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Exploring how actors translate public policy content into practice provides new insight into policy processes. Because they are driven by contextual circumstances and values, that is, they are socially constructed, studying the interpretations and negotiations involved in the translation process advances our understanding of what shapes implementation agents, and subsequently the success of policy implementation. The Swedish moose policy, a legislative framework for decentralizing moose management in order to balance the various interests affected by the presence and abundance of moose, was used as a case study. In response to the task of implementation, some of the key stakeholders sought their own strategies for successful implementation and to achieve the national policy goals. This response expressed itself as two separate agreements, in 2016 and 2019, between different constellations of implementing actors (landowner and hunter organizations). These agreements provide an example of how key actors can translate policy, and expose inadequate policy designs. Revealing how the implementing actors perceive the policy and each other helps explain the continued presence of social and political conflict. Our results indicate that power struggles underpin the translation process; by constructing the core problem differently, not sharing ideas about management and using language that discourages collaboration, the actors' translations, together with a lack of clarity in policy design, hinder the chances of successful policy implementation. Policy processes have become increasingly complex, and differences between implementers present as obstacles that have to be overcome. The paper contributes to our understanding of implementation processes within a collaborative governance setting, where the responsibility of the implementation process has been devolved to non-state actors.

Background: Blood donation is associated with a number of adverse events. Most of these are both uncommon and non-severe, leading to mild discomfort for the donor at worst. However, adverse events occurring outside of the donation facility have largely not been studied. In this study, we aim to further the understanding by performing the first large-scale analysis of short-term risks following whole blood donation. Methods: We set up a nationwide cohort of donors who donated whole blood between 1987 and 2018. Analyses were conducted using conditional logistic regression in a self-comparison design, where each donor was compared only to themselves, considering the 30-day risk of 16 outcomes following whole blood donation. Outcomes included cardiac/vascular diseases such as myocardial infarction, unspecified conditions such as fainting, accidents or external causes of injury, and death. Results: A total of 963,311 donors were included, 19,670 of whom experienced at least one of the outcomes within 30 days of a blood donation. For fainting and hypotonia we observed transient 2 to 5-fold risk increases on the day of donation and the subsequent 2–3 days. Importantly, the risk increase for the most pronounced effect corresponded to less than 1 additional events of fainting per 200,000 blood donations. Risks of all other outcomes were either unaffected or lower than expected right after blood donation. Discussion: To conclude, we found no evidence of new or unexpected short-term health effects after blood donation and confirmed that risks of hypotension-related events requiring hospital care are present but small.

Objective Suicidality in eating disorders (EDs) is high, and identification of therapeutically targetable traits associated with past, current, and future suicidality is of considerable clinical importance. We examined overall and ED subtype‐specific associations among suicidal ideation, suicide attempts, and general and specific aspects of emotion dysregulation in a large sample of individuals with ED, at presentation for treatment and 1‐year follow‐up. Method Using registry data from 2,406 patients, scores on the Difficulties in Emotion Dysregulation Scale (DERS) at initial registration were examined as predictors of recent suicidal ideation and self‐report lifetime suicide attempts. Associations were examined in the full sample and in each ED subtype. In 406 patients, initial DERS scores were examined as predictors of suicidality at 1‐year follow‐up. Results Overall DERS was associated with suicidal ideation and suicide attempts, even when adjusting for ED psychopathology and current depression. Perceived lack of emotion regulation strategies showed unique associations with suicidal ideation and suicide attempts, both in the full sample and in most ED subtypes. Initial DERS was also associated with follow‐up suicidal ideation and suicide attempts, although this association did not remain when adjusting for past suicidality. Discussion Results suggest that emotion dysregulation may be a potential mechanism contributing to suicidality in EDs, beyond the effects of ED psychopathology and current depression. Although the prevalence of suicidality differs across ED subtypes, emotion dysregulation may represent a risk trait for future suicidality that applies transdiagnostically. Results support addressing emotion dysregulation in treatment in order to reduce suicidality.

Background The vagus nerve provides essential parasympathetic innervation to the gastrointestinal system and is known to have anti-inflammatory properties. Aims To explore the relationship between vagotomy and the risk of inflammatory bowel disease (IBD) and its major categories: Crohn's disease (CD) and ulcerative colitis (UC). Methods A matched cohort comprising 15 637 patients undergoing vagotomy was identified through the Swedish Patient Register from 1964 to 2010. Each vagotomised patient was matched for birth year and gender with 40 nonvagotomised individuals on the date of vagotomy. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for IBD using flexible parametric models adjusted for matching variables, year of vagotomy, birth country, chronic obstructive pulmonary disease and comorbidity index. Results We observed 119 (0.8%) patients with vagotomy developed IBD compared to 3377 (0.5%) IBD cases in nonvagotomised individuals. The crude incidence of IBD (per 1000 person-years) was 0.38 for vagotomised patients and 0.25 for nonvagotomised individuals. We observed a time-dependent elevated risk of IBD associated with vagotomy, for instance, the HR (95% CI) was 1.80 (1.40-2.31) at year 5 and 1.49 (1.14-1.96) at year 10 post-vagotomy. The association appeared to be stronger for truncal than selective vagotomy and limited to CD (HR was 3.63 [1.94-6.80] for truncal and 2.06 [1.49-2.84] for selective vagotomy) but not UC (1.36 [0.71-2.62] for truncal and 1.25 [0.95-1.63] for selective vagotomy). Conclusions We found a positive association between vagotomy and later IBD, particularly for CD. The finding indirectly underlines the beneficial role of the vagal tone in IBD.

Background Peanut allergy diagnosis relies on clinical reactivity to peanut supported by detection of specific IgE (sIgE) antibodies. Extract-based sIgE tests have low specificity, so component-resolved diagnostics may complement whole-extract testing. Methods We systematically collected peanut allergen component data in seven databases and studied the diagnostic accuracy of peanut storage proteins (Arah1, 2, 3) and cross-reactive peanut proteins (Arah8 PR-10 and Arah9 lipid transfer protein) through meta-analyses. The systematic literature review included studies employing peanut components and oral food challenge (OFC) as reference standard in patients suspected of peanut allergy. Data for component sIgE at pre-defined detection thresholds were extracted and combined in random-effects bivariate meta-analyses. Risk of bias was assessed as recommended by Cochrane, with two additional quality items of importance for this review. Results Nineteen eligible studies presented data suitable for meta-analysis. In cross-sectional pediatric studies, the pooled sensitivity of Arah2-sIgE at 0.35 kUA /L cutoff was 83.3% [95% CI 75.6, 88.9] and specificity in diagnosing objective peanut allergy was 83.6% [95% CI 77.4, 88.4]. Compared with 0.1 and 1.0 kUA /L, this threshold provided the best diagnostic accuracy. At 0.35 kUA /L, Arah1 and Arah3 had comparable specificity (86.0% and 88.0%, respectively) but significantly lower sensitivity compared with Arah2 (37.0% and 39.1%, respectively; P Conclusion sIgE to Arah2 can enhance the certainty of diagnosis and reduce the number of OFC necessary to rule out clinical peanut allergy in unclear cases.

Background There are paucity of data on sensitization to furry animal allergen components in adults. Furry animals are major sensitizers and contributors to asthma burden in northern Europe and North America. Objective To characterize sensitization patterns to furry animal allergen components in Swedish adults. Methods Based on the West Sweden Asthma Study, a random population (n = 1103) and an asthma sample (n = 769) were tested for allergen sensitization using Phadiatop® . Those with IgE ≥ 0.35 kUA /L were tested for cat (Fel d 1, 2, and 4), dog (Can f 1, 2, 3, and 5), and horse (Equ c 1) allergen component sensitization. We defined allergen component poly-sensitization patterns, identified data-driven sensitization clusters, described component sensitization overlaps, and assessed determinants of sensitization patterns. Results The prevalence of allergen component sensitization ranged from 0.8% for Fel d 2 and Can f 3 to 8.9% for Fel d 1. The most common dog component was Can f 5 (3.6%); 2.1% were sensitized to Equ c 1. Those sensitized to Fel d 2 and Fel d 4 were commonly sensitized to Fel d 1. The most common dog component overlap was between Can f 1/Can f 2 and Can f 5. Mono-sensitization was 5.6%, double sensitization 1.5% and poly-sensitization 2.1%. Sensitization was always higher in the asthma than in the random sample. Three sensitization clusters were derived, namely non-sensitized (90% in random vs 66% in asthma sample); Fel d 1-driven sensitized (7% vs 19%); and multi-sensitized (3% vs 15%). Key determinants of sensitization were gender, age, raised on a farm, family history of allergy or asthma, smoking, and occupational exposure to dust or fumes. Conclusions & clinical relevance Fel d 1 and Can f 5 are the most common cat and dog components sensitization in this adult Swedish population. Mono-sensitization is more common than poly-sensitization. This detailed characterization highlights the current distribution of furry animal allergen components in Swedish adults, and their impact on clinical outcomes of asthma will be further explored.

In this article, the opportunities of fast forming of multistacked UD prepreg when using high-pressure forming were examined in an experimental study. Forming is often considered a bottleneck in ma ...

Background Prenatal exposure to maternal adverse life events has been associated with offspring ADHD, but the role of familial confounding is unclear. We aimed to clarify if adverse life events during pregnancy are related to ADHD symptoms in offspring, taking shared familial factors into account. Method Data were collected on 34,751 children (including 6,427 siblings) participating in the population-based Norwegian Mother and Child Cohort Study. During pregnancy, mothers reported whether they had experienced specific life events. We assessed ADHD symptoms in five-year-old children with the Conners' Parent Rating Scale-Revised: short form. We modeled the associations between life events and mean ADHD scores with ordinary linear regression in the full cohort, and with fixed-effect linear regression in sibling comparisons to adjust for familial confounding. Results Children exposed to adverse life events had higher ADHD scores at age 5, with the strongest effect observed for financial problems (mean differences 0.10 [95% CI: 0.09, 0.11] in adjusted model), and the weakest for having lost someone close (0.02 [95% CI 0.01, 0.04] in adjusted model). Comparing exposure-discordant siblings resulted in attenuated estimates that were no longer statistically significant (e.g. mean difference for financial problems -0.03 [95% CI -0.07, 0.02]). ADHD scores increased if the mother had experienced the event as painful or difficult, and with the number of events, whereas sibling-comparison analyses resulted in estimates attenuated toward the null. Conclusions These results suggest that the association between adverse life events during pregnancy and offspring ADHD symptoms is largely explained by familial factors.

It is a common causal inference problem that, even with theoretically infinite samples, we might be able to only provide bounds for the parameters of interest. This problem occurs naturally, for example, in estimating causal interaction between two risk factors and in estimating the average causal effect using the instrumental variable or Mendelian randomization method. Current procedures include linear programming to get the estimated bounds, plus bootstrapping to get confidence intervals. We describe a likelihood-based procedure that automatically yields the interval estimate from the flat likelihood region and show some theory that allows us to construct confidence intervals from this non-regular likelihood. Finally, we illustrate the procedure with examples from the estimation of causal interaction between two risk factors and the treatment effect under partial compliance.

Objective To investigate the risk of psychiatric disorders among children of parents with cancer in a nationwide population-based setting. Methods Based on Swedish national registers, the study included 101 339 children with parental cancer diagnosed either during pregnancy (N = 1047) or after birth (N = 100 292) that were born during 1983 to 2000. For each exposed child, we randomly selected 10 unexposed children from the general population after individual matching by year of birth and sex. The matched cohort was followed during 2001 to 2010. Clinical diagnoses of psychiatric disorders and use of prescribed psychiatric medications were identified for all children. Cox regression and logistic regression were used to evaluate the associations of parental cancer with psychiatric disorder diagnosis and psychiatric medication use, respectively. Results Parental cancer during pregnancy was not associated with the risk of psychiatric disorders overall, although paternal cancer during pregnancy was associated with a higher risk of psychiatric medication use among females. Parental cancer after birth was associated with higher risks of psychiatric disorder diagnoses, particularly stress reaction and adjustment disorders (males: hazard ratio [HR]: 1.24, 95% confidence interval [CI], 1.08-1.43; females: HR: 1.27, 95% CI, 1.14-1.41), and use of psychiatric medication (males: odds ratio [OR]: 1.09, 95% CI, 1.04-1.13; females: OR: 1.14, 95% CI, 1.10-1.18). The positive associations were stronger for parental cancer with poor expected survival and for parental death after cancer diagnosis. Conclusions Parental cancer, primarily the life-threatening cancer, might confer a higher risk of psychiatric disorders among children. These findings have potential implications for health care professionals in providing targeted support to children living with a parent with cancer.

This paper applies Monte Carlo simulations to evaluate the size and power properties in the presence of a structural break, for the standard Augmented Dickey-Fuller (ADF) test versus nonlinear expo ...

Objective To determine the prevalence of selected canine vector-borne diseases (Leishmania infantum, Anaplasma spp., Ehrlichia canis, Borrelia burgdorferi and Dirofilaria immitis) and endo- and ectoparasites in Samoan dogs presenting for surgical sterilisation and to report on the general health management of the dogs. Methods This study was a prospective serological cross-sectional survey. Management data were obtained for 242 dogs by interview with their owners. Blood samples were collected from 237 dogs and screened for the canine vector-borne diseases using point-of-care qualitative ELISA assays. Anaplasma spp. positive samples were screened by PCR and sequenced for species identification. Rectal faecal samples were collected from 204 dogs for faecal flotation and immunofluorescent antibody tests were performed for Giardia and Cryptosporidium spp. on a subset of 93 faecal samples. The skin and coat of 221 dogs were examined for presence of ectoparasites. Results The D. immitis antigen was detected in 46.8% (111/237) of dogs. Seroprevalence of Anaplasma spp. was 8.4% (20/237); A. platys was confirmed by PCR. Prevalence of hookworm was 92.6% (185/205) and Giardia was 29.0% (27/93). Ectoparasites were detected on 210/221 (95.0%) of dogs examined and 228/242 dogs (94.2%) had previously never received any preventative medication. Conclusions There was a very high prevalence of D. immitis, hookworm and external parasites in Samoan dogs, and prophylactic medication is rarely administered. This is the first report confirming A. platys in Samoa and the South Pacific islands. The public health implications of poor management of the dogs should be considered and investigated further.

Children's value systems develop through youth and influence attitudes and actions. But there is a lack of appropriate measures for children and adolescents. The objective of this study was to construct and validate a questionnaire that reveals distinct value systems among adolescents, and to evaluate the identified value systems' relationship to degree of ego-development and moral development. A quantitative study in a Swedish School with ages 12 through 16 (grades 6 to 9) was performed (N = 204). A set of pattern recognition statistical analyses has been used to identify different profiles of values systems and demonstrate that these systems can be arranged in a hierarchical order similar to other development. Results revealed three value systems in this sample. The identified value systems reflect different degrees of moral and ego-development among children in the study. Three distinct value systems were identified: the first (n = 9) and the second value systems (n = 35) correspond to pre-conventional stages, and the third value system (n = 155) corresponds to early conventional stages of ego development. Ego development scoring of test statements to assess stages. The value system was significantly related to moral development in the personal interest and the maintaining norms schemas of the Defining Issues Test (DIT). However, many students did not complete the entire DIT, so those results should be looked at with caution. It appears that this new test (Test for Adolescent Value Systems - TAVS) does relate to an established ego development rating scale.

The inflammatory milieu plays an important role in colon cancer development and progression. Previously, we have shown that tumor-associated macrophages (TAMs), an important component of the tumor microenvironment, are enriched in tumors compared with normal tissue and confer a poorer prognosis. In the present study, we found that matrix metallopeptidase-9 (MMP-9), which degrades extracellular matrix proteins, was increased in biopsies from colon cancer patients and in mouse xenografts with SW480 cell-derived tumors. SW480 colon cancer cells exposed to M2-like macrophage-conditioned medium (M2-medium) exhibited increased MMP-9 mRNA, protein expression and gelatinase activity. A similar effect was obtained by the addition of tumor necrosis factor-α (TNFα) and leukotriene D4 (LTD4 ). MMP-9 expression and activity were reduced by a TNFα blocking antibody adalimumab and a cysteinyl leukotriene receptor 1 (CysLTR1, the receptor for LTD4 ) antagonist montelukast. M2-medium also induced changes in the epithelial-mesenchymal transition (EMT) markers E-cadherin, β-catenin, vimentin, and snail in SW480 cells. We also found that both M2-medium and TNFα and LTD4 induced stabilization/nuclear translocation of β-catenin. Furthermore, we also observed an elongated phenotype that may indicate increased invasiveness, as confirmed in a collagen I invasion assay. M2-medium increased the invasive ability, and a similar effect was also obtained by the addition of TNFα and LTD4 . The specific MMP inhibitor I or adalimumab and montelukast reduced the number of invasive cells. In conclusion, our findings show that M2-medium enriched in TNFα and LTD4 promote colon cancer cell invasion via MMP-9 expression and activation and the induction of EMT.

The tumor suppressor 15‐hydroxyprostaglandin dehydrogenase (15‐PGDH) is the key enzyme in prostaglandin E2 catabolism and is down‐regulated in colorectal cancer (CRC) tissue. Canonical Wnt signaling is frequently elevated in colon cancers and has been shown to down‐regulate 15‐PGDH expression. Therefore, we have in the current study investigated if the non‐canonical ligand WNT5A relates to increased expression of 15‐PGDH in colon cancer cells. In the same cohort of patients, we demonstrated a parallel and significant loss of 15‐PGDH and WNT5A protein expression in CRC tissues compared with matched normal colon tissues. Furthermore, patients with low 15‐PGDH/WNT5A expression in their tumors showed reduced survival compared with patients with high 15‐PGDH/WNT5A expression. To investigate if WNT5A signaling directly affects 15‐PGDH expression, we performed in vitro analyses of colon cancer cells (HT‐29 and Caco‐2). Both cell lines, when treated with recombinant WNT5A (rWNT5A) or Foxy‐5, a WNT5A‐mimicking peptide, responded by increasing their expression of 15‐PGDH mRNA and protein. Our investigations showed that rWNT5A and Foxy‐5 induced this increased expression of 15‐PGDH through reduced β‐catenin signaling as well as increased JNK/AP‐1 signaling in colon cancer cells. WNT5A signaling also induced increased 15‐PGDH expression in a breast cancer cell line both in vitro and in vivo. In agreement, WNT5A signaling also increased the expression of the differentiation markers sucrose‐isomaltase and mucin‐2 in colon cancer cells. Our results show that WNT5A signaling regulates 15‐PGDH expression, thus uncovering a novel mechanism by which WNT5A acts as a tumor suppressor and suggests that increased 15‐PGDH expression could be used as an indicator of a positive response to Foxy‐5 in patients treated with this WNT5A agonist.

High Body mass index (BMI) has been directly associated with risk of aggressive or fatal prostate cancer. One possible explanation may be an effect of BMI on serum levels of prostate-specific antigen (PSA). To study the association between BMI and serum PSA as well as prostate cancer risk, a large cohort of men without prostate cancer at baseline was followed prospectively for prostate cancer diagnoses until 2015. Serum PSA and BMI were assessed among 15,827 men at baseline in 2010-2012. During follow-up, 735 men were diagnosed with prostate cancer with 282 (38.4%) classified as high-grade cancers. Multivariable linear regression models and natural cubic linear regression splines were fitted for analyses of BMI and log-PSA. For risk analysis, Cox proportional hazards regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) and natural cubic Cox regression splines producing standardized cancer-free probabilities were fitted. Results showed that baseline Serum PSA decreased by 1.6% (95% CI: -2.1 to -1.1) with every one unit increase in BMI. Statistically significant decreases of 3.7, 11.7 and 32.3% were seen for increasing BMI-categories of 25

Carbon nanotubes offer the potential for improved or changed matrix properties, thereby enabling the creation of novel, multifunctional composite materials. By using highly-aligned, multiwall, carb ...

Overseeing the continued recovery, dispersal and management of large carnivore populations while simultaneously considering human viability and welfare requires delicately balancing local concerns for rural communities' livelihood prospects and property vulnerability with international concerns for saving threatened species. In this article, we propose an integrated analytical perspective to elucidate how competing interests and power relationships influence the governance and management of contested wildlife resources. However, simply identifying these patterns is not enough. It is also imperative that the interrelationships between broader biophysical, social, political, economic, and cultural contexts and histories be explored in order to describe, analyze and better understand how and why individual and collective responses vary. In doing this, we drew from findings from a variety of social science disciplines (environmental communication, environmental psychology, human ecology, human geography, poli...

The return of the grey wolf Canis lupus lupus, after a temporary absence, to rural and forest-fringe areas has resulted in more encounters between humans and protected wildlife when wolves prey on farmers' and hunters' living private property. In locations where wolves are considered problematic, permits can be issued for the controlled hunting of individual wolves to protect livestock and companion animals and prevent damage. I examine applications for the targeted removal of problematic wolves in Sweden through lethal control, and authorities' decisions regarding controlled hunting. The empirical basis of the paper is a content analysis of applications for and decisions regarding controlled hunting. The data concern three counties in middle Sweden, with 2002–2010 as the study period. I analyse 1) the applicants' stated reasons for applying for controlled hunting and 2) the authorities' rationales for rejecting or approving these applications. My aim is to identify the aspirations, desires, and motives evident in these texts.In investigating controlled hunting applications and decisions, the paper applies anthropological perspectives on ecosystem management, place and landscape, and decision-making, and the results illustrate the underlying framing of the reasons favouring lethal removal. We encounter a layered reflexive communication of intentions and beliefs regarding the goals and interests that should guide state action to manage wolves demonstrating ‘transgressive’ and ‘unnatural’ behaviour threatening the local social and cultural environment. Perceptions diverge regarding how best to understand the natural landscape and how such understandings are embodied in applications and decisions regarding the targeted removal of wolves.

Introduction Wheat sensitization is common but IgE antibodies (IgE-abs) to wheat are not predictive of clinical symptoms in children with suspected wheat allergy. Wheat allergen components other than ω-5 gliadin have not been well studied. Our aim was to characterize the clinical profile and investigate the value of adding measurements of IgE-abs to wheat components in a group of children with a doctor's diagnosed wheat allergy. Method Sixty-three children with a doctor's diagnosis of wheat allergy confirmed sensitization to wheat and, on a wheat elimination diet, went through oral wheat challenges or had a convincing recent history of wheat allergy. IgE-ab to ω-5 gliadin, low molecular weight glutenin (LMW-glutenin), high molecular weight glutenin (HMW-glutenin) and a native gliadin preparation containing α-, β-, γ-, and ω-gliadin (gliadin) were analyzed. Results Twenty-six children were positive in challenge, while six children were regarded as wheat allergic due to recent anaphylactic reactions. The IgE-ab levels to all four wheat components were significantly higher in the group with wheat allergy compared to the group with no wheat allergy (p

Studies have found an association between low birth weight and ADHD, but the nature of this relation is unclear. First, it is uncertain whether birth weight is associated with both of the ADHD dimensions, inattentiveness and hyperactivity-impulsivity. Second, it remains uncertain whether the association between birth weight and ADHD symptom severity is confounded by familial factors.Parents of all Swedish 9- and 12-year-old twins born between 1992 and 2000 were interviewed for DSM-IV inattentive and hyperactive-impulsive ADHD symptoms by the Autism - Tics, AD/HD and other Comorbidities (A-TAC) inventory (N = 21,775 twins). Birth weight was collected prospectively through the Medical Birth Registry. We used a within-twin pair design to control for genetic and shared environmental factors.Reduced birth weight was significantly associated with a mean increase in total ADHD (β = -.42; 95% CI: -.53, -.30), inattentive (β = -.26; 95% CI: -.33, -.19), and hyperactive-impulsive (β = -.16; 95% CI: -.22, -.10) symptom severity. These results imply that a change of one kilogram of birth weight corresponded to parents rating their child nearly one unit higher (going from "no" to "yes, to some extent" on a given symptom) on the total ADHD scale. These associations remained within pairs of MZ and DZ twins, and were also present when restricting the analyses to full term births.There is an independent association between low birth weight and all forms of ADHD symptoms, even after controlling for all environmental and genetic confounds shared within twin pairs. These results indicate that fetal growth restriction (as reflected in birth weight differences within twin pairs) and/or the environmental factors which influence it is in the casual pathway leading to ADHD.