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Objectives While glucocorticoid (GC) treatment initiated for COVID-19 reduces mortality, it is unclear whether GC treatment prior to COVID-19 affects mortality. Long-term GC use raises infection and thromboembolic risks. We investigated if patients with oral GC use prior to COVID-19 had increased mortality overall and by selected causes.Design Population-based observational cohort study.Settings Population-based register data in Sweden.Participants All patients infected with COVID-19 in Sweden from January 2020 to November 2021 (n=1 200 153).Outcome measures Any prior oral GC use was defined as ≥1 GC prescription during 12 months before index. High exposure was defined as ≥2 GC prescriptions with a cumulative prednisolone dose ≥750 mg or equivalent during 6 months before index. GC users were compared with COVID-19 patients who had not received GCs within 12 months before index. We used Cox proportional hazard models and 1:2 propensity score matching to estimate HRs and 95% CIs, controlling for the same confounders in all analyses.Results 3378 deaths occurred in subjects with any prior GC exposure (n=48 806; 6.9%) and 14 850 among non-exposed (n=1 151 347; 1.3%). Both high (HR 1.98, 95% CI 1.87 to 2.09) and any exposure (1.58, 1.52 to 1.65) to GCs were associated with overall death. Deaths from pulmonary embolism, sepsis and COVID-19 were associated with high GC exposure and, similarly but weaker, with any exposure. High exposure to GCs was associated with increased deaths caused by stroke and myocardial infarction.Conclusion Patients on oral GC treatment prior to COVID-19 have increased mortality, particularly from pulmonary embolism, sepsis and COVID-19.

This article argues for a broader and more socially relevant photosynthesis instruction in compulsory science education. Presently, the predominant practice is traditional instruction, focusing on students' conceptual understanding of photosynthesis based on molecular and energy-related principles. Views of what is referred to as scientific literacy change in line with the new values and demands of a globalised society. Scientific literacy has evolved from a narrow conception of natural sciences to a broader teaching approach, addressing science from a whole society perspective. The article discusses how photosynthesis instruction can be redirected to future issues such as societal and sustainability and argues for a wider approach to scientific literacy involving active citizenship to address present and future sustainability challenges. A scientific literacy model is presented, along with its relation to the concept of powerful knowledge, defined as the kind of knowledge students need to have control and agency in their own lives. Powerful knowledge is discussed in terms of how photosynthesis instruction could be used to address societal and sustainability issues such as climate change, food chains, energy issues and food production. The need for a new and updated photosynthesis education 2.0 is presented.

Our joint environmental and energy commitments mean we must reduce the building’s energy use. Improved central heating control can play a role in how this is accomplished. There are three common control strategies: feedforward (traditional), feedback, and model predictive control (MPC). The latter two often work in parallel, where feedback uses indoor temperature sensors to adjust the supply water temperature. In contrast, the supply temperature setpoint is continuously calculated in MPC, fed with weather forecasts. The weather forecasts are often highlighted as essential ingredients in MPC, but at the same time, it is emphasized that temperature sensors are used to ensure a pleasant indoor temperature. To an outside observer, it is difficult to determine what is what in such combined control arrangements. Is energy saved because of the room sensors or because of the model? And what role do the weather forecasts play? This study quantifies the impact of the control strategy on energy use and indoor temperature. It concludes that PI-based feedback heating control saves approximately as much energy as MPC, and weather forecasts do not save significantly more energy than real-time weather data but are easier to obtain. The overall results for both control strategies align with the lower end of the result ranges of previous studies. The novelty is that the impact of weather forecasts has been studied separately and that different control strategies are compared against each other based on a model of a typical Swedish multi-family building.

Europe needs to save energy, and lowered indoor temperature is frequently promoted as part of the solution. To facilitate this, heating control systems with feedback from indoor temperature sensors are often required to avoid thermal discomfort and achieve long-term temperature reductions. This article describes a measurement- and interview-based study on feedback control where 107 Swedish multifamily buildings were analysed. The obtained results show that buildings with lowered indoor temperatures had reduced annual heating demand by 4 kWh/m2 and a reduced indoor temperature of 0.4 °C. There were, however, significant individual differences and even buildings with increased indoor temperatures, which harmed the energy savings. Temperature fluctuation was most often significantly reduced, but the impact on heating power demand during cold weather was, on average, only 2%. An interview with different actors indicated higher energy savings, possibly due to their stock’s original room temperature levels. Several interviewees also mentioned other advantages of temperature mapping. Most of the results obtained in this study were in line with several previous investigations. The study’s novelty lies in the large number of investigated buildings with mature commercial heat control technology, including PI-control for adjusting supply temperature, indoor temperature sensors in almost every apartment and a parallel analysis of additional affected parameters.

The loss of insect biodiversity is a major global sustainability issue that is highly relevant to science education. Science education can support and develop learners' competence to take actions to sustain insect biodiversity and empower learners to deal actively with this sustainability issue. However, we currently lack an instrument to assess these aspects of individual competence. This paper aims to fill this gap by introducing the Self-Perceived Action Competence for Insect Conservation scale (SPACIC). This scale allows for investigating learners' action competence by focusing on self-perceived knowledge, confidence, and willingness to take insect conservation actions. The scale is grounded in theory and face-validated by external experts. The piloting with 180 secondary school students showed a good quality of the instrument in terms of reliability and validity, as the reliability analyses and confirmatory factor analysis show. The SPACIC scale is applicable to various formal and informal educational settings. Applying the scale can yield information about the effects of educational approaches and inform learners, educators, and researchers about changes in self-perceived competence. In this way, the SPACIC scale can contribute to the evaluation and design of educational approaches and eventually boost learners' development into becoming active environmental citizens.

This study examines the relation between student experiences of participation in a whole school approach (WSA) and students' self-perceived action competence. We surveyed 902 students in three Norwegian upper-secondary schools participating in an education for sustainable development (ESD) programme. The questionnaire measured students' experiences in decision-making and influencing within a WSA, containing the components: (1) school and leadership, (2) teaching and learning, (3) community connections and (4) student council. We measured students' self-perceived action competence through: (1) knowledge of action possibilities, (2) confidence in one's own influence and (3) willingness to act. A structural equation model indicates a positive relation between student participation in ESD teaching and learning and students' knowledge of action possibilities and confidence in their own influence. Participation through the student council positively related to all action competence components. We found no significant relation between participation in school and leadership or community connections on any action competence factors. It is important to note that this cross-sectional study with a limited number of schools does not establish causality, necessitating further research. Nevertheless, the results suggest that promoting student participation in teaching and learning and facilitating a well-functioning student council can promote students' development of action competence for sustainability.

The article demonstrates how a questionnaire gauging students' experiences of participation in decision-making at their school can operationalise student participation in a whole school approach (WSA) to education for sustainable development model. Some 902 students in three upper secondary schools participated in the study by giving their answers to Likert-scale items developed to tap into their experience of participation in the decision-making at their school. The students identified four distinct pathways of participation: (1) School and Leadership, (2) Teaching and Learning, (3) Community Connections, and (4) Student Council. The results are discussed in the light of focus group interviews with eleven of the participants. The student WSA participation questionnaire proved to be a reliable and valid instrument that, together with the student WSA participation model, can be used by school leaders wanting to increase student participation, and by researchers investigating student participation throughout the whole school.