| 1. |
- Bonnier, Gaga, et al.
(author)
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Inclusive India - Re:Pune
- 2012
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Reports (other academic/artistic)abstract
- The historie core of Pune is seriously neglected, despite its rich cultural-historical values and evidence of the city's past for future generations. These assets are not taken inta consideration in development plans for the city. Besides the national monument of Shaniwar Wada, INTACH has identified around 200 more buildings on its heritage list. These vary from temples, to private residences and public buildings to bridges. Apart from this, INTACH also has identified heritage precincts -areas with a particular distinct character -either architectural or due to the nature of the activities which take place there. Of this list, more than a hundred buildings have found a place on the heritage list adopted by the Pune Municipal Corporation (PMC).
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| 2. |
- Eriksson, Monica, 1952-, et al.
(author)
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A sense of coherence and health. The Salutogenesis in a societal context : Åland - a special case?
- 2007
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In: Journal of Epidemiology and Community Health. - 0143-005X .- 1470-2738. ; 61:8, s. 684-688
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Journal article (peer-reviewed)abstract
- Background:Antonovsky's salutogenic concept of a sense of coherence (SOC) has proved most influential in the way that health is now perceived.Aim:To (1) describe the distribution of SOC among 40–70-year-old Ålanders; (2) examine the distribution of depression in Åland, Finland, and its relationship with SOC; and (3) discuss the findings within a salutogenic framework in a societal context.Design:A cross-sectional study design was adopted. Antonovsky's SOC Questionnaire (13 items) and the Beck Depression Inventory (13 items) were used. In addition, in a separate questionnaire, sociodemographic information about each participant was sought, together with a question specific to this study and designed to measure self-rated health.Setting:Åland, an autonomous island province of Finland.Results:The proportion of respondents reporting good health was high (64%). The overall mean (SD) SOC was 70.7 (11.7) points, whereas for farmers and fishermen it was 73.88 (8.8) and 74.33 (9.2) points, respectively. SOC was significantly and strongly related to the self-rated health score. The higher the SOC, the better was the health of the respondents. Furthermore, the study provided clear evidence of the potential of the SOC concept as a positive mental health indicator.Conclusion:The SOC seems to be a health-promoting resource that supports the development of a positive subjective state of health.
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| 3. |
- Gervind, Elisabet, et al.
(author)
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The influence of organizational models on the implementation of internet-based cognitive behavior therapy in primary care: A mixed methods study using the RE-AIM framework
- 2024
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In: Internet Interventions. - : Elsevier. - 2214-7829. ; 35
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Journal article (peer-reviewed)abstract
- Background: Internet-Based Cognitive Behavioral Therapy (iCBT) holds great potential in addressing mental health issues, yet its real-world implementation poses significant challenges. While prior research has predominantly focused on centralized care models, this study explores the implementation of iCBT in the context of decentralized organizational structures within the Swedish primary care setting, where all interventions traditionally are delivered at local Primary Care Centers (PCCs).Aim: This study aims to enhance our understanding of iCBT implementation in primary care and assess the impact of organizational models on the implementation's outcome using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework.Method: A mixed-methods research design was employed to identify the factors influencing iCBT implementation across different levels, involving patients, therapists and managers. Data spanning two years was collected and analyzed through thematic analysis and statistical tests. The study encompassed 104 primary care centers, with patient data (n = 1979) sourced from the Swedish National Quality Register for Internet-Based Psychological Treatment (SibeR). Additionally, 53 iCBT therapists and 50 PCC managers completed the Normalization Measure Development Questionnaire, and 15 leaders participated in interviews.Results: Our investigation identified two implementation approaches, one concentrated and one decentralized. Implementation effectiveness was evident through adherence rates suggesting that iCBT is a promising approach for treating mental ill-health in primary care, although challenges were observed concerning patient assessment and therapist drift towards unstructured treatment. Mandatory implementation, along with managerial and organizational support, positively impacted adoption. Results vary in terms of adherence to established protocols, with therapists working in concentrated model showing a significantly higher percentage of registration in the quality register SibeR (X2 (1, N = 2973) = 430.5774, p = 0.001). They also showed significantly higher means in cognitive participation (Z = - 2.179, p = 0.029) and in reflective monitoring (Z = - 2.548, p = 0.011). Discussion: Overall, the study results demonstrate that iCBT, as a complex and qualitatively different intervention from traditional psychological treatment, can be widely implemented in primary care settings. The study's key finding highlights the substantial advantages of the concentrated organizational model. This model has strengths in sustainability, encourages reflective monitoring among therapists, the use of quality registers, and enforces established protocols.Conclusion: In conclusion, this study significantly contributes to the understanding of the practical aspects associated with the implementation of complex internet interventions, particularly in the context of internetbased cognitive-behavioral therapy (iCBT). The study highlights that effective iCBT integration into primary care requires a multifaceted approach, taking into account organizational models, robust support structures, and a commitment to maintaining quality standards. By emphasizing these factors, our research aims to provide actionable insights that can enhance the practicability and real-world applicability of implementing iCBT in primary care settings.
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| 4. |
- Greenwood, Sarah L., et al.
(author)
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Exceptions to bed-controlled ice sheet flow and retreat from glaciated continental margins worldwide
- 2021
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In: Science Advances. - : American Association for the Advancement of Science (AAAS). - 2375-2548. ; 7:3
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Journal article (peer-reviewed)abstract
- Projections of ice sheet behavior hinge on how ice flow velocity evolves and the extent to which marine-based grounding lines are stable. Ice flow and grounding line retreat are variably governed by the coupling between the ice and underlying terrain. We ask to what degree catchment-scale bed characteristics determine ice flow and retreat, drawing on paleo-ice sheet landform imprints from 99 sites on continental shelves worldwide. We find that topographic setting has broadly steered ice flow and that the bed slope favors particular styles of retreat. However, we find exceptions to accepted rulesof behavior: Regional topographic highs are not always an impediment to fast ice flow, retreat may proceed in a controlled, steady manner on reverse slopes and, unexpectedly, the occurrence of ice streaming is not favored on a particular geological substrate. Furthermore, once grounding line retreat is under way, readvance is rarely observed regardless of regional bed characteristics.
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| 5. |
- Lilja, Monica
(author)
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School attainment of children who had a single umbilical artery at birth
- 2010
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In: Paediatric and Perinatal Epidemiology. - : Wiley. - 0269-5022 .- 1365-3016. ; 24:2, s. 166-170
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Journal article (peer-reviewed)abstract
- P>Lilja M. School attainment of children who had a single umbilical artery at birth. Paediatric and Perinatal Epidemiology 2010; 24: 166-170. To the best of our knowledge, this is the first registry study of school achievements among children born with a single umbilical artery (SUA). A total of 1600 infants born with SUA during 1983-86 were studied. We linked the Swedish Medical Birth Registry with the Swedish School Registry, which contains the school grades of all children in Sweden when leaving compulsory school. Risks were estimated as odds ratios (OR) using the Mantel-Haenzel procedure, after adjustment for four potential confounders: year of birth, maternal age, parity and maternal education. There was a 60% excess of children born with SUA who did not complete compulsory school after removal of infants born preterm, small-for-gestational age and low Apgar score (OR = 1.60 [95% confidence interval 1.28, 2.00]). When sports and the three core school subjects (mathematics, English and Swedish) were studied, there was an increased risk for 'not passed' in all subjects except sport and a slight decrease in the probability of achieving 'passed with distinction or excellence'. In the three core subjects there was an association with gender, boys with SUA being more likely to have 'not passed' than girls. In conclusion the children born with SUA are more likely than children born with three vessels to show impaired school achievements.
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| 6. |
- Malcus, Peter, et al.
(author)
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Massive feto-maternal hemorrhage: diagnosis by cardiotocography, Doppler ultrasonography and ST waveform analysis of fetal electrocardiography.
- 2006
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In: Fetal Diagnosis and Therapy. - : S. Karger AG. - 1015-3837 .- 1421-9964. ; 21:1, s. 8-12
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Journal article (peer-reviewed)abstract
- A 34-year-old healthy gravida 2 para 1 presented after an uncomplicated pregnancy at term with a 2-day history of diminished fetal movements. Fetal anemia was suspected by fetal heart rate monitoring and Doppler estimation of the fetal peak blood flow velocity of the middle cerebral artery. We were also fortunate to register pathological ST waveform changes of the fetal ECG indicating fetal hypoxia. The diagnosis of a massive feto-maternal hemorrhage was confirmed by an extremely high fraction of erythrocytes containing fetal hemoglobin in maternal blood and, after delivery, by placental histology. Copyright (c) 2006 S. Karger AG, Basel.
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| 7. |
- Mesterton, Johan, et al.
(author)
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Case mix adjustment of health outcomes, resource use and process indicators in childbirth care : A register-based study
- 2016
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In: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 16:1
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Journal article (peer-reviewed)abstract
- Background: Unwarranted variation in care practice and outcomes has gained attention and inter-hospital comparisons are increasingly being used to highlight and understand differences between hospitals. Adjustment for case mix is a prerequisite for meaningful comparisons between hospitals with different patient populations. The objective of this study was to identify and quantify maternal characteristics that impact a set of important indicators of health outcomes, resource use and care process and which could be used for case mix adjustment of comparisons between hospitals. Methods: In this register-based study, 139 756 deliveries in 2011 and 2012 were identified in regional administrative systems from seven Swedish regions, which together cover 67 % of all deliveries in Sweden. Data were linked to the Medical birth register and Statistics Sweden's population data. A number of important indicators in childbirth care were studied: Caesarean section (CS), induction of labour, length of stay, perineal tears, haemorrhage > 1000 ml and post-partum infections. Sociodemographic and clinical characteristics deemed relevant for case mix adjustment of outcomes and resource use were identified based on previous literature and based on clinical expertise. Adjustment using logistic and ordinary least squares regression analysis was performed to quantify the impact of these characteristics on the studied indicators. Results: Almost all case mix factors analysed had an impact on CS rate, induction rate and length of stay and the effect was highly statistically significant for most factors. Maternal age, parity, fetal presentation and multiple birth were strong predictors of all these indicators but a number of additional factors such as born outside the EU, body mass index (BMI) and several complications during pregnancy were also important risk factors. A number of maternal characteristics had a noticeable impact on risk of perineal tears, while the impact of case mix factors was less pronounced for risk of haemorrhage > 1000 ml and post-partum infections. Conclusions: Maternal characteristics have a large impact on care process, resource use and outcomes in childbirth care. For meaningful comparisons between hospitals and benchmarking, a broad spectrum of sociodemographic and clinical maternal characteristics should be accounted for.
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| 8. |
- Nilsson, Caroline, et al.
(author)
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Phadiatop Infant® detects IgE-mediated diseases among pre-school children: A prospective study
- 2012
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In: Pediatric Allergy and Immunology. - : Wiley. - 0905-6157 .- 1399-3038. ; 23, s. 160-166
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Journal article (peer-reviewed)abstract
- IgE-sensitization to food and inhalant allergens may precede and accompany the appearance of clinical symptoms of allergic diseases. The aim was to study the diagnostic capacity of Phadiatop® Infant (Phinf) for detecting IgE-sensitization at 5yr of age and further to evaluate the predictive capacity of Phinf longitudinally with regard to sensitization and allergic symptoms in pre-school children. Methods: Two hundred and one children with complete data on sIgE testing for 10 individual allergens, Phinf analyses, and clinical evaluations at 2 and 5yr of age were evaluated. Results: The diagnostic performance of Phinf, applied at the age of 5 and compared to specific IgE testing, gave a sensitivity of 84% and a specificity of 98%. The positive and negative predictive values were 97% and 92%, respectively. A positive Phinf test at 2yr increased the odds 35.6-fold (95% CI 11.8-107) for IgE-sensitization and 14.7-fold (95% CI 4.4-49.7) for any allergic symptom at 5yr of age. The association (OR) between Phinf and current symptoms was, at 2 and 5yr of age, 3.6 (95% CI 1.6-7.9) and 18.4 (95% CI 7.4-45.8), respectively. Conclusions: Phinf seems to be a reliable tool for predicting future sensitization as well as allergic symptoms in young children. © 2011 John Wiley & Sons A/S.
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| 9. |
- Simkins, Lauren M., et al.
(author)
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Advances in understanding subglacial meltwater drainage from past ice sheets
- 2022
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In: Annals of Glaciology. - 0260-3055 .- 1727-5644. ; 63:87-89, s. 83-87
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Journal article (peer-reviewed)abstract
- Meltwater drainage beneath ice sheets is a fundamental consideration for understanding ice–bed conditions and bed-modulated ice flow, with potential impacts on terminus behavior and ice-shelf mass balance. While contemporary observations reveal the presence of basal water movement in the subglacial environment and inferred styles of drainage, the geological record of former ice sheets, including sediments and landforms on land and the seafloor, aids in understanding the spatiotemporal evolution of efficient and inefficient drainage systems and their impact on ice-sheet behavior. We highlight the past decade of advances in geological studies that focus on providing process-based information on subglacial hydrology of ice sheets, how these studies inform theory, numerical models and contemporary observations, and address the needs for future research.
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