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This study identified and discussed principals' perceptions of acceleration and enrichment for gifted students. These areas have proven significant for the teaching of the gifted. The research questions included questions about perceptions of giftedness and how principals organize to allow gifted students to develop and learn based on their conditions and needs. The empirical material consisted of open questions where the informants freely could describe their knowledge and perceptions about gifted students and their education. The principals' mission statement formed the theoretical basis for analysis. The method used was content analysis. Previous research has shown that acceleration and enrichment are significant for teaching and learning for gifted students. It is therefore of importance that principals, responsible for the activities of the schools they are responsible for, are aware of these and enable the teachers to work with acceleration and enrichment based on the different needs of the gifted students. The results showed that the principals in the study believed that (a) acceleration should primarily take place in the gifted students' age-appropriate class, (b) second by studying subjects or courses with higher classes, (c) third, that the teachers enable enrichment for gifted students in their age-appropriate class, (d) fourth, grade skipping is complicated and should be avoided.

Abstract In this study an in situ forming gel for curcumin and piperine delivery is investigated as a long-lasting strategy in the local treatment of inflammatory and degenerative joint disease, such as osteoarthritis and rheumatoid arthritis. Particularly glyceryl monooleate, in association with phosphatidylcholine and ethanol, were employed. Different ratios between excipients were tested, with the aim to obtain a liquid form suitable for subcutaneous injection, gaining a semisolid consistency in contact with biological fluids. A formulative study was conducted to assess the composition impact on the structural properties of the formulations, particularly focusing on injectability and phase transition. Curcumin and piperine were loaded, singularly or jointly, in selected in situ forming gels. Structural characterization, performed by X-ray scattering, revealed disordered reverse micellar phases, undergoing transition to hexagonal and cubic Pn3m phase upon hydration. In vitro dialysis release study demonstrated a sustained release of both drugs over 96 h, with a faster release in the case of jointly loaded drugs. Mechanistic analysis and water uptake studies indicated a drug release governed by both diffusion and swelling/erosion of the lipid supramolecular structure. Furthermore, an ex vivo release analysis performed using human skin explants suggested the formulation suitability for subcutaneous injection, indicating that the presence of piperine in the in situ formed gel allowed to double the curcumin release with respect to the simple curcumin loaded gel.

Abstract Aims To study differences in cardiovascular prevention and hypertension management in primary care in men and women, with comparisons between public and privately operated primary health care (PHC). Methods We used register data from Region Stockholm on collected prescribed medication and registered diagnoses, to identify patients aged 30 years and above with hypertension. Age-adjusted logistic regression was used to calculate odds ratios (ORs) with 99% confidence intervals (99% CIs) using public PHC centers as referents. Results In total, 119,267 patients with a registered hypertension diagnosis at their primary care center were included; 58,239 men and 61,028 women. In terms of co-morbidities and medications, there were some differences between privately and publicly run PHC: registered diagnosis of dementia, which was higher at private PHC, age-adjusted OR 1.80 (1.24–2.69). For lifestyle counseling, privately run PHC had a higher rate of registered counseling for tobacco 1.17 (1.06–1.29), physical activity 1.13 (1.06–1.17), unhealthy diet 1.08 (1.04–1.13), and counseling according to highest prioritized level of advice stated by national guidelines 1.14 (1.09–1.18). Differences in comorbidities between men and women were found, with higher frequencies of coronary heart disease, congestive heart failure, atrial fibrillation, stroke, diabetes, and gout among men. Regarding antihypertensive treatment, women received less treatment of calcium channel blockers and ACE inhibitors, but more of angiotensin receptor blockers. Conclusions These findings highlight the need for targeted preventive efforts in PHC, especially for male patients, to address disparities in cardiovascular health outcomes. Small differences in preventive measures between public and privately run PHC suggest generally consistent care across healthcare ownership models.

To review the longitudinal trajectories -- and the factors influencing their development -- of mental health problems in children with neurodevelopmental disabilities. Systematic review methods were employed. Searches of six databases used keywords and MeSH terms related to children with neurodevelopmental disabilities, mental health problems, and longitudinal research. After the removal of duplicates, reviewers independently screened records for inclusion, extracted data (outcomes and influencing factors), and evaluated the risk of bias. Findings were tabulated and synthesized using graphs and a narrative. Searches identified 94,662 unique records, from which 49 publications were included. The median publication year was 2015. Children with attention deficit hyperactivity disorder were the most commonly included population in retrieved studies. In almost 50% of studies, trajectories of mental health problems changed by < 10% between the first and last time point. Despite multiple studies reporting longitudinal trajectories of mental health problems, greater conceptual clarity and consideration of the measures included in research is needed, along with the inclusion of a more diverse range of populations of children with neurodevelopmental disabilities.

The aim of this technical note is to describe the Cycle 46 reference configuration of the HARMONIE-AROME convection-permitting numerical weather prediction model. HARMONIE-AROME is one of the canonical system configurations that is developed, maintained, and validated in the ACCORD consortium, a collaboration of 26 countries in Europe and northern Africa on short-range mesoscale numerical weather prediction. This technical note describes updates to the physical parametrizations, both upper-air and surface, configuration choices such as lateral boundary conditions, model levels, horizontal resolution, model time step, and databases associated with the model, such as for physiography and aerosols. Much of the physics developments are related to improving the representation of clouds in the model, including developments in the turbulence, shallow convection, and statistical cloud scheme, as well as changes in radiation and cloud microphysics concerning cloud droplet number concentration and longwave cloud liquid optical properties. Near real-time aerosols and the ICE-T microphysics scheme, which improves the representation of supercooled liquid, and a wind farm parametrization have been added as options. Surface-wise, one of the main advances is the implementation of the lake model FLake. An outlook on upcoming developments is also included.

This study explored professional Judokas’ experiences of the anterior cruciate ligament (ACL) injury process, the consequences of the injury, and their perceptions of underlying factors contributing to the injury. Eleven professional Judokas treated with ACL reconstruction were interviewed using semi-structured interviews. Qualitative content analysis of the transcripts revealed two main themes: ‘from the mat to mastery: a Judoka’s quest in the wake of injury’ and ‘beyond the physical: the silent struggle for psychological victory.’ Judokas described judo as a lifestyle, with their injuries impacting both physical performance and mental health. Fatigue, high training intensity, and bad luck were identified as contributing factors to their injuries. While the injury posed significant physical and mental challenges, Judokas emphasized the role of the discipline and structure learned through judo to navigate the recovery process. Judokas attributed their ACL injuries to a mix of preparation and unpredictable elements, and reported both positive and negative consequences of their experiences.

ABSTRACT The aim was to study if nurse‐managed hypertension care was associated with differences in pharmacotherapy, lifestyle counseling, and prevalence of comorbid cardiometabolic diseases among patients receiving care at primary health care centers. To assess the extent of nurses' involvement in the hypertension care, a questionnaire was distributed to all primary health care centers in Region Stockholm. Age‐adjusted logistic regression models were used to analyze the results, odds ratios with 99% confidence intervals. Data was acquired from VAL, the administrative databases of Region Stockholm in Sweden, encompassing all individuals 30 years or older with a registered hypertension diagnosis who attended to the primary health care center they were registered at. Our analysis comprised 119 267 patients diagnosed with hypertension registered in one of the 224 included primary health care centers. Of the 81 primary health care centers that responded to the questionnaire, 54 reported having nurse‐managed hypertension care. Nurse‐managed hypertension care was not significantly associated with differences in pharmacotherapy or patients’ comorbidity, except for diabetes. Primary health care centers with nurse‐managed hypertension care had a 10% greater adherence to national guidelines for lifestyle counseling (33.5%) compared to those without nurse‐managed hypertension care (22.5%). Regardless of the organizational form of hypertension care management, more men received lifestyle counseling according to guidelines compared to women. In‐house routines for hypertension care, with designated nurses, and booking systems were associated with more lifestyle counseling, which has been associated with signs of better hypertension care.

BackgroundCertain species from the normal respiratory tract microbiota have recently been proposed to positively influence human health. Corynebacterium propinquum and C. pseudodiphtheriticum (Corynebacteria) are two Gram-positive species that frequently colonize the upper respiratory tract and strongly associate with a reduced incidence of respiratory tract infections. The specific role of Corynebacteria during respiratory health and disease is, however, largely uncharacterized.MethodRespiratory tract epithelial cells NCI-H292 and BALB/cByJ mice were inoculated with Corynebacteria (C. propinquum 2018M3 and 2019M4, and C. pseudodiphtheriticum 2019M8 and 2020M12) alone or with subsequent challenge with Streptococcus pneumoniae (pneumococci). The inflammatory response and the bacterial burden of both species over time were determined by Western blot, luciferase assay, cytokine bead array, flow cytometry and viable plate counts on blood agar plates.ResultsClinical isolates of Corynebacteria were well tolerated by human cells and mice. Corynebacteria induced a transient inflammatory response during healthy conditions in the absence of known pathogens. Pre-exposure or nasal priming with Corynebacteria did not affect subsequent acquisition of pneumococci but were associated with a modulated inflammatory response in vitro and in vivo as well as with a reduced pneumococcal burden in the respiratory tract of mice. This indicates that the presence of C. propinquum or C. pseudodiphtheriticum may protect against severe pneumococcal infections.ConclusionsIn this study, we delineate the role of Corynebacteria from the normal microbiota that epidemiologically associate with respiratory health. We show that the presence of Corynebacteria modulates the inflammatory response to pneumococci and associate with faster decrease in pneumococcal burden, primarily in the lower respiratory tract. Our data indicate that Corynebacteria has potential to protect against severe pneumococcal infections.

Background: The primary aim was to assess psychological distress in patients with longstanding hip and groin pain (LHGP) and compare them with healthy controls. The secondary aim was to explore the association between psychological distress and symptom duration, self-reported pain and symptoms in patients with LHGP. Methods: Seventy-two patients with LHGP and sixty-three controls were included. The Kessler Psychological Distress Scale (K10) was used to assess psychological distress and the Copenhagen Hip and Groin Outcome Score (HAGOS) subscale for pain and symptoms to assess hip and groin pain and symptoms. The Mann–Whitney U test was used for between-group comparisons, and the Spearman's rank-order correlation to examine the association between the K10 and HAGOS. Results: There was no difference in psychological distress between patients with LHGP and controls (p ​= ​0.060) on the K10 total score. More individuals were categorized as having “high or very high” psychological distress in the LHGP group (45 ​%) compared to the control group (26 ​%) (p ​= ​0.035). There was no difference between patients with 3–12 months and >12 months symptom duration for the K10 (p ​= ​0.232). There was a moderate association between more psychological distress and worse self-reported pain (p ​= ​0.003) and symptoms (p ​

Background: Depression in adolescence is a significant global health concern, notably in Sweden where recent trends suggest an increase in depressive symptoms among adolescents. This study aims to explore changes in the prevalence of self-reported depressive symptoms among Swedish high school students over the past two decades, utilizing the Children's Depression Inventory (CDI). Method: A cohort study was conducted with two adolescent groups aged 13–16 years old, born nearly twenty years apart. The first cohort (n = 80), recruited in 2004, and the second (n = 617), recruited between 2019 and 2020, were both assessed using the CDI. The study employed a comparative analysis, using independent samples t-tests, ANOVA, and the Mann-Whitney U test for item-specific comparisons. Results: The analysis revealed no significant differences in total CDI scores between the 2004 and 2019/20 cohorts. However, the later cohort exhibited higher scores on three CDI items (''Nothing is fun at all,'' ''I am bad all the time,'' ''I can never be as good as other kids'') and in the sub-domain of self-deprecation. Sex differences were observed, with girls scoring higher than boys in both cohorts. Conclusion: There is no statistically significant increase in self-assessed levels of depressive symptoms among adolescents when comparing the 2004 and 2019–20 cohorts. However, there are higher scores in specific areas of the CDI in the later cohort, particularly among young women. This study underscores the need for continuous, structured assessments of adolescent mental health, considering societal changes and trends.

IntroductionOvarian cancer is a lethal disease with low survival rates for women diagnosed in advanced stages. Current cancer immunotherapies are not efficient in ovarian cancer, and there is therefore a significant need for novel treatment options. The β-galactoside-binding lectin, Galectin-3, is involved in different immune processes and has been associated with poor outcome in various cancer diagnoses. Here, we investigated how Galectin-3 affects the interaction between natural killer (NK) cells and neutrophils in the tumor microenvironment of ovarian cancer.MethodAscites from the metastatic tumor microenvironment and cyst fluid from the primary tumor site were collected from patients with high-grade serous carcinoma (HGSC) together with peripheral blood samples. Galectin-3 concentration was measured in ascites, cyst fluid and serum or plasma. Neutrophils isolated from HGSC ascites and autologous blood were analyzed to evaluate priming status and production of reactive oxygen species. In vitro co-culture assays with NK cells, neutrophils and K562 target cells (cancer cell line) were conducted to evaluate NK cell viability, degranulation and cytotoxicity.ResultsHigh levels of Galectin-3 were observed in cyst fluid and ascites from patients with HGSC. Neutrophils present in HGSC ascites showed signs of priming; however, the priming status varied greatly among the patient samples. Galectin-3 induced production of reactive oxygen species in ascites neutrophils, but only from a fraction of the patient samples, which is in line with the heterogenous priming status of the ascites neutrophils. In co-cultures with NK cells and K562 target cells, we observed that Galectin-3-induced production of reactive oxygen species in neutrophils resulted in decreased NK cell viability and lowered anti-tumor responses.ConclusionTaken together, our results demonstrate high levels of Galectin-3 in the tumormicroenvironment of HGSC. High levels of Galectin-3 may induce production of reactiveoxygen species in ascites neutrophils in some patients. In turn, reactive oxygen species produced by neutrophils may modulate the NK cell anti-tumor immunity. Together, this study suggests further investigation to evaluate if a Galectin-3-targeting therapy may be used in ovarian cancer.

During the past decades there has been an increase in mental ill-health problems among children. Social-emotional learning (SEL) has shown promise to promote well-being by supporting children in developing abilities to cope with everyday difficulties. Structured SEL programs can be part of the school curriculum from early age. However, teachers' positive perceptions of the values of such programs are essential for program success. The aim of this evidence synthesis was to describe and understand teachers' experiences of providing SEL programs to students and their perceived effect on students' mental well-being. We followed the ENTREQ and PRISMA guidelines. Systematic searches were conducted and we included seven studies with a moderate level of methodological limitations. We conducted a thematic meta-synthesis, and confidence in the evidence was assessed with GRADE-CERQual. Teachers perceived that students developed a higher level of coping with their feelings and created improved relationships as a result of the SEL programs. As they received new tools to support students' well-being, teachers were positive to the programs. They noted, however, that the programs needed adaptation to the local context. To the best of our knowledge, this is the first meta-synthesis on the experiences among teachers on the impact of SEL programs on students' well-being. Notably, the results suggest that SEL programs could help teachers to attend to students' mental health. After conducting extensive searches for data, only studies from high-income countries were found. Therefore, further studies are needed within low-income countries in regard to SEL programs and experiences among teachers on students' mental wellbeing. It would also be beneficial to synthesize research on the students and their experiences on how SEL programs impact their mental well-being.

Background Disabilities can hinder children’s and youths’ participation (frequency of attendance and engagement) and independence in everyday life.Aims To identify factors that predict levels of participation and independence in everyday activities in Swedish children and youths with disabilities.Material and methods This cross-sectional study, including 131 participants, utilised instruments about child and environmental factors. LASSO regression analyses were conducted to identify predictors of participation and independence.Results An item screening for comprehension difficulties was the strongest predictor of attendance, engagement, and independence in daily activities. Other influential child factors included the presence of seizures, speech abilities, age, pain levels, and motor functions. None of the studied environmental factors were retained as predictors in the models.Conclusions Difficulties in intellectual functioning need to be evaluated and considered in planning interventions to improve participation and independence. Likewise, multifaceted nature of challenges found in this study underscores the need for diversity of interventions tailored for individual needs.Significance The result underscores the critical role of comprehension and intellectual functioning in predicting and enhancing participation and independence in children and youths with disabilities, advocating for comprehensive assessments and sustained support.