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Autonomous vehicles promise to revolutionize society and improve the daily life of many, making them a coveted aim for a vast research community. To enable complex reasoning in autonomous vehicles, researchers are exploring new methods beyond traditional engineering approaches, in particular the idea of drawing inspiration from the only existing being able to drive: the human. The mental processes behind the human ability to drive can inspire new approaches with the potential to bridge the gap between artificial drivers and human drivers. In this review, we categorize and evaluate existing work on autonomous driving influenced by cognitive science, neuroscience, and psychology. We propose a taxonomy of the various sources of inspiration and identify the potential advantages with respect to traditional approaches. Although these human-inspired methods have not yet reached widespread adoption, we believe they are critical to the future of fully autonomous vehicles., CC BY-NC-ND 4.0 DEED© 2023Corresponding author: E-mail address: alice.plebe@unitn.it (A. Plebe)

Background: Stimulating activities are associated with a decreased risk of dementia. However, the extent to which this reflects a protective effect of activity or non-participation resulting from dementia is debated. We investigated the association of stimulating leisure-time activity in late adulthood with the risk of dementia across up to two decades' follow-up. Methods: We used data from five prospective cohort studies from Finland and Sweden. Mental, social, outdoor, consumptive and physical leisure-time activities were self-reported. Incident dementia was ascertained from clinical diagnoses or healthcare and death registers. Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results: Of the 33 263 dementia-free individuals aged ≥50 years at baseline, 1408 had dementia during a mean follow-up of 7.0 years. Active participation in mental (HR: 0.52, 95% CI: 0.41 to 0.65), social (HR: 0.56 95% CI: 0.46 to 0.72), outdoor (HR: 0.70, 95% CI: 0.58 to 0.85), consumptive (HR: 0.67, 95% CI: 0.53 to 0.94) and physical (HR: 0.62, 95% CI: 0.51 to 0.75) activity, as well as variety (HR: 0.54, 95% CI: 0.43 to 0.68) and the overall frequency of activity (HR: 0.41, 95% CI: 0.34 to 0.49) were associated with a reduced risk of dementia in <10 years' follow-up. In ≥10 years' follow-up all associations attenuated toward the null. Conclusion: Stimulating leisure-time activities are associated with a reduced risk of dementia in short-term but not long-term follow-up. These findings may reflect a reduction in leisure-time activity following preclinical dementia or dilution of the association over time., CC BY 4.0 Deed© 2024 The Author(s)Correspondence Address: K. Heikkilä; Department of Public Health, University of Turku, Turku, Kiinamyllynkatu 10, 20520, Finland; email: katriina.heikkila@utu.fi; CODEN: AANGASNAC-K receives financial support from the Swedish Research Council (Vetenskapsrådet, 2011-6,243; 2017-06088), the Swedish Research Council for Health, Working Life and Welfare (FORTE, 2016-07175), and is supported by the Swedish Ministry of Health and Social Affairs and the participating County Councils and Municipalities. MK was supported by Wellcome Trust (221854/Z/20/Z), UK Medical Research Council (S011676, Y014154), US National Institute on Aging (NIH, R01AG056477, R01AG062553), and Research Council Finland (350426). JV was supported by the Academy of Finland (321409 and 329240). S Stenholm was supported by Research Council Finland (332030), Juho Vainio Foundation and Signe and Ane Gyllenberg Foundation. S Stenlund was supported by Signe and Ane Gyllenberg Foundation. The authors thank the research teams that collected, linked and curated data and especially all the individuals who participated in the longitudinal cohort studies.

Purpose: The paper aims to explore how values and knowledge are expressed in student’s discussions about food and health. Design/methodology/approach: Food practices present a complex phenomenon extending beyond biomedical descriptions, including social dynamics of food in families and communities. Contextual conditions of social groups and settings have significant impacts on food choices and practices. Although values constitute a central part of educational goals, deliberate values education remains an often-neglected area, with a tendency in both curricula and educational practice to focus on knowledge and overlook how values intersect with knowledge. The paper utilises group interviews supported by participant observations to study the food and health practices as expressed in students' discussions. Findings: The paper’s findings show how values are expressed together with knowledge as value-knowledges around food and health within the social contexts of family, cultural identities and peer relationships. While moving through their lives, students draw on and utilise biomedical, social-cultural and sensory value-knowledges, simultaneously considering the nutrition and taste of foods, the value of connecting with family and peers in cultural settings as well as getting enough food to feel satiated. Originality/value: The paper presents an original approach around the necessity to consider and integrate cultural identities in discussions and education about food and health to empower students and their communities in a way that is socially just and equitable. This involves shifting discussions of health education away from students as (ir)rational obstacles but rather as partners in co-creating knowledge for sustainable food and health equity. © 2024, Emma Oljans, Tecklah Usai, Doroth Chinofunga and Martin Mickelsson.

Little is known about the experiences of the social partners in helping undeclared workers resist Occupational Safety and Health (OSH) issues. This study draws upon Walter Korpi’s ‘power resource theory’ to gain a deeper understanding of how power resources within the construction, transport, and cleaning sectors influence the ability of social partners to respond to OSH issues related to undeclared work. This mixed-method study uses survey data from employer representatives in the construction (n = 686) and transport (n = 650) sectors in Sweden in 2019 to estimate the nature and magnitude of undeclared work-related problems. To also study the view of union representatives, a duplicate survey was sent to union representatives in the transport, construction, and cleaning sectors (n = 57) in 2020, followed by 13 semi-structured interviews with Regional Safety Representatives (RSRs) in 2021–2023. Our findings show that employer representatives in construction and transport reported that the violation of OSH regulations was uncommon and remained unchanged, most union representatives said the opposite. We found a gradient of activism among the unions towards OSH issues related to undeclared work dependent on their power resources. Furthermore, structural and organizational factors limited the RSRs’ ability to address undeclared work. The RSRs identified strategies to tackle OSH issues related to undeclared work in their sectors, these included but were not limited to, dismantling the language barrier between unions and undeclared foreign-born workers, for OSH coordinators and main contractors to be held responsible for OSH violations and greater cooperation between the relevant authorities dealing with undeclared work.

Introduction: Risk-allele carriers of a Monoamine oxidase A (MAOA) gene, short-allele (MAOA-S) in males and long-allele (MAOA-L) in females, in the presence of a negative environment, are associated with alcohol misuse. Whether MAOA-S/L alleles also present susceptibility to a positive environment to mitigate the risk of alcohol misuse is unknown. Thus, we assessed the association of the three-way interaction of MAOA, maltreatment, and positive parent-child relationship with alcohol consumption among adolescents. Methods: This prospective study included 1416 adolescents (females: 59.88%) aged 16 ̵ 19 years from Sweden, enrolled in the “Survey of Adolescent Life in Västmanland” in 2012. Adolescents self-reported alcohol consumption, maltreatment by a family (FM) or non-family member (NFM), parent-child relationship, and left saliva for MAOA genotyping. Results and discussion: We observed sex-dependent results. Females carrying MAOA-L with FM or NFM and a good parent-child relationship reported lower alcohol consumption than those with an average or poor parent-child relationship. In males, the interactions were not significant. Results suggest MAOA-L in females, conventionally regarded as a “risk”, is a “plasticity” allele as it is differentially susceptible to negative and positive environments. Results highlight the importance of a good parent-child relationship in mitigating the risk of alcohol misuse in maltreated individuals carrying genetic risk. However, the interactions were not significant after adjusting to several environmental and behavioural covariates, especially parent’s alcohol use, negative parent-child relationship, and nicotine use (smoking and/or snus), suggesting predictor and outcome intersection. Future studies and frameworks for preventive strategies should consider these covariates together with alcohol consumption. More studies with larger sample sizes are needed to replicate the findings.

Background: Handgrip strength (HGS) is a surrogate marker of whole body strength that has been observed to correlate inversely with the metabolic syndrome (MetS). In this study, we examined whether HGS in young, healthy individuals, was associated with surrogate endpoints of the MetS. A secondary goal was to examine whether absolute HGS (absHGS) or relative HGS (relHGS) was a stronger predictor of MetS. Method: 834 subjects (577 women), aged 18–26, were recruited. Surrogate endpoints for MetS were waist circumference, HDL, fasting glucose, fasting insulin, triglycerides, and systolic and diastolic blood pressure (BP). We also examined the association between HGS and body fat percentage, HOMA-IR, CRP, orosomucoid and apolipoprotein A-1 and apolipoprotein B. The associations were examined using multivariable linear regression. Results: AbsHGS and relHGS were each associated with several surrogate endpoints of the metabolic syndrome, with RelHGS being statistically significantly associated with a greater number of the variables – all except fasting glucose and diastolic BP. Conclusion: RelHGS correlates with components of the MetS even in young, healthy populations. It is a better predictor of MetS components than absHGS. As a cheap and easy to use biomarker, relHGS holds merit as a screening tool for metabolic dysfunction even in preclinical contexts.

Although structural violence is known to interact with and reinforce direct violence in the form of interpersonal violence (e.g., intimate partner violence), little debate takes place in public health on how it can lead to revictimization, leading to even poorer health outcomes (including psychological ill health). This viewpoint aims to discuss this issue using examples from empirical studies to elucidate how structural violence (perpetrated through institutions) contributes to revictimization among people who are already suffering direct violence. Public health professionals (and researchers) need to make efforts to theorize and measure structural violence to aid efforts toward the study of how it intersects with interpersonal violence to influence health outcomes. This will ultimately contribute to better prevention and intervention efforts to curb interpersonal violence and improve population health and well-being. In addition, there is a need to include structural violence in the academic curriculum when training future generations of public health professionals. Increased education on structural violence will bring about an awareness of the grave consequences of the potential additional harm that institutions could inflict on the lives of people they should be protecting or care for., CC BY 4.0© 2023 The Author(s).

Background: Literature indicates the need to prepare health professionals who are clinically competent and socially conscious. Engagement in community projects, as an extension of workplace learning, can build professional competence and social awareness. Aim: To interrogate one such engagement; an emergency first aid responder training course was orchestrated by undergraduate students studying Emergency Medical Care. Setting: The intervention was offered in response to a community need emerging from the research project being conducted in a community in the Western Cape, South Africa. Method: Qualitative data were gathered as narrative texts from participants in the intervention and student reports about their learning experience. The data were interrogated through the application of reflexive thematic analysis and the theoretical lens of asymmetrical reciprocity. Findings: The three themes that emerged were: from research to a student led intervention, deep authentic learning, and learning as a shared experience. Benefit accrued to the students and community through a partnership of asymmetrical participants. The community offered a learning experience while students offered desired skills acquisition to community members. Conclusion: Through this interaction, students learnt respect for local knowledges, and gained enhanced social awareness, in a transdisciplinary partnership, that aimed to create a learning environment where academics, students, and community members are partners in a project delivered with a core value of social justice. Contribution: A pedagogy of partnership describes an education model arising from community-based research that enabled a social programme intervention as a relevant learning project for health science students.

Background: Continuity of care constitutes the basis of primary health care services and is associated with decreased hospitalization. In Finland, accessibility to primary care and increased use of hospital services are recognized challenges for the health care system. Objectives: The aim of the study was to determine whether having a named GP is associated with hospital service use. Methods: The data are part of the Health and Social Support study (HeSSup) based on a random Finnish working-age population sample. The cohort of the study comprised participants of postal surveys in 1998 (n = 25,898) who returned follow-up questionnaires both in 2003 and 2012 (n = 11,924). Background characteristics were inquired in the questionnaires, and hospitalization was derived from national registries (Hilmo-register). Results: A named GP was reported both in 2003 and 2012 only by 34.3% of the participants. The association between hospital days and a named GP was linearly rising and statistically significant in a single predictor model. The strongest associations with hospital use were with health-related factors, and the association with a named GP was no longer significant in multinomial analysis. Conclusion: A named GP is associated with an increased use of hospital days, but in a multinomial analysis the association disappeared. Health related factors showed the strongest association with hospital days. From the perspective of the on-going Finnish health and social services reform, continuity of care should be emphasized., CC BY 4.0 DEEDCC0 1.0 DEED© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.Correspondence Address: E. Lautamatti; Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; email: emmi.lautamatti@tuni.fiOpen access funding provided by Tampere University (including Tampere University Hospital). A personal grant was awarded to the corresponding author by the Foundation of General Practice, General Practitioners in Finland (GPF), Tampere University Hospital, The Finnish Medical Association and The Finnish Medical Foundation (No. 7045).

In 2022, we celebrated 200 years since the birth of Johann Gregor Mendel. Although his contributions to science went unrecognized during his lifetime, Mendel not only described the principles of monogenic inheritance but also pioneered the modern way of doing science based on precise experimental data acquisition and evaluation. Novel statistical and algorithmic approaches are now at the center of scientific work, showing that work that is considered marginal in one era can become a mainstream research approach in the next era. The onset of data-driven science caused a shift from hypothesis-testing to hypothesis-generating approaches in science. Mendel is remembered here as a promoter of this approach, and the benefits of big data and statistical approaches are discussed.

Operations on high-dimensional, fixed-width vectors can be used to distribute information from several vectors over a single vector of the same width. For example, a set of key-value pairs can be encoded into a single vector with multiplication and addition of the corresponding key and value vectors: the keys are bound to their values with component-wise multiplication, and the key-value pairs are combined into a single superposition vector with component-wise addition. The superposition vector is, thus, a memory which can then be queried for the value of any of the keys, but the result of the query is approximate. The exact vector is retrieved from a codebook (a.k.a. item memory), which contains vectors defined in the system. To perform these operations, the item memory vectors and the superposition vector must be the same width. Increasing the capacity of the memory requires increasing the width of the superposition and item memory vectors. In this article, we demonstrate that in a regime where many (e.g., 1,000 or more) key-value pairs are stored, an associative memory which maps key vectors to value vectors requires less memory and less computing to obtain the same reliability of storage as a superposition vector. These advantages are obtained because the number of storage locations in an associate memory can be increased without increasing the width of the vectors in the item memory. An associative memory would not replace a superposition vector as a medium of storage, but could augment it, because data recalled from an associative memory could be used in algorithms that use a superposition vector. This would be analogous to how human working memory (which stores about seven items) uses information recalled from long-term memory (which is much larger than the working memory). We demonstrate the advantages of an associative memory experimentally using the storage of large finite-state automata, which could model the storage and recall of state-dependent behavior, This research was supported by Air Force Office of Scientific Research Program on Cognitive and Computational Neuroscience, FA9550-19-1-0241. DK has received funding from the European Union’s Horizon 2020 Research and Innovation Programme under the Marie Skłodowska-Curie grant agreement no. 839179. Publication made possible in part by support from the Berkeley Research Impact Initiative (BRII) sponsored by the UC Berkeley Library.

Introduction A positive childbirth experience promotes women’s health, both during and beyond the perinatal period. Understanding what constitutes a positive childbirth experience is thus critical to providing high-quality maternity care. Currently, there is no clear, inclusive, woman-centered definition of a positive childbirth experience to guide practice, education, and research. Aim To formulate an inclusive woman-centered definition of a positive childbirth experience. Methods A six-step process was undertaken: (a) Key concepts associated with a positive childbirth were derived from a rapid literature review; (b) The key concepts were used by interdisciplinary experts in the author group to create a draft definition; (c) The draft definition was presented to clinicians and researchers during a European research meeting on perinatal mental health; (d) The authors integrated the expert feedback to refine the working definition; (e) A revised definition was shared with women from consumer groups in six countries to confirm its face validity; and (f) A final definition was formulated based on the women’s feedback (n = 42). Results The following definition was formulated: “A positive childbirth experience refers to a woman’s experience of interactions and events directly related to childbirth that made her feel supported, in control, safe, and respected; a positive childbirth can make women feel joy, confident, and/or accomplished and may have short and/or long-term positive impacts on a woman’s psychosocial well-being.” Conclusions This inclusive, woman-centered definition highlights the importance of provider interactions for facilitating a positive childbirth experience. Feeling supported and having a sense of control, safety, and respect are central tenets. This definition could help to identify and validate positive childbirth experience(s), and to inform practice, education, research, advocacy, and policy-making., CC BY-NC-ND 4.0Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)© 2022 The Authors. Birth published by Wiley Periodicals LLC.First published: 05 July 2022Correspondence Julia Leinweber, PhD, RM, Institute of Midwifery, Charité - University Medicine Berlin, Oudenarder Strasse 16, 13347 Berlin, Germany. Email: julia.leinweber@charite.de

Oral health is a complex issue associated with social and behavioral factors and general health. Therefore, this study aims to explore Swedish older adults’ perceptions of oral health and its influence on general health, based on the World Dental Federation's (FDI) definition and framework of oral health. The study adopted a descriptive qualitative design. Data were collected from semi-structured individual and focus group interviews with older adults (n = 23) and were analyzed with deductive direct content analysis. The study was evaluated using the COnsolidated criteria for REporting Qualitative research (COREQ) checklist. The older adults described the importance of good oral health in the physical, social, emotional, and mental aspects of their daily lives. The findings also indicate that older adults described oral health as multifaceted and agreed with the FDI's definition and framework of oral health. Therefore, the study findings might provide healthcare professionals with new knowledge and further insight into older adults’ perceptions of oral health and its influence on their well-being and general health., CC BY 4.0Attribution 4.0 International (CC BY 4.0)© The Author(s) 2022.Copyright © 2022 by Vårdförbundet First published online September 13, 2022Corresponding author: Maria Snögren, School of Health Sciences, University of Skövde, Högskolevägen, Box 408, 541 28 Skövde, Sweden. Email: maria.snogren@his.se

Objectives: Limited and inconsistent findings have been reported on the link between social connections and support and emergency department (ED) visits in older populations. Moreover, the adequacy of informal care for older adults has rarely been considered. This study explored the associations of social connections, social support, and informal care with ED visits in younger-old (<78 years) and oldest-old (≥78 years) adults. Methods: This is a prospective cohort study based on community-living adults ≥60 years old participating in the Swedish National Study on Aging and Care in Kungsholmen (N=3066 at wave 1, 2001-2004; N=1885 at wave 3, 2007-2010; N=1208 at wave 5, 2013-2016). Standardised indexes were developed to measure social connections, social support, and informal care. The outcome variable was hospital-based ED visits within 4 years of the SNAC-K interview. Associations between exposure variables and ED visits were assessed through negative binomial regressions using generalised estimating equations. Results: Medium (IRR 0.77; 95% CI 0.59–0.99) and high (IRR 0.77; 95% CI 0.56–0.99) levels of social support were negatively associated with ED visits compared to low levels of social support, but only in oldest-old adults. No statistically significant associations were observed between social connections and ED visits. Higher ED visit rates were seen in oldest-old adults with unmet informal care needs, even if the differences did not reach statistical significance. Conclusions: ED visits were associated with social support levels among adults aged ≥78 years. Public health interventions to mitigate situations of poor social support may improve health outcomes and reduce avoidable ED visits in oldest-old adults. © 2023

BACKGROUND: Loneliness is described as a public health problem and can be both a consequence of aging and a cause of ill health. Lonely older adults tend to have difficulties making new social connections, essential in reducing loneliness. Loneliness often varies over time, but established loneliness tends to persist. Maintaining good health is fundamental throughout the life course. Social connections change with aging, which can contribute to loneliness. AIM: This study aimed to investigate loneliness in relation to social factors and self-reported health among older adults. METHOD: A cross-sectional research design was used based on data from the Swedish National Study on Aging and Care, Blekinge (SNAC-B), from February 2019 to April 2021. Statistical analysis consisted of descriptive and inferential analysis. RESULTS: Of n = 394 participants, 31.7% (n = 125) stated loneliness. Close emotional connections were necessary for less loneliness. Loneliness was more common among those who did not live with their spouse or partner and met more rarely. Furthermore, seeing grandchildren and neighbors less often increased loneliness, and a more extensive social network decreased loneliness. CONCLUSION: This study underlined the importance of social connections and having someone to share a close, emotional connection with to reduce loneliness., SNAC

A deeper understanding of care demands the methodological finesse of qualitative research: we must observe, listen, and witness to expose what matters to care recipients. In this paper, we – a team of three: one early-career researcher and two supervisors – reflect on our experiences of designing and then seeking ethics approval for ethnographic research on care for older adults, many of whom demonstrate a lack of capacity to consent to research. Viewing experiences of well-being and dignity as embedded within interpersonal negotiations, this study privileges care home residents' daily life, looking to stories and observations of daily life to reveal the complexities of well-being in the care home setting. This paper emphasizes the importance of using qualitative research methods to gain a deeper understanding of care practices, particularly in the context of care for older adults with varying cognitive capacities. By privileging the daily life experiences of care home residents and employing the logic of process consent, we aim to include the voices of all participants, not just those who can provide written informed consent. However, obtaining ethics approval for this type of research presents several challenges, requiring careful negotiation and the inclusion of consultee advice. This paper highlights the tensions between procedural ethics and the need for better inclusion of vulnerable populations in ethnographic research on care. By addressing these challenges, we can move towards a more context-sensitive and humanised approach to research ethics that values the lived experiences of care recipients.

Aim: To investigate contextual factors and their influence on implementing a 90-credit midwifery education programme for nurses at a university in the eastern DRC. Background: To improve maternal and neonatal health, there is a government policy in the Democratic Republic of Congo (DRC) to educate midwives at a higher education level according to international norms. This study investigates contextual factors and their influence on the implementation of a midwifery education programme which is based on national curriculum and has a profile of person-centred care, simulation-based learning pedagogy and information and communication technology. Method: A qualitative study was conducted with data collected through semi-structured interviews with 22 participants who were directly or indirectly involved in establishing the midwifery education programme. Transcribed interviews were analysed using content analysis. Results: The factors influencing the implementation of the new midwifery education programme comprise facilitating and hindering factors. Facilitating factors were: (i) awareness that midwives educated at a higher education level can deliver higher-quality health care, (ii) women are motivated to seek care from well-educated midwives, (iii) the planned programme is attractive and (iv) the university has a stable academic administration and established collaborations. Hindering factors were: (i) Students’ lack of prerequisites for study; (ii) objections to educating midwives at a higher education level; (iii) inadequate teaching resources; and (iv) inadequate working conditions for midwives. Conclusion: The facilitating factors strengthen the belief that it is possible to implement this midwifery education programme, while the hindering factors need to be addressed to run the programme successfully. The findings can guide higher education institutions starting similar midwifery education programmes in the DRC and elsewhere, although it is crucial to conduct a con

Aim: To describe the meaning of caring for older persons based on the experiences of nursing students in Greece. Background: The present study is conducted based on a caring science perspective derived from a holistic viewpoint of human beings, aiming to support the well-being of older persons. In Greece, informal caregivers play an important role in caring for older people; however, as the population ages, the need for registered nurses specialising in caring for older people is also increasing. Previous research in other countries has reported a relative lack of interest in this field, which is a threat to the quality of care. To ensure an adequate number of new-generation nurses caring for older people, nursing students’ perceptions of the phenomenon of caring for older persons should be well understood and explored in a context where the number of long-term care beds and residential care facilities are low and where informal caregiving is common. Design: Based on Descriptive Phenomenology, in line with the Reflective Lifeworld Research (RLR) approach. Methods: A total of 12 nursing students at a university in Greece underwent in-depth lifeworld interviews online during June and July 2021 and March 2022; Interviews were transcribed verbatim and were analysed according to the principles of RLR that approaches the phenomena with openness and constant reflection. The participants were students in their fourth or fifth year of nursing education; they had previous experience in older person care and were not acquainted with the authors. Results: The results show the essential structure of the meaning of caring for older persons, where otherness consists of intertwined demanding and rewarding elements. The essence is further conveyed by three constituents: otherness of the older person: witnessing someone's vulnerability; trustful caring: struggling with normative structures; and closeness and distance: balancing between familiarity and professionalism. Conclusion: To

Background: In this study, the focus is on how to support the competence development needed for nursing assistants in home care. Home care services for older persons can be challenging concerning the nature of the interpersonal interaction and communication needed to care for and respond to the diverse needs of older people who seek to live well in our communities. This implies a need to offer more person-centred care (PCC) to older persons. However, there is a lack of knowledge on how to develop such competence. We, therefore, developed A Person-centred CommunicaTION (ACTION) programme, which is a web-based educational intervention aimed at supporting competence development for nursing assistants. The research objective is to evaluate the ACTION programme with respect to participants’ responses to and the effect of the intervention. Methods: A multicentre case–control study with pre- and post-assessments was designed. The ACTION programme will be implemented at home care units, in two different geographic areas in Sweden. A total of 300 nursing assistants will be recruited: 150 for the intervention group and 150 for the control group. We will evaluate the impact measures and the process. Pre- and post-assessments will be performed with data collected via a) audio recordings of communication, b) a questionnaire on self-efficacy communication skills, PCC, empathy and job satisfaction, c) user data, evaluation forms, field notes and observations, and d) interviews. The data will be analysed with descriptive and analytic statistics and/or qualitative methods for meanings. Discussion: This study has the potential to contribute to the evidence supporting competence development required to offer person-centred and quality home care to older persons and to meet upcoming needs for flexible and easily accessible competence development. Trial registration: ISRCTN64890826. Registered 10 January 2022, https://www.isrctn.com/ISRCTN64890826

Problem: Little is known about issues of patient-reported problems, in particular within psychiatric services for children with mental ill health. Child and family complaints related to child mental health services can be analyzed and discussed in light of the universal human right to health and healthcare. Therefore, the aim of this study was to analyze child and family complaints related to child mental health services. Methods: A retrospective, descriptive design was used. Child and family complaints were analyzed with a qualitative thematic analysis. Findings: The findings were described in three themes describing lack of access to care, inadequate communication between services and children with mental ill health and their families, and lack of clarity of who is responsible for care, leading to neglect of children's needs. These issues place a huge responsibility on parents or relatives. Conclusion: Better communication within mental health services, and better collaboration with other services such as school and social services, could limit children's suffering. Healthcare services with named professionals who specialize in child mental health and provide continuity in care, are required. General human rights principles should guide planning and care of children.

Aims: To describe nursing students' experiences of a TeamSTEPPS® longitudinal team training program and the application of teamwork skills in clinical practice. Design: A descriptive qualitative design. Methods: Overall, 22 nursing students participated in six online focus group interviews after attending a TeamSTEPPS® team training program from their first semester. The data were audio-recorded, transcribed and analysed using inductive content analysis and reported following the COREQ guidelines. The focus group interviews took place in the students' fifth's semester. Results: The main category “Learning teamwork is not an event; it's a journey” emerged from 3 generic categories and 12 subcategories. The participants reported that grasping the relevance of team training and the use of teamwork skills takes time. Utilizing these skills improved their awareness of being a team member and facilitated learning. Conclusion: Team training raised the participants' awareness of teamwork as an essential component of being a professional nurse. Additionally, understanding the complexity of teamwork takes time.

Background: Worldwide people are living longer. The need for healthcare for older adults is increasing. The trend is towards advanced home healthcare, where registered nurses are key figures. This implies challenges for municipal home healthcare, as well as for registered nurses’ leadership. The aim is to explore registered nurses’ perceptions of challenges and suggestions for improvements in their leadership close to older adults in municipal home healthcare. Methods: The present study is part of a larger web-based questionnaire survey with a cross-sectional design. The design is inductive, analysing data using qualitative content analysis and descriptive statistics. A questionnaire with open-ended and closed-ended questions was used. A total of n = 70 registered nurses leading close to older adults participated in seven municipalities in two geographic areas in Sweden. Results: The results show registered nurses’ perceptions of challenges as leaders close to older adults in terms of 11 categories. The categories are motivating for care, adjusting and coordinating nursing care to the older adult, relating to next of kin, managing communication difficulties, relating to social situations in the home, managing demands, working alone, having lack of time, collaborating with physicians, and care staff having low competence. The registered nurses suggested improvements for their leadership close to older adults in terms of nine categories. The categories are adjusting the work to the older adult, clarifying registered nurses’ responsibility, balancing demands and resources, setting time aside, improving staffs’ competence, ensuring staff’s competence development, improving the work environment, and cooperation between professions in the municipality, as well as between healthcare organizations. Conclusion: The results show that registered nurses’ leadership in municipal home healthcare implies a wide range of challenges. There is a need for strategies to improve the org, Correction published 30 March 2023. https://doi.org/10.1186/s12912-023-01266-0

Vibrotactile feedback training may be used as a complementary strategy to reduce time in demanding postures in manual handling. This study evaluated the short- and medium-term effects of concurrent posture-correction vibrotactile feedback training on trunk inclination exposure in real manual sorting work. Fifteen warehouse workers completed the training and the follow-up sessions. Trunk inclination angles were recorded using the ambulatory Smart Workwear System. Questionnaires were used for assessing system usability, perceived physical exertion, and work ability. The results showed reduced time in trunk inclination >30°, >45°, and >60°, and reductions in the 90th, 95th, and 99th percentile trunk inclination angles, when receiving feedback and immediately after feedback withdrawal. No significant reduction was retained after one and three weeks. The wearer's comfort was scored high, and the feedback did not increase the perceived cognitive demands. No significant effects attributed to changed trunk inclination exposure were observed for perceived physical exertion or work ability. The training program has the potential of contributing to reduced trunk inclination exposure in the short term. Future studies are needed to evaluate if improvements in the feedback training can transfer the short-term results to retained median- and long-term effects. Practitioner summary: A two-day training program with concurrent posture-correction vibrotactile feedback can contribute to reduced exposure of trunk inclination in real manual sorting work in the short term. More research is needed on how to design the feedback training programs in order to be effective in the long term., QC 20230322

Multidomain interventions have shown tremendous potential for improving cognition in older adults. It is unclear if multidomain interventions can be delivered remotely and whether remote intervention is beneficial for older adults who are vulnerable or at risk of cognitive decline. In a 26-week multi-site, home-based, double-blind, randomized controlled trial, 120 cognitively healthy older adults (75 robust, 45 pre-frail; age range = 60–94) recruited from Switzerland, Canada, and Belgium were randomized to receive either the StayFitLonger (SFL) computerized multidomain training program or an active control intervention. Delivered on tablets, the SFL intervention combined adapted physical exercises (strength, balance, and mobility), cognitive training (divided attention, problem solving, and memory), opportunities for social and contributive interactions, and psychoeducation. The active control intervention provided basic mobilization exercises and access to video games. Cognitive outcomes were global cognition (Z-scores of attention, verbal fluency, and episodic memory for nondemented older adults; ZAVEN), memory, executive function, and processing speed. Linear mixed model analyses indicated improved performance on the ZAVEN global cognition score in the SFL group but not in the active control group. Stratified analyses by frailty status revealed improved ZAVEN global cognition and processing speed scores following SFL in the pre-frail group but not in the robust group. Overall, the study indicates that a computerized program providing a multidomain intervention at home can improve cognition in older adults. Importantly, pre-frail individuals, who are at higher risk of cognitive decline, seem to benefit more from the intervention. Trial registration: ClinicalTrials.gov, NCT037519 Registered on January 22, 2020—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04237519.

Aim: The aim of this study was to review empirical articles to explore the meaning and the application of student-centered learning in nursing education. Background: Teachers in higher education are encouraged to adopt student-centered learning principles, but research shows that many still apply teacher-centered methods. There is therefore a need to clarify the meaning of student-centered learning, including how it is performed and the reasons to apply it in nursing education. Design: This study employed an integrative review method, following Whittemore and Knafl's framework. Methods: The databases CINAHL, Education Database and Education Research Complete were searched for related literature published from 2010 to 2020. The initial search located 308 articles. After screening and checking for eligibility, 25 articles were critically appraised. Data were extracted from the articles and displayed in matrices to be categorized and compared. Results: Three themes with attendant sub-themes emerged through the analysis: foundation, using core concepts to define and explain student-centered learning, eligibility, enhancing student knowledge, developing student abilities and supporting student self-reliance and realization, learning in interaction with peers, learning individually and learning in interaction with the teacher. Conclusion: Student-centered learning in nursing education is an approach where the teacher is a facilitator of student learning and students are empowered to take control of their own studies. Students study together in groups; they are listened to by the teacher and their needs are taken into consideration. The main reasons to apply student-centered learning are to enhance students’ theoretical and practical learning; to improve their generic competencies, such as problem-solving and critical-thinking abilities; and to strengthen students’ self-reliance.

Article; Early Access, Phenomenon: Physician immigration from other countries is increasing as developed countries continue to be desirable destinations for physicians; however, the determinants of Turkish physicians’ migration decisions are still unclear. Despite its wide coverage in the media and among physicians in Türkiye, and being the subject of much debate, there is insufficient data to justify this attention. With this study, we aimed to investigate the tendency of senior medical students in Türkiye to pursue their professional careers abroad and its related factors. Approach: This cross-sectional study involved 9881 senior medical students from 39 different medical schools in Türkiye in 2022. Besides participants’ migration decision, we evaluated the push and pull factors related to working, social environment and lifestyle in Türkiye and abroad, medical school education inadequacy, and personal insufficiencies, as well as the socioeconomic variables that may affect the decision to migrate abroad. The analyses were carried out with a participation rate of at least 50%. Findings: Of the medical students, 70.7% had emigration intentions. Approximately 60% of those want to stay abroad permanently, and 61.5% of them took initiatives such as learning a foreign language abroad (54.5%) and taking relevant exams (18.9%). Those who wanted to work in the field of Research ; Development were 1.37 (95% CI: 1.22–1.54) times more likely to emigrate. The push factor that was related to emigration intention was the “working conditions in the country” (OR: 1.89, 95% CI: 1.56–2.28) whereas the “social environment/lifestyle abroad” was the mere pull factor for the tendency of emigration (OR: 1.73, 95% CI: 1.45–2.06). In addition, the quality problem in medical schools also had a significant impact on students’ decisions (OR: 2.20, 95% CI: 1.83–2.65). Insights: Although the percentage of those who want to emigrate “definitely” was at the same level as in the other developing countries, the tendency

Severe muscle weakness is a symptom appearing in certain neuromuscular diseases (NMDs), such as Duchenne Muscular Dystrophy (DMD), affecting people's daily lives by reducing functionality, decreasing independence, and reducing the ability to perform essential daily activities. This patient group might benefit from using active-assistive devices by having the potential to provide precise support torque counterbalancing the passive forces acting on the arm, the movement intention of the user, and external forces exerted by lifted objects. However, the determination of support to counteract the weight of lifted objects is an ongoing challenge. This research aims to improve the understanding of external forces by using data classification algorithms to distinguish between different lifted weights in a human experiment. Fourteen healthy individuals participated in this experiment, lifting weights ranging from 0 - 1000 grams while an active-assistive device compensated for the passive torques acting on the arm. Data was collected using various sensors: a force sensor, an Inertial Measurement Unit (IMU), a joint encoder, and surface Electromyography (sEMG) electrodes. Subsequently, this data was processed and fed into a K Nearest Neighbour (KNN) classifier and a Support Vector Machine (SVM) classifier to determine the lifted weights during human elbow flexion and extension. The classifier showing the highest performance achieved an accuracy of 39.70% on the test dataset, indicating several misclassifications. However, a recall percentage of 76.95% for the 1000-gram class within the multi-class classification demonstrates the capability to distinguish larger weights. While demonstrating potential in weight discrimination, especially for larger weights, improvements in the compensation strategy, arm support alignment, and experimental design are crucial. Future research on the impact of picking and placing objects, the influence of muscle weakness, and the application of alt, Mechanical Engineering

Purpose: This study aimed to illustrate upper secondary school pupils’ experience using a self-administered web-based health-promoting tool, the Swedish Physical Power, Mental Harmony, and Social Capacity (FMS) student profile. Method: Five upper secondary schools in Sweden were included. Focus group interviews with pupils (10 girls, 5 boys, 15–19 years) were conducted, and data were analyzed using qualitative content analysis. Result: Two themes were generated from six categories: a sense of participation and self-control of health: everyday well-being, objective formulation, disappointment, health awareness, limitations, and health-promoting change. The participants experienced that using the FMS made them aware of factors that influence their health. They also reported that being given feedback visually from the FMS, peers, and staff involved in the school was beneficial in increasing their motivation to maintain a health-promoting change regarding physical activity and lifestyle factors. Conclusion: The use of a self-administered web-based health-promoting tool is viewed as beneficial for raising awareness and motivation to implement strategies that help attain a healthier lifestyle in upper secondary school students regarding factors affecting perceived health.

Introduction: Both educational attainment and genetic propensity to education (PGSEdu) have been associated with geographic mobility. Socioeconomic conditions are, in turn, associated with individuals’ health. Geographic mobility could therefore lead to better health for some since it could provide better opportunities, like education. Our aim was to study how attained education and genetic predisposition for higher education are related to geographic mobility, and how they affect the association between geographic mobility and mortality. Methods: We used data from the Swedish Twin Registry (twins born 1926–1955; n = 14,211) in logistic regression models to test if attained education and PGSEdu predicted geographic mobility. Cox regression models were then performed to test if geographic mobility, attained education, and PGSEdu were associated with mortality. Results: The results show that both attained education and PGSEdu predicted geographic mobility, in both independent and joint effect models, with higher education associated with higher mobility. Geographic mobility was associated with lower mortality in the independent effect model, but joint effect models showed that this association was completely explained by attained education. Conclusions: To conclude, both attained education and PGSEdu were associated with geographic mobility. Moreover, attained education explained the relationship between geographic mobility and mortality.

Democratic societies face the challenge of effecting sustainability transformations, allowing for variously imagined futures and underpinned by a diversity of practices of knowledge production and action. This article investigates how political imagination of sustainable futures informs the ways knowledge and action are understood and linked in sustainability and research policy, and what potential implications this has for democratic transformative change. Empirically, the article analyses the overarching sustainability and research policies in Sweden, focusing on the central documents produced by the government and public research financiers. The analysis shows parallels between the conceptualisations of sustainability and knowledge-action, characterised by linearity, instrumentalisation of knowledge and circumscription of power-sharing spaces for knowledge creation against the background of endorsement of collaborations between academia and society. Such conceptualisations, apart from sending mixed signals to sustainability researchers and practitioners, potentially enable knowledge and action processes driven by impact, competitiveness and atomisation, precluding the exercise of the intrinsic value of democratic knowledge and action practices necessary for reflexive governance of transformations towards sustainability.

Background: It is important that easy-to-use measures like subjective questions about physical activity (PA) and sedentary behaviour are valid and reliable providing accurate measures, when they are used in health promotion work aiming to support people to improve their lifestyle habits such as PA. The aim of this study was to evaluate the concurrent validity of a structured interview form estimating self-reported PA and a question about sitting time used in Swedish targeted health dialogues in the context of primary health care. Method: The study was conducted in the southern part of Sweden. To evaluate concurrent validity of the interview form, time spent in moderate-to-vigorous physical activities (MVPA) and energy expenditure related to MVPA estimated by an interview form was compared with the same measures assessed by an ActiGraph GT3X-BT accelerometer. To evaluate a question about sitting time, the Swedish School of Sport and Health Sciences’ single-item question about sitting time (SED-GIH) was compared with measures from an activPAL inclinometer. Statistical analyses included deriving Bland‒Altman plots and calculating Spearman’s rank correlation coefficients. Result: Bland‒Altman plots indicated lower absolute variation in the difference between self-reported and device-based PA measures for lower PA levels, both for energy expenditure and time spent in MVPA. No systematic over- or underestimation was observed. The Spearman’s correlation coefficient between self-reported and device-based PA measures was 0.27 (p = 0.014) for time spent in MVPA and 0.26 (p = 0.022) for energy expenditure. The correlation coefficient between the single item question and device-based sitting time measures was 0.31 (p = 0.002). Sitting time was underestimated by 74% of the participants. Conclusion: The PA interview form and the SED-GIH question on sitting time may be of value in targeted health dialogues in primary health care with the intention to support sedentary and insuffic

Background Sense of Coherence (SOC) relates to an individual’s overall life orientation, and stronger SOC is associated with better health, quality of life, and coping strategies. When our research group used the SOC-13 questionnaire for the first time in Nepal, we identified difficulties in response patterns. The findings necessitated further evaluation of the Nepali version of the SOC-13 questionnaire. Objective To qualitatively evaluate the SOC-13 questionnaire in Nepali for cross-cultural adaptation. Method Nineteen nurses were interviewed. We used the methodological approach of “think aloud” to obtain a deeper understanding of the interferences of the scales. Transcribed materials were analyzed using a deductive approach through qualitative content analysis. The original translated version of the SOC-13 questionnaire in Nepali was modified by replacing words that were easier to understand. Result Participants found the questionnaire content general and non-specific but easy to complete. The nurses experienced that the meanings and sentences in some of the items and response alternatives were difficult to understand. However, the overall comprehensiveness of most items and response alternatives was perceived as good. Nurses’ interpretation of the SOC-items in the translated version of the SOC-13 questionnaire in Nepali matched the original English version. Items that were experienced as difficult in the Nepali language were modified to increase their comprehensiveness. Modified items and response alternatives had the same content as before, but some words and meanings were substituted with easier language. Conclusion The current revised version of SOC-13 in Nepali is valid and useful to explore individuals’ overall life orientation and their abilities to deal and cope with various life events in the Nepalese context.

Purpose: To describe parents’ experiences of the significance of interpersonal interactions for becoming parents and a family during neonatal intensive care. Design and Methods: We employed a qualitative descriptive design with semi-structured family interviews. Ten families were included from four neonatal intensive care units (NICU) in Sweden. Results were evaluated using thematic analysis. Results: The results were presented as two themes: 1) Interactions within the family, and 2) Interactions between parents and staff. Analyses revealed that interpersonal interactions could both facilitate and hinder development in becoming a parent and a family. Conclusion: Interactions within the family and with the staff have an important function in the process of becoming a parent and a family. This process would benefit from a systemic approach, focusing on the family as a unit, as unique individuals, and as parents with unique needs and experiences. Practice implications: Our findings can facilitate changes to reduce the separation between family members (mother-father-newborn-siblings) during their stay in NICU; guiding parents to take care of their child, while being sensitive and balancing their situation as to where they are in their process; supporting the family through joint conversations by listening to the parents and their expectations and experiences both in the NICU and at home; and encouraging parents to do everyday things together outside NICU like an ordinary family. © 2022 The Authors

Objectives: Handgrip strength (HGS) is a surrogate marker of general risk and nutritional status, frequently used in clinical practice. This study aimed to determine clinically useful reference intervals for healthy, young adults from Northern Europe. Methods: This cross-sectional study was conducted in central Sweden, recruiting 834 young, nonsmoking adults ages 18 to 26 y. Subjects responded to a questionnaire on general health status, medication (including contraceptives), exercise habits, and parental and their own country of birth. Anthropometry, bioimpedance analysis for determination of fat-free mass (FFM), and HGS was measured. Reference intervals were calculated as mean and standard deviation. Differences between men, women, and women using estrogen contraceptives were analyzed using an analysis of variance with Tukey's post hoc test. Associations between HGS and determinant variables were analyzed using Spearman and linear regressions. Results: Men and women differed in HGS, but no significant difference was found in average HGS based on contraceptive use in women. Mean HGS was 53 kg in men and 34 kg in women, with a range of 22 kg to 90 kg in men and 16 kg to 73 kg in women. Height correlated with HGS. Subjects with a body mass index (BMI) <20 had statistically significantly lower HGS than those in higher BMI groups. There was no statistically significant mean difference between the group of subjects with a BMI of 20 to 25 and those with BMI >25 in neither men nor women. HGS in both sexes showed a gradual increase through tertiles of FFM. In linear regression models, sex, height, and FFM were the main determinants of HGS. Conclusions: In this study, we established reference intervals for HGS in healthy Swedish adults ages 18 to 26 y. As a surrogate marker of whole-body muscle mass, these reference intervals can be used in health assessments and the planning of health-promoting measures in the individual young adults. Differences in HGS based on heig

Worry about crime has been linked to several detrimental outcomes including worse mental health. However, there has been little research on the association between worry about crime and loneliness, even though loneliness is increasingly being recognised as a serious public health issue. To address this deficit, this study examined the association between worry about crime and loneliness in nine countries of the former Soviet Union (FSU - Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, and Ukraine), using data from 18,000 respondents aged 18 and above that were collected during the Health in Times of Transition (HITT) survey in 2010/11. Results from a pooled logistic regression analysis showed that compared to those who reported no worry about crime, individuals with a high level of worry had significantly higher odds of loneliness (odds ratio [OR]: 1.43, 95% confidence interval [CI]: 1.17–1.75). Sex- and age-stratified analyses further showed that the association was observed in women with a mid (OR: 1.37, 95%CI: 1.10–1.71) and a high level (OR: 1.70, 95%CI: 1.33–2.17) of worry about crime but not in men, and that a high level of worry about crime was linked to loneliness in adults aged 35–59 (OR: 1.39, 95%CI: 1.02–1.91) and 60 and above (OR: 1.64, 95%CI: 1.12–2.40) but not in those aged 18–34. High levels of worry about crime are associated with loneliness in the FSU countries. Reducing crime and its associated worries may have important public health benefits in these countries.

Clinical reasoning is a complex and crucial ability health professions students need to acquire during their education. Despite its importance, explicit clinical reasoning teaching is not yet implemented in most health professions educational programs. Therefore, we carried out an international and interprofessional project to plan and develop a clinical reasoning curriculum with a train-the-trainer course to support educators in teaching this curriculum to students. We developed a framework and curricular blueprint. Then we created 25 student and 7 train-the-trainer learning units and we piloted 11 of these learning units at our institutions. Learners and faculty reported high satisfaction and they also provided helpful suggestions for improvements. One of the main challenges we faced was the heterogeneous understanding of clinical reasoning within and across professions. However, we learned from each other while discussing these different views and perspectives on clinical reasoning and were able to come to a shared understanding as the basis for developing the curriculum. Our curriculum fills an important gap in the availability of explicit clinical reasoning educational materials both for students and faculty and is unique with having specialists from different countries, schools, and professions. Faculty time and time for teaching clinical reasoning in existing curricula remain important barriers for implementation of clinical reasoning teaching.

Based on a new materialist analysis of “vibrant matter” to understand the liveliness of sexual objects in toy-based sexual play, in this article I investigate the politics of thinking digital technologies as operating partly beyond human forms of agency and control. I use as my core examples privacy breaches and data leaks in the world of networked sex toys – such as a vibrator which allegedly audio recorded its clients’ play sessions without express permission – to engage with questions of intimacy and privacy in digital networks of humans and nonhumans. In particular, the discussion focuses on the consequences of new forms of publicness for how we can understand sexual intimacy and sexual play. What does it mean to have an intimate moment when connected to a device, a medium and a network that is by definition public, corporate and leaky? And how could we imagine other ways of being sexually intimate and exposed – yet safe – in public digital networks? Drawing on discussions of queer intimacy, sexual consent and queer BDSM, I suggest that current understandings of privacy and sensitive data (as per GDPR) may need unconventional sources to further ways of knowing what consent might mean, and how it feels. © The Author(s) 2020.

Background: Picture My Participation (PmP) is a picture-supported child-report instrument of participation of children with disabilities. Aims: This study described the development of a mobile application of the PmP Traditional Chinese version (PmP-C) and evaluated its usability. Methods: The PmP-C App includes features that allow the input of a child’s demographics, identification of frequency and involvement of 22 culturally appropriate activities, selection of the three most important activities and the specification of the environmental facilitators and barriers. The usability test was conducted with 10 healthcare workers, who interviewed 10 children with disabilities aged 6–12 years. The healthcare workers completed a usability questionnaire and were asked to provide feedback on the ease of use, learning, satisfaction and perceived usefulness. Results: The mean score for the usability questionnaire ranged from 2.7 to 4.6 out of 5.0. The feedback indicated that the interface was simple to operate by the healthcare workers and was attractive and motivating to children. Improvements of layout design, operation instructions and technical problems were recommended, which contributed to the app program optimization. Conclusions: The PmP-C App provides a practical tool with initial support for usability to enable active engagement and communication of children with disabilities with healthcare providers.