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The main drivers of Svalbard reindeer population dynamics are likely to be limited food resources, periods of harsh winter weather and their abundant parasitic nematode infections. To show parasite demographic impact requires three approaches: field observation to document life history and abundances of parasites/hosts; manipulation of infection to quantify the effect of parasite intensity on host fitness; appropriate population models of density-dependent transmission. We monitored the reindeer population and intensity of parasites in culled reindeer, and treated a randomly selected reindeer group with an anthelmintic, comparing their fitness with a control group. The two main nematode species differed in life histories. Ostertagia gruehneri infected reindeer over the summer. Marshallagia marshalli transmission was limited to the harsh arctic winter. This implies that our treatment only affected O. gruehneri and showed that reindeer fecundity depends on intensity of O. gruehneri infection, which varied between years and was positively related to host population size. Modelling this interaction suggested a role for O. gruehneri in reindeer population regulation. More experiments with a delayed anthelmintic treatment, designed to manipulate M. marshalli numbers over the winter, provided little evidence of this parasite’s impact on host population dynamics.
A diagnosis of congenital heart disease (CHD) in offspring triggers psychological distress in parents. Results of previous studies have been inconsistent regarding the psychological impact of a prenatal versus a postnatal diagnosis. The aim of this study was to evaluate the influence of the time of diagnosis on levels of parental distress.
Pregnant women and their partners with a fetus diagnosed with complex CHD, parents of children with postnatally diagnosed CHD, and pregnant women and their partners with uncomplicated pregnancies were invited to participate. Data were collected during pregnancy and 2–6 months after delivery using the Hospital Anxiety and Depression Scale, sense of coherence, life satisfaction, and Dyadic Adjustment Scale.
During pregnancy, the prenatal group scored lower sense of coherence compared to controls (p=0.044). Postnatally the prenatal group scored lower on sense of coherence compared to the postnatal group and controls (p=0.001; p=0.001). Postnatally, the prenatal and postnatal groups had higher levels of anxiety compared to controls (p=0.025; p=0.0003). Life satisfaction was lower in the prenatal group compared to that in the postnatal group and in controls (p=0.000; p=0.0004).
Parents with a prenatal diagnosis of CHD in offspring report a low sense of coherence already during pregnancy which decreased further at follow-up. The same group reported a lower satisfaction with life compared to parents of a child with postnatal diagnosis of CHD and parents of a healthy child. This motivates further efforts to improve counselling and support during pregnancy and for parents after a prenatal diagnosis.
If there is consensus about how to handle a patient with a specific condition, from the ambulance service point of view, it matters less for the patient which ambulance arrives to take care of the patient. Guidelines are a way of standardizing treatment or management of the patient for a given patient condition. Clear and implemented guidelines that promote the handling of the patients is done from best practice and are evidence-based according to the best ability of the organization.
The aim of the current study was to implement guidelines into an organization that was not currently using guidelines. The study was conducted as a collaborative effort between a Swedish pre-hospital training organization and the local ambulance service organization in Kosovo.
An iterative process of implementing the guidelines was applied:
1.Identify guidelines appropriate for the local organization. For each iteration, five guidelines are chosen.
2.Have the five guidelines translated into Albanian.
3.The guidelines are adapted to local conditions and context.
4.The five guidelines are approved by an expert group.
5.The five guidelines are implemented in the organization.
The initial iteration included was carried out in the form of a workshop where 22 persons (doctors and nurses) from the local ambulance service in Kosovo participated. During the workshop, the first three implementation steps were taken, while remaining steps were carried out by the local organization.
With the local management and ambulance personnel involved throughout the process, the implementation of guidelines were delivered in a more feasible way as well as more easily accepted and adhered to. Supporting a standardized treatment or management of the patient will benefit future patients. These standards should be based in evidence-based practice adopted to local conditions.
Nephrops norvegicus is a commercially valuable demersal fisheries species. Relatively little is understood about this species’ population dynamics across its distribution with previous mitochondrial and microsatellite studies failing to identify significant population-level differentiation. In this study, sequence variation in the mitochondrial (mtDNA) D-loop was analysed from samples across the distribution range, and compared with COI sequences for this species retrieved from GenBank. Analysis of a 375 bp fragment of the D-loop revealed significant genetic differentiation between samples from the North-east Atlantic and the east Mediterranean (FST = 0.107, P < 0.001). Tau (τ), theta (θ0 and θ1) and Fu's FS values suggest the species spread between 10,500 to 19,000 ybp and subsequently expanded rapidly across the Atlantic.
The Western diet is characterized by high meat consumption, which negatively affects the environment and human health. Transitioning toward eating more plant-based products in Western societies has been identified as a key instrument to tackle these problems. However, one potential concern is that radically reducing meat in the current diet might lead to deficiencies in nutritional intake. In this paper, we explore a scenario in which meat consumption in Sweden is reduced by 50% and replaced by domestically grown grain legumes. We quantify and discuss the implications for nutritional intake on population level, consequences for agricultural production systems and environmental performance. The reduction in meat consumption is assumed to come primarily from a decrease in imported meat. We use data representing current Swedish conditions including the Swedish dietary survey, the Swedish food composition database, Statistics Sweden and existing life cycle assessments for different food items. At population level, average daily intake of energy and most macro- and micro-nutrients would be maintained within the Nordic Nutrition Recommendations after the proposed transition (e.g., for protein, fat, zinc, vitamin B12 and total iron). The transition would also provide a considerable increase in dietary fiber and some increase in folate intake, which are currently below the recommended levels. The transition scenario would increase total area of grain legume cultivation from 2.2% (current level) to 3.2% of Swedish arable land and is considered technically feasible. The climate impact of the average Swedish diet would be reduced by 20% and the land use requirement by 23%. There would be a net surplus of approximately 21,500 ha that could be used for bioenergy production, crop production for export, nature conservation, etc. Implementation of this scenario faces challenges, such as lack of suitable varieties for varying conditions, lack of processing facilities to supply functional legume-based ingredients to food industries and low consumer awareness about the benefits of eating grain legumes. In sum, joint efforts from multiple actors are needed to stimulate a decrease in meat consumption and to increase cultivation and use of domestically grown grain legumes.
Impairments in mechanisms underlying early information processing have been reported in posttraumatic stress disorder (PTSD); however, findings in the existing literature are inconsistent. This current study capitalizes on technological advancements of research on electroencephalographic event-related potential and applies it to a novel PTSD population consisting of trauma-affected refugees.
A total of 25 trauma-affected refugees with PTSD and 20 healthy refugee controls matched on age, gender, and country of origin completed the study. In two distinct auditory paradigms sensory gating, indexed as P50 suppression, and sensorimotor gating, indexed as prepulse inhibition (PPI), startle reactivity, and habituation of the eye-blink startle response were examined. Within the P50 paradigm, N100 and P200 amplitudes were also assessed. In addition, correlations between psychophysiological and clinical measures were investigated.
PTSD patients demonstrated significantly elevated stimuli responses across the two paradigms, reflected in both increased amplitude of the eye-blink startle response, and increased N100 and P200 amplitudes relative to healthy refugee controls. We found a trend toward reduced habituation in the patients, while the groups did not differ in PPI and P50 suppression. Among correlations, we found that eye-blink startle responses were associated with higher overall illness severity and lower levels of functioning.
Fundamental gating mechanisms appeared intact, while the pattern of deficits in trauma-affected refugees with PTSD point toward a different form of sensory overload, an overall neural hypersensitivity and disrupted the ability to down-regulate stimuli responses. This study represents an initial step toward elucidating sensory processing deficits in a PTSD subgroup.
The concept of risk is a prominent feature of the Swedish legal system, and of Swedish tort law in particular. Risk was a prime concern in the development of the welfare state as well as the concern of the wide-ranging regulations instigating the safety nets that continue to be such a characteristic feature of Swedish society. Addressing risk has involved a division of labour between private law and public law, with public law taking on key overt measures to regulate risks to the public, as discussed further in the Swedish Part II chapter (Ch. 13). While the issues of the concept of risk and the regulation of risk are covered, the focus of the present chapter is on risk in generating liability from the perspective of Swedish tort law.
Swedish private law can be characterised as striving to limit various risks of harm in society. We will focus on tort and compensation law to present how the Swedish legislator has made different choices in regulating risks, and how courts and other legal agencies interpret that legislation, decide on the boundaries between acceptable and non-acceptable risks and, in turn, create law concerning risks. The choices can be seen as prioritisations: first, amongst separate kinds of harm – in the sense of ‘ which types of damage should be compensated by someone other than the injured party?’ – and second, ‘when – that is, under which circumstances and to what extent – should liability be assigned?’ A third question is, ‘who should bear the costs in those situations?’
Swedish doctrine does not explore risk as a specific legal topic, but risk is clearly an element in broader discussions of liability and why certain areas of society should be subject to attempts of behaviour control by legal instruments. The most important elaboration of rules for risk has flowed from courts interpreting tort law's open-textured norms. It is fair to say that the legislator has great trust in the courts’ ability to develop legal concepts in line with societal developments and to do so swiftly enough to deal with new problems as they arise.
Perhaps part of the reason for tort law's doctrinal discussion about risk being undeveloped is Sweden's distinctive emphasis on insurance solutions, particularly for personal injuries.
The monoaminergic stabiliser (−)-OSU6162 has in previous studies shown promising effects on mental fatigue after stroke and traumatic brain injury. This study investigated the safety and effectiveness of (−)-OSU6162 in patients with myalgic encephalomyelitis/chronic fatigue syndrome.
A total of 62 patients were randomly assigned to placebo or (−)-OSU6162. Primary outcomes were assessment on the mental fatigue scale (MFS) and the clinical global impression of change (CGI-C) scale. Secondary outcomes were results on the FibroFatigue scale (FF), the Beck Depression Inventory (BDI), the pain visual analogue scale and neuropsychological tests. Assessments were performed at baseline, after 1 and 2 weeks of treatment and at follow-up after 6 weeks.
MFS and CGI-C showed significant improvements for both treatment groups after treatment but not at follow-up; a similar pattern was seen for FF and BDI. However, significant differences between groups could not be demonstrated. On the other hand, correlation analyses showed a significant correlation between (−)-OSU6162 concentration and change in MFS, FF, and BDI score within the concentration interval 0.1–0.7 µM. Exploratory subgroup analyses showed a larger treatment effect with (−)-OSU6162 in improving MFS and FF symptoms in patients on antidepressant therapy compared to those without antidepressant treatment.
(−)-OSU6162 was found to be safe and well tolerated. When analysing the entire material (−)-OSU6162 was not found to differ significantly from placebo in alleviating fatigue in ME patients but was superior to placebo in counteracting fatigue in a subgroup of ME patients who received concomitant pharmacological treatment for depression.
This article offers a fresh perspective on the evolution of energy consumption in Britain from the 1920s to the 1970s. The twentieth century witnessed a series of energy transitions – from wood and coal to gas, electricity, and oil – that have transformed modern lives. The literature has primarily followed supply, networks, and technologies. We need to know more about people and their homes in this story, because it was here where energy was used. The article investigates the forces that shaped domestic demand by focusing on working-class households in public housing. It examines the interaction between political frameworks, public housing infrastructures, and the changing norms and practices of people's daily lives. It connects social and political history with material culture and compares the different paths taken in London, Stocksbridge, and Stevenage in the provision of gas, electricity, and heating. Evidence collected by local authorities is used to analyse the uptake, use, and resistance to changes in domestic infrastructures, such as gas-lit coke ovens and central heating. The case-studies make a more general pitch for a new historical study of energy that places people's lifestyles, their ideas of comfort, and political attempts to change them more squarely at the centre of inquiry.
As part of further investigations into three linked haemorrhagic fever with renal syndrome (HFRS) cases in Wales and England, 21 rats from a breeding colony in Cherwell, and three rats from a household in Cheltenham were screened for hantavirus. Hantavirus RNA was detected in either the lungs and/or kidney of 17/21 (81%) of the Cherwell rats tested, higher than previously detected by blood testing alone (7/21, 33%), and in the kidneys of all three Cheltenham rats. The partial L gene sequences obtained from 10 of the Cherwell rats and the three Cheltenham rats were identical to each other and the previously reported UK Cherwell strain. Seoul hantavirus (SEOV) RNA was detected in the heart, kidney, lung, salivary gland and spleen (but not in the liver) of an individual rat from the Cherwell colony suspected of being the source of SEOV. Serum from 20/20 of the Cherwell rats and two associated HFRS cases had high levels of SEOV-specific antibodies (by virus neutralisation). The high prevalence of SEOV in both sites and the moderately severe disease in the pet rat owners suggest that SEOV in pet rats poses a greater public health risk than previously considered.
Background: There is limited research into the effect of supervision in cognitive behavioural therapy (CBT) from the supervisees’ perspective. Aims: The aim of the study was to acquire knowledge from the supervisees’ perspective as to what in particular in the supervision process contributes to the therapy process. Method: Fourteen supervisees on a foundation course participated in the study. A qualitative approach was used with thematic analysis of the participants’ written diaries after supervision and therapy sessions. Results: Analyses of supervisees’ experiences suggested that a variety of therapeutic interventions were easier to implement if one had the supervisor's support and felt free to decide if and when the suggested interventions could best be implemented. Evaluation in the form of positive feedback from the supervisor indicating that the supervisee was ‘doing the right thing’ was perceived to be important. A unifying theme when supervisees felt they were not getting anything out of the supervision was that the supervisees did not have a supervision question. Conclusions: The results of this research suggest that the supervisor's support during training is perceived to be important for the supervisee. Receiving positive feedback from one's supervisor in an evaluation is perceived to have a great impact on whether the therapist implements the suggested therapeutic interventions discussed in the previous supervision.
Recirculation of nitrogen (N) from crop residue and green-manure biomass resources may reduce the need to add new reactive N to maintain crop yield and quality. The aim of this study was to determine how different strategies for recycling residual and green-manure biomass influence yield and N concentration of the edible parts of food crops in a stockless organic cropping system. For this purpose, three biomass distribution treatments were investigated in a field experiment, based on a cropping system designed to produce both high-quality food crops and biomass resources from crop residues, cover crops and a green-manure ley. The three treatments, applied at the cropping system level, were: (1) incorporating the aboveground biomass resources in situ (IS); (2) harvesting, ensiling and redistributing the same biomass resources to the non-legume crops (biomass redistribution, BR); and (3) harvesting, ensiling and using the biomass resources as substrate for production of bio-methane via anaerobic digestion (AD) followed by distribution of the digestate as bio-fertilizer to the non-legume crops. The redistribution of ensiled (BR) and digested (AD) biomass did not increase the yield of the edible parts in winter rye (Secale cereal L.), white cabbage (Brassica oleracea L.) or red beet (Beta vulgaris L.) compared with leaving the biomass on the ground at harvest (IS). The BR treatment increased the yield of lentil intercropped with oat, compared with IS treatment in one of the two studied years. The total biomass yield of the cover crop following winter rye was significantly higher in the BR treatment than in IS in both years. The legume proportion in the green-manure ley was significantly higher in the AD and BR treatments as compared with IS in one of the experimental years. This study showed that strategic biomass redistribution has the potential to enhance biomass productivity while maintaining food crop yields, thereby enhancing whole system productivity. Biomass redistribution systems both with and without biogas digestion offer a new strategy for the development of multifunctional arable cropping systems that rely on internal nutrient cycling.
Obsessive–compulsive disorder (OCD) is a chronic psychiatric disorder leading to considerable distress and disability. Therapies are effective in a majority of paediatric patients, however, many only get partial response. It is therefore important to study the underlying pathophysiology of the disorder.
1H magnetic resonance spectroscopy (MRS) was used to study the concentration of brain metabolites in four different locations (cingulate gyrus and sulcus, occipital cortex, thalamus and right caudate nucleus). Treatment-naive children and adolescents with OCD (13 subjects) were compared with a group of healthy age- and gender-matched subjects (11 subjects). Multivariate analyses were performed on the concentration values.
No separation between controls and patients was found. However, a correlation between metabolite concentrations and symptom severity as measured with the Children’s Yale-Brown Obsessive–Compulsive Scale (CY-BOCS) was found. Strongest was the correlation with the CY-BOCS obsession subscore and aspartate and choline in the caudate nucleus (positively correlated with obsessions), lipids at 2 and 0.9 ppm in thalamus, and occipital glutamate+glutamine, N-acetylaspartate and myo-inosytol (negatively correlated with obsessions).
The observed correlations between 1H MRS and CY-BOCS in treatment-naive patients further supports an occipital involvement in OCD. The results are consistent with our previous study on adult OCD patients. The 1H MRS data were not supportive of a separation between the patient and control groups.
Little evidence exists on the treatment of traumatised refugees.
To estimate treatment effects of flexible cognitive–behavioural therapy
(CBT) and antidepressants (sertraline and mianserin) in traumatised
Randomised controlled clinical trial with 2×2 factorial design
(registered with Clinicaltrials.gov, NCT00917397, EUDRACT no.
2008-006714-15). Participants were refugees with war-related traumatic
experiences, post-traumatic stress disorder (PTSD) and without psychotic
disorder. Treatment was weekly sessions with a physician and/or
psychologist over 6 months.
A total of 217 of 280 patients completed treatment (78%). There was no
effect on PTSD symptoms, no effect of psychotherapy and no interaction
between psychotherapy and medicine. A small but significant effect of
treatment with antidepressants was found on depression.
In a pragmatic clinical setting, there was no effect of flexible CBT and
antidepressants on PTSD, and there was a small-to-moderate effect of
antidepressants and psychoeducation on depression in traumatised