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Bakgrund: Bröstcancer är den vanligaste cancerformen bland kvinnor i Sverige, tio procent av kvinnorna i Sverige utvecklar bröstcancer uncer sin livstid. Globalt sett rapporteras de högsta antalet cancerfall i de afrikanska länderna söder om Sahara. Mastektomi är en av behandlingsmetoderna för bröstcancer, och att genomgå mastektomi kan framkalla känslor som inverkar på livet och därmed skulle kunna inverka på livskavlitén.

Syfte: Denna studies syfte var att beskriva erfarenheter av förändrad livskvalité hos kvinnor som genomgått bröstcancer, där behandlingen varit mastektomi.

Metod: Artikelsökningar genomfördes i de vetenskapliga databaserna PubMed och Cinahl. Tretton kvalitativa artiklar valdes ut där deras resultat sedan analyserades med hjälp av Fribergs femstegsmodell för kvalitativa litteraturstudier.

Resultat: Resultatet av analysen resulterade i tre teman med tillhörande subteman. Dessa var; Förändring av kroppsuppfattning och identitet, Psykologiska utmaningar: Känslor av oro, ångest och normalitet, och Vikten av stöd.

Konklusion: Resultatet visade på en förändrad kroppsuppfattning och sexualitet, vilket försämrade kvinnornas livskvalité. Stöd framställs som en viktig faktor för kvinnornas fortsatta återhämtning. Vårdpersonalens möjlighet till ökad information skulle kunna leda till förbättrad livskvalitet hos kvinnor som genomgått mastektomi till följd av bröstcancer.

Background: There are 1,6 million children in Sweden, of which about 350 receive a cancer diagnosis each year. The disease affects the child in many ways. The nurse has a significant role in the care of children with cancer. An important task that the nurse has is to create a safe and supportive environment for the child and the child’s family.  

Aim: The aim was to illuminate nurses´experiences of caring for children with cancer in inpatient care. 

Methods: Literature study based on eight qualitative studies. Database search was conducted in Pubmed and Cinahl. Fribergs five-step model was used to analyze the eight studies. 

Results: The analysis resulted in three main categories and four subcategories. The main categories were: “Feeling conflicting emotions at work”, “Needing support at work" and “Developing a strong relationship with the child and family”. 

Conclusion: Nurses caring for children with cancer face demanding tasks that involve both positive and negative emotions. It can be challenging to provide good nursing and build relationships with the family and at the same time deal with your own emotions. Receiving support in one’s work is an important aspect to increase the nurse’s well-being and improve the quality of care. 

Background: Malaria prevention during pregnancy significantly minimizes maternal–fetal adverse events. However, optimal uptake of malaria preventive therapy in pregnancy (MPTp) remains a major challenge for both women living with HIV and those without. In Uganda, suboptimal uptake of MPTp is primarily due to inadequate knowledge among women. This study aimed to develop and assess the feasibility and acceptability of an educational video to improve knowledge of MPTp among pregnant women living with and without HIV.

Methods: This study describes the second phase of a mixed methods study conducted among pregnant women (living with and without HIV) and midwives from a public antenatal care clinic in Kampala, Uganda. The study was conducted from October 2022 to Jan 2024, and the first phase involved qualitative data collection from pregnant women, health workers, and Ministry of Health officials to develop a video-based intervention to enhance uptake of MPTp. The second phase involved administration of the developed intervention to a group of purposively selected pregnant women living with and without HIV. Questionnaires, focus group discussions, and interviews were used to collect data among women and midwives, and to assess feasibility and acceptability of the intervention. Quantitative data were summarized using descriptive statistics and analysed using different scales of measurement including the modified system usability scale and the Evidence-based Practice and Attitude Scale (EBPAS), which assessed acceptability among pregnant women and midwives, respectively. The qualitative data were coded and analysed using inductive and deductive thematic methods in Atlas ti.8.

Results: A total of 45 women and six midwives were enrolled in the current study phase. The mean age (± standard deviation, SD) of the women was 26 ± 6 years, and the median gestational age (interquartile range, IQR) was 24 (20–32) weeks, and less than half (42%, n = 19) were living with HIV. On the system usability scale, most women (91%, n = 41) rated the intervention as good or excellent, and most (93%, n = 42) were satisfied or very satisfied with the intervention. On the EBPAS, midwives perceived the intervention as reliable with Cronbach’s alpha of 0.74, and all midwives found the intervention appropriate and feasible in their facility. All women comprehended and highly accepted the intervention.

Conclusion: The video-based intervention for uptake of MPTp was found acceptable among women and midwives and was feasible and appropriate to a public health facility. Future studies would test the effectiveness of the intervention in improving knowledge and uptake of MPTp.

Background: The assessment of left ventricular (LV) filling pressure in heart failure (HF) poses a diagnostic challenge, as HF patients may have normal LV filling pressures at rest but often display elevated LV filling pressures during exercise. Rapid preload increase during passive leg lift (PLL) may unmask HF in such challenging scenarios. We explored the dynamic interplay between simultaneous left atrial (LA) function and volume using LA strain/volume loops during rest and PLL and compared its diagnostic performance with conventional echocardiographic surrogates to detect elevated LV filling pressure.

Methods: We retrospectively reviewed 35 patients with clinical HF who underwent simultaneous echocardiography and right heart catheterization before and immediately after PLL. Patients with atrial fibrillation (n = 4) were excluded. Twenty age-matched, healthy controls were added as controls. LA reservoir strain (LASr) was analyzed using speckle-tracking echocardiography. LA strain–volume loops were generated, including the best-fit linear regression line employing simultaneous LASr and LA volume.

Results: LA strain–volume slope was lower for HF patients when compared with controls (0.71 vs. 1.22%/mL, p < 0.001). During PLL, the LA strain–volume slope displayed a moderately strong negative correlation with invasive pulmonary arterial wedge pressure (PAWP) (r = −0.71, p < 0.001). At a 0.74%/mL cut-off, the LA strain–volume slope displayed 88% sensitivity and 86% specificity to identify elevated PAWP (AUC 0.89 [0.76–1.00]). In comparison, LASr demonstrated strong but numerically lower diagnostic performance (AUC 0.82 [0.67–0.98]), and mitral E/e’ showed poor performance (AUC 0.57 [0.32–0.82]).

Conclusions: In this proof-of-concept study, LA strain–volume characteristics provide incremental diagnostic value over conventional echocardiographic measures in the identification of elevated LV filling pressure.

Lateral connectivity between rivers and terrestrial landscapes is critical for both river and landscape health. Due to widespread anthropogenic degradation of riverscapes, river management is aiming to connect rivers to floodplains, riparian zones, and wetlands, putting a spotlight on lateral connectivity. However, there is currently no consensus on how to conceptualize and study lateral connectivity in rivers across disciplines. Here, we review lateral connectivity between riverscapes and terrestrial landscapes. We focus on the natural sciences, considering hydrology, geomorphology, ecology and biogeochemistry, but also consider social connectivity and the management and restoration of lateral connectivity. We emphasize the importance of considering the bidirectional nature of lateral connectivity, operating both into and out of river channels and the balance between these directions. The resulting “lateral connectivity balance” provides a framework to understand natural spatial and temporal variability in connectivity. Anthropogenic impacts have swung the balance of lateral connectivity, enhancing the transport of materials into and through river networks while suppressing fluxes from rivers to adjacent landscapes. We conclude that further research at the interfaces between the aquatic and terrestrial components of riverscapes is critical to advance our conceptual understanding of river and catchment systems. We propose that such research should be framed within the paradigm of “rebalancing” lateral connectivity, explicitly recognizing the natural bidirectionality of laterally connecting processes, the significance of the hydrologic, geomorphic, and biologic functions they support, and the value to society of the ecosystem services and climate change resilience they provide.

Periodontal diseases represent a significant global health burden, with the bacteria Aggregatibacter actinomycetemcomitans (Aa) recognized as a key contributor in young individuals. Among its variants, the highly leukotoxic Aa JP2 genotype produces up to 20 times more leukotoxin than non-JP2 clones and is known to exacerbate periodontal disease. The compounds in fermented rye bran (FRB) have been found to possess antimicrobial properties, making it interesting to explore their potential impact on leukotoxin (LtxA) production in the JP2 genotype.

This study aimed to assess the influence of FRB on the LtxA production in an Aa JP2 strain.

Aa JP2 was grown in the presence of different concentrations of FRB. Subsequently, THP-1 cells were exposed to these bacteria, and cell viability was evaluated by neutral red uptake, to determine the LtxA production of the bacteria.

The results suggest that FRB influences the cytotoxicity of Aa JP2, particularly at moderate bacterial concentrations (multiplicity of infection ≤12.5). The presence of FRB was associated with increased THP-1 cell viability in a dose-dependent manner, indicating that FRB may mitigate the overall cytotoxic effects of Aa JP2. However, these findings should be interpreted as a reduction in cytotoxicity rather than a direct measurement of LtxA production, as the study indirectly evaluates the impact of Aa on cell viability.

These findings underscore the potential of FRB as a prophylactic agent against periodontal disease. Because of its accessibility, it could make a great difference in economically challenged regions, where there today are no periodontal disease treatment options available.

Transthyretin (TTR) amyloidosis is a progressive disorder characterized by peripheral neuropathy, autonomic dysfunction, and cardiomyopathy. The precise mechanism by which TTR misfolds and forms fibrils in vivo remains incompletely understood, posing challenges to the development of effective therapeutics. In this study, we reveal that the recently identified nonnative pathological species of TTR (NNTTR), which is enriched in the plasma of ttr-val30met gene carriers, exhibits strong amyloidogenic properties, making it a promising therapeutic target. Notably, we demonstrate that NNTTR formation is dependent on an intermolecular disulfide bond and can be promoted by oxidative conditions while being effectively suppressed by reducing agents. The formation of this disulfide bond is incompatible with the native TTR fold, thereby necessitating structural flexibility. We further show that this required flexibility can be constrained using tetramer-stabilizing drugs, thereby suppressing NNTTR formation. Interestingly, the flexibility is also hindered by macromolecular crowding, and NNTTR formation is strongly suppressed by the high protein concentration in plasma. This suppression is released upon dilution, which thus promotes NNTTR formation in areas with lower protein content, highlighting a potential link to the interstitial space, brain, and vitreous body of the eye, where TTR-amyloid is frequently observed. In summary, we demonstrate that NNTTR displays strong amyloidogenic features, underscoring its potential as a therapeutic target. We identify the redox environment and macromolecular crowding as key modulatory factors. Our findings propose a mechanistic explanation for TTR misfolding and suggest a novel therapeutic approach.

Digital innovation is an open collaborative process that involves many contributors for creating digital products and services. Entrepreneurs continuously engage with various external actors during their venture's lifecycle, utilizing these interactions to source opportunities, knowledge and resources, while shaping the project vision. However, the mechanisms governing digital innovation sourcing remain unclear. This paper proposes an entrepreneurial storytelling perspective to bridge this gap. We study the case of digital innovation sourcing by analyzing the crowdfunding story of Pebble Time, the most successful Kickstarter campaign to date. Using digital archival sources, we trace Pebble's approach over the course of the campaign. Our findings contribute to the digital innovation literature by demonstrating how the company's efforts allowed diverse actors to participate collectively and affect the entrepreneurial story over time. We identify four modes of actions that digital ventures employ in the collective construction of entrepreneurial narratives: nudging, pushing, scanning, and highlighting. We suggest that the modes of digital action enable digital innovation sourcing when crafting a compelling narrative in the digital age.

Användning av vårdhundar på äldreboenden är en metod som får allt mer uppmärksamhet inom vård och omsorg, särskilt i arbetet med äldre och äldre med demens. Detta examensarbete syftar till att undersöka effekterna av vårdhundar på äldreboenden genom att analysera erfarenheter och uppfattningar från olika professionella inom vården, såsom hundförare, enhetschefer och undersköterskor. Den centrala frågan är att förstå hur vårdhundar påverkar välbefinnandet hos äldre personer, inklusive dem med demens, samt hur dessa insatser integreras i den dagliga omsorgen. För äldre personer, och särskilt dem med demens, kan vårdhundar ha positiva effekter på humör, socialt engagemang och minskade känslor av ensamhet och ångest. Dessutom kan interaktionen med hundarna bidra till förbättrad fysisk aktivitet och kognitiv stimulans. Denna studie undersöker både de direkta och indirekta effekterna av vårdhundar, och hur personalen upplever att vårdhundar påverkar de äldre. Intervjuer genomfördes med tre yrkesgrupper som har direkt erfarenhet av vårdhundar i äldreomsorgen: två hundförare, en enhetschef, och en undersköterska. Hundförarna, som har specialiserad utbildning för att arbeta med sina vårdhundar, beskrev hur hundens närvaro och interaktion med de äldre individerna skapar positiva förändringar i deras beteende och känslomässiga tillstånd. Enligt hundförarna är det inte ovanligt att äldre som vanligtvis är tillbakadragna och inaktiva blir mer öppna och aktiva när de interagerar med hunden, vilket kan leda till förbättrade kommunikations- och relationsfärdigheter.

 Självskadande beteende ansågs inte alltför länge sedan som ett tämligen sällsynt fenomen. Synen på självskadande beteende är däremot förändrad och idag finns det flera typer av självskadebeteende. Sexuellt självskadebeteende är en typ av självskada, som det sällan pratas om. Syftet med studien är att undersöka när ett sexuellt beteende övergår till att betraktas som självskada enligt socionomer på Ungdomsmottagningen (UMO) och Barn- och ungdomspsykiatrin (BUP). Till grund för studien återfinns tidigare forskning som belyser sexuellt självskadebeteende, dess definition och bakomliggande faktorer som kan ligga till grund för självskadebeteendet. Studien har en teoretisk utgångspunkt i teorin om Stigma, utvecklad av Erving Goffman.

För att samla in data har kvalitativa semistrukturerade intervjuer genomförts med fyra socionomer från olika regioner i Sverige. Det insamlade materialet transkriberades och analyserades sedan genom en tematisk analys. Resultatet visar att begreppet sexuellt självskadebeteende saknar en entydig definition då det finns flera sätt att definiera det på. Resultatet visar att ett sexuellt beteende kan anses vara en sexuell självskada när handlingen utförs för att dämpa bakomliggande känslor kopplade till ångest och andra svårigheter. Att ungdomen tänjer på sina gränser och utsätter sig för sexuella risker kan även definieras som självskada. Vidare visar resultatet att bakomliggande faktorer, så som ångest och tidigare trauman, är vanligt hos personer med ett sexuellt självskadebeteende. Resultatet visar även att ungdomar sällan är medvetna om sitt självskadebeteende. 

Kommuner tillsammans med regioner bär ansvaret för arbetet med Sveriges missbruksvård. Alkohol- och narkotikabruket resulterar i stora samhällskostnader för Sverige varje år. I kommunernas arbete med individer med missbruksproblematik finns det många olika faktorer att ta hänsyn till. Interpersonella egenskaper som exempelvis motivation diskuteras ofta som en framträdande faktor, men även de sociala faktorerna är av stor betydelse.

Denna kvalitativa studie har det övergripande syftet att undersöka sociala faktorers påverkan på risken för återfall i missbruk efter frivillig behandling i slutenvård, ur ett socialsekreterarperspektiv. Tidigare forskning visar att de flesta återfall som inträffar sker inom det första året efter avslutat behandling, samt att viktiga faktorer för att lyckas med behandling och hålla sig nykter och drogfri är en kombination av professionellt stöd och individuella handlingar. För att undersöka syftet samt besvara studiens frågeställningar har fyra intervjuer utförts med socialsekreterare som är eller har varit verksamma på socialtjänstens vuxenenheter i olika kommuner i Sverige. För att analysera empirin i studien har systemteoretiskt perspektiv applicerats. Resultatet visar att boende, sysselsättning samt det sociala nätverket främst kan påverka risken för återfall i missbruk efter behandling i slutenvård. Vidare visar resultatet att det finns utmaningar och svårigheter gällande att ta sociala faktorer i beaktning, i form av samverkan med andra enheter inom socialtjänsten gällande planering av eftervården och att planeringen utformas utan att det blir någon typ av "glapp". I resultatet lyfts även svårigheter gällande att ge stöd och insatser för att förändra det sociala nätverket, vilket beskrivs som en viktig del i att vara fortsatt nykter coh drogfri efter behandling. Att ha möjlighet att kunna hjälpa individen att flytta till en annan kommun är enligt empirin önskvärt, men skildras som en utmaning. 

Denna studie syftar till att undersöka och kartlägga det insatser och stöd som kan erbjudas till våldsutsatta kvinnor, samt de svårigheter som kan uppstå i arbetet enligt en grupp som arbetar inom kvinnojouren. För att samla data gjordes semistrukturerade intervjuer med socionomer som är aktiv i arbetet med våldsutsatta kvinnor via kvinnojouren. Intervjupersonerna kommer från olika kommuner och intervjuerna gjordes via teams. Det insamlade empiriska data analyserades sedan med hjälp av tematiska analysmetod. Studien visar att utifrån det stora och flexibla handlingsutrymmet har man möjligheten att arbeta på olika sätt med våldsutsatta kvinnor, men att den främsta insatsen är samtalsmetoder. Vidare visade resultatet att det största hindret med att arbeta med våldsutsatta kvinnor är den rådande resursbristen. Det visar sig i olika former och i resultatet presenteras ett perspektiv utifrån de verksamma intervjupersonerna i kvinnojouren. Det här perspektivet belyste hur den specifika verksamheten är påverkad av resursbristen och samverkan med andra myndigheter som lider av kunskapsbrist.  

Undersökningen har bidragit till med bredare kunskap om de insatser som används för att stödja våldsutsatta kvinnor. Vidare har den gett en inblick i vilka svårigheter socialarbetare som arbetar med den målgrupp möter. Sist har vi med hjälp av undersökningen kunnat identifiera kunskapsluckor som finns bland socialarbetare. Sedan ges det förslag på fortsatt forskningen om att förbättra samarbetet mellan socialtjänsten och kvinnojouren.  

Detta är en fallstudie om förtroendet för socialtjänsten i anknytning till propaganda på socialamedier, specifikt med fokus på ungdomars förtroende. Genom tidigare forskning, relevanta teorier,utvalda lagar samt intervjuer har det varit möjligt att besvara våra frågeställningar. Studiensintervjuer hålls med två ungdomar samt en adjunkt vid Umeå universitet, detta för att ge synvinklarpå propagandans möjliga påverkan samt en synvinkel på möjligheten att utveckla lagen. Resultatenvisar att det finns en del man kan förbättra för att bemöta propagandan för att på sin tur förbättraförtroendet för socialtjänsten. Det har vidare visat sig att ungdomar kan påverkas av propagandanvia sociala medier samt sin omgivning på ett sätt en möjligen inte hade trott innan. Beroende påindividens egna erfarenheter och personers åsikter i dennes närhet har alla olika risk att påverkasmer eller mindre av propaganda om socialtjänsten. Angående lagen visade resultatet att vissaändringar varit möjliga för att hjälpa socialarbetares säkerhet men andra inte går att reformera irelation till propaganda.

Rapporten syftar till att undersöka varför Sverigedemokraterna lyckats så bra i just Skåne och Blekinge och vad som kännetecknar den regionala politiska kultur som dominerar i detta område. Vid 2022 års val fick man 30 procent av rösterna i detta område, mot drygt 20 procent i Sverige som helhet. Den politiska regionen Skåne-Blekinge (SD) innefattar 25 av de 38 kommunerna i dessa län. Partiet har där gjort inbrytningar i alla samhällsgrupper, men särskilt i dess kärngrupper av män, arbetare, lågutbildade och lågavlönade.

Den kanske viktigaste förklaringen till Sverigedemokraternas framgångar i denna politiska region är att medborgarna redan innan detta parti dök upp hade mer konservativa och nationalistiska åsikter, som motsvarade Sverigedemokraternas. De hade också svag tillit till andra människor och var särskilt missnöjda med det politiska systemet. Detta mönster präglade både arbetarklass och medelklass. Särskilt de socialdemokratiska sympatisörerna hade sådana uppfattningar och lockades snabbt över till det nya partiet. 

Det historiska ursprunget till detta åsikts- och handlingsmönster är höjt i dunkel, men en negativ inställning till invandrare har djupa rötter och är dokumenterat inom både fackföreningsrörelsen och på den skånska landsbygden. Skånsk separatism och närheten till kontinenten har också angivits som skäl. Detta förhållningssätt överförs också alltjämt från generation till generation.

Steam is a versatile medium to transfer heat and can be used in a variety of applications.In Solenis a steam system is used for heating the chemical liquids in the production linesand to keep some factory buildings warm in the company. The boiler is running at different loads depending on the heat needed, using natural gas as fuel. The annual energylosses in the steam system has been estimated at 40% of total gas consumption in 2022.This project studies more deeply these energy losses aiming to identify and classify thereasons for these losses.The project focuses on the boiler‘s performance and the potential energy losses in it.The direct method was used to calculate the efficiency of the boiler, where it presentshow much of the chemical energy in the fuel is converted into usable energy carried bygenerated steam. The calculations have been done by using recorded data for gas consumption and feedwater tank. The results show that the efficiency of the boiler rangesbetween 70% and 82%. It changes from day to day depending on gas consumption, operation load and other work conditions. The indirect method can only be used duringthe steady load operation, so a flue gas analysis has been done at 9 levels of operationloads. After that, many possible energy losses have been listed, and each type of losses hasbeen calculated and presented separately at each operation level. The results show thatthe total rate of energy losses is around 35% of total gas consumption. Flue gas-relatedenergy losses seem to have a normal and reasonable value which is around 17%. Energylosses due to radiation and convection have the most interesting result since its value isaround 8% which is high. In general, the main reason for the high rate of energy losses isthe oversized boiler, as the heat demand in Solenis is low and variable, leading to boileroperation at low loads. The oversized boiler is directly related to 15% energy losses in theboiler. In other words, the normal efficiency of the used boiler in Solenis ranges between80% and 85%, but the oversized boiler and its operation conditions decrease it to around65%. So, changing the design or size of the boiler, or using two small boilers can be agood solution.

In situ hybridization visualizes RNA in cells, but image analysis is complex. We present a protocol based on open-source software for automated high-content multiplex fluorescence in situ transcriptomics analysis. Steps include nuclei segmentation with a Fiji macro and quantification of up to 14 mRNA probes per image. We describe procedures for storing raw data, quality control images, and the use of a Python app to summarize all the results in one spreadsheet detailing the number of single or co-positive cells.

This article challenges the consumer-centric view of pornography, which overlooks the exploitation and abuse of individuals documented in its production. The lack of conceptual clarity surrounding the nature of pornography obscures these abuses, leading to significant consequences for those affected. To address this, a conceptual framework is proposed—rooted in the lived experiences of individuals documented in pornography, informed by feminist scholarship, and grounded in the principle that technology-facilitated sexual violence is equivalent to its offline counterparts. The framework begins by asking the critical question, “What is the nature of the act that has occurred?” before examining the implications of its documentation and dissemination as pornography. Understanding the nature of the act, alongside its documentation and dissemination, is crucial for establishing the realities of pornography, exposing exploitation and abuse, correcting public perceptions, and informing policy and legal reform. By exposing the underlying nature and consequences of pornography, this framework aims to transform public discourse and drive the development of robust protection and support systems for those directly harmed by pornography.

Bakgrund: År 2022 rapporterades cirka tjugo miljoner nya cancerfall i världen. Behandlingen av cancer innebär ofta en långvarig och komplex process som medför betydande fysiska och psykiska påfrestningar för den drabbade. Den psykiska belastningen till följd av behandlingar kan i sin tur bidra till utveckling av psykisk ohälsa.

Syfte: Syftet med denna studie var att beskriva personers psykiska ohälsa relaterat till cancerbehandling.

Metod: En litteraturstudie genomfördes med hjälp av nio kvalitativa studier. Databassökning utfördes i CINAHL, PubMed och Apa PsycInfo. Fribergs femstegmodell används för att analysera de inkluderade studierna.

Resultat: Analysen resulterade i tre huvudkategorier och sju underkategorier. De tre huvudkategorierna var: ’psykologiska reaktioner vid cancerbehandling,’ ’psykisk ohälsa som begränsning’ och ’betydelsen av stöd för att stärka psykisk hälsa’.

Konklusion: Cancerbehandling kan medföra betydande psykisk ohälsa hos patienterna till följd av behandlingar och biverkningar. Stödet från vårdpersonal kan vara avgörande för att lindra de negativa psykologiska reaktionerna. Vidare forskning behövs för att få en djupare förståelse av vilka stödinsatser som är mest effektiva för att minska psykisk ohälsa hos cancerpatienter i samband med cancerbehandling.

In the present climate, almost all high-latitude rivers in northern regions freeze every winter. In the future, however, climate change may cause shifts in freezing, duration and breakup of river ice cover, runoff, and sediment transport. The main aim of the study is to determine changes in surface flow velocity during river ice freezing and melting periods. We also examine the interplay between surface flow velocity and the initiation and progress of freezing and break-up. The study was performed in three Nordic rivers: the Pulmanki (northern Finland), the Koita (eastern Finland), and the Sävar (northern Sweden). They represent different slope and depth conditions and are representative of boreal and sub-arctic channel types. The flow characteristics were measured and remote sensing data for video-based surface velocimetry analyses (STIV) were collected during one season in each river during autumn ice-formation and spring ice break-up. STIV enabled analyses of surface flow velocities, which were compared to direct flow measurements and against freezing (incl. frazil ice, and partial ice cover) and break-up characteristics. Notable variations were observed in the interaction between ice cover and flow velocities among the three rivers. The Pulmanki River showed the most rapid decrease in flow velocities during freezing due to increased friction from the ice cover. Continuous frazil ice formation occurred in the Sävar and Pulmanki Rivers, while the Koita River experienced intermittent episodes. Temperature was key in accelerating freezing during colder days and causing ice break-up during warmer days. During the melting period, the Pulmanki River had the highest flow velocities during melting, while the Koita and Sävar Rivers showed a steady increase as the ice melted. Regression models showed that higher flow velocities reduced ice cover, with air temperature also influencing ice behavior. The STIV method enabled effective detection of flow and ice rafting and proved useful for tracking river ice with affordable time-lapse cameras. These findings provide valuable insights for managing river systems in cold climates.

Background: Approximately 130,000 - 150,000 people in Sweden live with dementia, and each year, between 20,000 - 50,000 cases are diagnosed. In connection with dementia, these individuals are at risk of developing eating difficulties and malnutrition. The nurse’s role is to identify, prevent, and treat eating difficulties and malnutrition through individualized measures to promote nutritional intake.

Aim: The aim of this literature study was to describe the experiences of healthcare staff in how to promote nutritional intake among people with dementia in nursing homes.

Methods: The literature review is based on eight qualitative articles. Cinahl and PubMed were used to search for relevant articles. The data analysis was conducted using Friberg's five-step model.

Results: The analysis resulted in three main categories and eight subcategories. The three main categories were: Support and facilitate nutritional intake during mealtime, create a calm feeling and good interactions during mealtime and opportunities to create good conditions to benefit nutritional intake.

Conclusion: There are various means to support and facilitate nutritional intake during mealtimes that also create a calm feeling and contribute to good interactions. Knowledge and competence about dementia and nutrition create good conditions for benefiting nutritional intake. The literature study contributes information to the healthcare staff so that they can work for a good nutritional intake while promoting independence, which can preserve autonomy and quality of life.

Background: Alcohol problems are a stigmatized societal issue that affects both individual health and society. The fear of facing negative attitudes within healthcare can lead many individuals with alcohol problems to avoid seeking help. Stigma and shame are highlighted as key factors contributing to this. The healthcare system thus plays a crucial role in identifying and providing support and treatment for individuals with alcohol problems. 

Aim: The aim of this literature review is to map the attitudes of nursing staff towards patients with alcohol use disorder. 

Methods: The study is a literature review based on nine quantitative articles. Data collection was conducted using the databases PubMed, CINAHL, PsycINFO, and Scopus. The quality of the articles is assessed using Olsson & Sörensen's review template and analysed according to Popenoe et al. practical guide. 

Results: The study identified a range of attitudes. These were categorized into three subthemes: judgmental and blaming attitudes, attitudes marked by understanding and compassion and attitudes related to personal competence and responsibility. 

Conclusion: It is challenging to determine the most common attitudes toward individuals with alcohol problems among healthcare staff due to a lack of studies using comparable measurement tools. However, the results indicate that negative attitudes are prevalent, which may contribute to stigmatization in healthcare settings. To improve the quality of care for individuals with alcohol problems, healthcare staff should reflect on their own attitudes and strive for change where necessary.

Background: It is part of the nurse's duties to promote, preserve and strengthen the patient's sexual health. Diseases and drug side effects can affect sexuality. By getting involved in the patient's sexual health, the nurse demonstrates person-centered nursing work, which can contribute to an increased quality of life for the patient.

Aim: The purpose was to describe the nurse's experiences of communicating about sexual health in the nursing work.

Methods: A literature study with qualitative design and inductive approach based on eight scientific articles. Quality review was done with a review template according to Olsson and Sörensen and the analysis was done with Friberg's five-step model.

Results: Three categories and six subcategories could be identified. The category "On organizational level" had the subcategories "Organizational conditions as a cause of lack of holistic care" and "Lack of knowledge and education about sexual health". The following category "At patient level" had the subcategories "Prejudice about sexual needs" and "Uncertainty in relation to the patient". The last category "On nurse level" had the subcategories "The nurse's own attitude towards sex and sexual health" and "Management strategies for approaching the sexual conversation".

Conclusion: The nurse experiences a lack of knowledge about sexuality, sexual health and sexual conversation methodology. There are organizational deficiencies which mean that the nurse is not supported in the work with sexual health by the employer. Training efforts are needed for the nurses both in basic education and in the nurses' workplaces.

Bakgrund: Ungefär 55 miljoner människor i världen har diagnosen demenssjukdom och ca 90% av de som drabbas utvecklar beteendemässiga och psykologiska symtom vid demens (BPSD). Omvårdnadsåtgärder ses nu som förstahandsalternativ vid behandling av dessa symtom och där dockterapi är en av dessa åtgärder.

Syfte: Syftet med studien var att kartlägga dockterapins effekt på beteendemässiga och psykiska symtom vid demenssjukdom på äldreboende.

Metod: Litteraturstudien har en kvantitativ design och baseras på åtta kvantitativa artiklar. Databaser som användes i sökningarna var Cinahl, Pubmed, Scopus och Web of Science. Artiklarna kvalitetsgranskades och analysen gjordes enligt Popenoes riktlinjer.

Resultat: Resultatet visade att dockterapi minskar BPSD signifikant med undantag från två artiklar som inte kunde se en signifikant minskning. Större delen av deltagarna i artiklarna var kvinnor och studierna utfördes i flera olika länder. Medelåldern för deltagarna var mellan 82 och 88 år.

Konklusion: Dockterapi är en omvårdnadsåtgärd, grundad i anknytningsteorin, som visat en signifikant effekt på BPSD efter en interventionstid på minst en månad. Det är en personcentrerad omvårdnadsåtgärd som främst studerats på äldre kvinnor med demenssjukdom. Det behövs vidare forskning kring ämnet genom att bland annat inkludera män och/eller med ett större deltagarantal för att kunna generalisera resultatet.

Abstract

Background: Transgender people are individuals with a gender expression or gender identity that differs from what they were assigned with at birth. Research shows that transgender people experience inequity in health care settings and that the way nurses interact and care for transgender people varies. Therefore, it is important to highlight nurses' experiences of caring for with transgender individuals in order to promote good nursing care.

Aim: To explore nurses’ experiences of providing care for transgender persons.

Methods: A qualitative literature review based on ten empirical studies, generated from the databases Pubmed, Cinahl and PsycInfo. These studies were analyzed and summarized into different themes.

Results: Presented two themes; knowledge and attitudes, as well as six subthemes; education, lack of knowledge about gender-affirming care, confusion regarding terminology and dehumanizing language practices, discomfort and lack of respect for patients' gender identity, correlations between personal values and inclusive care, isolation and compassion regarding the vulnerability of transgender individuals.

Conclusion: Nurses demonstrated a lack of knowledge, but a willingness to learn more about transgender people and their healthcare needs. Openness and understanding of transgender individuals varied among nurses. Furthermore, nurses placed emphasis on an equal healthcare environment. This aligns with the experiences of transgender people within healthcare, and nurses should work towards providing a more open and mindful care.

Abstract

Background: Children often experience significant pain during venipuncture procedures, which can intensify with fear. While pharmacological methods are widely used, non-pharmacological interventions offer complementary or alternative approaches to manage procedural pain.

Aim: The aim of the study is to present non-pharmacological pain relief methods and their effects during venipuncture in children aged 6–12 years.

Methods: A quantitative literature review was conducted using data from 13 randomized controlled trials, encompassing 1662 children. Articles were selected through a systematic search in Cinahl and PubMed, focusing on studies that assessed pain reduction using validated scales. The studies were quality-assessed, analyzed, and data were compiled from the results.

Results: Nine of the studied non-pharmacological interventions were shown to be effective, with significant differences between groups and medium to high effect sizes based on Cohen's d. Five methods were categorized as active (playing with a robot, squeezing a ball, coughing technique, blowing soap bubbles, and coloring figures), three as passive (distraction cards, VR, kaleidoscope), and one as physical (cold application combined with vibration).

Conclusion: Non-pharmacological methods can be effective in alleviating pain associated with venous punctures in children and have the potential to enhance their healthcare experience. However, the study was not extensive enough to determine which specific method or group of methods was the most effective. The findings highlight the need for further research to explore the combination of these methods with pharmacological approaches, as well as the involvement of children in selecting the methods used.

Svenska för invandrare (Swedish for immigrants [SFI]) is a programme for immigrants who study Swedish as a second language. When learning a new language, practicing pronunciation is central for developing a comprehensible speech. The syllabus contains one paragraph regarding pronunciation stating that students should be given the opportunity to develop “good pronunciation”. The aim of this study is to investigate what perceptions on teaching pronunciation that are verbalized by teachers at SFI. Also, this study aims to investigate how the paragraph in the syllabus regarding development of a good pronunciation shows in the classroom practice, and how teachers provide an environment for a dialogue-based learning. The study draws on qualitative research methods, where the data collection has been conducted with classroom observation and semi-structured interviews. The data set has been analysed using thematic analysis (Braun & Clarke, 2006) and categorized in five dominant themes. The results shows that pronunciation is challenging, and the absence of explicit pronunciation teaching is evident. Furthermore, the result shows contradictory views on pronunciation, and that education at SFI constitutes mainly on solitary work. The organization of SFI is described as an obstacle to more dialogue-based pedagogics. In conclusion, explicit pronunciation teaching is almost non-existing in the observed classroom practices, with very low range of dialogue-based learning.

En av de sårbaraste grupperna i samhället är ensamkommande barn. Att anlända till ettfrämmande land, långt bort från sina anhöriga kan ha stor inverkan på det psykiska ochfysiska välbefinnandet. Ofta har dessa barn rest lång väg innan de anländer till Sverige. Välframme ska de lära sig nya seder, anpassa sig till kulturen och ta till sig ett nytt språk. Alltdetta sker utan en nära anhörig närvarande eller som stöd att navigera i den nya tillvaron (Al-Sudany, 2018).

En gemensam faktor för dessa barn och ungdomar är att separationen från sina anhöriga oftaskett i en känslomässigt skör ålder. De kan även ha föregåtts av traumatiska händelser vilketgör att de har större risk att utveckla social problematik som psykisk ohälsa. Den psykiskaohälsan kan ses i ökade nivåer av ångest, depression och posttraumatiskt stressyndrom(PTSD), i jämförelse med barn och ungdomar som anländer tillsammans med sina anhöriga(Socialstyrelsen, 2020).Det är därför av stor vikt att de vuxna som bemöter dessa barn och ungdomar i sin yrkesrollsom exempelvis socialarbetare, personal på HVB-hem och gode man har en förståelse för hurdessa barn fungerar utifrån deras historik och förhåller sig icke dömande.

Syftet med studien är att undersöka en grupp ensamkommande barn och ungdomarsupplevelser kring tiden på HVB-hem. Fokus ligger på hur de upplevde det stöd som erbjödsunder vistelsen samt deras relationer till personal och övriga boende.Studien genomfördes med hjälp av intervjuer med personer som vistats på HVB-hem undersin första tid i Sverige.

Våld i nära relationer är ett omfattande samhällsproblem. Våldsutsatta kvinnors stöd kan se olika ut beroende på i vilket samhälle kvinnan befinner sig i. I Sverige är den vanligaste typen av stöd för våldsutsatta kvinnor de ideella kvinnojourernas verksamhet. Syftet med studien har varit att undersöka anställda jourarbetares upplevelser kring kvinnojourers roll, förutsättningar samt utmaningar med arbetet våld i nära relation i mindre kommuner i Sverige. För att undersöka studiens syfte har fyra semistrukturerade intervjuer genomförts med ideella kvinnojourers anställda i mindre kommuner i Sverige. Vårt insamlade material analyserades med hjälp av en tematisk analys och sedan sorterades materialet in i olika teman. I studien har teorin intersektionalitet använts för att belysa maktskillnader i stöd till våldsutsatta kvinnor ur geografiska aspekter samt kvinnans sociala identitet. De slutsatser som framkommit i studien var att kvinnojourer hade en betydande roll i mindre kommuner i Sverige. Det ideella kvinnojourernas verksamhet fångade upp hela spannet av kvinnor och arbetar som ett komplement för offentliga aktörer. Jourernas kompetens och goda möjligheter till kompetensutveckling ansågs vara en förutsättning för stödet till våldsutsatta i mindre kommuner. Vart jourerna var placerade ansågs även vara en förutsättning. Att kommunerna såg nyttan med jourernas verksamhet bidrog till bättre förutsättningar för att kunna vara verksamma. Fenomenet “alla känner alla” påverkade kvinnojouren ur olika aspekter. Det blev en utmaning för mindre kommuner när “alla känner alla” med samverkan samt att bristen på anonymitet för våldsutsatta kvinnor avgjorde vem som fick sina behov tillgodosedda. De ideella kvinnojourernas stöd till alla våldsutsatta kvinnor var en utmaning då behoven var komplexa. Stödinsatser som exempelvis skyddade boenden har på grund av en ny lag försvårat stödet till kvinnor i våldsamma relationer i mindre kommuner i Sverige.

Background: Anastomotic leakage after rectal cancer surgery is linked to reduced survival and higher recurrence rates. While an aggravated inflammatory response may worsen outcomes, few studies have explored the combined effects of leakage and inflammation.

Methods: This is a retrospective multicenter cohort study including patients operated with anterior resection for rectal cancer in Sweden during 2014–2018. Anastomotic leakage within 12 months was exposure and primary outcome was recurrence-free survival. Mediation analysis was performed to evaluate the potential effect of systemic inflammatory response, as measured by the highest postoperative C-reactive protein (CRP) level within 14 days of surgery. Confounders were chosen using a causal diagram.

Results: Some 1036 patients were eligible for analysis, of whom 218 (21%) experienced an anastomotic leakage. At the end of follow-up at a median of 61 months after surgery, recurrence-free survival amounted to 82.6% and 77.8% in the group with and without leakage, respectively. The median highest postoperative CRP value after surgery was higher in the leakage group (219 mg/l), compared with the group without leakage (108 mg/l). Leakage did not lead to worse recurrence-free survival (HR 0.66; 95% CI 0.43–0.94), and there was no apparent effect through postoperative highest CRP (HR 1.12; 95% CI 0.93–1.29).

Conclusions: In conclusion, anastomotic leakage, with its accompanying CRP increase, was not found to be associated with recurrence-free survival after anterior resection for rectal cancer in this patient cohort. Larger, even more detailed studies are needed to further investigate this topic.

Micronutrients such as vitamins are transferred from lower to higher trophic levels, but no general ecological concept describes the factors regulating this process. Here, we investigated thiamin (thiamine, vitamin B1), which is an example of a metabolically important water-soluble micronutrient. Thiamin is produced by organisms such as bacteria and phytoplankton, and all consumers, such as zooplankton and fish, rely on a continuous intake of thiamin through their diet and possibly from de novo-synthesized thiamin by gut microbiota. A deficiency in thiamin negatively affects reproduction in fish and bird populations worldwide. The aim of this study was to quantify thiamin transfer in a planktonic food web in response to thiamin and/or nutrient addition, using an outdoor mesocosm system (an approximately 1.9 m3 bag submerged in sea water). These estimates were then compared with literature data on thiamin concentrations at different trophic levels. The results showed that thiamin was rapidly taken up by phytoplankton in both the ambient and nutrient-amended treatments. However, large differences in thiamin concentrations in phytoplankton did not lead to any significant changes in community composition or abundance. Nitrogen addition led to changes in the abundance and community composition of picoplankton and phytoplankton but there were no additional major effects of thiamin addition. Differences in thiamin concentrations in phytoplankton were not detected at the next trophic level in zooplankton. Although the concentrations did not change, a greater abundance of some zooplankton taxa were developed in the thiamin treatments. Comparing the mesocosm results with literature data demonstrated a gradual reduction in thiamin concentrations along the food chain, with six percent of the concentration in producers occurring in top consumers (i.e., piscivorous fish). Overall, these observations illustrate the concept of trophic dilution of micronutrients where concentrations decrease along the food web from phytoplankton via zooplankton and planktivorous fish to piscivorous fish.

Objective: The aim of this study was to describe perceived health problems among disaster responders after the earthquake in eastern Turkey/Syria in February 2023.

Methods: A non-probability cross-sectional study was conducted using an online survey.

Results: A total of 525 local (18%) and international disaster responders (81%) participated in the study. Of these responders, 46% reported physical or mental health problems during or after their deployment, 15% required medical care during the mission, and 7% required medical evacuation. The most common health problems during the field mission were feeling scared or unsafe, sleeping problems, and headache. After the mission, fatigue, sleeping problems, and feeling depressed were the most frequently reported health problems. The local responders perceived significantly more health problems than did the international responders. Approximately 11% of the participants could not return to their ordinary work after deployment because of infections or mental health issues.

Conclusions: Physical and mental health problems are commonly perceived by disaster responders and may reduce the effectiveness of disaster response. Raising awareness of health risks among disaster response workers and employers is essential to ensure proper duty of care and should include reparations and medical support during and after disaster response operations.

Smart and autonomous earthmoving equipment enhances energy efficiency,productivity, and safety at construction sites and mines. The innovations provide means to reach high-set sustainability goals and be profitable despite increasing labor shortages. In addition, recent technological breakthroughs in artificial intelligence highlight the potential of superhuman capabilities to further enhance operations. This thesis presents a computational approach to end-to-end optimization of autonomous wheel loaders operating in a dynamic environment. Wheel loaders are mainly used for repeatedly loading material and carrying it to load receivers in quarries and mines. The difficulty lies in that each loading action alters the state of the material pile. The resulting state affects the possible outcomes of the subsequent loading process and, ultimately, the total performance. Thus, the challenge is to achieve both autonomous and high-performance wheel loading over a sequence of tasks. Achieving this requires the ability to predict future outcomes and account for the cumulative effect of loading actions. The thesis constructs a real-time wheel loader simulator, develops world models for sequential loading actions with evolving pile states, formulates the end-to-end optimization problem, and introduces a look-ahead tree search method to solve the problem. These contributions provide insights into utilizing physics-based simulation in combination with machine learning to further improve sustainability in mining and construction.

The aim of this study was to identify the consequences related to ethical values in older people’s experiences of using medication-dispensing robots in Swedish home care services. The research material comprised 17 qualitative interviews with people aged 67–90 years. An assemblage perspective was used to analyze the material. The study results showed that medication-dispensing robots contributed to feelings of safety and continuity among older people but that robots could also limit feelings of autonomy for people with more outwardly oriented lifestyles. The introduction of robots changed roles and relations in eldercare, with older people having to actively add and compensate for perceived limitations in robot functionalities. To feel both safe and autonomous, older people had to “craft” ethics by putting different kinds of effort into everyday care involving medication-dispensing robots. In the study, ethics in home care came forth as a cocreational, ongoing, and precarious practice rather than a set of ethical principles embedded in robotic technology. Given that home care services for older people involve several key stakeholders, it would be of interest to identify and compare different perspectives of ethics and what potential benefits could come from using medication-dispensing robots in home care services.

Introduction: The main strategy to achieve equal provision of oral care in Sweden has been to offer partial subsidies for the adult population. However, their effects on unmet oral care needs (UOCNs) have not been extensively assessed.

Objective: This study used an intersectionality framework to examine 1) the overall frequency of UOCNs, 2) single-indicator inequities, and 3) intersectional inequities in total UOCNs and financial-related UOCNs (FUOCNs) in Sweden before and after implementation of a partial subsidization reform in 2008.

Methods: Data from 12 national surveys conducted over 2004 to 2018 were divided into 3 periods: prereform (2004 to 2007), early postreform (2008 to 2011), and late postreform (2012 to 2018). The analytic sample consisted of 98,177 respondents aged 24 to 84 y. Changes in the prevalence of UOCNs were estimated by inferential statistics. Single-indicator and intersectional inequities were examined by intersectional analysis of individual heterogeneity and discriminatory accuracy, across 48 strata defined by gender, age, educational level, income, and immigrant status. Results: The prevalence of total UOCNs and FUOCNs decreased significantly early after the reform, followed by a slight rebound. Relative inequities increased by education, income, and immigrant status after the reform and decreased for age. The discriminatory accuracy for both types of UOCNs was moderate and improved marginally but significantly with the inclusion of the intersectional strata. Most intersectional strata showed greater FUOCN inequities after the reform.

Conclusions: Contrary to expected, larger inequities in FUOCNs were identified in most intersectional strata after the reform. The moderate discriminatory accuracy suggested that Sweden could benefit from future strategies to foster equity that are universal but proportionately more intense among the intersectional strata with greater inequities (proportionate universalism). Knowledge Transference Statement: This analysis highlighted the benefit of adopting the principle of proportionate universalism as a strategy to reduce unmet oral care needs in Sweden. This would mean implementing universal strategies and specific support measures for the most vulnerable social groups as a future oral care policy change in Sweden.

We still know relatively little about how the human brain supports intelligence. I this personal view I argue that adopting the framework of neurocognitive component processes (NCP) might advance the current state of knowledge. Integration of information processing across distributed brain regions is proposed as a potential NCP, and some possible clinical implications of adopting the NCP framework are outlined.

Influencer Politics focuses on current discussions about the role and impact of social media influencers in the political sphere, and how the personal, political and promotional often converges in digital media. A key question is how core ideas of influencer culture – authenticity, intimacy, commercialism, and self-branding – shape the ways in which politics are expressed and understood in this context, as well as opens up space for new ways of connecting and interacting with the public. It also highlights the way that influencer culture itself is infused with politics, where issues of, for example, empowerment and exploitation are articulated and discussed in different ways. The book is the result of a common interest among researchers engaged in work on political aspects of influencer marketing and influencer culture from critical, cultural, and strategic perspectives, and offers a range of case studies devoted to both the promises and limitations of influencer politics.

• A unique overview of influencer politics and its different dimensions. 
• Contributions from leading scholars in the field. 
• Addresses questions of power, politics and influence that are widely discussed in the public sphere globally.

Background: Exposure to standard petrodiesel exhaust is linked to adverse health effects. Moreover, there is a mounting request to replace fossil-based fuels with renewable and sustainable alternatives and, therefore, rapeseed methyl ester (RME) and other biofuels have been introduced. However, recent toxicological research has indicated that biodiesel exhaust may also induce adverse health-related events.

Aim: To determine whether exposure to 100% RME biodiesel (BD100) exhaust would cause an acute airway neutrophilic recruitment in humans.

Methods: Fourteen healthy subjects underwent exposure to diluted BD100 exhaust and filtered air for 1-h, in a blinded, random fashion. Bronchoscopy with endobronchial mucosal biopsies, bronchial wash (BW) and bronchoalveolar lavage (BAL) was performed six hours after exposure. Differential cell counts and inflammatory markers were determined in the supernatant and biopsies were stained immunohistochemically.

Results: Compared with filtered air, BD100 exhaust exposure increased bronchial mucosal endothelial P-selectin adhesion molecule expression, as well as neutrophil, mast cell and CD68 + macrophage numbers. An increased influx of neutrophils and machrophages was also seen in BW.

Conclusion: Exposure to biodiesel exhaust was associated with an acute airway inflammation that appeared similar to preceding petrodiesel exposure studies. The present findings, together with the recently reported adverse cardiovascular effects after similar biodiesel exposure, indicate that biodiesel is not free of toxicity and may affect human health.

Although asthma is more frequently diagnosed in childhood, a substantial proportion of cases manifests in adulthood. Nonetheless, few studies have comprehensively examined asthma incidence across different ages, genders, and asthma phenotypes. We conducted a retrospective evaluation of asthma incidence from birth to late adulthood, stratified by age, gender, and the presence or absence of allergies. Our analysis indicates that a significant number of asthma cases emerged in adulthood, particularly among middle-aged women, with adult-onset asthma surpassing childhood-onset asthma after the age of 35 years. Additionally, allergic asthma was more common in younger than older individuals but decreases with age, ultimately leading to a higher proportion of non-allergic asthma in older than younger individuals. These findings underscore the predominance of adult-onset asthma among females and confirm the majority of allergic asthma in children, which declines with age. Additionally, increasing age is associated with increased incidence of non-allergic asthma. Asthma heterogeneity should be considered in both clinical management and research.

Digital textbooks are rapidly becoming a common feature in mathematics and science teaching. At the same time, there is limited research on teachers’ use of digital textbooks for teaching. Our study takes a comparative approach, contributing to the field’s understanding of the implementation of digital textbooks in mathematics and science education. Four lower secondary teachers’ use of digital textbooks was deductively analysed concerning various features in the textbooks, using data from classroom observations and interviews with teachers and students. Results revealed similarities between teachers regardless of subject, such as using functions to guide students in the digital textbook and recognising the advantages of using videos or animations. One conclusion is that these similarities could be regarded as generic for the use of digital textbooks and important regardless of the subject. A prominent difference concerned the use of digital textbooks as a means of content processing through writing. In the mathematics classrooms, paper and pencil were used, mostly due to the limited possibility of writing mathematics in digital textbooks. In the science classrooms paper and pencil were not used, as this subject is different and to a lesser extent based on being able to represent subject content through calculations, symbols, and figures. Another difference concerns teachers’ approach to planning and tracking students’ progress, where the science teachers focus on the group and the mathematics teachers on individuals. This implies the importance of including a focus on subject-specific aspects when designing and integrating digital resources in teaching.

The approximately 850,000 recreational boats in Sweden, has shown to have a significant impact on the marine environment of the Swedish west coast. The extensive weather-protected archipelagos and fjords with minor tidal activity, offers excellent conditions to uncover traces of leisure boats exhaust from the background. In this study we focus on polycyclic aromatic hydrocarbons (PAHs) from boat exhausts in surface sediments and water (using SPMD) in a busy harbour and a pristine fjord. The PAH analyses were performed using gas chromatography – mass spectrometry after suitable extraction procedures. Concentrations of total PAHs in water and sediments was 4–8 ng/L and 200–5500 ng/g respectively. In addition to PAH measurements, we used the number of documented motorboat passages together with residence time of water, to quantify the concentration enhancement of up to 40% due to recreational boating. Here we have for the first time succeeded in distinguishing the leisure boat PAH signature in coastal marine environments. This by combining our data and observed compositions from lakes where emissions from leisure boats is documented as a dominating source of pollution. Comparisons with Environmental Quality standards (EQS) showed elevated levels of up to more than five times in the most exposed sediments, while the water concentrations were below the EQS. The study concludes that boating activities significantly contribute to PAH-levels in these coastal environments, with implications for environmental management and pollution mitigation strategies.

Introduction: Swedish healthcare has undergone significant changes since the transferral of home healthcare from a regional to municipal responsibility, and since the new 2018 law regulating discharge from hospital. This meant changes to ways of working for Occupational Therapists (OTs), as OTs play a key role in planning for discharging patients, a crucial process before patients return home, and in the transition between care givers.

Aim: The aim of this study is to illuminate how OTs experience the intra-professional collaboration during the discharge process between inpatient care and home healthcare.

Methods: Interviews were conducted with OTs (N = 12), with even distribution between inpatient care and home healthcare, in three geographical locations in Sweden. Data analysis was performed according to qualitative content analysis.

Results: A central theme ran through all categories; the multi faces of intra-professional communication are challenging, intertwined and emotional. The categories illuminate experiences in terms of important but neglected patient participation and safety, different forms of mind-set depending on setting, complex rapid communication, unpredictable paths of discharge, unclear responsibility and organisational guidelines and, impact on work health and OT emotions.

Conclusion: Intra-professional communication is complex with many aspects and perspectives of importance for collaboration to run smoothly, but also the many individuals involved in the collaboration process of discharging a patient. This situates high demands on the professionals involved to distinguish and identify necessary information to make the discharge sound and safe for patient, as well as for relatives, involved services, and manageable for OTs.

Motor impairments are common in individuals with autism spectrum disorder (ASD) although less is known about the neural mechanisms related to such difficulties. This review provides an outline of functional magnetic resonance imaging (fMRI) findings associated with execution and observation of naturalistic actions in autistic adults. Summarized outcomes revealed that adults with ASD recruit similar brain regions as neurotypical adults during action execution and during action observation, although with a difference in direction and/or magnitude. For action execution, this included higher and lower activity bilaterally in the precentral cortex, the parietal cortex, the inferior frontal gyrus (IFG), the middle temporal gyrus (MTG), the occipital cortex, and the cerebellum. For action observation, differences mainly concerned both higher and lower activity in bilateral IFG and right precentral gyrus, and lower activity in MTG. Activity overlaps between action execution and observation highlight atypical recruitment of IFG, MTG, precentral, and parieto-occipital regions in ASD. The results show atypical recruitment of brain regions subserving motor planning and/or predictive control in ASD. Atypical brain activations during action observation, and the pattern of activity overlaps, indicate an association with difficulties in understanding others' actions and intentions.

Every issue of Education Inquiry publishes peer-reviewed articles in one, two or three different sections. In the Open section, articles are sent in by authors as part of regular journal submissions and published after a blind review process. In the Thematic section, articles may reflect the theme of a conference or workshop and are published after a blind review process. The Invited section feature articles by researchers invited by Education Inquiry to shed light on a specific theme or for a specific purpose and they are also published after a review process. This issue of Education Inquiry contains a Thematic and an Open section.

Background: Ultrasound-guided nerve block can be used for perioperative analgesia and can potentially improve the course of recovery. Although iliohypogastric-ilioinguinal nerve block has been successfully used for inguinal hernia surgery, the poor blocking effect of intraoperative traction reflex remains a major drawback of this technique. The main objective of this study was to investigate the feasibility of single-point ultrasound-guided iliohypogastric-ilioinguinal-genitofemoral nerve (GFN) blockage for open anterior inguinal hernia repair in older adults. Methods: A total of 40 older adult patients [categorized as American Society of Anesthesiologists (ASA) I–III, body mass index (BMI) ≤28 kg/m2, age ≥60 years] undergoing open anterior inguinal hernia repair (the Lichtenstein technique) from June 2018 to December 2019 were recruited and randomly separated into an iliohypogastric-ilioinguinal nerve block group (group A; n=20) and an iliohypogastric-ilioinguinal-GFN block group (group B; n=20). The numerical rating scale (NRS) score in the post-anesthesia care unit (PACU) was the primary endpoint. Moreover, the following secondary indicators were recorded: the NRS score at 4 and 12 h after surgery and the duration of the nerve block; the total consumption of anesthetics; the occurrence of perioperative complications; and the mean arterial pressure (MAP), heart rate (HR), and respiration rate (RR), and oxygen saturation (SpO2) at baseline (T0), before skin incision (T1), 1 min after skin incision (T2), after dissection of the hernial sac (T3), at mesh placement (T4), and at the end of surgery (T5). Results: Patients in Group B had lower NRS scores in the PACU (0.9±0.7 vs. 2.1±0.9), at 4 hours post-operation (1.9±1 vs. 2.7±0.7), lower intraoperative traction response scores (0.6±0.8 vs. 1.7±1.2), and fewer postoperative complication scores (0.1±0.3 vs. 0.8±0.9) compared to group A (P<0.05). In addition, the MAP in group A was significantly higher than that in group B (P<0.01) at T2 (89.3±6.7 vs. 83.8±4.9), T3 (92.4±6.9 vs. 86.6±4.8), and T4 (87.8±5.2 vs. 83.1±4.6). The HR in group A was also higher than that in group B (P<0.05) at T2 (73.3±8.4 vs. 68.4±5.4) and T3 (77.0±14.7 vs. 68.7±6.9). Finally, compared to group B, group A showed a higher consumption of sufentanil (5.5±3.9 vs. 2.4±2.8) and lidocaine (3.4±2.3 vs. 1.0±2.0) (P<0.05). Conclusions: Performing an ultrasound-guided iliohypogastric-ilioinguinal-GFN block through a single puncture point is a feasible clinical approach. This strategy provides appropriate intraoperative and postoperative analgesia in older adult patients undergoing open anterior inguinal hernia repair and significantly reduces postoperative complications and thus has the potential to emerge as a novel analgesic option for inguinal hernia surgery.

This chapter looks at studies done in the field of Sami literacy research between 2010 and 2022 and looks at some interesting new developments and community initiatives within Sami literacy studies that have yet not been fully investigated. The chapter reveals an emerging field of study and pedagogical and didactic development that enter the Indigenous literacy landscape, which is often loaded with linguistic input and literacy content in languages other than Sami. The complexity of the context is reflected, among other things, in the empirical studies that have investigated the writing processes of multilingual language learners in Sápmi. The learners often view, or experience, writing in the Indigenous heritage language as less fluent and more laborious than writing in the state majority languages, or even in English. Policy document analysis suggests that the steering bodies do not treat the locally spoken and learned heritage languages as equal to the majority languages, which creates an inherent literacy gap between the languages. Attitudes and language ideologies among the learners and teachers have the potential to create negative hierarchical views on languages, writing, and language learning. Development of research, practical training, and community initiatives, as well as implementation in teacher training, is needed to counteract views, ideologies and practices that may undermine the future of local literacies and that put the growth of future generations of Sami writers at risk.

Selective antegrade cerebral perfusion (SACP) is a protective procedure to ascertain adequate brain perfusion during aortic arch surgeries requiring moderate hypothermic circulatory arrest. SACP entails catheterization of arteries feeding the brain, which can be done bilaterally (bSACP) or unilaterally (uSACP), but there is no consensus on when to use each approach. bSACP may increase the risk of embolization, while uSACP risks hypoperfusion due to insufficient perfusion pressure in the contralateral hemisphere, since a single catheter must perfuse both hemispheres. We developed and tested the feasibility of a new method for predicting cerebral perfusion pressures (CPP) during SACP, which could potentially aid clinicians in preoperatively identifying which SACP approach to use. Feasibility of the method was evaluated in five patients eligible for aortic arch surgery (65 ± 7 years, 3 men). Patients were investigated preoperatively with computed tomography angiography (CTA) and 4D flow magnetic resonance imaging (MRI) to assess patient-specific arterial anatomy and blood flows. From the imaging, computational fluid dynamics (CFD) simulations estimated the patients' vascular resistances. Applying these resistances and intraoperative SACP pressure/flow settings to the model's boundary conditions allowed for predictions of contralateral CPP during SACP. Predicted pressures were compared to corresponding intraoperative pressure measurements. The method showed promise for predicting contralateral CPP during both uSACP (median error (range): 2.4 (−0.2–18.0) mmHg) and bSACP (0.8 (−3.3–5.4) mmHg). Predictions were most sensitive to collateral artery size. This study showed the feasibility of CPP predictions of SACP, and presents key features needed for accurate modelling.