the conditions and resources connected to digital management systems and remote work, stratified by working from home or at the office. The results showed digital conditions and resources being associated with indicators of sustainable work. Furthermore, the results showed that social work relations were additional important explanatory factors for sustainable remote work. This study contributes to the development of a new post-pandemic work-life balance by concluding that sustainable remote work needs to be ensured by functional digital management systems and adequate leadership supporting the development of a positive team and learning climate.

RAMP (Risk Assessment and Management tool for manual handling – Proactively), is arisk management tool focusing on manual handling work. Since 2017 RAMP has beenspread to over 105 countries. More than other methods, RAMP supports the entire riskmanagement process. RAMP is based on risk factors documented in scientific literature,and it has been evaluated regarding usability and reliability. It is now used for MSDrisk management in many organisations. The feedback from RAMP users is positive,and there are indications of reductions in sick absence.The purpose of the ongoing project is to investigate a selection of effects thatimplementation entails and to examine the implementation of RAMP from a leadershipand system perspective. Specific questions are: What happens when a companyimplements RAMP? Are the risk factors reduced? What affects the change? Whatstrategies do companies use when implementing RAMP? Are the effects of whichstrategies companies apply when implementing affected? What are the facilitators andbarriers to the implementation of this risk management method?The project is carried out as an implementation study based on mixed methods incollaboration between researchers and four production companies and two FHV actors.The effects and implementation of RAMP will be evaluated by comparing risk levels,qualitative interviews, document analyses, questionnaires and structured observationsof work processes. For changes in risk factors, RAMP risk assessments, which includeobservations and objectivemeasurements of push-pull forces, carried out at baseline andat follow-up will be compared. If possible, in addition to the above data collection, thecompany's own data on sick leave, productivity and quality (eg quality deficiency data)will be included and monitored over time.Implementations and effects of RAMP will be summarized in so-called logicalmodels. These models will identify inputs (e.g. time and resources set aside forimplementation), activities (e.g. training and measures implemented), intermediate(short-term) outcomes (e.g. the extent to which RAMP is used in the systematic workenvironment work and in the entire process for risk management, how much of the highrisks have been reduced, what type of measures have been taken and how the riskawareness has developed among employees), long-term outcomes (e.g. employees'perception of the workload, perceived health and perceived problems), and possiblylong-term outcomes (e.g. changes in sick absence, quality and productivity as well assharing good examples within the organisation).157At this point in the project, the questionnaire has been designed, companies havebeen contacted, and data collection at the first company, that now has assigned animplementation strategy, is about to start.The project is expected to show what effects on the work environment (possibly alsohealth, quality and productivity) that systematic application of the RAMP method canhave, aswell aswhich of the studied factors affect the implementation and to what extentthey do so. The results are expected to lead to new knowledge in the area of systematicrisk management and implementation strategies.