För att kunna hantera framtida klimatrelaterade händelser behöver samhällets beredskap anpassas och sannolikt utökas. Kunskapsläget över vilken förmåga som behövs för att hantera risker i ett förändrat klimat behöver sammanställas och framtida behov behöver jämföras mot nuvarande beredskapsnivåer för att identifiera lämpliga åtgärder. En analys behöver göras kring eventuella brister, utifrån vilken åtgärder sedan kan prioriteras och vidtas avseende olika delar i förmågan att hantera händelser, bland annat avseende tillhandahållande av statliga förstärkningsresurser. Denna studie analyserar vilken systematik som kan vara aktuell för att möjliggöra sådana analyser och utredningar.Studiens övergripande syfte är att ge förslag kring hur bedömningar kan göras om framtidens behov av statliga förstärkningsresurser i syfte att möta framtidens klimatrelaterade risker. Detta inkluderar en sammanställning av kunskapsläget kring risker och scenarion avseende framtida naturhändelser utifrån ett klimatförändringsperspektiv, med information om var mer kunskap kan hittas. Det inkluderar också att titta på metoder för att dels analysera behov av förmåga på olika nivåer att hantera de klimatrelaterade riskerna och dels hur dimensionering av förmåga kan göras för att möta behovet.Studien består av två delar. I del 1 ges en sammanställning av kunskapsläget om riskbilder och scenarion i Sverige vad gäller framtida naturhändelser utifrån ett klimatförändringsperspektiv och tidsperioden fram till ca år 2100. I del 2 presenteras initialt ett konceptuellt ramverk för kartläggning av beredskap uppdelat i fyra huvuddomäner: Behov, Resurs, Styrning och Beroenden. Baserat på ramverket presenteras därefter en metodik för att analysera samhällets förmåga att hantera framtida händelser i ett förändrat klimat. För att kunna identifiera en lämplig framtida beredskapsnivå, behöver samhällets förmåga att hantera händelser gentemot en framtida riskbild analyseras. Del 2 fokuserar på hur relevanta myndigheter ska kunna gå tillväga för att göra en sådan analys som slutligen kan utgöra beslutsunderlag avseende framtida beredskap. Avslutningsvis ges ett exempel på hur metoden kan användas där händelsen skogsbrand, av omfattningen att nationella förstärkningsresurser i form av MSBs upphandlade helikoptrar och flygplan för skogsbrandbekämpning kan bli aktuella att nyttja, utgör själva händelsen.

There is a growing interest in addressing global waste problems by applying innovative ideas and philosophies such as zero-waste and circular economy. As a new sustainability paradigm, zero-waste challenges the common assumption of waste as a valueless and unavoidable by-product created at the end of the product’s life phase. Instead, it acknowledges that waste is a "misallocated resource" or "resource in transition" produced during the intermediate phases of production and consumption activities. Waste should be recirculated to production and consumption processes. Therefore, zero waste means no "waste" would be wasted under the circular economy system. This chapter presents various examples of zero-waste practices derived from family, community, business, and city levels. In addition, zero-waste implementation strategies and actions are also discussed in the chapter. Despite its potential, the visionary zero-waste goals cannot be achieved without responsible global stewardship and active citizens’ role. 

Older adults were particularly vulnerable to the COVID-19 pandemic, necessitating significant efforts to avoid contamination. This extraordinary situation posed an increased risk of mental pressure, and the ability to handle stressful situations is affected by several aspects. Therefore, this study aims to explore the coping strategies employed by older adults during the early months of the COVID-19 pandemic. A sample of 41 Swedish older adults aged 70-85 participated in phone interviews regarding their experiences with social distancing due to COVID-19. The interviews were conducted between April and May 2020, with nine follow-up interviews conducted in November and December 2020. The findings revealed results that despite the challenging circumstances, the participants demonstrated a strong mindset and resilience. Strategies utilised to improve their wellbeing and manage the situation included following recommendations, accepting the situation and maintaining a positive outlook. The influence of previous experiences on their coping strategies was evident. Additionally, the participants expressed a longing for their relatives and a need to adopt new technologies to manage their everyday lives. The follow-up interviews indicated no significant changes in worry or behaviour; if anything, participants were less worried at the beginning of the pandemic. This study contributes to the ongoing discussion on vulnerability among older adults by highlighting the diverse range of coping strategies employed during a prolonged crisis such as the COVID-19 pandemic. It demonstrated that though they are medically vulnerable, they are situationally resilient and, in many ways, well set to handle a challenging situation. During crises, older adults might need practical assistance. On the other hand, they can be a resource regarding mental preparedness during crises. Further research should explore the possibilities of balancing the needs of older adults and, at the same time, viewing them as a resource during long-time crises. 

Övning ger färdighet och det gäller inte bara i traditionell undervisning utan också vid krisledning. Krisledning kännetecknas av att medlemmarna i en krisledningsgrupp ska ansvara för sina respektive verksamhetsområden och genom snabb interaktion och samordning över verksamhetsgränserna mildra effekterna av krisen för organisationen eller samhället som helhet. Det innebär att rollmedvetenhet och kommunikationsförmåga måste tränas för den enskilde så väl som för gruppen som helhet. På gruppnivå är också samverkan och koordinering internt och externt viktigt att öva. Tidigare studier visar att organisationer är intresserade av möjligheten att öva mer via digitala verktyg (Wik et al., 2017). Inom ramen för det till och med 2021 pågående Interregprojektet CriseIT 2 utvecklar vi ett koncept för övningsstöd baserat på lärplattformar. Kapitlet beskriver genom en fallstudie hur en seminarieövning kan genomföras med stöd av lärplattformen Canvas. Data till studien har samlats in genom observationer, enkäter, storgruppsdiskussion och deltagarnas indata till Canvas. Erfarenheter från fallstudien sammanfattas i möjligheter, problem och förbättringsbehov kopplade till Canvas och övningsdesignen, och rekommendationer ges både för krisövning och för undervisning baserad på problematisering och dilemmaövningar i klassrummet.

Background: Climate change brings uncertainties that pose challenges for urban planning. Under the Swedish Planning and Building Act (2010:900), municipalities are responsible for land-use planning within their defined geographical area. Coastal areas are in many cases highly developed, densely populated and economically important, and sea level rise is expected to expose these areas to complex risks that may result in loss of life, land and livelihoods if actions are not implemented. It is therefore widely recognised that climate adaptation cannot wait. Land elevation in Sweden have a mitigating effect on the sea level rise. The aim of this study is to investigate how Swedish municipalities deal with these uncertainties in the zone planning process based on different theories of decision making.

Method: The study is based on a multi-case study design in order to build up cases that can be compared and weighed against each other in order to gain generalizable knowledge. Qualitative method was used as an inspiration to compile large amounts of evidence and to keep the focus on the collected data throughout the process. The cases Helsingborg City and Varberg Municipality have been selected through a strategic selection: the municipalities have active or recently adopted zone plans in the coastal area. Two data sources have been used in the study: expert interviews from the selected cases and documentation linked to the selected cases. The transcripts of the expert interviews and the documents have been analysed through a qualitative content analysis.

Results: Both municipalities have identified a risk of flooding from the sea in the zone planning process. The city of Helsingborg has a policy document, adopted by the municipal council, with specified safety levels for construction near the coast. This level has been used for zone planning until now, but it is under discussion in a separate ongoing planning process within the municipality due to newly available research-based knowledge. The sustainability of the new construction is the most important factor for climate adaptation. The IPCC scenario RCP8.5 has been used as a safety measure during the process and the time perspective is set to 2150. In other areas a shorter time perspective might be used due to present development.

Varberg municipality acknowledges that their current policy document is outdated due to new and accumulated knowledge on the effects of climate change. The municipality has been in contact with various governmental agencies to identify suitable actions. However, the prerequisites given by different authorities are conflicting, and the County Administrative Board announced that an expert study must be conducted. The municipality has chosen the worst-case scenario of the year 2150 as a condition in their planning. However, since the ground cannot be sufficiently raised due to existing development, they have a finished-floor-level ordinance in the zone plan. 

Conclusion: Sea level rise poses complex and combined risks, but due to popularity, short-term growth takes precedence over safety in urban planning even when areas are identified as unsuitable by the civil servants. Uncertainty and the constant addition of new knowledge pose a challenge for local authorities. Municipalities want to build sustainable residential areas, but the conditions of the existing buildings at the location can have an impact on the climate adaptation. Helsingborg uses the precautionary principle and As Low As Reasonably Practicable (ALARP) decision-making strategies in their urban planning, while Varberg uses ALARP. During the process of the study a new theoretical framework have evolved.

Background: This article investigates the impact of a non-mandatory and age-specific social distancing recommendation on isolation behaviours and disease outcomes in Sweden during the first wave of the coronavirus disease 2019 (COVID-19) pandemic (March to July 2020). The policy stated that people aged 70 years or older should avoid crowded places and contact with people outside the household. Methods: We used a regression discontinuity design-in combination with self-reported isolation data from COVID Symptom Study Sweden (n = 96 053; age range: 39-79 years) and national register data (age range: 39-100+ years) on severe COVID-19 disease (hospitalization or death, n = 21 804) and confirmed cases (n = 48 984)-to estimate the effects of the policy. Results: Our primary analyses showed a sharp drop in the weekly number of visits to crowded places (-13%) and severe COVID-19 cases (-16%) at the 70-year threshold. These results imply that the age-specific recommendations prevented approximately 1800-2700 severe COVID-19 cases, depending on model specification. Conclusions: It seems that the non-mandatory, age-specific recommendations helped control COVID-19 disease during the first wave of the pandemic in Sweden, as opposed to not implementing a social distancing policy aimed at older adults. Our study provides empirical data on how populations may react to non-mandatory, age-specific social distancing policies in the face of a novel virus.

Background and ObjectiveCancer drug costs have increased considerably within healthcare systems, but many drugs lack quality-of-life (QoL) and overall survival (OS) data at the time of reimbursement approval. This study aimed to review the extent of subsequent literature documenting improvements in OS and QoL for cancer drug indications where no such evidence existed at the time of reimbursement approval.MethodsDrug indications with claims of added therapeutical value but a lack of evidence on OS and QoL that were reimbursed between 2010 and 2020 in Sweden were included for review. Searches were conducted in PubMed and ClinicalTrial.gov for randomized controlled trials examining OS and QoL.ResultsOf the 22 included drug indications, seven were found to have at least one trial with conclusive evidence of improvements in OS or QoL after a mean follow-up of 6.6 years. The remaining 15 drug indications either lacked subsequent randomized controlled trial data on OS or QoL (n = 6) or showed no statistically significant improvements (n = 9). Only one drug demonstrated evidence of improvement in both OS and QoL for its indication.ConclusionsA considerable share of reimbursed cancer drug indications continue to lack evidence of improvement in both OS and QoL. With limited healthcare resources and an increasing cancer burden, third-party payers have strong incentives to require additional post-reimbursement data to confirm any improvements in OS and QoL.

Mittenzwei et al. (2019) recognise the need for a broadened view on climate literacy among students that takes into account a deep understanding of the energy concept, but also matters of risk perception, and attitudes towards climate change, and a willingness to change towards a more climate-friendly behaviour. In a collaboration between Karlstad University and the Leibniz Institute for Science and Mathematics Education (IPN) in Kiel, we run a project aiming to contribute to understanding of prerequisites for secondary students’ development of resilience in relation to human-made climate change. Towards this aim we develop learning activities in different contexts that show varying degrees of authenticity of risk. Contexts in the Swedish part of the project involve: the increased risk of flooding due to climate change in western Sweden; increasing frequency of forest fires in Sweden the last decade; students’ understanding of energy transfer and transformations by use of infrared cameras. In the presentation we focus on results from pilot studies in relation to the flooding and infrared-camera contexts. Regarding the risk of flooding, through the game Riskville preservice teacher students have experienced in a hands-on manner the conflicts and connections urban planning, conflicting interests, and climate related risk (Christenson et al., 2019). By using infrared cameras, students get the opportunity to see otherwise invisible phenomena, such as heat convection and radiation (Haglund et al., 2015).

A procedure for model reduction of stochastic ordinary differential equations with additive noise was recently introduced in Colangeli et al (2022 J. Phys. A: Math. Theor.55 505002), based on the Invariant Manifold method and on the Fluctuation–Dissipation relation. A general question thus arises as to whether one can rigorously quantify the error entailed by the use of the reduced dynamics in place of the original one. In this work we provide explicit formulae and estimates of the error in terms of the Wasserstein distance, both in the presence or in the absence of a sharp time-scale separation between the variables to be retained or eliminated from the description, as well as in the long-time behavior.

Risk management, justice (i.e. equity, fairness), and sustainability are tightly interconnected. This literature review investigates how and why justice is considered in flood risk management. 20 scientific documents published between 2015 and 2020 are analyzed in depth. The results show a distinction between distributive and procedural justice and a complicated judgment of fairness based on different philosophies that vary depending on the country, the type of flood, and the type of strategy studied. Equity is found to be an under-discussed topic compared to its importance. Justice in flood risk management matters because (i) the impacts of floods affect different people unevenly, (ii) the interest in equity evinced by public authorities influences societal transformation, and (iii) the perception of fairness matters at both individual and collective levels. This paper analyzes the link between justice considerations and sustainability in relation to four dimensions: social, ecological, spatial, and temporal. Social and spatial issues are the most commonly studied in the literature, while ecological and temporal ones have generally been overlooked, creating a research gap. The results are discussed in terms of their diversities of justice concepts, places of investigation, and types of strategies. Various justice frameworks are used, but since none of them focus specifically on the contribution of flood risk management to sustainability through justice considerations, a flood risk justice framework is developed, which translates into theoretical and practical tools. It is based on the considerations of both humans and non-humans into different spatio-temporal scales.

Comprehensively addressing different aspects of justice is essential to enable risk management to contribute to sustainable development. This article offers a new conceptual framework called risk justice that comprises procedural, distributive, and corrective justice in four dimensions related to sustainable development: social, ecological, spatial, and temporal issues. Risk justice is defined as the quality of being fair and reasonable while governing and managing a possible negative event. After explaining the conceptual framework, a detailed content analysis of two international guidelines for disaster risk management (the Sendai Framework for Disaster Risk Reduction 2015-2030 and the European Floods Directive) illustrates the analytical potential of the risk justice framework. Findings show strong emphasis on social and spatial aspects of distributive and procedural justice in the two documents, whereas considerations of corrective justice and temporal and ecological issues are scarce or indirect. This may result in conflicting impacts of disaster risk management on sustainable development. Therefore, discussing risk management with a risk justice viewpoint while elaborating guidelines or choosing risk management strategies provides new avenues for sustainable development and facilitates transparent trade-offs. Our risk justice framework enables risk practitioners and researchers to reflect systemically about justice in risk management in different risk contexts and can be used both as a proactive and as a retrospective tool.

IntroductionFall injuries caused by icy road conditions are a prevalent public health problem during winters in Sweden, especially in older populations. To combat this problem, many Swedish municipalities have distributed ice cleats to older adults. While previous research has shown promising results, there is a lack of comprehensive empirical data on the effectiveness of ice cleat distribution. We address this gap by investigating the impact of these distribution programmes on ice-related fall injuries among older adults. MethodsWe combined survey data on ice cleat distribution in Swedish municipalities with injury data from the Swedish National Patient Register (NPR). The survey was used to identify municipalities that have distributed ice cleats to older adults at some point between 2001 and 2019. Data from NPR were used to identify municipality-level data on patients who have been treated for injuries related to snow and ice. We used a triple differences design-a generalisation of difference in differences-that compared ice-related fall injury rates before and after intervention in 73 treatment and 200 control municipalities, with unexposed age groups serving as within-municipality controls. ResultsWe estimate that the average ice cleat distribution programmes reduced ice-related fall injury rates by -0.24 (95% CI -0.49 to 0.02) per 1000 person-winters. The impact estimate was larger in municipalities that distributed more ice cleats (-0.38 (95% CI -0.76 to -0.09)). No similar patterns were found for fall injuries unrelated to snow and ice. ConclusionOur results suggest that ice cleat distribution can decrease the incidence of ice-related injuries among older adults.

Modelling, Assessment, and Promotion of Climate Literacy

Several studies show that students often lack conceptual knowledge and show multiple misconceptions when explaining climate change (e.g, Boyes & Stanisstreet, 1993; Flener-Lovitt, 2014; Shepardson et al., 2011). Hence, it is often argued that science education should focus on conveying sufficient conceptual knowledge about climate change, its causes, consequences, and potential ways of adaptation and mitigation. However, besides scientific content knowledge, decision-making and the intention to act in a climate-friendly manner seem also to be influenced by non-scientific factors such as attitudes and value attribution (Dietz, Dan, & Shwom, 2007). The USGCRP (2009) thus promotes to focus education on climate literacy, which includes specific knowledge about climate change, as well as skills and attitudes relevant to the topic. So far, studies examining the impact of climate literacy on actual decision-making are scarce, and the general picture about other factors that contribute to young learners' conceptions of climate change – including the media, family, peers, but also emotional attachment and risk perception – remains somewhat unclear. In this related paper set, we aim to elaborate how climate literacy can be modelled and assessed, how it can be promoted through meaningful instruction, and how teacher professional development can contribute to this. 

Taping is a common technique used to address proprioceptive deficits in both healthy and patient population groups. Although there is increasing interest in taping to address proprioceptive deficits, little is known about its effects on the kinetic aspects of proprioception as measured by force sense accuracy. To address this gap in the literature, the present systematic review and meta-analysis was conducted to evaluate the impact of taping on force sense accuracy. A search for relevant literature was conducted following PRISMA guidelines across seven databases and one register. Eleven studies with 279 participants were included in the review out of 7362 records. In the between-group analyses, we found a significant improvement in absolute (p < 0.01) and relative (p = 0.01) force sense accuracy with taping compared to no comparator. Likewise, a significant improvement in absolute (p = 0.01) force sense accuracy was also observed with taping compared to placebo tape. In the within group analysis, this reduction in the absolute (p = 0.11) force sense accuracy was not significant. Additional exploratory subgroup analyses revealed between group improvement in force sense accuracy in both healthy individuals and individuals affected by medial epicondylitis. The findings of this meta-analysis should be interpreted with caution due to the limited number of studies and a lack of blinded randomized controlled trials, which may impact the generalizability of the results. More high-quality research is needed to confirm the overall effect of taping on force sense accuracy. 

Objective: To synthesize the outcomes reported in the rehabilitation and community literature for adults with traumatic lower limb amputation (LLA). Data Sources: The search strategy was conducted in 3 databases (Medline, EMBASE, and CINAHL) from inception to April 2022. Study Selection: To be eligible, articles could be of any design but were required to have at least 50% adult individuals with traumatic LLA and had to report on interventions and outcomes in either a rehabilitation or community setting. Data Extraction: The extracted outcomes were classified using Dodd’s framework, which is designed for organizing research outcomes. Heterogeneity was observed in the outcome measures (OMs) used for evaluation. Two reviewers independently conducted the data extraction, which was verified by a third reviewer. Data Synthesis: Of the 7,834 articles screened, 47 articles reporting data on 692 individuals with traumatic LLA, met our inclusion criteria. Four core areas encompassing 355 OMs/indicators were identified: life effect (63.4%), physiological/clinical (30.1%), resource use (5.1%), and adverse events (1.4%). Physical functioning (eg, gait, mobility) was the most frequently reported outcome domain across studies, followed by nervous system outcomes (eg, pain) and psychiatric outcomes (eg, depression, anxiety). Domains such as global quality of life and role/emotional functioning were seldomly reported. Conclusion: The study provides a list of outcome indicators explicitly published for adults with traumatic LLA, highlighting inconsistent reporting of outcome indicators. The lack of a standardized set of OMs is a barrier to performing meta-analyses on interventions, preventing the identification of effective care models and clinical pathways. Developing a core outcome set that includes OMs relevant to the needs of the traumatic LLA population may address these issues. 

BackgroundCompliant flooring may prevent fall injuries in residential care, but evidence is inconclusive. We investigate compliant sports floors and fall-related injuries in a residential care setting and update a meta-analysis from a recent systematic review on compliant flooring. MethodsA non-randomised study comparing outcomes in a residential care unit that installed sports flooring in bedrooms with four units with regular flooring in a Norwegian municipality (n=193). Data on falls were collected for a period of 46 months (323 falls on sports flooring; 414 on regular flooring). Outcomes were injurious falls per person bed-day, falls per person bed-day and injury risks per fall. Confounding was adjusted for using Andersen-Gill proportional hazards and log-binomial regression models. Random-effects inverse variance models were used to pool estimates. ResultsInjurious fall rates were 13% lower in the unit with sports flooring (adjusted HR (aHR): 0.87 (95% CI: 0.55 to 1.37)). There was limited evidence of adverse effects on fall rates (aHR: 0.93 (95% CI: 0.63 to 1.38)) and the injury risk per fall was lower in fall events that occurred on sports floors (adjusted relative risk (RR): 0.75 (95% CI: 0.53 to 1.08)). Pooling these estimates with previous research added precision, but the overall pattern was the same (pooled RR for injurious falls: 0.66 (95% CI: 0.39 to 1.12); fall rates: 0.87 (95% CI: 0.68 to 1.12); injury risks per fall: 0.71 (95% CI: 0.52 to 0.97)). ConclusionSports floors may be an alternative to novel shock-absorbing floors in care settings; however, more research is needed to improve precision.

I samband med införandet av nuvarande lag (2003:778) om skydd mot olyckor (LSO) instiftades samtidigt kravet på en skriftlig redogörelse av brandskydd (Regeringens proposition, 2002/03:119). Kravet gäller för verksamheter där konsekvenser av en brand kan bli särskilt stora. Lagstiftarens intention var att den skriftliga redogörelsen skulle fungera som ett underlag för kommunens tillsyn över den enskildes (ägare och nyttjanderättshavare) brandskydd. Redogörelsen var även tänkt att tydliggöra den enskildes ansvar för brandskyddet. LSO har genom åren följts upp och det har kommit indikationer på att redogörelsen inte till fullo fyller den funktion som lagstiftaren avsåg. I denna studie undersöks hur redogörelsen används idag i förhållande till dess intention. Studien inkluderar även hur det systematiska brandskyddsarbetet (SBA) bedrivs i praktiken, med förskolor som exempel, samt vilken inverkan redogörelsen haft på SBA.För att besvara syftet har en enkät skickats ut till landets samtliga räddningstjänster och den enskildes synpunkter har fångats med hjälp av intervjuer med två fastighetsägare och 12 förskolechefer.Resultatet visar att två tredjedelar av landets räddningstjänster använder redogörelsen. Trots det, finns delade meningar om redogörelsens funktion för tillsynsverksamheten och många menar att nyttan är högst begränsad. Det beror främst på att räddningstjänsten upplever att informationen i redogörelsen inte är av det slag som behövs eller att den inte är tillförlitlig. Redogörelsen är svårbegriplig för den enskilde att fylla i vilket leder till att den enskilde antingen inte skickar in redogörelsen eller att inkommande redogörelser inte är tillförlitliga. Problematiken förstärks ytterligare av att räddningstjänsterna ofta upplever att den arbetsinsats som krävs för att hantera och bearbeta inkomna redogörelser är allt för betungande.I Regeringens proposition (2002/03:119) var tanken att redogörelsen inte skulle bli onödigt betungande. De innehållsmässiga kraven på dokumentationen skulle begränsas till de för brandskyddet mest väsentliga och den enskilde skulle få praktiska verktyg till stöd för att förstå brandskyddet. Dessa delar har inte genomförts, vilket innebär ett problem då de anses viktiga för att redogörelsen ska fungera likt dess intention. Däremot skulle en systematisk återkoppling kunna tydliggöra ansvaret. Det är en viktig pusselbit i den enskildes SBA och oavsett nivå. Problemet idag är att återkopplingen sker sporadiskt vid tillsyn, vilket är ett betungande och delvis ineffektivt arbetssätt.Den enskilde behöver ökade kunskaper samt förståelse för varför SBA ska bedrivas. Den måste förstå vikten och innebörden med SBA, annars är sannolikheten stor att de visserligen uppfyller lagen men att arbetet inte blir gjort i praktiken. Räddningstjänsten tycker att MSB bör peka ut vilka delar för SBA som ska betraktas som kritiska, dvs. hur brandskyddet ska prioriteras. De menar även att tydligare krav bör riktas mot SBA i sin helhet och inte enbart mot det tekniska systemet.

Genom en litteraturstudie identifierades ett flertal olika metoder som kan användas för att uppskatta, mäta och modellera oskyddade trafikanters rörelsemönster. En utvärdering och jämförelse av metodernas pålitlighet och lämplighet för framtida implementering i Sverige är dock svår i dagsläget på grund av stora skillnader i studiernas ansatser. Framtida metoder kommer med stor sannolikhet förlita sig på individers mobila rörelsedata, insamlade med smart teknologi genom applikationer, platsbaserade tjänster och spårning genom rumsliga nätverk såsom telekommunikationsnätverk, globala navigationssystem eller Bluetooth.Syftet med denna studie var att genom en litteraturstudie kartlägga olika tekniker och metoder som kan användas för uppskattning av oskyddade trafikanters exponering och rörelsemönster för användning vid riskkartering och andra spatiala riskanalyser. Vi genomförde två delstudier: (i) en internationell kartläggning av hur tidigare forskning som använt sig av geografiska analyser har kvantifierat exponering och rörelsemönster bland fotgängare och cyklister, och (ii) en litteraturgranskning av nya metoder för att mäta exponering.Den internationella litteraturgranskningen visade att man enbart i ett fåtal studier använt sig av faktiska exponeringsdata i studier av geografiska skademönster bland oskyddade trafikanter. De flesta metoder som bygger på direkt uppskattning av trafikanter i rörelse (t.ex. genom att räkna cyklister) kan vara svåra att generalisera eftersom detta vanligtvis görs på specifika platser eller under vissa tider och på ett icke-heltäckande sätt över vägnätet. Att använda sig av resedatamodeller för att uppskatta exponering på vägsegmentnivå kan vara ett genomförbart tillvägagångssätt, vilket framgår av flera studier som analyserats. De vanligaste uppskattningsmetoderna som används i Sverige idag är flödesmätningar och resvaneundersökningar. Internationellt har flera studier utförts med flera andra metoder som kan vara intressanta även för implementering i Sverige. Främst bland dem är analyser på data från lånecyklar och GPS-data från crowdsourcing med mobilapplikationer. Betydligt fler studier kunde identifieras som rör uppskattning av cyklister än fotgängare. Resvaneundersökningar är ett bra alternativ för att undersöka generella trender över tid. Dock saknas rumslig noggrannhet och det är svårt att kartlägga resandet i en stad endast baserat på resvaneundersökningar. Genom att kombinera data från resvaneundersökningar med befolkningsstatistik kan enkla sketchplaneringar genomföras. Ofta görs dessa modeller med enkla och lättåtkomliga data vilket gör att metoderna är lätta att genomföra och billiga. Det finns en mängd olika tekniker för att implementera flödesmätningar på oskyddade trafikanter i praktiken. Tekniskt sett är det genomförbart att applicera stickprovsmodeller på liknande vis vad som görs i vägnätet för fordonstrafik. En bra uppskattning för resmönstret hos trafikanterna kräver dock många mätningar, detta medför kostnader i form av både utrustning och arbetstid. I nuläget sker förmodligen för få flödesmätningar i de flesta svenska städer, speciellt mätningar av gångtrafikanter för att kunna applicera en sådan metod med ett acceptabelt resultat. Flödesmätningar kan dock användas i kombination med andra metoder för att bekräfta deras resultat. Flödesmätningar är förmodligen den effektivaste metoden för att kontrollera resmönster på små geografiska områden. En känslig fråga som begränsar användning av spårningsteknik idag genom nätverkstriangulering, Bluetooth eller mobila applikationer är personlig integritet. Utöver detta är det en högre risk att sårbara delar av befolkningen (t.ex. barn och äldre) exkluderas av automatisk spårning då dessa individer med större sannolikhet inte medför smart teknisk utrustning. Ändå anses denna teknik mycket framtidsorienterad, effektiv, billig och pålitlig, speciellt när lokaliseringsenheter börjar prata med varandra, när mängden insamlade data och dess tillgänglighet ökar och om dagens begränsningar gällande personlig integritet och lagstiftning förändras.

Denna rapport, som redovisar del 2 av projektet Social sårbarhet för klimatrelaterade hot, syftar till att ta fram ett generellt sårbarhetsindex för Sverige, men också specifika index för tre olika naturhot: översvämning (älv respektive kust), skogsbrand och ras/skred/erosion. För dessa specifika index har sårbarheten kombinerats med en bedömd exponering för de tre olika hoten. Analysen är gjord på kommun- och RegSO-nivå.

Collaboration has the potential to aid the balancing of values and goals that belong to different, sometimes competing, policy fields, such as energy, climate adaptation and nature conservation-a key component of sustainable governance. However, we need to know more of how collaboration can function as integrating (and integrated) components of governance systems. Three regulated Swedish rivers are used here as examples to explore factors that influence this function. The following factors are identified: transparency of value trade-offs, understanding of collaboration and governance, interplay between public sectors, integrating funding mechanisms, clarity of mandate, strategic use of networks and consistency of the governance system. As a consequence of the poor management of these factors in our case, water quality and ecology values are not integrated in strategic decision making, e.g., regarding hydropower, urban development or climate adaptation. Instead, they are considered add-ons, or "decorations". The Swedish case illustrates the meaning of the factors and their great importance for achieving sustainable governance.

At the end of 2019, a new coronavirus made its appearance and in March 2020 it was classified as a pandemic by the World Health Organization (WHO). In Sweden, the disease following infection by the virus, COVID-19, has been classified as a danger to society which have allowed the authorities to apply extraordinary measures. In April 2020, the elderly was encouraged to stay in voluntary quarantine. Knowing from earlier studies that this quarantine has resulted in deteriorating psychological well-being and great anxiety, this paper seeks to understand what factors might be contributing to this anxiety. By studying existing text answers from previous studies and analysing them with regards to a theory of psychological resilience by John Reich, results indicate that increased anxiety stems from lack of information, loss of control and a great longing for social contact. Furthermore, many of the respondents feel wrongfully lumped together in a risk category which makes it harder for them to accept decisions made by the authorities. By segmenting the group that is target for risk and crisis communication, and by giving the grounds for decisions taken by the authorities, psychological well-being and compliance to recommendations would probably be increased.

Goda förutsättningar för aktiva transporter, som att promenera eller att cykla när vi tar oss till våra destinationer, är viktiga aspekter i den hållbara staden och dessutom något som kan förbättra folkhälsan. Många kommuner har identifierat säkerheten för oskyddade trafikanter som ett problem och arbetat fram vägledande strategier för hur de ska arbeta preventivt med denna trafikantgrupp (SKL, 2015:a)(SKL, 2015:a)(SKL, 2015:a), emellertid varierar åtgärderna bland kommunerna.Syftet med denna studie har varit att identifiera och teoretiskt granska, praktiskt och/eller empiriskt välgrundade interventioner som främjar säkerheten för i första hand cyklister och fotgängare. För att skapa en uppfattning om den rådande situationen har kommuner intervjuats om hur de ser på och arbetar med frågan. Tolv intervjuer genomfördes med kommuner av varierande storlekar spridda över landet och intervjumaterialet bearbetades med kvalitativ innehållsanalys.Resultatet visar att det finns ett starkt engagemang för att främja säkerheten för oskyddade trafikanter, men att arbetet hämmas av bristande systematik, knappa ekonomiska resurser och att även brist på kunskap kan utgöra ett hinder. Hastighetsreducerande åtgärder dominerar som främsta trafiksäkerhetsåtgärd, dock har separering av trafikslagen fått ett större fokus och utbyggnad och underhåll av GC-vägar prioriteras.Det framstår som att en systematisk och genomtänkt planering förtydligar målen och ger trafiksäkerhetsarbetet en tydligare inriktning för samtliga kommuner, oavsett storlek. Förutom det så kan ett fortsatt steg för att främja säkerheten för oskyddade trafikanter och samtidigt skapa bättre förutsättningar för aktiv transport vara att tydliggöra indikatorerna för uppföljning av trafiksäkerheten mot skyddade trafikanter.

Introduction

The risk for outdoor falls tends to increase during winter due to icy road conditions. Several Swedish municipalities have introduced programs that provide their senior citizens with a pair of ice cleats in an attempt to tackle this problem. In this paper, we perform a process evaluation to identify potential barriers to the success of these programs and analyze the logic of their design.

Methods

We sent a survey to all 290 Swedish municipalities to collect data on the characteristics of ice cleat distribution programs. We also performed focus-group interviews with older adults to gain insight into their thoughts about ice cleat programs. We synthesized our data with existing literature on ice cleats and behavior change theory to populate a logic model to identify and analyze hidden assumptions and potential flaws using program theory analysis.

Results

On average, about 40% of the eligible population living in the intervention municipalities collected a pair of ice cleats. While we identified some other, but mostly minor, barriers to implementation, the main barrier appears to be a lack of scale (i.e., insufficient procurement and distribution of ice cleats), as 90% of all purchased ice cleats were eventually distributed. While previous research suggests that ice cleats can decrease injury risks if worn, we find that there is limited evidence on the effects of distribution on ice cleat use. Our interviewees emphasized the potential utility of ice cleats for staying safe and active during winter but stressed that ice cleats need to be user-friendly and of high-quality to increase the likelihood that a distribution program encourages behavior change.

Conclusion

Existing ice cleat distribution programs appear to have reached a meaningful share of the targeted population. Additional research is required to assess their effects on ice cleat use and injury rates.

Introduction Ice cleats may help prevent ice-related falls in places with icy roads, but there is limited evidence about the association between ice cleat distribution and ice cleat use. Our study examined the association between Swedish municipal distribution programmes and ice cleat use among older adults (65+ years). Methods We combined data on municipal ice cleat distribution programmes (n=63) with repeated cross-sectional self-reports of ice cleat use in Sweden from 2007, 2010, 2014 and 2018. Respondents (n=63 234) were classified as exposed if they lived in a municipality with a programme, belonged to an eligible age group and responded after distribution (n=2507). Dose-response was assessed using distributed ice cleat pairs per capita (mean: 0.38). Linear probability models were used to estimate probability differences in ice cleat use between exposed and unexposed respondents, adjusting for age, sex, country of birth, education, survey wave and municipality. Ineligible age groups living in programme municipalities, who should be unaffected by ice cleat distribution, were used for bias assessment. Results Exposure to ice cleat distribution programmes was associated with 7.5 percentage points (95% CI 4.2 to 10.9) higher self-reported ice cleat use after confounding adjustment. The association was larger in municipalities that distributed one pair of ice cleats per capita (17.3 percentage points (95% CI 11.2 to 23.4)). No association was found among the ineligible age groups (-2.3 (95% CI -5.5 to 1.0)). Conclusion Distributing ice cleats to older adults may help increase their use of ice cleats in settings with icy road conditions.

Background: Closing delivery units increases travel time for some women. Whether increased travel time is associated with maternal outcomes is important for understanding the consequences of such closures. Previous studies are limited in measuring travel time and restricted to the outcome of caesarean section. Methods: Our population-based cohort includes data from the Swedish Pregnancy Register for women giving birth between 2014 and 2017 (N = 364,630). We estimated travel time from home to the delivery ward using coordinate pairs of actual addresses. The association between travel time and onset of labour was modelled using multinomial logistic regression, and logistic regression was used for the outcomes postpartum haemorrhage (PPH) and obstetric anal sphincter injury (OASIS). Findings: Over three-quarters of women had ≤30 min travel time (median 13.9 min). Women who travelled ≥60 min arrived to care sooner and laboured there longer. Women with further to travel had increased adjusted odds ratio (aOR) of having an elective caesarean section (31–59 min aOR 1.11; 95% confidence interval [CI] 1.07–1.16; ≥60 min aOR 1.25; 95% CI 1.16–1.36) than spontaneous onset of labour. Women (at full term with spontaneous onset) living ≥60 min away had reduced odds of having a PPH (aOR 0.84; 95% CI 0.76–0.94) or OASIS (aOR 0.79; 95% CI 0.66–0.94). Interpretation: Longer travel time increased the odds of elective caesarean section. Women with furthest to travel arrived sooner and spent more time in care; although they had a lower risk of PPH or OASIS, they also tended to be younger, have a higher body mass index and were Nordic born. 

Denna rapport är resultatet av en förstudie för projektförslaget Centrum för Planering för Gång, hädanefter kallat Forskningsprogrammet Planering för Gång. Syftet med det tilltänkta forskningsprogrammet är att arbeta med transportslaget gång enligt de två övergripande projektmålen att öka kunskapen om (1) hur gångtrafiken kan öka och (2) hur trafikslagets säkerhetssituation kan förbättra. Syftet är även att integrera dessa tillsammans, på ett systematiskt och tvärvetenskapligt sätt inom trafikplaneringen. Betydelsen av att ”färdas till fots” är bred i denna ansats, med fokus på att behandla det ”som ett transportsätt".

I denna förstudie har tre seminarier genomförts för att identifiera forskningsämnen, partners, behovet och fokus av ett sammanhållet forskningsprogram avseende transportslaget gång och dess olika aspekter. De tre seminarierna har ordnats med deltagare från kommuner, Trafikverket och andra statliga aktörer, teknik- och designföretag/Innovationsföretagen m.fl. Denna förstudie avser således verksamhetsplanering för fortsatt Forskningsprogrammet Planering för Gång.

Deltagarna till seminarierna valdes strategiskt ut från författarens professionella nätverk. Syftet var att inkludera ett stort antal olika intresseorganisationer, offentliga myndigheter och privata företag från hela Skandinavien. Totalt bjöds 162 personer in till de tre seminarierna, och totalt 68 personer deltog vid ett, två, eller alla tre seminarierna. De identifierade övergripande frågeställningarna eller perspektiven var:

• Synen på gångtrafik och fotgängare

Ett tydligt och genomgående tema eller perspektiv i seminarierna var den makthierarki som befästs inom trafikmiljön. Den dominerande synen är att motoriserad transport prioriteras, följt av cykling. Längst ned i hierarkin finns gång.

• Samhällelig och rumslig planering

Detta tema behandlar planering i en vid betydelse – på gatunivå ända upp till urban/regional nivå.Från både ett design-, säkerhets- och upplevelseperspektiv är mjuka värden såsom upplevelser, trygghet och estetik viktiga komponenter i relation till att uppmuntra transportslaget gång.

• Data och indikatorer och data för uppföljning

Oavsett om det handlar om exponeringsdata, skadedata, trygghetsdata eller framåtblickande indikatorer i relation till fotgängare finns stora brister i datakvalitet och definitioner. Bristen på data innebär i sin tur att utvärderingar av interventioner är svåra att genomföra.

• Ansvar och organisation

Behoven hos fotgängare, oavsett om dessa relaterar till underhåll, planering eller säkerhet, är spridda på många olika samhällsaktörer.

• Brist på övergripande strategier och riktlinjer samt ett spretigt forskningsfält

Trots det miljö- och hälsomässiga fördelarna av gång finns inga nationella strategier för hur antalet fotgängare ska öka eller hur mängden steg ska öka.

• Socio-ekonomiska aspekteriv

Då socio-ekonomiska faktorer är centrala för att förstå och förklara risk, exponering och beteendemönster är bristen på denna typ av kunskap problematiskt. Inte minst gäller detta i relation till planering, interventioner eller underhåll för att veta hur olika socioekonomiska grupper påverkas och deras möjlighet att gå (på ett säkert sätt).

• Samhällsekonomiska effekter

För att fullt ut förstå gångens fulla effekt på individer och samhälle behövs en mer sammansatt förståelse av transportslaget gångs effekter på samhällets kostnader och vinster.

• En övergripande modell

Utöver perspektiven ovan identifierades också ett övergripande perspektiv – relationen mellan individen, klimatet och dess omkringliggande (byggda) miljö.

Vår målsättning är att Forskningsprogrammet Planering för Gång ska bli ett nationellt kunskapsprogram för forskning och utbildning om transportslaget gång och fotgängare. Grunden för vår verksamhetsidé är att forskningsprogrammet ska vara öppet för alla relevanta aktörer och intressenter för kunskapsutbyte och innovation för transportslaget gång och fotgängare. Forskningsprogrammet Planering för Gång ska öka det tvärvetenskapliga samarbetet, arbeta för långsiktig kunskapsuppbyggnad, knyta forskningen närmare samhället och uppfylla följande syften om transportslaget gång och fotgängare:

• Att möta samhällets utmaningar och aktörernas behov genom tillämpad forskning och utveckling samt spridning av kunskap.
• Att bygga upp en långsiktig, konkurrenskraftig och sammanhållen kompetens inom transportslaget gång och fotgängare genom forskning, utbildning och professionell erfarenhet.
• Att skapa en plattform för excellent och innovativ forskning.

Baserat på utredningen ovan är förslaget att organisationsformen för ett framtida ”center” är forskningsprogram. Detta ger de tydligaste förutsättningarna gällande både organisation och hantering av ekonomi. Organisationsformen forskningsprogram ger även möjlighet till den mest inkluderande ansatsen, olika typer av professionella organisationer kan delta, och det blir tydligt hur och när eventuell medfinansiering kan ske, samt hur avtal för det kan tas fram.

Adventure tourism is a form of nature-related tourism where activities with varying degrees of risk are in focus for the experience. Globally, adventure tourism has become a growing industry while at the same time being an important source of income for many of the communities that offer experiences within the concept. But it isn´t an experience free from risk. Risk factors related to the environment, weather and the individual himself are often present in nature-related experiences which can give rise to serious events and incidents regardless of whether the risk level in activity's is high or low. Research shows that individual-oriented measures may often be in focus when measures are recommended, while several researchers believe that risk management needs to be based on a holistic perspective where collaboration between actors in the industry is significant for risk management.

The purpose of this thesis is to investigate how the safety prevention work through collaboration is developed and maintained with the Mountain Safety Council at the forefront. The study was conducted using a qualitative method where the material for the study was collected through 13 interviews. The interviews have then been transcribed and analyzed with a qualitative content analysis and the results present similarities and differences between the respondents´ perspectives.

The results show that there are several similarities, but also differences in how the respondents experience the local in the security promotion work. But also similarities regarding the importance of collaboration where the respondents feels that collaboration contributes to building and strengthening the relationships between the actors. At the same time, there are some differences in how the respondents perceive the legislation and several respondents also experience that there are some challenges in communication and reaching out with information. But also challenges in the form of lack of injury surveillane and limited opportunities to evaluate measures.

Introduction: Despite a positive long-term trend in fire mortality rates, more knowledge is required concerning the causes and typologies of fatal residential fires in order to improve preventative efforts and further decrease fatality rates. A previous study suggested that fatal residential fires can be grouped into six categories, however, the analyses were performed on a limited dataset that is now more than a decade old. As such, there are some uncertainties regarding the current situation. Also, in the previous study, no subgroups were analyzed separately, despite fatal fires being renowned for being strongly age-dependent. Method: This study re-analyzes the typologies for fatal residential fires in Sweden using cluster analysis, based on data for a period of 20 years with a particular focus on older adults. Results: The results suggest that the original cluster analyses were relatively robust for both the total population and for the elderly population, thereby indicating that fatal fires seem to be consistently grouped into certain types. Conclusions: The results suggest that preventative efforts can be directed toward these types of events involving identified individuals. The results also suggest that the number of fatal residential fires with unknown causes has increased in relation to other fires during the 20-year study period. Practical Implications: Fatal residential fires with unknown causes are more often large night-time fires occurring in houses in rural locations. In order to prevent these, both prevention and reactive strategies need to be re-evaluated.

Studien har tagit fram ett sårbarhetsindex på kommunal nivå i Sverige, baserat på 37 socio-ekonomiska variabler. Metoden som utvecklats i USA bygger på statistisk analys (PCA) och visualisering i ett GIS. Resultaten visar på tydliga regionala skillnader för social sårbarhet. Metoden behöver fortsatt utveckling, med studier för att öka förståelsen för vad som skapar sårbarhet i en svensk kontext.

In Europe, flash floods are one of the most significant natural hazards, causing serious risk to life and destruction of buildings and infrastructure. The intense rain causing those floods has a few different names, however, with very similar meaning. The term chosen in this study, ‘cloudburst’, was introduced by Woolley (1946) as “…a torrential downpour of rain which by its spottiness and relatively high intensity suggests the bursting and discharge of the whole cloud at once”. While these events play an important role in the ongoing flood risk management discussion, they are under-represented among flood models.

The main aim of this study is to demonstrate an approach by showing how methods and techniques can be integrated together to construct a catastrophe model for flash flooding of Jönköping municipality in Sweden. The model is developed in the framework of the ‘Oasis Loss Modelling Framework’ platform, jointly with end-users from the public sector and the insurance industry. Calibration and validation of the model were conducted by comparisons against three historical cloudburst events and corresponding insurance-claim data.

The analysis has shown that it is possible to get acceptable results from a cloudburst catastrophe model using only rainfall data, and not surface-water level as driving variable. The approach presented opens up for such loss modelling in places where complex hydraulic modelling cannot be done because of lacking data or skill of responsible staff. The Swedish case study indicates that the framework presented can be considered as an important decision making tool, by establishing an area for collaboration between academia; insurance businesses; and local authorities, to reduce long-term disaster risk in Sweden.

Cloudburst flash floods cause big casualties and economic losses. This study primarily investigated if a cloudburst catastrophe (cat) model could be constructed to meaningfully assess such a hazard, exposure and vulnerability in Swedish urban context. Rainfall intensity was used directly as hazard measure, bypassing hydraulic water-level modelling, to predict vulnerability. The Splash (Swedish pluvial modelling analysis and safety handling) cloudburst-disaster model was constructed using the Oasis Loss Modelling Framework, and was based on individual property values and building locations, property-level insurance-loss data, high-resolution geographical data, and rainfall data from a dense municipal gauge network in the city of Jönköping. One major cloudburst event was used to derive a vulnerability curve. The following two events were used for validation and supported the hypothesis that the vulnerability curve changed with time because of municipal flood-risk-reduction measures after the first event. A faulty rain gauge during the first event, replaced by a trustworthy private gauge, clarified the very high sensitivity to cloudburst input. Given the limited amount of loss data, our results were uncertain but they pointed towards possible ways to further this study with other loss data at other locations, possibly using more easily available aggregated loss data. We concluded that a cat model based only on rainfall intensity provided acceptable results, thus providing an opening for future, simplified cloudburst cat models applicable in most geographical contexts where reliable cloudburst data are available, especially in cities with limited topographic data and hydraulic-modelling capacity.

Vision Zero is a term mainly connected with road traffic safety and has its roots in the Swedish road safety strategy. It was formally adopted by the Swedish parliament in 1997, and due to the initial success of lowering the number of deaths in traffic crashes significantly, it has become a role model for road safety strategies in countries and cities all over the world. In Sweden, Vision Zero for road safety has also inspired the introduction of Vision Zero policies in other sectors, and this chapter focuses on Vision Zero from a multi-sectoral perspective. The purpose of this chapter is twofold: to present five different cases of Vision Zero policies and to discuss what constitutes a Vision Zero policy based on these five cases. The five cases are found in road traffic safety, fire safety, patient safety, suicide, and workplace safety. Every case has its unique preconditions in terms of laws, actors, scope, etc., but they are also similar in relation to injury prevention and the ambition to decrease the number of deaths and serious injuries. The five Vision Zero policies are summarized by presenting the problem and problem framing, the goal, measures, and solutions as well as leading actors and governing structures. We find that the problem itself is quite self-explanatory in each case but that the problem framing and attribution of responsibility differ. All cases have on paper been inspired by the road safety strategies, but the systems approach, so intimately connected with Vision Zero, is more or less absent in the cases of fire safety and suicide. Furthermore, in the field of fire safety, responsibility is placed on the individual and on the business sector rather than based on a shared responsibility and ultimately on the system designers. In all five cases, there are a set of measures in place, but there are differences in implementation due to temporal factors and also what kind of governing and steering structures are in place. There is also a difference in internal support where the Vision Zero for suicide stands out as having less support among agencies working with the issue. Finally, the monitoring systems differ from case to case. The Vision Zero for road traffic safety stands out as having a monitoring and evaluating system based on specific safety targets ultimately aiming toward zero (management by objectives). Based on the empirical findings, we argue that besides having a clear problem and problem framing, a toolbox of measures, a monitoring system, and a governing structure, a policy based on a visionary approach with an ambition to reach zero needs additional perspectives or criteria in order to be successful: (1) a scientific approach to problem framing and solutions, (2) a comprehensive approach, (3) a long-term commitment, and (4) a system and structure based on governance. These criteria do not necessarily have to be in place in order to adopt Vision Zero, but they are a prerequisite for building a system based on Vision Zero.

OBJECTIVE: The first automatic emergency braking (AEB) system was presented in 2003 and aimed to mitigate or reduce rear-end crashes. Since then, several AEB systems aimed to reduce other collision types have been introduced and studies have shown that they reduce crash risks. The aim with this study was to evaluate crash reductions of cars fitted with AEB systems with pedestrian detection and those with bicyclist detection. METHODS: The study is based on the Swedish Traffic Accident Data Acquisition that includes road traffic accidents reported by the police and by emergency hospitals. Crashes occurring between 2015 and 2020 and with cars from model years 2015 to 2020 were included. The statistical analysis used odds ratio calculations with an induced exposure approach where the outcomes of sensitive and nonsensitive crashes were studied. The sensitive crashes were hit pedestrians and bicyclists, respectively. The nonsensitive crash type in both comparisons was struck vehicles in rear-end crashes. Evaluations were also made for different light and weather conditions and for high and low speed roads. RESULTS: Seven hundred and twelve hit pedestrians and 1,105 hit bicyclists were included, and the nonsensitive crashes consisted of 1,978 vehicles. The overall reduction on crash risk for AEB with pedestrian detection was 8% (±15%; ns) and for AEB with bicyclist detection it was 21% (±17%). When separating for light conditions, no reduction in crash risk for AEB with pedestrian detection nor for AEB with bicyclist detection could be seen in darkness. However, in daylight and twilight conditions, AEB with pedestrian detection reduced pedestrian crash risk by 18% (±19%; ns) and AEB with bicyclist detection reduced bicyclist crash risk by 23% (±19%). No significant reductions could be seen when separating for weather conditions except for a 53% (±31%) reduction for bicyclists in rain, fog, and snowfall. A larger reduction on high-speed roads (50-120 km/h) compared with low-speed roads (10-40 km/h) was also found. CONCLUSIONS: AEB systems with bicyclist detection were found to reduce the numbers of hit bicyclists, especially in daylight and twilight conditions. In darkness, no reduction for hit pedestrians or bicyclists was found.

AimTo investigates the financial consequences in the overall population spouses of persons with stroke in Sweden as well as for subgroups based on spouses age, sex and modified Rankin Scale (mRS) of the person with stroke.MethodsThe study population consists of spouses aged <= 60 during the year of their partner's stroke event. Each spouse was matched to four reference individuals. This longitudinal registry data covers spouses and a reference population between 2005 and 2016. We use difference-in-differences to estimate the impact on individual income from paid work, disposable individual income, and disposable family income.ResultsThe primary analysis shows a small and statistically insignificant decrease on spouses' individual income from paid work and disposable individual income. In the subgroup analysis based on mRS, the largest effect is seen in mRS 4-5, where spouses' individual income from paid work and disposable individual income increases after their partner's stroke. Further, younger female spouses' individual income from paid work decreases by 1 614 EUR (p = 0.008) on average.ConclusionThe financial consequences are small in the overall population of spouses. However, for some subgroups, younger women, and spouses of persons with stroke and mRS 4-5, the financial consequences are more prominent.

Background: In a global perspective are floods, after storms, the natural hazard that causes the most economic damage. Within the European Union (EU), floods gained increased focus after Europe was hit by major floods in 2002. Because of this, the EU-funded project STAR-FLOOD was launched in October 2012. Among other things, the project resulted in a guidebook for how flood risks can be managed. The guidebook, written by Raadgever et.al. (2016), recommends a mix of strategies (diversification) for the management of flood risks. Within the EU, flood risks have traditionally been managed through structural protection, being just one of several strategies. In Sweden, floods are managed mainly in the acute phase and through private insurance. Flood protection has recently become increasingly important for how floods are handled in Sweden, which can be exemplified by the levee that is to be built on Falsterbonäset in Vellinge municipality in Skåne. However, there is a paradox with this type of structural flood protection, and it is that these can increase the risk of flooding. The paradox is called the levee effect and means that structural flood protection can lead to a false sense of security in those who live in the protected area. A diversified strategy for managing flood risks can reduce the risk of the levee effect.

Purpose: Study to which extent a diversified strategy can be traced in the case of structural protection that is planned structural on Falsterbonäset.

Method: A descriptive case study of how flood risks from the sea are managed on Falsterbonäset. The material has mainly been collected through qualitative interviews which have then been analysed with a directed qualitative content analysis. As a complement to the interviews, other material has also been analysed, mainly municipal documents. The theory on which the study is based, is the levee effect and the theory of risk homeostasis.

Results: Based on the guidebook by Raadgever et.al. (2016), it is possible for Vellinge municipality to do more to reduce the probability and the consequences of floods on Falsterbonäset. For example, it would have been possible to limit the development in the protected area and set clear requirements for heights for new buildings. At the same time, the municipality's strategy has never been as diversified as it is now, due to the forthcoming flood protection. However, there are some indications of conditions for a levee effect to occur.

Certain groups (e.g., those of higher age, lower educational attainment, lower income, living alone, immigrants, etc.) have a greater risk of residential fire mortality. Previous research has also shown that individuals belonging to high-risk groups have generally lower levels of fire protection, and it has been suggested that this is due to a lower risk perception in this group. As such, this study investigates how the perceived risk of being injured in a residential fire varies in the Swedish population. The results show that risk perception varies in the Swedish population depending upon sociodemographic factors. When the different sociodemographic factors are controlled against each other, women, individuals with a low educational level, individuals living in rural communities and individuals born outside of the Nordic countries consistently experience their risk to be higher. With the exception of women, the results show that high-risk individuals have a high risk perception. These results are important as they indicate that it is not a lack of risk awareness that is the reason why high-risk groups are less inclined to implement fire safety practices.

Rapid urbanization in developing countries often results in uncontrolled urban growth. In order to support sustainable urban development, reliable and up-to-date information on urban land cover changes and their environmental impact is needed. In this study, we aim at evaluating the potential of Sentinel-2 (S-2) Multi-spectral Instrument (MSI) data for urban land cover change monitoring and for analyzing resulting impacts on Ecosystem Services (ES) provision in Kigali, Rwanda. Land cover classification into eight distinct urban classes (84% overall accuracies, 0.8 Kappa) was performed on data from 2016 and 2021 using a hybrid approach combining Random Forest with a U-Net-based impervious surface segmentation that improved the delineation of urban areas. The bi-temporal land cover maps were then analyzed regarding landscape structure using Landscape Metrics (LM). Ecosystem service bundles were derived for both years and their changes were summarized. Service providing areas were further evaluated in terms of changes in spatial attributes and structure of patches. ES were aggregated into eight bundles and grouped into provisioning, regulating and supporting services. The bundles were further analyzed using a matrix spatially linking landscape units with service supply and demand budgets. The results illustrated that three urban development scenarios can be distinguished including infill through housing and infrastructures development in core urban areas, urban sprawl in fringe zones and the development of urban patches at distant locations intercepted by cropland. The results revealed that the changes in LM negatively affected ES supply mainly through a decrease in cropland and forest. The expansion of built-up areas resulted in a high demand for provisioning and regulating services, especially food and water provision, surface runoff mitigation and erosion control. This is the first study demonstrating that detailed monitoring of urbanization and resulting environmental impacts can be performed with open access S-2 MSI data in Sub-Saharan Africa. Moreover, the framework developed in this study has the potential to be transferred to other Sub-Saharan cities.

Societal safety is often centred on handling or managing a single risk from the perspective of a particular at-risk group or individual, in a specific time and place. However, such linear and single-facetted processes are rare and the current approaches in societal risk management fail to comprehensively include and discuss the full range of outcomes and its inherent uncertainty and complexity. By combining different examples of known and unknown outcomes of societal risk management in the scientific literature, this paper aim to contribute to the risk and safety research field by presenting a conceptual model of risk transfer. The conceptual model shows how traditional societal risk management strategies often aim at reducing a targeted risk, considering the original actors affected by this risk, in a defined geographical area and for a decided time frame despite risk management also altering the landscape of risks for other actors, in other places, and at other times, as well as for the original actors, in the original place, and during the original time. Combining these aspects in a conceptual model that accepts and incorporates complexity, the underlying intention is to initiate a discussion regarding the current approaches and understandings of societal risk management and societal safety. 

In Europe, a demographic transition has occurred meaning that countries have larger older adult populations who are increasingly living alone and receiving homecare rather than institutional care. Given that living alone is the greatest individual risk factor for fire mortality amongst older adults and that large differences exist in terms of both fire mortality risk and living arrangements between countries, this study investigates the association between co-living rates and fire mortality rates among older adults in Europe. Freely available datasets with aggregated European data on fire mortality, living arrangements among older adults, population statistics and GDP were analyzed using Poisson regression models. The results show that fire-related mortality rates amongst older adults in Europe is correlated with living arrangements after adjusting for GDP. Specifically, in Europe, when the share of older adults living alone increases by one percentage point, fire mortality rates increase by roughly 4 percent for both sexes.

Rescue services are one of the most crucial actors in providing fire-related societal protection, particularly interms of response times. To achieve this, considerable funding and/or full-time organisations are required –something that is not always feasible and leads to differences in rescue service related protection in differentmunicipalities. In turn, the question is how such variations affect the perceived risk of being injured in a resi-dential fire and levels of general institutional trust in the municipality. By utilising a dataset on risk perceptionand trust, combined with data on the ability and structure of municipal rescue services, this study can show that amunicipal’s average perception of the risk of attaining a fire-related injury closely follows response times –indicating that individuals living in areas with less societal protection are aware of this fact. However, the resultsalso indicate that general institutional trust and perception of risk on a municipal level seems to relate to eachother in such a way that municipal types (with similar sociodemographic characteristics and rescue serviceability) congregate around similar levels of perceived risk and trust. In turn, this study therefore indicates thatperceived risk and trust differs in different municipalities and that efficiency measurements not necessarilyencompass all these differences.

When individuals self-select (or are selected) into a study based on factors that influence the outcome, conclusions may not generalize to the full population. To compensate for this, results may be adjusted, for example, by standardization on the set of common causes of participation and outcome. Although such standardization is useful in some contexts, the common causes of participation and outcome may in practice not be fully observed. Instead, the researcher may have access to one or several variables related to the common causes, that is, to proxies for the common causes. This article defines and examines different types of proxy variables and shows how these can be used to obtain generalizable study results. First of all, the researcher may exploit proxies that influence only participation or outcome but which still allow for perfect generalizability by rendering participation and outcome conditionally independent. Further, generalizability can be achieved by leveraging 2 proxies, one of which is allowed to influence participation and one of which is allowed to influence the outcome, even if participation and outcome do not become independent conditional on these. Finally, approximate generalizability may be obtained by exploiting a single proxy that does not itself influence participation or outcome.

Background: Participants in epidemiological cohorts may not be representative of the full invited population, limiting the generalizability of prevalence and incidence estimates. We propose that this problem can be remedied by exploiting data on baseline participants who refused to participate in a re-examination, as such participants may be more similar to baseline non-participants than what baseline participants who agree to participate in the re-examination are. Methods: We compared background characteristics, mortality, and disease incidences across the full population invited to the Malmö Diet and Cancer (MDC) study, the baseline participants, the baseline non-participants, the baseline participants who participated in a re-examination, and the baseline participants who did not participate in the re-examination. We then considered two models for estimating characteristics and outcomes in the full population: one (“the substitution model”) assuming that the baseline non-participants were similar to the baseline participants who refused to participate in the re-examination, and one (“the extrapolation model”) assuming that differences between the full group of baseline participants and the baseline participants who participated in the re-examination could be extended to infer results in the full population. Finally, we compared prevalences of baseline risk factors including smoking, risky drinking, overweight, and obesity across baseline participants, baseline participants who participated in the re-examination, and baseline participants who did not participate in the re-examination, and used the above models to estimate the prevalences of these factors in the full invited population. Results: Compared to baseline non-participants, baseline participants were less likely to be immigrants, had higher socioeconomic status, and lower mortality and disease incidences. Baseline participants not participating in the re-examination generally resembled the full population. The extrapolation model often generated characteristics and incidences even more similar to the full population. The prevalences of risk factors, particularly smoking, were estimated to be substantially higher in the full population than among the baseline participants. Conclusions: Participants in epidemiological cohorts such as the MDC study are unlikely to be representative of the full invited population. Exploiting data on baseline participants who did not participate in a re-examination can be a simple and useful way to improve the generalizability of prevalence and incidence estimates. 

In studies recruited on a voluntary basis, lack of representativity may impair the ability to generalize findings to the target population. Previous studies, primarily based on surveys, have suggested that generalizability may be improved by exploiting data on individuals who agreed to participate only after receiving one or several reminders, as such individuals may be more similar to non-participants than what early participants are. Assessing this idea in the context of screenings, we compared sociodemographic characteristics and health across early, late, and non-participants in two large population-based screening studies in Sweden: STROKESTOP II (screening for atrial fibrillation; 6,867 participants) and SCREESCO (screening for colorectal cancer; 39,363 participants). We also explored the opportunities to reproduce the distributions of characteristics in the full invited populations, either by assuming that the non-participants were similar to the late participants, or by applying a linear extrapolation model based on both early and late participants. Findings showed that early and late participants exhibited similar characteristics along most dimensions, including civil status, education, income, and health examination results. Both these types of participants in turn differed from the non-participants, with fewer married, lower educational attainments, and lower incomes. Compared to early participants, late participants were more likely to be born outside of Sweden and to have comorbidities, with non-participants similar or even more so. The two empirical models improved representativity in some cases, but not always. Overall, we found mixed support that data on late participation may be useful for improving representativeness of screening studies.

This article builds on the field of collaborative crisis management, a mix of collaborative public management (CPM) and crisis management (CM). A field that often focuses on large-scale threats, sometimes labelled societal challenges, whose impacts are broad and cross-cutting and impacts many actors in society and drives demand for collaboration. In this study, we are interested in events that have broad and disastrous impacts on soci- ety, high degrees of uncertainty and potentially cascading effects and we study this through an in-depth case study of collaborative crisis manage- ment tasked with contingency planning for dam failure risk in a large river basin in central Sweden. We find that there was a lack in reach of the col- laboration potentially limiting capacity and capacity building in ways that can limit preparedness and increase vulnerability in a crisis situation. We also found that contingency planning was treated as a demarcated project with a beginning and an end and not entirely as a continuous process. Both these observations go against the basic principles of contingency planning. Hence, there is a need to acknowledge and abridge varying lev- els of organisational capacity and build/maintain awareness within and between the organisations and actors involved. This study shows that the practice of cross-sector collaboration and contingency planning is both complex and complicated. The article has the potential to aid policy-mak- ers in the field to pinpoint central aspects of cross-sector collaboration and contingency planning that needs to be addressed in order to mitigate limits to preparedness and increased vulnerability in a crisis situation. A deeper knowledge on these challenges and problems can also support progress towards the UN Sustainable Development Goal 9 (especially in relation to the aspect of building resilient infrastructure) through its empir- ical focus on infrastructure failure in terms of dam failure.