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The article focuses on identification of students' performance to write paragraphs and the topics needed by students to be developed post global English textbooks exposure. This study aimed to investigate description of current students' performance to write paragraphs after studying a paragraph writing using Global English Textbooks and to find out the topics needed by students to be developed as teaching English textbook materials for Paragraph Writing Course. The research employed a mixed-methods approach, combining quantitative analysis of students' paragraph writing performance with qualitative interpretation into their perceptions to the use of global English textbooks as writing paragraph teaching materials. The total samples were 44 students of English Study Program, Faculty of Letters, Universitas Muslim Indonesia. To obtain information from the informants, the researchers employed questionnaires of Paragraph Writing distributed to the students through the Learning Management System (LMS) Google form. The results showed that students exhibited a wide range of proficiency levels in paragraph writing, from advanced to fundamental deficiencies, necessitating targeted support across all skill levels. Moreover, a significant proportion of students lacked confidence in their writing abilities, emphasizing the importance of tailored instruction to address uncertainties effectively. Challenges with global English textbooks, including language complexity and cultural references, exacerbated these issues. Despite the inherent benefits of paragraph writing, such as language development and critical thinking skills, some students questioned its relevance in non-native English education settings. Additionally, doubts about fundamental language aspects like vocabulary and grammar underscored the need for focused instruction in these areas. Overall, addressing these challenges required comprehensive supports and resources to enhance students' paragraph writing skills and confidence levels effectively. Meanwhile, the exploration of sixty topics provided valuable insights into students' interests and knowledge. Among them, sixteen topics emerged as notably popular, indicating a strong resonance with students. These topics ranged from personal narratives to societal issues, reflecting students' diverse values and concerns. Furthermore, themes related to self improvement and academic success garnered considerable interest, underscoring students' aspirations for growth. Even less chosen topics still demonstrated students' engagement with various aspects of interpersonal relationships and cultural identity. Moreover, the inclusion of less common topics reflected students' recognition of broader educational and patriotic ideals, albeit with less enthusiasm.

This piece is a collective exploration by seven doctoral researchers in Child Studies, who discuss notions of listening to children and young people in a Swedish context. We approach different aspects of listening in research and in practices such as education, psychiatry, and social work. The discussions in this collective writing are an invitation for continuous reflections about the contexts where listening to children is done, its challenges and possibilities.

A survey of developments in plant taxonomy, floristics, and phytogeography in Greece during 2005 to 2016 is presented. Species diversity in different areas and on different scales is summarised in five maps. A list of new taxa described during this period is provided, together with their type citations and taxonomic comments where relevant; almost all of the taxa are based on Greek plant material.

Abstract Background Work-related musculoskeletal disorders are common among healthcare workers (HCWs) but might be prevented by risk assessment and further promotion of occupational safety and health. The aim of this study was to investigate if the risk assessment instrument TilThermometer can be used to identify risk profiles of physical exposure in HCWs working with patient handling and movement (PHM). Further aims were to describe HCWs’ perceptions and experiences of using the TilThermometer. Methods This feasibility study has a mixed design methodology. In total, 54 HCWs from 17 Swedish care units participated and performed risk assessments with the TilThermometer. Data collected from the risk assessments were used to identify risk profiles of physical exposure. HCWs’ experiences of using the TilThermometer were collected from activity logs and analysed qualitatively. Three questionnaires were used to assess perceived acceptability, appropriateness, and feasibility of the risk assessment, and eight study specific questions were used for perceived usefulness. Results The TilThermometer was used at the care units by assessing each care recipient, and when compiling the data at a group level, a summarized risk profile for the care unit could be provided. Risk for physical exposure was reported as high in two work tasks; no care unit used the high-low adjustable seat when showering care recipients sitting down, and 13% used the recommended assistive devices when putting compression stockings on. However, 99% used high-low adjustable assistive devices when caring and bathing care recipients lying down. TilThermometer was described as easy to use, enabling team reflections and providing an overview of the care units’ recipients and workload, but difficulties in categorizing for mobility groups were also reported. The TilThermometer was, on a five-point scale, perceived as acceptable (mean 3.93), appropriate (mean 3.9), and feasible (mean 3.97). These scores are in line with questions evaluating usefulness. Conclusion The risk assessment provided risk profiles with potential to contribute to care units’ development of a safe patient handling and movement practice. The findings suggest that the TilThermometer can be used to assess risks for physical exposure in relation to patient handling and movement in care units at hospital and nursing homes.

Objective: To compare the effects of a neck-specific exercise programme with internet support and 4 physiotherapist sessions (NSEIT) and the same neck-specific exercises supervised by a physiotherapist (NSE) on neck muscle endurance and cervical range of motion. Design: Randomized controlled trial. Patients: A total of 140 participants with chronic whiplash-associated disorders grade II or grade III were randomly assigned to the NSEIT or NSE groups. Methods: Outcomes were changes in active cervical range of motion, cranio-cervical flexion test, neck muscle endurance, and neck pain, at 3- and 15-month follow-ups. Results: There were no significant differences between the NSEIT and NSE groups. There was a significant group-by-time inter-action effect in active cervical range of motion flexion/extension where the NSEIT group improved to 3-month follow-up, but the NSE group did not. Both groups were significantly improved over time in all other outcomes (p

AbstractObjective Prior to a multifaceted implementation strategy for a healthy lifestyle-promoting practice the expectations of primary health care managers, appointed internal facilitators and health care professionals on supporting change was explored.Design This study had an explorative qualitative design using data gathered from individual interviews and focus groups. Qualitative content analysis with a deductive category development was applied using the Consolidated Framework for Implementation Research.Setting and participants The study was conducted in a primary care setting in central Sweden as a part of the Act in Time research project. Prior to a multifaceted implementation strategy, we held 16 individual interviews with managers and appointed facilitators and five focus groups with 26 health care professionals.Results Managers, facilitators, and professionals held similar expectations, where their expressed need for support corresponded to three constructs: Readiness for implementation, Implementation climate, and Engaging. Our findings indicate the need for strong leadership engagement to focus on how the healthy lifestyle-promoting practice can be anchored among the professionals. Managers at all levels should communicate the vision and goals, enable facilitators and professionals to improve their competencies, build inter-professional teams, and jointly plan the new practice.Conclusion To change to a healthy lifestyle promoting practice professionals request support from their managers, who in turn need support from the middle and top managers. The requested support includes helping to prioritise health promotion and enabling the primary care centres to build competence and take ownership of the implementation.Trial registration ClinicalTrials.gov NCT04799860

There is limited research targeting communication interventions for children with severe/profound intellectual and multiple disabilities. This study addressed outcomes from a communication course for parents of children with severe/profound intellectual and multiple disabilities and follows up on a previous publication by Rensfeldt Flink et al. (2020). Potential observable changes in the children's and parents' communicative behavior were studied as well as the parents' experiences of the intervention process and the effect of the course on parent--child communication. A mixed-methods design with a case-study framework was used. Two mother--child dyads participated. Data were collected before, during, and after the course. Video-recorded repeated play interactions by the dyads were coded and analyzed for the mothers' responsivity and use of augmentative and alternative communication and the children's interactive engagement. Longitudinal interview data from the mothers were analyzed thematically. No clear signs of behavioral change were observed in the coded video data. However, thematic analyses showed that the mothers experienced changes to communicative behaviors. Moreover, the course affected both mothers' reasoning about communication with their child and their child's communicative needs. The mothers' narratives contributed insights into how reflective processes might guide action in parent-mediated communication interventions. The implications for research and clinical practice are discussed.

Objectives To assess emergency preparedness (EP) actions in women with a recent live birth. Methods Weighted survey procedures were used to evaluate EP actions taken by women with a recent live birth responding to an EP question assessing eight preparedness actions as part of the 2016 Tennessee Pregnancy Risk Assessment and Monitoring System (PRAMS) survey. Factor analysis was used to group preparedness actions. Results Overall, 82.7% [95% Confidence Interval (CI) 79.3%, 86.1%] of respondents reported any preparedness actions, with 51.8% (95% CI 47.2%, 56.4%) completing 1-4 actions. The most common actions were having supplies at home (63.0%; 95% CI 58.5%, 67.4%), an evacuation plan for children (48.5%; 95% CI 43.9%, 53.2%), supplies in another location (40.2%; 95% CI 35.6%, 44.7%), and a communication plan (39.7%; 95% CI 35.1%, 44.2%). Having personal evacuation plans (31.6%; 95% CI 27.3%, 36.0%) and copies of documents in alternate locations (29.3%; 95% CI 25.0%, 33.5%) were least common. Factor analysis yielded three factors: having plans, having copies of documents, and having supplies. Specific preparedness actions varied by education and income level. Conclusions for Practice Most Tennessee women (about 8 in 10 women) with a recent live birth reported at least one EP action. A three-part EP question may be sufficient for assessing preparedness in this population. These findings highlight opportunities to improve public health education efforts around EP., Author(s): Angela M. Miller [sup.1] , Romeo R. Galang [sup.2] , Lindsey E. Hall [sup.1] , Penelope Strid [sup.2] , Uvonne Leverett [sup.1] , Sascha R. Ellington [sup.2] Author Affiliations: [...]

Abstract Objective: To assess the associations between adherence to the Swedish dietary guidelines and all-cause mortality (i.e. assessing the index’ ability to predict health outcomes), as well as levels of dietary greenhouse gas emissions (GHGEs). Design: A longitudinal study 1990–2016 within the population-based cohort Västerbotten Intervention Programme. Dietary data were based on FFQs. Diet quality was assessed by the Swedish Healthy Eating Index for Adults 2015 (SHEIA15), based on the 2015 Swedish dietary guidelines. Dietary GHGEs were estimated from life cycle assessment data including emissions from farm to industry gate. Hazard ratios (HR) and 95 % CI of all-cause mortality were evaluated with Cox proportional hazards regression, and differences in median GHGEs were tested between quintiles of SHEIA15 score using the Kruskal–Wallis one-way ANOVA test. Setting: Northern Sweden. Participants: In total, 49 124 women and 47 651 men, aged 35–65 years. Results: Median follow-up times were 16·0 years for women and 14·7 years for men, during which time 3074 women and 4212 men died. A consistent trend of lower all-cause mortality HR for both sexes with higher SHEIA15 scores was demonstrated. For women, the all-cause mortality HR was 0·81 ((95 % CI 0·71, 0·92); P = 0·001) and for men 0·90 ((95 % CI 0·81, 0·996); P = 0·041) between the quintile with the highest SHEIA15 score compared with the quintile with the lowest SHEIA15 score. A consistent trend of lower estimated dietary GHGEs among both sexes with higher SHEIA15 scores was also found. Conclusions: Adherence to Swedish dietary guidelines, estimated by SHEIA15, seems to promote longevity and reduce dietary climate impact.

Artikeln handlar om mäns våld mot kvinnor i nära relationer i Sverige. Syftet är att redogöra för kvinnors våldserfarenhet i nutid, och att relatera den till kvinnors utsatthet för tjugo år sedan. Artikeln använder ett feministiskt våldsperspektiv för att undersöka kvinnors utsatthet för mäns våld och dess kopplingar till kvinnors hälsa och välmående. Data baseras på en enkätundersökning (n=6 611) som fångar kvinnors samlade erfarenheter av fysiskt våld, sexuellt våld och hot om våld. Resultaten visar, för det första, att kvinnors och tjejers erfarenhet av våld i det formellt jämställda Sverige är omfattande: 55 % av kvinnorna i studien har utsatts för fysiskt våld, sexuellt våld eller hot om våld från en man. För det andra, visar resultaten att våldet inte verkar minska över tid. Tvärtom har under en tjugoårsperiod mäns våld mot kvinnor ökat, trots politiskt tal om och fokus på frågan under samma period. För det tredje, visar resultaten att unga tjejer är särskilt utsatta för mäns och killars våld, inte minst för sexuellt våld. För det fjärde, visar resultaten på ett samband mellan olika former av våld och ett sammanhållet mönster mellan våldsutsatthet och hälsa. Resultaten diskuteras i ljuset av den första svenska omfångsstudien av mäns våld mot kvinnor, Slagen dam (2001).

Children with cochlear implants (CIs) demonstrate proficiency in verbal-story elicited-response (VS-ER) false-belief tasks, such as the Sally & Ann task, at a similar age as typically developing hearing children. However, they face challenges in non-verbal spontaneous-response (NV-SR) false-belief tasks, measured via looking times, which hearing infants typically pass by around 2 years of age, or earlier. The purpose of the present study was to examine whether these difficulties remain in a non-verbal-story elicited-response (NVS-ER) false-belief task, in which children are offered the opportunity to provide an elicited response to a non-verbal-story task. A total of thirty 4- to 8-year-old children with CI-s and hearing children completed three different kinds of false-belief tasks. The results showed that children with CI-s performed above chance level on the verbal task (i.e., VS-ER task), but not on the two non-verbal tasks, (i.e., NVS-ER and NV-SR tasks). The control group of typically developing hearing children performed above chance on all three kinds of tasks (one-tailed significance level). Our findings highlight the importance of external narrative support for children with CIs in tasks that involve mental perspective-taking, and specifically predicting actions based on false beliefs.

Abstract Background There is moderate to strong evidence of the effectiveness of health-promotion interventions, but implementation in routine primary health care (PHC) has been slow. In the Act in Time project implementation support is provided for a health promotion practice using individually targeted lifestyle interventions in a PHC setting. Identifying health care professionals’ (HCPs’) perceptions of barriers and facilitators helps adapt implementation activities and achieve a more successful implementation. This study aimed, at a pre-implementation stage, to describe the expectations of managers, appointed internal facilitators (IFs) and HCPs on implementing a healthy lifestyle-promoting practice in PHC. Methods In this qualitative study five focus group discussions with 27 HCPs and 16 individual interviews with managers and appointed IFs were conducted at five PHC centres in central Sweden. The PHC centres are participating in the Act in Time project, evaluating the process and outcomes of a multifaceted implementation strategy for a healthy lifestyle-promoting practice. A deductive qualitative content analysis based on the Consolidated Framework for Implementation Research (CFIR) was followed using inductive analysis. Results Twelve constructs from four of five CFIR domains were derived: Innovation characteristics, Outer setting, Inner setting, and Characteristics of individuals. These domains are related to the expectations of HCPs to implement a healthy lifestyle-promoting practice, which includes facilitating factors and barriers. The inductive analysis showed that the HCPs perceived a need for a health-promotion approach to PHC. It serves the needs of the patients and the expectations of the HCPs, but lifestyle interventions must be co-produced with the patient. The HCPs expected that changing routine practice into a healthy lifestyle-promoting practice would be challenging, requiring sustainability, improved structures, cooperation in inter-professional teams, and a common purpose. A collective understanding of the purpose of changing practice was vital to successful implementation. Conclusions The HCPs valued implementing a healthy lifestyle-promoting practice in a PHC setting. However, changing routine methods was challenging, implying that the implementation strategy should address obstacles and facilitating factors identified by the HCPs. Trial registration This study is part of the Act in Time project, registered in ClinicalTrials.gov with the number NCT04799860 . Registered 03 March 2021.

Loss of animals is a considerable waste of resources in the meat supply chain, where quantitative data are scarce but critical for guiding improvements. In this study, we used material flow analysis to track the amount of beef diverted away from the food supply chain at the farm level. The beef losses (absolute and as the proportion of yearly initial production) were estimated from data on assisted and unassisted deaths of cattle on Swedish farms obtained from the central register of bovine animals for 2002–2021 combined with official statistics on slaughter weight. The fallen animals were grouped according to age, sex and breed, to enable estimations of the lost amount of carcass weight, both in total and per animal group. The yearly loss during primary production 2017–2021 was on average 13,000 ton carcass weight, or 8.5% of the initial production. No decreasing trend for the loss rate could be determined after 2015, when the Agenda 2030 target 12.3 (Halved food waste and reduced early losses) was introduced. Female dairy breeds showed greater beef losses than dairy males or beef breeds and crossbreeds of both sexes, and their beef losses mostly occurred at 4–5 years of age, thus constituting the hot spot group for lost beef. The results can serve as a base for directed reduction efforts.

Medicinal and Aromatic Plants (MAPs) play a critical role in providing ecosystem services through their provision of herbal remedies, food and natural skin care products, their integration into local economies, and maintaining pollinators’ diversity and populations and ecosystem functioning. Mountainous regions, such as Chelmos-Vouraikos National Park (CVNP), represent unique reservoirs of endemic MAP diversity that require conservation prioritisation. This study aims to provide insights into the sustainable management of MAPs, contributing to efforts to protect Mediterranean biodiversity amid the dual challenges of climate and land-use change, using a suite of macroecological modelling techniques. Following a Species Distribution Modelling framework, we investigated the vulnerability of endemic and non-endemic MAPs to climate and land-use changes. We examined the potential shifts in MAP diversity, distribution, and conservation hotspots within the CVNP. Our results revealed species-specific responses, with endemic taxa facing severe range contractions and non-endemic taxa initially expanding but eventually declining, particularly under land-use change scenarios. Local biodiversity hotspots are projected to shift altitudinally, with considerable area losses in the coming decades and elevated species turnover predicted throughout the CVNP, leading to biotic homogenization. Climate and land-use changes jointly threaten MAP diversity, calling for adaptive conservation strategies, thus highlighting the importance of proactive measures, such as awareness raising, establishing plant micro-reserves, assisted translocation, and promoting sustainable harvesting to protect these species within the CVNP. Our study offers vital insights for managing biodiversity hotspots amid global change pressures, stressing the need to integrate ecological and socioeconomic factors.

Abstract Background Persistent organic pollutants (POPs) in wildlife and humans remain a cause of global concern, both in regard to traditional POPs, such as the polychlorinated biphenyls (PCBs), and emerging POPs, such as the polybrominated diphenyl ethers (PBDEs). To determine the time related concentrations, we analyzed human milk for these substances at three time points between 1987 and 1999. Polychlorobiphenylols (OH-PCBs), the dominating class of PCB metabolites, some of which are known to be strongly retained in human blood, were also included in the assessment. Methods We obtained milk from the Faroe Islands, where the population is exposed to POPs from their traditional diet (which may include pilot whale blubber). In addition to three pools, nine individual samples from the last time point were also analyzed. After cleanup, partitioning of neutral and acidic compounds, and separation of chemical classes, the analyses were carried out by gas chromatography and/or gas chromatography/mass spectrometry. Results Compared to other European populations, the human milk had high PCB concentrations, with pool concentrations of 2300 ng/g fat 1987, 1600 ng/g fat in 1994, and 1800 ng/g fat in 1999 (based on the sum of eleven major PCB congeners). The nine individual samples showed great variation in PCB concentrations. The OH-PCBs were present in trace amounts only, at levels of approximately 1% of the PCB concentrations. The PBDE concentrations showed a clear increase over time, and their concentrations in human milk from 1999 are among the highest reported so far from Europe, with results of individual samples ranging from 4.7 to 13 ng/g fat Conclusion Although remote from pollution sources, the Faroe Islands show high concentrations of POPs in human milk, particularly PCBs, but also PBDEs. The PBDEs show increasing concentrations over time. The OH-PCB metabolites are poorly transferred to human milk, which likely is related to their acidic character.

Monocytes are heterogeneous innate effector leukocytes generated in the bone marrow and released into circulation in a CCR2-dependent manner. During infection or inflammation, myelopoiesis is modulated to rapidly meet the demand for more effector cells. Danger signals from peripheral tissues can influence this process. Herein we demonstrate that repetitive TLR7 stimulation via the epithelial barriers drove a potent emergency bone marrow monocyte response in mice. This process was unique to TLR7 activation and occurred independently of the canonical CCR2 and CX3CR1 axes or prototypical cytokines. The monocytes egressing the bone marrow had an immature Ly6C-high profile and differentiated into vascular Ly6C-low monocytes and tissue macrophages in multiple organs. They displayed a blunted cytokine response to further TLR7 stimulation and reduced lung viral load after RSV and influenza virus infection. These data provide insights into the emergency myelopoiesis likely to occur in response to the encounter of single-stranded RNA viruses at barrier sites.

The COVID-19 pandemic has been a multifaceted crisis, impacting health, the economy, policy and society at large, and also resulting in a humanitarian crisis. These crises have impacted everyone, although the effects have been unevenly distributed, leading to further disadvantage and marginalisation for those who were already vulnerable and marginalised. The pandemic laid bare and intensified pre-existing gender inequalities in many aspects of life, from the labor market and educational opportunities to health and social protection systems. The unequal impacts on women and men have been observed in the economy and employment, in domestic work and care, in physical and mental health, and in violence. The collection of articles in this special issue critically interrogates these key issues relating to the impact of the pandemic on gender equality in Europe, highlighting exacerbated gender inequalities, policy responses and the potential for a gender-responsive recovery. This special issue brings together a collection of eight articles that investigate various aspects of gender inequality exacerbated by the COVID-19 pandemic, and that explore potential pathways towards achieving greater gender equality in the post-pandemic world. They summarise the findings and contributions of several social scientists and also of two EU funded projects: RESISTIRÉ (GA 101015990) and GEARING Roles (GA 824536). The articles are structured around five main themes: labor market disparities, education and skill development, social and political responses, post-pandemic opportunities, and care. Each article contributes unique insights, empirical findings and policy recommendations from a feminist perspective to enrich the ongoing discourse on gender equality. Together, the articles show the necessity of feminist analysis of crisis, and reveal the structural roots of inequalities while simultaneously emphasising the necessity for transformative action to address inequalities.

This article problematises gender-mainstreaming in Swedish policy responses to COVID-19 in relation to economic politics. The aim is to understand how gender mainstreaming was implemented, and with what effects. Little is still known about gender mainstreaming in crisis management and policymaking, and even less is known in relation to pandemic policy responses. To contribute to this field of knowledge, the article therefore analyses the Swedish National Recovery and Resilience Plan, supplemented by interviews with public servants, to understand the factors that impact the implementation of gender mainstreaming in policymaking in times of societal crises. At a theoretical level, the article draws on feminist institutionalism and implementation studies, the notion of resilience, and insights from critical frame analysis. The data is based on a larger dataset collected as part of the EU-funded RESISTIRÉ: Responding to Outbreaks through Co-creative Inclusive Equality Strategies project. The results indicate that gender mainstreaming is limited in its rationale and scope in times of crisis and that the integration of a gender equality perspective in crisis management needs to be developed in several important ways.

The purpose of this study was to determine the politeness strategies used by teachers when teaching English in coeducational classrooms and the impact of these strategies on students. We focused on analyzing teachers' verbal perceptions of off-record politeness and explained the implications of politeness as found in two English lesson recordings. Researchers employed targeted selection and informative qualitative studies to obtain data. Data were collected through interviews and observations. Researchers transcribed the conversation and applied the theory of Brown and Levinson to analyze it. The subjects of this study were high school English teachers in South Sulawesi. Researchers observed classrooms by recording teacher activity and analyzing it using The theory of etiquette techniques by Brown and Levinson. Consequently, the effects on students in learning are motivation, student attitudes (emotional), respect for teachers, self-confidence, activity, participation in the teaching and learning process, and integrity.