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This article reports on research addressing the role of incident reporting at the workplace as a textual representation of lean management techniques. It draws on text and discourse analysis as well as on ethnographic data, including interviews, recorded interaction, and observations, from two projects on workplace literacy in Sweden: a study in an eldercare facility and a study in a large factory. Analysis of the data set demonstrates striking similarities, both in the way incident reporting texts are structured and worded and in the literacy practices that contextualize them. Dominant characteristics in the texts are the absence of actors and the structured, process-based approach of problems and problem handling. The forms often generate conflicts in the ways workers are asked to textually represent an incident. In this article, we argue that lean thinking has penetrated texts and literacy practices of two considerably different workplaces, and this has a large impact on the way workers are instructed to think and act with regard to problem handling techniques.

In the research project Literacy Practices in Working Life, the role played by reading and writing in common nonacademic occupations in Sweden was investigated. The results highlight not only some typical ways of using writing to frame units of work but also differences reflecting the main focus of work ("people" or "things") and overall organizing principles. This article deals with patterns in the use of writing, which may be related to modern ways of organizing work (efficiency and flexibility, personal responsibility, identification with the company, etc.). Case studies show a range of literacy practices--running from extensive and rather complicated uses of writing connected with individual responsibility to very restricted and dependent uses of reading and writing governed by a top-down organization. Examples illustrate how emerging ways of governing work through written discourse, related to the new, knowledge-based work order, create very different roles for workers. (Contains 4 tables, 4 figures and 4 notes.)

Background: Gambling disorder is known to be associated with increased risk of suicidal behavior. However, relatively little is known about how the risk of suicide attempts in gambling disorder is influenced by comorbid alcohol or drug use disorders, as well as other psychiatric conditions. Methods: The present study is a nationwide, diagnostic register study assessing the risk of suicide attempts (including fatal ones) in gambling disorder in Sweden in 2005–2016. Results: In a total of 2,099 individuals (23 percent women) with gambling disorder, 417 individuals had a suicide attempt (including 10 fatal cases of suicide) during the study period. Suicidal behavior was more common in patients with substance use disorders at any time during the study period (50 percent if both alcohol and drug use disorders were present, and 10 percent if none of these were present). In logistic regression, suicidal behavior was significantly associated with female gender (OR 2.13 [1.63–2.78]), mood disorders (OR 2.65 [2.00–3.50]), anxiety disorders (OR 1.78 [1.34–2.35]), and with alcohol (OR 1.95 [1.51–2.51]) or drug use disorders (OR 3.60 [2.76–4.69]), respectively. Conclusions: Suicidal behavior in clinical gambling disorder patients is common, but markedly more common in the presence of substance use and other comorbid disorders. [ABSTRACT FROM AUTHOR]

Microplastics (MP) are transported from land-based sources from rivers to marine waters. However, there is currently little knowledge about MP fate from land sources to marine waters. Traffic is estimated to be one of the largest sources of MP; hence, stormwater is expected to be an important transportation route of MP to marine waters. The aim of this study was to investigate the effect of the size and density of tyre wear particles in road run-off on their fate in the Göta River in Sweden using hydrodynamic modelling. The model of the stretch of Göta River, Sweden's largest river, passing through Gothenburg (Sweden's second largest city) and out to the sea, was set up using MIKE 3 FM software. Literature data were used to define the MP characteristics: concentrations in stormwater, prevalent particle sizes, density of MP commonly occurring in road run-off and settling velocities. Results show that higher concentrations of MP are found on the south side of the river, compared with the north side, due to higher annual average daily traffic loads along the south side of the river. The mixing processes in the river and the MP concentrations were generally influenced by the vertical water density gradient caused by saline water from the Kattegat strait. While most MP with higher density and larger size settle in the river, smaller MP with density close to 1.0 g/cm3 do not settle in the river and therefore reach the Kattegat strait and the marine environments. Further research is needed to describe the fate and transport of microplastics in the stormwater system, including treatment facilities, i.e. biofouling, aggregation, degradation and/or further fragmentation and settling. [ABSTRACT FROM AUTHOR]

Aim: The aim was to identify and describe nurses' understanding of working with evidence‐based nursing (EBN) in clinical practice. Background: Evidence‐based health care is recognized as fundamental to nursing practice, but it is challenging to implement. How nurses understand this part of their work can affect their practice. Methods: Using a qualitative explorative design with a phenomenographic approach, we interviewed 21 nurses working in Swedish surgical wards. Results: We identified three understandings of EBN among nurses in surgical care: A. a fragmentary and difficult concept that is not integrated or used in clinical practice; B. an important approach guided by knowledgeable colleagues and students; and C. a process that nurses are responsible for developing and leading. Conclusion: Nurses' understandings of working with EBN in surgical wards vary widely. Nurse managers have an important task to create a common outlook among nurses about integrating research, patient experience and clinical experience in decision‐making. Implication for nursing management: These findings could inspire nurse managers to reflect on how to move nurses towards a more comprehensive understanding of EBN and how to identify nurses who could act as facilitators in quality improvement work. [ABSTRACT FROM AUTHOR]

Background: Breast cancer exhibits significant molecular, pathological, and clinical heterogeneity. Current clinicopathological evaluation is imperfect for predicting outcome, which results in overtreatment for many patients, and for others, leads to death from recurrent disease. Therefore, additional criteria are needed to better personalize care and maximize treatment effectiveness and survival. Methods: To address these challenges, the Sweden Cancerome Analysis Network - Breast (SCAN-B) consortium was initiated in 2010 as a multicenter prospective study with longsighted aims to analyze breast cancers with next-generation genomic technologies for translational research in a population-based manner and integrated with healthcare; decipher fundamental tumor biology from these analyses; utilize genomic data to develop and validate new clinically-actionable biomarker assays; and establish real-time clinical implementation of molecular diagnostic, prognostic, and predictive tests. In the first phase, we focus on molecular profiling by next-generation RNA-sequencing on the Illumina platform. Results: In the first 3 years from 30 August 2010 through 31 August 2013, we have consented and enrolled 3,979 patients with primary breast cancer at the seven hospital sites in South Sweden, representing approximately 85% of eligible patients in the catchment area. Preoperative blood samples have been collected for 3,942 (99%) patients and primary tumor specimens collected for 2,929 (74%) patients. Herein we describe the study infrastructure and protocols and present initial proof of concept results from prospective RNA sequencing including tumor molecular subtyping and detection of driver gene mutations. Prospective patient enrollment is ongoing. Conclusions: We demonstrate that large-scale population-based collection and RNA-sequencing analysis of breast cancer is feasible. The SCAN-B Initiative should significantly reduce the time to discovery, validation, and clinical implementation of novel molecular diagnostic and predictive tests. We welcome the participation of additional comprehensive cancer treatment centers. Trial registration: ClinicalTrials.gov identifier NCT02306096. [ABSTRACT FROM AUTHOR]

Objective Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome is an autoinflammatory disease of unknown etiology that primarily affects preschool-aged children. PFAPA syndrome is characterized by recurrent attacks of fever and symptoms of inflammation consistent with the disease acronym. Since autoinflammatory diseases are, by definition, mediated by cells of the innate immune system, the aim of this study was to evaluate the functional features of neutrophils, the most abundant innate immune cell in the circulation, in children with PFAPA syndrome. Methods Blood polymorphonuclear leukocytes (PMNs), obtained from patients with PFAPA syndrome during both febrile and asymptomatic, afebrile phases of the disease, as well as from healthy children (afebrile controls) and children with fever and abdominal pain (febrile controls), were analyzed for 3 key neutrophil characteristics: 1) apoptosis (measured by annexin V/7-aminoactinomycin D staining), 2) production of reactive oxygen species (ROS) (measured by luminol/isoluminol-amplified chemiluminescence), and 3) priming status (measured as responsiveness to galectin-3 and up-regulation of CD11b). Results Compared to PMNs obtained from patients with PFAPA syndrome during an afebrile interval and those from febrile controls, PMNs obtained from patients during a PFAPA syndrome flare produced elevated levels of intracellular NADPH oxidase-derived ROS, had significantly diminished rates of spontaneous apoptosis, and displayed signatures of priming. In contrast, PMNs from afebrile patients with PFAPA syndrome had a significantly elevated rate of spontaneous apoptosis compared to PMNs from afebrile controls. Conclusion These findings demonstrate that 3 key aspects of neutrophil innate immune function, namely, apoptosis, priming, and generation of an intracellular oxidative burst, are altered, most prominently during febrile attacks, in children with PFAPA syndrome. [ABSTRACT FROM AUTHOR]

In this article we discuss the results of a study within the project Language work as care work. The study focuses on the documentation practices of carers and assistant nurses within three elder care facilities in Sweden. The aim is to explore how representations of work and work content are remediated and recontextualised in some of the key written genres in the nursing home. In this process different discourses, and thus different versions of the practice of caring, are promoted and restrained. In order to show how the literacy practices and written text genres of elder care construe different meanings of caring we closely examine four key genres in the communicative chain and analyse them in terms of genre and discourse. The data discussed here was collected in an ethnographic study lasting eighteen months, using participant observation, qualitative interviews and collection of key texts as the main tools. [ABSTRACT FROM AUTHOR]

The article presents a study to investigate the influence of galectin 3 deficiency in a murine model of arthritis. Wild-type (WT) and galectin 3–deficient (galectin 3&sup–/–;) mice were subjected to antigen-induced arthritis (AIA), and the concentration of serum cytokines, antigen-specific antibodies and cellular IL-17 responses were examined. Galectin 3&sup–/–; mice showed a relatively greater suppression in joint inflammation and bone erosion, thereby suggesting that galectin 3 plays a pathogenic role in the development and progression of AIA.

Abstract: Continuous daily measurements of airborne particles were conducted during specific periods at an underground platform within the subway system of the city center of Stockholm, Sweden. Main emphasis was placed on number concentration, particle size distribution, soot content (analyzed as elemental and black carbon) and surface area concentration. Conventional measurements of mass concentrations were conducted in parallel as well as analysis of particle morphology, bulk- and surface composition. In addition, the presence of volatile and semi volatile organic compounds within freshly collected particle fractions of PM10 and PM2.5 were investigated and grouped according to functional groups. Similar periodic measurements were conducted at street level for comparison. The investigation clearly demonstrates a large dominance in number concentration of airborne nano-sized particles compared to coarse particles in the subway. Out of a mean particle number concentration of 12000 particles/cm3 (7500 to 20000 particles/cm3), only 190 particles/cm3 were larger than 250nm. Soot particles from diesel exhaust, and metal-containing particles, primarily iron, were observed in the subway aerosol. Unique measurements on freshly collected subway particle size fractions of PM10 and PM2.5 identified several volatile and semi-volatile organic compounds, the presence of carcinogenic aromatic compounds and traces of flame retardants. This interdisciplinary and multi-analytical investigation aims to provide an improved understanding of reported adverse health effects induced by subway aerosols. [Copyright &y& Elsevier]

Background and Aims: The lockdown of sports and gambling venues during the coronavirus disease 2019 (COVID-19) pandemic caused a fear of increased gambling on other online gambling types, with a risk for transfer to more addictive gambling than otherwise. This study aimed to estimate changes in gambling activity during COVID-19-affected periods among all gamblers at a Swedish state-owned gambling operator and to analyse observable sex differences., Methods: This study included gambling tracking data from the Swedish state-owned gambling operator Svenska Spel Sports & Casino (sports betting, online bingo, casino and poker). All individuals (n = 616,245) who gambled at least once from February 10 to July 19, 2020, were included. The study period was divided into four periods according to their expected level of COVID-19 impact on gambling opportunities: one pre-COVID period and three COVID-affected periods (sports cancellation, emerging return of sports, substantial return of sports)., Results: Sports betting experienced an apparent decrease, followed by a gradual normalization and an end level substantially below prepandemic levels. For online bingo, gambling levels increased upon sports interruption and then decreased with the return to normality in sports events but remained higher than baseline levels. We observed a similar trend for online poker during the interruption of sports, but with a lower level than baseline levels when sports events normalized. We noticed a trend favouring online casinos during the sports interruption period regarding gambling intensity but not wagering levels., Discussion and Conclusions: Dramatic changes in the content of the gambling market may divert some gamblers to other gambling types, but maintained effects could not be demonstrated.

Background and Aims: Gambling disorder (GD) appears to be an independent risk factor for suicide, and all-cause mortality has been sparsely studied in patients with GD. This study aims to explore mortality and suicide rates in individuals with GD compared to the general population as well as explore risk factors associated with all-cause mortality and suicide mortality., Methods: This is a nationwide register study on 2,099 individuals with a GD diagnosis in the Swedish inpatient and/or outpatient specialist health care system between the years of 2005-2016. Comorbid diagnoses from treatment episodes included in national registers were categorized into diagnostic groups according to the 10th revision of International Classification of Diseases, and prevalence rates (any occurrence during 2005-2016) were calculated for each diagnostic group. Multivariate Cox regression analyses on risk factors for death and suicide were performed, controlling for age, gender, and major categories of comorbidity. Standardized mortality ratios (SMRs) were calculated for men and women with regard to overall mortality and suicide compared to the general Swedish population., Results: The population consisted of 1,625 men and 474 women ranging from 18 to 83 years of age at first GD diagnosis (mean: 36.5 years). Sixty-seven individuals passed away, among whom 21 deaths were due to suicide. SMR calculations showed a 1.8-fold increase in mortality for individuals 20-74 years old with GD compared to the general population, and a 15-fold increase in suicide mortality. All-cause mortality was predicted by higher age and any treatment episode for cardiovascular disease, whereas suicide death was predicted by depression., Discussion and Conclusions: Mortality and suicide rates are significantly elevated among individuals with GD. Although common mental health comorbidities did not predict overall mortality, depression predicted suicide death. Findings call for attention to long-term risk of death in GD patients and interventions against comorbid health problems.

The methane potential of activated sludge from six Swedish pulp and paper mills was evaluated. The methane production potential of sludge samples ranged from 100-200 NmL CH4 g(-1) volatile solids (VS) and for four of the six sludge samples the potential exceeded 170 NmL CH4 g(-1) VS. The effects of sludge age and dewatering on the methane production potential were evaluated. The effects of enzymatic and ultrasonic pre-treatment on the digestibility of sludge were also investigated, but energy or enzyme inputs in viable ranges did not exert a detectable, positive effect. Long-term, semi-continuous trials with sludge from two of the mills were also conducted in attempts to develop stable biogas production at loading rates up to 4 g VS L(-1). Cobalt addition (0.5 mg L(-1)) was here found to positively affect the turnover of acetate. High viscosity was a problem in all the experimental reactors and this limited the organic loading rate.

This study evaluates the feasibility of a computerized alcohol screening and intervention in patients seeking care at an emergency department. The aim of the study was to explore prevailing attitudes among nursing staff to alcohol prevention in general and the computerized screening concept before the introduction of the computerized screening procedure. Interviews were performed with six nursing staff members and a written questionnaire applied to all staff participating in training before the implementation of the concept. Observation was done in order to evaluate how the screening was performed and implemented in order to gain more knowledge about possible obstacles to alcohol screening at an emergency department. The project concept of computerized screening and low staff involvement was found to be a feasible way to overcome organizational barriers such as time limitation but there were still important attitudinal barriers among staff; thus a great disparity in practices between different staff members was observed. The results suggest that it is possible, given the time limitation, to include a computerized screening and intervention in the routines of an emergency department, when the staff regard prevention as part of their responsibilities. The findings provide evidence about the acceptability by nursing staff and feasibility of a computerized screening and personalized print out as feed back to the patients.