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Background: Digital solutions in healthcare can facilitate and improve care. However, the experiences and the usefulness of using either digital foot examinations or traditional foot examinations need to be evaluated. The aims of the study were to evaluate: 1) The differences in patient experiences, having their foot examined supported by the Clinical Decision Support System as compared with having their foot examined in traditional practice, 2) How healthcare professionals, by using the digital tool, experienced the routine compared with performing the foot examination as in traditional practice. Methods: Of a total of 141 patients, 100 patients with diabetes were single-blind digitally randomised to one of two parallel arms: having their foot examined by a healthcare professional using a digital tool (n = 47) or having their foot examined as in traditional practice (n = 53) at the Department of Prosthetics and Orthotics at Sahlgrenska University Hospital, Gothenburg, Sweden. Patients filled in a modified version of the National Patient Survey and the Orthotics and Prosthetics Users' Survey at study end. Two healthcare professionals, working at a Department of Prosthetics and Orthotics, answered surveys regarding the interaction between the patient and the certified prosthetist and orthotist. Results: Patients, aged 66 ± 13 years, perceived a high level of satisfaction with the service at the department, regardless of the method used. No significant differences between groups were found when evaluated by 27 questions in the National Patient Survey or by the Orthotics and Prosthetics Users' Survey, with scores of 67.17 ± 12.18 vs. 66.35 ± 16.52 (p = 0.78) for the intervention and control group respectively. For the same patient that healthcare professionals foot examined, the risk class was fully obtained when the risk to develop foot ulcers was assessed by using the digital tool, whereas only 2% of the patients were classified when foot assessed in traditional practice. Conclusions: Regardless of the method used for the foot examination, patients perceived a high level of satisfaction with the services at the Department of Prosthetics and Orthotics. All the patients were risk classified in the intervention group. The healthcare professionals found that, by using the Clinical Decision Support System, the foot examination was structured and followed clinical guidelines. Furthermore, the documentation in the electronic health record was thorough, even though further improvements, such as integration with co-existing health record systems, were requested. Trial registration: Clinical Trials NCT03088566, Registered 23 March 2017. [ABSTRACT FROM AUTHOR]

The article delves into the topic of safety in critical care nursing, particularly in intensive care units (ICUs), through interviews with nurses and nurse leaders in Sweden. It highlights the importance of maintaining a safety mindset, fostering commitment to patient safety, and continuous learning to ensure safe care practices. The document also includes research articles on patient safety culture, qualitative research methods, and the impact of the COVID-19 pandemic on ICUs, offering insights for enhancing healthcare practices and quality of care. [Extracted from the article]

In this article, we explore the intricacies of veteran care and show how care practices come to incorporate veterans' 'self‐performances' to raise political attention and funding for future rehabilitation activities. By bringing into dialogue theories of care and theories of performance and representation, we illustrate how a seemingly classic form of care—veteran rehabilitation—takes the form of representative performance. Drawing on ethnographic fieldwork and interviews with the Danish Invictus Games team, we demonstrate how politics, research and TV documentaries are integrated into veteran care practices. Through this integration, mentally wounded veterans, while performing 'themselves' for shifting audiences with shifting agendas, come to assume the roles of both caregivers and care receivers. Crucially, we highlight that wounded veterans, while undertaking their personal rehabilitation journey, are curated into and (un)willingly positioned as representatives of others. By showing how caring for wounded veterans goes hand in hand with caring for fictive, future wounded veterans and for political, research and media agendas, this article offers new ways of thinking of and with care. [ABSTRACT FROM AUTHOR]

Purpose: Hyperglycemia is affected by lifestyle and genetic factors. We investigated if dietary patterns associate with glycemia in individuals with high or low genetic risk for type 2 diabetes (T2D). Methods: Men (n = 1577, 51–81 years) without T2D from the Metabolic Syndrome in Men (METSIM) cohort filled a food-frequency questionnaire and participated in a 2-hour oral glucose tolerance test. Polygenetic risk score (PRS) including 76 genetic variants was used to stratify participants into low or high T2D risk groups. We established two data-driven dietary patterns, termed healthy and unhealthy, and investigated their association with plasma glucose concentrations and hyperglycemia risk. Results: Healthy dietary pattern was associated with lower fasting and 2-hour plasma glucose, glucose area under the curve, and better insulin sensitivity (Matsuda insulin sensitivity index) and insulin secretion (disposition index) in unadjusted and adjusted models, whereas the unhealthy pattern was not. No interaction was observed between the patterns and PRS on glycemic measures. Healthy dietary pattern was negatively associated with the risk for hyperglycemia in an adjusted model (OR 0.69, 95% CI 0.51–0.95, in the highest tertile), whereas unhealthy pattern was not (OR 1.08, 95% CI 0.79–1.47, in the highest tertile). No interaction was found between diet and PRS on the risk for hyperglycemia (p = 0.69 for healthy diet, p = 0.54 for unhealthy diet). Conclusion: Our findings suggest that healthy diet is associated with lower glucose concentrations and lower risk for hyperglycemia in men with no interaction with the genetic risk. [ABSTRACT FROM AUTHOR]

AbstractLet G be an infinite simple group of finite Morley rank and α a supertight automorphism of G so that the fixed point subgroup Pn:=CG(αn) is pseudofinite for all n∈N∖{0} . It is know (using CFSG) that the socle Sn:=Soc(Pn) is a (twisted) Chevalley group over a pseudofinite field. We prove that there is r∈N∖{0} so that for each n we have [Pn:Sn]n the sizes of the Sylow 2-subgroups of Sn are bounded by m. We also note that in the recent identification result of G under the assumption pr2(G)=1 , the use of CFSG is not needed. [ABSTRACT FROM AUTHOR]

Shipping is a vital component of global trade. However, shipping activities have negative environmental impacts, including emissions to air and water. The Baltic Sea is severely affected by eutrophication, mainly due to nutrient inputs, especially nitrogen and phosphorus. Understanding the contributions of various nutrient sources is essential for informed environmental regulation. The aim of this research is to quantify the nutrient content of black and grey water discharged from cargo ships in the Baltic Sea in order to assess their contribution to the total nutrient load. Specifically, this research examines the nitrogen and phosphorus loadings from ships calling the port of HaminaKotka and addresses key questions regarding nutrient generation, discharge proportions, emission shares by ship type, and their importance compared to other sources. Using a methodology based on ship data and nutrient production estimates, this study found that 2545 cargo ships generated a total of 781 kg of nitrogen and 134 kg of phosphorus in their effluents during their voyages to the port in 2021. However, only a small fraction (0.5%) of the cargo ships discharged their wastewater at port reception facilities. This study concludes that nutrient discharges from cargo ships' wastewaters are relatively small, contributing less than 0.06% phosphorus and 0.01% nitrogen to the total load in the area. This result indicates that the impact of cargo ships' wastewater on the eutrophication of the Baltic Sea is smaller than previously thought. The methodology used in this study can be applied in other ports and regions to assess nutrient discharges from cargo ships' wastewaters on a wider scale. Further research is recommended to assess the effectiveness of on-board treatment systems, the impact of other contaminants in wastewater, and the development of port reception facilities to facilitate proper wastewater management in the maritime trade. [ABSTRACT FROM AUTHOR]

Background: Being a family member to someone who suffers from a serious illness can change one's perspectives about life. A sudden and severe illness can result in a demanding journey that involves acute admission to hospital, intensive care, post‐care, and finally, returning home. Aim: To describe the experience of staying beside a next of kin throughout the healthcare journey, from the onset of illness at home, to the intensive care unit, post‐care, and returning home. Methods: The study employed a qualitative design, with data collected via semi‐structured interviews and analysed using reflexive thematic analysis. A purposive sampling was used to recruit participants (n = 14), who had experiences of staying beside a next of kin throughout the healthcare journey from the onset of illness to discharge from the hospital. Findings: Family members' experiences were captured under the overarching theme Journey through an emotional turmoil and the themes Entering a new world, Continuing the journey towards something unknown, and Striving for the new normal at home. They described going through a non‐linear process, characterised by transitions or changes in several aspects. The transitions included shifts in the roles that the family members played, in the various environments they found themselves in, and in the progression of the patient's illness or injury. Conclusion: The study suggested that family members with a next of kin who experienced life‐threatening situations undergo challenging transitions. The informal caregiver role placed on family members of intensive care unit‐survivors significantly impacts their lives and the healthcare systems should prioritise providing high‐quality support to family members throughout the entire healthcare journey. Elevating the importance of nursing care within the healthcare system can contribute to delivering holistic care and facilitating transitions. Further research should focus on understanding the support that family members perceive as necessary to facilitate their transition and enhance their well‐being. [ABSTRACT FROM AUTHOR]

This study investigates the utilisation of GFL by three English as a foreign language (EFL) teachers who serve as linguistic role models for their students at a Thai university. It challenges the belief that gender representation is limited to only males and females, highlighting the need for inclusive practices in applied linguistics and TESOL. Thus, it suggests using they as the default pronoun when preferences are unknown, promoting inclusivity and respect for all genders. Drawing upon Trans-Affirming Queer Inquiry-Based Pedagogies (TAQIBPs) as a conceptual framework and employing an exploratory qualitative approach, the research utilises classroom observations and individual interviews as data collection tools. The findings reveal that while the teachers acknowledged the importance of GFL in fostering inclusivity and respect, and eradicating gender biases, they still employed gendered language in certain instances. Notably, this occurred when providing specific examples during lessons and referring to or addressing individual students. The continued use of gendered language can be attributed to limited access to GFL-compliant teaching materials, a lack of grammatically acceptable alternatives within the English language, and a shortage of neutral terms to address students in the classroom. The implications of these findings are discussed, and recommendations are provided. [ABSTRACT FROM AUTHOR]

There are persistent and profound racialised inequalities in maternal and reproductive health in the UK. Yet in multiple settings, these disparities have been blamed on class or ethnicity, individuals and communities rather than the structures within which they live. In this study, we draw on narratives told within a ‘slow‐stitch’ craft workshop, organised in southern England for racialised women with reproductive trauma, to show how processes of racialisation and racism shape experiences of maternal and reproductive healthcare. Experiences of reproductive trauma were multiple and cumulative. The burden of knowledge of racialised disparities was carried into health‐care spaces, with plans made in advance to self‐manage in risky spaces. The constant management of racialised stereotypes and subsequent strategies of bodily and emotional containment ultimately was not protective and there was little agency over levels of care received in health‐care spaces. Perceptions surrounding racialised bodies shaped treatment, whilst proximities to whiteness afforded alternative realities. Taking a phenomenological approach we analyse race as a sensory, spatial and relational constellation haunted by long‐standing histories of fraught inequality. Bringing together in the crafting circle a group of women racialised in different ways enabled the sharing of “unspeakable” stories surrounding racism and reproductive trauma, and allowed race to be brought into being as a form of solidarity and connection. [ABSTRACT FROM AUTHOR]

While a number of studies focused on identity construction, teacher attrition, and lived experiences among early-career teachers, studies on early-career English as a Foreign Language (EFL) teachers' professional practices for teacher learning remain underexplored. Using the United Kingdom Professional Standards Framework dimensions of professional practice as a framework and a narrative inquiry as a method, this study explores how early-career EFL teachers engaged in teacher learning through a reflective practice of their teaching beliefs, classroom practices, and professional values. Findings from the open-ended written interview questions and semi-structured individual interviews suggest that early-career EFL teachers' experience and academic orientation influence their preconceived beliefs and professional values towards teaching. However, such beliefs and attitudes are negotiated and changed when teachers engage in teacher learning through a professional development program that provides them the space to reflect on who and what they are as teachers. This study has implications for early-career EFL teachers' professional practices and language education curriculum programs. [ABSTRACT FROM AUTHOR]

This article analyzes the implementation of a novel concept in Norwegian planning and building law (PBA), the Regional Planning Strategy (RPS), which was introduced before the 2011-2015 electoral period. How the RPS was understood and implemented is the focus of this analysis. This article presents new knowledge of how new strategic elements unfold within a country’s legal framework through its implementation in practice. We add to the planning-theory dialogue by discussing translation by regional re-contextualization in the implementation of a new element in regional strategic planning (Røvik 1998, 2002). A study of the implementation of the RPS over three ‘generations’ (2011-2022) reveals interesting and surprising differences. Drawing on translation theory, we find that the translation, contextualization, and re-contextualization of the PBA with respect to the implementation of RPSs were diverse in 2011/12, that there was a convergence in the second generation, and that diversity reappears in new ways in the third generation. This article confirms how a new idea like RPS develops in regional planning processes is dependent on the central government’s need and ability to manage the counties’ RPS work, as well as the counties’ need and ability to make regional adjustments and to set their own political priorities. [ABSTRACT FROM AUTHOR]

This exploratory study investigated cerebrospinal fluid (CSF) synaptic protein biomarkers in bipolar disorder (BD), aiming to highlight the neurobiological basis of the disorder. With shared cognitive impairment features between BD and Alzheimer's disease, and considering increased dementia risk in BD patients, the study explores potential connections. Fifty-nine well-characterized patients with BD and thirty-seven healthy control individuals were examined and followed for one year. Synaptic proteins encompassing neuronal pentraxins (NPTX)1, NPTX2, and NPTX-receptor, 14–3-3 protein family epsilon, and zeta/delta, activating protein-2 complex subunit beta, synucleins beta-synuclein and gamma-synuclein, complexin-2, phosphatidylethanolamine-binding protein 1, rab GDP dissociation inhibitor alpha, and syntaxins 1B and 7 were measured in CSF using a microflow liquid chromatography-mass spectrometric multiple reaction monitoring set-up. Biomarker levels were compared between BD and HC and in BD before, during, and after mood episodes. The synaptic proteins revealed no statistically significant differences between BD and HC, neither at baseline, one-year follow-up, or in terms of changes from baseline to follow-up. Moreover, the CSF synaptic protein levels in patients with BD were unaltered compared to baseline when they stabilized in euthymia following an affective episode and at one-year follow-up. It is uncertain what the CSF biomarker concentrations reflect since we yet do not know the mechanisms of release of these proteins, and we are uncertain of what increased or decreased levels reflect. This first-ever investigation of a panel of CSF protein biomarkers of synaptic dysfunction in patients with BD and HC individuals found no statistically significant differences cross-sectionally or longitudinally. • A longitudinal investigation of 59 patients with bipolar disorder and 37 healthy individuals • A novel panel of CSF protein biomarkers of synaptic dysfunction was applied. • Intriguing trends but no statistically significant changes were found. [ABSTRACT FROM AUTHOR]

The island of Seili, in the south-western archipelago of Finland, is famous for its history as a leprosy colony and mental asylum. The island formed a small, hierarchical community run by priests and hospital officials. In this article, we examine the history of the burial crypt in Seili church by comparing information from historical documents and observations made during archaeological fieldwork. The material gathered from these two sources is conflicting, suggesting an interesting history in the use of the burial crypt. It seems that women's coffins could easily be moved elsewhere from the crypt when new coffins belonging to males were interred. It is argued that identifying the buried individuals would be necessary for a taphonomic study of the mummification processes and ensuring that the information about the crypt is based on facts. However, the identification is difficult due to inconsistent historical records. This underlines the importance of Post-Medieval archaeology in studying sites connected to family histories. [ABSTRACT FROM AUTHOR]

Background Frailty Index (FI) reflects health, functioning and well-being of older people. It is valuable to compare how frailty has changed over time in ageing cohorts. This study aims to examine trends in frailty among 75–95-year-old men and women over three decades. Methods The Helsinki Ageing Study started in 1989 and includes repeated cross-sectional postal surveys every 10 years examining community-dwelling cohorts of older people (75, 80, 85, 90 and 95 years). FI comprises the same 36 items in each cohort. Results The mean FI was 0.22 (SD 0.12), 0.25 (SD 0.15), 0.26 (SD 0.15) and 0.23 (SD 0.15) in 1989, 1999, 2009 and 2019, respectively (P for linearity for crude values.11). Adjusted for age and sex, the four cohorts differed in their frailty the 2019 cohort having the lowest FI. This sex-adjusted difference was seen among 75-, 80-, 85- and 90-year-olds but not among 95-year-olds. FI decreased more among men than women (P for cohort <.001, P for sex <.01, P for interaction =.19). Conclusions The prevalence of frailty among community-dwelling individuals aged 75, 80, 85 and 90 years—but not among those aged 95 years—has significantly decreased over the last decades. This positive trend may have important implications for health policies in societies with increasing longevity. [ABSTRACT FROM AUTHOR]

Background: Pediatric acute-onset neuropsychiatric syndrome (PANS) is a symptom-based and clinically heterogeneous condition characterized by an abrupt and dramatic onset of symptoms such as loss of motoric and cognitive abilities, anxiety, compulsion, tics, and eating disorders. PANS is a new diagnosis and the condition has gathered controversy in research and clinical practice. Aim: We aimed to investigate the process by which parents of children with PANS acquire knowledge about the condition; the causes that lead parents to search for knowledge; the ways in which they search for knowledge; and the manner in which this knowledge is received by medical care professionals. Method: The study employed in-depth semi-structured, individual interviews with 13 parents of children diagnosed with PANS. An inductive qualitative thematic analysis was used as a guide for analyzing the data. Results: Challenges to understand their child's illness and receive effective care led the parents to search for knowledge about PANS and provide an explanation for their child's symptoms. They used personal and social resources to search for knowledge. They felt trusted and encouraged when clinicians endorsed their knowledge. On the other hand, when they were dismissed as a source of knowledge, they experienced a lack of trust towards professionals. Conclusions: A driving force for parents' search for knowledge is a perceived incapacity to give meaning to their experiences. Another reason is mistrust of healthcare staff's existing knowledge. Highlights: PANS is a new diagnosis and the condition has gathered controversy in research and clinical practice, particularly with regard to the role of autoimmune and infectious diseases at the onset of PANS. Parents of children with PANS manage challenges to understand their child's illness and receive effective care by searching for knowledge about PANS. They used personal and social resources to search for knowledge. They felt trusted and encouraged when clinicians endorsed their knowledge. On the other hand, when they were dismissed as a source of knowledge, they experienced a lack of trust towards professionals. The results illustrate a need for in-depth knowledge of PANS in mental healthcare and enhanced person-centered care where parents are regarded as valuable carriers of knowledge. [ABSTRACT FROM AUTHOR]

Objectives: Endovascular thrombectomy has demonstrated a major therapeutic improvement in the treatment of acute ischemic stroke. The benefit of endovascular thrombectomy is commonly reported by determining the functional outcome using the modified Rankin Scale (mRS). There is a lack of knowledge concerning the quality of life (QoL) and factors impacting the QoL after endovascular thrombectomy. The aim of this study was to assess the QoL of stroke survivors who underwent endovascular thrombectomy and to determine the variables associated with QoL. Methods: Prospective single‐center analysis of 98 patients who underwent endovascular thrombectomy between 2015 and 2019. QoL was assessed by using the Rand 36‐Item Health Survey (RAND‐36), Beck's Depression Inventory (BDI), Stroke Impact Scale‐16 (SIS‐16), and Alcohol Use Disorders Identification Test (AUDIT) questionnaires. Results: Of the 98 patients, 53 (54.1%) reported poor QoL. According to the logistic regression analysis, the National Institutes of Health Stroke Scale (NIHSS) score > 6 on the first postprocedural day, right hemispheric infarction, and depression were independently associated with poor QoL. Depression was reported by 40.8% of all the respondents. QoL scores of the patients treated with endovascular thrombectomy were impaired in physical functioning, physical and emotional role functioning, social functioning, and general health compared to the age‐adjusted values of the Finnish general population. Conclusion: Endovascular thrombectomy (EVT)‐treated stroke survivors experience disability in multiple levels. More than half of the patients report poor QoL. Neurological disability, functional dependence, depression, and comorbidities are associated with poor QoL. Social capability is impaired and the difficulties are more distinct among individuals with age above 65 years. [ABSTRACT FROM AUTHOR]

Denmark and Sweden have witnessed a historically significant amplification of parental influence in compulsory schools during the past two decades. The emphasis on parental involvement in these two countries reflects international trends of neoliberal governing of educational processes. We know very little about the interplay between beginning teachers' encounters with parents and how that influences the teachers' identity formation. This article investigates beginning teachers' experiences with parents in Sweden and Denmark and how these experiences reflect the teachers' professional identity development. Through a comparative case study approach, interviews were carried out with 10 teachers in pre-service and in-service phases of their profession to capture their interpretations of their experiences with parents. A framework involving the concepts of parent-teacher relations, professional teacher identity, and emerging and thickening trajectories was used to develop the interview questions and analyse data. The results show that beginning teachers experience challenges in their relations with parents and these challenges put a strain on their self-definition as professionals. These results provide implications for addressing the constraints on teachers' professional autonomy brought by a culture of clientelism which has the potential to change the role of teachers and therefore affect their professional identity development. [ABSTRACT FROM AUTHOR]

Purpose: This study determined the effects of a 2-week step-reduction period followed by 4-week exercise rehabilitation on physical function, body composition, and metabolic health in 70–80-year-olds asymptomatic for injury/illness. Methods: A parallel-group randomized controlled trial (ENDURE-study, NCT04997447) was used, where 66 older adults (79% female) were randomized to either intervention or control group. The intervention group reduced daily steps to < 2000, monitored by accelerometer, for two weeks (Period I) and then step-reduction requirement was removed with an additional exercise rehabilitation 4 times per week for 4 weeks (Period II). The control group continued their habitual physical activity throughout with no additional exercise intervention. Laboratory tests were performed at baseline, after Period I and Period II. The primary outcome measure was leg lean mass (LLM). Secondary outcomes included total lean and fat mass, blood glucose and insulin concentration, LDL cholesterol and HDL cholesterol concentration, maximal isometric leg press force (MVC), and chair rise and stair climb performance. Results: LLM remained unchanged in both groups and no changes occurred in physical function nor body composition in the intervention group in Period I. HDL cholesterol concentration reduced after Period I (from 1.62 ± 0.37 to 1.55 ± 0.36 mmol·L−1, P = 0.017) and returned to baseline after Period II (1.66 ± 0.38 mmol·L−1) in the intervention group (Time × Group interaction: P = 0.065). MVC improved after Period II only (Time × Group interaction: P = 0.009, Δ% = 15%, P < 0.001). Conclusion: Short-term step-reduction in healthy older adults may not be as detrimental to health or physical function as currently thought. [ABSTRACT FROM AUTHOR]

Background: Previous studies show social inequality in tooth loss, but the underlying pathways are not well understood. The aim was to investigate the mediated proportion of sugary beverages (SBs) and diabetes and the association between educational level and tooth loss, and to investigate whether the indirect effect of SBs and diabetes varied between educational groups in relation to tooth loss. Methods: Data from 47,109 Danish men and women aged 50 years or older included in the Danish Diet, Cancer and Health Study was combined with data from Danish registers. Using natural effect models, SBs and diabetes were considered as mediators, and tooth loss was defined as having <15 teeth present. Results: In total, 10,648 participants had tooth loss. The analyses showed that 3% (95% confidence interval 2–4%) of the social inequality in tooth loss was mediated through SBs and diabetes. The mediated proportion was mainly due to differential exposure to SBs and diabetes among lower educational groups. Conclusions: The findings show that SBs and diabetes to a minor degree contribute to tooth-loss inequalities. The explanation indicates that individuals in lower educational groups have higher consumption of SBs and more often suffer from diabetes than higher educational groups. [ABSTRACT FROM AUTHOR]

AbstractParental suicide in childhood increases the risk of mental ill-health, substance use and premature mortality, particularly through suicide. Postvention supports tailored to the well-being and functioning of suicide-bereaved children and their remaining parents are thus of critical importance to counteract negative development. This explorative cross-sectional study seeks clinically relevant knowledge by investigating posttraumatic stress (PTS), sense of coherence (SOC) and family functioning among children (n = 22), adolescents (n = 18) and parents (n = 40) before their attendance at a family-based grief support program. The results demonstrate critical health outcomes for children and parents, and in particular for adolescents. Clinically relevant symptoms of PTS were found in 36% of children, 65% of adolescents, and 37% of parents. All groups showed lower SOC than the norm. Adolescents reported dysfunctional family functioning for the dimensions Communication and Affective Responsiveness. Psychoeducational and trauma-informed support is recommended where family communication and meaning construction of suicide is given special attention. [ABSTRACT FROM AUTHOR]

Let G be an infinite simple group of finite Morley rank and of Prüfer 2-rank 1 which admits a supertight automorphism α such that the fixed-point subgroup C G (α n) is pseudofinite for all integers n > 0. The main result of this paper is the identification of G with PGL 2 (K) for some algebraically closed field K of characteristic ≠2. [ABSTRACT FROM AUTHOR]

Ethical and sustainable thinking is an important competence in the engineering education to support students' abilities to act and perform in a responsible manner in corporate contexts, and consequently contribute to a sustainable future. This paper investigates engineering students' attitudes towards ethical and sustainable thinking focusing on the corporate social responsibility (CSR) principles in the context of entrepreneurship courses as a part of larger research project. Engineering students from a Finnish and an Estonian university (N = 342) responded to a self-assessment survey. The students' attitudes towards CSR principles were assessed both on the enterprise level and the individual level as expectations of potential future employees. The findings indicate that engineering students acknowledge the need to take into account responsible thinking and that it is important for enterprises to be both socially and environmentally responsible in their activities. The self-assessment tool of ethical and sustainable thinking associated with the entrepreneurship competence model and CSR principles can be helpful in practice when university teachers wish to support and assess their students' attitudes towards CSR principles among other entrepreneurship competencies when creating new course content. [ABSTRACT FROM AUTHOR]

Objective: To determine the inter‐relationships between five first‐trimester biomarkers (pregnancy associated plasma protein A [PAPP‐A], alpha‐fetoprotein [AFP], beta human chorionic gonadotrophin [beta‐hCG], placenta growth factor [PlGF] and soluble fms‐like tyrosine kinase receptor‐1 [sFlt‐1]) and a range of adverse pregnancy outcomes (APOs). Design: Prospective cohort study of nulliparous singleton pregnancy. Setting: Cambridge, UK. Population or Sample: 4056 pregnancy outcome prediction study participants. Methods: The biomarker concentrations were measured in maternal serum at ~12 weeks of gestation. Univariable analysis of APOs was performed using logistic regression. Multivariable analysis used best subsets logistic regression with cross‐validation. Main outcome measures: Pre‐eclampsia (PE), small for gestational age (SGA), including severe SGA (birthweight <3rd), fetal growth restriction (FGR), preterm birth (PTB, both induced and spontaneous [iPTB and sPTB, respectively]), pre‐viable loss and stillbirth, plus combinations of outcomes. Results: Lower values of PAPP‐A, PlGF and sFlt‐1 and higher values of AFP were associated with FGR (OR for 1 SD higher value 0.59 [95% CI 0.48–0.74], OR 0.56 [95% CI 0.44–0.70], OR 0.68 [95% CI 0.54–0.87] and OR 1.53 [95% CI 1.25–1.88]), severe SGA (OR 0.59 [95% CI 0.49–0.72], OR 0.71 [95% CI 0.57–0.87], OR 0.74 [95% CI 0.60–0.91] and OR 1.41 [95% CI 1.17–1.71]), sPTB (OR 0.61 [95% CI 0.50–0.73], OR 0.79 [95% CI 0.66–0.96], OR 0.57 [95% CI 0.47–0.70] and OR 1.41 [95% CI 1.18–1.67]) and iPTB (OR 0.72 [95% CI 0.57–0.91], OR 0.62 [95% CI 0.49–0.78], OR 0.71 [95% CI 0.56–0.90] and OR 1.44 [95% CI 1.16–1.78]), respectively. When combinations of biomarkers were assessed, PAPP‐A and AFP were independently associated with severe SGA; PAPP‐A alone with PE + PTB; PlGF alone with severe PE; PlGF, beta‐hCG, AFP and PAPP‐A with the combination of PE and SGA; AFP and sFlt‐1 with sPTB; and AFP and PlGF with iPTB. Conclusions: Combinations of first‐trimester placental biomarkers are associated with APOs. However, the patterns vary for different types of APO, indicating heterogeneity in the underlying pathophysiological pathways. [ABSTRACT FROM AUTHOR]

Objective Assessment of posttraumatic hypothalamic–pituitary dysfunctions is expected to be the most relevant assessment to offer patients with severe intracranial affection. In this study, we aim to investigate the prevalence of hypopituitarism in patients with severe acquired traumatic brain injury (TBI) compared with nontraumatic brain injury (NTBI) and to relate pituitary insufficiency to functional and patient-reported outcomes. Design This is a prospective study. Methods We included patients admitted for inpatient neurorehabilitation after severe TBI (N = 42) and NTBI (N = 18). The patients underwent a pituitary function assessment at a mean of 2.4 years after the injury. Functional outcome was assessed by using Functional Independence Measure and Glasgow Outcome Scale-Extended (both 1 year after discharge from neurorehabilitation) and patient-reported outcome was assessed by using Multiple Fatigue Inventory-20 and EQ-5D-3L. Results Hypopituitarism was reported in 10/42 (24%) patients with TBI and 7/18 (39%) patients with NTBI (P =.23). Insufficiencies affected 1 axis in 14/17 (82%) patients (13 hypogonadotropic hypogonadism and 1 growth hormone [GH] deficiency) and 2 axes in 3/17 (18%) patients (1 hypogonadotropic hypogonadism and GH deficiency, and 2 hypogonadotropic hypogonadism and arginin vasopressin deficiency). None had central hypoadrenalism or central hypothyroidism. In patients with both TBI and NTBI, pituitary status was unrelated to functioning and ability scores at 1 year and to patient-reported outcome scores at a mean of 2.4 years after the injury. Conclusion Patients with severe acquired brain injury may develop long-term hypothalamus–pituitary insufficiency, with an equal occurrence in patients with TBI and NTBI. In both types of patients, mainly isolated deficiencies, most commonly affecting the gonadal axis, were seen. Insufficiencies were unrelated to functional outcomes and patient-reported outcomes, probably reflecting the complexity and heterogeneous manifestations in both patient groups. [ABSTRACT FROM AUTHOR]

Monitoring neoplasms in standardized registries facilitates epidemiologic studies of risk factors for tumor development and predisposition. In an observational study, we determined incidence rates (IR) and malignant tumor incidence rate ratios (IRR) by age, sex, and breed in Swiss dogs using demographic data from the official Swiss dog registration database Amicus. The dataset analyzed included 54'986 tumors diagnosed by histology and cytology in four Swiss veterinary pathology laboratories between 2008 and 2020. Diagnoses were coded according to the Vet-ICD-O-canine-1 system. Most tumors occurred in the skin (n = 19'045; 34.64%), soft tissues (n = 11'092; 20.17%), and mammary glands (n = 7'974; 14.50%). The IRs for all and for malignant tumors were 775/100'000 dog-years at risk (95%CI 764–777) and 338/100'000 dog-years at risk (95%CI 333–342), respectively. Females (850; 95%CI 834–853) had a higher overall tumor IR than males (679; 95%CI 666–684). The highest tumor IR was found at 11 years of age (1'857; 95%CI 1'780–1'867). Potential novel breed-specific predispositions were uncovered, with high IRs for several benign and malignant tumors in Polski Owczarek Nizinnys (overall IR: 3'303; 95%CI 2'502–3'864) and high IRs for malignant tumors in Russian Black Terriers (melanomas: 345; 95%CI 138–708), Field Spaniels (adenocarcinomas: 376; CI95% 138–817), Dogo Argentinos (mast cell tumors: 844; CI95% 591–1'169), King Charles Spaniels and Manchester Terriers (lymphomas: 319; CI95% 137–627 and 302; CI95% 98–704, respectively), Landseers (osteosarcomas: 74; CI95% 15–216), Bouvier des Flandres (hemangiosarcomas: 127; CI95% 26–371), and Bearded Collies and Cane Corso Italianos (gliomas: 91; CI95% 45–162 and 34; CI95% 7–99, respectively). Nordic hunting dogs had the highest (8.08; CI95% 3.55–16.7) and Chihuahueno the lowest cancer IRRs (0.42; 95%CI 0.31–0.57) compared to mixed breeds. In conclusion, the calculated IRs and IRRs revealed previously unknown predisposing factors, including novel breed-specific susceptibilities. The results may have implications for cancer screening, diagnostic work-up, breeding management and oncologic and translational research. [ABSTRACT FROM AUTHOR]

Merkel cell carcinoma (MCC) is a highly immunogenic skin cancer primarily induced by Merkel cell polyomavirus, which is driven by the expression of the oncogenic T antigens (T-Ags). Blockade of the programmed cell death protein-1 (PD-1) pathway has shown remarkable response rates, but evidence for therapy-associated T-Ag-specific immune response and therapeutic strategies for the nonresponding fraction are both limited. We tracked T-Ag-reactive CD8+ T cells in peripheral blood of 26 MCC patients under anti-PD1 therapy, using DNA-barcoded pMHC multimers, displaying all peptides from the predicted HLA ligandome of the oncoproteins, covering 33 class I haplotypes. We observed a broad T cell recognition of T-Ags, including identification of 20 T-Ag-derived epitopes we believe to be novel. Broadening of the T-Ag recognition profile and increased T cell frequencies during therapy were strongly associated with clinical response and prolonged progression-free survival. T-Ag-specific T cells could be further boosted and expanded directly from peripheral blood using artificial antigen-presenting scaffolds, even in patients with no detectable T-Ag-specific T cells. These T cells provided strong tumor-rejection capacity while retaining a favorable phenotype for adoptive cell transfer. These findings demonstrate that T-Ag-specific T cells are associated with the clinical outcome to PD-1 blockade and that Ag-presenting scaffolds can be used to boost such responses. [ABSTRACT FROM AUTHOR]

This article deals with dilemma situations that are typical for a profession. First, it is explained how dealing with dilemmas can be helpful for professional practice. Second, dilemma is defined in general and professional dilemma in particular. Professional dilemmas of the library profession are outlined, from the areas of management, pedagogy, and some that arise from the specific values of the library profession itself. At the end, there are hints on how to deal in practice with dilemmas that are – in fact – irresolvable. Schulz von Thun's "Wertequadrat" is used as an instrument for the visualization and analysis of dilemmas.Mithilfe von www.DeepL.com/Translator (free version) übersetzt. [ABSTRACT FROM AUTHOR]

Understanding the ubiquitous digitalization of everyday life and associated inequalities presupposes rich conceptualizations of the associated social dynamics. Accordingly, we investigate digital service domestication as a social dimension of people's lives, building on concepts that center users' everyday lives and agency. We adopt the perspective of people who find the use of digital services difficult and examine the hurdles they face when attempting access. Our data consists of semi-structured interviews with migrant women (N = 22) living in Finland, where most essential services are digitalized. The study highlights the societal boundedness of the participants' agency, which we maintain is a key dynamic of inequality. We classify digital services in four categories, interactive communication services; information, media, and entertainment services; private customer services, and public health and social welfare services. The first two are voluntary digital services that did not create insurmountable barriers for the participants, but enabled them to conduct action they valued. By contrast, essential private and public services require mastering more complicated service technologies, a foreign language, and complex contents. Our results highlight how diversity-blind essential digital services produce and reinforce inequalities. Our analysis emphasizes the need for researchers to consider the coercive dimensions of digitalization. [ABSTRACT FROM AUTHOR]

Sensory archaeology explores how past individuals engaged with their world through all their senses. The use of senses is also a cornerstone in Viking Age reenactment. We argue that research on Viking Age material culture can benefit from the knowledge and experience of Viking Age reenactors, particularly when studying the sensory dimension of using and crafting objects. The traditional dichotomy between archaeologists and reenactors can also be challenged, as many individuals can be professional archaeologists but also reenactors. The application of reenactment in archaeological research is nevertheless situated on the boundary between subjective experiences and objective academic research. For this kind of research to work, methodological rigour and a theoretical framework is required to ensure the reliability and validity of interpretations. By applying a relevant theoretical framework, for example one that embraces the theories of sensory archaeology, while acknowledging the nuanced interplay of authenticity and subjectivity, Viking Age reenactment can provide a unique tool to study Viking Age material culture. [ABSTRACT FROM AUTHOR]

A study published in the Journal of Antimicrobial Chemotherapy (JAC) by Gwee et al. examined the use of vancomycin as a treatment for staphylococcal bloodstream infections in young infants. The study found that the recommended dosage regimen provided inadequate levels of the drug for preterm infants with a gestational age below 29 weeks. The authors recommend increasing the initial daily dose for this patient group and suggest using a combination of peak and trough measurements, along with AUC24 calculation, as a cost-effective method for monitoring vancomycin levels. The study highlights the importance of optimizing vancomycin exposure and monitoring concentrations in all infants. [Extracted from the article]

Background: We assessed the accuracy of four estimated glomerular filtration rate (eGFR) methods: MDRD, Cockcroft–Gault, CKD-EPI, and Wright. Method: The four methods were compared to measure GFR (mGFR) in patients with urothelial urinary tract cancer (T2-T4bNxMx) receiving platinum-based chemotherapy at Rigshospitalet, Copenhagen, from January 2019 to December 2021. Using standardized assays, creatinine values were measured, and mGFR was determined using Technetium-99 m diethylenetriaminepentaacetic acid (Tc-99 m-DTPA) or Cr-51-ethylenediaminetetraacetic acid (Cr-51-EDTA) plasma clearance. Patients (n = 146) with both mGFR and corresponding creatinine values available were included (n = 345 measurements). Results: The CKD-EPI method consistently demonstrated superior accuracy, with the lowest Total Deviation Index of 21.8% at baseline and 22.9% for all measurements compared to Wright (23.4% /24.1%), MDRD (26.2%/25.5%), and Cockcroft–Gault (25.x%/25.1%). Bland Altman Limits of agreement (LOA) ranged from − 32 ml/min (Cockcroft–Gault) to + 33 ml/min (MDRD), with CKD-EPI showing the narrowest LOA (− 27 ml/min to + 24 ml/min and lowest bias (0.3 ml/min). Establishing an eGFR threshold at 85 ml/min—considering both the lower limit of agreement (LOA) and the minimum cisplatin limit at 60 ml/min—allows for the safe omission of mGFR in 30% of patients in this cohort. Conclusion: CKD-EPI equation emerged as the most suitable for estimating kidney function in this patient group although not meeting benchmark criteria. We recommend its use for initial assessment and ongoing monitoring, and suggest mGFR for patients with a CKD-EPI estimated GFR below 85 ml/min. This approach could reduce costs and decrease laboratory time for 30% of our UC patients. [ABSTRACT FROM AUTHOR]

Background: In Turku, Finland, we introduced a home oxygen treatment and app-based monitoring program for hospitalized COVID-19 patients to facilitate an early discharge during the Omicron wave. In this case series we explore the clinical parameters of patients enrolled in the program and evaluate the cost–benefit and safety issues of the program. Methods: Hospitalized COVID-19 patients with marked hypoxemia but otherwise in stable condition were screened from Turku City Hospital and Turku University Hospital by treating doctors for eligibility in the program. Peripheral oxygen saturation of > 92% and breathing frequency < 30/min in rest with oxygen supplementation were among the criteria. All patients actively participating in the program between 10th of January 2022 and 30th of September 2022 were included in this case series. Clinical data of hospitalization and monitoring were analysed, and cost–benefit evaluation was based on the number of saved hospitalization days. Results: Nineteen COVID-19 patients were included in this case series and recruited from three different hospital departments in the Turku city region, South-West Finland. All patients were male, the median age was 59 years and the median duration of hospitalization before enrolment in the program was 6 days (range 3—20 days). The median duration of home oxygen treatment was 13 days (range 3—72 days) and the median duration of home monitoring was 18 days (range 7—41 days). A total of 210,5 hospital days were prevented, resulting in savings of €144,490 of healthcare expenditure (on average 9 days and €7,605 per patient). No major safety issues were reported during the program. Conclusions: In our case series, home oxygen treatment combined with home monitoring was safe and economically beneficial. Application based monitoring could be considered in other post-acute pulmonary conditions to reduce hospitalization and healthcare costs. [ABSTRACT FROM AUTHOR]

The article is an introduction to the second volume of "Women in Microscopy," which features a collection of papers on various microscopy techniques and technologies. The volume includes contributions on topics such as surface passivation, time-modulated structured illumination, Mesolens imaging, array tomography, and quantification in life sciences microscopy. The article also highlights the implementation of an interdisciplinary bootcamp at UC Berkeley aimed at promoting networking and support for women in microscopy. The bootcamp provides opportunities for undergraduate students to connect with women role models in academia and industry. Other papers in the volume discuss improvements in glass coatings for microscopy, a temporal method for improving localisation precision, mesoscale standing wave imaging, and array tomography in 3D electron microscopy. The volume concludes with a review on microscopy data quantification in the life sciences. Overall, the article showcases the diverse contributions of women in the field of microscopy and highlights the importance of supporting and promoting gender equity in the discipline. [Extracted from the article]

AbstractThis study inquires how students of Arab heritage in an urban setting in Denmark interpret Islamic literacy artefacts available in their homes, and how these interpretations reflect broader faith literacy practices in the students’ diaspora community. Through a linguistic ethnographic study design students have been invited to photograph literacy artefacts of their own choice in their homes and to discuss these photos in group interviews. A framework of syncretic literacy practices with a focus on faith literacy practices is employed to analyse data. We discuss how faith literacies in diaspora communities are inherently multilingual practices as they include the language of religious texts and its various registers, the home language, and the mainstream language. As such, these literacy practices play an important role in the formation of students’ transnational identities. Our findings indicate that syncretic literacy practice has the potential to contribute to improve the policies and curriculum of literacy education, as well as linguistic minority students’ literacy learning. [ABSTRACT FROM AUTHOR]

Background: Abnormalities in cerebrospinal fluid (CSF)-amyloid-beta (Aβ)42, CSF-Aβ40, CSF-Aβ38, CSF-soluble amyloid precursor proteins α and β, CSF-total-tau, CSF-phosphorylated-tau, CSF-neurofilament light protein (NF-L), CSF-neurogranin, plasma-Aβ42, plasma-Aβ40, plasma-total-tau, plasma-NF-L and, serum-S100B during affective episodes may reflect brain changes that could impact cognitive function in patients with bipolar disorder (BD). The study aimed to investigate the association between these biomarkers indicative of Alzheimer's disease and those reflecting neurodegeneration alongside their impact on cognitive function in patients with BD and healthy control individuals (HC). The primary hypothesis was that GL and VL would increase with increasing levels of CSF-Aβ42 based on data from T0 and T3 in BD and HC jointly. Methods: In a prospective, longitudinal case–control study euthymic patients with BD (N = 85) and HC (N = 44) were evaluated with clinical assessment and neuropsychological testing at baseline (T0) and during euthymia after a year (T3). Patients' affective states were recorded weekly as euthymic, subthreshold level, major depression, or (hypo)mania. If an episode occurred during follow-up, the patient was also assessed in post-episode euthymia. Cognitive performance was measured as a global cognitive score (GL) for four cognitive domains including verbal learning and memory (VL). Results: Estimated in a linear mixed model GL increased with 0.001 for each increase of 1 pg/ml of CSF-Aβ42 (97.5%, CI 0.00043–0.0018, adjusted-p = 0.0005) while VL increased by 0.00089 (97.5%, CI 0.00015–0.0018, adjusted-p = 0.045) in BD and HC jointly. The association was weak, however stronger in patients with BD compared to HC. Associations between other biomarkers including CSF-neurogranin, and cognitive domains were overall weak, and none remained significant after adjustment for multiple testing. Limitations: Modest sample size. A complete data set regarding both CSF-AB-42 and cognitive test scores was obtained from merely 61 patients with BD and 38 HC individuals. Conclusion: CSF-Aβ42 may be associated with cognitive dysfunction in patients with BD and HC individuals. The association appeared to be stronger in BD but with overlapping confidence intervals. Hence it remains uncertain whether the association is a general phenomenon or driven by BD. [ABSTRACT FROM AUTHOR]

Strategic staff recruitment has to focus on all phases of the professional biography. It begins with the entry into a professional field through professional training or studies. Work-study programs – or "dual study programs" – are considered particularly flexible in this respect and promise an early bond between the library and prospective graduates. Due to various regulations, there is currently no officially "dual" study program in library and information science in Germany, but there are flexible and unbureaucratic alternatives. This article explains which "dual-like" options for a combination of (paid) professional practice and studies the library and information science institutes offer. [ABSTRACT FROM AUTHOR]

This article analyses and discusses funeral participation and participants in funerals in Denmark. Through a data material consisting of survey data, observations and personal interviews, it asks: who participate in funerals, in terms of social background variables and in terms of relations with the deceased? What do participants do in the course of and in relation to the funeral? Which patterns are there between types of participants and patterns of actions? Through engaging theoretical concepts suggested by Bailey and Walter, as well as O’Rourke et al., as well as a practice-theoretical perspective, it suggests that not only are there quite clear patterns in participation and participants’ actions, but that these are also essential for the pursuit of funerals’ purposes as well as for forming funerals’ subjects. By doing that, it contributes to the so far rather limited research on funeral participation. [ABSTRACT FROM AUTHOR]

Rapid improvements in the field of prenatal medicine have been achieved due to the technological advancement of ultrasonography that has allowed recognition of various ultrasonographic findings and their combination with biochemical results and demographic characteristics in order to estimate a final individual risk for a chromosomal anomaly of the fetus and analysis of short fragments of fetal DNA released into the mother's bloodstream through a natural process of cell death. Invasive testing still remains the main clinically available diagnostic modality for the definite diagnosis of both chromosomal anomalies and many single-gene disorders. Amniocentesis is performed between 15 and 20 weeks of pregnancy to obtain fetal cells for genetic testing. This method is performed almost in the middle of pregnancy, and waiting for the results of the analysis may indicate termination of pregnancy in the second trimester. Chorionic villus sampling (CVS), usually performed between 11+0 and 13+6 weeks of gestation, is one of the invasive diagnostic methods used to diagnose chromosomal, genetic, and metabolic diseases in the embryonic period. Invasive procedures such as CVS and amniocentesis still remain the only definitive diagnostic tests for aneuploidy in pregnancy. CVS, as an invasive procedure carried out with experienced physicians in specialist centers, is not associated with a significant increase in fetal loss rate, with a risk rate below 0.5%, and the possible background risk for miscarriage is significantly higher in the presence of fetal anomaly and abnormal karyotype. Ultrasound-guided transabdominal (TA) CVS is a useful outdoor procedure and is considered the method of choice for fetal sampling and accurate early prenatal diagnosis. [ABSTRACT FROM AUTHOR]

Appropriate management of adrenal insufficiency in pregnancy is challenging due to the rarity of both primary, secondary, and tertiary forms of the disease and the lack of evidence-based recommendations to guide clinicians to glucocorticoid and sometimes also mineralocorticoid dosage adjustments. Debut of adrenal insufficiency during pregnancy requires immediate diagnosis as it can lead to adrenal crisis, intrauterine growth restriction, and foetal demise. Diagnosis is difficult due to the overlap of symptoms of adrenal insufficiency and its crisis with those of pregnancy. Adrenal insufficiency in stable replacement treatment needs careful monitoring during pregnancy to adapt to the physiological changes in the requirements of the adrenal hormones. This is hampered because the diagnostic threshold of most adrenocortical hormones is not applicable during pregnancy. The frequent use of assisted reproduction technology with controlled ovarian hyperstimulation in these patient groups with disease-induced low fertility has created an unrecognised risk of adrenal crises due to accelerated oestrogen stimulation with an increased risk of even life-threatening complications for both the woman and foetus. The area needs consensus recommendations between gynaecologists and endocrinologists in tertiary referral centres to alleviate such increased gestational risk. Patient and partner education and the use of the EU emergency card for the management of adrenal crises can also contribute to better pregnancy outcomes. There is a strong need for more research on, for example, the improvement of glucocorticoid replacement as well as crisis management treatment and biomarkers for treatment optimization in this field, which suffers from the rare nature of the diseases and poor funding. [ABSTRACT FROM AUTHOR]

This study aimed to analyze how adolescent girls residing in Kathmandu valley, Nepal, talk about food within the context of their everyday experiences. We conducted 10 in-depth and four focus group interviews. Qualitative thematic analysis based on the constructivist paradigm was used to organize the interviews. The Utilitarian domain contained health statements using biomedical language and lay theories on health. Hedonic talk emphasized the taste of food, but notions about enjoyment were limited. Collective talk constructed an ideal family. In agency talk, the interviewees described their active role in achieving a slim body. Participants were not concerned about food insecurity but about eating too much. [ABSTRACT FROM AUTHOR]

Gas entrainment presents a safety challenge within sodium-cooled fast reactors. This problem is similar to two-phase free surface interactions in a Taylor–Couette flow characterized by a large annulus gap (small radius ratio, η ≈ 0.333) and highly turbulent swirling flows (R e ≈ 10 5 ). The aim of the current work is to test strategies that could mitigate this phenomenon. A three-dimensional numerical model of the primary sodium pump annulus region involved in gas entrainment due to shaft rotation was developed, and turbulent swirling flow that occurs in the annular gap between the vessel and the shaft is investigated. The influence of baffle plates mounted on the stationary vessel with and without porosity was examined during the study. The simulation results revealed that submerged porous plates placed on the outer cylindrical wall both delayed vortex breakdown and suppressed shear waves near the surface. Both these effects substantially delayed gas entrainment into the liquid. [ABSTRACT FROM AUTHOR]

Assessments and treatments of mental health conditions such as depression use language that may be difficult to understand or translate. Here, we studied how interpreters assessed the usefulness of simplifying the language of a depression screen. Two alternative versions of the PRIME-MD PHQ depression screen were generated, with increasing linguistic simplicity. All the versions (standard, moderately simplified and most simplified) were translated from Finnish into Arabic, English, Farsi, Russian, and Swedish. Ten professional interpreters then assessed the different usefulness aspects of the three versions. The interpreters' perceptions of usefulness of the different language versions for clients varied, and both simplified versions of the depression screen were commonly considered useful for interpreting contexts. The usefulness of the simplified language versions was seen as especially important for clients with multiple linguistic challenges, caused by, for example, dementia and immigration backgrounds. The language of depression screens can be greatly simplified. Simplified versions may significantly improve the accessibility of questionnaires for the wide range of individuals with compromised language competence. Simplified versions may also be helpful for inter-language interpreting in health care, and importantly, they may facilitate the transparency and cross-cultural calibration needed in evidence-based medicine. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: Perineal wound dehiscence is associated with complications, such as infections, perineal pain, dyspareunia, and altered sexual function, that severely affects women's health. Currently, few studies have examined secondary repair of first- and second-degree perineal wound dehiscence and episiotomies, and there is currently no consensus on the optimal treatment option for dehisced perineal wounds. The objective was to evaluate whether resuturing or conservative treatment of first- and second-degree dehisced perineal wounds and episiotomies is the optimal treatment modality in terms of postoperative healing time and other secondary outcomes. Methods: A systematic literature search was carried out using PubMed, Embase, and Cochrane databases. All included studies were evaluated using the SIGN methodology checklist, with the purpose of assessing the study quality. Results: Three randomized controlled trials were included. Only two small sample-sized studies presented data regarding healing time for both the resuturing and the conservative treatment groups. However, no significant difference was found between the two groups at 4–6 weeks' healing time (RR 1.16, 95% CI 0.53–2.52). One study found that women being resutured experienced a significantly reduced healing time and higher satisfaction with the appearance of the wound healing at 3 months compared with the conservative treatment group. Conclusion: We found no significant differences in the healing time between the resuturing group and the conservative treatment group. However, the sample sizes of the studies were small. A well-designed, large, and prospective randomized controlled trial is needed to evaluate the optimal treatment modality for dehisced perineal wounds. [ABSTRACT FROM AUTHOR]

The bending stiffness distribution of beams composed of simple‐span precast prestressed beams, which are made continuous by deck reinforcement at intermediate supports, is not constant. As the structure undergoes loading, the deck slab at the intermediate support cracks earlier than the prestressed span soffit and due to that the bending stiffness distribution changes along the beam length. The effect of nonconstant bending stiffness distribution on the moment redistribution of the structure before the yielding is studied experimentally and analytically. Two continuous beams with spans of 10 m + 10 m were manufactured, loaded to failure, and studied. It was concluded that the studied structure undergoes considerable moment redistribution before yielding although it would be designed for zero redistribution at the ultimate limit state. If this elastic redistribution is neglected in the structural analysis, the service limit state sagging moment at midspan may end up on the unconservative side. Elastic redistribution can be predicted quite accurately with the help of nonlinear analysis or roughly with simplified idealization as proposed in this article. [ABSTRACT FROM AUTHOR]

Background In pregnancy, women are encouraged to cease smoking and limit caffeine intake. We employed objective definitions of smoking and caffeine exposure to assess their association with adverse outcomes. Methods We conducted a case cohort study within the Pregnancy Outcome Prediction study to analyse maternal serum metabolomics in samples from 12, 20, 28 and 36 weeks of gestational age. Objective smoking status was defined based on detectable cotinine levels at each time point and objective caffeine exposure was based on tertiles of paraxanthine levels at each time point. We used logistic and linear regression to examine the association between cotinine, paraxanthine and the risk of pre-eclampsia, spontaneous pre-term birth (sPTB), fetal growth restriction (FGR), gestational diabetes mellitus and birthweight. Results There were 914 and 915 women in the smoking and caffeine analyses, respectively. Compared with no exposure to smoking, consistent exposure to smoking was associated with an increased risk of sPTB [adjusted odds ratio (aOR) = 2.58, 95% CI: 1.14 to 5.85)] and FGR (aOR = 4.07, 95% CI: 2.14 to 7.74) and lower birthweight (β = –387 g, 95% CI: –622 g to –153 g). On univariate analysis, consistently high levels of paraxanthine were associated with an increased risk of FGR but that association attenuated when adjusting for maternal characteristics and objective—but not self-reported—smoking status. Conclusions Based on objective data, consistent exposure to smoking throughout pregnancy was strongly associated with sPTB and FGR. High levels of paraxanthine were not independently associated with any of the studied outcomes and were confounded by smoking. [ABSTRACT FROM AUTHOR]

Aim: This article explores experiential knowledge of living with paediatric acute-onset neuropsychiatric syndrome (PANS), and the factors that are associated with perceived good care. Methods: Ten people with lived experience of PANS participated, five women and five men aged 19--34. Semi-structured interviews were used to explore their experience of living with PANS and their encounters with healthcare. Thematic analysis was carried out to identify central themes in the transcribed interviews. Results: The study revealed a group of young adults living fairly isolated lives, dependent on care from relatives. To them, the illness was a tangible presence. They perceived a lack of knowledge among healthcare staff on PANS in healthcare, and negative consequences linked to this. In addition, their experience-based knowledge of their own illness is devalued in healthcare encounters. A feeling of being pushed around in healthcare, without anyone taking responsibility for the treatment, emerged in the interviews. The participants emphasized the need for increased knowledge among staff to identify PANS and be able to offer effective treatment. Conclusion: There is a need to increase the knowledge about PANS in healthcare and to coordinating care between neurology, immunology and psychiatry. To be able to offer evidence-based care to children with PANS, in-depth knowledge is needed about aetiology, treatment effects, and user experiences and preferences. [ABSTRACT FROM AUTHOR]

Purpose: Although previous research indicates that care transitions differ between rural and urban areas, the knowledge of challenges related to care transitions in rural areas appears limited. This study aimed to provide a deeper understanding of what registered nurses' perceive as the main concerns in care transitions from hospital care to home healthcare in rural areas, and how they handle these during the care transition process. Methods: A Constructivist Grounded Theory method based on individual interviews with 21 registered nurses. Results: The main concern in the transition process was "Care coordination in a complex context". The complexity stemmed from several environmental and organizational factors, creating a messy and fragmented context for registered nurses to navigate. The core category "Actively communicating to reduce patient safety risks" was explained by the three categories-- "Collaborating on expected care needs", "Anticipating obstacles" and "Timing the departure". Conclusions: The study shows a very complex and stressed process that includes several organizations and actors. Reducing risks during the transition process can be facilitated by clear guidelines, tools for communication across organizations and sufficient staffing. [ABSTRACT FROM AUTHOR]

Previous research has widely recognized the challenges uniformed police officers face in their working lives. However, little is known about the overall lifestyles of police officers, including what they do in private life. We interviewed 17 officers and used reflexive thematic analysis to explore their experiences. The study sheds light on how uniformed police officers navigate the intersection between their private and professional lives, as well as how their professional role impacts their day-to-day doings and private life roles. The key findings relate to how the demands of their professional role impact their private life, such as the profession becoming a way of life. Furthermore, they highlight the challenges of avoiding certain environments where they might be recognized as police officers. It also entails balancing energy levels in work and private life, as well as how their profession's unpredictability affects their daily routines and roles. The findings also show how their personal choices in private life are frequently influenced by their professional role. The study's findings have theoretical as well as practical implications, contributing to a better understanding of uniformed police officers' challenges and resources for a sustainable and healthy lifestyle. [ABSTRACT FROM AUTHOR]