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With biodiversity loss as one of today's most pressing global problems, it is crucial to raise public recognition of this crisis and promote acceptance of conservation efforts. Plants, which typically struggle with low awareness ('plant blindness') and less emotional connection than animals with humans, are facing a special challenge. Promoting positive attitudes towards, and interest in, plants might provide the key to resolve this discrepancy. This study aims to differentiate attitudes and interest within the plant awareness framework while at the same time identify criteria for developing positive attitudes and interest towards plants in students. In a mixed-method approach, a questionnaire with closed and open items on attitudes and interest was developed and administered online to 179 students aged 9-19. Quantitative as well as qualitative results show that 'attitudes towards plants' can be differentiated from 'interest in plants'. Attitudes towards plants were positive, whereas interest in plants was rather low, with cultural and regulating ecosystem services acting as primary reasons for students' positive attitudes. These two components can be easily incorporated in botany teaching in order to promote plant awareness and increase knowledge about their crucial role in ecosystems and global climate, thus raising acceptance for conservation.

This study evaluated drivers and barriers in consumer willingness to purchase plant-based yoghurt analogues (PBYA) and assessed the most important attributes of PBYA. Questionnaire data from 702 Swedish adults (19% vegan, 20% lacto-ovo-vegetarian, 21% flexitarian, 41% omnivore) showed that attitudes and preferences regarding PBYA differed between consumers with different dietary preferences. Animal welfare was an important driver for vegans, while interest in trying new foods was one of the main drivers for omnivores. All four consumer groups believed that PBYA is good for the environment. The main reasons indicated for not consuming PBYA were unpleasant taste and lack of motive to switch from dairy yoghurt to PBYA. All groups indicated taste, appearance and price as overall driving forces when choosing PBYA. The importance of some factors, such as local ingredients, few additives and low sugar content, was rated higher by flexitarians and omnivores than by vegans and lacto-ovo vegetarians. These data about consumer attitudes and preferences regarding PBYA should be implemented during PBYA product development, especially when targeting different food preference groups., This work was supported by Formas research council , grant numbers 2020–00861 , 2018–01869 and 2020-02839 .

Introduction: Individuals’ comprehension of the information provided in consent forms should fundamentally influence whether to participate initially in a study and later whether to remain a participant. Existing evidence, however, suggests that participants do not thoroughly read, comprehend, or recall the information in consent forms. This study aimed to better understand how well participants recalled trial procedure information in the consent materials they received prior to taking part in a trial of a digital alcohol intervention. Method: This study was nested within an online effectiveness trial. The study included a contrast between two layout approaches to present the trial procedure information: one where all materials were shown on the same page (One page) and one where participants had to click on links to get materials for certain parts of the study information (Active request). Recall of trial procedures was measured 2 months post-randomization with four questions. Participants were also asked to leave a comment after each question. Result: Of the 2437 individuals who registered interest in the parent trial, 1197 were randomized to One page and 1240 were randomized to Active request. Approximately 90% consented to participate and 53% of the participants responded to the recall questionnaire. Contrasting the consent layout showed no marked differences between groups in three out of the four questions on recall of trial procedures. There was, however, evidence that recall of aspects of how personal data would be handled during the trial did differ between the two groups, with the Active request group reporting less recall than the One page group. Free-text comments were used to give nuance to the quantitative analysis. Conclusion: Participants exposed to different layouts of trial procedure information exhibited varying levels of information recall 2 months after consenting. The findings highlight the influence of the presentation of consent forms, which, This study was conducted under the auspices of the Alcohol Research Council of the Swedish Alcohol Retailing Monopoly (grant numbers 2019-0056 and 2020-0043) and the Swedish Research Council for Health, Working Life, and Welfare (grant number 2022-00193)

Background: Despite the high prevalence of oral dryness and awareness of its complications, there is limited research on the clinical management of patients with oral dryness in general dental care. Purpose: To (1) describe and compare awareness among dental care professionals regarding saliva functions, potential causes and complications of oral dryness, and patient management (2) Investigate if the length of professional experience influences these aspects. Methods: A digital self-administrated survey was sent to 2668 dental care professionals working in the general dental care, Public Dental Service, in Sweden. Twelve dental care professionals reviewed the questionnaire prior to its distribution. The questionnaire comprised 32 questions about patient management, awareness of saliva functions, causes and complications of oral dryness, and self-assessment queries. Results: The response rate was 18.6% (241 dentists and 257 dental hygienists). Older adults (65+) were asked more often about dry mouth (93.0%) compared to those aged 18-23 years (50.0%) and those under 18 years (24.9%). Dental hygienists encountered individuals with oral dryness more frequently (61.1%) than dentists (48.5%) (p < 0.01), and more often asked individuals in the age groups 18-23 years (p = 0.003), 24-40 years (p = 0.045), and 41-65 years (p = 0.031) about dry mouth. A higher proportion of dental hygienists (88.3%) than dentists (51.0%) had measured salivary secretion rate, (p < 0.001) and more often suggested preventive dental care 3-4 times a year, (42.5% vs. 30.5%) (p < 0.007). Dentists had a higher awareness of saliva functions, while dental hygienists had a higher awareness about causes and complications of oral dryness. Higher proportions of dentists and dental hygienists with over 10 years of professional experience had measured salivary secretion rate (69.1% vs. 95.7%) compared to their counterparts with less than 10 years of professional experience (35.9% vs. 79.5%) (p

Background: Moral distress is a problem and negative experience among health-care professionals. Various instruments have been developed to measure the level and underlying reasons for experienced moral distress. The moral distress thermometer (MDT) is a single-tool instrument to capture the level of moral distress experienced in real-time. Aim: The aim of this study was to translate the MDT and adapt it to the Swedish cultural context. R esearch design: The first part of this study concerns the translation of MDT to the Swedish context, and the second part the psychometric testing of the Swedish version. Participants and research context: 89 healthcare professionals working at a hospital in northern Sweden participated. Convergent validity was tested between MDT and Measure of Moral Distress-Healthcare Professionals (MMD-HP), and construct validity was tested by comparing MDT scores among healthcare professionals. MDT was compared with responses to the final questions in MMD-HP. One-way ANOVA, Welch’s ANOVA, Games–Howell post-hoc test and Pearson’s correlation analysis were done. Ethical considerations: The study was approved by the Swedish Ethics Review Authority (dnr 2020-04120) in accordance with Helsinki Declaration. Results: The translated Swedish version of MDT was described as relevant to capture the experience of moral distress. The mean value for MDT was 2.26, with a median of 2 and a mode value of 0. The result showed moderate correlations between the MDT and MMD-HP total scores. There was a significant difference when comparing MDT and healthcare professionals who had never considered leaving their present position with those who had left and those who had considered leaving but had not done so, with the latter assessing significantly higher moral distress. Conclusion: The MDT is an easily available instrument useful as an extension to MMD-HP to measure the real-time experience of moral distress among healthcare professionals in a Swedish context.

The study aimed to investigate how child welfare social workers assessed the leadership of their first-line managers over a period of fifteen years and to examine whether the assessments have changed over time. More specifically, the analysis focused on the extent to which social workers perceive the leadership of their first-line managers to be empowering, supportive and fair. Data were collected in the years 2003 (n = 293), 2014 (n = 300) and 2018 (n = 309) using the same questionnaire, mainly based on QPS Nordic, which was distributed to social workers working with investigations of children and youth. The results show that the social workers assessed all measured aspects of their first-line managers' leadership as better in 2014 compared to 2003 and significantly better in 2018 compared to 2003. In light of previous studies showing that child welfare managers experience less optimal conditions for their leadership, the results are surprising. How is it possible that the first-line managers, despite their own descriptions of a more difficult leadership situation, are seen as more supportive, empowering and fair in their leadership from the social workers' perspective? Possible explanations for the social workers' better assessments over the years, such as specialisation, are discussed. This article investigates how child welfare social workers have assessed the leadership of their first-line managers over a period of fifteen years. Questionnaires were collected in the same geographical areas in 2003, 2014 and 2018. The results show that child welfare social workers assessed the leadership of their first-line managers as increasingly empowering, supportive and fair over the years. In light of previous studies showing that child welfare managers experience less optimal conditions for their leadership, the results are surprising. How is it possible that the first-line managers, despite their own descriptions of a more difficult leadership situation, are seen as more

The environment is everything around us. The environment provides fresh air, clean water and productive fertile soil for the manufacture of food etc., But in the current global scenario, it has been observed that human activities are continuously and constantly impacting our mother nature in a negative way. As we navigate the complexities of the 21st century, it becomes increasingly evident that our actions today profoundly impact the world we will inhabit tomorrow. In the 21st century our environment is facing a lot of problems like climate change, depletion of ozone layer, acid rain, population explosion, loss of biodiversity due to over exploitation of nature and natural resources. Therefore, there is an urgent need and it is high time to rescue our environment thereby to maintain a harmonious relationship between man and nature in a sustainable way. In the pursuit of progress and prosperity, humanity has often overlooked the critical importance of environmental sustainability. This book, "Sustainable Development in 21st Century through Clean Environment," explores the nexus between sustainable development and environmental preservation. Our collective challenge lies in fostering development that uplifts communities without compromising the integrity of these ecosystems upon which all life depends. Through a multidisciplinary approach, this book seeks to unravel the multifaceted dimensions of sustainable development. The various chapters included in this book are from different areas of environment on the current issues of environmental challenges and possible sustainable ways to overcome those issues. We sincerely hope that this book will be a great help and support to all the students, teachers, researchers and other environmental activists who wants to do some meaningful contributions towards the environment. We would also like to express our heartfelt gratitude to our publisher Mrs. Rajani Adam for her immense love and moral support and timely help in bringin

This article is a correction to:Mandarin Chinese translation of the Artificial-Social-Agent questionnaire instrument for evaluating human-agent interaction (Frontiers in Computer Science, (2023), 5, (1149305), 10.3389/fcomp.2023.1149305)

An owner-completed questionnaire was designed to monitor the level of chronic pain and impact on quality of life in horses with osteoarthritis (OA). A standardized approach to develop and validate subjective-state scales for clinical use was followed. Scale items were generated through literature review, focus group meetings, and expert panel evaluation. The draft tool was tested for reading level and language ambiguity and piloted in 25 owners/caregivers of horses with osteoarthritis, with factor analysis performed on responses. The resulting revised questionnaire is currently undergoing validation in a larger sample population of 60 OA and 20 sound control horses. In the pilot group, 21 people (84%) found the questionnaire easy to complete and 22 people (88%) found it useful. It could be completed within 5 min by all participants. Readability scores (Flesch Reading Ease Score, Flesch–Kincaid grade level, SMOG index) indicated an English language reading level comparable to that of 6th to 7th grade in the U.S. system (age 11–12 years). Cronbach’s alpha of all items in the tool was 0.957, indicating excellent inter-item correlation. Interim analysis for 23 OA horses from the sample population showed good test–retest reliability and higher scores compared to 5 control horses. Full validation must be completed for the instrument to be used in clinical practice.

Highlights:1. A questionnaire, comprising various risk factors associated with food allergies, is anticipated to provide reliable indications for determining the necessity of restrictive diets for patients within primary healthcare settings.2. Over time, the findings of this study can facilitate the development of a streamlined and cost-effective diagnostic tool, which will be particularly beneficial in remote regions due to its practical and efficient means of identifying food allergies. AbstractIn Gresik, Indonesia, limited resources have led to challenges in accurately diagnosing food allergies. This study aimed to identify risk factors for food allergies among children in Gresik using a questionnaire-based approach. The study's ultimate goal was to develop a simple diagnostic tool in primary healthcare settings. Conducted at Petrokimia Gresik Hospital, this cross-sectional study enrolled children aged ≥6 months experiencing respiratory symptoms or atopic dermatitis for ≥1 week. The subjects (n = 247) underwent a two- to four-week restrictive diet for diagnostic purposes. The questionnaire demonstrated validity and reliability. Bivariate statistical analyses were performed to examine the correlations between risk factors and the incidence of food allergies (p < 0.05). A receiver operating characteristic (ROC) curve analysis was used to establish the cut-off values for the number of food allergies and atopic family members. The majority of the 247 children enrolled in this study were 6 to 12 years old. Respiratory symptoms (56.3%) were more common than atopic dermatitis (38.1%). The significant risk factors for food allergies included atopic dermatitis (p = 0.001; R = 0.203), previous history of suspected food allergies (p < 0.001; R = 0.747), and atopy in the family (p = 0.013; R = 0.157). The ROC curve analysis established the cut-off values for the number of atopic family members at 1.5 (p = 0.005; 95% CI 0.53-0.67) and the number of food allergies at

This paper analysed differences in social capital between grade 12 students in Tallinn, Estonia based on whether they had primarily studied in Estonian or Russian since grade 1. Social capital was conceptualized by utilising five categories commonly used to measure social capital: trust, group membership and participation, altruism and political engagement, shared norms, and informal interaction. This was analysed using a quantitative close-ended survey. The data collection using surveys was carried out in schools in person and sent to schools over email to be sent to their students. The results were analysed in the context of previous international and local social capital research through the lens of ethno-linguistic differences in social capital. Overall, the research results indicated that there were no significant differences for most categories of social capital based on primary schooling language since grade 1. Yet, those who had primarily studied in Estonian had higher institutional trust and interest in politics; and those who had primarily studied in Russian had higher ease of making new acquaintances, and group membership and participation.

The purpose of this paper is to describe the process of evaluating the reliability and validity of the questionnaire developed to record information on the level of satisfaction of the agents involved in the processes that include the convening, development and implementation of research projects. The detailed description of this process allows to offer the academic community an instrument to carry out further validations by fully complying with the steps that include: expert evaluation, construct evaluation, reliability and validity evaluation by applying multivariate statistical techniques. Applying a duly elaborated and validated instrument will allow researchers to carry out studies that contribute to improve the quality of research, carry out meta-analysis, among other inputs that will contribute to provide effective solutions to real problems in search of a sustainable and sustainable social transformation., El presente escrito tienen como fin, decribir solventemente el proceso de evaluación de la confiabilidad y validez del cuestionario desarrollado para registrar información sobre el nivel de satisfacción de los agentes involucrados en los procesos que incluyen la convocatoria, desarrollo e implementación de los proyectos de investigación. El describir detalladamente este proceso permite ofrecer a la comunidad académica un instrumento para realizar otras validaciones cumpliendo cabalmene los pasos que incluyen: evaluación de expertos, evaluación de constructo, evaluación de confiabilidad y validez aplicando técnicas estadísticas multivariantes. Aplicar un instrumento debidamente elaborado y validado permitirá a investigadores realizar estudios que tributen a enriquerer la calidad de la investigación, realizar metá análisis, entre otros insumos que tributaran a dar soluciones efectivas a problemas reales en búsqueda de una transformación social sostenible y sustentable.

It is important to be able to measure the range of clear focus in clinical practice to advise on presbyopia correction techniques and to optimise the correction power. Both subjective and objective techniques are necessary: subjective techniques (such as patient reported outcome questionnaires and defocus curves) assess the impact of presbyopia on a patient and how the combination of residual objective accommodation and their natural DoF work for them; objective techniques (such as autorefraction, corneal topography and lens imaging) allow the clinician to understand how well a technique is working optically and whether it is the right choice or how adjustments can be made to optimise performance. Techniques to assess visual performance and adverse effects must be carefully conducted to gain a reliable end-point, considering the target size, contrast and illumination. Objective techniques are generally more reliable, can help to explain unexpected subjective results and imaging can be a powerful communication tool with patients. A clear diagnosis, excluding factors such as binocular vision issues or digital eye strain that can also cause similar symptoms, is critical for the patient to understand and adapt to presbyopia. Some corrective options are more permanent, such as implanted inlays / intraocular lenses or laser refractive surgery, so the optics can be trialled with contact lenses in advance (including differences between the eyes) to better communicate with the patient how the optics will work for them so they can make an informed choice.

Author contributions: MO: Writing – original draft, Writing – review & editing. MC: Writing – review & editing, Conceptualisation. IG: Writing – review & editing, Conceptualisation., Assessing chronic pain in dogs has been greatly favoured by the development of Owner-Reported Outcome Measures. Among them, the Liverpool Osteoarthritis in Dogs (LOAD) has been widely used for this purpose. Most of these tools have been written in English and its use by non English natives requires not only translation but also linguistic validation for use by veterinarians and owners. For its use, the LOAD has not undergone translation into Spanish and the objective was to generate a linguistically validated Spanish translation of the LOAD. Following the World Health Organisation and the International Society for Pharmacoeconomics and Outcomes Research published guidelines, the original LOAD English version underwent analysis and translation by two native linguists proficient in the target language. Both translations were then reviewed by a third native linguist to identify potential disparities and establish a cohesive translation (reconciliation). Subsequently, an independent linguist, fluent in both English and the target language, conducted the back translation. Finally, the research team compared the original and back translated versions to pinpoint and resolve any significant dierences. Following the creation of the translated version, a cognitive debriefing was conducted to assess the questionnaire within the target population. A total of 89 surveys were distributed to dog owners of varying ages, genders, and socioeconomic backgrounds. Although there were some suggestions and comments, and some adjustments were made, all respondents found the survey to be clear, achieving a linguistic validation of the Spanish LOAD., Depto. de Medicina y Cirugía Animal, Fac. de Veterinaria, TRUE, pub

The objective of this research was to determine the level of satisfaction among patients attending the postgraduate clinics at the University of Costa Rica during 2022 using the Dental Satisfaction Questionnaire. The research included the entire population of patients and/or legal guardians who received dental care in the postgraduate clinics of pediatric dentistry and prosthodontics at the School of Dentistry between August and October 2022. A questionnaire consisting of Dental Satisfaction Questionnaire items and sociodemographic variables was applied. Descriptive statistics were performed to establish the absolute and relative frequencies, measures of central tendency, and variability, depending on the nature of the variables. The Kolmogorov-Smirnov test was used to assess the data’s conformity to a normal distribution. Questionnaire and sociodemographic variables were analyzed using the Mann-Whitney U Test and the Kruskal-Wallis Test. The response rate was 54.1%, with 95% of the participants expressing satisfaction or high satisfaction with the dental services received. Statistically significant differences were observed in some of the domains concerning sociodemographic variables: between the educational level and pain management (p=0.022) and between the frequency of dental visits and availability (p=0.008). Additionally, a statistically significant difference was observed among postgraduate categories in the domain of quality (p=0.038). This study concludes that patients attending the postgraduate clinics of prosthodontic and pediatric dentistry at the School of Dentistry, University of Costa Rica, are generally satisfied with the care they receive., El objetivo de esta investigación fue determinar el nivel de satisfacción de los pacientes que asisten a las clínicas de posgrado en la Universidad de Costa Rica utilizando el cuestionario Dental Satisfaction Questionnaire durante 2022.La investigación se realizó con toda la población de pacientes y/o tutores legales que recibieron atención dental en las clínicas de postgrado de odontopediatría y prostodoncia de la Facultad de Odontología entre agosto y octubre de 2022. Se aplicó un cuestionario con preguntas del Dental Satisfaction Questionnaire y variables sociodemográficas. Se realizó estadística descriptiva para establecer la frecuencia absoluta y relativa, así como medidas de tendencia central y variabilidad, según la naturaleza de las variables. La prueba de Kolmogorov-Smirnov se utilizó en la evaluación de la conformidad de los datos para la distribución normal. Las relaciones entre las puntuaciones obtenidas del Dental Satisfaction Questionnaire y las variables sociodemográficas fueron analizadas mediante el Test U de Mann-Whitney y el Test de Kruskal-Wallis. La tasa de respuesta fue de 54,1%; el 95% de los participantes estuvieron satisfechos o muy satisfechos con el servicio odontológico recibido. Hubo una diferencia estadísticamente significativa en algunos de los dominios y las variables sociodemográficas: entre el nivel educativo y el manejo del dolor (p=0.022) y entre la frecuencia de visitas al dentista y la disponibilidad (p=0.008). Adicionalmente, se observó una diferencia estadística entre los posgrados en el dominio de calidad (p=0.038). Los pacientes que son atendidos en el servicio odontológico de las clínicas posgrados de prostodoncia y odontopediatría de la Facultad de Odontología Universidad de Costa Rica están satisfechos con la atención recibida.

The objective of this research was to determine the degree of satisfaction of dental service users in some clinical externships at the Faculty of Dentistry from the University of Costa Rica during the year 2022, through the application of a modification of the Dental Satisfaction Questionnaire. The sample population consisted of 396 patients and/or legal guardians who attended during May and June of this year at the “Rotación Clínica Comunitaria Palmares,” “Rotación Sede del Atlántico (Turrialba-Guápiles),” “Rotación en Externado Clínico Recinto Paraíso”, “Rotación Clínica del Externado de San Ramón” and “Rotación Comunitaria del curso externado clínico en la Clínica Dental del Recinto de Grecia.” An instrument was applied, physically or digitally, which included DSQ questions and sociodemographic data. Descriptive analysis of all variables was performed. To establish whether there was an association between sociodemographic variables and DSQ, the Kolmogorov-Smirnov tests, Mann-Whitney U test, Kruskal-Wallis test and the post-hoc Bonferroni test were implemented. The response rate was 49.32%; participants indicated satisfaction with the dental service. There was a statistically significant difference not only between the variable of sex and availability, but also between the domains (satisfaction, access, pain management, availability and quality) and the different externships. The study population is satisfied with the dental service received; however, there are significant differences in the DSQ domains and each externship., El objetivo de esta investigación fue determinar el grado de satisfacción de los usuarios en el servicio de odontología en algunos externados clínicos de la Facultad de Odontología de la Universidad de Costa Rica durante el año 2022, a través de la aplicación de una modificación del Cuestionario de Satisfacción Dental (Dental Satisfaction Questionnaire). La población de estudio fueron 396 pacientes y/o encargados atendidos durante mayo y junio del 2022 en la Rotación del Externado Clínico del Recinto de Paraíso, Rotación Sede del Atlántico Turrialba-Guápiles, Rotación Clínica del Externado de San Ramón, Rotación Comunitaria del curso Externado Clínico en la Clínica Dental del Recinto de Grecia y Rotación Clínica Comunitaria de Palmares. Se aplicó un instrumento, de forma física o digital, que incluyó preguntas del DSQ y datos sociodemográficos. Se efectuó análisis descriptivo de todas las variables. Para establecer si existía asociación entre las variables sociodemográficas y el DSQ se utilizaron las pruebas de Kolmogorov-Smirnov, Prueba U de Mann-Whitney, Prueba de Kruskal-Wallis y la prueba post-hoc de test de Bonferroni. La tasa de respuesta fue de 49,32%. Los participantes indicaron estar satisfechos con el servicio de odontología. Hubo diferencia estadísticamente significativa tanto entre la variable de sexo y la disponibilidad, como entre los dominios de satisfacción, acceso, manejo de dolor, disponibilidad y calidad con los externados. La población de estudio está satisfecha con el servicio odontológico recibido, no obstante, existen diferencias significativas en los dominios del DSQ entre los distintos externados.

Background: Concern over medical students' well-being is a global issue, with studies showing high psychological distress rates. Impostor Phenomenon (IP), i.e., underestimating one's abilities, attributing success to external factors, and feeling like a fraud, has been implicated as one reason behind these troubling findings. Meanwhile, resilience has been suggested to protect against psychological distress. This study aimed to investigate the prevalence of IP and its association with resilience among undergraduate medical students. Methods: The Clance Impostor Phenomenon Scale (CIPS), the Brief Resilience Scale (BRS), and sociodemographic questions were completed by 457 medical students registered in their 2-10th semester at a Swedish university. Of the respondents, 62.6% identified as women, 36.1% as men, and 1.3% as others. Results: The prevalence of IP was 58.4% (defined as CIPS score ≥ 62). According to the CIPS scoring guidelines, 10.3% of participants had low IP, 29.5% moderate, 41.6% frequent, and 18.6% intense IP. Of all participants, almost 90% experienced at least moderate and 60.2% frequent to intense IP. Women had significantly higher CIPS scores and lower BRS scores than men. In contrast, neither attending semester nor age group significantly impacted CIPS scores. Finally, there was a moderate inverse correlation between the level of resilience and the prevalence of IP. Conclusions: Our findings suggest that the majority of Swedish medical students feels like an impostor, and of these students, most do so frequently. Furthermore, IP is more prevalent among female students - who also show lower levels of resilience. Moreover, our results indicated that IP could hinder achieving higher resilience. Future longitudinal studies should investigate how gender norms may contribute to IP feelings and explore the potential advantages of counteracting IP and strengthening resilience among medical students. However, targeted interventions addressing individual stu

Objective This study aimed to investigate whether ChatGPT-4 could replace traditional forward-backward translation by humans when translating a questionnaire from English to Danish in a non-inferiority design. Methods The questionnaire Abdominal Hernia-Q was translated twice using two different modalities, once with traditional forward-backward translations by human translators and once with ChatGPT-4. Two parallel arms were included, one for each translation. For face validation, both translations were randomly assigned to 10 participants who had previously undergone a ventral hernia repair. All 20 participants had to assess the two translations randomly, both before and after face validation. The participants and the interviewer who conducted the face validation were blinded to the translation modalities. In the assessment, participants were asked on a Likert scale of 1-5 to evaluate readability, comprehension, appropriate use of language, and their overall opinion of the two translated questionnaires before and after face validation. For each outcome, the non-inferiority limit was set to 1 point on the Likert scale. Results Both translations were evaluated by 20 participants before face validation and 18 participants after. Before face validation, relevant and significant differences were found for all outcomes, and most participants accurately guessed the translation modality and generally preferred the human translation. After face validation, there were no significant differences between the assessments of the two versions of the questionnaire, their guesses were less accurate, and no significant difference in preference was observed. Conclusion Traditional forward-backward translation can be replaced by ChatGPT-4, when translating an outcome questionnaire if the ChatGPT-4 translation is subjected to quality control and pretested through face validation before clinical use.

Bovine digital dermatitis remains a widespread endemic disease of dairy cattle worldwide. Footbathing is commonly used as a control measure and has significant economic and environmental impacts. Few studies document footbathing practices on dairy farms or evaluate their suitability for achieving foot disinfection. This study describes footbathing practices on 32 farms observed in the United Kingdom, Ireland, and the Netherlands. We measured solution depth throughout footbathing and observed levels below 7 cm on 9 out of 32 farms, which leads to inadequate foot coverage. Solution depth was associated with the number of cow passages and decreased by 1.2 cm for every 100 cow passages. We also describe levels of OM content (g/L) throughout footbathing as a proxy for footbath hygiene. Our data indicates that almost half of footbaths (15/32) became contaminated above the 20 g/L threshold to which veterinary biocides are tested for efficacy, and that OM content is associated with the number of cow passages per liter of footbathing solution provided. A multivariable mixed model predicted that 1 L of footbathing solution per cow should be sufficient to prevent excess contamination. As a further measure of hygiene, we tested a subset of footbath samples to quantify the amount of DNA present from the Treponema species which are considered instrumental in the etiology of digital dermatitis. We did not detect Treponema DNA in footbath samples, which suggested they are unlikely to act as infection reservoirs for this disease. Multivariable mixed models including farm identity as a random effect demonstrated that for both change in solution depth and OM content the effect of farm-level factors was large. Because of the magnitude of this farm effect, applying model predictions will not translate to adequate solution depth and hygiene on all farms. Our data highlights the importance of footbath auditing on individual farms.

Epidermolysis Bullosa (EB) is a rare disease that significantly impacts the Quality of Life (QoL) of both patients and their caregivers, often imposing an overwhelming burden. This study aimed to delve into the patients' lived experiences, capture their perspectives, and discern their needs to construct a comprehensive QoL questionnaire. The Delphi method was selected as the optimal approach for this endeavor, integrating group discussions with individual, anonymous data collection sessions. Qualitative analysis of spontaneously generated statements culminated in the iterative refinement of the questionnaire through multiple Delphi rounds. The final question-naire aims to become a valuable resource to evaluate EB patients' QoL and to facilitate ongoing monitoring of patients' progress and eventually assess treatments’ efficacy over time.

INTRODUCCIÓN. La educación artística influye beneficiosamente en el desarrollo integral del ser humano. Sin embargo, existe una carencia por lo que respecta a su investigación, como también lo es respecto al conocimiento de estas ventajas. Por ese motivo, es de especial relevancia examinar la actitud de los futuros maestros sobre el arte, o de forma más concreta, en cuanto a su didáctica. No obstante, hasta el momento no se han encontrado escalas que evalúen, desde una metodología cuantitativa, las actitudes con respecto a la Didáctica de la Expresión Plástica. Por ese motivo, este trabajo tuvo como objetivo diseñar y validar la Escala breve de Actitudes sobre la Didáctica de la Expresión Plástica (EADEP) y observar la invarianza entre sexos. MÉTODO. Para ello, se partió de una muestra de 190 futuros docentes (Medad = 20.05; DT = 3.67) para un primer estudio y 790 (Medad = 19.88; DT= 4.03) para un segundo. RESULTADOS. El primero de ellos arrojó un factor para la EADEP con adecuadas propiedades psicométricas. El segundo de ellos indicó un buen ajuste de los datos para la estructura unidimensional de la EADEP, manteniéndose invariante en función del sexo. CONCLUSIÓN. Se ofrece, por tanto, un instrumento de medida válido y fiable para la actitud hacia la Didáctica de la Expresión Plástica y se reflexiona sobre la necesidad de aumentar los estudios en este campo., INTRODUCTION. Artistic education has a beneficial influence on the integral development of the human being. However, there is a gap in their research, as well as in their knowledge of these advantages. For this reason, it is especially relevant to examine the attitude of future teachers about art, or more specifically, in terms of its didactics. However, so far no scales have been found that assess, from a quantitative methodology, attitudes regarding the Didactics of Plastic Expression. For this reason, this work aimed to design and validate Brief Scale of Attitudes on the Didactics of Plastic Expression (EADEP) and observe the invariance between sexes. METHOD. To do this, a sample of 190 future teachers (Mage= 20.05; SD= 3.67) was used for a first study and 790 (Mage= 19.88; SD= 4.03) for a second. RESULTS. The first of these yielded a factor for EADEP with adequate psychometric properties. The second one indicated a good fit of the data for the unifying structure of EADEP, remaining invariant according to gender. CONCLUSION. Therefore, it offers a valid and reliable measurement instrument for the attitude towards Didactics of Plastic Expression and reflects on the need to increase studies in this field.

Introduction and objectives Only about 50% of chronic patients in high-income countries adhere to their treatment. There are methods to measure medication adherence but none of them can be considered optimal. This study will aim to design and validate a questionnaire to measure medication adherence in patients with ischaemic heart disease using a direct method as a gold-standard adherence measure and taking into account the gender perspective. Moreover, the profile of low adherence in these patients will be determined. Methods and analysis First study phase consists on the questionnaire design following the next steps: identification of the dimensions, definition of the target population, questionnaire items and order, response coding, questionnaire instructions, content validity by experts and understandability. In the second phase, a cross-sectional study will be performed to end the questionnaire development and validate it. Four hundred and forty patients (50% female) with acute coronary syndrome receiving treatment within the previous 12 months will be included. Patient will answer the initial questionnaire and adherence to aspirin and statin will be measured using a direct method (drug concentration analysis in blood) and other questionnaires. From the set of preselected questionnaire items, those most closely associated with the gold standard measure will be selected using multivariate statistics. Ethics and dissemination All participants gave their written informed consent before participating in the study. The study protocol follows the recommendations of the Declaration of Helsinki and was approved by the ethics committees of the three participating centres. The results of this study will be displayed at national and international conferences and in peer-reviewed scientific journals.

Objective To translate and cross-culturally adapt the Stroke Self-Efficacy Questionnaire (SSEQ) from English to Swedish and to evaluate psychometric properties of the questionnaire.Methods A cross-sectional study design, where the translation followed a process including initial translation, synthesis, backward translation, expert committee, and pretest. Content validity was assessed using Content validity index (CVI). Psychometric assessments included floor-ceiling effects and internal consistency.Results Language and cultural congruence were achieved, and content validity index scores were high (0.923-1). The psychometric evaluations provided acceptable outcomes concerning internal consistency, with Cronbach's alpha scores for the total scale (0.902), the activities subscale (0.861) and the self-management subscale (0.818) respectively. Ceiling effects were evident, but no floor effects.Conclusion This study found the Swedish version of the SSEQ promising as a tool for assessment of self-efficacy in a Swedish stroke care setting, although further psychometric assessments are recommended in future studies.

The global all-ages prevalence of epidemiologically-measured 'functional' presbyopia was estimated at 24.9% in 2015, affecting 1.8 billion people. This prevalence was projected to stabilise at 24.1% in 2030 due to increasing myopia, but to affect more people (2.1 billion) due to population dynamics. Factors affecting the prevalence of presbyopia include age, geographic location, urban versus rural location, sex, and, to a lesser extent, socioeconomic status, literacy and education, health literacy and inequality. Risk factors for early onset of presbyopia included environmental factors, nutrition, near demands, refractive error, accommodative dysfunction, medications, certain health conditions and sleep. Presbyopia was found to impact on quality-of-life, in particular quality of vision, labour force participation, work productivity and financial burden, mental health, social wellbeing and physical health. Current understanding makes it clear that presbyopia is a very common age-related condition that has significant impacts on both patient-reported outcome measures and economics. However, there are complexities in defining presbyopia for epidemiological and impact studies. Standardisation of definitions will assist future synthesis, pattern analysis and sense-making between studies., Den globala prevalensen för alla åldrar av epidemiologiskt uppmätt "funktionell" presbyopi uppskattades till 24,9% 2015 och berörde 1,8 miljarder människor. Denna prevalens beräknades stabiliseras på 24,1% år 2030 på grund av ökande närsynthet, men påverka fler människor (2,1 miljarder) på grund av befolkningsdynamiken. Faktorer som påverkar förekomsten av presbyopi är ålder, geografiskt läge, stad kontra landsbygd, kön och, i mindre utsträckning, socioekonomisk status, läskunnighet och utbildning, hälsokunskap och ojämlikhet. Riskfaktorer för tidig ålderssynthet var bland annat miljöfaktorer, kost, krav på nära håll, brytningsfel, ackommodativ dysfunktion, läkemedel, vissa hälsotillstånd och sömn. Presbyopi visade sig påverka livskvaliteten, i synnerhet synkvaliteten, arbetskraftsdeltagandet, arbetsproduktiviteten och den ekonomiska bördan, den psykiska hälsan, det sociala välbefinnandet och den fysiska hälsan. Den nuvarande kunskapen gör det tydligt att presbyopi är ett mycket vanligt åldersrelaterat tillstånd som har betydande inverkan på både patientrapporterade resultatmått och ekonomi. Det är dock komplicerat att definiera presbyopi för epidemiologiska studier och effektstudier. Standardisering av definitioner kommer att underlätta framtida synteser, mönsteranalys och meningsskapande mellan studier., A prevalência global, para todas as idades, da presbiopia "funcional" medida epidemiologicamente foi estimada em 24,9% em 2015, afectando 1,8 mil milhões de pessoas. Prevê-se que esta prevalência estabilize em 24,1% em 2030 devido ao aumento da miopia, mas que afecte mais pessoas (2,1 mil milhões) devido à dinâmica populacional. Os factores que afectam a prevalência da presbiopia incluem a idade, a localização geográfica, a localização urbana versus rural, o sexo e, em menor grau, o estatuto socioeconómico, a literacia e a educação, a literacia em saúde e a desigualdade. Os factores de risco para o aparecimento precoce da presbiopia incluem factores ambientais, nutrição, exigências na proximidade, erro refrativo, disfunção acomodativa, medicamentos, certas condições de saúde e sono. Verificou-se que a presbiopia tem impacto na qualidade de vida, em particular na qualidade da visão, na participação na força de trabalho, na produtividade do trabalho e nos encargos financeiros, na saúde mental, no bem-estar social e na saúde física. O conhecimento atual torna claro que a presbiopia é uma doença muito comum relacionada com a idade que tem impactos significativos tanto nas medidas de resultados relatados pelos doentes como na economia. No entanto, existem complexidades na definição de presbiopia para estudos epidemiológicos e de impacto. A normalização das definições ajudará a futuras sínteses, análises de padrões e a fazer sentido entre estudos.

The allocation of renewable energy plants, especially wind turbines, is stagnating in Germany. Although the citizens approve of the energy transition, they resist concrete local projects. In recent years, research has shown that interactive map applications support participatory planning through motivation, social interaction, and knowledge transfer. We aim to reduce biases against renewable energy (RE) and support informed decision making while accepting local responsibility. We hypothesized that finding a new gamified participation format, based on behavioral mechanisms, would strengthen the empowerment of people. To this end, we designed a dialogue tool and participation format,’Vision:En 2040’, which combines: (i) a precise target electricity yield, (ii) an interactive map showing results of people’s actions, information about environmental impacts, and (iii) game rules which foster cooperation. In facilitated workshops, participants simulate the allocation of wind and photovoltaic power plants in their municipality to achieve a target electricity yield. The developed tool is based on methods of environmental planning and geoinformatics.’Vision:En 2040’ was systematically tested with a technical test and a pre-test. In addition, its impact on participants was assessed through surveys and qualitative content analysis. The evaluation results show that the tool can influence the acceptance of the energy transition in terms of attitude. Through’Vision:En 2040’, participants became aware of the community’s responsibility in the energy transition and expanded their knowledge. In addition, decision makers used the workshop results to plan RE sites. Our results indicate that’Vision:En 2040’ is helpful for informal citizen participation in accelerating the energy transition.

Adolescents’ mental health is a current public health issue. However, research, on adolescents’ views on different aspects of mental health, and the prevalence of mental well-being, mental illness and related stigma, among adolescents is limited in Sweden. The overall aim of this thesis was to explore perceptions and status of mental health and stigma related to mental health problems among adolescents in a Swedish context. Study I and II were based on qualitative interviews with 32 adolescents on the Swedish island Gotland. Study I indicated that the adolescents had a complex understanding of various mental health concepts but labelled mental well-being as ‘feeling good’ and mental illness as ‘feeling bad’. In Study II, the adolescents described mental health problems as common due to current living conditions, e.g. stress related to school performance and social media and an increased openness about mental health problems. Stigmatisation of people with mental health problems was perceived as problematic, caused by lack of experience and knowledge, but also as related to rumour spreading and stereotypical gender norms. Study III and IV were based on the Life and Health Youth survey, conducted in secondary schools located on Gotland. In study III, the results according to the dual-factor model of mental health showed that most adolescents had vulnerable mental health status (47.5%), while 36.2% had complete mental health. A smaller proportion had troubled (13,9%) or symptomatic but content (2,5%) mental health status. Associations were observed between mental health status and gender, grades, truancy, stress level, resilience, and subjective social status in school. In study IV, the factor structure and internal consistency was acceptable for the modified Attitudes About Mental Illness and its Treatment scale, but the adolescents perceived it as difficult to answer. Further, negative attitudes towards people with mental health problems were present, and more comm, Ungdomars psykiska hälsa är en aktuell folkhälsofråga. Forskning om ungdomars syn inom området psykisk hälsa och om förekomst av psykiskt välbefinnande, psykisk ohälsa och relaterat stigma är dock begränsad i Sverige. Syftet med avhandlingen var att undersöka uppfattningar om och status för psykisk hälsa och stigma relaterat till psykisk ohälsa bland ungdomar i en svensk kontext. Studie I och II byggde på kvalitativa intervjuer med 32 ungdomar på Gotland. I studie I framkom att ungdomarna hade en komplex förståelse för begrepp inom området psykisk hälsa, men benämnde psykiskt välbefinnande som att ”må bra” och psykisk ohälsa som att ”må dåligt”. I studie II beskrev ungdomarna psykisk ohälsa som vanligt förekommande utifrån nuvarande levnadstillståndsförhållanden med t.ex. stress relaterat till skolprestationer och sociala medier, samt ökad öppenhet kring psykisk ohälsa. Stigmatisering av personer med psykiska problem uppfattades som negativt och beroende på bristande erfarenhet och kunskap, men också relaterat till ryktesspridning och stereotypa könsnormer. Studie III och IV byggde på enkäten Liv och Hälsa Ung Gotland som genomfördes i högstadiet och gymnasiet på Gotland. I studie III visade resultaten utifrån två-faktormodellen för psykisk hälsa att 36,2% hade fullständig psykisk hälsa. De flesta ungdomarna hade sårbar psykisk hälsa (47,5%). En mindre andel hade besvärad eller symtomatisk men nöjd psykisk hälsostatus (13,9% respektive 2,5%). Resultaten visade också samband mellan psykisk hälsostatus och kön, betyg, skolk, stressnivå, resiliens och subjektivt upplevd social status i skolan. I studie IV uppvisade den modifierade versionen av skattningsskalan Attitudes About Mental Illness and its Treatment acceptabel faktorstruktur och intern konsistens. Ungdomarna upplevde den dock som svår att besvara. Vid mätningen med skattningsskalan återfanns viss förekomst av negativa attityder mot personer med psykisk ohälsa, vilket var vanligare bland pojkar och utlandsfödda

Background: Patients’ online record access (ORA) enables patients to read and use their health data through online digital solutions. One such solution, patient-accessible electronic health records (PAEHRs) have been implemented in Estonia, Finland, Norway, and Sweden. While accumulated research has pointed to many potential benefits of ORA, its application in mental healthcare (MHC) continues to be contested. The present study aimed to describe MHC users’ overall experiences with national PAEHR services. Methods: The study analysed the MHC-part of the NORDeHEALTH 2022 Patient Survey, a large-scale multi-country survey. The survey consisted of 45 questions, including demographic variables and questions related to users’ experiences with ORA. We focused on the questions concerning positive experiences (benefits), negative experiences (errors, omissions, offence), and breaches of security and privacy. Participants were included in this analysis if they reported receiving mental healthcare within the past two years. Descriptive statistics were used to summarise data, and percentages were calculated on available data. Results: 6,157 respondents were included. In line with previous research, almost half (45%) reported very positive experiences with ORA. A majority in each country also reported improved trust (at least 69%) and communication (at least 71%) with healthcare providers. One-third (29.5%) reported very negative experiences with ORA. In total, half of the respondents (47.9%) found errors and a third (35.5%) found omissions in their medical documentation. One-third (34.8%) of all respondents also reported being offended by the content. When errors or omissions were identified, about half (46.5%) reported that they took no action. There seems to be differences in how patients experience errors, omissions, and missing information between the countries. A small proportion reported instances where family or others demanded access to their records (3.1%), and about o

Objective: To assess if received professional and social support are associated with father-infant bonding among primiparous (first-time) and multiparous (multi-time) fathers. Background: Early father-infant bonding predicts several positive child outcomes. However, while received professional and social support positively impacts fathers’ transition into parenthood, little research has tested if these factors are associated with a stronger father-infant bond. Methods: In total, 499 fathers (296 primiparous and 203 multiparous) of infants (aged 0–12 months) completed a cross-sectional online survey between November 2018 and March 2020. The survey included items related to socio-demographics, having a planned pregnancy, postnatal midwifery support, child health nurse support, child health center attendance, and social support. The parent-infant bonding questionnaire (PBQ) was used to assess the father-infant bond. Multiple linear regression models were estimated for the total sample and based on paternal parity. Missing data were managed through multiple imputation procedures. Findings: Fathers reported fewer bonding disturbances if they received support from their partners, postnatal midwives, child health nurses, and attended more child health visits. Primiparous fathers reported fewer bonding disturbances when receiving support from their partners, postnatal midwives, and the child health nurse. However, multiparous fathers had more bonding disturbances than primiparous fathers and received less professional and partner support. Conclusions: Receiving more partner and professional support is associated with less father-infant bonding disturbances. To encourage a better father-infant bond, clinicians should invite and support all fathers, regardless of parity, as they transition to parenthood. © 2024 The Authors

Background: The escalating costs of sports equipment, coupled with socioeconomic disparities, hinder children’s participation in physical activities. The Leisure Equipment Library (LEL), a unique service in Sweden, addresses this challenge by providing free equipment lending. This study investigated the significance of providing free lending of sports and recreational equipment for children’s and youth’s opportunities to engage in physical activities during leisure time. Method: Utilizing a cross-sectional survey during the summer-2022 period, the study is based on data from 427 LEL users aged 7 to 25 years. User characteristics (demography, socioeconomic status, physical activity profiles), equipment usage patterns and perceived significance are also analyzed. The findings are discussed using the concept of consumer-brand identification. Results: The results showed that LEL reaches a broad and diverse group of children and young people in terms of gender, age, socioeconomic status, and physical activity profile. The borrowed equipment, primarily used for play and recreation, serves as an essential resource for children and youths and, in particular, for those with low socioeconomic status. LEL is considered highly important by all user groups, with a majority emphasizing its significance in facilitating leisure activities. Conclusions: The study suggests LEL’s success lies in its accessibility and that users identify with the brand of LEL. Users perceive LEL as a service catering to various recreational needs rather than sports, fostering inclusivity. The localization of stores in various types of areas, combined with high-quality products, enable children and young people from different socioeconomic areas to use the service. LEL’s success hinges on maintaining a positive brand image and promoting a recreation-oriented identity. Opportunities exist to strengthen emotional bonds with users, enhance branding strategies, and position LEL as a valuable resource for in

This thesis explores the integration of AI in the entrepreneurial process, focusing on the initial phase of the process. AI can be a driving force in entrepreneurship; however, the topic still needs to be explored. AI's potential to enhance entrepreneurial activities is analyzed through empirical research, testing whether AI utilization positively impacts the activities performed in the opportunity analysis phase. By applying a combination of primary and secondary research methodologies, this study assesses the experiences and attitudes of entrepreneurs towards AI, alongside their actual deployment of AI tools in these critical initial activities. The findings aim to improve the understanding of how AI can influence foundational activities within the entrepreneurial process, potentially offering significant benefits. This research contributes to the academic discourse on the intersection of entrepreneurship and AI, providing insights into how AI could be a transformative element in the modern entrepreneurial landscape. Additionally, the study explores the correlation between specific entrepreneurial skills and the successful integration of AI, offering implications for both practice and future research., Masterarbeit Universität Innsbruck 2024

This article aims to compare the pattern of responses obtained by a web-based and a paper-based survey used to investigate the transit safety of travellers in railway stations in Sweden. This aim is achieved by evaluating whether the response and the completion rates change as the surveys progress, assessing the effect of the survey mode on respondents' answers (after controlling for the surveys' internal consistency and differences in the samples), and the potential impact of the order of alternatives in multiple-choice questions on the responses. To carry out the study, a sample of 500 responses was taken from each population and later compared using a series of statistical tests. Findings indicate that despite the surveys' high internal consistency, the prevalence of victimisation, fear of crime, and precautions detected in the web survey was higher than those found in the paper survey. The web survey shows a major drop just after the initial questions, while the paper survey shows a more stable pattern of responses, but was also affected by a single compulsory question that pushed the completion rate down. Finally, the order of alternatives in multiple-choice questions (fixed or random) did not affect the answers given by the respondents, providing a solid base for safety interventions in transit environments, regardless of survey mode. The article concludes by making suggestions for both research and practice., Correction: Ceccato, V., Gliori, G., Näsman, P. et al. Publisher Correction to: Comparing responses from a paper‑based survey with a web‑based survey in environmental criminology. Crime Prevention & Community Safety 26, 244 (2024). https://doi.org/10.1057/s41300-024-00210-x

Materials and Methods: Patients subjected to orthognathic surgery due to dentofacial deformity (DFD) and registered in the National Register of Orthognathic Surgery (NROK) in Sweden between 2017 and 2020 were eligible for inclusion in this study. The Swedish-validated Orthognathic Quality of Life Questionnaire (S-OQLQ) was used to evaluate patient quality of life before and after surgery. The S-OQLQ measured each patient's subjective experience regarding social aspects. Results: Eighty-four participants were included in this cohort study, including 45 men (mean age 24.7 years), 48 women (mean age 23.4 years), and eight patients who stated no gender. Women generally graded several aspects of the S-OQLQ higher than men, including facial aesthetics p = 0.029), oral function (p < 0.001), and awareness of facial deformity (p = 0.0054). For all domains of the questionnaire (social, facial aesthetics, function, and awareness), a significant improvement was seen 6–24 months after surgery (p < 0.001). Women rated improvement of function and awareness of facial deformity higher than men (p < 0.001 and p = 0.039, respectively). Conclusion: Quality of life aspects of orthognathic surgery have a strong impact on the treatment outcome. Although functional impairment is often considered a major indication for surgery, the social and aesthetic influence of DFD is highly rated by patients, whereas pain is not an issue before or after treatment.

OBJECTIVES: To analyze whether self-perceived oral health and orofacial appearance change with increasing age. METHODS: This longitudinal study is based on data from a questionnaire used in the Swedish National Study of Aging and Care. The sample comprises 160 participants 60 years of age at baseline 2001-2003. The same participants were re-examined at 66-, 72-, and 78 years of age. To analyze whether perceptions of oral health and orofacial appearance changed with increasing age, Cochran's Q test was conducted. Statistical significance was considered at p ≤ 0.05, and the calculated value Q must be equal to or greater than the critical chi-square value (Q ≥ 7.82). Significance values have been adjusted for the Bonferroni correction for multiple tests. RESULTS: Self-perceived mouth dryness, both day (Q = 7.94) and night (Q = 23.41), increased over the 18-year follow-up. When divided by gender, significant differences were only seen for mouth dryness at nighttime. A decrease in sensitive teeth was perceived with increasing age, and an increase in self-perceived satisfaction with dental appearance, and a decrease in self-perceived problems with dental gaps between the ages of 60 and 78. These changes were, however, not statistically significant. Men experienced a higher proportion of discomfort with discolored teeth at age 78 than at 60 (Q = 9.09). CONCLUSIONS: Self-perceived oral health and orofacial appearance were relatively stable, with few changes over an 18-year follow-up.

Objective: To map oral health-related standard of care in the context of head and neck cancer (HNC) treatment across the European Union (EU). Materials and Methods: Six hundred and ninety centers across the European Union were contacted. The questionnaire contained questions focusing on the team/department structure, HNC treatment planning routines, and assessment and handling of dental treatment needs prior to cancer treatment. Results: Eighty-seven centers across the EU responded. Department structure and number of HNC patients treated per year varied widely and dental professionals are included as part of the team in about 25% of the centers. Standard of care, in terms of dental assessment and preventive dentistry routines, such as recording an orthopantomogram, offering dental treatment, and providing a radiation protection splint and splint for fluoride application, differed significantly among the European regions. Independent of the region, these aspects are positively affected if dental professionals are part of the interdisciplinary treatment team and if dental treatment is offered within the center. Conclusion: Dental professionals are still only to a very limited extent included in interdisciplinary treatment planning teams of HNC patients. However, their inclusion and/or offering dental treatment within the same hospital/center appears to improve oral health-related standard of care. Clinical Relevance: Inclusion of dental professionals in treatment planning teams of HNC patients appears to improve oral health-related standard of care within HNC treatment.

BACKGROUND: When establishing Physical Employment Standards, validity is dependent on the correct identification and characterisation of critical job tasks. OBJECTIVE: To develop and validate a standardised protocol for the identification, characterisation, and documentation of critical physical job tasks in military occupational specialities in the Swedish Armed Forces (SwAF), and propose a definition of critical physical job tasks for use in the SwAF. METHODS: A protocol was drafted with three content domains, including a preliminary definition. Protocol content validity was iteratively assessed in two consecutive stages where ten subject experts rated relevance and simplicity. A consensus panel revised the protocol after each stage. Content validity index (CVI) was calculated as item-CVI (I-CVI) per each feature and as scale average (S-CVI/Ave) per content domain. Acceptable content validity thresholds were 0.78 and 0.90, respectively. RESULTS: The validated protocol consisted of 35 items with an I-CVI≥0.90 and≥0.80 for relevance and simplicity, respectively. The S-CVI/Ave was 0.97 for relevance and 0.98 for simplicity. The protocol was language reviewed, reorganised for easy use, and approved by the consensus panel. The final protocol includes: background and aim of the protocol, the accepted generic and critical physical job task definitions, protocol instructions, subject expert-qualifications, job task source and characteristics. CONCLUSION: A standardised protocol for identification and characterisation of critical job tasks in SwAF military occupational specialties was developed. The protocol content was rated relevant and simple by experts and will be of importance in future work establishing physical requirements in the SwAF.

Background: As global aging accelerates, routinely assessing the functional status and morbidity burden of older patients becomes paramount. The aim of this study is to assess the validity of the comprehensive clinical and functional Health Assessment Tool (HAT) based on four cohorts of older adults (60 + years) from the Swedish National study on Aging and Care (SNAC) spanning urban, suburban, and rural areas. Methods: The HAT integrates five health indicators (gait speed, global cognition, number of chronic diseases, and basic and instrumental activities of daily living), providing an individual-level score between 0 and 10. The tool was constructed using nominal response models, first separately for each cohort and then in a harmonized dataset. Outcomes included all-cause mortality over a maximum follow-up of 16 years and unplanned hospital admissions over a maximum of 3 years of follow-up. The predictive capacity was assessed through the area under the curve (AUC) using logistic regressions. For time to death, Cox regressions were performed, and Harrell’s C-indices were reported. Results from the four cohorts were pooled using individual participant data meta-analysis and compared with those from the harmonized dataset. Results: The HAT demonstrated high predictive capacity across all cohorts as well as in the harmonized dataset. In the harmonized dataset, the AUC was 0.84 (95% CI 0.81–0.87) for 1-year mortality, 0.81 (95% CI 0.80–0.83) for 3-year mortality, 0.80 (95% CI 0.79–0.82) for 5-year mortality, 0.69 (95% CI 0.67–0.70) for 1-year unplanned admissions, and 0.69 (95% CI 0.68–0.70) for 3-year unplanned admissions. The Harrell’s C for time-to-death throughout 16 years of follow-up was 0.75 (95% CI 0.74–0.75). Conclusions: The HAT is a highly predictive, clinically intuitive, and externally valid instrument with potential for better addressing older adults’ health needs and optimizing risk stratification at the population level. © The Author(s) 2024., SNAC, NEAR

BackgroundIn endoscopic care, favourable patient experiences before, during and after a colonoscopy are essential for the patient's willingness to repeat the procedure. To ensure that significant experiences are measured, patients should be involved in creating the measurement instruments. Thus, the aim of the present study was to develop a colonoscopy-specific PREM by (1) operationalising patient experiences before, during and after a colonoscopy procedure and (2) evaluating its content validity.MethodsThe colonoscopy-specific PREM was developed in two stages: (1) operationalisation with item generation and (2) content validity testing. A previously developed conceptual model, based on a systematic literature review that illustrates patients' (n = 245) experiences of undergoing a colonoscopy, formed the theoretical basis. To assess the degree to which the PREM reflected patients' experiences before, during and after a colonoscopy procedure, content validity was tested-through face validity with healthcare professionals (n = 4) and cognitive interviews with patients (n = 14) having experienced a colonoscopy. Content validity index (CVI) was calculated to investigate the relevance of the items.ResultsThe Patient Experience Colonoscopy Scale (PECS) is a colonoscopy-specific PREM consisting of five different constructs: health motivation, discomfort, information, a caring relationship and understanding. Each construct was defined and generated into a pool of items (n = 77). After face-validity assessment with healthcare professionals, a draft 52-item version of the PECS was ready for content validity testing by the patients. During cognitive interviews the patients contributed valuable insights that led to rewording and removal of items. Results from the CVI suggest that the PECS and its content are relevant (I-CVI range 0.5-1, S-CVI/Ave = 0.86). The final PECS consists of 30 items representing a colonoscopy-specific PREM.ConclusionThe PECS is a new 30-item PREM instru

Aim To determine the level of knowledge and explore the difference of hand hygiene between nursing students and nurses. Background Annually, 3.8 million people in Europe acquire healthcare-associated infections, highlighting the importance of hand hygiene. Despite WHO's emphasis on the fact that greater hand hygiene knowledge correlates with improved hand hygiene compliance, several studies have shown knowledge gaps among nurses and nursing students regarding hand hygiene. Design Descriptive cross-sectional comparative survey. Methods A version of the WHO “Hand Hygiene Knowledge Questionnaire”, translated into Swedish, was used for data collection among nursing students in the first and last semester, and registered nurses from a university and associated hospital. Data were analyzed by descriptive statistics, and comparison between groups with Fisher's exact test, one-way ANOVA, and post-hoc tests (Pairwise Z-Tests, Tukey HSD). Results The survey, conducted between December 2020 and January 2021, received responses from 201 participants, including 71 first semester students, 46 last semester students and 84 registered nurses, showing moderate (55.7% [50–74% correct answers]) to good (43.8% [75–100% correct answers]) knowledge levels. First-semester students scored lower (17.0 ± 2.1) than last-semester students (18.8 ± 1.8) and registered nurses (18.3 ± 2.1) out of 25 questions. Discussion It is necessary for all groups to receive proper education on hand hygiene knowledge and to have an educational program that does not separate the groups but combines them with continuing education, since the students will someday be influencing future hand hygiene knowledge as a peer, together with the nurse.

Background Quality of life (QoL) is a key outcome measure in healthcare. However, the heterogeneity in its definitions presents challenges in the objective evaluation of improvement. Universal questionnaires, tailored for a broad demographic group, inadequately represent the unique experiences of intensive care unit (ICU) survivors, including a lack of ability to discriminate issues related to QoL from issues that do not. Methods Using a 218-item, 13-domain provisional questionnaire, we assessed 395 adult ICU survivors, with a minimum 72-h stay at one of three Swedish university hospital ICUs, at 6 months to three years post-discharge. Their responses were compared to those of 195 controls, matched for age and sex and randomly recruited from the Swedish Population Registry. By multi-group exploratory factor analysis, we compared dimensionality in QoL perceptions between the two groups, emphasising patterns of correlation to 13 domain-specific QoL questions. Model fit was assessed using information criteria. Internal consistency reliability for each scale was determined using McDonald’s omega or Cronbach’s alpha. All analyses were conducted using Mplus, applying full information maximum likelihood to handle missing data. Results All domains except Cognition had a subset of questions correlating to the domain-specific QoL question in at least the ICU survivor group. The similarity between the two groups varied, with Physical health, Sexual health and Gastrointestinal (GI) functions mainly correlating the same issues to QoL in the two groups. In contrast, Fatigue, Pain, Mental health, activities of daily living, Sleep, Sensory functions and Work life showed considerable differences. In all, about one-fourth of the issues correlated to QoL in the ICU survivor group and about one-tenth of the issues in the control group. Conclusions We found most issues experienced by ICU survivors to be unrelated to quality of life. Our findings indicate that the consequences of post-IC

Street pavements are subject to various types of distress which necessitate a cost-effective management approach. This paper presents the outcomes of a survey focusing on street pavement maintenance and the utilization of machine learning (ML) pavement performance models on a 320 km municipal street network in Skellefteå municipality, Sweden. The findings reveal that the most common types of distress on Swedish streets include potholes, surface unevenness and alligator cracking, while prevalent causes of these distress are pavement ageing, heavy traffic and pavement patches. The windshield method of assessment of street pavement is prevalent, but the use of pavement management systems (PMS) is limited and pavement performance models are rarely employed. The case study reveals that Random Forest (RF) models developed for non-residential streets perform better than residential street models. RF models based on the variables age (A) and traffic (T) emerged as the best models, with 84% prediction accuracy. However, the R-squared value for the RF model applied to residential streets was 0.53, slightly surpassing the values for all models applied to non-residential streets (0.31, 0.50, 0.49). Further evaluation of models is suggested by using additional data., Part of ISBN [9783031635830]QC 20240823

A well-functioning street network is pivotal in the socio-economic development of a region. Street networks not only facilitate the movement of people and goods but also allocate space for utility services. Maintaining the street network in good condition and meeting the sustainability targets necessitate implementing optimal street maintenance strategies, leading to an efficient utilization of taxpayers' money. The objectives of this Licentiate thesis are to analyse pavement management practices and challenges faced by Swedish municipalities, specifically focusing on asphalt concrete (AC) pavements within street networks. Additionally, it seeks to integrate a sustainability tool into pavement maintenance to select maintenance measures that contribute to sustainability goals at the municipal street network management level. Furthermore, the study aims to enhance municipal-level pavement maintenance approaches through the implementation of machine learning (ML) models within a pavement management system (PMS). Within this context, three individual studies were conducted—two case studies and a survey involving Swedish municipalities. One case study explores sustainability framework application, whereas the other investigates the utilization of ML models in municipal AC pavement maintenance. The survey investigates the practices and challenges faced by municipal street network administrations in AC pavement maintenance. The sustainability framework SUNRA (Sustainability National Road Administrations) was adopted by the Swedish Transport Administration (STA) with a primary emphasis on promoting sustainability in pavement management on state-level roads. In this study, the framework has been tested, applied and further streamlined to be applicable for setting sustainability targets and monitoring sustainability performances at the project level within both the STA and municipal contexts. The aim was to simplify the framework so it is appropriate for investment, re-inve, Ett väl fungerande gatunät är avgörande för den socioekonomiska utvecklingen av en region. Gatunätet underlättar inte bara mobiliteten för människor och varor utan möjliggör också väl fungerande samhällstjänster. Effektiv användning av skattebetalarnas pengar åstadkommas genom att man underhåller gatunätet i gott skick och tillgodoser att man uppnår hållbarhetsmålen. Detta kräver att man implementerar optimala underhållsstrategier. Syftet med denna studie är att analysera vägunderhållsmetoder för vägbeläggningar inklusive utmaningar som svenska kommuner står inför. Särskilt fokus är på asfaltbeläggningar inom gatunätet. Vidare ingår att integrera ett hållbarhetsverktyg för vägunderhåll som möjliggör att man kan välja underhållsåtgärder som bidrar till att gatunätsförvaltningen kan nå kommunala hållbarhetsmålen. Studien syftar slutligen till att förbättra kommunala gatuunderhållsstrategier genom att implementera maskininlärningsmodeller inom ett vägförvaltningssystem (PMS). Inom Licentiatavhandlingen genomfördes tre studier – två fallstudier och en enkät med svenska kommuner. En fallstudie utforskar tillämpningen av hållbarhetsramverk, medan den andra undersöker användningen av maskininlärningsmodeller vid kommunalt underhåll av asfaltbeläggningar. Enkäten undersöker praxis och utmaningar för kommunala gatunätsförvaltningar vid underhåll av asfaltbeläggningar. Hållbarhetsverktyget SUNRA (Sustainability National Road Administrations) anpassades till Trafikverket för att främja hållbarhet inom vägförvaltning på statliga vägar. I denna studie har verktyget testats, tillämpats och förfinats för att sätta hållbarhetsmål och övervaka hållbarhetsprestanda på projektbasis inom både Trafikverket och kommunala sammanhang. Målet var att förenkla verktyget så att det passar för investering, återinvestering, underhåll och driftsprojekt och även för att förbättra användbarheten för olika användare. Vidare studerades hur verktyget kunde bidra till hållbarhet, identifiera drivkrafte, QC 20240412Research funders:Skellefteå municipalityMistra InfraMaint Project 1.8 (DIA 2016/28)

Background: FUNDES-Child-SE is a proxy rating questionnaire for measuring participation and independence in children with disabilities in a Swedish context. It includes the components of frequency of attendance, engagement and independence. The original, Taiwanese FUNDES-Child 7.0, has previously been found to have a four-factor structure for frequency of participation and a two-factor structure for independence. The aim of this study was to test the factor structure in FUNDES-Child-SE. The factor structure is an important part of construct validity. Methods: Caregivers of 163 children with disabilities aged 6–18 years participated in this cross-sectional study. Exploratory factor analysis was used to find the factor structure for Engagement. Confirmatory factor analysis was used to test the factor structure for all three components. Results: The proposed factor structure for frequency of participation (daily living participation frequency, mobility participation frequency, learning participation frequency and community participation frequency) and independence (daily living independence and social participation independence) fit with data from FUNDES-Child-SE after excluding three to five items and adding two to five covariances of residuals. In the engagement component, two factors, named engagement in informal activities and engagement in formal activities, were found. After excluding one item and adding 10 covariances of residuals, the factor structure had an acceptable fit to data. Conclusions: Differences in components' factor structure indicate that attendance and engagement are separate aspects of participation. Before using numeric scores from FUNDES-Child-SE in clinical settings, responsiveness and interpretability should be evaluated.

This study investigates the evolving landscape of nursing informatics by conducting a follow-up survey initiated by the International Medical Informatics Association (IMIA) Students and Emerging Professionals (SEP) Nursing Informatics (NI) group in 2015 and 2019. The participants were asked to describe what they thought should be done in their institutions and countries to advance nursing informatics in the next 5-10 years. For this paper, responses in English acquired by December 2023 were analysed using inductive content analysis. Identified needs covered a) recognition and roles, b) educational needs, c) technological needs, and d) research needs. The initial findings indicate that, despite significant progress in nursing informatics, the current needs closely mirror those identified in the 2015 survey.

Purpose: The aim was to investigate the associations between cognitive impairment and biopsychosocial factors among older stroke survivors and predictors of poststroke return to daily life. Materials and methods: This cross-sectional study involved 117 stroke survivors (61% men) with an average age of 77 years (range 65–91). The participants completed two questionnaires (Riksstroke and Short Form 36 questionnaires). The Montreal Cognitive Assessment (MoCA) was used to assess cognitive abilities. The International Classification of Functioning, Disability, and Health (ICF) framework guided the selection of biopsychosocial variables. We used Spearman’s correlation coefficient and multiple logistic regression in the analyses. Results: The average MoCA score was 21.7 points (range: 4–30, SD 5.6). The need for assistance from relatives and professionals, need for help with dressing and household chores, reliance on others for mobility, and reading and balance problems were correlated with more severe cognitive impairment (r = 0.20–0.33). Cognitive impairment, fatigue, and balance issues predicted an unfavorable return to daily life (odds ratio: 6.2–6.8). Conclusion: The study indicated that cognitive impairment is associated with difficulties in all ICF domains. Cognitive impairment, fatigue, and balance issues are associated with an unsuccessful return to daily life. Prioritizing these factors and screening for cognitive impairment with objective assessment tools may improve rehabilitation outcomes and enhance overall quality of life poststroke.

Introduction: Risk-allele carriers of a Monoamine oxidase A (MAOA) gene, short-allele (MAOA-S) in males and long-allele (MAOA-L) in females, in the presence of a negative environment, are associated with alcohol misuse. Whether MAOA-S/L alleles also present susceptibility to a positive environment to mitigate the risk of alcohol misuse is unknown. Thus, we assessed the association of the three-way interaction of MAOA, maltreatment, and positive parent-child relationship with alcohol consumption among adolescents. Methods: This prospective study included 1416 adolescents (females: 59.88%) aged 16 ̵ 19 years from Sweden, enrolled in the “Survey of Adolescent Life in Västmanland” in 2012. Adolescents self-reported alcohol consumption, maltreatment by a family (FM) or non-family member (NFM), parent-child relationship, and left saliva for MAOA genotyping. Results and discussion: We observed sex-dependent results. Females carrying MAOA-L with FM or NFM and a good parent-child relationship reported lower alcohol consumption than those with an average or poor parent-child relationship. In males, the interactions were not significant. Results suggest MAOA-L in females, conventionally regarded as a “risk”, is a “plasticity” allele as it is differentially susceptible to negative and positive environments. Results highlight the importance of a good parent-child relationship in mitigating the risk of alcohol misuse in maltreated individuals carrying genetic risk. However, the interactions were not significant after adjusting to several environmental and behavioural covariates, especially parent’s alcohol use, negative parent-child relationship, and nicotine use (smoking and/or snus), suggesting predictor and outcome intersection. Future studies and frameworks for preventive strategies should consider these covariates together with alcohol consumption. More studies with larger sample sizes are needed to replicate the findings.

Background: Integration of mobile health data collection methods into cohort studies enables the collection of intensive longitudinal information, which gives deeper insights into individuals’ health and lifestyle behavioral patterns over time, as compared to traditional cohort methods with less frequent data collection. These findings can then fill the gaps that remain in understanding how various lifestyle behaviors interact as students graduate from university and seek employment (student-to-work life transition), where the inability to adapt quickly to a changing environment greatly affects the mental well-being of young adults. Objective: This paper aims to provide an overview of the study methodology and baseline characteristics of participants in Health@NUS, a longitudinal study leveraging mobile health to examine the trajectories of health behaviors, physical health, and well-being, and their diverse determinants, for young adults during the student-to-work life transition. Methods: University students were recruited between August 2020 and June 2022 in Singapore. Participants would complete biometric assessments and questionnaires at 3 time points (baseline, 12-, and 24-month follow-up visits) and use a Fitbit smartwatch and smartphone app to continuously collect physical activity, sedentary behavior, sleep, and dietary data over the 2 years. Additionally, up to 12 two-week-long bursts of app-based ecological momentary surveys capturing lifestyle behaviors and well-being would be sent out among the 3 time points. Results: Interested participants (n=1556) were screened for eligibility, and 776 participants were enrolled in the study between August 2020 and June 2022. Participants were mostly female (441/776, 56.8%), of Chinese ethnicity (741/776, 92%), undergraduate students (759/776, 97.8%), and had a mean BMI of 21.9 (SD 3.3) kg/m2, and a mean age of 22.7 (SD 1.7) years. A substantial proportion were overweight (202/776, 26.1%) or obese (42/776, 5.4%), had