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  • 1.
    Algurén, Beatrix
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Faculty of Education, Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden.
    Jernberg, Tomas
    Department of Clinical Sciences, Danderyd University Hospital, Karolinska Institute, Stockholm, Sweden.
    Vasko, Peter
    Department of Internal Medicine, Central Hospital, Växjö, Sweden.
    Selb, Melissa
    ICF Research Branch, a cooperation partner within the WHO Collaborating Centre for the Family of International Classifications (at DIMDI), Nottwil, Switzerland; and Swiss Paraplegic Research, Nottwil, Switzerland .
    Coenen, Michaela
    ICF Research Branch, a cooperation partner within the WHO Collaborating Centre for the Family of International Classifications (at DIMDI), Nottwil, Switzerland; Department of Medical Information Processing, Biometry and Epidemiology-IBE, Chair of Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-Universität (LMU) Munich, Munich, Germany; and Pettenkofer School of Public Health (PSPH), Munich, Germany .
    Content comparison and person-centeredness of standards for quality improvement in cardiovascular health care2021In: PLOS ONE, E-ISSN 1932-6203, Vol. 16, no 1, article id e0244874Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Quality standards are important for improving health care by providing compelling evidence for best practice. High quality person-centered health care requires information on patients' experience of disease and of functioning in daily life.

    OBJECTIVE: To analyze and compare the content of five Swedish National Quality Registries (NQRs) and two standard sets of the International Consortium of Health Outcomes Measurement (ICHOM) related to cardiovascular diseases.

    MATERIALS AND METHODS: An analysis of 2588 variables (= data items) of five NQRs-the Swedish Registry of Congenital Heart Disease, Swedish Cardiac Arrest Registry, Swedish Catheter Ablation Registry, Swedish Heart Failure Registry, SWEDEHEART (including four sub-registries) and two ICHOM standard sets-the Heart Failure Standard Set and the Coronary Artery Disease Standard Set. According to the name and definition of each variable, the variables were mapped to Donabedian's quality criteria, whereby identifying whether they capture health care processes or structures or patients' health outcomes. Health outcomes were further analyzed whether they were clinician- or patient-reported and whether they capture patients' physiological functions, anatomical structures or activities and participation.

    RESULTS: In total, 606 variables addressed process quality criteria (31%), 58 structure quality criteria (3%) and 760 outcome quality criteria (38%). Of the outcomes reported, 85% were reported by clinicians and 15% by patients. Outcome variables addressed mainly 'Body functions' (n = 392, 55%) or diseases (n = 209, 29%). Two percent of all documented data captured patients' lived experience of disease and their daily activities and participation (n = 51, 3% of all variables).

    CONCLUSIONS: Quality standards in the cardiovascular field focus predominately on processes (e.g. treatment) and on body functions-related outcomes. Less attention is given to patients' lived experience of disease and their daily activities and participation. The results can serve as a starting-point for harmonizing data and developing a common person-centered quality indicator set.

  • 2.
    Bettencourt, Luís M. A.
    et al.
    Theoretical Division and Center for Nonlinear Studies (CNLS), Los Alamos National Laboratory, Los Alamos, NM, United States; Santa Fe Institute, Santa Fe, NM, United States.
    Lobo, José
    School of Human Evolution and Social Change and W. P. Carey School of Business, Arizona State University, Tempe, AZ, United States.
    Strumsky, Deborah
    Department of Geography and Earth Sciences, University of North Carolina at Charlotte, Charlotte, NC, United States.
    West, Geoffrey B.
    Theoretical Division and Center for Nonlinear Studies (CNLS), Los Alamos National Laboratory, Los Alamos, NM, United States; Santa Fe Institute, Santa Fe, NM, United States.
    Urban scaling and its deviations: Revealing the structure of wealth, innovation and crime across cities2010In: PLOS ONE, E-ISSN 1932-6203, Vol. 5, no 11, article id e13541Article in journal (Refereed)
    Abstract [en]

    With urban population increasing dramatically worldwide, cities are playing an increasingly critical role in human societies and the sustainability of the planet. An obstacle to effective policy is the lack of meaningful urban metrics based on a quantitative understanding of cities. Typically, linear per capita indicators are used to characterize and rank cities. However, these implicitly ignore the fundamental role of nonlinear agglomeration integral to the life history of cities. As such, per capita indicators conflate general nonlinear effects, common to all cities, with local dynamics, specific to each city, failing to provide direct measures of the impact of local events and policy. Agglomeration nonlinearities are explicitly manifested by the superlinear power law scaling of most urban socioeconomic indicators with population size, all with similar exponents (~1.15). As a result larger cities are disproportionally the centers of innovation, wealth and crime, all to approximately the same degree. We use these general urban laws to develop new urban metrics that disentangle dynamics at different scales and provide true measures of local urban performance. New rankings of cities and a novel and simpler perspective on urban systems emerge. We find that local urban dynamics display long-term memory, so cities under or outperforming their size expectation maintain such (dis)advantage for decades. Spatiotemporal correlation analyses reveal a novel functional taxonomy of U.S. metropolitan areas that is generally not organized geographically but based instead on common local economic models, innovation strategies and patterns of crime.

  • 3.
    Chuang, S.
    et al.
    Graduate Institute of Data Science, Taipei Medical University, Taipei, Taiwan.
    Ou, J. -C
    Department of Emergency Medicine, Shuang-Ho Hospital, Taipei Medical University, Taipei, Taiwan.
    Hollnagel, Erik
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Hou, S. -K
    Department of Emergency Medicine, Taipei Medical University Hospital, TaipeiMedical University, Taipei, Taiwan.
    Measurement of resilience potential: development of a resilience assessment grid for emergency departments2020In: PLOS ONE, E-ISSN 1932-6203, Vol. 15, no 9, article id e0239472Article in journal (Refereed)
    Abstract [en]

    Background Resilience engineering has been advocated as an alternative to the management of safety over the last decade in many domains. However, to facilitate metrics for measuring and helping analyze the resilience potential for emergency departments (EDs) remains a significant challenge. The study aims to redesign the Hollnagel’s resilience assessment grid (RAG) into a custom-made RAG (ED-RAG) to support resilience management in EDs. Methods The study approach had three parts: 1) translation of Hollnagel’s RAG into Chinese version, followed by generation of a tailored set of ED-RAG questions adapted to EDs; 2) testing and revising the tailored sets until to achieve satisfactory validity for application; 3) design of a new rating scale and scoring method. The test criteria of the ED-RAG questionnaire adopted the modified three-level scoring criteria proposed by Bloom and Fischer. The study setting of the field test is a private regional hospital. Results The fifth version of ED-RAG was acceptable after a field test. It has three sets of open structured questions for the potentials to respond, monitor, and anticipate, and a set of structured questions for the potential to learn. It contained 38 questions corresponding to 32 foci. A new 4-level rating scale along with a novel scaling method can improve the scores conversion validity and communication between team members and across investigations. This final version is set to complete an interview for around 2 hours. Conclusions The ED-RAG represents a snapshot of EDs’resilience under specific conditions. It might be performed multiple times by a single hospital to monitor the directions and contents of improvement that can supplement conventional safety management toward resilience. Some considerations are required to be successful when hospitals use it. Future studies to overcome the potential methodological weaknesses of the ED-RAG are needed.

  • 4.
    D'Arcangelo, Chiara
    et al.
    Department of Business Economics, University of Chieti-Pescara, Pescara, Italy.
    Morreale, Azzurra
    LUT Business School, LUT University, Lappeenranta, Finland.
    Mittone, Luigi
    Department of Economics and Management, University of Trento, Trento, Italy.
    Collan, Mikael
    LUT Business School, LUT University, Lappeenranta, Finland; .
    Ignorance is bliss?: Information and risk on crowdfunding platforms2023In: PLOS ONE, E-ISSN 1932-6203, Vol. 18, no 6 JUNE, article id e0286876Article in journal (Refereed)
    Abstract [en]

    This research examines the determinants of project success on crowdfunding platforms within a competitive context. We focus on the specific horizontal attributes of the project- attributes that do not affect the project returns but over which investors may have heterogeneous preferences-and on the project returns' risk level. We run a laboratory experiment with several set-ups, where multiple projects compete for funding simultaneously and where potential investors operate in a quasi-continuous time. We find the horizontal attributes' information affects project selection, while the risk level of the project returns affects the amount of collected funding.

  • 5.
    Earl, Robyn
    et al.
    Curtin University, Perth, Western Australia, Australia.
    Falkmer, Torbjörn
    Curtin University, Perth, Western Australia, Australia and Linköping University & Pain and Rehabilitation Centre, Linköping, Sweden.
    Girdler, Sonya
    Curtin University, Perth, Western Australia, Australia.
    Morris, Susan L.
    Curtin University, Perth, Western Australia, Australia.
    Falkmer, Marita
    Jönköping University, School of Education and Communication, HLK, CHILD. Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Curtin University, Perth, Western Australia, Australia.
    Viewpoints of pedestrians with and without cognitive impairment on shared zones and zebra crossings2018In: PLOS ONE, E-ISSN 1932-6203, Vol. 13, no 9, article id e0203765Article in journal (Refereed)
    Abstract [en]

    Background

    Shared zones are characterised by an absence of traditional markers that segregate the road and footpath. Negotiation of a shared zone relies on an individual’s ability to perceive, assess and respond to environmental cues. This ability may be impacted by impairments in cognitive processing, which may lead to individuals experiencing increased anxiety when negotiating a shared zone.

    Method

    Q method was used in order to identify and explore the viewpoints of pedestrians, with and without cognitive impairments as they pertain to shared zones.

    Results

    Two viewpoints were revealed. Viewpoint one was defined by “confident users” while viewpoint two was defined by users who “know what [they] are doing but drivers might not”.

    Discussion

    Overall, participants in the study would not avoid shared zones. Pedestrians with intellectual disability were, however, not well represented by either viewpoint, suggesting that shared zones may pose a potential barrier to participation for this group.

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  • 6.
    Evans, Kiah L.
    et al.
    Curtin University and Edith Cowan University.
    Millsteed, Jeannine
    Edith Cowan University.
    Richmond, Janet E.
    Edith Cowan University.
    Falkmer, Marita
    Jönköping University, School of Education and Communication, HLK, CHILD. Curtin University.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Curtin University.
    Working Sandwich Generation Women Utilize Strategies within and between Roles to Achieve Role Balance2016In: PLOS ONE, E-ISSN 1932-6203, Vol. 11, no 6, article id e0157469Article in journal (Refereed)
    Abstract [en]

    Increasingly, women simultaneously balance the roles of mother, parental carer and worker. However, individual role balance strategies among these working ‘sandwich’ generation women have not been thoroughly explored. Eighteen women combining these three roles were interviewed about their individual role balance strategies. Findings were identified through the framework analysis technique, underpinned by the Model of Juggling Occupations. Achieving and maintaining role balance was explained as a complex process accomplished through a range of strategies. Findings revealed the women used six within-role balance strategies: living with integrity, being the best you can, doing what you love, loving what you do, remembering why and searching for signs of success. The women also described six between-role balance strategies: maintaining health and wellbeing, repressing perfectionism, managing time and energy, releasing responsibility, nurturing social connection and reciprocating. These findings provide a basis for health care providers to understand and potentially support working ‘sandwich’ generation women.

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  • 7.
    Faulks, Denise
    et al.
    Clermont Université, Université d’Auvergne, EA3847, Centre de Recherche en Odontologie Clinique, Clermont-Ferrand, France.
    Norderyd, Johanna
    Jönköping University, School of Health and Welfare, HHJ. CHILD. National Oral Disability Centre, The Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Molina, Gustavo
    Facultad de Odontología, Universidad Nacional de Córdoba, Córdoba, Argentina.
    Macgiolla Phadraig, Caoimhin
    Dublin Dental University Hospital, Trinity College, Dublin, Ireland.
    Scagnet, Gabriela
    Quinquela Martin Hospital, Government of Buenos Aires City & National University of Buenos Aires, Buenos Aires, Argentina.
    Eschevins, Caroline
    Clermont Université, Université d’Auvergne, EA3847, Centre de Recherche en Odontologie Clinique, Clermont-Ferrand, France.
    Hennequin, Martine
    Clermont Université, Université d’Auvergne, EA3847, Centre de Recherche en Odontologie Clinique, Clermont-Ferrand, France.
    Using the International Classification of Functioning, Disability and Health (ICF) to describe children referred to special care or paediatric dental services2013In: PLOS ONE, E-ISSN 1932-6203, Vol. 8, no 4, article id e61993Article in journal (Refereed)
    Abstract [en]

    Children in dentistry are traditionally described in terms of medical diagnosis and prevalence of oral disease. This approach gives little information regarding a child's capacity to maintain oral health or regarding the social determinants of oral health. The biopsychosocial approach, embodied in the International Classification of Functioning, Disability and Health - Child and Youth version (ICF-CY) (WHO), provides a wider picture of a child's real-life experience, but practical tools for the application of this model are lacking. This article describes the preliminary empirical study necessary for development of such a tool - an ICF-CY Core Set for Oral Health. An ICF-CY questionnaire was used to identify the medical, functional, social and environmental context of 218 children and adolescents referred to special care or paediatric dental services in France, Sweden, Argentina and Ireland (mean age 8 years ± 3.6 yrs). International Classification of Disease (ICD-10) diagnoses included disorders of the nervous system (26.1%), Down syndrome (22.0%), mental retardation (17.0%), autistic disorders (16.1%), and dental anxiety alone (11.0%). The most frequently impaired items in the ICF Body functions domain were 'Intellectual functions', 'High-level cognitive functions', and 'Attention functions'. In the Activities and Participation domain, participation restriction was frequently reported for 25 items including 'Handling stress', 'Caring for body parts', 'Looking after one's health' and 'Speaking'. In the Environment domain, facilitating items included 'Support of friends', 'Attitude of friends' and 'Support of immediate family'. One item was reported as an environmental barrier - 'Societal attitudes'. The ICF-CY can be used to highlight common profiles of functioning, activities, participation and environment shared by children in relation to oral health, despite widely differing medical, social and geographical contexts. The results of this empirical study might be used to develop an ICF-CY Core Set for Oral Health - a holistic but practical tool for clinical and epidemiological use.

  • 8.
    Fismen, Anne-Siri
    et al.
    Norge.
    Smith, Otto Robert Frans
    Norge.
    Torsheim, Torbjørn
    Norge.
    Rasmussen, Mette
    Danmark.
    Pedersen Pagh, Trine
    Danmark.
    Augustine, Lilly
    Högskolan Kristianstad, Avdelningen för Humanvetenskap.
    Ojala, Kristiina
    Finland.
    Samdal, Oddrun
    Norge.
    Trends in food habits and their relation to socioeconomic status among Nordic adolescents 2001/2002-2009/20102016In: PLOS ONE, E-ISSN 1932-6203, Vol. 11, no 2Article in journal (Refereed)
    Abstract [en]

    Background

    In the Nordic countries, substantial policy and intervention efforts have been made to increase adolescents' consumption of fruit and vegetables and to reduce their intake of sweets and soft drinks. Some initiatives have been formulated in a Nordic collaboration and implemented at national level. In recent years, social inequalities in food habits have been attracted particular governmental interest and several initiatives addressing the socioeconomic gradient in food habits have been highlighted. However, few internationally published studies have evaluated how trends in adolescents' food habits develop in the context of Nordic nutrition policy, or have compared differences between the Nordic countries.

    Methods

    The study was based on Danish, Finnish, Norwegian and Swedish cross-sectional data from the international Health Behaviour in School-Aged Children (HBSC) study, collected via three nationally representative and comparable questionnaire surveys in 2001/2002, 2005/2006 and 2009/2010. Food habits were identified by students' consumption of fruit, vegetables, sweets and sugar sweetened soft drink. Socioeconomic status (SES) was measured with the Family Affluence Scale (FAS). Multilevel logistic regression was used to analyze the data.

    Results

    Trends in fruit consumption developed differently across countries, characterized by an increase in Denmark and Norway and more stable trends in Sweden and Finland. Vegetable consumption increased particularly in Denmark and to a lesser extent in Norway, whereas Sweden and Finland displayed stable trends. Decreased trends were observed for sweet and soft drink consumption and were similar in Norway, Sweden and Finland. Sweet consumption decreased across all survey years, whereas soft drink consumption decreased between 2001/2002–2005/2006 and was stable thereafter. Denmark displayed an increase between 2001/2002–2005/2006 followed by a similar decrease between 2005/2006–2009/2010 for both sweet and soft drink consumption. Socioeconomic inequalities in fruit and vegetable consumption were observed in all countries, with no cross-country differences, and no changes over time. Small but not significant cross-country variation was identified for SES inequalities in sweet consumption. Reduced SES inequalities were observed in Sweden between 2005/2006 and 2009/2010. SES was not associated with soft drink consumption in this study population, with the exception of Denmark for the survey year 2009/2010.

    Conclusion

    Different trends resulted in increased country differences in food habits during the time of observations. In survey year 2009/2010, Danish students reported a higher intake of fruit and vegetable consumption than their counterparts in the other Nordic countries. Finnish students reported the lowest frequency of sweets and soft drink consumption. Despite the positive dietary trends documented in the present study, the majority of Nordic adolescents are far from meeting national dietary recommendations. Our findings underline the need for more comprehensive initiatives targeting young people's food habits as well as a more deliberate and focused action to close gaps in social inequalities that affect food choices.

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  • 9.
    Fragkias, Michail
    et al.
    Department of Economics, Boise State University, Boise, ID, United States.
    Lobo, José
    School of Sustainability, Arizona State University, Tempe, AZ, United States.
    Strumsky, Deborah
    Department of Geography and Earth Sciences, University of North Carolina-Charlotte, Charlotte, NC, United States.
    Seto, Karen C.
    Yale School of Forestry and Environmental Studies, Yale University, New Haven, CT, United States.
    Does Size Matter? Scaling of CO2 Emissions and U.S. Urban Areas2013In: PLOS ONE, E-ISSN 1932-6203, Vol. 8, no 6, article id e64727Article in journal (Refereed)
    Abstract [en]

    Urban areas consume more than 66% of the world's energy and generate more than 70% of global greenhouse gas emissions. With the world's population expected to reach 10 billion by 2100, nearly 90% of whom will live in urban areas, a critical question for planetary sustainability is how the size of cities affects energy use and carbon dioxide (CO2) emissions. Are larger cities more energy and emissions efficient than smaller ones? Do larger cities exhibit gains from economies of scale with regard to emissions? Here we examine the relationship between city size and CO2 emissions for U.S. metropolitan areas using a production accounting allocation of emissions. We find that for the time period of 1999-2008, CO2 emissions scale proportionally with urban population size. Contrary to theoretical expectations, larger cities are not more emissions efficient than smaller ones. 

  • 10.
    Fristedt, Sofi
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Dahl, Anna K.
    Wretstrand, Anders
    Björklund, Anita
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Changes in community mobility in older men and women. A 13-year prospective study2014In: PLOS ONE, E-ISSN 1932-6203, Vol. 9, no 2, p. e87827-Article in journal (Refereed)
    Abstract [en]

    Community mobility, defined as "moving [ones] self in the community and using public or private transportation", has a unique ability to promote older peoples' wellbeing by enabling independence and access to activity arenas for interaction with others. Early predictors of decreased community mobility among older men and women are useful in developing health promoting strategies. However, long-term prediction is rare, especially when it comes to including both public and private transportation. The present study describes factors associated with community mobility and decreased community mobility over time among older men and women. In total, 119 men and 147 women responded to a questionnaire in 1994 and 2007. Respondents were between 82 and 96 years old at follow-up. After 13 years, 40% of men and 43% of women had decreased community mobility, but 47% of men and 45% of women still experienced some independent community mobility. Cross-sectional independent community mobility among men was associated with higher ratings of subjective health, reporting no depression and more involvement in sport activities. Among women, cross-sectional independent community mobility was associated with better subjective health and doing more instrumental activities of daily living outside the home. Lower subjective health predicted decreased community mobility for both men and women, whereas self-reported health conditions did not. Consequently, general policies and individual interventions aiming to improve community mobility should consider older persons' subjective health.

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  • 11.
    Fristedt, Sofi
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
    Svärdh, Samantha
    City of Malmö, Malmö.
    Löfqvist, Charlotte
    Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
    Schmidt, Steven M
    Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
    Iwarsson, Susanne
    Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
    "Am I representative (of my age)? No, I'm not"-Attitudes to technologies and technology development differ but unite individuals across rather than within generations2021In: PLOS ONE, E-ISSN 1932-6203, Vol. 16, no 4, article id e0250425Article in journal (Refereed)
    Abstract [en]

    While a broad spectrum of technologies is integrated in everyday life and routines, most research on ageing, health and technology has focused on attitudes toward and adoption of digital technologies including e-health, or home based monitoring systems. The aim of this study was to explore differences and similarities in attitudes and experiences with different types of technologies and development within and between three generations. We applied a qualitative, descriptive design and recruited a purposeful sample of participants from three generations (30-39, 50-59, 70-79 year old). The 25 participants took part in 3 x 2 focus groups. Forming four categories, the findings show that technologies enable as well as complicate everyday life. Participants expressed trust as well as uncertainty about risks when using technology and stated that use of digital services is required while support is limited. They identified that technology development is inevitable but not always in the service of users. In conclusion, experiences of and attitudes towards technologies and technology development are not limited to generation; perspectives sometimes unite individuals across rather than within generations. Thus future technologies and technology development, as well as services and policies aiming to support the use of said technologies should consider individual user perspectives including needs, desires, beliefs or goals neglected in the existing technology models, and involve users beyond generations defined by chronological age. Such strategies are likely to be more successful in supporting development of technologies usable for all.

  • 12.
    Fritzell, K.
    et al.
    Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden.
    Hedberg, Berith
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Woudstra, A.
    Team Advies en Onderzoek, Municipal Health Service (GGD) Kennemerland, Haarlem, Netherlands.
    Forsberg, A.
    Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.
    Sventelius, M.
    Regional Cancer Centre, Gotland, Stockholm, Sweden.
    Kottorp, A.
    Faculty of Health and Society, Malmö University, Malmö, Sweden.
    Jervaeus, A.
    Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden.
    Making the BEST decision: The BESTa project development, implementation and evaluation of a digital Decision Aid in Swedish cancer screening programmes-a description of a research project2023In: PLOS ONE, E-ISSN 1932-6203, Vol. 18, no 12 December, article id e0294332Article in journal (Refereed)
    Abstract [en]

    Sweden has a long tradition of organized national population-based screening programmes. Participation rates differ between programmes and regions, being relatively high in some groups, but lower in others. To ensure an equity perspective on screening, it is desirable that individuals make an informed decision based on knowledge rather than ignorance, misconceptions, or fear. Decision Aids (DAs) are set to deliver information about different healthcare options and help individuals to visualize the values associated with each available option. DAs are not intended to guide individuals to choose one option over another. The advantage of an individual Decision Aid (iDA) is that individuals gain knowledge about cancer and screening by accessing one webpage with the possibility to communicate with health professionals and thereafter make their decision regarding participation. The objective is therefore to develop, implement and evaluate a digital iDA for individuals invited to cancer screening in Sweden. Methods This study encompasses a process-, implementation-, and outcome evaluation. Multiple methods will be applied including focus group discussions, individual interviews and the usage of the think aloud technique and self-reported questionnaire data. The project is based on The International Patient Decision Aid Standards (IPDAS) framework and the proposed model development process for DAs. Individuals aged 23 74, including women (the cervical-, breast-and CRC screening module) and men (the CRC screening module), will be included in the developmental process. Efforts will be made to recruit participants with selfreported physical and mental limitations, individuals without a permanent residence and ethnic minorities. Discussion To the best of our knowledge, the present study is the first attempt aimed at developing an iDA for use in the Swedish context. The iDA is intended to facilitate shared decision making about participation in screening. Furthermore, the iDA is expected to increase knowledge and raise awareness about cancer and cancer screening.

  • 13.
    Grynne, A.
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Browall, Maria
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Fristedt, Sofi
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Rehabilitation. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Ahlberg, K.
    Univ Gothenburg, Sahlgrenska Acad, Inst Hlth & Care Sci, Gothenburg, Sweden.
    Smith, F.
    Reg Canc Ctr West, Gothenburg, Sweden.
    Integrating perspectives of patients, healthcare professionals, system developers and academics in the co-design of a digital information tool2021In: PLOS ONE, E-ISSN 1932-6203, Vol. 16, no 7 July, article id e0253448Article in journal (Refereed)
    Abstract [en]

    Background Patients diagnosed with cancer who are due to commence radiotherapy, often, despite the provision of a considerable amount of information, report a range of unmet information needs about the treatment process. Factors such as inadequate provision of information, or the stressful situation of having to deal with information about unfamiliar things, may influence the patient’s ability to comprehend the information. There is a need to further advance the format in which such information is presented. The composition of information should be tailored according to the patient’s individual needs and style of learning. Method and findings The PD methodology is frequently used when a technology designed artefact is the desired result of the process. This research is descriptive of its kind and provides a transparent description of the co-design process used to develop an innovative digital information tool employing PD methodology where several stakeholders participated as co-designers. Involving different stakeholders in the process in line with recommended PD activities enabled us to develop a digital information tool that has the potential to be relevant and user-friendly for the ultimate consumer. Conclusions Facilitating collaboration, structured PD activities can help researchers, healthcare professionals and patients to co-design patient information that meets the end users’ needs. Furthermore, it can enhance the rigor of the process, ensure the relevance of the information, and finally have a potential to employ a positive effect on the reach of the related digital information tool.

  • 14.
    Heikkilä, Katriina
    et al.
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Madsen, Ida E. H.
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Nyberg, Solja T.
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Fransson, Eleonor
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Ahola, Kirsi
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Alfredsson, Lars
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Bjorner, Jakob B.
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Borritz, Marianne
    Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark.
    Burr, Hermann
    Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany.
    Dragano, Nico
    Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.
    Ferrie, Jane E.
    School of Community and Social Medicine, University of Bristol, Bristol, United Kingdom.
    Knutsson, Anders
    Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Koskenvuo, Markku
    Department of Public Health, University of Helsinki, Helsinki, Finland.
    Koskinen, Aki
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Nielsen, Martin L.
    Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark.
    Nordin, Maria
    Department of Psychology, Umeå University, Umeå, Sweden.
    Pejtersen, Jan H.
    The Danish National Centre for Social Research, Copenhagen, Denmark.
    Pentti, Jaana
    Finnish Institute of Occupational Health, Helsinki, Tampere and Turku, Finland.
    Rugulies, Reiner
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Oksanen, Tuula
    Finnish Institute of Occupational Health, Helsinki, Tampere and Turku, Finland.
    Shipley, Martin J.
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Suominen, Sakari B.
    Folkhälsan Research Center, Helsinki, Finland.
    Theorell, Töres
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Väänänen, Ari
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Vahtera, Jussi
    Finnish Institute of Occupational Health, Helsinki, Tampere and Turku, Finland.
    Virtanen, Marianna
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Westerlund, Hugo
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Westerholm, Peter J. M.
    Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
    Batty, G. David
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Singh-Manoux, Archana
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Kivimäki, Mika
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Job Strain and the Risk of Inflammatory Bowel Diseases: Individual-Participant Meta-Analysis of 95 000 Men and Women2014In: PLOS ONE, E-ISSN 1932-6203, Vol. 9, no 2: e88711Article in journal (Refereed)
    Abstract [en]

    Background and aims: Many clinicians, patients and patient advocacy groups believe stress to have a causal role in inflammatory bowel diseases, such as Crohn's disease and ulcerative colitis. However, this is not corroborated by clear epidemiological research evidence. We investigated the association between work-related stress and incident Crohn's disease and ulcerative colitis using individual-level data from 95 000 European adults.

    Methods: We conducted individual-participant data meta-analyses in a set of pooled data from 11 prospective European studies. All studies are a part of the IPD-Work Consortium. Work-related psychosocial stress was operationalised as job strain (a combination of high demands and low control at work) and was self-reported at baseline. Crohn's disease and ulcerative colitis were ascertained from national hospitalisation and drug reimbursement registers. The associations between job strain and inflammatory bowel disease outcomes were modelled using Cox proportional hazards regression. The study-specific results were combined in random effects meta-analyses.

    Results: Of the 95 379 participants who were free of inflammatory bowel disease at baseline, 111 men and women developed Crohn's disease and 414 developed ulcerative colitis during follow-up. Job strain at baseline was not associated with incident Crohn's disease (multivariable-adjusted random effects hazard ratio: 0.83, 95% confidence interval: 0.48, 1.43) or ulcerative colitis (hazard ratio: 1.06, 95% CI: 0.76, 1.48). There was negligible heterogeneity among the study-specific associations.

    Conclusions: Our findings suggest that job strain, an indicator of work-related stress, is not a major risk factor for Crohn's disease or ulcerative colitis.

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  • 15. Heikkilä, Katriina
    et al.
    Nyberg, Solja
    Fransson, Eleonor
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Alfredsson, Lars
    De Bacquer, Dirk
    Bjorner, Jakob
    Bonenfant, Sébastien
    Borritz, Marianne
    Burr, Hermann
    Clays, Els
    Casini, Annalisa
    Dragano, Nico
    Erbel, Raimund
    Geuskens, Goedele
    Goldberg, Marcel
    Hooftman, Wendela
    Houtman, Irene
    Joensuu, Matti
    Jöckel, Karl-Heinz
    Kittel, France
    Knutsson, Anders
    Koskenvuo, Markku
    Koskinen, Aki
    Kouvonen, Anne
    Leineweber, Constanze
    Lunau, Thorsten
    Madsen, Ida
    Magnusson Hanson, Linda
    Marmot, Michael
    Nielsen, Martin
    Nordin, Maria
    Pentti, Jaana
    Salo, Paula
    Rugulies, Reiner
    Steptoe, Andrew
    Siegrist, Johannes
    Suominen, Sakari
    Vahtera, Jussi
    Virtanen, Marianna
    Väänänen, Ari
    Westerholm, Peter
    Westerlund, Hugo
    Zins, Marie
    Theorell, Töres
    Hamer, Mark
    Ferrie, Jane
    Singh-Manoux, Archana
    Batty, David
    Kivimäki, Mika
    Job strain and alcohol intake: A collaborative meta-analysis of individual-participant data from 140 000 men and women2012In: PLOS ONE, E-ISSN 1932-6203, Vol. 7, no 7, p. e40101-Article in journal (Refereed)
    Abstract [en]

    Background: The relationship between work-related stress and alcohol intake is uncertain. In order to add to the thus far inconsistent evidence from relatively small studies, we conducted individual-participant meta-analyses of the association between work-related stress (operationalised as self-reported job strain) and alcohol intake.

    Methodology and Principal Findings: We analysed cross-sectional data from 12 European studies (n = 142 140) and longitudinal data from four studies (n = 48 646). Job strain and alcohol intake were self-reported. Job strain was analysed as a binary variable (strain vs. no strain). Alcohol intake was harmonised into the following categories: none, moderate (women: 1–14, men: 1–21 drinks/week), intermediate (women: 15–20, men: 22–27 drinks/week) and heavy (women: >20, men: >27 drinks/week). Cross-sectional associations were modelled using logistic regression and the results pooled in random effects meta-analyses. Longitudinal associations were examined using mixed effects logistic and modified Poisson regression. Compared to moderate drinkers, non-drinkers and (random effects odds ratio (OR): 1.10, 95% CI: 1.05, 1.14) and heavy drinkers (OR: 1.12, 95% CI: 1.00, 1.26) had higher odds of job strain. Intermediate drinkers, on the other hand, had lower odds of job strain (OR: 0.92, 95% CI: 0.86, 0.99). We found no clear evidence for longitudinal associations between job strain and alcohol intake.

    Conclusions: Our findings suggest that compared to moderate drinkers, non-drinkers and heavy drinkers are more likely and intermediate drinkers less likely to report work-related stress.

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  • 16. Heikkilä, Katriina
    et al.
    Nyberg, Solja T
    Fransson, Eleonor I
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Alfredsson, Lars
    De Bacquer, Dirk
    Bjorner, Jakob B
    Bonenfant, Sébastien
    Borritz, Marianne
    Burr, Hermann
    Clays, Els
    Casini, Annalisa
    Dragano, Nico
    Erbel, Raimund
    Geuskens, Goedele A
    Goldberg, Marcel
    Hooftman, Wendela E
    Houtman, Irene L
    Joensuu, Matti
    Jöckel, Karl-Heinz
    Kittel, France
    Knutsson, Anders
    Koskenvuo, Markku
    Koskinen, Aki
    Kouvonen, Anne
    Leineweber, Constanze
    Lunau, Thorsten
    Madsen, Ida E H
    Magnusson Hanson, Linda L
    Marmot, Michael G
    Nielsen, Martin L
    Nordin, Maria
    Pentti, Jaana
    Salo, Paula
    Rugulies, Reiner
    Steptoe, Andrew
    Siegrist, Johannes
    Suominen, Sakari
    Vahtera, Jussi
    Virtanen, Marianna
    Väänänen, Ari
    Westerholm, Peter
    Westerlund, Hugo
    Zins, Marie
    Theorell, Töres
    Hamer, Mark
    Ferrie, Jane E
    Singh-Manoux, Archana
    Batty, G David
    Kivimäki, Mika
    Job strain and tobacco smoking: An individual-participant data meta-analysis of 166 130 adults in 15 European studies2012In: PLOS ONE, E-ISSN 1932-6203, Vol. 7, no 7, p. e35463-Article in journal (Refereed)
    Abstract [en]

    Background: Tobacco smoking is a major contributor to the public health burden and healthcare costs worldwide, but the determinants of smoking behaviours are poorly understood. We conducted a large individual-participant meta-analysis to examine the extent to which work-related stress, operationalised as job strain, is associated with tobacco smoking in working adults.

    Methodology and Principal Findings: We analysed cross-sectional data from 15 European studies comprising 166 130 participants. Longitudinal data from six studies were used. Job strain and smoking were self-reported. Smoking was harmonised into three categories never, ex- and current. We modelled the cross-sectional associations using logistic regression and the results pooled in random effects meta-analyses. Mixed effects logistic regression was used to examine longitudinal associations. Of the 166 130 participants, 17% reported job strain, 42% were never smokers, 33% ex-smokers and 25% current smokers. In the analyses of the cross-sectional data, current smokers had higher odds of job strain than never-smokers (age, sex and socioeconomic position-adjusted odds ratio: 1.11, 95% confidence interval: 1.03, 1.18). Current smokers with job strain smoked, on average, three cigarettes per week more than current smokers without job strain. In the analyses of longitudinal data (1 to 9 years of follow-up), there was no clear evidence for longitudinal associations between job strain and taking up or quitting smoking.

    Conclusions: Our findings show that smokers are slightly more likely than non-smokers to report work-related stress. In addition, smokers who reported work stress smoked, on average, slightly more cigarettes than stress-free smokers.

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  • 17.
    Hellström, Amanda
    et al.
    Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden.
    Hagell, Peter
    The PRO-CARE Group, Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden.
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT. Department of clinical neurophysiology, Linköping University hospital, Linköping, Sweden.
    Ulander, Martin
    Department of clinical neurophysiology, Linköping University hospital, Linköping, Sweden.
    Luik, Annemarie I.
    Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom.
    Espie, Colin A.
    Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom.
    Årestedt, Kristofer
    Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden.
    A classical test theory evaluation of the Sleep Condition Indicator accounting for the ordinal nature of item response data2019In: PLOS ONE, E-ISSN 1932-6203, Vol. 14, no 3, p. 1-13, article id e0213533Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Insomnia symptoms are common among young adults and affect about 5% to 26% of 19 to 34-year-olds. In addition, insomnia is associated with poor mental health and may affect daily performance. In research, as well as in clinical practice, sleep questionnaires are used to screen for and diagnose insomnia. However, most questionnaires are not developed according to current DSM-5 diagnostic criteria. An exception is the recently developed Sleep Condition Indicator (SCI), an eight-item scale screening for insomnia.

    AIM: The aim of this study was to perform a Classical Test Theory (CTT) based psychometric evaluation of the SCI in a sample of Swedish university students, by taking the ordinal nature of item level data into account.

    METHODS: The SCI was translated into Swedish and distributed online to undergraduate students at three Swedish universities, within programs of health, psychology, science or economy. Of 3673 invited students, 634 (mean age 26.9 years; SD = 7.4) completed the questionnaire that, in addition to the SCI, comprised other scales on sleep, stress, lifestyle and students' study environment. Data were analyzed according to CTT investigating data completeness, item homogeneity and unidimensionality.

    RESULTS: Polychoric based explorative factor analysis suggested unidimensionality of the SCI, and internal consistency was good (Cronbach's alpha, 0.91; ordinal alpha, 0.94). SCI scores correlated with the Insomnia Severity Index (-0.88) as well as with sleep quality (-0.85) and perceived stress (-0.50), supporting external construct validity.

    CONCLUSIONS: These observations support the integrity of the of the SCI. The SCI demonstrates sound CTT-based psychometric properties, supporting its use as an insomnia screening tool.

  • 18.
    Horlin, Chiara
    et al.
    School of Occupational Therapy & Social Work, CHIRI, Curtin University, Perth, Australia.
    Falkmer, Marita
    Jönköping University, School of Education and Communication, HLK, CHILD.
    Parsons, Richard
    School of Occupational Therapy & Social Work, CHIRI, Curtin University, Perth, Australia.
    Albrecht, Matthew A.
    School of Psychology, CHIRI, Curtin University, Perth, Australia.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ. CHILD.
    The cost of autism spectrum disorders2014In: PLOS ONE, E-ISSN 1932-6203, Vol. 9, no 9, article id e106552Article in journal (Refereed)
    Abstract [en]

    Objective

    A diagnosis of an autism spectrum disorders is usually associated with substantial lifetime costs to an individual, their family and the community. However, there remains an elusive factor in any cost-benefit analysis of ASD diagnosis, namely the cost of not obtaining a diagnosis. Given the infeasibility of estimating the costs of a population that, by its nature, is inaccessible, the current study compares expenses between families whose children received a formal ASD diagnosis immediately upon suspecting developmental atypicality and seeking advice, with families that experienced a delay between first suspicion and formal diagnosis.

    Design

    A register based questionnaire study covering all families with a child with ASD in Western Australia.

    Participants

    Families with one or more children diagnosed with an ASD, totalling 521 children diagnosed with an ASD; 317 records were able to be included in the final analysis.

    Results

    The median family cost of ASD was estimated to be AUD $34,900 per annum with almost 90% of the sum ($29,200) due to loss of income from employment. For each additional symptom reported, approximately $1,400 cost for the family per annum was added. While there was little direct influence on costs associated with a delay in the diagnosis, the delay was associated with a modest increase in the number of ASD symptoms, indirectly impacting the cost of ASD.

    Conclusions

    A delay in diagnosis was associated with an indirect increased financial burden to families. Early and appropriate access to early intervention is known to improve a child's long-term outcomes and reduce lifetime costs to the individual, family and society. Consequently, a per symptom dollar value may assist in allocation of individualised funding amounts for interventions rather than a nominal amount allocated to all children below a certain age, regardless of symptom presentation, as is the case in Western Australia.

  • 19.
    Hosen, I.
    et al.
    CHINTA Research Bangladesh (Centre for Health Innovation, Networking, Training, Action and Research-Bangladesh), Dhaka, Bangladesh.
    Pakpour, Amir H.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Sakib, N.
    CHINTA Research Bangladesh (Centre for Health Innovation, Networking, Training, Action and Research-Bangladesh), Dhaka, Bangladesh.
    Hussain, N.
    CHINTA Research Bangladesh (Centre for Health Innovation, Networking, Training, Action and Research-Bangladesh), Dhaka, Bangladesh.
    Al Mamun, F.
    CHINTA Research Bangladesh (Centre for Health Innovation, Networking, Training, Action and Research-Bangladesh), Dhaka, Bangladesh.
    Mamun, M. A.
    CHINTA Research Bangladesh (Centre for Health Innovation, Networking, Training, Action and Research-Bangladesh), Dhaka, Bangladesh.
    Knowledge and preventive behaviors regarding COVID-19 in Bangladesh: A nationwide distribution2021In: PLOS ONE, E-ISSN 1932-6203, Vol. 16, no 5, article id e0251151Article in journal (Refereed)
    Abstract [en]

    Assessing individuals' knowledge and preventive behaviors towards the Coronavirus Disease of 2019 (COVID-19) is essential for the related public health surveillance strategies. Although some of the studies were conducted in Bangladesh, none of these studies considered the geographical distribution of knowledge and preventive behaviors towards COVID-19. Therefore, the present nationwide cross-sectional study with 10,067 samples for the first-time aims to assess the knowledge gap by presenting the geographical distribution of the COVID-19 knowledge and preventive behaviors across all administrative districts of Bangladesh. The measures included socio-demographics and questions about knowledge and preventive behaviors related to COVID-19. One-way ANOVA, independent t-test, and multiple linear regression were used to analyze the data. In addition, GIS-based mapping identified district-wise distribution of the outcomes. Results indicated that the overall mean score of knowledge related to COVID-19 was 14.363 ± 3.073, whereas 16.95 ± 2.89 was for preventive behaviors. Participants' being male, being divorced or widowed, consuming alcohol, smoking cigarettes, living in villages, and having no formal education reported lower performing preventive COVID-19 behaviors. Those participants with higher knowledge scores reported higher preventive COVID-19 behaviors (β = 0.053, p<0.001). However, the model predicted only 13.2% of the variation in preventive COVID-19 behaviors while the overall model being significant. The findings suggest that the Bangladeshi government should initiate appropriate far-reaching program of health education focusing on knowledge and preventive behaviors towards COVID-19 at a community level. After all, the strategies to combat COVID-19 will require individuals' involvement to control and prevent the disease outbreak, for which education is essential.

  • 20.
    Hughes, Brett P.
    et al.
    School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ. CHILD. School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia.
    Anund, Anna
    Swedish Road and Transport Research Institute, VTI, Linköping, Sweden.
    Black, Melissa H.
    School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia.
    The relevance of U.S. Strategic Highway Safety Plans in a future context2019In: PLOS ONE, E-ISSN 1932-6203, Vol. 14, no 10, article id e0223646Article in journal (Refereed)
    Abstract [en]

    While road safety in the United States (U.S.) has been continually improving since the 1970's, there are indications that these improvements are becoming increasingly difficult to sustain. Strategic Highway Safety Plans (SHSPs) are prepared by States to guide road safety management, however assessing the appropriateness of these plans remains a significant challenge, especially for the future in which they are to be applied. This study developed a new methodology to assess SHSPs from the perspectives of comprehensive system-based safety management and relevant future issues that can be applied before SHSPs are implemented, thereby avoiding long periods after implementation before assessing the appropriateness of the plans. A rating scale was developed and applied to assess 48 U.S. SHSPs against two key criteria: 1. a comprehensive framework for road safety, and 2. the anticipated changing, difficult and unpredictable nature of future transport and its context. The analysis concluded that current SHSPs have good national oversight with several strengths but were weak in some areas of content and did not address future challenges. Improvements are suggested to strengthen the plans' thoroughness by being consistent with systems theory and practice, as well as ways that these SHSPs can be more resilient to future circumstances. Implementing the recommendations in this paper provides the opportunity to adopt a system-based safety management practice that has been successful in other hazardous industries. Doing so is expected to most efficiently and effectively continue the recent improvements to road safety, which is likely to be increasingly difficult otherwise. 

  • 21.
    Huus, Karina
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Åkerman, Linda
    Linköping University, Sweden.
    Raustorp, Anders
    Linnaeus University and University of Gothenburg, Sweden.
    Ludvigsson, Johnny
    Linköping University and Östergötland County Council, Sweden.
    Physical Activity, Blood Glucose and C-Peptide in Healthy School-Children, a Longitudinal Study2016In: PLOS ONE, E-ISSN 1932-6203, Vol. 11, no 6, article id e0156401Article in journal (Refereed)
    Abstract [en]

    Aim

    To further elucidate the relationship between physical activity and several risk factors for development of diabetes (glucose, C-peptide and obesity) over time.

    Methods

    A prospective longitudinal study where physical activity was measured on 199 children from Kalmar and Linköping at age 8, and the same 107 children from Linköping again at age 12. Anthropometric data was collected and blood was analyzed for C-peptide and f-glucose. The children in the study were representative for the general Swedish child population, and on an average lean.

    Results

    High physical activity was related to lower C-peptide at age 8 and 12. This correlation was especially pronounced in boys, who also were more physically active than girls at both time points. The association seen at 8 years of age was similar at age 12 in most children. Children with higher BMI Z-Score had a higher fasting C-peptide (age 12) but linear regression showed that children with more steps per day were less likely to have a higher fasting C-peptide irrespective of BMI. Longitudinal follow-up showed that a decrease in physical activity increased insulin resistance and β-cell load.

    Conclusions

    Already in young children, physical activity improves insulin sensitivity and decreases the need of C-peptide over time. This seems to become even more pronounced with increasing age when children are followed longitudinally. Low physical activity increases the load on insulin producing β-cells, might increase the risk for both type 1- and 2 diabetes.

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  • 22.
    Jacob, Andrew
    et al.
    Curtin University, Perth, Australia.
    Scott, Melissa
    Curtin University, Perth, Australia.
    Falkmer, Marita
    Jönköping University, School of Education and Communication, HLK, CHILD. Curtin University, Perth, Australia.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Curtin University, Perth, Australia.
    The costs and benefits of employing an adult with autism spectrum disorder: A systematic review2015In: PLOS ONE, E-ISSN 1932-6203, Vol. 10, no 10, p. 1-15, article id e0139896Article, review/survey (Refereed)
    Abstract [en]

    Background

    Despite an ambition from adults with Autism Spectrum Disorder (ASD) to be employed, there are limited opportunities for competitive employment for this group. Employment is not only an entitlement enjoyed by others in society, but employing adults with ASD also has economic benefits by decreasing lost productivity and resource costs for this group. Few studies have explored the cost-benefit ratio for employing adults with ASD and even fewer have taken the viewpoint of the employer, particularly applying this situation to ASD. Until such study occurs, employers may continue to be reluctant to employ adults from this group.

    Objective

    This review aimed to examine the costs, benefits and the cost-benefit ratio of employing adults with ASD, from a societal perspective and from the perspective of employers.

    Methods

    Eight databases were searched for scientific studies within defined inclusion criteria. These databases included CINAHL Plus, Cochrane Library, Emerald, Ovid Medline, ProQuest, PsycINFO, Scopus and Web of Science.

    Results and Conclusion

    Enhancing the opportunities for adults with ASD to join the workforce is beneficial from a societal perspective, not only from an inclusiveness viewpoint, but also from a strict economic standpoint. Providing supported employment services for adults with ASD does not only cut the cost compared with providing standard care, it also results in better outcomes for adults with ASD. Despite the fact that ASD was the most expensive group to provide vocational rehabilitation services for, adults with ASD have a strong chance of becoming employed once appropriate measures are in place. Hence, rehabilitation services could be considered as a worthwhile investment. The current systematic review uncovered the fact that very few studies have examined the benefits, the costs and the cost-benefit ratio of employing an adult with ASD from the perspective of employers indicating a need for this topic to be further explored.

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  • 23.
    Jones, M.
    et al.
    Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.
    Milbourn, B.
    Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.
    Falkmer, Marita
    Jönköping University, School of Education and Communication, HLK, CHILD. Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.
    Tan, T.
    School of Electrical Engineering, Computing and Mathematical Sciences, Faculty of Science and Engineering, Curtin University, Perth, WA, Australia.
    Bölte, S.
    Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.
    Girdler, S.
    Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.
    Strength-based technology clubs for autistic adolescents: A feasibility study2023In: PLOS ONE, E-ISSN 1932-6203, Vol. 18, no 2 February, article id e0278104Article in journal (Refereed)
    Abstract [en]

    Strength-based technology clubs are thought to help autistic adolescents transition to adulthood by developing positive traits, enhancing technical skills, and creating supportive networks. A newly developed strength-based technology club was delivered to 25 autistic adolescents, with the feasibility tested via qualitative and quantitative methods. Autistic adolescents, their parents, and club facilitators participated in separate focus groups, with audio data transcribed and thematically analyzed. Quantitative data was collected via adolescent and parent-reported pretest-posttest measures following the 15-week program. Autistic adolescents were highly satisfied with the club (acceptability), the technology club satisfied an unmet need (demand), with the program demonstrating the potential to be integrated into the current therapy system in Australia (integration). Feasibility areas that could be improved in delivering future clubs are discussed.

  • 24.
    Klaesson, Johan
    et al.
    Jönköping University, Jönköping International Business School, JIBS, Economics. Jönköping University, Jönköping International Business School, JIBS, Centre for Entrepreneurship and Spatial Economics (CEnSE).
    Lobo, J.
    Arizona State University, Tempe, AZ, United States.
    Mellander, Charlotta
    Jönköping University, Jönköping International Business School, JIBS, Economics. Jönköping University, Jönköping International Business School, JIBS, Centre for Entrepreneurship and Spatial Economics (CEnSE).
    Social interactions and COVID-19 vaccine hesitancy: Evidence from a full population study in Sweden2023In: PLOS ONE, E-ISSN 1932-6203, Vol. 18, no 11, article id e0289309Article in journal (Refereed)
    Abstract [en]

    We investigate whether an individual's information milieu-an individual's residential neighborhood and co-workers-affects the decision to get a COVID-19 vaccine. The decision to accept or refuse a vaccine is intensely personal and involves the processing of information about phenomena likely to be unfamiliar to most individuals. One can thus expect an interplay between an individual's level of education and skills and the information processing of others whom with whom she can interact and whose decision she can probe and observe. Using individual-level data for adults in Sweden, we can identify the proportion of an individual's neighborhood and workplace who are unvaccinated as indicators of possible peer effects. We find that individuals with low levels of educational attainment and occupational skills are more likely to be unvaccinated when exposed to other unvaccinated individuals at work and in the residential neighborhood. The peer effects in each of these information milieus further increases the likelihood of not getting vaccinated-with the two acting as information channels that reinforce one another.

  • 25.
    Kuzminski, Rebecca
    et al.
    School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, WA, Australia.
    Netto, Julie
    School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, WA, Australia.
    Wilson, Joel
    School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, WA, Australia.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket Brisbane, QLD, Australia.
    Chamberlain, Angela
    School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, WA, Australia.
    Falkmer, Marita
    Jönköping University, School of Education and Communication, HLK, CHILD. School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, WA, Australia.
    Linking knowledge and attitudes: Determining neurotypical knowledge about and attitudes towards autism2019In: PLOS ONE, E-ISSN 1932-6203, Vol. 14, no 7, article id e0220197Article in journal (Refereed)
    Abstract [en]

    "Why are neurotypicals so pig-ignorant about autism?" an autistic person wrote on the Curtin Autism Research Group's on-line portal as a response to a call for research questions. Coproduced with an autistic researcher, knowledge about and attitudes towards autism were analysed from 1,054 completed surveys, representing the Australian neurotypical adult population. The majority, 81.5% of participants had a high level of knowledge and 81.3% of participants had a strong positive attitude towards autism. Neither age, nor education level had an impact on attitudes. However, attitudes were influenced by knowledge about 'Societal Views and Ideas'; 'What it Could be Like to Have Autism'; and the demographic variables 'Knowing and having spent time around someone with autism'; and gender (women having more positive attitudes than men). Thus, targeted interventions, geared more towards men than women, to increase knowledge about autism could further improve attitudes and increase acceptance of the autistic community.

  • 26.
    Lewin, N. L.
    et al.
    Dept Laboratory Medicine, Ryhov Hospital, Jönköping, Sweden.
    Karlsson, J. -E
    Dept of Internal Medicine, Ryhov Hospital, Jönköping, Sweden; Dept of Health Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Dept Urology, Ryhov Hospital, Jönköping, Sweden.
    Robinsson, D.
    Fagerberg, M.
    Dept Urology, Ryhov Hospital, Jönköping, Sweden.
    Kentsson, M.
    Dept of Internal Medicine, Ryhov Hospital, Jönköping, Sweden.
    Sayardoust, Shariel
    Dept Periodontology, Ryhov Hospital, Jönköping, Sweden.
    Nilsson, M.
    Futurum, Academy of Health and Care, Region Jönköping, Jönköping, Sweden g Dept Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Shamoun, L.
    Dept Laboratory Medicine, Ryhov Hospital, Jönköping, Sweden.
    Andersson, B. -Å.
    Dept Laboratory Medicine, Ryhov Hospital, Jönköping, Sweden.
    Löfgren, S.
    Dept Laboratory Medicine, Ryhov Hospital, Jönköping, Sweden.
    Rutqvist, L. E.
    Scientific Affairs Group, Swedish Match AB, Stockholm, Sweden.
    Lewin, F.
    Dept Oncology, Ryhov Hospital, Jönköping, Sweden.
    Influence of single nucleotide polymorphisms among cigarette smoking and non-smoking patients with coronary artery disease, urinary bladder cancer and lung cancer2021In: PLOS ONE, E-ISSN 1932-6203, Vol. 16, article id e0243084Article in journal (Refereed)
    Abstract [en]

    Introduction Cigarette smoke is suggested to be a risk factor for coronary artery disease (CAD), urinary bladder cancer (UBCa) or lung cancer (LCa). However, not all heavy smokers develop these diseases and elevated cancer risk among first-degree relatives suggests an important role of genetic factor. Methods Three hundred and ten healthy blood donors (controls), 98 CAD, 74 UBCa and 38 LCa patients were included in this pilot study. The influence of 92 single nucleotide polymorphisms (SNPs) and impact of cigarette smoking were analysed. Results Out of 92 SNPs tested, differences in distribution of 14 SNPs were detected between controls and patient groups. Only CTLA4 rs3087243 showed difference in both CAD and UBCa patient group compared to control group. Stratified by smoking status, the impact of smoking was associated to frequencies of 8, 3 and 4 SNPs in CAD, UBCa, LCa patients, respectively. None of these 92 SNPs showed a statistically significant difference to more than one type of disease among smoking patients. In non-smoking patients, 7, 3 and 6 SNPs were associated to CAD, UBCa, LCa, respectively. Out of these 92 SNPs, CTLA4 rs3087243 was associated to both non-smoking CAD and UBCa. The XRCC1 rs25487 was associated to both non-smoking UBCa and LCa. Conclusion SNPs might be important risk factors for CAD, UBCa and LCa. Distribution of the SNPs was specific for each patient group, not a random event. Impact of cigarette smoking on the disease was associated to the specific SNP sequences. Thus, smoking individuals with SNPs associated to risk of these serious diseases is an important target group for smoking cessation programs.

  • 27.
    Lobo, José
    et al.
    School of Sustainability, Arizona State University, Tempe, AZ, United States.
    Bettencourt, Luís M. A.
    Santa Fe Institute, Santa Fe, NM, United States.
    Strumsky, Deborah
    Department of Geography and Earth Sciences, University of North Carolina at Charlotte, Charlotte, NC, United States.
    West, Geoffrey B.
    Santa Fe Institute, Santa Fe, NM, United States.
    Urban Scaling and the Production Function for Cities2013In: PLOS ONE, E-ISSN 1932-6203, Vol. 8, no 3, article id e58407Article in journal (Refereed)
    Abstract [en]

    The factors that account for the differences in the economic productivity of urban areas have remained difficult to measure and identify unambiguously. Here we show that a microscopic derivation of urban scaling relations for economic quantities vs. population, obtained from the consideration of social and infrastructural properties common to all cities, implies an effective model of economic output in the form of a Cobb-Douglas type production function. As a result we derive a new expression for the Total Factor Productivity (TFP) of urban areas, which is the standard measure of economic productivity per unit of aggregate production factors (labor and capital). Using these results we empirically demonstrate that there is a systematic dependence of urban productivity on city population size, resulting from the mismatch between the size dependence of wages and labor, so that in contemporary US cities productivity increases by about 11% with each doubling of their population. Moreover, deviations from the average scale dependence of economic output, capturing the effect of local factors, including history and other local contingencies, also manifest surprising regularities. Although, productivity is maximized by the combination of high wages and low labor input, high productivity cities show invariably high wages and high levels of employment relative to their size expectation. Conversely, low productivity cities show both low wages and employment. These results shed new light on the microscopic processes that underlie urban economic productivity, explain the emergence of effective aggregate urban economic output models in terms of labor and capital inputs and may inform the development of economic theory related to growth.

  • 28.
    Luna-Cortés, Gonzalo
    et al.
    Fundación Universitaria Konrad Lorenz, Bogotá, Colombia.
    López-Bonilla, Luis M.
    Departamento de Administración de Empresas y Marketing, Universidad de Sevilla, Sevilla, Spain.
    López-Bonilla, Jesús M.
    Departamento de Administración de Empresas y Marketing, Universidad de Sevilla, Sevilla, Spain.
    The influence of social value and self-congruity on interpersonal connections in virtual social networks by Gen-Y tourists2019In: PLOS ONE, E-ISSN 1932-6203, Vol. 14, no 6, article id e0217758Article in journal (Refereed)
    Abstract [en]

    This research focuses on the relationship of self-congruity and perceived social value with the interpersonal connections established by Generation Y tourists in virtual social networks. A quantitative study was performed using a sample of young travelers from Spain. The methodologies of Confirmatory Factor Analysis (CFA) and Structural Equation Models (SEM) were used to analyze the results. The findings of the research show that self-congruity influences the perceived social value; the perceived social value leads to satisfaction and the creation of interpersonal connections in virtual social networks; and the interpersonal connections in virtual social networks influence the use of these tools by Generation Y travelers.

  • 29.
    Mac Innes, Hanna
    et al.
    Department of Social Work, University of Gothenburg, Gothenburg, Sweden.
    Dunér, Anna
    Department of Social Work, University of Gothenburg, Gothenburg, Sweden.
    Gustafsson, Susanne
    Jönköping University, School of Health and Welfare, HHJ, Department of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Lindahl, Lisbet
    Department of Research and Development (FoU i Väst), The Gothenburg Region Association of Local Authorities (GR), Gothenburg, Sweden.
    Older migrants' perceptions of places to meet: Insights for social work practice2023In: PLOS ONE, E-ISSN 1932-6203, Vol. 18, no 11, article id e0292730Article in journal (Refereed)
    Abstract [en]

    This study aimed to explore the experiences of older migrants' (70+) access to and participation in different meeting places. Qualitative interviews were conducted with participants originating from Finland and four countries in the Western Balkans: Bosnia- Herzegovina, Croatia, Montenegro, and Serbia. The participants used everyday places in the neighborhood, which were not primarily meant to be meeting places, to create and uphold social contacts. These meeting places contributed to experiences of community and trust. Both everyday meeting places and organized meeting places were used to establish and develop relationships that could result in an exchange of both practical and emotional support. Perceptions of "not belonging", limited proficiency in Swedish, and a strained financial situation created barriers to accessing some meeting places. The results of this study demonstrate the significance of meeting places that are not purposefully aimed at older people in general or older people from a specific country.

  • 30. MacDonald, K.
    et al.
    Thomas, M. L.
    Sciolla, A. F.
    Schneider, B.
    Pappas, K.
    Bleijenberg, G.
    Bohus, M.
    Bekh, B.
    Carpenter, L.
    Carr, A.
    Dannlowski, U.
    Dorahy, M.
    Fahlke, C.
    Finzi-Dottan, R.
    Karu, T.
    Gerdner, Arne
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health and Welfare, HHJ. Research Platform of Social Work.
    Glaesmer, H.
    Grabe, H. J.
    Heins, M.
    Kenny, D. T.
    Kim, D.
    Knoop, H.
    Lobbestael, J.
    Lochner, C.
    Lauritzen, G.
    Ravndal, E.
    Riggs, S.
    Sar, V.
    Schäfer, I.
    Schlosser, N.
    Schwandt, M. L.
    Stein, M. B.
    Subic-Wrana, C.
    Vogel, M.
    Wingenfeld, K.
    Minimization of childhood maltreatment is common and consequential: Results from a large, multinational sample using the Childhood Trauma Questionnaire2016In: PLOS ONE, E-ISSN 1932-6203, Vol. 11, no 1, p. 1-16, article id e0146058Article in journal (Refereed)
    Abstract [en]

    Childhood maltreatment has diverse, lifelong impact on morbidity and mortality. The Childhood Trauma Questionnaire (CTQ) is one of the most commonly used scales to assess and quantify these experiences and their impact. Curiously, despite very widespread use of the CTQ, scores on its Minimization-Denial (MD) subscale-originally designed to assess a positive response bias-are rarely reported. Hence, little is known about this measure. If response biases are either common or consequential, current practices of ignoring the MD scale deserve revision. Therewith, we designed a study to investigate 3 aspects of minimization, as defined by the CTQ's MD scale: 1) its prevalence; 2) its latent structure; and finally 3) whether minimization moderates the CTQ's discriminative validity in terms of distinguishing between psychiatric patients and community volunteers. Archival, item-level CTQ data from 24 multinational samples were combined for a total of 19,652 participants. Analyses indicated: 1) minimization is common; 2) minimization functions as a continuous construct; and 3) high MD scores attenuate the ability of the CTQ to distinguish between psychiatric patients and community volunteers. Overall, results suggest that a minimizing response bias-as detected by the MD subscale-has a small but significant moderating effect on the CTQ's discriminative validity. Results also may suggest that some prior analyses of maltreatment rates or the effects of early maltreatment that have used the CTQ may have underestimated its incidence and impact. We caution researchers and clinicians about the widespread practice of using the CTQ without the MD or collecting MD data but failing to assess and control for its effects on outcomes or dependent variables. © 2016 MacDonald et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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  • 31.
    Markussen, H. V.
    et al.
    Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
    Aasdahl, L.
    Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
    Viksveen, P.
    SHARE-Centre for Resilience in Healthcare, Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.
    Hedberg, Berith
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Rise, M. B.
    Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
    A treatment strategy for meeting life as it is. Patients' and therapists' experiences of brief therapy in a district psychiatric centre: A qualitative study2021In: PLOS ONE, E-ISSN 1932-6203, Vol. 16, no 10 October, article id e0258990Article in journal (Refereed)
    Abstract [en]

    Background Young adults increasingly seek help for mental health problems. In 2016, a district psychiatric centre in Norway started a brief treatment program to provide early and effective help for moderate depression and anxiety. Aim Exploring patients' and therapists' experiences of brief therapy, especially how the time limitation influences the treatment process. Methods Individual interviews with 12 patients and focus group interviews with eight therapists analyzed using systematic text condensation. Results The results constitute five themes: (1) Time-limit as a frame for targeted change, (2) Clarifying expectations and accountability, (3) Shared agreement on a defined treatment-project, (4) Providing tools instead of searching for causes, and (5) Learning to cope-not being cured. Conclusion Time-limitation in brief therapy appeared to play a positive role, helping the therapists to structure the therapeutic process and strengthening patients' motivation. Shared understanding and activation during brief therapy may reinforce patients' responsibility and expectations to achieve individual goals. Brief therapy can be viewed as the start of a personal process towards "mastering life as it is". More research is needed to investigate the patients' long-term outcomes after treatment and to shed light on the potential for, and limitations of, mastering everyday-life.

  • 32.
    Mellander, Charlotta
    et al.
    Jönköping University, Jönköping International Business School, JIBS, Economics. Jönköping University, Jönköping International Business School, JIBS, Centre of Excellence for Science and Innovation Studies (CESIS).
    Lobo, Jose
    Arizona State University, USA.
    Stolarick, Kevin
    OCAD University, Toronto, ON, Canada.
    Matheson, Zara
    University of Toronto, Toronto, ON, Canada.
    Night-time light data: A good proxy measure for economic activity?2015In: PLOS ONE, E-ISSN 1932-6203, Vol. 10, no 10, p. 1-18, article id e0139779Article in journal (Refereed)
    Abstract [en]

    Much research has suggested that night-time light (NTL) can be used as a proxy for a number of variables, including urbanization, density, and economic growth. As governments around the world either collect census data infrequently or are scaling back the amount of detail collected, alternate sources of population and economic information like NTL are being considered. But, just how close is the statistical relationship between NTL and economic activity at a fine-grained geographical level? This paper uses a combination of correlation analysis and geographically weighted regressions in order to examine if light can function as a proxy for economic activities at a finer level. We use a fine-grained geo-coded residential and industrial full sample micro-data set for Sweden, and match it with both radiance and saturated light emissions. We find that the correlation between NTL and economic activity is strong enough to make it a relatively good proxy for population and establishment density, but the correlation is weaker in relation to wages. In general, we find a stronger relation between light and density values, than with light and total values. We also find a closer connection between radiance light and economic activity, than with saturated light. Further, we find the link between light and economic activity, especially estimated by wages, to be slightly overestimated in large urban areas and underestimated in rural areas.

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  • 33.
    Nyberg, Solja T.
    et al.
    Finnish Institute of Occupational Health, Helsinki and Tampere, Finland.
    Fransson, Eleonor
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Heikkilä, Katriina
    Finnish Institute of Occupational Health, Helsinki and Tampere, Finland.
    Alfredsson, Lars
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Casini, Annalisa
    School of Public Health, Université libre de Bruxelles, Brussels, Belgium.
    Clays, Els
    Department of Public Health, Ghent University, Ghent, Belgium.
    De Bacquer, Dirk
    Department of Public Health, Ghent University, Ghent, Belgium.
    Dragano, Nico
    Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.
    Erbel, Raimund
    Department of Cardiology, West-German Heart Center Essen, University Duisburg-Essen, Essen, Germany.
    Ferrie, Jane
    School of Community and Social Medicine, University of Bristol, Bristol, United Kingdom.
    Hamer, Mark
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Jöckel, Karl-Heinz
    Institute for Medical Informatics, Biometry, and Epidemiology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany.
    Kittel, France
    School of Public Health, Université libre de Bruxelles, Brussels, Belgium.
    Knutsson, Anders
    Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Ladwig, Karl-Heinz
    German Research Center for Environmental Health, Neuherberg, Germany.
    Lunau, Thorsten
    Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.
    Marmot, Michael
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Nordin, Maria
    Department of Psychology, Umeå University, Umeå, Sweden.
    Rugulies, Reiner
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Siegrist, Johannes
    Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.
    Steptoe, Andrew
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Westerholm, Peter
    Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
    Westerlund, Hugo
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Theorell, Töres
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Brunner, Eric
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Singh-Manoux, Archana
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Batty, David
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Kivimäki, Mika
    Finnish Institute of Occupational Health, Helsinki and Tampere, Finland.
    Job strain and cardiovascular disease risk factors: Meta-analysis of individual-participant data from 47,000 men and women2013In: PLOS ONE, E-ISSN 1932-6203, Vol. 8, no 6, p. e67323-Article in journal (Refereed)
    Abstract [en]

    Background

    Job strain is associated with an increased coronary heart disease risk, but few large-scale studies have examined the relationship of this psychosocial characteristic with the biological risk factors that potentially mediate the job strain – heart disease association.

    Methodology and Principal Findings

    We pooled cross-sectional, individual-level data from eight studies comprising 47,045 participants to investigate the association between job strain and the following cardiovascular disease risk factors: diabetes, blood pressure, pulse pressure, lipid fractions, smoking, alcohol consumption, physical inactivity, obesity, and overall cardiovascular disease risk as indexed by the Framingham Risk Score. In age-, sex-, and socioeconomic status-adjusted analyses, compared to those without job strain, people with job strain were more likely to have diabetes (odds ratio 1.29; 95% CI: 1.11–1.51), to smoke (1.14; 1.08–1.20), to be physically inactive (1.34; 1.26–1.41), and to be obese (1.12; 1.04–1.20). The association between job strain and elevated Framingham risk score (1.13; 1.03–1.25) was attributable to the higher prevalence of diabetes, smoking and physical inactivity among those reporting job strain.

    Conclusions

    In this meta-analysis of work-related stress and cardiovascular disease risk factors, job strain was linked to adverse lifestyle and diabetes. No association was observed between job strain, clinic blood pressure or blood lipids.

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  • 34.
    Olsson, Tina M.
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Department of Social Work. Department of Social Work, University of Gothenburg, Gothenburg, Sweden.
    Enebrink, Pia
    Division of Psychology, Department of Clinical Neuroscience, Karolinska Institute, Solna, Sweden.
    Kapetanovic, Sabina
    Department of Psychology, Stockholm University, Stockholm, Sweden; Department of Behavioral Studies, University West, Trollhättan, Sweden.
    Ferrer-Wreder, Laura
    Department of Psychology, Stockholm University, Stockholm, Sweden.
    Stålnacke, Johanna
    Department of Social Work, University of Gothenburg, Gothenburg, Sweden; Department of Psychology, Stockholm University, Stockholm, Sweden.
    Eninger, Lilianne
    Department of Psychology, Stockholm University, Stockholm, Sweden.
    Eichas, Kyle
    Department of Psychological Sciences, Tarleton State University, Stephenville, TX, United States of America.
    Norman, Åsa
    Division of Psychology, Department of Clinical Neuroscience, Karolinska Institute, Solna, Sweden.
    Lindberg, Lene
    Department of Global Public Health, Karolinska Institute, Solna, Sweden; Center for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden.
    Gull, Ingela Clausén
    Division of Psychology, Department of Clinical Neuroscience, Karolinska Institute, Solna, Sweden.
    Hau, Hanna Ginner
    Department of Special Education, Stockholm University, Stockholm, Sweden.
    Allodi, Mara Westling
    Department of Special Education, Stockholm University, Stockholm, Sweden.
    Sedem, Mina
    Department of Special Education, Stockholm University, Stockholm, Sweden.
    Study protocol for a non-randomized controlled trial of the effects of internet-based parent training as a booster to the preschool edition of PATHS®: Universal edition of the Parent Web [protocol]2023In: PLOS ONE, E-ISSN 1932-6203, Vol. 18, no 4, article id e0284926Article in journal (Refereed)
    Abstract [en]

    Well implemented, universal parental support is often effective in families with younger children, but research on their effects on families with adolescent children is scarce. In this study, a trial of the universal parent training intervention "Parent Web" in early adolescence is added to the social emotional learning intervention Promoting Alternative Thinking Strategies (PATHS®), completed in early childhood. The Parent Web is a universal online parenting intervention based on social learning theory. The intervention aims to promote positive parenting and family interaction through five weekly modules completed over 6-8 weeks. The main hypothesis is that participants in the intervention group will exhibit significant pre- to post- intervention-related benefits relative participants in the comparison group. The aims of this study are: 1) provide Parent Web as a booster aimed at improving parenting support and practices at the transition into adolescence to a cohort of parents whose children have previously participated in preschool PATHS, and 2) examine the effects of the universal edition of Parent Web. The study has a quasi-experimental design with pre- and post-testing. The incremental effects of this internet-delivered parent training intervention are tested in parents of early adolescents (11-13 years) who participated in PATHS when 4-5 years old compared to a matched sample of adolescents with no prior experience of PATHS. The primary outcomes are parent reported child behavior and family relationships. Secondary outcomes include self-reported parent health and stress. The proposed study is one of the few trials to test the effects of universal parental support in families of early adolescents and will therefore contribute to the understanding of how mental health in children and young people can be promoted across developmental periods through a continuum of universal measures. Trial registration: Clinical trials.gov (NCT05172297), prospectively registered on December 29, 2021.

  • 35.
    Olsson, Tina M.
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Department of Social Work. Department of Social Work, Gothenburg University, Gothenburg, Sweden.
    Sundell, Knut
    University of Gävle, Department of Social Work and Criminology, Gävle, Sweden.
    Publication bias, time-lag bias, and place-of-publication bias in social intervention research: An exploratory study of 527 Swedish articles published between 1990-20192023In: PLOS ONE, E-ISSN 1932-6203, Vol. 18, no 2, article id e0281110Article in journal (Refereed)
    Abstract [en]

    Publication and related biases constitute serious threats to the validity of research synthesis. If research syntheses are based on a biased selection of the available research, there is an increased risk of producing misleading results. The purpose fo this study is to explore the extent of positive outcome bias, time-lag bias, and place-of-publication bias in published research on the effects of psychological, social, and behavioral interventions. The results are based on 527 Swedish outcome trials published in peer-reviewed journals between 1990 and 2019. We found no difference in the number of studies reporting significant compared to non-significant findings or in the number of studies reporting strong effect sizes in the published literature. We found no evidence of time-lag bias or place-of-publication bias in our results. The average reported effect size remained constant over time as did the proportion of studies reporting significant effects.

  • 36.
    Peterson, Anette
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Hanberger, Lena
    Department of Clinical and Experimental Medicine, Division of Pediatrics and Diabetes. Research Center, Linköping University Hospital, Linköping, Sweden.
    Åkesson, Karin
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Department of Pediatric, County Hospital Ryhov, Jönköping, Sweden.
    Bojestig, Mats
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Andersson-Gäre, Boel
    Jönköping University, School of Health and Welfare, HHJ, Quality Improvement and Leadership in Health and Welfare.
    Samuelsson, Ulf
    Department of Clinical and Experimental Medicine, Division of Pediatrics and Diabetes. Research Center, Linköping University Hospital, Linköping, Sweden.
    Improved results in paediatric diabetes care using a quality registry in an improvement collaborative: a case study in Sweden2014In: PLOS ONE, E-ISSN 1932-6203, Vol. 9, no 5(e97875), p. 1-6Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Several studies show that good metabolic control is important for children and adolescents with type 1 diabetes. In Sweden, there are large differences in mean haemoglobin A1c (HbA1c) in different hospitals and difficulties implementing national guidelines in everyday practice. This study shows how the participation in an improvement collaborative could facilitate improvements in the quality of care by paediatric diabetes teams. The Swedish paediatric diabetes quality registry, SWEDIABKIDS was used as a tool and resource for feedback and outcome measures.

    METHODS:

    Twelve teams at paediatric diabetes centres, caring for 30% (2302/7660) of patients in Sweden, participated in an 18-month quality improvement program. Each team defined treatment targets, areas needing improvement, and action plans. The main outcome was the centre patients' mean HbA1c levels, but other clinical variables and change concepts were also studied. Data from the previous six months were compared with the first six months after starting the program, and the long-term follow up after another eleven months.

    RESULTS:

    All centres reduced mean HbA1c during the second and third periods compared with the first. The mean reduction for all was 3·7 mmol/mol (p<0.001), compared with non-participating centres who improved their mean HbA1c with 1·7 mmol/mol during the same period. Many of the participating centres reduced the frequency of severe hypoglycaemia and/or ketoacidosis, and five centres reached their goal of ensuring that all patients had some sort of physical activity at least once weekly. Change concepts were, for example, improved guidelines, appointment planning, informing the patients, improving teamwork and active use of the registry, and health promotion activities.

    CONCLUSIONS:

    By involving paediatric diabetes teams in a quality improvement collaborative together with access to a quality register, the quality of paediatric diabetes care can improve, thereby contributing to a reduced risk of late complications for children and adolescents with diabetes.

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  • 37. Piirtola, M.
    et al.
    Jelenkovic, A.
    Latvala, A.
    Sund, R.
    Honda, C.
    Inui, F.
    Watanabe, M.
    Tomizawa, R.
    Iwatani, Y.
    Ordoñana, J. R.
    Sánchez-Romera, J. F.
    Colodro-Conde, L.
    Tarnoki, A. D.
    Tarnoki, D. L.
    Martin, N. G.
    Montgomery, G. W.
    Medland, S. E.
    Rasmussen, F.
    Tynelius, P.
    Tan, Q.
    Zhang, D.
    Pang, Z.
    Rebato, E.
    Stazi, M. A.
    Fagnani, C.
    Brescianini, S.
    Busjahn, A.
    Harris, J. R.
    Brandt, I.
    Nilsen, T. S.
    Cutler, T. L.
    Hopper, J. L.
    Corley, R. P.
    Huibregtse, B. M.
    Sung, J.
    Kim, J.
    Lee, J.
    Lee, S.
    Gatz, M.
    Butler, D. A.
    Franz, C. E.
    Kremen, W. S.
    Lyons, M. J.
    Magnusson, P. K. E.
    Pedersen, N. L.
    Dahl Aslan, Anna K.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Öncel, S.Y.
    Aliev, F.
    Derom, C. A.
    Vlietinck, R. F.
    Loos, R. J. F.
    Silberg, J. L.
    Maes, H. H.
    Boomsma, D. I.
    Sørensen, T. I. A.
    Korhonen, T.
    Kaprio, J.
    Silventoinen, K.
    Association of current and former smoking with body mass index: A study of smoking discordant twin pairs from 21 twin cohorts2018In: PLOS ONE, E-ISSN 1932-6203, Vol. 13, no 7, article id e0200140Article in journal (Refereed)
    Abstract [en]

    Background Smokers tend to weigh less than never smokers, while successful quitting leads to an increase in body weight. Because smokers and non-smokers may differ in genetic and environmental family background, we analysed data from twin pairs in which the co-twins differed by their smoking behaviour to evaluate if the association between smoking and body mass index (BMI) remains after controlling for family background.

    Methods and findings

    The international CODATwins database includes information on smoking and BMI measured between 1960 and 2012 from 156,593 twin individuals 18–69 years of age. Individual-based data (230,378 measurements) and data of smoking discordant twin pairs (altogether 30,014 pairwise measurements, 36% from monozygotic [MZ] pairs) were analysed with linear fixed-effects regression models by 10-year periods. In MZ pairs, the smoking co-twin had, on average, 0.57 kg/m2 lower BMI in men (95% confidence interval (CI): 0.49, 0.70) and 0.65 kg/m2 lower BMI in women (95% CI: 0.52, 0.79) than the never smoking co-twin. Former smokers had 0.70 kg/m2 higher BMI among men (95% CI: 0.63, 0.78) and 0.62 kg/ m2 higher BMI among women (95% CI: 0.51, 0.73) than their currently smoking MZ co-twins. Little difference in BMI was observed when comparing former smoking co-twins with their never smoking MZ co-twins (0.13 kg/m2, 95% CI 0.04, 0.23 among men; -0.04 kg/m2, 95% CI -0.16, 0.09 among women). The associations were similar within dizygotic pairs and when analysing twins as individuals. The observed series of cross-sectional associations were independent of sex, age, and measurement decade.

    Conclusions

    Smoking is associated with lower BMI and smoking cessation with higher BMI. However, the net effect of smoking and subsequent cessation on weight development appears to be minimal, i.e. never more than an average of 0.7 kg/m2 

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  • 38.
    Poorebrahim, A.
    et al.
    Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran.
    Lin, C. -Y
    Institute of Allied Health Sciences, Departments of Occupational Therapy and Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
    Imani, V.
    Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
    Kolvani, S. S.
    Guilan Prison Research Council, Rasht, Guilan, Iran.
    Alaviyoun, S. A.
    Guilan Prison Research Council, Rasht, Guilan, Iran.
    Ehsani, N.
    Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
    Pakpour, Amir H.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Using Mindful Attention Awareness Scale on male prisoners: Confirmatory factor analysis and Rasch models2021In: PLOS ONE, E-ISSN 1932-6203, Vol. 16, no 7 July, article id e0254333Article in journal (Refereed)
    Abstract [en]

    Aim: This study tested the construct validity (i.e., factor structure) of the Persian Mindful Attention Awareness Scale (MAAS) on a sample of male prisoners. Methods: All the participants (mean±SD age = 39.44±7.94 years) completed three scales - the Persian MAAS, the Insomnia Severity Index (ISI), and the 12-item General Health Questionnaire (GHQ-12). Confirmatory factor analysis (CFA) and Rasch analysis with differential item functioning (DIF) were applied to examine the construct validity of the MAAS. Specifically, the DIF was tested across different insomnia status (using ISI with a cutoff of 15), psychiatric well-being status (using GHQ-12 with a cutoff of 12), and age (using mean age of 39.44 as the cutoff). Results: The CFA results showed a single factor solution for the Persian MAAS. The Rasch results showed all MAAS items fit in the construct (infit mean square [MnSq] = 0.72 to 1.41; outfit MnSq = 0.74 to 1.39) without displaying DIF items (DIF contrast = -0.34 to 0.31 for insomnia condition; -0.22 to 0.25 for psychiatric well-being; -0.26 to 0.29 for age). Conclusions: The Persian version of the MAAS is, therefore, a valid instrument to measure mindfulness among Iranian male prisoners.

  • 39.
    Scott, Melissa
    et al.
    Curtin University, Perth, Australia.
    Falkmer, Marita
    Jönköping University, School of Education and Communication, HLK, CHILD. Curtin University, Perth, Australia.
    Girdler, Sonya
    Curtin University, Perth, Australia.
    Falkmer, Torbjorn
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Curtin University, Perth, Australia.
    Viewpoints on Factors for Successful Employment for Adults with Autism Spectrum Disorder2015In: PLOS ONE, E-ISSN 1932-6203, Vol. 10, no 10, article id e0139281Article in journal (Refereed)
    Abstract [en]

    This article explores the key factors for successful employment from the viewpoints of adults with autism spectrum disorder (ASD) and employers. Two groups of individuals participated in this study, 40 adults with ASD and 35 employers. Q method was used to understand and contrast the viewpoints of the two groups. Data were analysed using by-person varimax rotation factor analysis. Results showed that although both groups appear committed to the employment process, the difference in their understanding regarding the type of workplace support required, job expectations and productivity requirements continues to hinder successful employment. These results highlight the need to facilitate communication between employees and employers to ensure a clear understanding of the needs of both groups are met. The use of an ASD-specific workplace tool may assist in facilitating the necessary communication between these two groups.

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  • 40.
    Scott, Melissa
    et al.
    School of Occupational Therapy and Social Work, Curtin University, Perth, WA, Australia.
    Jacob, Andrew
    School of Occupational Therapy and Social Work, Curtin University, Perth, WA, Australia.
    Hendrie, Delia
    School of Public Health, Curtin University, Perth, WA, Australia.
    Parsons, Richard
    School of Occupational Therapy and Social Work, Curtin University, Perth, WA, Australia.
    Girdler, Sonya
    School of Occupational Therapy and Social Work, Curtin University, Perth, WA, Australia.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. School of Occupational Therapy and Social Work, Curtin University, Perth, WA, Australia.
    Falkmer, Marita
    Jönköping University, School of Education and Communication, HLK, CHILD. School of Occupational Therapy and Social Work, Curtin University, Perth, WA, Australia.
    Employers' perception of the costs and the benefits of hiring individuals with autism spectrum disorder in open employment in Australia2017In: PLOS ONE, E-ISSN 1932-6203, Vol. 12, no 5, article id e0177607Article in journal (Refereed)
    Abstract [en]

    Research has examined the benefits and costs of employing adults with autism spectrum disorder (ASD) from the perspective of the employee, taxpayer and society, but few studies have considered the employer perspective. This study examines the benefits and costs of employing adults with ASD, from the perspective of employers. Fifty-nine employers employing adults with ASD in open employment were asked to complete an online survey comparing employees with and without ASD on the basis of job similarity. The findings suggest that employing an adult with ASD provides benefits to employers and their organisations without incurring additional costs.

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  • 41.
    Shutters, Shade T.
    et al.
    Global Security Initiative, Arizona State University, Tempe, AZ, United States.
    Lobo, José
    School of Sustainability, Arizona State University, Tempe, AZ, United States.
    Muneepeerakul, Rachata
    Department of Agricultural and Biological Engineering, University of Florida, Gainesville, FL, United States.
    Strumsky, Deborah
    Arizona State University, Santa Fe Institute Center for Biosocial Complex Systems, Arizona State University, Tempe, AZ, United States.
    Mellander, Charlotta
    Jönköping University, Jönköping International Business School, JIBS, Economics. Jönköping University, Jönköping International Business School, JIBS, Centre of Excellence for Science and Innovation Studies (CESIS).
    Brachert, Matthias
    Department of Structural Change and Productivity, Halle Institute for Economic Research, Halle (Saale), Germany.
    Farinha, Teresa
    Department of Economic Geography, Human Geography and Spatial Planning, Utrecht University, Utrecht, Netherlands.
    Bettencourt, Luís M.A.
    Mansueto Institute for Urban Innovation, University of Chicago, Chicago, IL, United States.
    Urban occupational structures as information networks: The effect on network density of increasing number of occupations2018In: PLOS ONE, E-ISSN 1932-6203, Vol. 13, no 5, article id e0196915Article in journal (Refereed)
    Abstract [en]

    Urban economies are composed of diverse activities, embodied in labor occupations, which depend on one another to produce goods and services. Yet little is known about how the nature and intensity of these interdependences change as cities increase in population size and economic complexity. Understanding the relationship between occupational interdependencies and the number of occupations defining an urban economy is relevant because interdependence within a networked system has implications for system resilience and for how easily can the structure of the network be modified. Here, we represent the interdependencies among occupations in a city as a non-spatial information network, where the strengths of interdependence between pairs of occupations determine the strengths of the links in the network. Using those quantified link strengths we calculate a single metric of interdependence–or connectedness–which is equivalent to the density of a city’s weighted occupational network. We then examine urban systems in six industrialized countries, analyzing how the density of urban occupational networks changes with network size, measured as the number of unique occupations present in an urban workforce. We find that in all six countries, density, or economic interdependence, increases superlinearly with the number of distinct occupations. Because connections among occupations represent flows of information, we provide evidence that connectivity scales superlinearly with network size in information networks.

  • 42.
    Sithravel, RatnaKala
    et al.
    Department of Architecture, Faculty of Design and Architecture, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
    Ibrahim, Rahinah
    Department of Architecture, Faculty of Design and Architecture, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
    Lye, Munn Sann
    Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
    Perimal, Enoch Kumar
    Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
    Ibrahim, Normala
    Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
    Dahlan, Nur Dalilah
    Department of Architecture, Faculty of Design and Architecture, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
    Morning boost on individuals’ psychophysiological wellbeing indicators with supportive, dynamic lighting in windowless open-plan workplace in Malaysia2018In: PLOS ONE, E-ISSN 1932-6203, Vol. 13, no 11, article id e0207488Article in journal (Refereed)
    Abstract [en]

    Workplace architectural lighting conditions that are biologically dim during the day are causing healthy individuals to experience light-induced health and performance-related problems. Dynamic lighting was reported beneficial in supporting individuals’ psychological behavior and physiological responses during work period in Europe. It has yet to be investigated in workplaces with minimal/no natural daylight contribution in tropical Malaysia. Hence, an exploratory experimental study was initiated in an experimental windowless open-plan workplace in Universiti Putra Malaysia, Serdang. The aim was to identify dynamic lighting configurations that were more supportive of a morning boosting effect than the control constant lighting, to support dayshift individuals’ psychophysiological wellbeing indicators during the peak morning work period. The immediate impact of a 2-hour morning exposure to overhead white LED (6500 K) with different horizontal illuminance levels and oscillations (lighting patterns) were investigated on physiological indicator limited to urinary 6-sulfatoxymelatonin, and psychological indicators for alertness, mood, visual comfort, cognitive and visual task performance. Not all of the investigated dynamic lighting configurations were supportive of a morning boost. Only configurations 500increased to750 and 500increased to1000 lx therapeutically supported most of the indicators. Both these configurations suppressed urinary 6-sulfatoxymelatonin, and improved alertness, cognitive performance, positive affect, and visual comfort better than ‘visit 1: 500constant500’ lx (control). The increasing oscillation was observed more beneficial for the morning boost in tropical Malaysia, which is in reverse to that specified in the human rhythmic dynamic lighting protocol developed by researchers from the Netherlands for application during winter. The findings from this study present the feasibility of dynamic architectural lighting acting as an environmental therapeutic solution in supporting the individuals’ psychophysiological wellbeing indicators in windowless open-plan workplace in tropical Malaysia. Further investigations on the two prospective configurations are recommended to determine the better supportive one for the morning boosting effect in Malaysia.

  • 43.
    Skoog, T.
    et al.
    Department of Psychology, University of Gothenburg, Göteborg, Sweden.
    Bergström, M.
    School of Social Work, Lund University, Lund, Sweden.
    Karlsson, M.
    Department of Social Work, University of Gothenburg, Göteborg, Sweden.
    Olsson, Tina M.
    Jönköping University, School of Health and Welfare, HHJ, Department of Social Work. Department of Social Work, University of Gothenburg, Göteborg, Sweden.
    Study protocol for leaving care: A comparison study of implementation, change mechanisms and effectiveness of transition services for youth2024In: PLOS ONE, E-ISSN 1932-6203, Vol. 19, no 2, article id e0293952Article in journal (Refereed)
    Abstract [en]

    Introduction Youth placed in out-of-home care is a large and highly vulnerable group at high risk of negative developmental outcomes. Given the size and extent of negative developmental outcomes for youth placed in out-of-home care, interventions to help this vulnerable group navigate successfully towards independent living and promote wellbeing across a spectrum of outcome areas are needed. To date, there is a lack of such interventions, particularly in Sweden. Importing interventions from other societies and cultures is associated with difficulties. The aim of the research project is to implement, test, and evaluate interventions that have been recently developed in Swedish practice to close this gap. Methods The project has an ambitious and complex data collection and analysis strategy using qualitative, quantitative, and multiple information methods (hybrid effectiveness-implementation study) over the course of two years. Both the implementation and effectiveness of the interventions will be evaluated. The recently developed My Choice-My Way! leaving care program for youth aged 15+ will be the primary focus of the project and will be compared to usual services. Conclusions The project has the potential to offer novel insights into how society can promote wellbeing across a spectrum of outcome areas for the high-risk group of youth transitioning from out-of-home care to independent living. As such, the project will have important implications for both research and practice.

  • 44.
    Sveen, Josefin
    et al.
    Palliative Research Centre, Ersta Sköndal University College, Stockholm, Sweden .
    Pohlkamp, Lilian
    Palliative Research Centre, Ersta Sköndal University College, Stockholm, Sweden.
    Öhlén, Joakim
    Palliative Research Centre, Ersta Sköndal University College, Stockholm, Sweden.
    Sandberg, Jonas
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Palliative Research Centre, Ersta Sköndal University College, Stockholm, Sweden.
    Brandänge, Kristina
    Department of Psychiatry, Ersta Hospital, Stockholm, Sweden.
    Gustavsson, Petter
    Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Posttraumatic stress among not-exposed traumatically bereaved relatives after the MS Estonia disaster2016In: PLOS ONE, E-ISSN 1932-6203, Vol. 11, no 11, article id e0166441Article in journal (Refereed)
    Abstract [en]

    Background: Little is known about posttraumatic stress (PTS) reactions in bereaved individuals following loss in disaster who were not directly exposed to disaster. The aim of the present study was to examine the course of PTS up to three years after losing relatives in the MS Estonia ferry disaster, one of the worst maritime disasters in modern times.

    Methods: Seven postal surveys were sent out over three years post-disaster. The respondents were invited and added consecutively during the three years and 938 relatives participated in one or more of the surveys, representing 89% of the MS Estonia's Swedish victims. The survey included the Impact of Event Scale (IES) to measure PTS. Latent growth curve modeling was used to analyze PTS over time.

    Results: The majority of bereaved individuals had high levels of PTS. At three years post-loss, 62% of the respondents scored above the recommended cut-off value on the IES. Over time, PTS symptoms declined, but initially high symptoms of PTS were associated with a slower recovery rate.

    Conclusion: The present finding suggests that being an indirectly-exposed disaster-bereaved close-relative can lead to very high levels of PTS which are sustained for several years.

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  • 45. Tahir, M. J.
    et al.
    Malik, N. I.
    Ullah, I.
    Khan, H. R.
    Perveen, S.
    Ramalho, R.
    Siddiqi, A. R.
    Waheed, S.
    Mohamed Shalaby, M. M.
    de Berardis, D.
    Jain, S.
    Vetrivendan, G. L.
    Chatterjee, H.
    Gopar Franco, W. X.
    Shafiq, M. A.
    Fatima, N. T.
    Abeysekera, M.
    Sayyeda, Q.
    Shamat, S. F.
    Aiman, W.
    Akhtar, Q.
    Devi, A.
    Aftab, A.
    Shoib, S.
    Lin, C. -Y
    Pakpour, Amir H.
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Nursing Science.
    Internet addiction and sleep quality among medical students during the COVID-19 pandemic: A multinational cross-sectional survey2021In: PLOS ONE, E-ISSN 1932-6203, Vol. 16, no 11 November, article id e0259594Article in journal (Refereed)
    Abstract [en]

    Background The emergence of the COVID-19 pandemic has affected the lives of many people, including medical students. The present study explored internet addiction and changes in sleep patterns among medical students during the pandemic and assessed the relationship between them. Methods A cross-sectional study was carried out in seven countries, the Dominican Republic, Egypt, Guyana, India, Mexico, Pakistan, and Sudan, using a convenience sampling technique, an online survey comprising demographic details, information regarding COVID-19, the Pittsburgh Sleep Quality Index (PSQI), and the Internet Addiction Test (IAT). Results In total, 2749 participants completed the questionnaire. Of the total, 67.6% scored above 30 in the IAT, suggesting the presence of an Internet addiction, and 73.5% scored equal and above 5 in the PSQI, suggesting poor sleep quality. Internet addiction was found to be significant predictors of poor sleep quality, causing 13.2% of the variance in poor sleep quality. Participants who reported COVID-19 related symptoms had disturbed sleep and higher internet addiction levels when compared with those who did not. Participants who reported a diagnosis of COVID-19 reported poor sleep quality. Those living with a COVID-19 diagnosed patient reported higher internet addiction and worse sleep quality compared with those who did not have any COVID-19 patients in their surroundings. Conclusion The results of this study suggest that internet addiction and poor sleep quality are two issues that require addressing amongst medical students. Medical training institutions should do their best to minimize their negative impact, particularly during the current COVID-19 pandemic.

  • 46.
    Tang, Julia
    et al.
    Curtin University, Perth, Western Australia, Australia.
    Falkmer, Marita
    Jönköping University, School of Education and Communication, HLK, CHILD. Curtin University, Perth, Western Australia, Australia.
    Horlin, Chiara
    Curtin University, Perth, Western Australia, Australia.
    Tan, Tele
    Curtin University, Perth, Western Australia, Australia.
    Vaz, Sharmila
    Curtin University, Perth, Western Australia, Australia.
    Falkmer, Torbjörn
    Curtin University, Perth, Western Australia, Australia.
    Face recognition and visual search strategies in autism spectrum disorders: Amending and extending a recent review by Weigelt et al.2015In: PLOS ONE, E-ISSN 1932-6203, Vol. 10, no 8, p. 1-19, article id e0134439Article, review/survey (Refereed)
    Abstract [en]

    The purpose of this review was to build upon a recent review by Weigelt et al. which examined visual search strategies and face identification between individuals with autism spectrum disorders (ASD) and typically developing peers. Seven databases, CINAHL Plus, EMBASE, ERIC, Medline, Proquest, PsychInfo and PubMed were used to locate published scientific studies matching our inclusion criteria. A total of 28 articles not included in Weigelt et al. met criteria for inclusion into this systematic review. Of these 28 studies, 16 were available and met criteria at the time of the previous review, but were mistakenly excluded; and twelve were recently published. Weigelt et al. found quantitative, but not qualitative, differences in face identification in individuals with ASD. In contrast, the current systematic review found both qualitative and quantitative differences in face identification between individuals with and without ASD. There is a large inconsistency in findings across the eye tracking and neurobiological studies reviewed. Recommendations for future research in face recognition in ASD were discussed.

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  • 47.
    Thompson, Craig
    et al.
    Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, QLD, Australia.
    Bölte, Sven
    Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, QLD, Australia.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, QLD, Australia.
    Girdler, Sonya
    Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, QLD, Australia.
    To be understood: Transitioning to adult life for people with Autism Spectrum Disorder2018In: PLOS ONE, E-ISSN 1932-6203, Vol. 13, no 3, article id e0194758Article in journal (Refereed)
    Abstract [en]

    Introduction: The purpose of this study was to explore the viewpoints of parents of young people with Autism Spectrum Disorder (ASD) in relation to their child's transition to adulthood.

    Methods: Data were collected during four structured focus groups with 19 parents of young people with ASD with average to high intellectual capacities. Condensed meaning units were identified and checked during focus groups, and were subsequently linked to the International Classification of Functioning, Disability and Health (ICF).

    Results: Three major themes emerged: to be understood, to understand the world and to succeed. The ICF domains of activity and participation and environmental factors emerged as having the greatest potential to influence transition outcomes.

    Conclusions: Policies and services should focus on strengths to maximise participation in higher education, employment and independent living amongst young people with ASD. Interventions targeting environmental factors could be effective in improving participation in adult life. Person-centred and individualised approaches could further complement this approach supporting the transition to adulthood for people with ASD, ultimately improving outcomes in adulthood. 

  • 48.
    Thompson, Melanie
    et al.
    Curtin University.
    Elliott, Catherine
    Curtin University.
    Willis, Claire
    University of Western Australia.
    Ward, Roslyn
    University of Western Australia.
    Falkmer, Marita
    Jönköping University, School of Education and Communication, HLK, CHILD. Curtin University.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Curtin University.
    Gubbay, Anna
    University of Western Australia.
    Girdler, Sonya
    Curtin University.
    Can, Want and Try: Parents’ Viewpoints Regarding the Participation of Their Child with an Acquired Brain Injury2016In: PLOS ONE, E-ISSN 1932-6203, Vol. 11, no 7, article id e0157951Article in journal (Refereed)
    Abstract [en]

    Background 

    Acquired brain injury (ABI) is a leading cause of permanent disability, currently affecting 20,000 Australian children. Community participation is essential for childhood development and enjoyment, yet children with ABI can often experience barriers to participation. The factors which act as barriers and facilitators to community participation for children with an ABI are not well understood. 

    Aim

    To identify the viewpoints of parents of children with an ABI, regarding the barriers and facilitators most pertinent to community participation for their child. 

    Methods 

    Using Q-method, 41 parents of children with moderate/severe ABI sorted 37 statements regarding barriers and facilitators to community participation. Factor analysis identified three viewpoints. 

    Results 

    This study identified three distinct viewpoints, with the perceived ability to participate decreasing with a stepwise trend from parents who felt their child and family "can" participate in viewpoint one, to "want" in viewpoint two and "try" in viewpoint three. 

    Conclusions 

    Findings indicated good participation outcomes for most children and families, however some families who were motivated to participate experienced significant barriers. The most significant facilitators included child motivation, supportive relationships from immediate family and friends, and supportive community attitudes. The lack of supportive relationships and attitudes was perceived as a fundamental barrier to community participation. 

    Significance 

    This research begins to address the paucity of information regarding those factors that impact upon the participation of children with an ABI in Australia. Findings have implications for therapists, service providers and community organisations.

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  • 49.
    Täljedal, T.
    et al.
    Region Västmanland - Uppsala University, Centre for Clinical Research, Västmanland Hospital Västerås, Västerås, Sweden.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ, Department of Social Work. Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD. Department of Mental Health, Norway Technical and Natural Sciences University, Trondheim, Norway.
    Almqvist, Lena
    Jönköping University, School of Education and Communication, HLK, CHILD. School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
    Osman, F.
    CHAP, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Norén Selinus, E.
    Region Västmanland - Uppsala University, Centre for Clinical Research, Västmanland Hospital Västerås, Västerås, Sweden.
    Fängström, K.
    CHAP, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Patterns of mental health problems and well-being in children with disabilities in Sweden: A cross-sectional survey and cluster analysis2023In: PLOS ONE, E-ISSN 1932-6203, Vol. 18, no 7, article id e0288815Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Children with disabilities have an increased risk of mental health problems. Patterns of mental health problems and well-being may vary. AIMS: To identify patterns of mental health problems and well-being in children with disabilities in Sweden, and investigate the influence of parental background (migration, education), and child cognitive level. METHOD: In this cross-sectional study, cluster analysis was used to analyse parents' ratings of conduct problems, emotional symptoms, and prosocial behaviour on the Strengths and Difficulties Questionnaire (SDQ) in children with disabilities (n = 136). The influence of parental background (migration, education) and child cognitive level on cluster membership was explored through multinomial logistic regression. RESULTS: Five clusters of mental health patterns emerged. Three clusters had mean ratings near or past clinical cut-off for one each of the SDQ-subscales. One cluster had difficulties on all three subscales. Greater child cognitive difficulties increased the likelihood of low prosocial behaviour (OR 2.501, p < .001) and of difficulties on all three subscales (OR 2.155, p = .006). Parental background did not influence cluster membership. CONCLUSION: Children with disabilities display varying mental health patterns. Awareness of the complexity of mental health patterns among children with disabilities is important. Screening and support for emotional symptoms and prosocial behaviour deficits should be considered for children with conduct problems. 

  • 50.
    Ulfenborg, Benjamin
    et al.
    Högskolan i Skövde, Institutionen för biovetenskap.
    Karlsson, Alexander
    Högskolan i Skövde, Institutionen för informationsteknologi.
    Riveiro, Maria
    Högskolan i Skövde, Institutionen för informationsteknologi.
    Améen, Caroline
    Takara Bio Europe AB, Gothenburg, Sweden.
    Åkesson, Karolina
    Takara Bio Europe AB, Gothenburg, Sweden.
    Andersson, Christian X.
    Takara Bio Europe AB, Gothenburg, Sweden.
    Sartipy, Peter
    Högskolan i Skövde, Institutionen för biovetenskap.
    Synnergren, Jane
    Högskolan i Skövde, Institutionen för biovetenskap.
    A data analysis framework for biomedical big data: Application on mesoderm differentiation of human pluripotent stem cells2017In: PLOS ONE, E-ISSN 1932-6203, Vol. 12, no 6, article id e0179613Article in journal (Refereed)
    Abstract [en]

    The development of high-throughput biomolecular technologies has resulted in generation of vast omics data at an unprecedented rate. This is transforming biomedical research into a big data discipline, where the main challenges relate to the analysis and interpretation of data into new biological knowledge. The aim of this study was to develop a framework for biomedical big data analytics, and apply it for analyzing transcriptomics time series data from early differentiation of human pluripotent stem cells towards the mesoderm and cardiac lineages. To this end, transcriptome profiling by microarray was performed on differentiating human pluripotent stem cells sampled at eleven consecutive days. The gene expression data was analyzed using the five-stage analysis framework proposed in this study, including data preparation, exploratory data analysis, confirmatory analysis, biological knowledge discovery, and visualization of the results. Clustering analysis revealed several distinct expression profiles during differentiation. Genes with an early transient response were strongly related to embryonic-and mesendoderm development, for example CER1 and NODAL. Pluripotency genes, such as NANOG and SOX2, exhibited substantial downregulation shortly after onset of differentiation. Rapid induction of genes related to metal ion response, cardiac tissue development, and muscle contraction were observed around day five and six. Several transcription factors were identified as potential regulators of these processes, e.g. POU1F1, TCF4 and TBP for muscle contraction genes. Pathway analysis revealed temporal activity of several signaling pathways, for example the inhibition of WNT signaling on day 2 and its reactivation on day 4. This study provides a comprehensive characterization of biological events and key regulators of the early differentiation of human pluripotent stem cells towards the mesoderm and cardiac lineages. The proposed analysis framework can be used to structure data analysis in future research, both in stem cell differentiation, and more generally, in biomedical big data analytics.

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