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Abstract Wildlife might be important to psychologically restorative values and disvalues of nature, as interactions with wildlife could trigger both positive and negative feelings. Research on positive experiences of human–wildlife interactions has largely involved participants who voluntarily sought out wildlife experiences or it has addressed encounters with non‐threatening animals in urban green spaces. Less is known about the opportunities for psychological restoration in landscapes shared with mammals that are perceived to pose a threat to human activities and health. This study provides a nuanced understanding of the role of wildlife in public perceptions of the restorative potential and experience of psychological restoration in local natural settings. Twenty‐eight participants (15 women, 13 men, 18–75 years) took part in focus group interviews subject to a reflexive thematic analysis. As an analytical framework, we used a theoretical model for how people appraise the relevance, implications, coping potential and norm congruence of human–wildlife interactions and how such appraisals may support or hinder the restoration experienced in local natural settings. Relevance appraisals revealed shifts in consideration of the presence of wildlife from an integrated part of the natural scenery (background) to a distinct figure (foreground). Implication appraisals revealed that wildlife encounters would hinder the experienced psychological restoration if the animal was appraised as dangerous, disgusting, causing a nuisance or destructive. Wildlife encounters would promote restoration if the animal displayed attractive traits, features or fascinating behaviour or movements, and if it opened engaging interaction situations. Coping strategies perceived as feasible to deal with negative implications of wildlife involved avoidance of the local natural setting, preparatory behaviour displayed before a visit and precautionary behaviour displayed during the visit. Important public health effects might be gained if wildlife policy and management explicitly consider what animals mean to the perceived restorative potential of local natural settings. Read the free Plain Language Summary for this article on the Journal blog.

IntroductionPeople as individual consumers are regularly targeted in sustainability campaigns or communications with the hope of enhancing sustainable behavior at an individual level, with subsequent sustainability transformation at a larger societal scale. However, psychological motivation is complex and campaigns need to be based on an understanding for what individual, and contextual, factors support or hinder sustainable behavioral choices.MethodsIn a discrete choice experiment, participants made hypothetical online purchases in each of three rooms designed to evoke associations to hedonic, gain, and normative goal frames. Participants were shown a campaign message intended to prime sustainable textile consumption prior to the purchase. For each product (t-shirt or bananas) hedonic (comfort/look), gain (price), and normative (organic/ fairtrade) attributes were varied in an online choice experiment.ResultsPreferences for the normative attribute of t-shirts increased in the normative room compared to the room with gain associations. No effect of the rooms with hedonic or gain priming was observed on the choice.DiscussionThe study supports the hypothesis that the physical room can enhance goal frame activation and behavioral choice but concludes that such priming effect is sensitive to specificity of the prime.

In the effort to limit global warming to 1.5°C above the pre-industrial level, decarbonization of supply chains is crucial. Companies will need to reduce not only their direct and indirect emissions (scope 1 and 2) but also their indirect emissions (scope 3). In some sectors, the upstream scope 3 emissions can actually be larger than the companies’ direct emissions. Therefore, a systematic literature review was carried out to understand how previous research in the field of supply chain management (SCM) approached energy efficiency and energy management in the upstream supply chain. The results indicate that only a few studies have addressed energy efficiency within SCM, and the majority assess energy solely as total energy use, without exploring opportunities to reduce final energy use among upstream suppliers. Moreover, results show that there is a lack of standards and methods to assess suppliers’ energy use, making it difficult for suppliers, particularly small and medium-sized enterprises, to overcome barriers to implementing energy management. In conclusion, even though energy efficiency is a cost-effective means to reduce CO2 emissions, only a limited number of studies in the field of SCM have integrated energy efficiency, revealing a vast knowledge gap in this field.

Developing sustainable energy systems through system integration and sector coupling may involve permeating previous isolated and idiosyncratic reactions through the whole system. This study examines supply side dynamics of how uncertainty and spot prices influence electric power supply in an internationally connected electricity system. By applying quantile methods, the study reveals highly nonlinear and asymmetric responses in supplied electricity given a change in uncertainty or system spot prices. The findings show that while the total supply of electricity is largely unaffected by uncertainty and spot price, both supply level and changes in power supply for specific dispatchable power sources are influenced differently depending on the type of uncertainty (domestic or global). The findings also show that the response structure induced by uncertainty and spot price seems to be largely uniform and power source specific. This has implications for creating, amongst other things, integrated systems, and sector coupling, where there is a need for inexpensive excess power supply.

Inhibition of IL-4/IL-13 signaling has dramatically improved the treatment of atopic dermatitis (AD). However, in many patients, clinical responses are slow to develop and remain modest. Indeed, some symptoms of AD are dependent on IL-31, which is only partially reduced by IL-4/IL-13 inhibition. Thus, there is an unmet need for AD treatments that concomitantly block IL-4/IL-13 and IL-31 pathways. We engineered NM26-2198, a bispecific tetravalent antibody designed to accomplish this task. In reporter cell lines, NM26-2198 concomitantly inhibited IL-4/IL-13 and IL-31 signaling with a potency comparable with that of the combination of an anti–IL-4Rα antibody (dupilumab) and an anti–IL-31 antibody (BMS-981164). In human PBMCs, NM26-2198 inhibited IL-4–induced upregulation of CD23, demonstrating functional binding to FcγRII (CD32). NM26-2198 also inhibited the secretion of the AD biomarker thymus and activation-regulated chemokine (TARC) in blood samples from healthy human donors. In male cynomolgus monkeys, NM26-2198 exhibited favorable pharmacokinetics and significantly inhibited IL-31–induced scratching at a dose of 30 mg/kg. In a repeat-dose, good laboratory practice toxicology study in cynomolgus monkeys, no adverse effects of NM26-2198 were observed at a weekly dose of 125 mg/kg. Together, these results justify the clinical investigation of NM26-2198 as a treatment for moderate-to-severe AD.

Aims and objectivesThe study aim was to explore the use of an Intensive Care Unit (ICU) diary within four different ICUs units in Sweden and thereby contribute to practice guidelines regarding the structure, content and use of an ICU diary.BackgroundICU diaries are used to aid psychological recovery among critical care patients, but differences remain in diary writing both within and across countries. Few studies have focused on the combined views and experiences of ICU patients, family members and nursing staff about the use of ICU diaries.DesignAn instrumental multiple case study design was employed.MethodsThree focus groups interviews were carried out with 8 former patients and their family members (n = 5) from the research settings. Individual interviews were carried out with 2 patients, a family member and a nurse respectively. Observations, field notes, documentary analysis and conversations with nursing staff were also conducted. Consolidated criteria for reporting qualitative research (COREQ) was followed.ResultsThe qualitative findings firstly consisted of a matrix and descriptive text of the four ICU contexts and current practices. This highlighted that there were similarities regarding the aims and objectives of the diaries. However, differences existed across the case study sites about how the ICU diary was developed and implemented. Namely, the use of photographs and when to commence a diary. Second, a thematic analysis of the qualitative data regarding patients' and family members' use of the ICU diary, resulted in four themes: i) the diary was used to take in and fully understand the situation; ii) the diary was an opportunity to assimilate warm, personalised and human care; iii) the diary was used to manage existential issues; and iv) the diary was a tool in daily activities.ConclusionsAnalysis of the instrumental case study data led to the identification of core areas for inclusion in ICU diary practice guidelines.

Abstract Adaptive flyway management of superabundant geese is emerging as a strategy to reduce damage to agricultural crops and other ecosystem disservices, while also ensuring sustainable use and conservation objectives. Given the calls for intensified hunting as part of flyway management in Europe, we need to increase the understanding of structural, situational, and psychological factors important for goose hunting among hunters. Our survey data, retrieved in southern Sweden, showed a higher potential to intensify hunting among goose hunters than other hunters. In response to hypothetical policy instruments (including regulations, collaborative, and others), hunters declared a minor increase in their intention to hunt geese, with the greatest expected increase among goose hunters should the hunting season be extended. Situational factors (e.g., access to hunting grounds) were associated with goose hunting (frequency, bag size, and intention to increase hunting). In addition, controlled motivation (derived from external pressures or to avoid guilt) and more importantly autonomous motivation (due to hunting being enjoyable or valuable) were along with goose hunter identity positively associated with goose hunting. Hunters’ involvement in flyway management may be encouraged by using policy instruments to remove situational barriers and facilitate their autonomous motivation.

Abstract Whole genome sequencing (WGS) has the potential to be a comprehensive genetic test, especially relevant for individuals with neurodevelopmental disorders, syndromes and congenital malformations. However, the cost consequences of using whole genome sequencing as a first-line genetic test for these individuals are not well understood. The study objective was to compare the healthcare costs and diagnostic yield when WGS is performed as the first-line test instead of chromosomal microarray analysis (CMA). Two cohorts were analyzed retrospectively using register data, cohort CMA (418 patients referred for CMA at the department of Clinical Genetics, Karolinska University Hospital, during 2015) and cohort WGS (89 patients included in a WGS-first prospective study in 2017). The analysis compared healthcare consumption over a 2-year period after referral for genetic testing, the diagnostic yield over a 2- and 3-year period after referral was also compiled. The mean healthcare cost per patient in cohort WGS was $2,339 lower compared to cohort CMA ($ − 2339, 95% CI − 12,238–7561; P = 0.64) including higher costs for genetic investigations ($1065, 95% CI 834–1295; P

ABSTRACTMesothelin (MSLN) is an attractive immuno-oncology target, but the development of MSLN-targeting therapies has been impeded by tumor shedding of soluble MSLN (sMSLN), on-target off-tumor activity, and an immunosuppressive tumor microenvironment. We sought to engineer an antibody-based, MSLN-targeted T-cell engager (αMSLN/αCD3) with enhanced ability to discriminate high MSLN-expressing tumors from normal tissue, and activity in the presence of sMSLN. We also studied the in vivo antitumor efficacy of this molecule (NM28-2746) alone and in combination with the multifunctional checkpoint inhibitor/T-cell co-activator NM21-1480 (αPD-L1/α4-1BB). Cytotoxicity and T-cell activation induced by NM28-2746 were studied in co-cultures of peripheral blood mononuclear cells and cell lines exhibiting different levels of MSLN expression, including in the presence of soluble MSLN. Xenotransplant models of human pancreatic cancer were used to study the inhibition of tumor growth and stimulation of T-cell infiltration into tumors induced by NM28-2746 alone and in combination with NM21-1480. The bivalent αMSLN T-cell engager NM28-2746 potently induced T-cell activation and T-cell mediated cytotoxicity of high MSLN-expressing cells but had much lower potency against low MSLN-expressing cells. A monovalent counterpart of NM28-2746 had much lower ability to discriminate high MSLN-expressing from low MSLN-expressing cells. The bivalent molecule retained this discriminant ability in the presence of high concentrations of sMSLN. In xenograft models, NM28-2746 exhibited significant tumor suppressing activity, which was significantly enhanced by combination therapy with NM21-1480. NM28-2746, alone or in combination with NM21-1480, may overcome shortcomings of previous MSLN-targeted immuno-oncology drugs, exhibiting enhanced discrimination of high MSLN-expressing cell activity in the presence of sMSLN.

The problem of occupational accidents in the construction industry has necessitated a focus on proactive measures such as safety management programs. An example of this is safety parks, i.e. facilities where employees and managers from different construction companies can participate in site-specific activities and train in safety-related matters in a realistic context. Two specific focus areas are often present within these types of safety management programs: hands-on safety training and safety culture development as being within the purview of management. The purpose of this article is to investigate the developers' intentions with the park in relation to safety culture development. Twenty interviews were conducted with experts in the area of health and safety. Results indicate that the safety park can contribute as a mirror for the companies own operations, with new information and knowledge of how work can be performed with safety being prioritized, to developing communication regarding safety-related matters, and finally the stations at the park may initiate a translation process as to how the lessons learned at the park can be applied to the participants’ own workplaces. All in all, the activities at the park can be said to be normative in nature, i.e. the developers seemingly have a desire to steer the safety culture development in a certain direction. There is a need for further research focusing on the concept of safety culture in these types of programs and, more broadly, in relation to its intended industry-wide effects.

IntroductionIndependent mobility is every child's right and has implications for their health, wellbeing, and development. This scoping review addresses children's needs and experiences of light conditions in their everyday outdoor life. The review examines peer-reviewed scientific literature that analyses associations between different light conditions and children's independent mobility (CIM) during dark hours.MethodsBy formulating a Boolean search string, including terms related to children independent mobility, light and outdoor environment, five scientific databases were searched. The search resulted in 67 eligible papers that were analyzed through an inductive, thematic analysis.ResultsFour overarching themes representing the researched topics of the effects of light conditions with importance for CIM during dark hours were identified: (1) physical activity (PA) and active travel, (2) outdoor activities and place use, (3) safety perception, and (4) outdoor risks. The findings highlight that darkness constitutes a major obstacle for CIM, and that fear of darkness is common among children. It restricts the degree of CIM and influences children's safety perception as well as how they navigate through public places outdoors. The findings show that the type and design of outdoor settings during dark hours and children's familiarity with places during daytime could play a role in the degree of CIM after dark. The presence of outdoor lighting is related to children's increased PA and active travel, and outdoor lighting seems to also influence children's place use and interaction with the environment. The presence and extent of outdoor lighting and lighting quality may play a role in children's safety perception, which in turn can influence CIM.DiscussionThe findings suggest that promoting CIM during dark hours might not only contribute to the accumulation of children's PA, confidence, and skills, but also support mental health. The understanding of children's perspectives on the quality of outdoor lighting needs to be deepened to support CIM. Highlighting the child perspective would aid the development of current recommendations for outdoor lighting and the implementation of the Agenda 2030 of ensuring healthy lives and promoting wellbeing for all at all ages, and making cities inclusive, safe, resilient and sustainable throughout the day and seasons.

Precision medicine has the potential to transform healthcare by moving from one-size-fits-all to personalised treatment and care. This transition has been greatly facilitated through new high-throughput sequencing technologies that can provide the unique molecular profile of each individual patient, along with the rapid development of targeted therapies directed to the Achilles heels of each disease. To implement precision medicine approaches in healthcare, many countries have adopted national strategies and initiated genomic/precision medicine initiatives to provide equal access to all citizens. In other countries, such as Sweden, this has proven more difficult due to regionally organised healthcare. Using a bottom-up approach, key stakeholders from academia, healthcare, industry and patient organisations joined forces and formed Genomic Medicine Sweden (GMS), a national infrastructure for the implementation of precision medicine across the country. To achieve this, Genomic Medicine Centres have been established to provide regionally distributed genomic services, and a national informatics infrastructure has been built to allow secure data handling and sharing. GMS has a broad scope focusing on rare diseases, cancer, pharmacogenomics, infectious diseases and complex diseases, while also providing expertise in informatics, ethical and legal issues, health economy, industry collaboration and education. In this review, we summarise our experience in building a national infrastructure for precision medicine. We also provide key examples how precision medicine already has been successfully implemented within our focus areas. Finally, we bring up challenges and opportunities associated with precision medicine implementation, the importance of international collaboration, as well as the future perspective in the field of precision medicine.

Abstract Human–wildlife interactions occur when humans and wildlife overlap in the same landscapes. Due to the growing human population, the number of interactions will continue to increase, and in some cases, develop further into social conflicts. Conflicts may occur between people disagreeing about wildlife conservation or arguing over which wildlife management measures should be taken. Social conflicts between humans are based on different attitudes, values and land‐use aspirations. The success of solving these social conflicts strongly depends on building trust between the public, stakeholders, authorities and researchers, as trust is fundamental to all communication and dialogue. Here we have examined how trust in large carnivore research differs within a geographically stratified sample of the Norwegian population. The comprehensive survey, including 2,110 respondents, allows us to explore how people perceive factual statements about large carnivores depending on the source of these statements. Specifically, the respondents were given multiple statements and asked to judge them in terms of meaning and authenticity depending on whether the statements were made by a politician, the Norwegian farmers' association, the Norwegian Fish and Game association or a large carnivore researcher. Based on the variations in perceptions, we inferred that trust in large carnivore researchers and their research results varied with people's attitudes, values and direct experience of large carnivores. In general, respondents perceived 60% of the statements to be genuine when given no information of who had made them. Although this increased to 75% when informed that the statements were made by a large carnivore researcher, there was still a 25% probability that the statement was perceived as manipulative or political. Age, environmental values and negative experiences of carnivores increased the probability of perceiving research statements as manipulative or political. People living in areas with high proportions of hunters showed particularly polarized views, either more strongly perceiving the statements as political, or in contrast as research. This study provides a novel perspective in understanding the role trust plays in social conflicts related to human–wildlife interactions. A free Plain Language Summary can be found within the Supporting Information of this article.

The growth of Sweden’s urban population necessitates new approaches for increasing the sustainability and energy efficiency of multifamily buildings. The development of such approaches will require a holistic and integrated understanding of the factors driving the decision making of both professionals who design buildings and end-users who live in them. This paper, therefore, uses the goal framing theory to determine which aspects of multifamily buildings are considered important by these two groups of actors. An empirical study based on semi-structured interviews with professionals involved in building design and development (project developers, housing company representatives, architects, and engineers; N = 15) was conducted to identify goals affecting the choices made during building design and development. In parallel, a questionnaire survey of building end-users (N = 61) was conducted to determine which factors guided their choice of dwelling. It was found that professionals’ design choices were primarily governed by normative goals relating to environmental benefits but were also influenced by the other goals. These included gain goals relating to budgetary constraints and keeping the building’s operational and maintenance costs low. Hedonic goals were also important; some design choices were made with the aim of providing pleasant, comfortable, and convenient living environments, or of giving the buildings a distinct aesthetic or some other special features. By comparing the professionals’ responses to the end-user surveys, it was found that the two groups had similar views concerning gain goals; both considered it important for apartments to be affordable and easy to maintain. However, their views on hedonic and normative goals differed markedly. The professionals sought to strike an optimal balance between different related aspects, whereas end-users placed greater importance on aspects relating to hedonic and gain goals when choosing dwellings. The findings provide a basis for constructive discussions on building design and development, and the scope for creating buildings that encourage end-users to adopt sustainable living practices while also satisfying their needs and preferences.

Abstract Background We report the findings from 4437 individuals (3219 patients and 1218 relatives) who have been analyzed by whole genome sequencing (WGS) at the Genomic Medicine Center Karolinska-Rare Diseases (GMCK-RD) since mid-2015. GMCK-RD represents a long-term collaborative initiative between Karolinska University Hospital and Science for Life Laboratory to establish advanced, genomics-based diagnostics in the Stockholm healthcare setting. Methods Our analysis covers detection and interpretation of SNVs, INDELs, uniparental disomy, CNVs, balanced structural variants, and short tandem repeat expansions. Visualization of results for clinical interpretation is carried out in Scout—a custom-developed decision support system. Results from both singleton (84%) and trio/family (16%) analyses are reported. Variant interpretation is done by 15 expert teams at the hospital involving staff from three clinics. For patients with complex phenotypes, data is shared between the teams. Results Overall, 40% of the patients received a molecular diagnosis ranging from 19 to 54% for specific disease groups. There was heterogeneity regarding causative genes (n = 754) with some of the most common ones being COL2A1 (n = 12; skeletal dysplasia), SCN1A (n = 8; epilepsy), and TNFRSF13B (n = 4; inborn errors of immunity). Some causative variants were recurrent, including previously known founder mutations, some novel mutations, and recurrent de novo mutations. Overall, GMCK-RD has resulted in a large number of patients receiving specific molecular diagnoses. Furthermore, negative cases have been included in research studies that have resulted in the discovery of 17 published, novel disease-causing genes. To facilitate the discovery of new disease genes, GMCK-RD has joined international data sharing initiatives, including ClinVar, UDNI, Beacon, and MatchMaker Exchange. Conclusions Clinical WGS at GMCK-RD has provided molecular diagnoses to over 1200 individuals with a broad range of rare diseases. Consolidation and spread of this clinical-academic partnership will enable large-scale national collaboration.

Farmers who keep livestock in large carnivore areas are exposed to threat of predation directly impacting on finances and workload as well as the associated psychological stress indirectly impacting on farmers well-being. So far, little is known about such stress responses. The concept of “stress” or “stress reaction” is often used as an undifferentiated umbrella concept for the experience of negative emotional episodes. However, the stress reactions could be divided into cognitive, physiological, and behavioural aspects. This study aimed to develop and apply a theory-based approach to identify stress responses among sheep farmers in the Swedish “wolf-region.” A thematic analysis of interviews conducted with sheep farmers showed ample support for stress responses among the informants in relation to large carnivores and their management, although the interviews were conducted with a different focal topic. The findings support the idea that stress responses could be categorised into cognitive, physiological, and behavioural aspects. This distinction would help to identify and fully understand the cumulative impact of stress from the presence of large carnivores on farmers’ well-being.

Prenatal DNA tests, such as chromosomal microarray analysis or exome sequencing, increase the likelihood of receiving a diagnosis when fetal structural anomalies are identified. However, some parents will receive uncertain results such as variants of uncertain significance and secondary findings. We aimed to develop a set of attributes and associated levels for a discrete-choice experiment (DCE) that will examine parents' preferences for tests that may reveal uncertain test results. A two phase mixed-methods approach was used to develop attributes for the DCE. In Phase 1, a "long list" of candidate attributes were identified via two approaches: 1) a systematic review of the literature around parental experiences of uncertainty following prenatal testing; 2) 16 semi-structured interviews with parents who had experienced uncertainty during pregnancy and 25 health professionals who return uncertain prenatal results. In Phase 2, a quantitative scoring exercise with parents prioritised the candidate attributes. Clinically appropriate levels for each attribute were then developed. A final set of five attributes and levels were identified: likelihood of getting a result, reporting of variants of uncertain significance, reporting of secondary findings, time taken to receive results, and who tells you about your result. These attributes will be used in an international DCE study to investigate preferences and differences across countries. This research will inform best practice for professionals supporting parents to manage uncertainty in the prenatal setting.

Birt-Hogg-Dube syndrome (BHDS) (MIM: 135150) is a rare autosomal dominant disorder with variable penetrance, caused by pathogenic variants in the FLCN gene. Only a few hundreds of families have so far been described in the literature. Patients with BHDS present with three distinct symptoms: fibrofolliculomas, pneumothorax due to lung cyst formation, and increased lifetime risk of kidney tumours. The aim of the current study was to estimate the incidence of BHDS in the Swedish population and further describe the clinical manifestations and their frequency. Splice variant c.779+1G>T was the most common pathogenic variant, found in 57% of the families, suggesting this may be a founder mutation in the Swedish population. This was further investigated using haplotype analysis in 50 families that shared a common haplotype. Moreover, according to gnomAD the carrier frequency of the c.779+1G>T variant has been estimated to be 1/3265 in the Swedish population, however our data suggest that the carrier frequency in the Swedish population may be significantly higher. These findings should raise awareness among physicians of different specialties to patients presenting with fibrofolliculomas, pneumothorax and/or kidney tumours. We also stress the importance of consensus recommendations regarding diagnosis and clinical management of this, not that uncommon, syndrome.

Abstract Background Recent global changes have led to an increase in distribution of ticks towards higher elevation and latitude in Europe and livestock are at increasing risk of contracting tick-borne diseases, but psychological aspects of how this affects human well-being are rarely assessed. Departing from the theory on emotional appraisal coming from psychology, this study investigates which factors that modulate worry and fear associated with the presence of ticks among livestock owners of sheep and/or cattle. Methods Survey data from 775 livestock owners in Norway were analysed by hierarchical multiple regression analysis with an index of fear of tick-borne diseases among livestock as the outcome variable. Results Twenty-nine per cent of the livestock owners reported worry and fear of tick-borne diseases among their livestock. The model explained 35% of the variance in worry and fear. There was a weak association between estimated incidences of tick-borne diseases in livestock and livestock owners’ worry and fear. Whereas previous personal experience of ticks and tick-borne diseases in livestock, and the livestock owners’ appraisals of the situation were more strongly associated with relatively stronger feelings of worry and fear. Conclusions Livestock owners’ worry and fear of tick-borne diseases in livestock can partly be understood as their appraisals of perceived personal relevance of the presence of ticks, its potential negative implications for their daily life at large, and what potential they have to cope by different strategies to adapt or adjust to the situation.

Objective: Comprehensive geriatric assessment (CGA) is recommended for the management of frailty. Little is known about professionals’ experiences of CGA; therefore we wanted to investigate the experiences of staff in primary care using a new CGA tool: the Primary care Assessment Tool for Elderly (PASTEL). Design: Focus group interviews. Manifest qualitative content analysis. Setting: Nine primary health care centres in Sweden that participated in a CGA intervention. These centres represent urban as well as rural areas. Subjects: Nine nurses, five GPs and one pharmacist were divided into three focus groups. Main outcome measures: Participants’ experiences of conducting CGA with PASTEL. Results: The analysis resulted in four main categories. A valuable tool for selected patients: The participants considered the assessment tool to be feasible and valuable. They stated that having enough time for the assessment interview was essential but views about the ideal patient for assessment were divided. Creating conditions for dialogue: The process of adapting the assessment to the individual and create conditions for dialogue was recognised as important. Managing in-depth conversations: In-depth conversations turned out to be an important component of the assessment. Patients were eager to share their stories, but talking about the future or the end of life was demanding. The winding road of actions and teamwork: PASTEL was regarded as a good preparation tool for care planning and a means of support for identifying appropriate actions to manage frailty but there were challenges to implement these actions and to obtain good teamwork. Conclusion: The participants reported that PASTEL, a tool for CGA, gave a holistic picture of the older person and was helpful in care planning.Key points To manage frailty using comprehensive geriatric assessment (CGA) in primary care, there is a need for tools that are efficient, user-friendly and which support patient involvement and teamwork •This study found that the Primary care Assessment tool for Elderly (PASTEL) is regarded as both valuable and feasible by primary care professionals •Use of carefully selected items in the tool and allowing enough time for dialogue may enhance patient-centeredness •The PASTEL tool supports the process of identifying actions to manage frailty in older adults. Teamwork related to the tool and CGA in primary care needs to be further investigated and developed

Addressing the biodiversity crisis requires renewed collaborative approaches. Large carnivores are ambassador species, and as such they can aid the protection of a wide range of species, including evolutionarily distinct and threatened ones, while being popular for conservation marketing. However, conflicts between carnivores and people present a considerable challenge to biodiversity conservation. Our cross disciplinary essay brings together original research to discuss key issues in the conservation of large carnivores as keystone species for biodiversity rich, healthy ecosystems. Our findings suggest the need to promote coexistence through challenging ‘wilderness’ myths; to consider coexistence/conflict as a continuum; to include varied interest groups in decision making; to address fear through positive mediated experiences, and to explore further partnerships with zoos. As wide-reaching institutions visited by over 700 million people/year worldwide, zoos combine knowledge, emotion and social context creating ideal conditions for the development of care towards nature, pro-environmental behaviors and long-term connections between visitors and carnivores. Based on current research, we provide evidence that large carnivores and zoos are both powerful catalysts for public engagement with biodiversity conservation, recognizing barriers and suggesting future ways to collaborate to address biodiversity loss.

Abstract Background Since different types of genetic variants, from single nucleotide variants (SNVs) to large chromosomal rearrangements, underlie intellectual disability, we evaluated the use of whole-genome sequencing (WGS) rather than chromosomal microarray analysis (CMA) as a first-line genetic diagnostic test. Methods We analyzed three cohorts with short-read WGS: (i) a retrospective cohort with validated copy number variants (CNVs) (cohort 1, n = 68), (ii) individuals referred for monogenic multi-gene panels (cohort 2, n = 156), and (iii) 100 prospective, consecutive cases referred to our center for CMA (cohort 3). Bioinformatic tools developed include FindSV, SVDB, Rhocall, Rhoviz, and vcf2cytosure. Results First, we validated our structural variant (SV)-calling pipeline on cohort 1, consisting of three trisomies and 79 deletions and duplications with a median size of 850 kb (min 500 bp, max 155 Mb). All variants were detected. Second, we utilized the same pipeline in cohort 2 and analyzed with monogenic WGS panels, increasing the diagnostic yield to 8%. Next, cohort 3 was analyzed by both CMA and WGS. The WGS data was processed for large (> 10 kb) SVs genome-wide and for exonic SVs and SNVs in a panel of 887 genes linked to intellectual disability as well as genes matched to patient-specific Human Phenotype Ontology (HPO) phenotypes. This yielded a total of 25 pathogenic variants (SNVs or SVs), of which 12 were detected by CMA as well. We also applied short tandem repeat (STR) expansion detection and discovered one pathologic expansion in ATXN7. Finally, a case of Prader-Willi syndrome with uniparental disomy (UPD) was validated in the WGS data. Important positional information was obtained in all cohorts. Remarkably, 7% of the analyzed cases harbored complex structural variants, as exemplified by a ring chromosome and two duplications found to be an insertional translocation and part of a cryptic unbalanced translocation, respectively. Conclusion The overall diagnostic rate of 27% was more than doubled compared to clinical microarray (12%). Using WGS, we detected a wide range of SVs with high accuracy. Since the WGS data also allowed for analysis of SNVs, UPD, and STRs, it represents a powerful comprehensive genetic test in a clinical diagnostic laboratory setting.

We examined feeding problems, including Avoidant Restrictive Food Intake Disorder (ARFID), in preschool children with Autism Spectrum Disorder (ASD). Data were collected from a prospective longitudinal study of 46 children with ASD in a multiethnic, low resource area in Gothenburg, Sweden. Feeding problems were found in 76% of the children with ASD, and in 28%, the criteria for ARFID were met. The study highlights early onset age, the heterogeneity of feeding problems, and the need for multidisciplinary assessments in ASD as well as in feeding problems, and also the need for further elaboration of feeding disorder classifications in children.

The EU directive 92/57/EEC focuses on ensuring that health and safety-related matters are taken into consideration during every stage of construction-related work and has been introduced into the regulations of the member countries. In 2006, Sweden was tasked by the European Commission to clarify its implementation of the directive, including which management roles and responsibilities were to come into effect during both the planning and eventual execution of construction work—changes that ultimately were introduced into the national regulations in 2009. Focusing on the accident trends in the construction industry in the years immediately following these regulatory changes, we find that the new management roles and responsibilities had no apparent effect on the accident rates. Furthermore, we argue that there is a need to broaden the analysis regarding the implementation of the EU directive 92/57/EEC to also include nation-specific changes to health and safety management and policy. These qualitative studies should also include a dedicated focus on how changes to management structures and processes may affect the prevalence of occupational diseases specifically.

This study investigates how a design team with researchers and participants from different parts and levels of an organisation may function as a participatory method for socially transformative innovation. The experiences gained by a design team in one of Sweden’s major forestry companies are examined through a participatory, single case study approach, in which researchers and employees jointly developed new insights and ideas. The results reveal that the design team functioned well in terms of channelling the participants’ expertise and experiences into innovative ideas, but less well as regards aligning the latter with the company’s regular management procedures, thus reducing the function of the design team to an abstract symbol of organisational ‘modernity’, rather than an effective instrument for social transformation.

Abstract Background The CTLA-4 blocking antibody ipilimumab has demonstrated substantial and durable effects in patients with melanoma. While CTLA-4 therapy, both as monotherapy and in combination with PD-1 targeting therapies, has great potential in many indications, the toxicities of the current treatment regimens may limit their use. Thus, there is a medical need for new CTLA-4 targeting therapies with improved benefit-risk profile. Methods ATOR-1015 is a human CTLA-4 x OX40 targeting IgG1 bispecific antibody generated by linking an optimized version of the Ig-like V-type domain of human CD86, a natural CTLA-4 ligand, to an agonistic OX40 antibody. In vitro evaluation of T-cell activation and T regulatory cell (Treg) depletion was performed using purified cells from healthy human donors or cell lines. In vivo anti-tumor responses were studied using human OX40 transgenic (knock-in) mice with established syngeneic tumors. Tumors and spleens from treated mice were analyzed for CD8+ T cell and Treg frequencies, T-cell activation markers and tumor localization using flow cytometry. Results ATOR-1015 induces T-cell activation and Treg depletion in vitro. Treatment with ATOR-1015 reduces tumor growth and improves survival in several syngeneic tumor models, including bladder, colon and pancreas cancer models. It is further demonstrated that ATOR-1015 induces tumor-specific and long-term immunological memory and enhances the response to PD-1 inhibition. Moreover, ATOR-1015 localizes to the tumor area where it reduces the frequency of Tregs and increases the number and activation of CD8+ T cells. Conclusions By targeting CTLA-4 and OX40 simultaneously, ATOR-1015 is directed to the tumor area where it induces enhanced immune activation, and thus has the potential to be a next generation CTLA-4 targeting therapy with improved clinical efficacy and reduced toxicity. ATOR-1015 is also expected to act synergistically with anti-PD-1/PD-L1 therapy. The pre-clinical data support clinical development of ATOR-1015, and a first-in-human trial has started (NCT03782467).

Collaborative governance regimes may be vulnerable because of dependency on stakeholders’ voluntary engagement and efforts. This study focuses on the Swedish moose management system, a multi-level collaborative governance regime inspired by the ecosystem approach. Self-determination theory is used to explore perceived prerequisites of basic needs for intrinsic motivation across sub-groups of stakeholder representatives who are engaged across different social-ecological contexts. Questionnaire data collected among representatives at two governance levels, moose management groups (n = 624) and moose management units (n = 979), were subjected to two-step cluster analysis. The analyses revealed two sub-groups of representatives, characterized by differences in species composition and land ownership structure: managers of multi-ungulate areas and managers of large-carnivore areas. In several respects, these groups significantly differed in how they perceived the prerequisites. This included prerequisites of perceived competence with regard to their need for knowledge of topics and usefulness of monitoring methods, perceived autonomy operationalized as possibilities to perform their tasks with sufficient time, resources, and support from their organizations, and perceived relatedness to different groups of actors. Further efforts should be made to understand the conditions required for representatives to energize and direct their behavior. The institutional system must better fit the needs of stakeholder representatives across various local contexts, otherwise the space for local voluntary engagement might be hampered.

This article reports on an educational design research study exploring the potential of combining entrepreneurship and mathematics – two of the key competencies stressed as important in a society of lifelong learning. The aim of the study was to explore what happens when entrepreneurship is integrated into mathematics lessons. Eight Swedish primary schools were involved in the iterative design wherein researchers and teachers together planned, implemented, and evaluated lessons. The results indicate that combining entrepreneurial and mathematical competencies may produce a win-win situation. Entrepreneurial competencies can be of value when students are learning mathematics, and at the same time mathematics teaching can be organised so that students develop both mathematical and entrepreneurial competencies.

Co-stimulatory 4–1BB receptors on tumor-infiltrating T cells are a compelling target for overcoming resistance to immune checkpoint inhibitors, but initial clinical studies of 4–1BB agonist mAbs were accompanied by liver toxicity. We sought to engineer a tri-specific antibody-based molecule that stimulates intratumoral 4–1BB and blocks PD-L1/PD-1 signaling without systemic toxicity and with clinically favorable pharmacokinetics. Recombinant fusion proteins were constructed using scMATCH3 technology and humanized antibody single-chain variable fragments against PD-L1, 4–1BB, and human serum albumin. Paratope affinities were optimized using single amino acid substitutions, leading to design of the drug candidate NM21-1480. Multiple in vitro experiments evaluated pharmacodynamic properties of NM21-1480, and syngeneic mouse tumor models assessed antitumor efficacy and safety of murine analogues. A GLP multiple-dose toxicology study evaluated its safety in non-human primates. NM21-1480 inhibited PD-L1/PD-1 signaling with a potency similar to avelumab, and it potently stimulated 4–1BB signaling only in the presence of PD-L1, while exhibiting an EC50 that was largely independent of PD-L1 density. NM21-1480 exhibited high efficacy for co-activation of pre-stimulated T cells and dendritic cells. In xenograft models in syngeneic mice, NM21-1480 induced tumor regression and tumor infiltration of T cells without causing systemic T-cell activation. A GLP toxicology study revealed no evidence of liver toxicity at doses up to 140 mg/kg, and pharmacokinetic studies in non-human primates suggested a plasma half-life in humans of up to 2 weeks. NM21-1480 has the potential to overcome checkpoint resistance by co-activating tumor-infiltrating lymphocytes without liver toxicity.

This paper is an attempt to advance research on walking at a neighborhood level of analysis for people with disabilities by proposing a theoretical model that combines the knowledge of two disciplines: traffic planning and environmental psychology. The aim is to provide guidance for a discussion and a plan for future interdisciplinary investigations by proposing a model that accounts for the dynamic interaction between environmental characteristics, human processes, and walking experience among individuals with a disability. For this purpose, traffic planners, and environmental psychologists came together to discuss theories, concepts, and thematic relevance in a series of focus group meetings. These meetings led to the selection of the Human Environment Interaction (HEI) model, originally developed from the field of environmental psychology and operationalized to describe how walking experiences result from the interplay between individual abilities, emotional processes, and the physical and social characteristics of the environment (Küller, 1991). The proposed model aims to sustain interdisciplinary discussion and research planning around the topic of neighborhood walking for people with disabilities. By operationalizing each dimension in the model, a good fit between groups with disabilities and individual differences associated with walking experiences is assumed, which, in turn, will have the potential to provide a more conscious analysis of wellbeing-related outcomes, such as usability of the environment, frequency of mobility, and quality of life. However, to improve understanding of urban walking at a neighborhood level for people with disabilities, empirical studies must be carried out to test the proposed model.

This paper draws on data from a quantitative study of upper secondary students’ general mathematical self-efficacy, anxiety towards mathematics, and their relationship to achievement in mathematics. The main objective of this article is to discuss the type of information that may be lost if potential problems of validity and extreme multicollinearity in exploratory factor analysis would be solved by only removing variables without doing a profound analysis. We also describe a method that treats Likert items in the questionnaire as ordinal variables that may represent the underlying continuous variable. Our study shows, for example, that removal of problematic variables without a profound analysis leads to a loss of significant information about test anxiety. Our qualitative analysis of problematic variables also led to an unexpected finding regarding the relationship between general mathematical self-efficacy and motivational values in mathematics.

Communication interventions are commonly proposed as a way to address people's fear and negative attitudes to build tolerance in shared landscapes between humans and large carnivores. Therefore, managing authorities sometimes respond to people's fear of brown bears (Ursus arctos) by organizing an information meeting. This study increases the understanding of the information meeting to address fear of encountering brown bears. Using a mixed-method approach the study analyzes the explicit meta-communication, i.e., verbal interactions to coordinate communication between presenter and participants, the effects of the meeting on fear and fear-related variables over time, and how these effects compare with the effects of a visit to a permanent brown bear exhibition, and the effects of a guided walk with exposure to brown bears and their habitat as two alternative communication interventions. Participation in information meetings contributed to reduce self-reported fear and the effect lasted over at least 6 months. The information meetings were, as assessed immediately after participation, less efficient than participation in a guided walk, but more efficient than a visit to a permanent brown bear exhibition in reducing fear. The content and format of the meeting was in line with the expectations of an information meeting, e.g., the presenter dominated the initiative in the explicit meta-communication, but still allowing for misconceptions and misunderstandings to be addressed and solved. In the development of communication strategies to address fear of large carnivores, managing authorities should pay attention to details in information content and format as well as to trade-offs between the number of people reached by the intervention and the strength of the effects on fear and fear-related variables among participants.

We examine university students’ motivation and self-efficacy beliefs about proof and proving, i.e., beliefs about personal abilities to understand, construct and present mathematical proofs, as well as their certainty about self-produced proofs. The sample of the study consists of 29 Finnish and Swedish students who were studying mathematics in tertiary level. The results show that the students were highly motivated to learn to understand and construct proofs, but they were more uncertain about their proving skills. Moreover, the study revealed reasons for the uncertainty about proving achievements. Most of the reasons are caused by deficiencies with respect to knowledge of, understanding about or experience from proof and proving.

Herpes simplex virus 1 (HSV-1) and 2 (HSV-2) can infect the central nervous system (CNS) with dire consequences; in children and adults, HSV-1 may cause focal encephalitis, while HSV-2 causes meningitis. In neonates, both viruses can cause severe, disseminated CNS infections with high mortality rates. Here, we differentiated human induced pluripotent stem cells (iPSCs) towards cortical neurons for infection with clinical CNS strains of HSV-1 or HSV-2. Progenies from both viruses were produced at equal quantities in iPSCs, neuroprogenitors and cortical neurons. HSV-1 and HSV-2 decreased viability of neuroprogenitors by 36.0% and 57.6% (p < 0.0001), respectively, 48 h post-infection, while cortical neurons were resilient to infection by both viruses. However, in these functional neurons, both HSV-1 and HSV-2 decreased gene expression of two markers of synaptic activity, CAMK2B and ARC, and affected synaptic activity negatively in multielectrode array experiments. However, unaltered secretion levels of the neurodegeneration markers tau and NfL suggested intact axonal integrity. Viral replication of both viruses was found after six days, coinciding with 6-fold and 22-fold increase in gene expression of cellular RNA polymerase II by HSV-1 and HSV-2, respectively. Our results suggest a resilience of human cortical neurons relative to the replication of HSV-1 and HSV-2.

This study assessed whether methods for capturing the pedestrian experience of outdoor lighting, previously evaluated in a full-scale laboratory, were applicable in a real-world setting. It applied an approach capturing the human response to outdoor lighting in a systematic way, by assessing perception, evaluation and behaviour in the lit environment. The study involved 81 participants from two age groups (Young—n: 48, mean age: 26, 63% women; Elderly—n: 33, mean age: 69, 67% women) and was carried out on a pedestrian path in a park in the centre of Malmö, Sweden, in the evenings during wintertime. Two LED lighting applications, differing in light distribution, uniformity and horizontal illuminance, were presented, and the pedestrians’ perception (facial expression recognition and sign reading), evaluation (arousal, valence and perceived outdoor lighting quality) and behaviour (pedestrian flow) were assessed. The results from the perceptual tasks differed significantly between the lighting applications, in favour of the lighting application with greatest uniformity and horizontal illuminance. There was a significant difference in sign reading distance between the two age groups. The methods applied in this study are feasible to administer and could be used to assess lighting solutions in order to capture the needs of vulnerable groups.

The Swedish school education in geography has developed slowly and still focuses on names of, for example, countries and capitals, rather than geographical concepts and processes. To implement the secondary and upper secondary school curricula, teachers need both broad and deep geographical knowledge. For example, teachers need knowledge of geographic information systems (GIS), which are computerised information systems for analysis and presentation of geographical data. This literature-based discussion article aims to analyse opportunities and difficulties with using GIS programs in the teacher and school education. In summary, the preconditions are good, with few technical barriers, for developing GIS-based teaching in the teacher and school education that promotes active, inquiry-based, cooperative, and problem-based learning. This would make the school education more problem-oriented and interdisciplinary so that it promotes pupils’ opportunities to achieve the competencies stipulated in the curricula. Such development requires that teacher educators and school teachers get the time and resources needed to develop technological pedagogical content knowledge. However, it is probably enough for educators and teachers to get started with simpler internet- and web-based GIS and then develop their knowledge at an appropriate pace.

Teaching in higher education should be based on research findings. Urban design and architecture are ‘making disciplines’ and their link to formal research is described as tenuous. This paper reports on a collaborative educational workshop, the Walkshop, designed to bridge the gap between the multidisciplinary research project Urban Walking and the master’s programme in sustainable urban design and city planning. The need for understanding of differences regarding knowledge competence and cultural skills between disciplines for successful multidisciplinary communication was addressed in the Walkshop design through theoretical input, acquaintance with methodology, design task, and presentation of design solutions. The Walkshop facilitated the students’ learning process towards a close-up perspective in analysis of the environment. Students’ design proposals integrated new perspectives and key facts from research, and provided inspiration and concrete suggestions for the analysed urban area. Collaborative educational workshops seem to be a useful component to include in a Master’s course syllabus, to strengthen the link to research in practice-based education, and to disseminate current research results directly into practice.

When daylight hours are limited, pedestrians are dependent on appropriate outdoor lighting. Although new city lighting applications must consider both energy usage and pedestrian responses, current methods used to capture pedestrian walking behaviour during dark conditions in real settings are limited. This study reports on the development and evaluation of a video-based method that analyses pedestrians’ microscopic movements (VAPM—video analysis of pedestrian movements), including placement and speed, in an artificially lit outdoor environment. In a field study utilising between-subjects design, 62 pedestrians walked along the same path under two different lighting applications. VAPM accurately discriminated pedestrians’ microscopic movements in the two lighting applications. By incorporating methodological triangulation, VAPM successfully complemented observer-based assessments of pedestrians’ perceptions and evaluations of the two lighting applications. It is suggested that in evaluations of pedestrian responses to city lighting applications, observer-based assessments could be successfully combined with an analysis of actual pedestrian movement while walking in the lit environment. However, prior to employing a large-scale application of VAPM, the methodology needs to be further adapted for use with drones and integration into smart city lighting systems.

This study identifies and applies methods for evaluating the human response to pedestrian lighting applications intended for future use by the municipality of Malmö, Sweden. The methods employed provide a supplementary perspective to that given by the photometric properties of the lighting applications. The study involved 89 participants from two age groups (Young: N: 43, 19-31 yrs.; Elderly: N: 46, 62-77 yrs.). Data were collected in a full-scale laboratory using a mock-up pedestrian pathway. Three lighting applications (one ceramic metal halide and two LED) were presented and the participants' behavior (walking speed), perception (ability to perform visual tasks-recognize facial expressions, detect obstacles, read street signpost), affective response, and evaluation of the lighting quality were assessed. The three lighting applications significantly differed with regard to the human response. The facial expression recognition distance, sign reading distance and the obstacle detection task, along with the evaluation of lighting quality and level of arousal, distinguished one of the LEDs (Correlated Color Temperature: 3810, Color Rendering Index: 75, Scotopic/Photopic ratio: 1.48) from the other two lighting applications-the participants performed better on the visual tasks, and the lighting was perceived as brighter, more arousing and less pleasant. Methods to capture human perception, evaluation and behavior in relation to outdoor lighting, provide a valuable perspective that should be systematically applied when municipalities consider different pedestrian lighting applications.

Attention biases have been reported for ancestral threats like spiders and snakes in infants, children, and adults. However, it is currently unclear whether these stimuli induce increased physiological arousal in infants. Here, 6-month-old infants were presented with pictures of spiders and flowers (Study 1, within-subjects), or snakes and fish (Study 1, within-subjects; Study 2, between-subjects). Infants’ pupillary responses linked to activation of the noradrenergic system were measured. Infants reacted with increased pupillary dilation indicating arousal to spiders and snakes compared with flowers and fish. Results support the notion of an evolved preparedness for developing fear of these ancestral threats.

Genom cooperative education (co-op) ges studenter möjlighet att inom utbildningen, praktiskt tillämpa sina kunskaper på en arbetsplats. Under co-op tilldelas studenten en av arbetsgivaren utsedd handledare. Co-op är ett trepartssamarbete mellan högskola, student och arbetsplats. Merparten av tidigare studier fokuserar studenternas upplevelse av co-op eller vad co-op kan innebära för studentens studiemotivation, framtida karriär och möjlighet till arbete. Syftet med denna fenomenografiska studie är att beskriva handledares uppfattning om handlednings syfte. Studien kan därmed bidra till kunskap om den utbildningssituationen studenter ställs inför i co-op. Studiens resultat, som är baserad på intervjuer, visar fyra olika uppfattningar om handlednings syfte: Stödja in i gemenskapen, Delge specifikt kunskapsinnehåll, Att få möjlighet att lära och Bidra till produktionen. Handledarnas uppfattningar indikerar att studenten förväntas praktiskt tillämpa teoretisk kunskap och få arbets- och yrkesrelaterade erfarenheter genom ett socialt lärande. Variationerna i handledarnas uppfattningar antyder även att det samlade kunskapsinnehållet som studenten får ta del av under co-op kan variera stort. Utifrån resultatet diskuteras möjligheter och hinder för studentens lärande under co-op.

Thioredoxin reductase 1 (TRXR1) and microsomal glutathione transferase 1 (MGST1) are important redox and detoxifying enzymes in adult life. The aim of this study was to investigate the expression of these enzymes during fetal life. In addition, the role of gene methylation was studied since this might play an important role in the on-and-off switch of gene expression between fetal and adult life. To this end, the expression of the TRXR1-encoding gene TXNRD1 and the MGST1-encoding gene MGST1 was studied in fetal tissues. The mean mRNA expression of TXNRD1 in fetal livers were seven times higher compared to the mean expression in adult livers (p

The life expectancy of people with intellectual disabilities (ID) has steadily increased, which has been accompanied by an increased risk of dementia. Staff and managers are key resources for safety diagnosis since they deliver information about people with ID behavior every day. The aim of the present study was to explore the identification process employed by staff and managers to detect signs of suspected dementia in people with an ID within intellectual disability services (ID-services). Twenty managers and 24 staff within an ID-service were interviewed and qualitative latent content analysis was applied. A model consisting of three themes on three levels of resources for the identification process of signs of suspected dementia emerged from the analysis. On the first level was the time and continuity in the care relationship, which is crucial for identifying and responding to changes in cognitive ability that indicate dementia. On the second level, the staff identify deficiencies in their own knowledge, seek support from colleagues and managers within their workplace and, on the third level, outside their workplace. Staff and managers expressed a need for early and continuous guidance and education from specialists in dementia and primary healthcare. This finding indicates an urgent need for intervention research and digital support for staff in dementia care.

The speed-reducing effect of speed humps during darkness is important to ensure a consistent speed reduction and a decreased probability of accidents during darkness. This study examined the effects of speed humps, compared with a control location, on a residential road in Sweden with light-emitting diode (LED) street lighting and a 30 km/h posted speed limit. Hypotheses tested were that: (I) vehicle speed is higher during daylight than in darkness; (II) speed at speed humps is lower than at control locations during both daylight and darkness; (III) speed at humps is higher during daylight; (IV) vehicle speed at humps is lower when luminance or visibility of the humps is greater; and, (V) the road environment of speed humps is perceived as being similar by drivers. The results showed that vehicle speed at the control location was negligibly higher (+0.3 km/h) during daylight than in darkness. Speed humps reduced driving speed by 20% when compared with the posted speed limit and the effect was not significantly different between daylight and darkness. Speed reduction for the three speed humps varied between 9% and 29% as compared with the posted speed limit. In this study, the LED road lighting that was placed directly above or in front of the hump achieved the highest luminance. This study could not reveal any significant differences in vehicle speed attributable to light conditions per se.

An increasing number of people with intellectual disability (ID) are reaching older ages today although they experience more health problems than the older population without ID. Leaders in intellectual disability services can greatly influence the conditions for a healthy ageing, and the aim of the present study was to explore healthy ageing in this group from the perspective of the leaders. Interviews with 20 leaders were subjected to qualitative content analysis. The findings gave rise to the overall theme ageing in dependence, which emerged from the following six categories: Supporting self-determination; Inaccessible activities after retirement; Signs of decline; Increased and specific needs for support and care; A non-question of gender; Aspects concerning the end of life and death. A prerequisite for healthy ageing in the case of people with ID is, according to the leaders, that they can live the life according to their preferences and make independent choices whilst at the same time receiving adequate support. With the shrinking of their social network after retirement, they become increasingly dependent on staff and leaders in the group home, who need to know what healthy ageing implies.

Objectives. To assess early growth characteristics and socioeconomic factors of children in relation to body mass index (BMI) and presence of overweight among four-year-old children. Methods. Two Child Health Centres (CHC) participated in the study. They were selected to obtain two populations of children featuring divergent socio-economic characteristics. Growth data registered at the CHCs from birth to the 4-year check-up were recovered. Overweight was defined by the BMI cut-offs established by IOTF. BMI values expressed as BMI standard deviation score (BMISDS) were used for analysis. Results. At the 4-year check-up, the BMISDS and the proportion of children with overweight (including the obese) were significantly higher in the district with lower socio-economic status. High BMI at birth and low socio-economic status of the population in the CHC-district were shown to be independent determinants for overweight and BMISDS at four years of age. Conclusions. More research is needed to understand the mechanisms and how intervention programs should be designed in order to prevent the development of overweight and obesity in children.

AbstractGenetic and phenotypic parameters were estimated for various traits of Farta and their crosses with Washera sheep in northwest Ethiopia. Data collected from 2015 to 2020 on 4318 lambs were used. A number of models were evaluated, all contained the direct additive animal genetic effect and then, either the maternal genetic or permanent environment or both effects. The estimates of direct heritability for birth weight, weaning weight, pre-weaning daily gain, six-month weight, yearling weight and pre-weaning lamb survival were 0.08 ± 0.03, 0.20 ± 0.05, 0.15 ± 0.05, 0.24 ± 0.06, 0.29 ± 0.14 and 0.14 ± 0.04, respectively. The maternal heritabilities were 0.29 ± 0.05, 0.31 ± 0.05, 0.40 ± 0.05, 0.15 ± 0.57 and 0.02 ± 0.15 for weaning weight, pre-weaning daily gain, six-month weight, yearling weight and pre-weaning lamb survival, respectively. Genetic correlation between birth weight and pre-weaning lamb survival was negative (−0.36 ± 0.22), implying heavier lambs have low pre-weaning survival. For the other pairs of traits, genetic correlations ranging from 0.10 ± 0.16 between yearling weight and pre-weaning lamb survival to 0.98 ± 0.01 between weaning weight and pre-weaning daily gain were estimated. Overall, the present study showed that heritability is more likely to be overestimated if the maternal genetic and permanent environment effects are not taken into account. Parameters estimated in the current study can be used to design sheep breeding programs.