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The aim of this study was to explore, analyse, and critically discuss conditions for Swedish ICT coordinators working on school digitalisation in a local municipal school context. More specifically, the study draws on findings from interviews with 13 Swedish information and communication technology (ICT) coordinators working in eight municipalities that have adopted two contrasting approaches to school digitalisation. One is a general approach with a strong element of individual within-school accountability in the work, and the other a specific approach in which such work is addressed more as an organisational process with involvement of municipal governing officials. Findings show that the two approaches set different conditions in terms of how and with whom the ICT coordinators work and the foci of their efforts although both are framed by the same national educational policy. A conclusion is that the ICT coordinators' role, function, and responsibility should be considered in parity to the level of support, in-school resources, and mandate given to them, not least when organisational instability and reorganisations hamper the work in progress.

This study compares creativity test performance in Individual versus Team settings, addressing a gap in research that mostly focuses on individual outcomes. A total of 120 individuals participated in two sessions. The first session involved cognitive assessments, including the Advanced Progressive Matrices (APM), the Creative Reasoning Test (CRT), and the Test for Creative Thinking–Drawing Production (TCT-DP), as well as mood and personality questionnaires. In the second session, participants were assigned to either an Individual or a Team condition (N=3 each), based on and controlling for APM scores. The same assessments, except for the personality questionnaire, were conducted in this second session. In the Team condition, members were encouraged to collaborate in solving the tasks. We tested whether the conditions have a differential effect on the second session performances, particularly on divergent and convergent thinking scores in CRT, and/or on TCT-DP scores and/or on APM scores.

Ancestral Coast Salish societies in the Pacific Northwest kept long-haired woolly dogs that were bred and cared for over millennia. However, the dog wool-weaving tradition declined during the 19th century, and the population was lost. In this study, we analyzed genomic and isotopic data from a preserved woolly dog pelt from Mutton, collected in 1859. Mutton is the only known example of an Indigenous North American dog with dominant precolonial ancestry postdating the onset of settler colonialism. We identified candidate genetic variants potentially linked with their distinct woolly phenotype. We integrated these data with interviews from Coast Salish Elders, Knowledge Keepers, and weavers about shared traditional knowledge and memories surrounding woolly dogs, their importance within Coast Salish societies, and how colonial policies led directly to their disappearance.

Abstract Background Numerous studies have investigated links between body mass index (BMI) trajectories and cardiovascular risk, yet discrepancies in BMI measurement duration and timing of the cardiovascular-related outcome evaluation have led to inconsistent findings. Methods We included participants from the Swedish birth cohort (BAMSE) and applied latent class mixture modeling to identify BMI trajectories using data of multiple BMI measures (≥ 4 times) from birth until 24-year follow-up (n = 3204). Subsequently, we analyzed the associations of BMI trajectories with lipids (n = 1974), blood pressure (n = 2022), HbA1c (n = 941), and blood leukocytes (n = 1973) using linear regression. We also investigated the circulating levels of 92 inflammation-related proteins (n = 1866) across BMI trajectories. Results Six distinct BMI groups were identified, denoted as increasing—persistent high (n = 74; 2.3%), high—accelerated increasing (n = 209; 6.5%), increasing—accelerated resolving (n = 142; 4.4%), normal—above normal (n = 721; 22.5%), stable normal (n = 1608; 50.2%), and decreasing—persistent low (n = 450; 14.1%) BMI groups. The increasing—persistent high and high—accelerated increasing BMI groups had higher levels of total cholesterol [mean difference (95% confidence intervals): 0.30 (0.04–0.56) and 0.16 (0.02–0.31) mmol/L], triglyceride, low-density lipoprotein, hemoglobin A1C [3.61 (2.17–5.54) and 1.18 (0.40–1.98) mmol/mol], and low-density lipoprotein/high-density lipoprotein ratios, but a lower level of high-density lipoprotein than the stable normal BMI group. These two groups also had higher leukocyte cell counts and higher circulating levels of 28 inflammation-related proteins. No increased cardiometabolic markers were observed in the increasing—accelerated resolving BMI group. Conclusions Participants with persistently high or accelerated increasing BMI trajectories from birth to young adulthood have elevated levels of cardiometabolic risk markers at young adulthood than those with stable normal BMI. However, a raised BMI in childhood may not be inherently harmful to cardiometabolic health, provided it does not persist into adulthood.

Abstract Background Problem-solving interventions with workplace involvement (PSI-WPI) have been shown to reduce sick leave and increase return to work in an occupational health services context. However, many employees struggle with reduced work functioning, anxiety-, and depressive symptoms up to 12 months after a sick leave episode, and it is unclear if the intervention affects outcomes other than sick leave. The aim of this study is to investigate if a PSI-WPI added to care as usual (CAU) is superior to CAU with respect to self-reported sick leave, psychological symptoms, work ability, work performance, and health after RTW when provided in primary care. Methods Employed individuals aged 18–59 years on sick leave (2 to 12 weeks) diagnosed by a physician at a primary care center with mild to moderate depression, anxiety, or adjustment disorder were enrolled in a two-armed cluster-randomised trial evaluating the effectiveness of a PSI-WPI. Multiple outcomes were recorded at baseline, six months, 12 months, and every fourth week during the study period. Outcomes were categorised into psychological symptoms, health, work ability, work performance, and self-reported sick leave. Data were analysed using MANOVA, GEE (Generalized Estimating Equations), and cox regression. Results One hundred ninety-nine individuals responded to the invitation to participate; one participant withdrew, one was excluded as the employment ended, nine did not answer the baseline survey, and three were removed from the analysis due to missing data. The analysis included 81 subjects who received the intervention and 104 subjects who received the control. Baseline characteristics were similar across both groups. No differences between the groups were found among either variables except one. There was a significant difference between the groups in self-rated health (EQ5D) in favour of the CAU group from baseline to six-month follow-up, with a mean difference of -8.44 (-14.84, -2.04). Conclusions A problem-solving intervention with workplace involvement added to CAU did not result in statistically significant reductions in outcomes. Further research is needed to understand why problem-solving interventions appear to have an effect on sick leave in an occupational health services context and not in a primary care context. Trial registration NCT3346395, registration date 2017–11-17.

Abstract Background Social and emotional development are important aspects of young children’s well-being but can be difficult to assess during the first years of life. The Ages and Stages Questionnaire: Social-Emotional Second Edition (ASQ:SE-2) is a parent-rated assessment tool for child socioemotional development between 1 and 72 months of age. In this study, we examined the psychometric properties of this instrument in 18-month-old Swedish children. Methods Data from 586 Swedish-speaking parents of 18-month-old children were included. In addition to the ASQ:SE-2, parents also completed the Social-Emotional Assessment/Evaluation Measure (SEAM), and the child’s socioemotional development was assessed by a nurse at the Child Health Services. We used exploratory factor analysis and Rasch methodology to explore dimensionality and item properties of the ASQ:SE-2. Furthermore, we used Pearson and Spearman rank correlations to study associations with the SEAM and the nurse assessment. Results An exploratory factor analysis suggested a one-factor model for the ASQ:SE-2 items. However, several items showed weak factor loadings, and a final scale including 18 of the original 29 items was further explored. The Rasch analysis revealed problems with targeting, and the final scale showed acceptable reliability only in the 22% with the highest levels of socioemotional difficulties. The total score of the final version showed a strong association with the parent-rated SEAM but a weak association with the nurse observations. We labeled the reduced 18-item scale Social Interaction. Conclusions The results of this study highlight that the original Swedish version of the ASQ:SE-2 for 18-month-old children may not be an adequate tool for assessing social and emotional competencies in a normal population since acceptable reliability was reached only in children with the greatest difficulties (above the 78th percentile). In conclusion, the suggested 18-item version works best either as a screening instrument for problems with social interaction or as a continuous measure of such problems in children with high levels of social interaction difficulties.

Abstract Background Activated fibroblast-like synoviocytes (FLS) are drivers of synovitis and structural joint damage in rheumatoid arthritis (RA). Despite the use of disease-modifying drugs, only about 50% of RA patients reach remission in real-world settings. We used an unbiased approach to investigate the effects of standard-of-care methotrexate (MTX) and a Janus kinase inhibitor, tofacitinib (TOFA), on gene expression in RA-FLS, in order to identify untargeted disease mediators. Methods Primary RA-FLS were activated by stimulation with interleukin-1β (IL-1β) or platelet-derived growth factor + IL-1β in the presence or absence of MTX or TOFA, with or without additional inhibitors. Co-cultures of synovial cells were performed in direct and indirect systems. Cells were collected for RNA sequencing or qPCR, and supernatants were analyzed for protein concentrations. Results Six thousand three hundred fifty genes were differentially expressed, the majority being upregulated, in MTX-treated activated RA-FLS and 970 genes, the majority being downregulated, in TOFA-treated samples. Pathway analysis showed that MTX had largest effects on ‘Molecular mechanisms of cancer’ and TOFA on ‘Interferon signaling’. Targeted analysis of disease-associated genes revealed that MTX increased the expression of cell cycle-regulating genes but also of pro-inflammatory mediators like IL-1α (IL1A) and granulocyte–macrophage colony-stimulating factor, GM-CSF (CSF2). The MTX-promoted expression of CSF2 in activated RA-FLS peaked at 48 h, could be mediated via either NF-κB or AP-1 transcription factors, and was abrogated by IL-1 inhibitors (IRAK4 inhibitor and anakinra). In a co-culture setting, MTX-treatment of activated RA-FLS induced IL1B expression in macrophages. Conclusions MTX treatment induces secretion of IL-1 from activated RA-FLS which by autocrine signaling augments their release of GM-CSF. This unexpected effect of MTX might contribute to the persistence of synovitis.

Kaisa Bjuresäter,1 Mattias Bergström Andrén,2,3 Elina Mäki-Torkko,4,5 Agneta Anderzén-Carlsson,6 Per-Inge Carlsson2,5 1Institution of Health Sciences, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden; 2Department of Audiology, Central Hospital, Region Värmland, Karlstad, Sweden; 3School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; 4Audiological Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; 5School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; 6University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, SwedenCorrespondence: Kaisa Bjuresäter, Email kaisa.bjuresater@kau.seBackground: Hearing loss increases with age and due to increased life expectancy there is an increase in the number of individuals living with hearing loss. Older people with hearing loss residing in nursing homes are often dependent on healthcare professionals to help them with their hearing aids.Objective: The aim of the study was to translate and test the psychometric properties of a Swedish version of a Norwegian questionnaire and to assess healthcare professionals’ self-reported knowledge, experience, skills, competence, and information needs pertaining to residents’ hearing loss and hearing aids in the Swedish context.Materials and Methods: A Norwegian questionnaire was translated and adapted, and thereafter distributed to healthcare professionals in nine nursing homes in mid Sweden between 2020 and 2021, and 313 questionnaires were returned.Results: An exploratory factor analysis demonstrated adequate factorial structure in six factors, satisfying construct validity and internal consistency for the Swedish version. A confirmatory factor analysis showed a satisfactory model fit. Healthcare professionals reported having the skills required for handling hearing aids, but reported lower scores for having received information about hearing aids, taking initiatives to refer residents to hearing healthcare units, and checking for earwax. Registered nurses generally reported lower perceived knowledge and practical skills concerning hearing aids. Seventy-seven percent of the total group reported a need for information regarding hearing aid maintenance.Conclusion: Healthcare professionals reported that the majority of nursing home residents need help with their hearing aids, but only a minority of these professionals had received education on hearing loss and training in hearing aid maintenance. Enrolled nurses and care assistants demonstrated higher levels of competence in handling hearing aids compared to registered nurses. In order to ensure safe and effective care, as well as facilitate communication among older adults with hearing loss, healthcare professionals need appropriate education and training.Keywords: hearing loss, nursing homes, health care professionals, competence, instrument translation, psychometric testing

Abstract Steatotic liver disease has been shown to associate with cardiovascular disease independently of other risk factors. Lipoproteins have been shown to mediate some of this relationship but there remains unexplained variance. Here we investigate the plasma lipidomic changes associated with liver steatosis and the mediating effect of these lipids on coronary artery disease (CAD). In a population of 2579 Swedish participants of ages 50 to 65 years, lipids were measured by mass spectrometry, liver fat was measured using computed tomography (CT), and CAD status was defined as the presence of coronary artery calcification (CAC score > 0). Lipids associated with liver steatosis and CAD were identified and their mediating effects between the two conditions were investigated. Out of 458 lipids, 284 were found to associate with liver steatosis and 19 of them were found to also associate with CAD. Two fatty acids, docosatrienoate (22:3n6) and 2-hydroxyarachidate, presented the highest mediating effect between steatotic liver disease and CAD. Other mediators were also identified among sphingolipids and glycerophospholipids, although their mediating effects were attenuated when adjusting for circulating lipoproteins. Further research should investigate the role of docosatrienoate (22:3n6) and 2-hydroxyarachidate as mediators between steatotic liver disease and CAD alongside known risk factors.

This article explores students’ perspectives on English language learning in relation to the Language Introduction Programme in Sweden, which is an individual transitional programme for newly arrived immigrants and seeks to quickly transition adolescents into further education or the job market. High proficiency in English is vital in Swedish society, and insufficient knowledge of English can lead to negative long-term consequences for both individuals and society regarding inequality. The methodology used is based on linguistic ethnography, and the data for this article consists of eight semi-structured interviews with students in the programme at one school. Foucauldian perspectives are used to analyse power and the construction of language ideologies relating to the multilingual English-language classroom and learner identity. The results show that the importance of proficiency in English for a success- ful educational transition from the Language Introduction Programme is rarely communicated to students. Furthermore, English is positioned as a subject of low importance within the organisation. The results also show that monolingual norms and language hierarchies limit the stu- dents’ ability to use their first language when learning English.

Abstract Background Spinal manipulation (SM) has been claimed to change anatomy, either in structure or position, and that these changes may be the cause of clinical improvements. The aim of this systematic review was to evaluate and synthesise the peer-reviewed literature on the current evidence of anatomical changes in response to SM. Methods The review was registered with PROSPERO (CRD42022304971) and reporting was guided by the standards of the PRISMA Statement. We searched Medline, Embase, CINAHL, AMED, Cochrane Library all databases, PEDro, and the Index to Chiropractic Literature from inception to 11 March 2022 and updated on 06 June 2023. Search terms included manipulation, adjustment, chiropractic, osteopathy, spine and spine-related structures. We included primary research studies that compared outcomes with and without SM regardless of study design. Manipulation was defined as high-velocity, low-amplitude thrust delivered by hand to the spine or directly related joints. Included studies objectively measured a potential change in an anatomical structure or in position. We developed a novel list of methodological quality items in addition to a short, customized list of risk of bias (RoB) items. We used quality and RoB items together to determine whether an article was credible or not credible. We sought differences in outcomes between SM and control groups for randomised controlled trials and crossover studies, and between pre- and post-SM outcomes for other study designs. We reported, in narrative form, whether there was a change or not. Results The search retrieved 19,572 articles and 20 of those were included for review. Study topics included vertebral position (n = 3) facet joint space (n = 5), spinal stiffness (n = 3), resting muscle thickness (n = 6), intervertebral disc pressure (n = 1), myofascial hysteresis (n = 1), and further damage to already damaged arteries (n = 1). Eight articles were considered credible. The credible articles indicated that lumbar facet joint space increased and spinal stiffness decreased but that the resting muscle thickness did not change. Conclusion We found few studies on this topic. However, there are two promising areas for future study: facet joint space and spinal stiffness. A research strategy should be developed with funding for high quality research centres.

Abstract Background Environmental bacteria in animal healthcare facilities may constitute a risk for healthcare-associated infections (HAI). Knowledge of the bacterial microflora composition and factors influencing the environmental bacterial load can support tailored interventions to lower the risk for HAI. The aims of this study were to: (1) quantify and identify environmental bacteria in one operating room (OR) and one ultrasound room (UR) in a small animal hospital, (2) compare the bacterial load to threshold values suggested for use in human healthcare facilities, (3) characterise the genetic relationship between selected bacterial species to assess clonal dissemination, and (4) investigate factors associated with bacterial load during surgery. Settle plates were used for passive air sampling and dip slides for surface sampling. Bacteria were identified by Matrix Assisted Laser Desorption—Time Of Flight. Antimicrobial susceptibility was determined by broth microdilution. Single nucleotide polymorphism-analysis was performed to identify genetically related isolates. Linear regression was performed to analyse associations between observed explanatory factors and bacterial load. Results The bacterial load on settle plates and dip slides were low both in the OR and the UR, most of the samples were below threshold values suggested for use in human healthcare facilities. All settle plates sampled during surgery were below the threshold values suggested for use in human clean surgical procedures. Staphylococcus spp. and Micrococcus spp. were the dominating species. There was no indication of clonal relationship among the sequenced isolates. Bacteria carrying genes conveying resistance to disinfectants were revealed. Air change and compliance with hygiene routines were sufficient in the OR. No other factors possibly associated with the bacterial load were identified. Conclusions This study presents a generally low bacterial load in the studied OR and UR, indicating a low risk of transmission of infectious agents from the clinical environment. The results show that it is possible to achieve bacterial loads below threshold values suggested for use in human healthcare facilities in ORs in small animal hospitals and thus posing a reduced risk of HAI. Bacteria carrying genes conveying resistance to disinfectants indicates that resistant bacteria can persist in the clinical environment, with increased risk for HAI.

Abstract Turner syndrome (TS) is a genetic condition characterized by partial or complete monosomy X. A reduced life expectancy has been shown in TS, depending on an increased risk of aortic dissection, and ischemic heart disease. Studies covering the occurrence of psychiatric conditions are sparse within TS. Several case reports describe concomitant TS and neuropsychiatric abnormalities that may represent a pathogenetic link to genetics, as well as feature correlates of TS. The aim of this study was to determine the presence, and the frequency of psychiatric diagnosis in women with TS in a Swedish cohort followed during 25 years’ time. Statistics from the entire female population in Sweden of corresponding age was used as reference. Data were retrieved from clinical examinations and validated from the National Board of Health and Welfare registries for women with TS (n = 487), aged 16 to 84 years, with respect to mental health disorders. The most common diagnoses in TS were mood and anxiety disorders. There was no increase in psychiatric diagnosis within the group with time, nor correlation to specific karyotype or somatic comorbidity as congenital heart disease and hypothyroidism, hormonal treatment, or childbirth. In addition, the frequency of psychiatric diagnosis in TS was lower than in the population-based data. Further investigations are needed in the view of the fact that women with Turner syndrome should not be burdened with more severe diagnoses.

Learning vocabulary is a central and time-consuming endeavour for a language learner and it has thus been suggested that the foreign language classroom has to supply explicit support for students' vocabulary development. A major source of explicit word focus is vocabulary exercises in teaching materials and students' learning can be facilitated if they are designed in a way that is conducive to learning. Few studies have so far sought to establish what learning opportunities tasks in materials provide. The present study reports an analysis of the vocabulary exercises in three series of Swedish intermediate EFL materials, focusing on target vocabulary and learning conditions. The target vocabulary was analysed in terms of frequency distribution in general English and the learning conditions provided were studied using a modified version of the Involvement Load Hypothesis. The results indicate that learning is facilitated through extensive retrieval opportunities in the material. However, it was also found that the exercises seldom require students to use the target vocabulary and that it comprises primarily high-frequency words, that is, words that the learners are likely to already know. It is therefore concluded that a more systematic approach to vocabulary has to be adopted by materials developers to ensure that word-focused tasks contribute significantly to students' learning.