| 1. |
- Almborg, Ann-Helene, et al.
(författare)
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Discharge planning of stroke patients : the relatives' perceptions of participation
- 2009
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Ingår i: Journal of Clinical Nursing. - 0962-1067 .- 1365-2702. - 0962-1067 ; 18:6, s. 857-865
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Tidskriftsartikel (refereegranskat)abstract
- To describe relatives' perceived participation in discharge planning for patients with stroke and identify correlates to perceived participation. Stroke affects both patients and their relatives and previous research shows that relatives were often dissatisfied with their perceived involvement in discharge planning and the information they get. Prospective cross-sectional study. The study comprised 152 consecutively enrolled relatives (mean age = 60.8 years) of acute stroke patients admitted to a stroke unit in southern Sweden during 2003-2005. Data were collected through interviews 2-3 weeks after discharge using 'Relative's Questionnaire about Participation in Discharge planning'. This instrument measures perceived participation in three subscales: R-Information-Illness, R-Information-Care/support, and R-Goals and Needs. The Overall Rating of Relative's Perceived Participation in Discharge Planning was measured by a visual analogue scale (VAS) (1-10 score). Among the relatives, 56-68% reported positively according to R-Information-Illness, but 46-53% perceived that they did not receive any information about care/medication/rehabilitation/support. About 80% perceived no participation at all in goals and needs. The mean value of the VAS was 3.89 (SD 3.40) score. Regression analyses revealed that longer stay at hospital, patients with higher education, and relatives of female patients and female relatives were associated with relatives' perceptions of higher participation in discharge planning. Relatives perceived that they needed more information and knowledge about stroke and care/medication/rehabilitation/support. They also needed to be more involved in goal-setting and in identifying patient needs. Professionals should take into consideration these associated variables to improve relatives' perceived participation. Clinicians should give more attention to the altered situation of stroke patients' relatives when planning for continuing care and when setting postdischarge goals for the patients. The professionals need to develop strategies to involve relatives in sharing information, goal-setting and needs assessment in discharge planning.
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| 2. |
- Grote, Ludger, 1964, et al.
(författare)
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National Knowledge-Driven Management of Obstructive Sleep Apnea-The Swedish Approach
- 2023
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Ingår i: Diagnostics. - : MDPI AG. - 2075-4418. ; 13:6
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: This paper describes the development of "Swedish Guidelines for OSA treatment" and the underlying managed care process. The Apnea Hypopnea Index (AHI) is traditionally used as a single parameter for obstructive sleep apnea (OSA) severity classification, although poorly associated with symptomatology and outcome. We instead implement a novel matrix for shared treatment decisions based on available evidence. Methods: A national expert group including medical and dental specialists, nurses, and patient representatives developed the knowledge-driven management model. A Delphi round was performed amongst experts from all Swedish regions (N = 24). Evidence reflecting treatment effects was extracted from systematic reviews, meta-analyses, and randomized clinical trials. Results: The treatment decision in the process includes a matrix with five categories from a "very weak"" to "very strong" indication to treat, and it includes factors with potential influence on outcome, including (A) OSA-related symptoms, (B) cardiometabolic comorbidities, (C) frequency of respiratory events, and (D) age. OSA-related symptoms indicate a strong incitement to treat, whereas the absence of symptoms, age above 65 years, and no or well-controlled comorbidities indicate a weak treatment indication, irrespective of AHI. Conclusions: The novel treatment matrix is based on the effects of treatments rather than the actual frequency of respiratory events during sleep. A nationwide implementation of this matrix is ongoing, and the outcome is monitored in a prospective evaluation by means of the Swedish Sleep Apnea Registry (SESAR).
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| 3. |
- Le Toan, T., et al.
(författare)
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Biomass retrieval from P-band polarimetric and interferometric SAR data, challenges and recent results
- 2014
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Ingår i: Joint 2014 IEEE International Geoscience and Remote Sensing Symposium, IGARSS 2014 and the 35th Canadian Symposium on Remote Sensing, CSRS 2014; Quebec City; Canada; 13 July 2014 through 18 July 2014. - 9781479957750 ; , s. 1417-1420
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Konferensbidrag (refereegranskat)abstract
- In the frame of the Biomass mission activities, this paper presents the challenges and recent results in the retrieval of forest biomass from polarimetric (PolSAR) and interferometric (PolInSAR) P-band SAR data. During the mission Phase A, critical issues in the biomass retrieval algorithms in boreal and tropical forests have been identified and addressed. In boreal forest, multi polarization backscatter data can be used to mitigate much of the variability due to environment effects. In high biomass tropical forest, because of the low sensitivity of the backscatter to biomass, appropriate correction methods were developed to mitigate the disturbing effects. Also to enhance the retrieval results, a combination of PolSAR and PolInSAR methods was proposed.
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| 4. |
- Le Toan, T., et al.
(författare)
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The BIOMASS mission retrieval algorithms: Results from recent campaigns
- 2012
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Ingår i: Proc. IGARSS 2012, IEEE International Geoscience and Remote Sensing Symposium, Munich, Germany, 22-27 July 2012. - 2153-6996. - 9781467311588 ; , s. 5546-5549
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Konferensbidrag (refereegranskat)abstract
- The BIOMASS mission is designed to map the full range of the world's above-ground forest biomass, for the needs of national scale inventory and global carbon flux calculations. This objective is achieved with advanced P-band SAR techniques. The P-band biomass measurement concept was based on previous work over the past two decades. During the preparatory phase, new campaigns have been conducted to address critical issues on the biomass retrieval algorithms, over tropical and boreal forests. The collected datasets comprise accurate and complete sets of in situ data and advanced P-band SAR data. This paper presents the retrieval algorithms developed using the collected datasets.
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| 5. |
- Quegan, S., et al.
(författare)
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The science and measurement concepts underlying the BIOMASS mission
- 2012
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Ingår i: Proc. IGARSS 2012, IEEE International Geoscience and Remote Sensing Symposium, Munich, Germany, 22-27 July 2012. - 2153-6996. - 9781467311588 ; , s. 5542-5545
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Konferensbidrag (refereegranskat)abstract
- The BIOMASS mission is designed to provide unique information on the biomass in the world's forests at spatial and temporal resolutions suitable for characterizing their dynamics and their contribution to carbon cycle estimates. To achieve this it combines biomass estimates from direct inversion of polarimetric backscattering coefficients with Pol-InSAR forest height estimates. The mission will also support important secondary objectives, including sub-surface imaging in arid zones, production of a bare-earth DTM and ice applications, and is optimized to be robust against environmental and ionospheric disturbances.
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| 6. |
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| 7. |
- Fransson, J.E.S., et al.
(författare)
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Detection of storm-damaged forested areas using airborne CARABAS-II VHF SAR image data
- 2002
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Ingår i: IEEE Transactions on Geoscience and Remote Sensing. - 0196-2892 .- 1558-0644. ; 40:10, s. 2170-2175
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Tidskriftsartikel (refereegranskat)abstract
- Strong winds cause severe damage worldwide to forested land every year. The devastating storms that struck large parts of Europe in late 1999 destroyed the equivalent of several years of normal forest harvesting, amounting to very large economical sums. Therefore, rapid mapping of damaged areas is of major importance for assessment of short-term actions as well as for long-term reforestation purposes. In this paper, the use of airborne CARABAS-II very high frequency (VHF) (20-90 MHz) synthetic aperture radar (SAR) imagery for high spatial resolution mapping of wind-thrown forests has been investigated and evaluated. The investigation was performed at a test site located in southern Sweden and dominated by Norway spruce forests. A regression model estimating radar backscattering amplitude prior to the storm was developed. The estimated amplitudes were compared to measured amplitudes after the storm. The results clearly show that the backscattering amplitude, at a given stem volume, is considerably higher for wind-thrown forests than for unaffected forests. Furthermore, the backscattering from fully harvested storm-damaged areas was, as expected, significantly lower than from unaffected stands. These findings imply that VHF SAR imagery has potential for mapping wind-thrown forests. However, to prevent ambiguities in increased backscattering caused by normal stem volume growth or wind-fellings, multitemporal change detection techniques using VHF SAR images acquired prior to and after wind-fellings would be preferable.
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| 8. |
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| 9. |
- Le Toan, T., et al.
(författare)
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The BIOMASS mission: Mapping global forest biomass to better understand the terrestrial carbon cycle
- 2011
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Ingår i: Remote Sensing of Environment. - : Elsevier BV. - 0034-4257. ; 115, s. 2850-2860
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Tidskriftsartikel (refereegranskat)abstract
- In response to the urgent need for improved mapping of global biomass and the lack of any current spacesystems capable of addressing this need, the BIOMASS mission was proposed to the European Space Agency forthe third cycle of Earth Explorer Core missions and was selected for Feasibility Study (Phase A) in March 2009.The objectives of the mission are 1) to quantify the magnitude and distribution of forest biomass globally toimprove resource assessment, carbon accounting and carbon models, and 2) tomonitor and quantify changesin terrestrial forest biomass globally, on an annual basis or better, leading to improved estimates of terrestrialcarbon sources (primarily from deforestation); and terrestrial carbon sinks due to forest regrowth andafforestation. These science objectives require the mission to measure above-ground forest biomass from 70° Nto 56° S at spatial scale of 100–200 m, with error not exceeding ±20% or ±10 t ha−1 and forest height witherror of ±4 m. To meet the measurement requirements, the mission will carry a P-Band polarimetric SAR(centre frequency 435 MHz with 6 MHz bandwidth) with interferometric capability, operating in a dawn-duskorbit with a constant incidence angle (in the range of 25°–35°) and a 25–45 day repeat cycle. During its 5-yearlifetime, the mission will be capable of providing both direct measurements of biomass derived from intensitydata and measurements of forest height derived from polarimetric interferometry. The design of the BIOMASSmission spins together two main observational strands: (1) the long heritage of airborne observations intropical, temperate and boreal forest that have demonstrated the capabilities of P-band SAR for measuringforest biomass; (2) new developments in recovery of forest structure including forest height from Pol-InSAR,and, crucially, the resistance of P-band to temporal decorrelation, which makes this frequency uniquelysuitable for biomass measurements with a single repeat-pass satellite. These two complementarymeasurement approaches are combined in the single BIOMASS sensor, and have the satisfying property thatincreasing biomass reduces the sensitivity of the former approach while increasing the sensitivity of the latter.This paper surveys the body of evidence built up over the last decade, from a wide range of airborneexperiments, which illustrates the ability of such a sensor to provide the required measurements.At present, the BIOMASS P-band radar appears to be the only sensor capable of providing the necessary globalknowledge about the world's forest biomass and its changes. In addition, this first chance to explore the Earth'senvironment with a long wavelength satellite SAR is expected to make yield new information in a range ofgeoscience areas, including subsurface structure in arid lands and polar ice, and forest inundation dynamics.
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| 10. |
- Lin, Chung-Ying, et al.
(författare)
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A thorough psychometric comparison between Athens Insomnia Scale and Insomnia Severity Index among patients with advanced cancer
- 2020
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Ingår i: Journal of Sleep Research. - : John Wiley & Sons. - 0962-1105 .- 1365-2869. ; 29:1
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Tidskriftsartikel (refereegranskat)abstract
- For patients with cancer, sleep disturbance is commonplace. Using classical test theory and Rasch analyses, the present study compared two commonly used psychometric instruments for insomnia – Athens Insomnia Scale and Insomnia Severity Index – among patients with advanced cancer. Through convenience sampling, patients with cancer at stage III or IV (n = 573; 326 males; mean age = 61.3 years; SD = 10.7) from eight oncology units of university hospitals in Iran participated in the study. All the participants completed the Athens Insomnia Scale, Insomnia Severity Index, Edmonton Symptom Assessment Scale, Hospital Anxiety and Depression Scale, General Health Questionnaire-12, Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index. Additionally, 433 participants wore an Actigraph device for two continuous weekdays. Classical test theory and Rasch analysis both supported the construct validity for Athens Insomnia Scale (factor loadings from confirmatory factor analysis = 0.61–0.87; test–retest reliability = 0.72–0.82; infit mean square = 0.81–1.17; outfit MnSq = 0.79–1.14) and for Insomnia Severity Index (factor loadings from confirmatory factor analysis = 0.61–0.81; test–retest reliability = 0.72–0.82; infit mean square = 0.72–1.14; outfit mean square = 0.76–1.11). Both Athens Insomnia Scale and Insomnia Severity Index had significant associations with Edmonton Symptom Assessment Scale, Hospital Anxiety and Depression Scale, General Health Questionnaire-12, Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index, as well as having good sensitivity and specificity. Significant differences in the actigraphy measure were found between insomniacs and non-insomniacs based on Athens Insomnia Scale or Insomnia Severity Index score. With promising results, healthcare providers can use either Athens Insomnia Scale or Insomnia Severity Index to understand the insomnia of patients with advanced cancer.
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| 11. |
- Lin, C. -Y, et al.
(författare)
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Longitudinal relationships between nomophobia, addictive use of social media, and insomnia in adolescents
- 2021
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Ingår i: Healthcare. - : MDPI. - 2227-9032. ; 9:9
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Tidskriftsartikel (refereegranskat)abstract
- (1) Background: Temporal relationships between nomophobia (anxiety related to ‘no mobile phone phobia’), addictive use of social media, and insomnia are understudied. The present study aimed to use a longitudinal design to investigate temporal relationships between nomophobia, addictive use of social media, and insomnia among Iranian adolescents; (2) Methods: A total of 1098 adolescents (600 males; 54.6%; age range = 13 to 19) were recruited from 40 randomly selected classes in Qazvin, Iran. They completed baseline assessments. The same cohort was invited to complete three follow-up assessments one month apart. Among the 1098 adolescents, 812 (400 males; 49.3%; age range = 13 to 18) completed the baseline and three follow-up assessments. In each assessment, the participants completed three questionnaires, including the Nomophobia Questionnaire (NMP-Q), Bergen Social Media Addiction Scale (BSMAS), and Insomnia Severity Index (ISI); (3) Results: Multilevel linear mixed-effects regression analyses showed that participants demonstrated increased insomnia longitudinally over 3 months (B = 0.12 and 0.19; p = 0.003 and <0.001). Insomnia was associated with nomophobia (B = 0.20; p < 0.001) and addictive use of social media (B = 0.49; p < 0.001). Nomophobia and addictive use of social media interacted with time in associations with insomnia as demonstrated by significant interaction terms (B = 0.05; p < 0.001 for nomophobia; B = 0.13; p < 0.001 for addictive use of social media); (4) Conclusions: Both nomophobia and addictive use of social media are potential risk factors for adolescent insomnia. The temporal relationship between the three factors suggests that parents, policymakers, and healthcare providers may target reducing nomophobia and addictive use of social media to improve adolescents’ sleep.
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| 12. |
- Liu, K., et al.
(författare)
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Multiomics analysis of naturally efficacious lipid nanoparticle coronas reveals high-density lipoprotein is necessary for their function
- 2023
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Ingår i: Nature Communications. - 2041-1723. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- In terms of lipid nanoparticle (LNP) engineering, the relationship between particle composition, delivery efficacy, and the composition of the biocoronas that form around LNPs, is poorly understood. To explore this we analyze naturally efficacious biocorona compositions using an unbiased screening workflow. First, LNPs are complexed with plasma samples, from individual lean or obese male rats, and then functionally evaluated in vitro. Then, a fast, automated, and miniaturized method retrieves the LNPs with intact biocoronas, and multiomics analysis of the LNP-corona complexes reveals the particle corona content arising from each individual plasma sample. We find that the most efficacious LNP-corona complexes were enriched with high-density lipoprotein (HDL) and, compared to the commonly used corona-biomarker Apolipoprotein E, corona HDL content was a superior predictor of in-vivo activity. Using technically challenging and clinically relevant lipid nanoparticles, these methods reveal a previously unreported role for HDL as a source of ApoE and, form a framework for improving LNP therapeutic efficacy by controlling corona composition. ApoE is known to be important for lipid nanoparticle function. Here, the authors shows that efficacious coronal ApoE originates from high-density lipoprotein (HDL) particles and, enhances hepatic delivery, making HDL a superior biomarker for lipid nanoparticle potency.
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| 13. |
- López-Dekker, P., et al.
(författare)
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BIOMASS end-to-end mission performance assessment
- 2012
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Ingår i: Proc. IGARSS 2012, IEEE International Geoscience and Remote Sensing Symposium, Munich, Germany, 22-27 July 2012. - 2153-6996. - 9781467311588 ; , s. 1602-1605
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Konferensbidrag (refereegranskat)abstract
- This paper provides an overview of the BIOMASS Mission End-to-End simulator (BEES) and of the mission performance analysis performed with it. The end-to-end performance, in terms of biomass estimates error, is close to the 20% error goal set for the mission. The main sources of errors are temporal decorrelation and the limited available bandwidth, while system induced errors have a negligible impact on the final performance.
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| 14. |
- López-Dekker, P., et al.
(författare)
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BIOMASS End-to-End performance Simulator
- 2011
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Ingår i: IEEE International Geoscience and Remote Sensing Symposium, IGARSS 2011. Vancouver, 24-29 July 2011. - 9781457710049 ; , s. 4249-4252
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Konferensbidrag (refereegranskat)abstract
- This paper discusses the implementation of an end-to-end simulator for the BIOMASS mission. An overview of the system architecture is provided along with a functional description of the modules that comprise the simulator.
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| 15. |
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| 16. |
- Rajabi Majd, N., et al.
(författare)
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Efficacy of a Theory-Based Cognitive Behavioral Technique App-Based Intervention for Patients With Insomnia : Randomized Controlled Trial
- 2020
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Ingår i: Journal of Medical Internet Research. - Toronto, ON, Canada : JMIR publications. - 1438-8871. ; 22:4
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Sleep hygiene is important for maintaining good sleep and reducing insomnia. OBJECTIVE: This study examined the long-term efficacy of a theory-based app (including cognitive behavioral therapy [CBT], theory of planned behavior [TPB], health action process approach [HAPA], and control theory [CT]) on sleep hygiene among insomnia patients. METHODS: The study was a 2-arm single-blind parallel-group randomized controlled trial (RCT). Insomnia patients were randomly assigned to a treatment group that used an app for 6 weeks (ie, CBT for insomnia [CBT-I], n=156) or a control group that received only patient education (PE, n=156) through the app. Outcomes were assessed at baseline and 1 month, 3 months, and 6 months postintervention. Primary outcomes were sleep hygiene, insomnia, and sleep quality. Secondary outcomes included attitudes toward sleep hygiene behavior, perceived behavioral control, behavioral intention, action and coping planning, self-monitoring, behavioral automaticity, and anxiety and depression. Linear mixed models were used to evaluate the magnitude of changes in outcomes between the two groups and across time. RESULTS: Sleep hygiene was improved in the CBT-I group compared with the PE group (P=.02 at 1 month, P=.04 at 3 months, and P=.02 at 6 months) as were sleep quality and severity of insomnia. Mediation analyses suggested that perceived behavioral control on sleep hygiene as specified by TPB along with self-regulatory processes from HAPA and CT mediated the effect of the intervention on outcomes. CONCLUSIONS: Health care providers might consider using a CBT-I app to improve sleep among insomnia patients. TRIAL REGISTRATION: ClinicalTrials.gov NCT03605732; https://clinicaltrials.gov/ct2/show/NCT03605732.
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| 17. |
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| 18. |
- Sjögren, T.K., et al.
(författare)
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Suppression of Clutter in Multichannel SAR GMTI
- 2014
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Ingår i: IEEE Transactions on Geoscience and Remote Sensing. - 0196-2892 .- 1558-0644. ; 52:7, s. 4005-4013
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Tidskriftsartikel (refereegranskat)abstract
- In this paper, the results of moving-target detection in multichannel UHF-band synthetic aperture radar (SAR) dataare shown. The clutter suppression is done using finite-impulse response (FIR) filtering of multichannel SAR in combination with a two-stage fast-backprojection algorithm to focus the moving target using relative speed. The FIR filter coefficients are chosen with the use of space-time adaptive processing filtering. Two parameters are used for target focusing, target speed in range and in azimuth. When the target is focused, both speed parameters of the target are found. In the experimental results, two channels wereused in order to suppress clutter. In the resulting SAR images, it is obvious that very strong scatterers and the forest areas have been suppressed in comparison to the moving target in the image scene. The gain obtained can be measured using signal-to-clutterand- noise-ratio gain, which is about 19 dB. Another way to measure the signal processing gain is the ability to suppress the strongest reflecting object in the SAR scene. The gain of the targetin relation to this object is 25 dB. This shows that using UHF-band SAR ground moving target indication (GMTI) for suppressing forest and increasing the target signal can work.
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| 19. |
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| 20. |
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| 21. |
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| 22. |
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| 23. |
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| 24. |
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| 25. |
- Vu, Viet Thuy, et al.
(författare)
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Detection of Moving Targets by Focusing in UWB SAR-Theory and Experimental Results
- 2010
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Ingår i: IEEE Transactions on Geoscience and Remote Sensing. - : IEEE. - 0196-2892 .- 1558-0644. ; 48:10, s. 3799-3815
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Tidskriftsartikel (refereegranskat)abstract
- Moving-target detection in ultrawideband (UWB) synthetic aperture radar (SAR) is associated with long integration time and must accommodate azimuth focusing for reliable detection. This paper presents the theory on detection of moving targets by focusing and experimental results on single-channel SAR data aimed at evaluating the detection performance. The results with respect to both simulated and real data show that the ability to detect moving targets increases significantly when applying the proposed detection technique. The improvement in signal-to-clutter noise ratio, which is a basic requisite for evaluating the performance, reaches approximately 20 dB, using only single-channel SAR data. This gain will be preserved for the case of multichannel SAR data. The reference system for this study is the airborne UWB low-frequency SAR Coherent All RAdio BAnd Sensing II.
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| 26. |
- Westergren, Albert, 1967-, et al.
(författare)
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"Study circles" improves nutritional care and body mass index
- 2008
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Ingår i: Clinical nutrition supplements, Volume 3, Supplement 1, 2008, page 61. ; , s. 61-
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Konferensbidrag (refereegranskat)abstract
- The staffs’ knowledge, experiences and motivation are likely to be important and so is an adaptation to each unit’s context to achieve positive changes in nutritional practice. How do study circles (SCs) and policy documents (PD) affect nutritional interventions for persons with moderate or high risk for undernutrition (UN-risk) in special accommodations (SAs)? All SAs within six municipalities were involved. UN-risk was defined as the occurrence of at least two of; involuntary weight loss, Body Mass Index below limit (<20 if /=70 yrs) and/or presence of eating difficulties. In year 2005 and 2007 it was 361 (27%) out of 1337 and 322 (35%) out of 920 persons respectively that were at UN-risk and included in this study. Interventions: In 18 of the departments 39 SCs were implemented, involving 8 staff each, in total 315 persons. Each group met for 3 occasions (3 hours each time) to discuss eating and nutrition based on a manual (www.vardalinstitutet.net/scn). The SCs did not focus on the above definition of UN-risk. In four other SAs a PD was politically anchored. No intervention was implemented in the other SAs. SCs and PD increased the precision in provided nutritional actions significantly for persons at UN-risk. The precision (percent) in the provision of nutritional actions. Intervention Year 2005 Year 2007 P-value No intervention n=229, 86 y n=202, 87 y E-food 10 11 .875 Food supplement 31 29 .751 Eating assistance 65 67 .611 Study circles n=92, 87 y n=82, 87 y E-food 16 32 .012 * Food supplement 24 39 .045 * Eating assistance 67 69 .870 Policy document n=40, 86 y n=38, 85 y E-food 5 24 .023 * Food supplement 52 53 .999 Eating assistance 72 68 .805 y = mean age in years, * = significant increase in provision (p<0.05), E-food = Energy Enriched Both study circles and policy documents improves the precision in the provision of correct nutritional actions for those at moderate or high risk for undernutrition. It is likely that a combination of study circles and policy documents can improve the precision of provision of nutritional actions even more.
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| 27. |
- Westergren, Albert, et al.
(författare)
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"Study circles" improves nutritional care and body mass index
- 2008
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The staffs’ knowledge, experiences and motivation are likely to be important and so is an adaptation to each unit’s context to achieve positive changes in nutritional practice. How do study circles (SCs) and policy documents (PD) affect nutritional interventions for persons with moderate or high risk for undernutrition (UN-risk) in special accommodations (SAs)? All SAs within six municipalities were involved. UN-risk was defined as the occurrence of at least two of; involuntary weight loss, Body Mass Index below limit (<20 if /=70 yrs) and/or presence of eating difficulties. In year 2005 and 2007 it was 361 (27%) out of 1337 and 322 (35%) out of 920 persons respectively that were at UN-risk and included in this study. Interventions: In 18 of the departments 39 SCs were implemented, involving 8 staff each, in total 315 persons. Each group met for 3 occasions (3 hours each time) to discuss eating and nutrition based on a manual (www.vardalinstitutet.net/scn). The SCs did not focus on the above definition of UN-risk. In four other SAs a PD was politically anchored. No intervention was implemented in the other SAs. SCs and PD increased the precision in provided nutritional actions significantly for persons at UN-risk. The precision (percent) in the provision of nutritional actions. Intervention Year 2005 Year 2007 P-value No intervention n=229, 86 y n=202, 87 y E-food 10 11 .875 Food supplement 31 29 .751 Eating assistance 65 67 .611 Study circles n=92, 87 y n=82, 87 y E-food 16 32 .012 * Food supplement 24 39 .045 * Eating assistance 67 69 .870 Policy document n=40, 86 y n=38, 85 y E-food 5 24 .023 * Food supplement 52 53 .999 Eating assistance 72 68 .805 y = mean age in years, * = significant increase in provision (p<0.05), E-food = Energy Enriched Both study circles and policy documents improves the precision in the provision of correct nutritional actions for those at moderate or high risk for undernutrition. It is likely that a combination of study circles and policy documents can improve the precision of provision of nutritional actions even more.
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