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Autistic adults are at risk of stress-related psychiatric disorders and reduced life quality due to social, cognitive, and perceptual challenges. Mental health interventions adapted to autistic adults are scarce. Acceptance and commitment therapy has preliminarily indicated health benefits in autistic adults, although it has not been robustly evaluated. Overall, 39 adults (21 males; 21-72 years) with autism spectrum disorder and normal intellectual ability (IQ M = 108.5; SD = 13.5) were randomized to 14 weeks of adapted acceptance and commitment therapy group treatment (NeuroACT) or treatment as usual. The intervention was feasible. Perceived stress and quality of life (primary outcomes), alongside psychological inflexibility, cognitive fusion, cognitive and behavioral avoidance, and autistic mannerism were statistically significantly improved in NeuroACT compared with treatment as usual (d = 0.70-0.90). Clinically significant changes in perceived stress and quality of life were in favor of NeuroACT. Between-group altered depression, anxiety, sleep problems, one quality of life measure, functional impairment, social aspects of autism, and executive difficulties were statistically non-significant. Dropout was slightly higher in NeuroACT. NeuroACT may be a promising treatment for autistic adults with co-existing stress and reduced quality of life. More extensive studies are warranted to evaluate NeuroACT further.

This study aims to assess student motivation to provide valid responses to the PISA student questionnaire. This was done by modeling response times using a three-component finite mixture model, comprising two satisficing response styles (rapid and idle) and one optimizing response style. Each participant's motivation was operationalized as their probability of providing an optimizing response to questionnaire items. Overall, the model offered a good fit to the data. Results indicate that most responders were motivated to optimize, with a slight decline toward the end. Further, results showed a positive effect of questionnaire-taking motivation on PISA performance, suggesting a positive relationship to test-taking motivation. In conclusion, response times can be valuable indicators for assessing survey response quality and may serve as a proxy for test-taking motivation.

This article highlights interaction within physical and virtual spaces in a higher education HyFlex learning environment with live streamed lectures and seminars. What kinds of learning spaces do we shape when we connect physical and virtual spaces? How does a group of teachers interact in these spaces and how do the HyFlex spaces affect the interaction? The perspective of 'designs for learning' theoretically frames the study. The result shows that several different spaces are shaped: physical space, representational space, interactional space, and liminal space. The results also imply that a HyFlex model requires an increased didactic awareness of designing for learning.

This inquiry investigates whether effective implementation of pedagogical actions closely associated with strong engagement and greater than expected learning gains in writing by typically developing students apply similarly to engagement and gains in writing by students with mild to moderate intellectual disabilities (ID). It was undertaken in response to low levels of engagement and achievement in writing by students with ID noted by other researchers. A mixed methods research design, involving a three-month planned and deliberate instructional writing intervention with eight senior secondary students with ID in a Swedish special needs school, was employed. Pedagogical actions, designed to assist students recognise the purposefulness of writing tasks, involve them in constructing tasks and setting goals for successful implementation, observe tasks being demonstrated, reflect on the successful (or otherwise) completion of tasks and learn about writing in differentiated contexts, were considered in relation to learner outputs. A close association between strategic operationalisation of these actions and substantial increases in engagement and gains in writing by students with ID (particularly in relation to productivity, complexity and grammatical fluency) is noted.

This article utilizes news media representations to scrutinize the symbolic construction and legitimizing support for green megaprojects, with a particular focus on Northvolt’s battery factory in Skellefteå, Sweden. The study reveals that the media portrayed the project as crucial for local development, driven by Northvolt’s explicit competition, Sweden’s national ambition to lead in green technology, and a neoliberal agenda for regional economic growth. These narratives, deeply rooted in ideological fantasies about the implications of such a megaproject for a small, struggling community, effectively suppressed concerns about colonialism, environmental risks, and indigenous rights. The media’s emphasis on perceived benefits overshadowed potential risks, prompting questions about the long-term impact of such projects on local communities and the environment. The article argues that while these investments are framed as opportunities for progress, they may perpetuate historical patterns of exploitation and overlook critical socio-environmental issues. [ABSTRACT FROM AUTHOR]

The present study used process data from a computer-based problem-solving task as indications of behavioural level of test-taking effort, and explored how behavioural item-level effort related to overall test performance and self-reported effort. Variables were extracted from raw process data and clustered. Four distinct clusters were obtained and characterised as high effort, medium effort, low effort, and planner. Regression modelling indicated that among students that failed to solve the task, level of effort invested before giving up positively predicted overall test performance. Among students that solved the task, level of effort was instead weakly negatively related to test performance. A low level of behavioural effort before giving up the task was also related to lower self-reported effort. Results suggest that effort invested before giving up provides information about test-takers' motivation to spend effort on the test. We conclude that process data could augment existing methods of assessing test-taking effort.

This quasi-experimental intervention study examines the effect of genre-based instructional practices on 90 primary students' narrative writing achievements and is a result of six teachers' action to meet the educational goals of the Swedish national curriculum. Specifically, the authors examine the effects of Joint Construction, the phase in the genre pedagogical model of the Sydney School known as the Teaching and Learning Cycle, in which teachers and students work together to co-construct texts. Joint Construction has been put forward as the most powerful part of the Teaching and Learning Cycle. The authors challenge this argument, presenting findings that are inconsistent with this widely held belief. Using a pretest-posttest control group design, the study shows that the Joint Construction stage did not significantly improve the quality of students' narrative writing or increase the text length of their writings.

Introduction: Individuals recovering from COVID-19 often experience a range of post-recovery symptoms. However, the literature on post-COVID-19 symptoms reveals conflicting results, necessitating a heightened focus on longitudinal studies to comprehend the trajectory of impairments over time. Our study aimed to investigate changes in long-term impairments among individuals infected with COVID-19 and explore potential predictors influencing these changes. Methods: We conducted a web-survey targeting individuals that had been infected with COVID-19 at four time-points: T0 (baseline), T1 (three months), T2 (six months), and T3 (twelve months). The survey included contextual factors, factors related to body functions and structures, and post-COVID impairments. The longitudinal sample included 213 individuals (with a mean age of 48.92years). Linear mixed models were employed to analyze changes in post-COVID impairments over time and identify impacting factors. Results: Findings revealed a general decline in post-COVID impairments over time, with each symptom exhibiting a dynamic pattern of fluctuations. Factors such as initial infection severity, education level, and work status were significantly associated with the levels of impairments. Discussion: The study emphasizes that post-COVID impairments are not static but exhibit variations over time. Personalized care, especially for vulnerable populations, is crucial. The results underscore the need for long-term monitoring and multidisciplinary treatment approaches. Targeted support and interventions are highlighted for individuals with severe initial infections and those in socioeconomically disadvantaged groups. [ABSTRACT FROM AUTHOR]

Background: Despite a good prognosis, survivors of differentiated thyroid cancer (DTC) may have reduced health-related quality of life (HRQOL) many years after treatment, and it is unclear how suppression of thyroid-stimulating hormone (TSH) may contribute to HRQOL. This study investigated changes in HRQOL in the 5 years following DTC treatment, the association between HRQOL and TSH suppression, and how HRQOL compares to the general population. Methods: In this nationwide prospective cohort study, 487 patients with DTC were identified between 2012 and 2017 from all Swedish hospitals treating patients with DTC. Patients treated with total thyroidectomy and planned for radioiodine answered the Swedish version of the Short Form-36 Health Survey (SF-36) and a study specific questionnaire at treatment and after 1, 3, and 5 years. Summary measures for physical and mental QOL were derived from the SF-36, and TSH values were collected from patient records. To study changes in HRQOL over time, linear mixed models were fitted on multiply imputed data, with all patients and measurement points included in the model. Results: In total, 351 patients consented to participate in the study. In the 5 years following DTC treatment, physical QOL did not change significantly with time, while mental QOL improved by on average 0.61 (p < 0.001) per year. TSH levels were not predictive of either physical or mental QOL, or their change over time. At 5 years, there was a significant difference in physical and mental QOL compared with the Swedish general population, but effect sizes were small (Cohen's d = 0.29 and −0.21, respectively). The SF-36 domains general health, vitality, social functioning, and mental health were lower at 5 years compared with the general population (difference 8.7–13.3), and these differences were clinically significant. Conclusions: The mental component of HRQOL improves over time following DTC treatment. HRQOL in patients with DTC is not explained by TSH suppression. Although overall differences in physical and mental HRQOL compared with the general population were small 5 years after treatment, several specific psychosocial HRQOL domains were clinically meaningfully reduced. Psychosocial health issues should be screened for during DTC follow-up. [ABSTRACT FROM AUTHOR]

Background: Accidental hypothermia is common in all trauma patients and contributes to the lethal diamond, increasing both morbidity and mortality. In hypotensive shock, fluid resuscitation is recommended using fluids with a temperature of 37–42°, as fluid temperature can decrease the patient's body temperature. In Sweden, virtually all prehospital services use preheated fluids. The aim of the present study was to investigate how the temperature of preheated infusion fluids is affected by the ambient temperatures and flow rates relevant for prehospital emergency care. Methods: In this experimental simulation study, temperature changes in crystalloids preheated to 39 °C were evaluated. The fluid temperature changes were measured both in the infusion bag and at the patient end of the infusion system. Measurements were conducted in conditions relevant to prehospital emergency care, with ambient temperatures varying between − 4 and 28 °C and flow rates of 1000 ml/h and 6000 ml/h, through an uninsulated infusion set at a length of 175 cm. Results: The flow rate and ambient temperature affected the temperature in the infusion fluid both in the infusion bag and at the patient end of the system. A lower ambient temperature and lower flow rate were both associated with a greater temperature loss in the infusion fluid. Conclusion: This study shows that both a high infusion rate and a high ambient temperature are needed if an infusion fluid preheated to 39 °C is to remain above 37 °C when it reaches the patient using a 175-cm-long uninsulated infusion set. It is apparent that the lower the ambient temperature, the higher the flow rate needs to be to limit temperature loss of the fluid. [ABSTRACT FROM AUTHOR]

Background: Although there is growing awareness that early childhood development programs are important for a sustainable society, there is a knowledge gap about how to implement such programs. Successful implementation requires attention to implementation drivers (competency, organization, and leadership) during all phases of the implementation. The purpose of this study was to describe cross-sectoral operational workgroups' perceptions of facilitators, barriers and solutions related to implementation drivers in the preparationphase of implementing an evidence-based early childhood home visiting program. Methods: Quantitative and qualitative data were collected from twenty-four participants, divided into 5 groups, during implementation planning workshops. The workshops were guided by a structured method informed by the principles of Motivational Interviewing and within a framework of implementation drivers. Groups sorted cards with statements representing implementation drivers according to perceptions of facilitators and barriers, and percentages were calculated for each type of implementation determinant, for each type of driver. The groups discussed their card sorting and wrote action plans to address barriers, yielding documentation that was analyzed using deductive qualitative content analysis. Results: A mixed-methods analysis resulted identification of facilitators, barriers, unknowns and solutions in two to three subcategories under each main category of implementation driver. A competent and confident workforce, and enthusiasm and commitment were key facilitators. Key barriers were unclear roles and responsibilities, and insufficient articulation of local vision and goals. Many factors were described as yet unknown. Specific solutions were generated to support the implementation. Conclusions: Our study furthers the scientific understanding of how to take evidence-based early childhood programs from research to practice within an implementation drivers framework. Facilitators, barriers and solutions in key areas during the preparation phase were identified with the help of a novel tool. The results provide useful knowledge for decision makers and organizations preparing similar initiatives in communities striving to attain sustainable development goals. [ABSTRACT FROM AUTHOR]

Background: Mental health problems among children and adolescents are a growing public health concern. Self‐report questionnaires are pivotal for screening and early detection of mental health issues. We evaluate the psychometric properties and provide norm data of the 25‐item child and 25‐item parent‐report versions of the Revised Child Anxiety and Depression Scale (RCADS). Methods: A random probability sample of 29,000 children and adolescents (ages 4–17) from the Swedish population registry was invited. Data collection occurred from September 2021 to January 2022, accompanied by one postal and four SMS reminders. Results: Participants (N = 7045, 48.98% girls) demonstrate that the RCADS‐25 possesses relatively sound psychometric properties, albeit that the child‐report version assessed with children and adolescents aged 8 to 17 years rendered relatively better psychometric properties (e.g., ω = 0.87–0.92, CFI = 0.89) compared with the parent‐report version and the children 4 to 7 years old (e.g., ω = 0.72–0.82, CFI = 0.84). Conclusion: The RCADS‐25 instruments may be used as an effective instrument for the initial assessment of anxiety and depression in children and adolescents in Sweden. [ABSTRACT FROM AUTHOR]

Background: A small proportion of the older population accounts for a high proportion of healthcare use. For effective use of limited healthcare resources, it is important to identify the group with greatest needs. The aim of this study was to explore frequency and reason for hospitalisation and cumulative mortality, in an older population at predicted high risk of hospital admission, and to assess if a prediction model can be used to identify individuals with the greatest healthcare needs. Furthermore, discharge diagnoses were explored to investigate if they can be used as basis for specific interventions in the high-risk group. Methods: All residents, 75 years or older, living in Östergötland, Sweden, on January 1st, 2017, were included. Healthcare data from 2016 was gathered and used by a validated prediction model to create risk scores for hospital admission. The population was then divided into groups by percentiles of risk. Using healthcare data from 2017–2018, two-year cumulative incidence of hospitalisation was analysed using Gray´s test. Cumulative mortality was analysed with the Kaplan–Meier method and primary discharge diagnoses were analysed with standardised residuals. Results: Forty thousand six hundred eighteen individuals were identified (mean age 82 years, 57.8% women). The cumulative incidence of hospitalisation increased with increasing risk of hospital admission (24% for percentiles < 60 to 66% for percentiles 95–100). The cumulative mortality also increased with increasing risk (7% for percentiles < 60 to 43% for percentiles 95–100). The most frequent primary discharge diagnoses for the population were heart diseases, respiratory infections, and hip injuries. The incidence was significantly higher for heart diseases and respiratory infections and significantly lower for hip injuries, for the population with the highest risk of hospital admission (percentiles 85–100). Conclusions: Individuals 75 years or older, with high risk of hospital admission, were demonstrated to have considerable higher cumulative mortality as well as incidence of hospitalisation. The results support the use of the prediction model to direct resources towards individuals with highest risk scores, and thus, likely the greatest care needs. There were only small differences in discharge diagnoses between the risk groups, indicating that interventions to reduce hospitalisations should be personalised. Trial registration: clinicaltrials.gov Identifier: NCT03180606, first posted 08/06/2017. [ABSTRACT FROM AUTHOR]

Background: Compliance with a study protocol is central to meeting its research goals. In longitudinal research studies, data loss due to missed visits limit statistical power and introduce bias. The Environmental Determinants of Diabetes in the Young (TEDDY) study is a longitudinal multinational (US, Finland, Germany, and Sweden) investigation of children at risk for type 1 diabetes (T1D) that seeks to identify the environmental triggers of islet autoimmunity and T1D. The purpose of the current study was to identify sociodemographic variables and maternal characteristics assessed in the first year of TEDDY that were associated with study visit compliance in the subsequent 3 years. Methods: Sociodemographic variables, maternal life-style behaviors, post-partum depression, maternal reactions to the child's T1D risk, and study-related variables were collected at child-age 6 months and 15 months. Multiple linear regression was used to examine the association of these variables to study visit compliance in the subsequent 3 years. Results: Study visit compliance was highest in Sweden (p > 0.001), in children who were their mother's first child (p > 0.001), and whose mothers were older (p > 0.001) and more satisfied with the TEDDY study (p > 0.001). Father participation was also associated with better study visit compliance (p > 0.001). In contrast, children whose mothers smoked (p > 0.001), suffered from post-partum depression (p = 0.034), and were more anxious about their child's T1D risk (p = 0.002), completed fewer visits. Father's study satisfaction was also associated with study visit compliance (p = 0.029); however, it was not significant in models that included maternal study satisfaction. Conclusions: Sociodemographic variables, maternal characteristics—including study satisfaction—and fathers' participation in the first year of a longitudinal study were associated with subsequent study visit compliance in a sample of children genetically at-risk for T1D followed for 4 years. This information can inform future strategies designed to improve study visit compliance in longitudinal pediatric studies. Trial registration: NCT00279318, 06/09/2004. [ABSTRACT FROM AUTHOR]

Family Check‐up (FCU) was introduced in Sweden more than a decade ago. Little is known about what parents experience as FCU's key mechanisms leading to changes in parenting. The aim of this study was to investigate Swedish parents' satisfaction with FCU, and their experiences of facilitators and barriers for making changes in their parenting. A mixed methods approach was employed using a parent satisfaction questionnaire (n = 77) and focus groups (n = 15). General satisfaction with FCU was adequate, with an average rating of 4 on a five‐point scale (range 3.1–4.6). The analysis of quantitative and qualitative data resulted in eight themes representing facilitators and four themes representing barriers, organized into three categories: (1) access and engagement; (2) therapeutic process; and (3) program components. Ease of access to FCU facilitated initial engagement. Individual tailoring and access to FCU during different phases of change facilitated sustained engagement and change. Therapeutic process facilitators were a meaningful, supportive relationship with the provider, psychological benefits for parents and benefits for the whole family. Program components that facilitated change in parenting were new learning of parenting strategies and use of helpful techniques such as videotaping and home practice. Negative experiences with service systems prior to starting FCU, parent psychological barriers, and parent‐provider mismatch were described as potential barriers. Some parents desired other program formats that were not offered, and some felt that new learning was insufficient to improve child behavior. Understanding the parent perspective can contribute to successful future work with implementing FCU. [ABSTRACT FROM AUTHOR]

Background: Behavioral risk factors are highlighted in the prevention of diabetes and cardiovascular disease. Screening for health locus of control could be a feasible way to better identify individuals who could benefit from preventive behavioral change interventions. The aim of the study was to investigate the correlation between a single question measuring internal health locus of control (IHLC) and the Multidimensional Health Locus of Control Scale (MHLC) and to assess how IHLC relates to the General Self‐Efficacy scale (GSE) in a primary care setting. Methods: Primary care patients, aged 18 and older, attending three primary care centers in southwest Sweden were consecutively asked to anonymously participate in the study. The patients were given a questionnaire and instructed to return the questionnaire in a sealed box in the waiting room. Results: In all, 519 patients were included. The correlation between MHLC Internality and IHLC was weak (r = 0.21, p < 0.001). An increase of one point on the internality scale of the MHLC gave an odds ratio of 1.19 (95% CI 1.11–1.28) for reporting high IHLC, and thus a five‐point increase gave a doubled likelihood, OR = 2.40, CI 1.67–3.46. The results for the other scales of the MHLC and GSE were similar. Conclusion: In this study, we found weak but statistically significant support for the single‐question IHLC as a measure of internal health locus of control. Given that the correlation was weak, we recommend using the MHLC when possible. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To estimate the risk of progression to stage 3 type 1 diabetes based on varying definitions of multiple islet autoantibody positivity (mIA). RESEARCH DESIGN AND METHODS: Type 1 Diabetes Intelligence (T1DI) is a combined prospective data set of children from Finland, Germany, Sweden, and the U.S. who have an increased genetic risk for type 1 diabetes. Analysis included 16,709 infants-toddlers enrolled by age 2.5 years and comparison between groups using Kaplan-Meier survival analysis. RESULTS: Of 865 (5%) children with mIA, 537 (62%) progressed to type 1 diabetes. The 15-year cumulative incidence of diabetes varied from the most stringent definition (mIA/Persistent/2: two or more islet autoantibodies positive at the same visit with two or more antibodies persistent at next visit; 88% [95% CI 85–92%]) to the least stringent (mIA/Any: positivity for two islet autoantibodies without co-occurring positivity or persistence; 18% [5–40%]). Progression in mIA/Persistent/2 was significantly higher than all other groups (P < 0.0001). Intermediate stringency definitions showed intermediate risk and were significantly different than mIA/Any (P < 0.05); however, differences waned over the 2-year follow-up among those who did not subsequently reach higher stringency. Among mIA/Persistent/2 individuals with three autoantibodies, loss of one autoantibody by the 2-year follow-up was associated with accelerated progression. Age was significantly associated with time from seroconversion to mIA/Persistent/2 status and mIA to stage 3 type 1 diabetes. CONCLUSIONS: The 15-year risk of progression to type 1 diabetes risk varies markedly from 18 to 88% based on the stringency of mIA definition. While initial categorization identifies highest-risk individuals, short-term follow-up over 2 years may help stratify evolving risk, especially for those with less stringent definitions of mIA. [ABSTRACT FROM AUTHOR]

During the last few decades in the handling of ongoing crises and preparing for future crises, governments and other public authorities increasingly emphasize the important role religious organizations can play in crises and disaster management. Considering this development, it is appropriate to ask whether the expectations by policymakers are mirrored by the religious organizations themselves? This article aims to answers this question by studying both the organizations' desired role in time of national crises and disasters and the actual role taken by local congregations in Sweden during the Covid‐19 pandemic. It also aims to study whether this differs in relation to organizational differences and religious affiliation. The study clearly shows that 8 out of 10 congregations believe they have an important role to play in the event of a disaster or crisis. However, despite the high level of willingness, the role congregations take may not always mirror the governments expectations. In terms of differences between congregations, although cross‐religious differences are noted, the size of the organization is the critical factor. The article concludes by discussing the disparity between policymakers' expectations and the willingness of organizations as well as the complexity of policymakers assuming that non‐profit organizations will help unequivocally. [ABSTRACT FROM AUTHOR]

Autism spectrum disorder is characterized by social impairments and behavioural inflexibility. In this pilot study, the feasibility and outcomes of a 6-week acceptance and commitment therapy-based skills training group were evaluated in a special school setting using a quasi-experimental design (acceptance and commitment therapy/school classes as usual). A total of 28 high-functioning students with autism spectrum disorder (aged 13-21 years) were assessed using self- and teacher-ratings at pre- and post-assessment and 2-month follow-up. All participants completed the skills training, and treatment satisfaction was high. Levels of stress, hyperactivity and emotional distress were reduced in the treatment group. The acceptance and commitment therapy group also reported increased prosocial behaviour. These changes were stable or further improved at the 2-month follow-up. Larger studies are needed to further evaluate the benefits of acceptance and commitment therapy for autism spectrum disorder.

The aim of this study is to describe and analyse the writing discourse in one classroom and how students learn through studying a topic, i.e. the teaching and learning of written argument. The study takes its stance from a sociocultural perspective and is influenced by discourse analyses, new literacy studies and critical literacy (Fairclough 1989; Barton 2007; Janks 2010; Ivanic 2004). Data from year 6 in Sweden consist of observations, informal conversations, teachers' planning and students' written texts, i.e. letters to the editor. The results are presented in terms of four themes that became apparent during the reading of the data, viz.: (1) teaching for learning -- deconstruction; (2) dialogue and scaffolding for learning -- enabling access; (3) feedback and students' reflections for learning; and (4) writing to learn -- reconstruction. The data are analysed and discussed on the basis of four concepts for developing critical literacy, viz. "access," "deconstruction," "reconstruction" and "domination" (cf. Janks 2010:21-32). The study indicates that explicit teaching of a written argument provides students with access to the dominating structure of the genre if they are given the time and tools to reflect and are given feedback from the teacher.

Background: The Occupational Depression Inventory (ODI) was recently devised to assess depressive symptoms that individuals specifically attribute to their work. One purpose of the ODI is to overcome limitations in current assessments of job-related distress. This study aimed to validate the Swedish version of the ODI. Methods: The study involved 365 individuals employed in Sweden. In addition to the ODI, the study included the Satisfaction with Life Scale, the Effort-Reward Imbalance Questionnaire, the Demand-Control-Support Questionnaire, the GAD-2, and the PHQ-9. We inquired into the factorial validity, dimensionality, scalability, test-score reliability, criterion validity, convergent validity, discriminant validity, and measurement invariance of the ODI. Results: Exploratory structural equation modeling bifactor analysis indicated that the ODI's Swedish version meets the requirements for essential unidimensionality (e.g., explained common variance = 0.872). Measurement invariance held across sexes, age groups, and occupational categories. The instrument exhibited strong scalability (e.g., H = 0.662). The observed total scores thus accurately ranked respondents on the latent continuum underlying the scale. The ODI's total-score reliability was high (e.g., McDonald's ω = 0.929). Speaking to the instrument's criterion validity, we found occupational depression to correlate, in the expected direction, with various work (e.g., job support) and nonwork (e.g., general anxiety) variables. Occupational depression showed large correlations with effort-reward imbalance (r = 0.613) and demand-control imbalance (r = 0.566) at work. Multiple regression analyses supported these associations further. As expected, we observed both a degree of convergent validity and a degree of discriminant validity when examining the ODI against the PHQ-9, an attribution-free measure of depression. Discussion: This study indicates that the ODI performs well within the Swedish context, consistent with the findings obtained in other linguistic and geographic contexts. The ODI promises to help researchers, practitioners, and public health decision-makers address job-related distress more effectively. [ABSTRACT FROM AUTHOR]

BACKGROUND: Per- and polyfluoroalkyl substances (PFAS) are widely used, environmentally ubiquitous, and stable chemicals that have been associated with lower vaccine-induced antibody responses in children; however, data on adults are limited. The drinking water from one of the two waterworks in Ronneby, Sweden, was heavily contaminated for decades with PFAS from firefighting foams, primarily perfluorohexane sulfonic acid and perfluorooctanesulfonic acid (PFOS). Vaccination against SARS-CoV-2 offered a unique opportunity to investigate antibody responses to primary vaccination in adults who had been exposed to PFAS. OBJECTIVES: Our objective was to evaluate associations between PFAS, across a wide range of exposure levels, and antibody responses in adults 5 wk and 6 months after a two-dose vaccination regime against SARS-CoV-2. METHODS: Adults age 20-60 y from Ronneby (푛 = 309, median PFOS serum level 47 ng/mL, fifth to 95th percentile 4-213 ng/mL) and a group with background exposure (푛 = 47, median PFOS serum level 4 ng/mL) received two doses of the Spikevax (Moderna) mRNA vaccine. The levels of seven PFAS were measured in serum before vaccination. Serum immunoglobulin G antibodies against the SARS-CoV-2 spike antigen (S-Abs) were measured before vaccination and at 5 wk (푛 = 350) and 6 months (푛 = 329) after the second vaccine dose. Linear regression analyses were fitted against current, historical, and prenatal exposure to PFAS, adjusting for sex, age, and smoking, excluding individuals with previous SARS-CoV-2-infection. RESULTS: PFAS exposure, regardless of how it was estimated, was not negatively associated with antibody levels 5 wk [current PFOS: -0.5% S-Abs/PFOS interquartile range (IQR); 95% confidence interval (CI): -8, 7] or 6 months (current PFOS: 3% S-Abs/PFOS IQR; 95% CI: -6, 12) after COVID-19 vaccination. DISCUSSION: Following a strict study protocol, rigorous study design, and few dropouts, we found no indication that PFAS exposure negatively affected antibody responses to COVID-19 mRNA vaccination for up to 6 months after vaccination. [ABSTRACT FROM AUTHOR]

NT-proBNP is frequently used for ruling out heart failure. Different cut-offs are used depending on the clinical context, e.g. an acute or chronic condition. Medical decision limits have been suggested at 125 and 300 ng/L or 400 ng/L in international guidelines. However, there is limited standardization between NT-proBNP methods and using the same blood sample might cause different treatment of patients. Data from the external quality assessment program for NT-proBNP from Equalis, Sweden, were extracted for the period 2011–2021, and categorized according to manufacturer. Manufacturer median NT-proBNP values were compared to total median values. CV% was calculated for each manufacturer and in comparison to different levels of NT-proBNP. Roche was the most common method, and its median results were closest to the median consensus results. When looking at the total CV at NT-proBNP levels in the range of 0–500 ng/L, the total CV varied from 4 to 27%. During 2019–2021, Siemens (Immulite, Centaur, Atellica) yielded results 16–20% above the consensus median depending on sample level. Similarly, Abbott was 5–7% above, while Roche and Siemens Stratus were 1% respectively 6–10% below the consensus median. The introduction of new manufacturers and methods in 2017 have caused the agreement between manufacturers to decline. This highlights the need for a common calibrator and reference materials, particularly since medical decision limits in guidelines, e.g. European Society of Cardiology 2021, which are mostly based on Roche methods, do not take these method differences into account. [ABSTRACT FROM AUTHOR]

Aims and Objective: To explore the experiences of patients with non‐cardiac chest pain and cardiac anxiety regarding participation in an internet‐delivered cognitive behavioural therapy program. Background: Non‐cardiac chest pain is common and leads to cardiac anxiety. Internet‐delivered cognitive behavioural therapy may be a possible option to decrease cardiac anxiety in these patients. We have recently evaluated the effect of an internet‐delivered cognitive behavioural therapy program on cardiac anxiety. Design: An inductive qualitative study using content analysis and the COREQ checklist. Methods: Semi‐structured interviews with 16 Swedish patients, who had participated in the internet‐delivered cognitive behavioural therapy program. Results: Three categories were found. The first, 'Driving factors for participation in the internet‐delivered cognitive behavioural therapy program' described the impact of pain on their lives and struggle that led them to participating in the program. The second, 'The program as a catalyst' described that the program was helpful, trustworthy and useful and the last category, 'Learning to live with chest pain' described the program as a tool for gaining the strength and skills to live a normal life despite chest pain. Conclusions: The program was experienced as an opportunity to return to a normal life. The program was perceived as helpful, trustworthy and useful, which helped the participants challenge their fear of chest pain and death, and gain strength and new insights into their ability to live a normal life. Relevance to Clinical Practice: A tailored internet‐delivered cognitive behavioural therapy program delivered by a nurse therapist with clinical experience of the patient group is important to improve cardiac anxiety. Patient or Public Contribution: Patients or the general public were not involved in the design, analysis or interpretation of the data of this study, but two patients with experience of non‐cardiac chest pain were involved in the development of the pilot study. Trial Registration: ClinicalTrials.gov NCT03336112; https://www.clinicaltrials.gov/ct2/show/NCT03336112. [ABSTRACT FROM AUTHOR]

Climate change leads to increased and new risks in societies. Pluvial flooding is one such risk that already generates major damages, which are expected to increase significantly in the future. Not least, many homeowners risk being affected by floods, and have been attributed a central role in Sweden's climate adaptation policy. Despite this, no previous Swedish studies have specifically investigated how homeowners have been affected by floods beyond damage costs, and few studies have investigated how homeowners have managed or view their responsibility to prevent pluvial flood risks. The lack of such knowledge may lead to less informed decisions about climate adaptation. Through interviews with homeowners affected by flooding, this study examines how they; experience flood risks, have been affected materially and health-wise, have managed the situation, and consider responsibility to prevent new damage. The study shows clear effects on the well-being of homeowners, that few have adapted their property and tend to underestimate the flood risk facing their property. Homeowners also tend to displace responsibility for preventive measures to other actors, mainly the municipality. [ABSTRACT FROM AUTHOR]

This study aimed to estimate the healthcare costs of kidney transplantation compared with dialysis using a propensity score approach to handle potential treatment selection bias. We included 693 adult wait-listed patients who started renal replacement therapy between 1998 and 2012 in Region Skåne and Stockholm County Council in Sweden. Healthcare costs were measured as annual and monthly healthcare expenditures. In order to match the data structure of the kidney transplantation group, a hypothetical kidney transplant date of persons with dialysis were generated for each dialysis patient using the one-to-one nearest-neighbour propensity score matching method. Applying propensity score matching and inverse probability-weighted regression adjustment models, the potential outcome means and average treatment effect were estimated. The estimated healthcare costs in the first year after kidney transplantation were €57,278 (95% confidence interval (CI) €54,467–60,088) and €47,775 (95% CI €44,313–51,238) for kidney transplantation and dialysis, respectively. Thus, kidney transplantation leads to higher healthcare costs in the first year by €9,502 (p = 0.066) compared to dialysis. In the following two years, kidney transplantation is cost saving [€36,342 (p < 0.001) and €44,882 (p < 0.001)]. For patients with end-stage renal disease, kidney transplantation reduces healthcare costs compared with dialysis over three years after kidney transplantation, even though the healthcare costs are somewhat higher in the first year. Relating the results of existing estimates of costs and health benefits of kidney transplantation shows that kidney transplantation is clearly cost-effective compared to dialysis in Sweden. [ABSTRACT FROM AUTHOR]

Aim: To investigate the complete clinical spectrum of individuals with paediatric tuberous sclerosis complex in southern Sweden and explore changes over time. Methods: In this retrospective observational study, 52 individuals aged up to 18 years at the study start were followed-up at regional hospitals and centres for habilitation from 2000 to 2020. Results: Cardiac rhabdomyoma was detected prenatally/neonatally in 69.2% of the subjects born during the latest ten years of the study period. Epilepsy was diagnosed in 82.7% of subjects, and 10 (19%) were treated with everolimus, mainly (80%) for a neurological indication. Renal cysts were detected in 53%, angiomyolipomas in 47%, astrocytic hamartomas in 28% of the individuals. There was a paucity of standardized follow-up of cardiac, renal, and ophthalmological manifestations and no structured transition to adult care. Conclusion: Our in-depth analysis shows a clear shift towards an earlier diagnosis of tuberous sclerosis complex in the latter part of the study period, where more than 60% of cases showed evidence of this condition already in utero due to the presence of a cardiac rhabdomyoma. This allows for preventive treatment of epilepsy with vigabatrin and early intervention with everolimus for potential mitigation of other symptoms of tuberous sclerosis complex. [ABSTRACT FROM AUTHOR]

Two studies were conducted to develop and evaluate an instrument intended to identify and measure personal values, values attainment, and persistence in the face of barriers. Study 1 describes a content validity approach to the construction and preliminary validation of the Bull's Eye Values Survey (BEVS), using a sample of institutionalized patients suffering from epilepsy. Study 2 investigated the psychometric properties of the BEVS with a sample of Swedish university students. Results suggest that the BEVS is sensitive to treatment effects and can differentiate between clients who receive values-based interventions and those who do not. The BEVS subscales and total score appear to measure an independent dimension of psychological functioning that is negatively correlated with measures of depression, anxiety, and stress, and positively correlated with a measure of psychological flexibility. The BEVS also exhibits acceptable temporal stability and internal consistency. The study provides preliminary support for the BEVS as both a research and clinical tool for measuring values, values-action discrepancies, and barriers to value-based living. (Contains 4 tables.)

The internationalization of higher education has been a major concern in the last decades for a variety of reasons. This concern has been addressed by policymakers in a number of ways, most commonly through increased international partnerships and recruitment of international students. Much of the underlying motivation for internationalization is underpinned by a desire for raising European universities' financial and/or academic position. This article argues that it is advantageous for all to develop internationalization policies in a creative, equal and reciprocal manner, focusing on the concept of "intercultural dialogue". Through the consideration of policy documents of three higher education institutions in Spain, Sweden and the UK, we identify opportunities for developing an intercultural dialogue approach to internationalization. Finally, a conceptual framework is proposed through which internationalization could be related to intercultural dialogue in universities.

In this article I discuss a number of excerpts from interviews with class grandparents; that is to say, older people helping out in schools for children in Sweden. The interviews focused on experiences of taking part in class grandparent projects. Indirectly, however, they dealt with identity. By treating the interviews as stories, as ways of storying people's lives, I show how some of these discourses seemed especially central to producing subject positions in the narratives on class grandparent experiences. I also suggest that the studied stories are ideological in character, in the sense that they constitute fantasies that cover over the contingencies of everyday life.

Purpose: The purpose of this study is to explore home care nurses' experience of learning in a multicultural environment. Design/methodology/approach: The study was based on qualitative research design. Data were collected through repeated interviews with registered home care nurses working in a multicultural area. The data were analyzed through a qualitative content analysis with a direct approach. Findings: Six categories describing nurses' experiences of learning were developed in order to define which components were determinative in facilitating or constraining home care in a multicultural environment. The findings show that home care demands high individual nursing skills and also offers many opportunities for further learning. The most important sources of learning were the challenges presented in the daily experience of encountering diversity of patients and families, by informal social interactions and exchange of knowledge with colleagues. Research limitations/implications: The strength of this study is that data are collected by two different methods with time for reflection in between. Limitations are that only female nurses participate in the study and from one team of nurses. Practical implications: The findings can be used by nurses to create an awareness of the opportunities that exist in everyday work. For managers, this study highlights learning and constraints that exist on the organisation level. Originality/value: This article adds to existing research by describing the learning environment for home care nurses in relation to the theoretical framework that examines the factors which either facilitate or constrain learning at work.

The implication of reading competence in developing reflection and thinking is an important issue for student teachers to consider. Reading is also a competence, in which the language at the disposal of a person is included, to use for social development and mutual understanding. This article is based on a case study and is concerned with how some student teachers in South Africa and Sweden conceive of themselves as readers from child to student and the value of language for reading competence. In the article we reflect on different reading practices in the two countries. The data consist of 25 written narratives with the theme, "I as a reader," written by student teachers in South Africa and Sweden. By using a socio-cultural basis for understanding reading, one can identify six reading practices concerning the students' reading events in the narratives. One reading practice, critical reading, is more explicit in the South African students' narratives than in the Swedish students' narratives.

This paper is a study of textbooks in chemical technology in Sweden during the industrialisation in the 19th century. In this period, teaching in technological education in general became more and more founded on science. However, there existed very few textbooks in chemical technology, and it is argued that the reason was that the essentials of the knowledge used for developing chemical industry were of a tacit and local character. Such knowledge could only with difficulty be transferred through textbooks with scientific ambitions. Thus the textbooks written or translated by scientists were not as widely used as the ones written or translated by chemical engineers. The usefulness of the latter group can be explained by the fact that they had been adapted to local circumstances, and expressed generalisations, not as scientific laws, but as rules of thumb. Finally, a model for the diffusion of knowledge is suggested, by which the role of textbooks in chemical technology better can be understood.

Aim: To assess the hypothesis that low internal health locus of control (IHLC) and psychological distress (PD) are associated with insulin resistance. Materials and methods: In 2002–2005, a random population sample of 2,816 men and women aged 30–74 years participated (76%) in two municipalities in southwestern Sweden. This study included 2,439 participants without previously known diabetes or cardiovascular disease. IHLC was measured by a global scale and PD was measured by the 12-item General Health Questionnaire. Insulin resistance was estimated using HOMA-ir. General linear models were used to estimate differences in HOMA-ir between groups with low IHLC, PD, and both low IHLC and PD, respectively. Results: Five per cent (n = 138) had both PD and low IHLC, 62 per cent of participants (n = 1509) had neither low IHLC nor PD, 18 per cent (n = 432) had PD, and 15 per cent (n = 360) low IHLC. Participants with both low IHLC and PD had significantly higher HOMA-ir than participants with neither low IHLC nor PD (Δ = 24.8%, 95%CI: 12.0–38.9), also in the fully adjusted model (Δ = 11.8%, 95%CI: 1.5–23.0). Participants with PD had significantly higher HOMA-ir (Δ = 12%, 95%CI: 5.7–18.7), but the significance was lost when BMI was included in the model (Δ = 5.3%, 95%CI:0.0–10.8). Similarly, participants with low IHLC had significantly higher HOMA-ir (Δ = 10.1%, 95%CI: 3.5–17.0) but the significance was lost in the fully adjusted model (Δ = 3.5%, 95%CI: -1.9–9.3). Conclusions: Internal health locus of control (IHLC) and psychological distress (PD) were associated with insulin resistance. Especially individuals with both PD and low IHLC may need special attention. [ABSTRACT FROM AUTHOR]

To study the influence of demographic and organizational factors to antibiotic utilization in dental implant surgery in Sweden. Descriptive statistics regarding antibiotic prescription between 2009 and 2019 was retrieved from two national registers, the Swedish Prescribed Drug Register and the Dental Health register, both administered by the National Board of Health and Welfare. During the years 2009–2019 a significant decrease of the proportion of prescriptions of systemic antibiotics in conjunction with implant surgical procedures occurred in all patient groups where the most common procedure was the insertion of a single implant. The proportion of dental visits when implant surgical treatment was performed which resulted in a prescription of antibiotics decreased significantly from 1/3 to approximately 1/5. However, comparing Public and Private dental care providers, the reduction was significantly greater in Public dental care. Patients with low level of education in urban regions, treated in Private dental clinics were more likely to receive antibiotics in conjunction to implant surgery compared to other groups. Phenoxymethylpenicillin is the most widely used substance in conjunction with implant surgery. There is still room for improvement in reduction of antibiotic prescriptions in conjunction to implant surgical procedures in Sweden. [ABSTRACT FROM AUTHOR]

Aim: To describe how Swedish emergency nurses experience the preconditions of providing safe care during the COVID‐19 pandemic when collecting blood culture in the emergency department. Design: A qualitative exploratory design using content analysis with a manifest approach. Method: Semi‐structured interviews were conducted with 13 emergency nurses working in the emergency department. Results: The analysis resulted in one main category: unprecedented preconditions create extraordinary stress and jeopardize safe care when collecting blood culture. This main category includes four additional categories: organizational changes, challenges in the isolation room, heavy workload creates great stress, and continuous learning. Conclusion: The COVID‐19 outbreak has made the emergency department a workplace where constant changes of routines combined with new information and reorganization risk jeopardize safe care during blood culture sampling. Accordingly, high workload and stress have been identified as a reason for emergency nurses not following guidelines. It is therefore necessary to optimize the preconditions during blood culture sampling and identify situations where there are shortcomings. [ABSTRACT FROM AUTHOR]

Aim: This study used 17 year of Swedish registry data (2003-2019) for 25,125 adults assessed for their severity of substance use to identify the baseline factors predicting the risk of being court-ordered into compulsory care and examine the association between admission to compulsory care and mortality risks due to alcohol- or drug-related causes. Methods and materials: Addiction Severity Index (ASI) assessment data were linked to register data on demographic characteristics, compulsory care, and alcohol- and drug-related mortality. Cox regression models were used to identify baseline factors predictive of post-assessment admission to compulsory care in the 5 years post-substance use assessment. Discrete-time random-effect logistic regression models were used to examine the association between compulsory care duration and alcohol or drug-related mortality risks. Propensity score matching was used for validation. Results: The first models identified that younger age, female gender, and ASI composite scores for drug use, mental health and employment were significantly associated with the risk of placement in compulsory care for drugs other than alcohol. Female gender and ASI composite scores for alcohol, drug use and employment were significantly associated with compulsory care treatment for alcohol use. The second models showed that older individuals and men were more likely to die due to alcohol-related causes, while younger individuals and men were more likely to die due to drug-related causes. Length of stay in compulsory care institutions significantly increased the likelihood of dying due to substance use-related causes. Propensity scores analyses confirmed the results. Conclusion: In Sweden, a significant concern is the higher likelihood of women and young individuals to be court-ordered to compulsory care. Although compulsory care is often advocated as a life-saving intervention, our findings do not provide strong support for this claim. On the contrary, our findings show that admission to compulsory care is associated with a higher risk of substance use-related mortality. Factors such as compulsory care often not including any medical or psychological therapy, together with relapse and overdose after discharge, may be possible contributing factors to these findings. [ABSTRACT FROM AUTHOR]

The edge beams of reinforced concrete bridges with de-icing salts sprayed experience extensive corrosion damage. The average service life of edge beams needing replacement in Sweden has been reported as only 45 years, causing great economic loss to both owners and users. Hence, finding a durable solution for edge beams would benefit society. Hybrid reinforced concrete structures, produced by adding a low-to-moderate fibre content into traditional reinforced concrete, can effectively limit the service crack width and improve resistance to chloride-induced corrosion damage. In this paper, different alternatives of hybrid and traditional reinforced edge beams were designed for a case study. The service life of the alternatives was compared by conducting chloride diffusion calculations and by applying a corrosion-induced cracking model. The economic and environmental (indicated by greenhouse gas emissions) benefits of using hybrid reinforced edge beams were assessed by life-cycle cost analysis and life-cycle assessment. The results showed that the service life of edge beams made of hybrid reinforced concrete can be prolonged by over 58%, thereby enabling a significant reduction in the total life-cycle costs and annual total greenhouse gas emissions. [ABSTRACT FROM AUTHOR]

There is a trend worldwide to induce pregnant women earlier. However, few studies have focused on women's experiences. The aim was to gain a deeper understanding of women's lived experiences of induction of labour in late- and post-term pregnancy. Phenomenology with a reflective lifeworld approach was chosen as the method. Twelve women participating in a larger study in which women were randomized to either induction of labour in week 41 or to expectant management until week 42, were interviewed one to three months after giving birth. The essence is described as follows: labour becomes another journey than the intended one. The women adapted to this new journey by seeing the advantages and handing themselves over to the healthcare system, but at the same time something about giving birth could be lost. The result is further described by its four constituents: planning the unplannable, being a guest at the labour ward, someone else controlling the labour, and overshadowed by how it turned out. Induced labour presents a challenge to maternity personnel to support the birthing woman's normal progress, not to rush her through labour, and to involve her in the process. [ABSTRACT FROM AUTHOR]

Background: The negative impact of the COVID-19 pandemic on the mental health is now clearly established. However, information on the levels of mental ill health of people infected with COVID-19 and potential correlates of poor mental health is still limited. Therefore, the current study aimed to study indicative of potential mental health problems in individuals with a history of probable or confirmed SARS CoV-2 infection/infections and address the impacts of post-COVID impairments and fatigue following COVID-19 infection/infections on depression, anxiety, and insomnia. Methods: A web-survey including demographics, questions related to COVID-19 status and post-COVID impairments, and standardized measures of depression, anxiety, insomnia, and fatigue was completed by 507 individuals with a history of probable or confirmed SARS CoV-2 infection/infections. Results: We found significant rates of significant depression, anxiety, and insomnia in our sample, with more than 70% experiencing levels above the clinical cut offs for at least one psychological health problems. Higher levels of depression, anxiety, and insomnia were associated with the severity of COVID-19 infection in the acute phase, hospitalization because of COVID-19, and higher levels of post-COVID impairments and fatigue. Reduced motivation emerged as the strongest predictor for mental ill health. Conclusions: These findings highlight that individuals infected with COVID-19, especially those who still have experienced post-COVID impairments, are more likely to suffer from mental ill-health and may be more vulnerable for poor mental health outcomes. Therefore, more effective actions are needed to take in order to promote and protect mental health of individuals with a history of COVID-19 infection. [ABSTRACT FROM AUTHOR]

Background: There is a growing body of research suggesting that psychological flexibility (PF) is an important psychological construct related to psychological health and human performance. The Psychological Flexibility in Sport Scale (PFSS) is the first general scale to assess sport-related PF. So far, the PFSS has not yet been validated in other contexts than Sweden. Therefore, the current study sought to investigate a Persian version of the PFSS (P-PFSS) and extend the investigation of the psychometric properties of the PFSS in Iranian athletes. Methods: A total of 302 athletes from both team and individual sports (average age of 20.7 years, SD ± 7.5, 62.3% were female) were involved in the current study. Statistical analysis was performed on the data to test validity and reliability. The validity of the P-PFSS was tested through face and content validity, construct validity, criterion validity, and known-groups validity. The reliability of P-PFSS was verified through internal consistency and temporal stability of the scale. Results: Results revealed that validity of the P-PFSS was satisfactory. The instrument was determined to have strong face and content validity. With modifications, the confirmatory factor analysis confirmed the scale's unidimensionality. The convergent validity of the P-PFSS was found to be acceptable (average variance extracted = 0.66) and satisfactory results were also found in the correlation matrix for the assessment of construct validity. The P-PFSS showed good criterion validity related to generic psychological flexibility and athletic-related variables. Also, the P-PFSS was able to differentiate PF between known groups. The P-PFSS was found to be reliable, with good internal consistency (Cronbach's alpha = 0.92; composite reliability = 0.92) and temporal stability on retest (intraclass correlation coefficient = 0.95). Conclusions: Overall, the Persian version of the PFSS showed good psychometric qualities in Iranian athletes. The current study provides additional support for the PFSS and extends the context-specific utility for practitioners and researchers in assessing sport-related PF. [ABSTRACT FROM AUTHOR]

Older persons in Sweden are increasingly encouraged to continue living at home and, if necessary, be supported by home care services (HCS). Studies have examined whether the work environment of staff has an impact on the experiences and well‐being of older persons in residential care facilities, but few have examined such associations in HCS. This study examined associations between home care staff's perceptions of their psychosocial work environment and satisfaction with care among older people receiving HCS. The setting was 16 HCS work units. Two surveys were conducted, one on psychosocial working conditions of staff, one on satisfaction of older persons receiving HCS. For each work unit, data on individual satisfaction were matched to average values concerning psychosocial work conditions. Outcomes analysed with linear regressions were overall satisfaction and indices regarding assessment of performance of services, contact with staff and sense of security. The index for treatment by staff was analysed with ordered logistic regressions. Cluster correlated‐standard error clustering on work units was used. Results showed that good working conditions were important for satisfaction with care, specifically overall satisfaction, treatment by staff and sense of security. The most important psychosocial work factors were work group climate, sense of mastery, job control, overall job strain, frustrated empathy, balancing competing needs, balancing emotional involvement and lack of recognition. Receiving more HCS hours was associated with stronger relationships between working conditions and satisfaction with care, especially with overall satisfaction and treatment by staff as outcomes. Managers and policymakers for home care need to acknowledge that the working conditions of home care staff are crucial for the satisfaction of older persons receiving HCS, particularly those receiving many HCS hours. Psychosocial work factors together with job strain factors are areas to focus on in order to improve working conditions for staff and outcomes for older persons. [ABSTRACT FROM AUTHOR]

This study aimed to investigate how maternal birthweight is related to early pregnancy obesity, gestational diabetes mellitus (GDM), and offspring birthweight. Females born term and singleton in Sweden between 1973 and 1995 (N = 305,893) were studied at their first pregnancy. Information regarding their birthweight, early pregnancy body mass index, and pregnancy complications was retrieved from the Swedish Medical Birth Register, as were data on their mothers and offspring. High maternal birthweights (2–3 standard deviation scores (SDS) and >3 SDS) were associated with greater odds of early pregnancy obesity, odds ratio (OR) 1.52 (95% confidence interval (CI) 1.42–1.63) and OR 2.06 (CI 1.71–2.49), respectively. A low maternal birthweight (<2 SDS) was associated with greater odds of GDM (OR 2.49, CI 2.00–3.12). No association was found between high maternal birthweight and GDM. A maternal birthweight 2–3 SDS was associated with offspring birthweight 2–3 SDS (OR 3.83, CI 3.44–4.26), and >3 SDS (OR 3.55, CI 2.54–4.97). Corresponding ORs for a maternal birthweight >3 SDS were 5.38 (CI 4.12–7.01) and 6.98 (CI 3.57–13.65), respectively. In conclusion, a high maternal birthweight was positively associated with early pregnancy obesity and offspring macrosomia. A low, but not a high maternal birthweight, was associated with GDM. [ABSTRACT FROM AUTHOR]

We develop a model for pollution abatement that distinguishes between prevention and treatment technologies, in order to better understand the optimal mix of abatement measures. Our model separates the production process into two stages, an initial production and prevention stage and a final treatment (or cure) stage. We allow for reallocation of abatement investment across the production stages, in order to improve overall abatement and production and to better understand the tradeoffs between abatement measures. This framework is relevant in practice for numerous industrial production processes, including manufacturing and energy, which employ different abatement measures at different stages of production. In our application to Sweden's pulp and paper sector, we find the industry could achieve further gains to both production and emissions reductions, beyond those estimated using more common single-stage technology estimation methods, by reallocating abatement investments. These results could be used to improve firm environmental management decisions, and to better target policy incentives to specific forms of abatement. [ABSTRACT FROM AUTHOR]

Background: Alpha-chloralose (AC) is a compound known to be toxic to various animal species and humans. In 2018 and 2019 an increase in suspected cases of AC poisoning in cats related to the use of AC as a rodenticide was reported to national veterinary and chemical authorities in Finland, Norway and Sweden by veterinarians working in clinical practices in respective country. The aims of this study were to prospectively investigate AC poisoning in cats, including possible secondary poisoning by consuming poisoned mice, and to study metabolism and excretion of AC in cats through analysis of feline urine. Methods: Data on signalment, history and clinical findings were prospectively collected in Finland, Norway and Sweden from July 2020 until March of 2021 using a questionnaire which the attending veterinarian completed and submitted together with a serum sample collected from suspected feline cases of AC-poisoning. The diagnosis was confirmed by quantification of AC in serum samples. Content of AC was studied in four feline urine samples, including screening for AC metabolites by UHPLC-HRMS/MS. Bait intake and amount of AC consumed by mice was observed in wild mice during an extermination of a rodent infestation. Results: In total, 59 of 70 collected questionnaires and accompanying serum samples were included, with 127 to 70 100 ng/mL AC detected in the serum. Several tentative AC-metabolites were detected in the analysed feline urine samples, including dechlorinated and oxidated AC, several sulfate conjugates, and one glucuronic acid conjugate of AC. The calculated amount of AC ingested by each mouse was 33 to 106 mg with a mean of 61 mg. Conclusions: Clinical recognition of symptoms of AC poisoning in otherwise healthy cats roaming free outdoors and known to be rodent hunters strongly correlated with confirmation of the diagnosis through toxicological analyses of serum samples. The collected feline exposure data regarding AC show together with the calculation of the intake of bait and subsequent AC concentrations in mice that secondary poisoning from ingestion of mice is possible. The results of the screening for AC metabolites in feline urine confirm that cats excrete AC both unchanged and metabolized through dechlorination, oxidation, glucuronidation and sulfatation pathways. [ABSTRACT FROM AUTHOR]

Background: Prediction of SARS-CoV-2-induced sick leave among healthcare workers (HCWs) is essential for being able to plan the healthcare response to the epidemic. Methods: During first wave of the SARS-Cov-2 epidemic (April 23rd to June 24th, 2020), the HCWs in the greater Stockholm region in Sweden were invited to a study of past or present SARS-CoV-2 infection. We develop a discrete time Markov model using a cohort of 9449 healthcare workers (HCWs) who had complete data on SARS-CoV-2 RNA and antibodies as well as sick leave data for the calendar year 2020. The one-week and standardized longer term transition probabilities of sick leave and the ratios of the standardized probabilities for the baseline covariate distribution were compared with the referent period (an independent period when there were no SARS-CoV-2 infections) in relation to PCR results, serology results and gender. Results: The one-week probabilities of transitioning from healthy to partial sick leave or full sick leave during the outbreak as compared to after the outbreak were highest for healthy HCWs testing positive for large amounts of virus (ratio: 3.69, (95% confidence interval, CI: 2.44–5.59) and 6.67 (95% CI: 1.58–28.13), respectively). The proportion of all sick leaves attributed to COVID-19 during outbreak was at most 55% (95% CI: 50%-59%). Conclusions: A robust Markov model enabled use of simple SARS-CoV-2 testing data for quantifying past and future COVID-related sick leave among HCWs, which can serve as a basis for planning of healthcare during outbreaks. [ABSTRACT FROM AUTHOR]