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When comparing lifelong learning systems in Europe, Swedish vocational education has been characterised as a statist, school-based ideal type, with strong emphasis on egalitarianism and social citizenship. However, the popularisation and expansion of higher vocational education (HVE), a post-secondary training form that has a mandate to train people to meet local labour market needs, complicates these composite descriptions. Building on conventions theory and pragmatic sociology, our analysis probes the plural worlds of HVE participation, beyond simplistic understandings of human capital accumulation or universalistic welfare. Drawing on interviews with participants and archival material, we analyse forms of justifications evoked by those engaged in this transforming skilling regime. Our analysis reveals that participants do not enrol merely for getting work or getting ahead. Rather, participation is described as a response to constraints, a means to challenge difficult circumstances encountered in the labour market, or related to contingencies. Taken together, HVE emerges as a flexible mode of governing vocational knowledge to match local labour market needs, with rivalling conventions of worth. We discuss the increasing significance of projection and anticipation for individuals and organisations involved in skilling regimes, and propose a prospective convention that underscores expectancy and promise.

Drawing on convention theory and sociology of critique, this article examines how teachers at a Swedish folk high school coordinate students' activities through tests. Through ethnographic descriptions of exercises, assignments, presentations, and exhibitions that test students' engagement, it is shown how the teachers seek to depart from the standardized assessment procedure associated with formalized schooling. More specifically, the teachers' tests destabilize the prevailing understanding of what art "is," support the students to collectively explore and experiment with materials and highlight promising dimensions in their art-making. The article highlights "what is at stake" in art education and recognizes certain conventions as central in formatting, confirming, and interrogating the students' understanding of their artistic practices. Through these tests, students face a contradiction of freedom: the freedom to find their unique voice and follow their inner calling, versus the explicit and imposed expectation to express their freedom in a certain way.

BACKGROUND: Immune checkpoint inhibitors (ICIs) represent a novel class of agents approved for the treatment of several cancers and progressive multifocal leukoencephalopathy (PML). However, due to the risk of autoimmune side effects, their use in people with autoimmune diseases such as multiple sclerosis (MS) has been limited. OBJECTIVE: To characterize outcomes in a cohort of adults with MS who received ICIs. METHODS: A single-center retrospective review of medical record data was performed for people with MS treated with ICIs. RESULTS: Seven people with MS were identified, with a mean (SD) age at ICI use of 55.4 (13.7) years and a mean MS duration of 18.2 (12.2) years. Six were treated for cancer; 1 was treated for PML. After mean (SD) follow-up of 1.76 (2.15) years after ICI, outcomes are: no evidence of disease (2), residual metastatic disease (1), death due to cancer (1), death due to PML (1), and lost to follow-up (2). Notably, 0 out of 7 patients experienced an MS relapse; two out of six had new asymptomatic demyelinating magnetic resonance imaging lesions. In the three patients with expanded disability status scale (EDSS) scores at baseline and follow-up, EDSS remained stable (mean delta 0.13). CONCLUSION: In this cohort, no people with MS experienced clinical relapses and one-third experienced asymptomatic radiological activity following ICI treatment.

The purpose of this scoping review was to explore operationalizations and related conceptualizations of young children's engagement in early childhood education and care (ECEC) settings. The literature search was conducted in March 2021 across ERIC, PsycINFO, Scopus, and Web of Science databases, with the aim of identifying studies where child engagement or involvement in ECEC settings was quantitatively assessed. The search resulted in 5965 articles, of which 286 were included in this review. Data were extracted about engagement conceptualization, theoretical frameworks, study population, study design, and engagement measurement tools and methods. Findings show variations in definitions and measurement of child engagement. Almost two-thirds of the studies lacked an explicit definition of child engagement. Young children's engagement was typically defined as behaviors and interactions with the social and material environment, while involvement was depicted as an internal experience. The most common method of measuring children's engagement in ECEC was observations by an external observer, followed by teacher surveys. Seventy-seven unique established measures of child engagement were identified. About one-third of the identified studies relied on unestablished measures of child engagement. Measures of general child engagement in ECEC had a focus on behavioral aspects of engagement, whereas most measures with a focus on engagement in academic activities also included cognitive and emotional aspects. To advance the research of child engagement in ECEC settings, more attention should be put into clarifying the concept of child engagement in terms of its generalizability, specificity, and temporality. Corresponding operationalizations should be precisely described. Our recommendations also include validating existing measures of child engagement and developing self-reports for young children.

BACKGROUND: A majority of women with multiple sclerosis (MS) are diagnosed prior to menopause, yet their experiences during this transition are not well characterized. OBJECTIVES: To explore associations between mental health, sleep, and other quality of life metrics, and vasomotor symptoms (VMSs) in ambulatory, menopausal women with MS. METHODS: A secondary analysis was performed of baseline data from two trials enrolling ambulatory peri/postmenopausal women with MS: NCT02710214 (N = 24, bothersome VMS) and NCT04002934 (ongoing, N = 35, myelin repair). Measures analyzed were 36-Item Short-Form Survey (SF-36) (primary scale: general mental health), subjective sleep quality (Pittsburg Sleep Quality Index), VMS (daily diary, interference), mood (Center for Epidemiologist Studies-Depression Scale (CES-D)), walking impairment (timed 25-foot walk (T25FW)), and global disability (Expanded Disability Status Scale (EDSS)). RESULTS: Participants characteristics (N = 59) were: mean age 51.8 years (SD = 3.4), mean disease duration 11.3 years (SD = 7.6), median EDSS 3.0 (IQR = 2.0-4.0). Mental health was associated with better sleep quality (rho = -0.41, p = 0.019) and better mood (rho = -0.75, p < 0.001), but not with EDSS or T25FW (rho < 0.20, p > 0.10). Worse sleep quality also correlated with more frequent VMS (rho = 0.41, p = 0.02) and VMS interference (rho = 0.59, p < 0.001). CONCLUSIONS: Findings suggest that optimizing sleep quality, mood, and hot flash quantity/interference could substantially improve mental health in menopausal women with MS-and highlight an important care gap in this population.

Abstract Background Rheumatoid arthritis (RA) is a chronic, systemic, inflammatory joint disease, that influences patients’ health in different ways, including physical, social, emotional, and psychological aspects. The goal of rheumatology care is to achieve optimal health and personalised care and therefore, it is essential to understand what health means for patients in the early course of RA. The aim of this study was to describe the understanding of health among patients with early RA. Methods The study had a descriptive qualitative design with a phenomenographic approach. Phenomenography is used to analyse, describe, and understand various ways people understand or experience a phenomenon, in this study, patients’ understandings of health. Individual semi-structured interviews were conducted with 31 patients (22 women and nine men, aged (38–80) with early RA, defined as a disease duration of

BackgroundOver one-third of multiple sclerosis (MS) patients are post-menopausal women, the primary demographic affected by breast cancer. After breast cancer diagnosis, there is little information about patients' clinical experiences with both diseases.ObjectiveUtilize a case series of MS patients diagnosed with breast cancer to characterize oncologic and MS trajectories, and generate novel insights about clinical considerations using qualitative analysis.MethodsA single-center retrospective review was performed on medical record data of patients with MS and breast cancer. Thematic analysis was used to characterize experiences with the concurrent diagnoses.ResultsFor the 43 patients identified, mean age was 56.7 years at cancer diagnosis and MS duration was 16.5 years. Approximately half were treated with MS disease modifying therapy at cancer diagnosis, and half of these subsequently discontinued or changed therapy. Altogether 14% experienced MS relapse(s) during follow-up (with 2 relapses in the first 2 years), with mean annualized relapse rate of 0.03. Cohort Expanded Disability Status Scale (EDSS) scores remained stable during follow-up. Qualitative insights unique to this population were identified regarding immunosuppression use and neurologic symptoms.ConclusionsMS relapses were infrequent, and there was modest progression during breast cancer treatment. Oncologic outcomes were comparable to non-MS patients with similarly staged cancer.

Background Knowledge about how patients with symptomatic aortic stenosis (AS) perform on cardiopulmonary exercise testing (CPET) is sparse. Since exercise testing in patients with symptomatic AS is not advised, submaximal parameters could be of special interest. We aimed to investigate maximal and submaximal physical capacity by CPET before and 1 year after surgical aortic valve replacement (sAVR) in patients with severe AS.Methods In this prospective longitudinal study, 30 adult patients (age 66±10 years) with severe AS referred for sAVR underwent maximal CPET (respiratory exchange ratio ≥1.05) on a bicycle ergometer before (PRE) and 1 year after (POST) sAVR. Normally distributed data are presented as mean (±SD) and non-normally distributed data are presented as median (IQR).Results Median peak workload increased by 8% from 133 (55) watts at PRE to 144 (67) watts at POST (p

ABSTRACTOver the past decade there has been an increase in scientific publications addressing intercultural competence (IC) of students. The sheer volume of publications available makes it difficult to determine the extent, breadth, and nature of research within the area. The aim of this scoping review was to describe the state of peer reviewed research related to IC, including academic disciplines addressing the issue, regions of the world conducting research, types of interventions used to foster IC and how outcomes are being evaluated. Six databases were searched, resulting in 15,128 articles. A total of 464 met the inclusion criteria. A trend was observed towards studying IC in interdisciplinary student populations as well as a post-COVID-19 trend towards more online interventions. Most research was conducted in North America (n = 198; 42.7%) within the discipline of education (n = 87; 18.8%). The most common intervention was pedagogical approaches delivered at the students’ home institution (n = 161; 34.7%). Results highlight a gap in research from the Global South and a lack of consensus regarding appropriate tools for evaluating IC. Continued work is required to determine the effects of specific interventions and to support educators in identifying appropriate tool(s) for measuring outcomes.

Purpose To describe and analyse experiences of living with lipedema. Methods: Individual, semi-structured interviews with a purposive sample of 12 women diagnosed with lipedema and analysed by qualitative content analysis utilizing an inductive approach. Results The overarching theme, “An uncertain uphill battle against a divergent body and societal ignorance”, covers the experiences of living with lipedema and is based on five categories; “Captivated by a disintegrating body”, “Face the impairments of a chronic condition”, “Experience social exclusion”, “Need emotional support to go on” and “Mull over an insecure future”. The women felt entrapped within their bodies and experienced social exclusion due to the chronic symptoms and the progressive body shape alteration caused by their illness. Having experienced deficient information on the illness, varying support from other people, and a deteriorating economic situation, the women face an uncertain future. Conclusions Symptoms and restrictions caused by lipedema affect women’s livelihood and future, as there are no indications for disease improvement. Preventive work aimed at reducing health deterioration should be a priority. More research is needed to raise healthcare awareness regarding difficulties experienced by patients with lipedema.

Background: Bipolar disorder (BD) is a serious chronic disease with a high frequency of suicide attempts (SA) and suicides. There are few long-term studies concerning characteristics of SA in BD, especially what characterizes early from late SA. Methods: A long-term study of 51 BD patients (DSM-IV) with SA were collected from lithium dispensaries in northern Sweden. Patients were divided into early SA (the first five years) after age of onset (AOO) or late SA. Results: Patients with early SA were younger (p = 0.036), met BD earlier (p = 0.005), had less repeated depressions before SA (p = 0.002), often performed SA at first episode (p < 0.001) and before initiating of lithium (p = 0.002). Before first SA they had, fewer but more frequent episodes/year (p < 0.001), fewer depressive (p < 0.001) but more frequent depressive episodes/year (p < 0.001), lower frequency of hypomanic (p = 0.016) or manic episodes (p = 0.006). They had a higher frequency of episodes/year off (p = 0.047) and on (p = 0.042) lithium. Twenty percent of all patients performed SA at first episode, 47 % early SA and 65 % first ten years after AOO.Early SA was associated with a family history of first- and/or second-degree relative of affective disorder (AD) (p = 0.005), first-degree relative of AD (p = 0.031) and first-degree relative of BD (p = 0.049). All patients with early SA had a family history of AD. Conclusions: Patients with early SA have a more severe form of BD. Family history of AD among first- and/or second-degree relatives is significantly associated with especially early SA which implies a special psychiatric treatment and care for this BD group.

We systematically investigate the influence of the fabrication process on dielectric loss in aluminum-on-silicon superconducting coplanar waveguide resonators with internal quality factors (Qi) of about one million at the single-photon level. These devices are essential components in superconducting quantum processors; they also serve as proxies for understanding the energy loss of superconducting qubits. By systematically varying several fabrication steps, we identify the relative importance of reducing loss at the substrate–metal and substrate–air interfaces. We find that it is essential to clean the silicon substrate in hydrogen fluoride (HF) prior to aluminum deposition. A post-fabrication removal of the oxides on the surface of the silicon substrate and the aluminum film by immersion in HF further improves the Qi. We observe a small, but noticeable, adverse effect on the loss by omitting either standard cleaning (SC1), pre-deposition heating of the substrate to 300 °C, or in situ post-deposition oxidation of the film’s top surface. We find no improvement due to excessive pumping meant to reach a background pressure below 6 × 10−8 mbar. We correlate the measured loss with microscopic properties of the substrate–metal interface through characterization with x-ray photoelectron spectroscopy, time-of-flight secondary ion mass spectrometry, transmission electron microscopy, energy-dispersive x-ray spectroscopy, and atomic force microscopy.

Background and objectivesThe biologic mechanisms underlying neurologic postacute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (PASC) are incompletely understood.MethodsWe measured markers of neurologic injury (glial fibrillary acidic protein [GFAP], neurofilament light chain [NfL]) and soluble markers of inflammation among a cohort of people with prior confirmed SARS-CoV-2 infection at early and late recovery after the initial illness (defined as less than and greater than 90 days, respectively). The primary clinical outcome was the presence of self-reported CNS PASC symptoms during the late recovery time point. We compared fold changes in marker values between those with and without CNS PASC symptoms using linear mixed-effects models and examined relationships between neurologic and immunologic markers using rank linear correlations.ResultsOf 121 individuals, 52 reported CNS PASC symptoms. During early recovery, those who went on to report CNS PASC symptoms had elevations in GFAP (1.3-fold higher mean ratio, 95% CI 1.04-1.63, p = 0.02), but not NfL (1.06-fold higher mean ratio, 95% CI 0.89-1.26, p = 0.54). During late recovery, neither GFAP nor NfL levels were elevated among those with CNS PASC symptoms. Although absolute levels of NfL did not differ, those who reported CNS PASC symptoms demonstrated a stronger downward trend over time in comparison with those who did not report CNS PASC symptoms (p = 0.041). Those who went on to report CNS PASC also exhibited elevations in interleukin 6 (48% higher during early recovery and 38% higher during late recovery), monocyte chemoattractant protein 1 (19% higher during early recovery), and tumor necrosis factor α (19% higher during early recovery and 13% higher during late recovery). GFAP and NfL correlated with levels of several immune activation markers during early recovery; these correlations were attenuated during late recovery.DiscussionSelf-reported neurologic symptoms present approximately 4 months after SARS-CoV-2 infection are associated with elevations in markers of neurologic injury and inflammation at earlier time points. Some inflammatory pathways seem to be involved months after acute infection. Additional work will be needed to better characterize these processes and to identify interventions to prevent or treat this condition.

Abstract Background Children with autism spectrum disorders are frequent visitors to high technology environments, and their needs may differ from those of their typically developed peers. Procedures in high technology environments can constitute a challenge for these children and their parents since the environment presents many challenges relevant to the child’s impairments. This systematic review aimed to explore the experiences of children with autism spectrum disorders and their parents during procedures in a high technology environment. Methods The following sources were searched for this systematic review: Cochrane CENTRAL Trials, CINAHL, Dentistry and Oral Sciences Source, MEDLINE, PsycINFO, Scopus, and Web of Science Core Collection. The search terms included variants of the following concepts: (1) children with autism spectrum disorder and/or their parents and (2) anesthesia or radiographic departments. Publications were not limited by date or study design. Result Out of 13,389 bibliographic records, nine studies were eligible for synthesis. After another search in October 2022, one additional study was eligible for synthesis.None of the studies reported children’s experiences, and all ten reported their parents’ experiences. Only one study was conducted in a radiographic context. Parents’ experiences were both positive and negative and were categorized into two main categories: (1) challenges in a new environment and (2) health care professionals’ approaches. Conclusion Studies describing children’s experiences with procedures in high technology environments are lacking. The parents described a need for health care professionals to work in structured ways with their child and to be able to make suitable adaptations. Systematic review registration This systematic review was registered in advance on the Open Science Framework, https://doi.org/10.17605/OSF.IO/5TXWJ .

Abstract The processes generating the earth’s montane biodiversity remain a matter of debate. Two contrasting hypotheses have been advanced to explain how montane populations form: via direct colonization from other mountains, or, alternatively, via upslope range shifts from adjacent lowland areas. We seek to reconcile these apparently conflicting hypotheses by asking whether a species’ ancestral geographic origin determines its mode of mountain colonization. Island-dwelling passerine birds at the faunal crossroads between Eurasia and Australo-Papua provide an ideal study system. We recover the phylogenetic relationships of the region’s montane species and reconstruct their ancestral geographic ranges, elevational ranges, and migratory behavior. We also perform genomic population studies of three super-dispersive montane species/clades with broad island distributions. Eurasian-origin species populated archipelagos via direct colonization between mountains. This mode of colonization appears related to ancestral adaptations to cold and seasonal climates, specifically short-distance migration. Australo-Papuan-origin mountain populations, by contrast, evolved from lowland ancestors, and highland distribution mostly precludes their further colonization of island mountains. Our study explains much of the distributional variation within a complex biological system, and provides a synthesis of two seemingly discordant hypotheses for montane community formation.

An assessment method for sustainability was developed by the authors in a previous article. Many social sustainability assessment methods rely on assessors’ subjective judgments, which can be problematic. This study aims to examine the level of consensus different assessors can achieve using various assessment methods and to compare their results with an assessment made by one of the authors, to reduce subjectivity. A selective sample of engineering students from Karlstad University were surveyed to test and compare three as-assessment methods against the initial assessment. The three methods are: Woxnerud’s (the authors’) method, Jan Gehl’s twelve quality criteria, and a structured survey. Seven student groups conducted the first assessment, followed by 12 individual students who performed the second and third assessments. The objectives were to determine whether multiple assessors could reach a consensus using each method, identify which method yielded the most consensus and was most effectively implemented, and measure each method’s consonance rate in relation to Woxnerud’s initial assessment. The first method achieved a 75.0% assessor consensus and 98.4% consonance. The second method achieved a 67.0% assessor consensus and 75.0% consonance. The third method achieved a 50% assessor consensus and 91.0% consonance. This limited study suggests that a subjective method, such as an assessment method for social sustainability, can yield somewhat similar results, and in addition, Woxnerud’s method is more objectively applicable than the two other methods tested in this article.

According to research, there is a disparity in the aesthetic design preferences of the public and architects. This is especially noticeable in urban areas environments, where there is a wide range of demographic variables and a lack of active public involvement in decision-making. The study included a visual preference survey to evaluate the perception and ranking of two dominant color schemes in local development projects in Stockholm across different age, ethnicity, and gender groups from Sweden. Over 400 people participated in the survey, which used photo-elicitation and a literature review. The objective was to determine the extent of divergence and disparities in the ranking of color schemes. The first dominant color schemes are a group of four analogous colors related to the Natural Color System’s (NSC’s) basic colors. The second is a group of four neutral colors that are related to grayscale colors. The study demonstrates that one could also measure building color schemes using visual preference ranking. Moreover, the research introduced a unique method for city planners to understand diverse ethnic, gender, and age group perceptions of color schemes in current projects, promoting active participation in decision-making and providing valuable insights. These insights can enhance people’s sense of belonging, a prerequisite for social sustainability, and improve the quality and profitability of future projects.

Quantum processors require a signal-delivery architecture with high addressability (low crosstalk) to ensure high performance already at the scale of dozens of qubits. Signal crosstalk causes inadvertent driving of quantum gates, which will adversely affect quantum gate fidelities in scaled-up devices. Here, we demonstrate packaged flip-chip superconducting quantum processors with signal-crosstalk performance competitive with those reported in other platforms. For capacitively coupled qubit-drive lines, we find on-resonant crosstalk better than −27 dB (average −37 dB). For inductively coupled magnetic-flux-drive lines, we find less than 0.13% direct-current flux crosstalk (average 0.05%). These observed crosstalk levels are adequately small and indicate a decreasing trend with increasing distance, which is promising for further scaling up to larger numbers of qubits. We discuss the implications of our results for the design of a low-crosstalk on-chip signal-delivery architecture, including the influence of a shielding tunnel structure, potential sources of crosstalk, and estimation of crosstalk-induced qubit-gate error in scaled-up quantum processors.

Background: Dialectical behavior therapy (DBT) is an evidence-based treatment for self-harm and emotion regulation difficulties. A modified version, DBT-Skills System (DBT-SS), has been developed in the USA for individuals with cognitive difficulties. The present study is a pilot study, testing the DBT-SS in a Swedish context. Methods: Six participants were treated with individual therapy and group skills training for 48 sessions each. A case series design was used to follow individual development over time. The primary outcome measure was reduction in challenging behaviors. Secondary outcomes were level of functioning in daily life, hospital admissions, and resilience and vulnerabilities in different risk domains. Data was analyzed using time-series diagrams. Effect sizes of changes were calculated using Cohen's d. Results: Challenging behaviors decreased over time and participants' global level of functioning increased. There was a reduction in number of hospital admissions over time. As for resilience and vulnerabilities, participants' overall level of risk in various areas remained unchanged or decreased after treatment. Conclusions: The results indicate that DBT-SS might be a promising treatment for cognitively challenged individuals with emotion regulation difficulties and challenging behaviors in a Swedish context. The study provides suggestions for a future randomized controlled trial.

This article contributes to the civic identity development literature by exploring how a scholarship program emphasizing entrepreneurship and economic revitalization can facilitate engagement across difference in pursuit of shared anti-poverty commitments. Drawing on theories of entrepreneurial action, civic identity development literature, and a mixed methods approach, we propose a framework for how students conceptualize identity, race, and poverty as "entrepreneurs of connection." The role of uncertainty is central to entrepreneurial action and a hallmark of community engagement. Combining an inquiry into their own sense of identity in relationship to their peers and community partners, students contribute to the development of the entrepreneurial ecosystem by making connections at the interpersonal, organizational, and systems levels. Students merge an understanding of their personal identities and situational context to build trust with diverse peers and community partners. Entrepreneurs of connection take action with community partners to pursue innovative solutions with a focus on social change.

It is well established that participation in formal adult education varies by individual background characteristics. However, less attention has been paid to examining inequality in participation as a consequence of policy changes, such as educational expansion. This paper examines the process of tremendous expansion in Swedish Higher Vocational Education (HVE), a vocationally oriented postsecondary educational segment driven by labor market needs. Using a demographic approach with a sociological lens on educational participation, we analyze administrative data from registers, uncovering who has been served by this expanding adult educational form. Our results indicate that expansion of HVE has led to growth in participation for policy-prioritized groups, although the rate of growth in enrollment between groups varies and corresponds to population changes. We also locate the extent of cumulative advantages in participation and discuss these results in relation to social (in)equality in formalized HVE.

OBJECTIVES: Radon is carcinogenic, but more studies are needed to understand relationships with lung cancer and extrathoracic cancers at low exposures. There are few studies evaluating associations with cancer incidence or assessing the modifying effects of smoking. METHODS: We conducted a case-cohort study with 16 434 underground uranium miners in the Czech Republic with cancer incidence follow-up 1977-1996. Associations between radon exposure and lung cancer, and extrathoracic cancer, were estimated with linear excess relative rate (ERR) models. We examined potential modifying effects of smoking, time since exposure and exposure rate. RESULTS: Under a simple ERR model, assuming a 5-year exposure lag, the estimated ERR of lung cancer per 100 working level months (WLM) was 0.54 (95% CI 0.33 to 0.83) and the estimated ERR of extrathoracic cancer per 100 WLM was 0.07 (95% CI -0.17 to 0.72). Most lung cancer cases were observed among smokers (82%), and the estimated ERR of lung cancer per 100 WLM was larger among smokers (ERR/100 WLM=1.35; 95% CI 0.84 to 2.15) than among never smokers (ERR/100 WLM=0.12; 95% CI -0.05 to 0.49). Among smokers, the estimated ERR of lung cancer per 100 WLM decreased with time since exposure from 3.07 (95% CI -0.04 to 10.32) in the period 5-14 years after exposure to 1.05 (95% CI 0.49 to 1.87) in the period 25+ years after exposure. CONCLUSIONS: We observed positive associations between cumulative radon exposure and lung cancer, consistent with prior studies. We observed a positive association between cumulative radon exposure and extrathoracic cancers, although the estimates were small. There was evidence that the association between radon and lung cancer was modified by smoking in a multiplicative or super-multiplicative fashion.

Abstract Exercise is often cited as a major factor contributing to improved cognitive functioning. As a result, the relationship between exercise and cognition has received much attention in scholarly literature. Systematic reviews and meta-analyses present varying and sometimes conflicting results about the extent to which exercise can influence cognition. The aim of this umbrella review was to summarize the effects of physical exercise on cognitive functions (global cognition, executive function, memory, attention, or processing speed) in healthy adults ≥ 55 years of age. Methods An umbrella review of systematic reviews with meta-analyses investigating the effect of exercise on cognition was performed. Databases (CINAHL, Cochrane Library, MEDLINE, PsycInfo, Scopus, and Web of Science) were searched from inception until June 2023 for reviews of randomized or non-randomised controlled trials. Full-text articles meeting the inclusion criteria were reviewed and methodological quality assessed. Overlap within included reviews was assessed using the corrected covered area method (CCA). A random effects model was used to calculate overall pooled effect size with sub-analyses for specific cognitive domains, exercise type and timing of exercise. Results Database searches identified 9227 reviews. A total of 20 met the inclusion criteria. They were based on 332 original primary studies. Overall quality of the reviews was considered moderate with most meeting 8 or more of the 16 AMSTAR 2 categories. Overall pooled effects indicated that exercise in general has a small positive effect on cognition (d = 0.22; SE = 0.04; p

This research aims to foster social sustainability by allowing residents to participate in community decisions and creating a sense of belonging. Utilizing the photoelicitation technique, we conducted a visual preference survey with an average of 457 participants in Sweden to assess the physical and urban features of local development projects. The composite assessment of built environment quality was based on 11 qualities: urban planning, building mass configurations, building orientation, parking planning, roof articulation, building materials, color scheme, entrance articulation, fenestration, and balcony articulation and placement. We conducted a subjective qualitative analysis and quantitative evaluation of the photoelicitation data. The study identified the most preferable features leading to the highest rankings, presented a novel method to increase the participatory process’s efficacy, and developed an assessment matrix based on the quality ranking of the 12 features. The primary outcome was the development of methods for knowledge transfer and quality assessment of built projects in Nordic cities, with a focus on putting residents’ voices front and center in urban development.

Abstract Introduction: Seattle Children’s Research Institute is identifying the amount and type of health equity scholarship being conducted institution wide. However, methods for categorizing how scholarship is equity-focused are lacking. We developed and evaluated the reliability of a health equity scholarship coding schema applied to Seattle Children’s affiliated scholarship. Methods: A 2021–2022 Ovid MEDLINE affiliation search yielded 3551 affiliated scholarship records, with 1079 records identified via an existing filter as scholarship addressing social determinants of health. Through reliability testing and examining concordance and discordance across three independent coders of these records, we developed a coding schema to classify health equity scholarship (yes/no). When health equity scholarship proved positive/Yes, the coders assigned a one through five maturity rating of the scholarship towards addressing inequities. Subsequent reliability testing including a new coder was conducted for 992 subsequent affiliated scholarship records (Oct 2022–June 2023), with additional testing of the sensitivity and specificity of the existing filter relative to the new coding schema. Results: Reliability for identifying health equity scholarship was consistently high (Fleiss kappas ≥ .78) and categorization of health equity scholarship into maturity levels was moderate (Fleiss kappas ≥ .47). The coding schema identified additional health equity scholarship not captured in an existing filter for social determinants of health scholarship. Based on the new schema, 23.3% of Seattle Childrens’ affiliated scholarship published October 2002–June 2023 was health equity focused. Conclusions: This new coding schema can be used to identify and categorize health equity scholarship to help quantitate the health equity focus of portfolios of human-focused research.

Background: Primary hyperhidrosis consists of excessive focal sweating. Affected individuals camouflage the sweating on their body, avoiding stigmatisation. Hence, misrepresentation in social interactions is a common feature in patients with hyperhidrosis. The aim of this study was to investigate impostor phenomenon, perfectionism, self-compassion, stress and anxiety among individuals with primary hyperhidrosis. Methods: A cross-sectional study was conducted at our clinic among 100 participants with axillary and palmar primary hyperhidrosis. The questionnaire contained a hyperhidrosis part and Perceived Stress Scale-4, Generalised Anxiety Disorder Scale-2, Clinical Perfectionism Questionnaire-6, Self-Compassion Scale Short form and Clance Impostor Phenomenon Scale. Descriptive statistics was used for analyses of categorical variables. As data were normally distributed independent t -test and one-way analysis of variance with post hoc Tukey test were used to compare the mean values for the questionnaires with other variables. Pearson’s correlation was used, and a forward multiple linear regression model was performed to predict presence of impostor phenomenon with gender, age and other scales in this study. Results: Impostor phenomenon occurred in almost half of our patients (48%) with hyperhidrosis. While feelings of impostor phenomenon were more common in women, there was no difference between gender regarding its intensity levels ( p = 0.07). In addition, we found a significant ( p

BackgroundFalls are common in people with multiple sclerosis (MS), causing injuries, fear of falling, and loss of independence. Although targeted interventions (physical therapy) can help, patients underreport and clinicians undertreat this issue. Patient-generated data, combined with clinical data, can support the prediction of falls and lead to timely intervention (including referral to specialized physical therapy). To be actionable, such data must be efficiently delivered to clinicians, with care customized to the patient’s specific context. ObjectiveThis study aims to describe the iterative process of the design and development of Multiple Sclerosis Falls InsightTrack (MS-FIT), identifying the clinical and technological features of this closed-loop app designed to support streamlined falls reporting, timely falls evaluation, and comprehensive and sustained falls prevention efforts. MethodsStakeholders were engaged in a double diamond process of human-centered design to ensure that technological features aligned with users’ needs. Patient and clinician interviews were designed to elicit insight around ability blockers and boosters using the capability, opportunity, motivation, and behavior (COM-B) framework to facilitate subsequent mapping to the Behavior Change Wheel. To support generalizability, patients and experts from other clinical conditions associated with falls (geriatrics, orthopedics, and Parkinson disease) were also engaged. Designs were iterated based on each round of feedback, and final mock-ups were tested during routine clinical visits. ResultsA sample of 30 patients and 14 clinicians provided at least 1 round of feedback. To support falls reporting, patients favored a simple biweekly survey built using REDCap (Research Electronic Data Capture; Vanderbilt University) to support bring-your-own-device accessibility—with optional additional context (the severity and location of falls). To support the evaluation and prevention of falls, clinicians favored a clinical dashboard featuring several key visualization widgets: a longitudinal falls display coded by the time of data capture, severity, and context; a comprehensive, multidisciplinary, and evidence-based checklist of actions intended to evaluate and prevent falls; and MS resources local to a patient’s community. In-basket messaging alerts clinicians of severe falls. The tool scored highly for usability, likability, usefulness, and perceived effectiveness (based on the Health IT Usability Evaluation Model scoring). ConclusionsTo our knowledge, this is the first falls app designed using human-centered design to prioritize behavior change and, while being accessible at home for patients, to deliver actionable data to clinicians at the point of care. MS-FIT streamlines data delivery to clinicians via an electronic health record–embedded window, aligning with the 5 rights approach. Leveraging MS-FIT for data processing and algorithms minimizes clinician load while boosting care quality. Our innovation seamlessly integrates real-world patient-generated data as well as clinical and community-level factors, empowering self-care and addressing the impact of falls in people with MS. Preliminary findings indicate wider relevance, extending to other neurological conditions associated with falls and their consequences.

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Studies have shown that psychological distress has a role in the symptomology of localized provoked vulvodynia. Therefore, psychosocial support has been presented as a valuable part of the treatment. However, little is known about which psychological variables that coincide with localized provoked vulvodynia. The purpose of this study was to identify qualities of psychological distress in patients with localized provoked vulvodynia. Patients with localized provoked vulvodynia were consecutively recruited to participate in this cross-sectional questionnaire-based study. Participants completed a self-report questionnaire measuring perfectionism, impostor phenomenon, self-compassion, anxiety and perceived stress. A sample of 30 patients were included. Questionnaire results suggestive of perfectionism was seen in 63%, impostor phenomenon in 80%, low self-compassion in 27%, anxiety in 43% and perceived stress in 23% of the participants. The level of self-compassion was higher in patients in a committed relationship. The investigated qualities appear to be more common in patients with localized provoked vulvodynia than in comparable groups. Impostor phenomenon and perfectionism were particularly common, with more than half of the study population scoring above the cutoff for clinical significance. This motivates research to investigate if interventions targeting impostor phenomenon and perfectionism, may aid in the treatment of localized provoked vulvodynia.

Abstract Background Symptoms from the vulva and vagina affect about one‐third of all women and have a negative influence both on sexual health and psychosocial well‐being. Research regarding vulvar diseases is sparse and there is a need for a better understanding of women seeking care for vulvar diseases. Objectives The objectives of this descriptive study were to investigate symptoms, signs, and background characteristics of women attending our multidisciplinary vulvar clinic at the University Hospital, Umeå, Sweden between 2005 and 2021. Methods We conducted a prospective study by using a vulvar‐specific questionnaire and reviewed the medical records to collect supplementary data. Results A total of 600 women participated. The most common symptom among all participants was dyspareunia (67.6%). Pain diagnoses dominated in the younger population while inflammatory diseases were most common among patients 40 years of age or more. We found a significant association between dyspareunia and negative experiences of gynaecological examination (p

Purpose: With the advancement of novel forms of text mining techniques, new possibilities have opened up to conduct large-scale content analysis of educational research from an international and comparative perspective. Since educational research tends to convey great variation based on country-specific circumstances it constitutes a good testbed for context-rich depictions of the knowledge formation within a given research field. Design/methodology/approach: In this article, the authors compare the educational research that has been produced by scholars in Singapore and Sweden. The article begins by providing a rich overview of what has characterised the formation and institutionalization of educational research in public policy. After this background they map the knowledge formation of education by means of a comparative bibliometric approach using words from abstracts, titles and keywords published in 9017 peer-reviewed articles between 2000 and 2020. First, the authors describe the dominant topics in each country using topic modelling techniques. Secondly, the authors identify the most distinguishing discourses when comparing the two countries. Findings: The findings illustrate two ideal-types for conducting educational research: Singapore being more centralised, practically-oriented, quantitative and uncritical, whereas Sweden is decentralised, pluralistic, qualitative and critical in orientation. After having mapped out the prevailing topics among researchers working in these locations, the authors connect these findings to larger debates on rivalling knowledge traditions in educational scholarship, the role of the state and the degree of autonomy within higher education. Originality/value: Through large scale text mining techniques, researchers have begun to explore the semantic composition of various research fields such as higher education research, research on lifelong learning, or social science studies. However, the bibliometric method has also been criticised for creating "mega-national comparisons" that suffer from a lack of understanding of the national ramifications of various research pursuits. The authors' study addresses these shortcomings and provides a rich depiction of educational research in Singapore and Sweden. It zooms in on the relationship between each country's institutional histories, research priorities and semantic output.

Doctoral studies offer a unique phase in the development and legitimisation of researchers, in which PhD students shift from consumption to production of knowledge. While literature exists concerning the information behaviour of graduate students and researchers, there is little work which focuses specifically on the information literacies of PhD students within the health sciences. To better understand this user group, we undertook a qualitative study at the Research School of Health and Welfare in Jönköping, Sweden. Twelve open-ended interviews with both PhD students and their supervisors were conducted and analysed according to a hermeneutic dialectic process. Findings revealed that the supervisors commonly assumed that PhD students already have necessary information literacy skills. Yet some of the students self-reported feeling uncertain when searching and getting 'stuck' with one strategy. Responses also indicated that the PhD students and their supervisors were often unaware of what services and support the library could provide.

The question of what the research of lifelong education is all about needs to be revisited from time to time. Not only is this line of research approached from a multitude of academic disciplines -- such as sociology, psychology or philosophy -- the very concepts that are used to denote the field also undergo important changes over time, e.g. from lifelong education to lifelong learning. In this contribution, we will explore this rather elusive research territory using a large-scale text analysis of a specific scientific journal, "International Journal of Lifelong Education," based on metadata (abstracts, keywords and titles) from 1,185 articles published between 1982 to 2021. Based on topic modelling techniques, we identify the main themes that have been prevalent within the journal, and how the journal's content has changed character over time. We end the paper with a more critical examination of what kind of political and scientific currents might help explain what has led research practices to be more descriptive, micro-oriented and work-related over time.