Explore the vast range of titles available.

This book combines theoretical and practical knowledge about key actors and driving forces that help to initiate and advance open data governance. Using Finland and Sweden as case studies, it sheds light on the roles of key actors in the open data movement, enabling researchers to understand the key operational elements of data-driven governance. It also examines the most salient manifestations of related networking activities, the motivations of stakeholders, and the political and socioeconomic readiness of the public, private and civic sectors to advance such policies. The book will appeal to e-government experts, policymakers and political scientists, as well as academics and students of public administration, public policy, and open data governance. Maxat Kassen is a political scientist and e-government scholar. He is a former Fulbright Scholar at the University of Illinois Chicago, USA. His research focuses on e-government and open data.

Increasing use of antibiotics and rising levels of bacterial resistance to antibiotics are a challenge to global health and development. Successful initiatives for containing the problem need to be communicated and disseminated. In Sweden, a rapid spread of resistant pneumococci in the southern part of the country triggered the formation of the Swedish strategic programme against antibiotic resistance, also known as Strama, in 1995. The creation of the programme was an important starting point for long-term coordinated efforts to tackle antibiotic resistance in the country. This paper describes the main strategies of the programme: committed work at the local and national levels; monitoring of antibiotic use for informed decision-making; a national target for antibiotic prescriptions; surveillance of antibiotic resistance for local, national and global action; tracking resistance trends; infection control to limit spread of resistance; and communication to raise awareness for action and behavioural change. A key element for achieving long-term changes has been the bottom-up approach, including working closely with prescribers at the local level. The work described here and the lessons learnt could inform countries implementing their own national action plans against antibiotic resistance.

Background In most countries, lower rates of COVID-19 vaccination have been observed in foreign-born individuals, yet little is known about the underlying reasons, especially as reported by these individuals themselves. This exploratory interview study investigated lack of information access and hesitancy towards taking the COVID-19 vaccine among foreign-born individuals in Sweden. Methods We used purposive sampling to recruit foreign-born adults who expressed being hesitant towards getting vaccinated, as well as health guides and doulas who were assigned to spread COVID-19 related information in immigrant-dense urban areas. Data were collected using semi-structured focus group interviews, which were transcribed verbatim and analysed according to systematic text condensation. Results Three focus group interviews were conducted with altogether eleven participants. One group consisted of health guides/doulas, while the participants in the other groups were gainfully employed in other jobs, or full-time students, or housewives. Four main themes emerged: (1) Language barriers and sociocultural differences, (2) Consequences of not using official Swedish information, (3) Decision-making on COVID-19 vaccination, and (4) Suggestions to improve information dissemination. The lack of information in other languages than Swedish and lack of effective information channels resulted in that most participants barely used information from official Swedish health care and public health institutions. Instead, they relied on social media, social contacts and international media, through which contradictive and negative information about the vaccine was spread. The decision to get vaccinated or not became a process fraught with insecurities about the effectiveness and side effects of the vaccine, which was balanced against wishing to be protected and to contribute to the battle against COVID-19. The participants suggested that information dissemination could be improved by producing a multilingual information outreach and to increase the use of transmission through social interaction with trusted persons and platforms. Conclusions An inadequately adapted information strategy prevented some members of the society from making fact-based decisions about getting vaccinated. Several suggestions for improving dissemination were brought forth that can be tested in future communication strategies.

Background  Telerehabilitation, i.e. rehabilitation at a distance using Information and Communication Technology (ICT), is a promising avenue for improving health among people with neurological diseases or older adults who often experience limited access to services. Still, little is known about physiotherapists’ use, perceptions and needs with regards to telerehabilitation services. Aims To describe physiotherapists use and perceptions of, as well as needs for, telerehabilitation services for the rehabilitation of people with neurological diseases or older adults in Sweden. Methods In this cross-sectional study, an author-created survey was sent out to members of the Swedish Association of Physiotherapists including questions about the use and perceptions of existing telerehabilitation services (e.g. telephone, internet-based applications and mobile applications) as well as needs of future telerehabilitation services. The results were presented descriptively as numbers and percentages. Results Three hundred seven physiotherapists were included in this study with 139 (45%) treating people with neurological diseases and 168 (55%) treating older adults. Most respondents did not provide telerehabilitation before (74%) or during (51%) the COVID-19 pandemic. Telephone, which was predominantly used for administrative tasks, was the most frequent utilised ICT used by 68% of the physiotherapist using ICTs several days/week. Few respondents used internet-based applications (12%), mobile applications (3%) or SMS services (8%) and videoconferencing (3%). A majority of the respondents were interested in ICT (78%), felt comfortable using ICT (57%) and were interested in learning how ICT can be used in rehabilitation (92%). Still, few respondents perceived that people with neurological diseases or older adults can use existing ICTs for rehabilitation purposes (18%) and that existing reimbursement system within health care facilitates remote rehabilitation (16%). Important functionality of future ICT perceived by physiotherapists covered patient communication (e.g. chat, SMS and video), assessments (e.g. digital surveys and assessment of physical activity) and treatment (e.g. exercise prescription). Conclusion While physiotherapists had an overall positive perception to use and willingness to learn about telerehabilitation, few used telerehabilitation services before nor during the COVID-19 pandemic and they also perceived multilevel barriers for implementation, ranging from patients ability to use ICT to existing reimbursement systems within health care. Our findings emphasize the need to strengthen the expertise regarding remote services among physiotherapists.

This study looks at population response to government containment strategies during initial stages of the COVID-19 pandemic in four high-trust Northern European countries–Denmark, Germany, the Netherlands, and Sweden–with special emphasis on expressions of governmental trust. Sentiment analysis and topic modeling analysis were performed using Twitter data from three phases during the initial European lockdown, and results were compared over time and between countries. Findings show that, in line with existing theory, assertive crisis responses and proactive communication were generally well-received, whereas tentative crisis responses or indications by the authorities that the crisis was manageable were generally met with suspicion. In addition, while government support was high in all countries during the height of the crisis, messages critical of the government as well as conspiracy theories were nevertheless widely circulated. Importantly, countries with the least assertive strategies, rather than clear negative responses, saw heightened polarization of sentiment in the population. Furthermore, in the case of Sweden, a laissez-faire strategy was generally accepted by the population, despite strong criticism from other countries, until mortality rates started to rise. Possible explanations for these findings are discussed with an emphasis of prior trust as a potential explanatory factor. Future research should seek to replicate these findings in other countries with different levels of prior governmental trust or with a different severity of the COVID-19 outbreak than the countries in this study as well as triangulate the findings of this study using alternative methods.

Background The use of welfare technology is gaining ground in municipal eldercare and is increasingly being integrated into everyday routines. However, the meanings that eldercare personnel attach to welfare technology in the care of older recipients, and thus the domestication of welfare technology, remain largely underexplored. This study explores how eldercare personnel understand and ascribe meanings to welfare technologies in their daily work, with the aim of understanding their domestication. Methods The empirical material comprised 181 photographs, each paired with corresponding text, from 61 participants across four municipalities in southern Sweden. The empirical material was thematically analysed, focusing on different categories of welfare technologies and their ascribed meanings. In our coding “convenience” and at times “inconvenience” were interpreted as recurrent patterns. Their repeated presence across various contexts and the meanings ascribed to different welfare technologies prompted deeper interpretive engagement, leading us to adopt it as a key theme. In the final step, the codes were synthesised through the lens of “convenience” to better understand the meanings participants attached to welfare technology in eldercare work. Results The participants ascribed meanings to welfare technology that resonate with broader societal and cultural understandings of technological solutionism, while aligning with national policies promoting welfare technology as a means of supporting safety, activity and independence for older adults. Welfare technology was often understood as both convenient and an act of care. Our analysis uncovered different dimensions of “convenience”, which we labelled as: “remote surveillance convenience”, “logistics convenience”, “communication convenience”, “safety convenience”, “comforting convenience” and “activation convenience”. Yet, in some cases, welfare technology was also seen as a hindrance to care, being inconvenient due to its inflexibility, technical difficulties and the tendency to create duplicate tasks. Conclusion This paper contributes to a deeper understanding of the domestication of welfare technology in eldercare. Our study found that eldercare personnel engage with and interpret welfare technologies by ascribing meanings related to perceived convenience — a concept not widely explored in this context. Welfare technologies were often seen as convenient substitutes for physical proximity and relational care, such as “remote surveillance convenience” through cameras and “comforting convenience” via robotic pets. However, convenience, while central to the participants’ experiences, should not be understood as inherently “good” or positive but as part of the domestication process, shaped by socio-technical contexts and the political economy of eldercare, which prioritises effectiveness and efficiency. By shedding light on these dynamics, our study examines how the domestication of welfare technology is shaped by and reinforces broader discourses of technological solutionism, raising questions about its long-term impact on care practices.

Background Health care organisations have a long history of dividing work and tasks into decentralised functions and units by forming divisions and departments with delegated power. New ways of working, such as process-oriented approaches, have been called for to address challenges such as staffing shortages and resource constraints. There is limited understanding of the interplays that will occur in health care organisations during a shift from a traditional decentralised structure to a process-oriented approach. This study aims to explore the perceptions of health care staff and leaders when introducing a process-oriented routine. Method We conducted interviews and focus groups with 29 participants in specialised and primary care in order to explore their experiences of a newly introduced routine regarding on-demand consultation, aimed at enhancing communication and patient coordination in a Swedish health care region. The participants included operating managers, schedulers and physicians. Data were analysed using reflexive thematic analysis in accordance with Braun & Clark’s guidance. Results The findings encompass three main themes when introducing a process-oriented routine: Creates a readiness to act, The critical role of trust for adopting on-demand consultation in everyday practice and Challenges associated with transformation . The results show that health care staff and leaders are positive about the new way of working, but the readiness to act is challenged by issues of trust, as well as cultural components and structural factors such as experienced resource constraints. Conclusion Our results underscore the need to consider not only organisational aspects but also social and individual relational factors when introducing a process-oriented way of work into a decentralised and complex health care system.

Background Technology for timely feedback of data has the potential to support quality improvement (QI) in health care. However, such technology may pose difficulties stemming from the complex interaction with the setting in which it is implemented. To enable professionals to use data in QI there is a need to better understand of how to handle this complexity. This study aims to explore factors that influence the adoption of a technology-supported QI programme in an obstetric unit through a complexity informed framework. Methods This qualitative study, based on focus group interviews, was conducted at a Swedish university hospital’s obstetric unit, which used an analytics tool for advanced performance measurement that gave timely and case mix adjusted feedback of performance data to support QI. Data was collected through three focus group interviews conducted with 16 managers and staff. The Nonadoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework guided the data collection and analysis. Results Staff and managers deemed the technology to effectively support ongoing QI efforts by providing timely access to reliable data. The value of the technology was associated with a clear need to make better use of existing data in QI. The data and the methodology in the analytics tool reflected the complexity of the clinical conditions treated but was presented through an interface that was easy to access and user friendly. However, prior understanding of statistics was helpful to be able to fully grasp the presented data. The tool was adapted to the needs and the organizational conditions of the local setting through a collaborative approach between the technology supplier and the adopters. Conclusions Technology has the potential to enable systematic QI through motivating professionals by providing timely and adequate feedback of performance. The adoption of such technology is complex and requires openness for gradual learning and improvement.

Background There is limited knowledge on the prevalence of disease in total populations. Such studies have historically been difficult to conduct but the development of health data registers has facilitated large-scale studies on recorded diagnoses in entire regions. The aim of this study was to analyze the prevalence of diagnosis of six common diseases in the Swedish capital region. Methods The study population included all living persons who resided in Stockholm County, Sweden, on December 31 st 2011 (N = 2 093 717). Information on all consultations between 2007 and 2011 was obtained from primary health care, specialist outpatient care and inpatient care. Prevalence was defined as the proportion of individuals with a recorded diagnosis of diabetes, depression, anxiety disorders, hypertension, asthma and chronic obstructive pulmonary disease during the five year period, respectively. Analyses were done by age and gender. Results Hypertension had the highest five-year prevalence (12.2%), followed by depression (6.6%), diabetes mellitus (6.2%), asthma (5.9%), anxiety disorders/phobia (4.8%), and COPD (1.8%). Diabetes was more common in men (5.3% of women and 7.1% of men) while depression (8.7% in women and 4.4% in men) and anxiety (6.3% in women and 3.4% in men) were considerably more common in women. Smaller gender differences were also found for hypertension (13.0% in women and 11.4% in men), asthma (6.4% in women and 5.4% in men) and COPD (2.1% in women and 1.6% in men). Diabetes, hypertension and COPD increased markedly with age, whereas anxiety, depression and asthma were fairly constant in individuals above 18 years. During one year of observation, more than half of all patients had only been diagnosed in primary health care, with hypertension being the diagnosis with the largest proportion of patients only identified in primary health care (70.6%). Conclusion The prevalence of common diseases in the population can be estimated by combining data gathered during consecutive years from primary care, specialist outpatient care and inpatient care. However, accuracy of disease prevalence is highly dependent on the quality of the data. The high prevalence of the six diagnoses analysed in this study calls for preventive action to minimize suffering and costs to society.

Extant research demonstrates that e-Government initiatives often fall short of achieving innovative forms of government and governance due to a techno-centric focus that limits such initiatives to minor improvements in service delivery. While it is evident that innovation is central to modernising and transforming governmental organisations, and that the co-creation of services by public authorities and community groups is an essential component of realising the benefits of investment in information and communication technology, there is little research focusing on the nature of innovation in transforming governmental organisations and services. Addressing this gap in the literature, this paper explores how open innovation strategies can transform public administration by examining how a network of municipalities in Sweden transforms value creation and service delivery by collaborating with each other and with external parties to accelerate the creation and exploitation of innovation. Using a case study with embedded units of analysis, four emerging typologies of governmental transformation based on open innovation are identified. The paper illustrates how these open innovation typologies (i) transform the organisation of the municipalities and (ii) help them deliver high quality co-created services to citizens. By examining the strategic and operational aspects that facilitate such activities, the analysis reveals the impact of open innovation on the business models of public authorities. The paper concludes that open innovation practices represent a more radical manifestation of transformational government than previously envisaged; signalling not only fundamental change in the nature of value creation and service delivery by public authorities, but potentially in the nature of their organisation.