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Heavy equipment manufacturers recognise an opportunity to realise customer value gains through offering new Product-Service Systems. Such transition implies a radical shift in how new systems are designed. Based on a set of interviews the paper investigates how radical PSS innovation can be enabled by the use of physical prototypes as boundary object to navigate early PSS design ambiguity. On such basis, suggestions for augmenting existing support tools are made in relation to the existing literature.
This chapter discusses the role of city festivals in shaping and re-imagining urban space. There has been increased interest in festivals among decision-makers and marketers as vehicles for cultural profiling, regeneration, and social inclusion. The chapter views space as inseparable from economic and social structures and practices which govern urban life. It draws attention to the political aspect of city festivals as being mobilized for economic, social, and cultural purposes. It draws on Lefebvre’s and Massey’s conceptualizations of space as socially produced to discuss examples of theatre festivals based in Northern Europe. It shows how, more than simply putting on a show, these festivals aim to infuse the cityscape with new meanings. In doing so, the festivals become implied in (re)configurations of social patterns of representation and marginalization, for example regarding how they open or close urban space to different audiences. The chapter argues that a spatial perspective provides a critical means for examining how festivals organize bodies, social hierarchies, and relations of inclusion and exclusion in the city.
We show that the compactly supported cohomology of certain
-Shimura varieties with
-level vanishes above the middle degree. The only assumption is that we work over a CM field
in which the prime
splits completely. We also give an application to Galois representations for torsion in the cohomology of the locally symmetric spaces for
. More precisely, we use the vanishing result for Shimura varieties to eliminate the nilpotent ideal in the construction of these Galois representations. This strengthens recent results of Scholze [On torsion in the cohomology of locally symmetric varieties, Ann. of Math. (2) 182 (2015), 945–1066; MR 3418533] and Newton–Thorne [Torsion Galois representations over CM fields and Hecke algebras in the derived category, Forum Math. Sigma 4 (2016), e21; MR 3528275].
The purpose of the present study was to evaluate the efficacy and safety of (−)-OSU6162 in doses up to 30 mg b.i.d. in patients suffering from mental fatigue following stroke or traumatic brain injury (TBI).
This 4 + 4 weeks double-blind randomised cross-over study included 30 patients afflicted with mental fatigue following a stroke or head trauma occurring at least 12 months earlier. Efficacy was assessed using the Mental Fatigue Scale (MFS), the Self-rating Scale for Affective Syndromes [Comprehensive Psychopathological Rating Scale (CPRS)], the Frenchay Activity Index (FAI), and a battery of neuropsychological tests. Safety was evaluated by recording spontaneously reported adverse events (AEs).
There were significant differences on the patients’ total FAI scores (p = 0.0097), the subscale FAI outdoor scores (p = 0.0243), and on the trail making test (TMT-B) (p = 0.0325) in favour of (−)-OSU6162 treatment. Principal component analysis showed a clear overall positive treatment effect in 10 of 28 patients; those who responded best to treatment had their greatest improvements on the MFS. Reported AEs were mild or moderate in severity and did not differ between the (−)-OSU6162 and the placebo period.
The most obvious beneficial effects of (−)-OSU6162 were on the patients’ activity level, illustrated by the improvement on the FAI scale. Moreover, a subgroup of patients showed substantial improvements on the MFS. Based on these observed therapeutic effects, in conjunction with the good tolerability of (−)-OSU6162, this compound may offer promise for treating at least part of the symptomatology in patients suffering from stroke- or TBI-induced mental fatigue.
This study investigated psychological symptoms in Bosnian women 3–4 years after their arrival in Sweden.
A simple random sample of 163 Bosnian women aged 19–59 was drawn from the Swedish populations register in 1996. The control group consisted of 392 Swedish-born women. Data were collected in face-to-face interviews. The Hopkins Symptom Checklist 25 (HSCL-25) and the Posttraumatic Symptom Scale (PTSS-10) were used to measure psychological symptoms of depression, anxiety, psychological distress, and posttraumatic stress disorder (PTSD). Unconditional logistic regression was used to estimate odds ratios (OR) for psychological symptoms after adjustment for age, country of birth, education, marital status, economic difficulties, social network, and feeling secure.
The prevalence of symptoms of PTSD was 28.3% among the Bosnian women. Bosnian women had significantly higher risks of symptoms of depression, anxiety, and psychological distress than Swedish-born women. For depression the odds ratio was 9.50 among Bosnian women.
Psychiatric community interventions need to target Bosnian refugee women. Awareness among health-care workers who encounter these women in a clinical setting should be improved.
This study analysed the association between country of birth and psychotic, affective, and neurotic disorders in seven immigrant categories, after adjustment for demographic and socioeconomic factors. A 2-year national cohort study of 4.5 million individuals in the age group 25–64 years was performed. Swedish national registers including individual demographic and socioeconomic data were linked to the hospital discharge register. Cox regression was used in the analysis. Several groups of immigrants, both men and women, had risks of hospital admission for psychotic, affective, or neurotic disorders compared to the Swedish-born reference group. The impact of demographic and socioeconomic factors on these risks seemed to be larger for men than for women. For foreign-born men, several of the risks no longer remained significant after adjustment for income and marital status. In contrast, most of the risks for foreign-born women remained significant after adjustment for income and marital status. Low income and being single were associated with an increased risk of psychiatric hospital admission. These results represent important knowledge for clinicians and public health planners who are involved in treatment and prevention of mental disorders among certain groups of immigrants, and among low income men and women irrespective of immigrant status.
Postpartum psychosis is a severe psychiatric disorder that leads to hospital admission in about one woman per 1,000 deliveries. It coincide with the vulnerable period associated with becoming a mother and may, if untreated, lead to suicide and infanticide. Some risk factors for postpartum psychosis have been identified in previous research, such as primiparity and previous psychiatric disorder.
Knowledge on how postpartum psychosis is related to obstetric factors might be helpful in the clinical risk assessment of postpartum psychosis.
The aim of this large-scale follow-up study was to examine the association between postpartum psychosis and certain pregnancy and delivery complications and other obstetric variables, after adjustment for age, year of delivery and previous hospitalization for psychiatric disorder.
1,133,368 Swedish first-time mothers were included during a 29-year period yielding 1,413 hospitalized cases of postpartum psychosis. Several obstetric variables were analyzed separately after adjustment for possible confounders.
Respiratory disorder in the neonate, severe birth asphyxia, preterm birth, caesarean section, perinatal death and SGA infant were associated with an increased risk of postpartum psychosis. After adjustment for previous hospitalization for psychiatric disorder only preterm birth and acute caesarean section remained significant risk factors for postpartum psychosis (relative risks were 1.20 and 1.31, respectively).
The relative risk of postpartum psychosis among first-time mothers with previous hospitalization for psychiatric disorder was increased more than 100-fold.
Careful clinical risk assessments of postpartum psychosis are crucial among women with a history of psychiatric disorder whereas obstetric variables have a minor importance.
The aim of this study was to assess exercise capacity, physical activity, and health-related quality of life within a broad and unselected group of adults with CHD.
From April 2009 to February 2014, 1310 patients were assessed for suitability to participate in this single-centre cross-sectional study. Seven hundred and forty-seven (57%) patients were included, performed a submaximal bicycle test, and answered questionnaires regarding physical activity and health-related quality of life. Exercise capacity, physical activity, and health-related quality of life were compared with reference values and correlations were studied.
The exercise capacities of men and women with CHD were 58.7 and 66.3%, respectively, of reference values. Approximately, 20–25% of the patients did not achieve the recommended amount of physical activity. In addition, men scored significantly less points on 7 out of 10 scales of health-related quality of life and women in 6 out of 10 scales, compared with reference values. The strongest correlation was between exercise capacity and the Short Form-36 (physical function).
Exercise capacity was impaired in all adults with CHD, including those with less complicated CHD. One-quarter of the patients did not achieve the recommended levels of physical activity. Exercise tests followed by individualised exercise prescriptions may be offered to all patients with CHD aiming to increase exercise capacity, levels of physical activity, improve health-related quality of life, and reduce the risk of acquired life-style diseases.
The number of older people (aged 65+) will more than double by 2050 in Sweden. The ageing population is an increasing concern due to rising health-care costs and a shortage of health professionals. Older people generally prefer ageing in place, as long as they feel confident and comfortable. However, preventive and supportive measures are needed to maintain older people's independence and active participation in society. The aim of this study is to explore the prerequisites for a healthy and independent life among older people in Sweden. A Delphi study was conducted in three rounds. In round 1, seven focus group interviews were performed with older persons aged 65–79, older persons aged ⩾80, next of kin of older persons, health professionals in primary and home health care, assistant nurses in home care, care managers and local politicians. The data were analysed using thematic analysis, resulting in 35 statements of the prerequisites needed for a healthy and independent life. These statements were sent to the participants from round 1, who were asked to evaluate the degree to which they agreed with each statement in round 2, and again in round 3. There was an agreement of at least 80 per cent for 31 of the 35 statements. When asked to identify the three prerequisites of most importance for a healthy and independent life, most participants stated: to have a social life, to have freedom of choice and power over one's own situation, and to have the possibility to choose independently one's type of housing. There was an overall high group agreement on the prerequisites needed for a healthy and independent life among older people. The main areas of importance were to have a social life, several dimensions of feeling safe and to retain one's personal control.
The need for psychotherapy in primary health care is on the increase but individual-based treatment is costly. The main aim of this randomised controlled trial (RCT) was to compare the effect of mindfulness-based group therapy (MGT) with treatment as usual (TAU), mainly individual-based cognitive behavioural therapy (CBT), on a broad range of psychiatric symptoms in primary care patients diagnosed with depressive, anxiety and/or stress and adjustment disorders. An additional aim was to compare the effect of MGT with TAU on mindful attention awareness.
This 8-week RCT took place in 2012 at 16 primary care centres in southern Sweden. The study population included both men and women, aged 20–64 years (n = 215). A broad range of psychiatric symptoms were evaluated at baseline and at the 8-week follow-up using the Symptom Checklist-90 (SCL-90). Mindful attention awareness was also evaluated using the Mindful Attention Awareness Scale (MAAS).
In both groups, the scores decreased significantly for all subscales and indexes in SCL-90, while the MAAS scores increased significantly. There were no significant differences in the change in psychiatric symptoms between the two groups. The mindfulness group had a somewhat larger change in scores than the control group on the MAAS (P = 0.06, non-significant).
No significant differences between MGT and TAU, mainly individual-based CBT, were found in treatment effect. Both types of therapies could be used in primary care patients with depressive, anxiety and/or stress and adjustment disorders, where MGT has a potential to save limited resources.
Understanding the microclimate in a given site influences the preconditions of sustainable development in many ways. Cold and strong winds in the winter will, for example, intensify the energy use in buildings depending on the air tightness of the building enclosure (Bagge et al., 2011), and in areas close to the seafront strong salty winds may also increase the wear and tear on building materials. High wind speed during winter also affects outdoor recreation, and the likelihood of people walking or cycling to local commerce and social activities subsides if the area is subject to highly uncomfortable wind speed (Glaumann & Nord, 1993). Thermal comfort during winter time is thus integrated in how people will access and use facilities in their local communities. Wind turbulence and funnel effects between buildings and along streets also occurg to a greater extent in cities compared to rural settlements, although wind speed in general is stronger in the countryside (Oke, 1987), illustrating the importance of scale in modelling the urban environment. In Sweden, especially during winter time, strong winds help lower the air temperature by several degrees and thus contribute to uncomfortable physical conditions (Glaumann & Westerberg, 1988).
Adult foreign language acquisition is challenging, and the degree of success varies among individuals. Anatomical differences in brain structure prior to training can partly explain why some learn more than others. We followed a sample of conscript interpreters undergoing intense language training to study learning-related changes in white-matter microstructure (FA, MD, RD and AD) and associations between differences in brain structure prior to training with acquired language proficiency. No evidence for changes in white matter microstructure relative to a control group was found. Starting values of RD, AD and MD were positively related to final test scores of language proficiency, corroborating earlier findings in the field and highlighting the need for further study of how initial brain structure influences and interacts with learning outcomes.
Livestock depredation by large carnivores is a global conservation challenge, and mitigation measures to reduce livestock losses are crucial for the coexistence of large carnivores and people. Various measures are employed to reduce livestock depredation but their effectiveness has rarely been tested. In this study, we tested the effectiveness of tall fences to reduce livestock losses to snow leopards Panthera uncia and wolves Canis lupus at night-time corrals at the winter camps of livestock herders in the Tost Mountains in southern Mongolia. Self-reported livestock losses at the fenced corrals were reduced from a mean loss of 3.9 goats and sheep per family and winter prior to the study to zero losses in the two winters of the study. In contrast, self-reported livestock losses in winter pastures, and during the rest of the year, when herders used different camps, remained high, which indicates that livestock losses were reduced because of the fences, not because of temporal variation in predation pressure. Herder attitudes towards snow leopards were positive and remained positive during the study, whereas attitudes towards wolves, which attacked livestock also in summer when herders moved out on the steppes, were negative and worsened during the study. This study showed that tall fences can be very effective at reducing night-time losses at corrals and we conclude that fences can be an important tool for snow leopard conservation and for facilitating the coexistence of snow leopards and people.
Synthetic Aperture Radar (SAR) satellite images are used to monitor Arctic sea ice, with systematic data records dating back to 1991. We propose a semi-supervised classification method that separates open water from sea ice and can utilise ERS-1/2, Envisat ASAR, RADARSAT-2 and Sentinel-1 SAR images. The classification combines automatic segmentation with a manual segment selection stage. The segmentation algorithm requires only the backscatter intensities and incidence angle values as input, therefore can be used to establish a consistent decadal sea ice record. In this study we investigate the sea ice conditions in two Svalbard fjords, Kongsfjorden and Rijpfjorden. Both fjords have a seasonal ice cover, though Rijpfjorden has a longer sea ice season. The satellite image dataset has weekly to daily records from 2002 until now, and less frequent records between 1991 and 2002. Time overlap between different sensors is investigated to ensure consistency in the reported sea ice cover. The classification results have been compared to high-resolution SAR data as well as in-situ measurements and sea ice maps from Ny-Ålesund. For both fjords the length of the sea ice season has shortened since 2002 and for Kongsfjorden the maximum sea ice coverage is significantly lower after 2006.
We are very happy that someone has finally tried to make sense of rationalization. But we are worried about the representational structure assumed by Cushman, particularly the “boxology” belief-desire model depicting the rational planner, and it seems to us he fails to accommodate many of the interpersonal aspects of representational exchange.
The study of the environmental impact of dietary patterns in relation to their nutrition quality and health impact is of recent development and great interest for both nutrition and environmental scientists. Preliminary research has been conducted on the potential application of nutrition and health indexes as reference units (i.e. functional units) in the life cycle assessment of foods. Although proposed methods to include nutrition and health aspects exist, more research is needed to increase the scientific quality and societal usefulness of such assessments.
Materials and Methods
SLF Healthy Diets is a 20-month project where 64 food items from the FFQ used in the population study “Västerbotten Intervention Programme” (VIP) will be characterized for their nutrition density and matched to the carbon footprint from life cycle assessment studies. Several nutrition density scores will be analyzed, among which the NRF9.3 score, a dietary-dependent NQI score, and a new nutrient index tailored for the Swedish population. Hazard ratios for total mortality will be estimated for 100.000 participants to the VIP study, and associations with reported intake of food products, nutrient density and environmental performance described.
Results and Discussion
Multiple results are expected from the project, among which a synthesis of the combined nutritional and environmental performance of the analyzed foods according to different methods, and hence the identification of the best nutritional index to apply in environmental studies. Additionally, the assessment in the VIP cohort of the associations between reported intake of food products and observed health outcomes will evaluate the ability of the suggested nutrition scores to predict the total mortality in the studied population.
The present project will allow for more robust quantification and communication of food products’ sustainability performance. Specifically, the project will: develop clear advice on which nutrition scores can best be used in LCA food studies; evaluate pros and cons of combined environmental, nutritional, and health metrics; validate nutrition and health metrics ability to predict health outcomes within a Swedish population-based cohort; investigate and propose how combined environmental, nutritional and health metrics can be implemented and used by food chain stakeholders.
Despite the growing evidence supporting legume consumption as part of healthy and sustainable diet, little information is known on legume intake in the Swedish population. The aim of the present study was to describe legume consumers in Sweden, their nutrient intake and study the association with biomarkers of nutritional status using food consumption and biomonitoring data from Swedish adults in the 2010–11 National Riksmaten survey. Total legume intake - including pulses, fresh legumes, soy products, peanuts, sprouts and mixed meals with legumes - was estimated using a web-based 4-d food records in adults 18–80 years (n = 1772). A range of biomarkers including non-fasted plasma ferritin and folate, as well as erythrocyte folate, were measured for a subsample of the population (n = 282). Legumes were consumed by 44% of the population, median intake was 36 g/d (Q1 = 16; Q3 = 71; n = 777). Legumes provided on average 3.3% of individual's total energy intake (%E) with no significant difference between sexes. Pulses were consumed by 33% of consumers contributing to 3.2 ± 2.8 %E intake whereas soy products were consumed by 8.6% of legume consumers but contributing to 6 ± 7.5 %E. Legume intake among self-reported vegetarians (n = 55) was significantly higher (p < 0.000) than for non-vegetarians, with mean daily intakes of 92 ± 99 g/d and 21 ± 42 g/d, respectively. Age (p 0.0066) was significantly higher in Q4 of legume intake and alcohol consumption was significantly lower (p 0.0008); BMI, gender, smoking habits, education and total energy intake did not differ. 23% of legume consumers have a fiber intake of 25–35 g/d whereas only 11% of non-consumers reach recommended intake (p 0.0001). Iron, folate and dietary fiber intakes were significantly higher (p < 0.000) in Q4 of legume intake. 32% of legume consumers meet recommended intakes of folate (RI 300 μg/d) versus 18% for non-consumers (p 0.000). Notably, 5.76% of women of reproductive age (18–44 y.o.) eating legumes reach 400 μg/d versus 0.79% for non-consumers (p 0.002). Plasma ferritin and erythrocyte folate levels did not differ between legume consumers and non-consumers. However, for women in reproductive age (n = 31), plasma folate levels were significantly higher in consumers than non-consumers (p 0.0102). Legume consumers have higher fiber intake and more frequently meet recommended folate intakes while maintaining adequate iron intake. In conclusion, legume consumers in Sweden are characterized by a defined diet pattern that generally is associated with better health.
To determine the accuracy of 12 previously validated short versions of the Geriatric Depression Scale (GDS) to detect major depressive disorder (MDD) in a high-risk population with and without global cognitive impairment.
Five hospitals, Western Sweden.
Older adults (age ≥70 years, n = 60) assessed at a home visit 1 year after hospital care in connection with suicide attempt.
Depression symptoms were rated using the established 15-item GDS. Eleven short GDS versions identified by a recent systematic review were derived from this administered version. Receiver operating characteristic curves and area under the curve (AUC) for the identification of MDD diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, were obtained for each version. The Youden Index optimal criterion was used to determine the appropriate cutoffs. Analyses were repeated after stratification by cognitive status (Mini Mental State Examination score ≤24 and >24) for the best performing GDS short versions and the established 15-item GDS.
The 7-item GDS according to Broekman et al. (2011), with a cutoff 3, was the most accurate among the 12 short versions (AUC 0.90, 95% confidence interval 0.80–1.00), identifying MDD with sensitivity 88% and specificity 81%. The cutoff score remained consistent in the presence of global cognitive impairment, which was not the case for the standardized 15-item GDS.
The Broekman 7-item GDS had high accuracy to detect MDD in this prospective clinical cohort at high risk for MDD. Further testing of GDS short versions in diverse settings is required.