| 1. |
- Abelsson, Tobias, et al.
(author)
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The dilemma of the split between theory and reality as experienced by primary healthcare professionals: a mixed methods study of evidence-based practice in a primary care context
- 2024
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In: BMC PRIMARY CARE. - 2731-4553. ; 25:1
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Journal article (peer-reviewed)abstract
- BackgroundPrimary care depends upon a good information flow across professional and structural boundaries to provide the best care for patients. Previous research has mainly focused on Evidence-Based Practice (EBP) within specific professions. Mapping of pan-professional experiences of and attitudes to EBP in publicly funded clinical practice is necessary to deepen the understanding of EBP and its implementation. Thus, this study aimed to investigate healthcare professionals' experiences of and attitudes towards working in accordance with EBP in primary care.MethodsThe study used a convergent mixed methods design divided into two strands: a quantitative enquiry tool (Evidence-Based Practice Attitude Scale, EBPAS) and a set of qualitative interviews analysed by means of qualitative content analysis. Both strands included all primary care employees with patient interaction in the studied county (n = 625), including doctors, nurses, physiotherapists, psychologists and assistant nurses. Out of the original 625 healthcare professionals, 191 finished the first strand and 8 volunteered for the second strand (2 nurses, 2 physiotherapists, 1 psychiatrist and 3 doctors).ResultsThe EBPAS value of 2.8 (max 4) indicated a generally positive attitude towards EBP amongst the population, which was also evident in the interviews. However, there were additional experiences of not having the ability or resources to engage in EBP. This was illustrated by the theme that emerged from the qualitative content analysis: "The dilemma of the split between theory and reality". Due to the organisational and managerial focus on efficiency rather than quality of care, there were few or no incentives for promoting individual educational or research development.ConclusionsAlthough the general attitude towards EBP is positive, experiences of practising it differ. There is a need to increase knowledge of EBP concepts, requirements and implementation in the clinical setting. The absence of opportunities to do research and collegial debate about new ways of finding and implementing research-based evidence results might influence the quality of care.
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| 2. |
- Ali, Sharafat, et al.
(author)
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Effect of composition on the thermal properties and structure of M-Al-Si-O-N glasses, M = Na, Mg, Ca
- 2024
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In: Progress in Solid State Chemistry. - : Elsevier Ltd. - 0079-6786 .- 1873-1643.
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Journal article (peer-reviewed)abstract
- The primary objective of this study is to explore the relationship between the composition, structure, and thermal characteristics of M-Al-Si-O-N glasses, with M representing sodium (Na), magnesium (Mg), or calcium (Ca). The glasses were prepared by melting in a quartz crucible at 1650 °C and AlN precursor (powder) was utilized as a nitrogen source. The measured thermal properties studied were glass transition temperature (Tg), crystallization temperature (Tc), glass stability, viscosity, and thermal expansion coefficient (α). The findings indicate that increasing the aluminum content leads to higher glass transition, crystallization temperatures, and viscosities. In contrast, fragility values increase with the Al contents, while modifier elements and silicon content influence thermal expansion coefficient values. FTIR analysis revealed that in all glasses, the dominant IR bands are attributed to the presence of Q2 and Q3 silicate units. The effect of Al is observed as a progressive polymerization of the silicate network resulting from the glass-forming role of Al2O3. In most samples, the Q4 silicate mode was also observed, strongly related to the high Al content. Overall, the study shows that the complexity of composition-property correlations where the structural changes affect the properties of Mg/Ca-based oxynitride glasses has potential implications for their use in various technological fields.
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| 3. |
- Bakoyan, Zaki, et al.
(author)
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Childhood atopic disorders in relation to placental changes-A systematic review and meta-analysis
- 2024
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In: Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology. - : Munksgaard Forlag. - 0905-6157 .- 1399-3038. ; 35:5, s. 1-17
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Research review (peer-reviewed)abstract
- Fetal programming may arise from prenatal exposure and increase the risk of diseases later in life, potentially mediated by the placenta. The objective of this systematic review was to summarize and critically evaluate publications describing associations between human placental changes and risk of atopic disorders during childhood. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. The inclusion criteria were original research articles or case reports written in English describing a human placental change in relation to disease occurring in offspring during childhood. The MEDLINE and EMBASE databases were searched for eligible studies. Risk of bias (RoB) was assessed using the ROBINS-I tool. The results were pooled both in a narrative way and by a meta-analysis. Nineteen studies were included (n = 12,997 participants). All studies had an overall serious RoB, and publication bias could not be completely ruled out. However, five studies showed that histological chorioamnionitis in preterm-born children was associated with asthma-related problems (pooled odds ratio = 3.25 (95% confidence interval = 2.22-4.75)). In term-born children, a large placenta (≥750 g) increased the risk of being prescribed anti-asthma medications during the first year of life. Placental histone acetylation, DNA methylation, and gene expression differences were found to be associated with different atopic disorders in term-born children. There is some evidence supporting the idea that the placenta can mediate an increased risk of atopic disorders in children. However, further studies are needed to validate the findings, properly control for confounders, and examine potential mechanisms.
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| 4. |
- Candefjord, Stefan, et al.
(author)
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Video support for prehospital stroke consultation: implications for system design and clinical implementation from prehospital simulations
- 2024
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In: BMC Medical Informatics and Decision Making. - 1472-6947. ; 24:1
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Journal article (peer-reviewed)abstract
- BackgroundVideo consultations between hospital-based neurologists and Emergency Medical Services (EMS) have potential to increase precision of decisions regarding stroke patient assessment, management and transport. In this study we explored the use of real-time video streaming for neurologist–EMS consultation from the ambulance, using highly realistic full-scale prehospital simulations including role-play between on-scene EMS teams, simulated patients (actors), and neurologists specialized in stroke and reperfusion located at the remote regional stroke center.MethodsVideo streams from three angles were used for collaborative assessment of stroke using the National Institutes of Health Stroke Scale (NIHSS) to assess symptoms affecting patient’s legs, arms, language, and facial expressions. The aim of the assessment was to determine appropriate management and transport destination based on the combination of geographical location and severity of stroke symptoms. Two realistic patient scenarios were created, with severe and moderate stroke symptoms, respectively. Each scenario was simulated using a neurologist acting as stroke patient and an ambulance team performing patient assessment. Four ambulance teams with two nurses each all performed both scenarios, for a total of eight cases. All scenarios were video recorded using handheld and fixed cameras. The audio from the video consultations was transcribed. Each team participated in a semi-structured interview, and neurologists and actors were also interviewed. Interviews were audio recorded and transcribed.ResultsAnalysis of video-recordings and post-interviews (n = 7) show a more thorough prehospital patient assessment, but longer total on-scene time, compared to a baseline scenario not using video consultation. Both ambulance nurses and neurologists deem that video consultation has potential to provide improved precision of assessment of stroke patients. Interviews verify the system design effectiveness and suggest minor modifications.ConclusionsThe results indicate potential patient benefit based on a more effective assessment of the patient’s condition, which could lead to increased precision in decisions and more patients receiving optimal care. The findings outline requirements for pilot implementation and future clinical tests.
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| 5. |
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| 6. |
- Jiang, Zheshun, et al.
(author)
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Hexavalent chromium still a concern in Sweden : Evidence from a cross-sectional study within the SafeChrom project
- 2024
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In: International journal of hygiene and environmental health. - : Elsevier. - 1438-4639 .- 1618-131X. ; 256
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Journal article (peer-reviewed)abstract
- ObjectivesHexavalent chromium (Cr(VI)) is classified as a human carcinogen. Occupational Cr(VI) exposure can occur during different work processes, but the current exposure to Cr(VI) at Swedish workplaces is unknown.MethodsThis cross-sectional study (SafeChrom) recruited non-smoking men and women from 14 companies with potential Cr(VI) exposure (n = 113) and controls from 6 companies without Cr(VI) exposure (n = 72). Inhalable Cr(VI) was measured by personal air sampling (outside of respiratory protection) in exposed workers. Total Cr was measured in urine (pre- and post-shift, density-adjusted) and red blood cells (RBC) (reflecting Cr(VI)) in exposed workers and controls. The Bayesian tool Expostats was used to assess risk and evaluate occupational exposure limit (OEL) compliance.ResultsThe exposed workers performed processing of metal products, steel production, welding, plating, and various chemical processes. The geometric mean concentration of inhalable Cr(VI) in exposed workers was 0.15 μg/m3 (95% confidence interval: 0.11–0.21). Eight of the 113 exposed workers (7%) exceeded the Swedish OEL of 5 μg/m3, and the Bayesian analysis estimated the share of OEL exceedances up to 19.6% for stainless steel welders. Median post-shift urinary (0.60 μg/L, 5th-95th percentile 0.10–3.20) and RBC concentrations (0.73 μg/L, 0.51–2.33) of Cr were significantly higher in the exposed group compared with the controls (urinary 0.10 μg/L, 0.06–0.56 and RBC 0.53 μg/L, 0.42–0.72). Inhalable Cr(VI) correlated with urinary Cr (rS = 0.64) and RBC-Cr (rS = 0.53). Workers within steel production showed the highest concentrations of inhalable, urinary and RBC Cr. Workers with inferred non-acceptable local exhaustion ventilation showed significantly higher inhalable Cr(VI), urinary and RBC Cr concentrations compared with those with inferred acceptable ventilation. Furthermore, workers with inferred correct use of respiratory protection were exposed to significantly higher concentrations of Cr(VI) in air and had higher levels of Cr in urine and RBC than those assessed with incorrect or no use. Based on the Swedish job-exposure-matrix, approximately 17 900 workers were estimated to be occupationally exposed to Cr(VI) today.ConclusionsOur study demonstrates that some workers in Sweden are exposed to high levels of the non-threshold carcinogen Cr(VI). Employers and workers seem aware of Cr(VI) exposure, but more efficient exposure control strategies are required. National strategies aligned with the European strategies are needed in order to eliminate this cause of occupational cancer.
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| 7. |
- Jiang, Zheshun, et al.
(author)
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P-205 THE SAFECHROM PROJECT - EVIDENCE FROM A CROSS-SECTIONAL STUDY SHOWS THAT HEXAVALENT CHROMIUM IS STILL A CONCERN IN SWEDEN
- 2024
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In: Occupational Medicine. - 0962-7480. ; 74:Suppl 1, s. 291-292
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Conference paper (other academic/artistic)abstract
- Hexavalent chromium Cr(VI) is a human carcinogen, but the current exposure to Cr(VI) at Swedish workplaces is unknown.Recruitment of 113 workers with potential Cr(VI) exposure and 72 controls was combined with measurements of inhalable Cr(VI) (only exposed workers) and total Cr in urine and red blood cells (RBC), Bayesian analysis of occupational exposure limit (OEL) compliance was used, as well as the Swedish job-exposure-matrix.Exposed workers performed processing of metal products, steel production, welding, and plating. The geometric mean concentration of inhalable Cr(VI) in exposed workers was 0.15 μg/m3. Eight workers (7\ exceeded the Swedish OEL (5 μg/m3), and the share of OEL exceedances was estimated to be up to 19.6\ and RBC-Cr were significantly higher in exposed workers compared with controls. Workers with inferred non-acceptable local exhaustion ventilation showed significantly higher inhalable Cr(VI), urine- and RBC-Cr than those with acceptable ventilation. Workers with inferred correct use of respiratory protection had higher inhalable Cr(VI), and, paradoxically, higher urine- and RBC-Cr concentrations than workers with incorrect use. We estimate that ~17 900 Swedish workers are occupationally exposed to Cr(VI) today.Our study showed that although most air measurements were relatively low, 7\ and particularly stainless steel workers are at risk for exceeding the OEL. The existing protective measures implemented at workplaces are still inadequate and insufficient.Some workers in Sweden are exposed to high levels of the non-threshold carcinogen Cr(VI). National strategies aligned with European strategies are needed to eliminate occupational cancer.
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| 8. |
- Jonauskaite, Domicele, et al.
(author)
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A comparative analysis of colour–emotion associations in 16–88-year-old adults from 31 countries
- 2024
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In: British Journal of Psychology. - : John Wiley and Sons Ltd. - 0007-1269 .- 2044-8295. ; 115:2, s. 275-
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Journal article (peer-reviewed)abstract
- As people age, they tend to spend more time indoors, and the colours in their surroundings may significantly impact their mood and overall well-being. However, there is a lack of empirical evidence to provide informed guidance on colour choices, irrespective of age group. To work towards informed choices, we investigated whether the associations between colours and emotions observed in younger individuals also apply to older adults. We recruited 7393 participants, aged between 16 and 88 years and coming from 31 countries. Each participant associated 12 colour terms with 20 emotion concepts and rated the intensity of each associated emotion. Different age groups exhibited highly similar patterns of colour–emotion associations (average similarity coefficient of.97), with subtle yet meaningful age-related differences. Adolescents associated the greatest number but the least positively biased emotions with colours. Older participants associated a smaller number but more intense and more positive emotions with all colour terms, displaying a positivity effect. Age also predicted arousal and power biases, varying by colour. Findings suggest parallels in colour–emotion associations between younger and older adults, with subtle but significant age-related variations. Future studies should next assess whether colour–emotion associations reflect what people actually feel when exposed to colour.
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| 9. |
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| 10. |
- Karlsson, Stefan
(author)
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Exploring API Behaviours by Example Generation
- 2024
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Doctoral thesis (other academic/artistic)abstract
- Understanding the behaviour of complex software-intensive systems is a hard task. For developers of such systems, understanding the actual behaviours is critical in order to successfully create, extend, and maintain them.The goal of the work in this thesis is to support explorations of the behaviour of software systems through their APIs. We fulfil this goal by generating examples of behaviours the system exhibits. An example is expressed as a sequence of API operations---with parameters, if required---that conforms to a specific behaviour.Examples of behaviours, such as sequences of operations performed on the system, have been shown to be a good way to further the understanding of software systems for both end users and developers. However, manually creating examples requires effort. In addition, manually created examples only contain what a human can imagine---which might miss important cases, such as unintended behaviours.The main proposed approach in this thesis is to support users in exploring the behaviour of their software system by automatically generating examples of actual behaviour. By only interacting with the system by the exposed API, we assess the behaviours as exposed to an end user of the API. The input to the approach is a set of API operations and schema of operation parameters. Sequences of operations are generated containing these provided operations. The observed responses from executing the generated sequences are used to assess if the API show an example of a sought behaviour. Found examples go through a shrinking process---trying to find a more minimal sequence showing the same behaviour---and are then reported to the user of the approach. The approach is capable of both generating examples of faults in the system and of generating examples of general behaviours. We show evidence of this through multiple evaluations. We have evaluated the fault-finding capabilities by generating examples producing fault-indicating error codes and showing how the configuration of generators affects the interaction with the system. In addition, we evaluate the capability of the approach to generate relevant examples, both in the general API case and in the specific case of REST APIs. By conducting multiple focus group sessions, we conclude that the examples of behaviours produced by the approach indeed aid industry practitioners. The generated examples are deemed relevant for use cases such as testing, documenting, and understanding the behaviour of the system.
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