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Ghai S, Chassé K, Renaud MJ, Guicherd-Callin L, Bussières A, Zidarov D. Transition of care from post-acute services for the older adults in Quebec: a pilot impact evaluation. BMC Health Serv Res 2024; 24:421. [PMID: 38570840 PMCID: PMC10993552 DOI: 10.1186/s12913-024-10818-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 03/03/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Early discharge of frail older adults from post-acute care service may result in individuals' reduced functional ability to carry out activities of daily living, and social, emotional, and psychological distress. To address these shortcomings, the Montreal West Island Integrated University Health and Social Services Centre in Quebec, Canada piloted a post-acute home physiotherapy program (PAHP) to facilitate the transition of older adults from the hospital to their home. This study aimed to evaluate: (1) the implementation fidelity of the PAHP program; (2) its impact on the functional independence, physical and mental health outcomes and quality of life of older adults who underwent this program (3) its potential adverse events, and (4) to identify the physical, psychological, and mental health care needs of older adults following their discharge at home. METHODS A quasi-experimental uncontrolled design with repeated measures was conducted between April 1st, 2021 and December 31st, 2021. Implementation fidelity was assessed using three process indicators: delay between referral to and receipt of the PAHP program, frequency of PAHP interventions per week and program duration in weeks. A battery of functional outcome measures, including the Functional Independence Measure (FIM) and the Patient-Reported Outcomes Measurement Information System (PROMIS) Global-10 scale, as well as fall incidence, emergency visits, and hospitalizations were used to assess program impact and adverse events. The Patient's Global Impression of Change (PGICS) was used to determine changes in participants' perceptions of their level of improvement/deterioration. In addition, the Camberwell Assessment of Need for the Elderly (CANE) questionnaire was administered to determine the met and unmet needs of older adults. RESULTS Twenty-four individuals (aged 60.8 to 94 years) participated in the PAHP program. Implementation fidelity was low in regards with delay between referral and receipt of the program, intensity of interventions, and total program duration. Repeated measures ANOVA revealed significant improvement in FIM scores between admission and discharge from the PAHP program and between admission and the 3-month follow-up. Participants also reported meaningful improvements in PGICS scores. However, no significant differences were observed on the physical or mental health T-scores of the PROMIS Global-10 scale, in adverse events related to the PAHP program, or in the overall unmet needs. CONCLUSION Findings from an initial sample undergoing a PAHP program suggest that despite a low implementation fidelity of the program, functional independence outcomes and patients' global impression of change have improved. Results will help develop a stakeholder-driven action plan to improve this program. A future study with a larger sample size is currently being planned to evaluate the overall impact of this program. CLINICAL TRIAL REGISTRATION Retrospectively registered NCT05915156 (22/06/2023).
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Affiliation(s)
- Shashank Ghai
- Department of Political, Historical, Religious and Cultural Studies, Karlstad University, Karlstad, Sweden.
- Centre for Societal Risk Research, Karlstad University, Karlstad, Sweden.
| | - Kathleen Chassé
- Montréal West Island Integrated University Health and Social Services Centre, Montreal, Québec, Canada
| | - Marie-Jeanne Renaud
- Montréal West Island Integrated University Health and Social Services Centre, Montreal, Québec, Canada
| | - Lilian Guicherd-Callin
- Montréal West Island Integrated University Health and Social Services Centre, Montreal, Québec, Canada
| | - André Bussières
- School of Physical and Occupational Therapy, McGill University, Montreal, Québec, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain, Montréal, Québec, Canada
- Departement Chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Diana Zidarov
- Faculté de Médicine, Université de Montréal, Montréal, Québec, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada
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Nordaunet OM, Gjevjon ER, Olsson C, Aagaard H, Borglin G. What about the fundamentals of nursing-its interventions and its continuity among older people in need of home- or facility-based care: a scoping review. BMC Nurs 2024; 23:59. [PMID: 38254154 PMCID: PMC10801980 DOI: 10.1186/s12912-023-01675-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 12/19/2023] [Indexed: 01/24/2024] Open
Abstract
AIM This scoping review investigated and descriptively summarised previous research about fundamental nursing, its focus (what care needs are described, how is it described and by whom is it described), continuity of care (is it described in relation to fundamental nursing) and possible nursing interventions or activities targeting older people's fundamentals of care needs in home- or facility-based care. METHODS This scoping review was carried out following the steps of Arksey and O'Malley's methodology and PRISMA-ScR reporting guidelines. Searches were conducted in PubMed via NIH, CINAHL via EBSCO and PsycInfo via ProQuest for the time period between January 2002 and May 2023. RESULTS Forty-two studies were included where the majority had been conducted in a facility-based care context. Nutrition-or rather nutritional care activities targeting eating and drinking-was the most frequently described fundamental care needs addressed. After this came personal care such as cleansing, dressing, oral care, skin, and foot care. Few studies addressed more than one fundamental care need at the time. The nursing staff described fundamental nursing as complex, comprehensive, and demanding. Older people and relatives described a gap between the fundamental nursing provided and their perceived need for support. Less attention was given to older peoples relational and psychosocial needs. Identified nursing interventions mainly targeted physical care needs. Our findings also implied that interventions focusing on fundamental nursing were described as feasible in practice with favourable or moderate results, while long-term effects were difficult to detect. No studies were identified focusing on fundamental nursing in relation to outcomes such as continuity of care. CONCLUSION Fundamental nursing was mainly described in relation to physical care needs, which were essentially conducted within facility-based care contexts. Interventions and activities primarily focused on one fundamental need at the time, mainly within the physical domain. No nursing interventions were identified focusing on relational and psychosocial needs where continuity of care can be viewed as a relevant outcome. Such limited focus are especially concerning as research has highlighted the importance of that older people with complex care needs can benefit from a holistic and person-centred approach i.e. fundamental nursing. TRIAL REGISTRATION Open Science Framework https://doi.org/10.17605/OSF.IO/XJ39E Protocol: http://dx.doi.org/10.1136/bmjopen-2022-069798.
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Affiliation(s)
- O M Nordaunet
- Department of Bachelor Education (Nursing), Lovisenberg Diaconal University College, Lovisenberggata 15B, NO-0456, Oslo, Norway.
- Institute of Health Sciences, Department of Nursing, Karlstad University, Universitetsgatan 2, 651 88, Karlstad, Sweden.
| | - E R Gjevjon
- Department of Bachelor Education (Nursing), Lovisenberg Diaconal University College, Lovisenberggata 15B, NO-0456, Oslo, Norway
- UiT The Arctic University of Norway, Havnegata 5, 9404, Harstad, Norway
| | - C Olsson
- Department of Bachelor Education (Nursing), Lovisenberg Diaconal University College, Lovisenberggata 15B, NO-0456, Oslo, Norway
- Institute of Health Sciences, Department of Nursing, Karlstad University, Universitetsgatan 2, 651 88, Karlstad, Sweden
| | - H Aagaard
- Department of Bachelor Education (Nursing), Lovisenberg Diaconal University College, Lovisenberggata 15B, NO-0456, Oslo, Norway
| | - G Borglin
- Department of Bachelor Education (Nursing), Lovisenberg Diaconal University College, Lovisenberggata 15B, NO-0456, Oslo, Norway
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Bokhari AH, Berggren M, Noreland D, Wadbro E. Loudspeaker cabinet design by topology optimization. Sci Rep 2023; 13:21248. [PMID: 38040802 PMCID: PMC10692115 DOI: 10.1038/s41598-023-46170-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 10/28/2023] [Indexed: 12/03/2023] Open
Abstract
Using material distribution-based topology optimization, we optimize the bandpass design of a loudspeaker cabinet targeting low frequencies. The objective is to maximize the loudspeaker's output power for a single frequency as well as a range of frequencies. To model the loudspeaker's performance, we combine a linear electromechanical transducer model with a computationally efficient hybrid 2D-3D model for sound propagation. The adjoint variable approach computes the gradients of the objective function with respect to the design variables, and the Method of Moving Asymptotes (MMA) solves the topology optimization problem. To manage intermediate values of the material indicator function, a quadratic penalty is added to the objective function, and a non-linear filter is used to obtain a mesh independent design. By carefully selecting the target frequency range, we can guide the optimization algorithm to successfully generate a loudspeaker design with the required bandpass character. To the best of our knowledge, this study constitutes the first successful attempt to design the interior structure of a loudspeaker cabinet using topology optimization.
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Affiliation(s)
- Ahmad H Bokhari
- Department of Computing Science, Umeå University, 901 87, Umeå, Sweden
| | - Martin Berggren
- Department of Computing Science, Umeå University, 901 87, Umeå, Sweden
| | - Daniel Noreland
- Department of Computing Science, Umeå University, 901 87, Umeå, Sweden
- The Forestry Research Institute of Sweden (Skogforsk), Uppsala Science Park, 75183, Uppsala, Sweden
| | - Eddie Wadbro
- Department of Computing Science, Umeå University, 901 87, Umeå, Sweden.
- Department of Mathematics and Computer Science, Karlstad University, 651 88, Karlstad, Sweden.
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Ghai S, Ghai I, Narciss S. Influence of taping on force sense accuracy: a systematic review with between and within group meta-analysis. BMC Sports Sci Med Rehabil 2023; 15:138. [PMID: 37864268 PMCID: PMC10588111 DOI: 10.1186/s13102-023-00740-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 09/20/2023] [Indexed: 10/22/2023]
Abstract
Taping is a common technique used to address proprioceptive deficits in both healthy and patient population groups. Although there is increasing interest in taping to address proprioceptive deficits, little is known about its effects on the kinetic aspects of proprioception as measured by force sense accuracy. To address this gap in the literature, the present systematic review and meta-analysis was conducted to evaluate the impact of taping on force sense accuracy. A search for relevant literature was conducted following PRISMA guidelines across seven databases and one register. Eleven studies with 279 participants were included in the review out of 7362 records. In the between-group analyses, we found a significant improvement in absolute (p < 0.01) and relative (p = 0.01) force sense accuracy with taping compared to no comparator. Likewise, a significant improvement in absolute (p = 0.01) force sense accuracy was also observed with taping compared to placebo tape. In the within group analysis, this reduction in the absolute (p = 0.11) force sense accuracy was not significant. Additional exploratory subgroup analyses revealed between group improvement in force sense accuracy in both healthy individuals and individuals affected by medial epicondylitis. The findings of this meta-analysis should be interpreted with caution due to the limited number of studies and a lack of blinded randomized controlled trials, which may impact the generalizability of the results. More high-quality research is needed to confirm the overall effect of taping on force sense accuracy.
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Affiliation(s)
- Shashank Ghai
- Department of Political, Historical, Religious and Cultural Studies, Karlstad University, Karlstad, Sweden.
- Centre for Societal Risk Research, Karlstad University, Karlstad, Sweden.
- Psychology of Learning and Instruction, Department of Psychology, School of Science, Technische Universität Dresden, Dresden, Germany.
- Centre for Tactile Internet With Human-in-the-Loop (CeTI), Technische Universität Dresden, Dresden, Germany.
| | - Ishan Ghai
- School of Life Sciences, Jacobs University Bremen, Bremen, Germany
| | - Susanne Narciss
- Psychology of Learning and Instruction, Department of Psychology, School of Science, Technische Universität Dresden, Dresden, Germany
- Centre for Tactile Internet With Human-in-the-Loop (CeTI), Technische Universität Dresden, Dresden, Germany
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Beckman L, Hassler S, Hellström L. Children and youth's perceptions of mental health-a scoping review of qualitative studies. BMC Psychiatry 2023; 23:669. [PMID: 37710217 PMCID: PMC10503183 DOI: 10.1186/s12888-023-05169-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 09/05/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Recent research indicates that understanding how children and youth perceive mental health, how it is manifests, and where the line between mental health issues and everyday challenges should be drawn, is complex and varied. Consequently, it is important to investigate how children and youth perceive and communicate about mental health. With this in mind, our goal is to synthesize the literature on how children and youth (ages 10-25) perceive and conceptualize mental health. METHODS We conducted a preliminary search to identify the keywords, employing a search strategy across electronic databases including Medline, Scopus, CINAHL, PsychInfo, Sociological abstracts and Google Scholar. The search encompassed the period from September 20, 2021, to September 30, 2021. This effort yielded 11 eligible studies. Our scoping review was conducted in accordance with the PRISMA-ScR Checklist. RESULTS As various aspects of uncertainty in understanding of mental health have emerged, the results indicate the importance of establishing a shared language concerning mental health. This is essential for clarifying the distinctions between everyday challenges and issues that require treatment. CONCLUSION We require a language that can direct children, parents, school personnel and professionals toward appropriate support and aid in formulating health interventions. Additionally, it holds significance to promote an understanding of the positive aspects of mental health. This emphasis should extend to the competence development of school personnel, enabling them to integrate insights about mental well-being into routine interactions with young individuals. This approach could empower children and youth to acquire the understanding that mental health is not a static condition but rather something that can be enhanced or, at the very least, maintained.
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Affiliation(s)
- Linda Beckman
- Department of Health Service, Management and Policy, University of Florida, 1125, Central Dr. 32610, Gainesville, FL, USA
- Department of Public Health Science, Karlstad University, Universitetsgatan 2, 651 88, Karlstad, Sweden
| | - Sven Hassler
- Department of Health Service, Management and Policy, University of Florida, 1125, Central Dr. 32610, Gainesville, FL, USA.
| | - Lisa Hellström
- Department of School Development and Leadership, Malmö University, 211 19, Malmö, Sweden
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Iwaya LH, Babar MA, Rashid A, Wijayarathna C. On the privacy of mental health apps: An empirical investigation and its implications for app development. Empir Softw Eng 2022; 28:2. [PMID: 36407814 PMCID: PMC9643945 DOI: 10.1007/s10664-022-10236-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/01/2022] [Indexed: 06/16/2023]
Abstract
UNLABELLED An increasing number of mental health services are now offered through mobile health (mHealth) systems, such as in mobile applications (apps). Although there is an unprecedented growth in the adoption of mental health services, partly due to the COVID-19 pandemic, concerns about data privacy risks due to security breaches are also increasing. Whilst some studies have analyzed mHealth apps from different angles, including security, there is relatively little evidence for data privacy issues that may exist in mHealth apps used for mental health services, whose recipients can be particularly vulnerable. This paper reports an empirical study aimed at systematically identifying and understanding data privacy incorporated in mental health apps. We analyzed 27 top-ranked mental health apps from Google Play Store. Our methodology enabled us to perform an in-depth privacy analysis of the apps, covering static and dynamic analysis, data sharing behaviour, server-side tests, privacy impact assessment requests, and privacy policy evaluation. Furthermore, we mapped the findings to the LINDDUN threat taxonomy, describing how threats manifest on the studied apps. The findings reveal important data privacy issues such as unnecessary permissions, insecure cryptography implementations, and leaks of personal data and credentials in logs and web requests. There is also a high risk of user profiling as the apps' development do not provide foolproof mechanisms against linkability, detectability and identifiability. Data sharing among 3rd-parties and advertisers in the current apps' ecosystem aggravates this situation. Based on the empirical findings of this study, we provide recommendations to be considered by different stakeholders of mHealth apps in general and apps developers in particular. We conclude that while developers ought to be more knowledgeable in considering and addressing privacy issues, users and health professionals can also play a role by demanding privacy-friendly apps. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s10664-022-10236-0.
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Affiliation(s)
- Leonardo Horn Iwaya
- Centre for Research on Engineering Software Technologies, The University of Adelaide, Adelaide, SA 5005 Australia
- Cyber Security Cooperative Research Centre (CSCRC), Joondalup, Australia
- Privacy and Security (PriSec), Department of Mathematics and Computer Science, Karlstad University, Karlstad, Sweden
| | - M. Ali Babar
- Centre for Research on Engineering Software Technologies, The University of Adelaide, Adelaide, SA 5005 Australia
- Cyber Security Cooperative Research Centre (CSCRC), Joondalup, Australia
| | - Awais Rashid
- Bristol Cyber Security Group, Department of Computer Science, University of Bristol, Bristol, UK
- REPHRAIN: National Research Centre on Privacy, Harm Reduction and Adversarial Influence Online, Bristol, UK
| | - Chamila Wijayarathna
- Centre for Research on Engineering Software Technologies, The University of Adelaide, Adelaide, SA 5005 Australia
- Cyber Security Cooperative Research Centre (CSCRC), Joondalup, Australia
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Stephen DA, Nordin A, Nilsson J, Persenius M. Using mHealth applications for self-care - An integrative review on perceptions among adults with type 1 diabetes. BMC Endocr Disord 2022; 22:138. [PMID: 35614419 PMCID: PMC9131554 DOI: 10.1186/s12902-022-01039-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 05/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Individually designed interventions delivered through mobile health applications (mHealth apps) may be able to effectively support diabetes self-care. Our aim was to review and synthesize available evidence in the literature regarding perception of adults with type 1 diabetes on the features of mHealth apps that help promote diabetes self-care, as well as facilitators and barriers to their use. An additional aim was to review literature on changes in patient reported outcome measures (PROMs) in the same population while using mHealth apps for diabetes self-care. METHODS Quantitative and qualitative studies focusing on adults aged 18 years and over with type 1 diabetes in any context were included. A systematic literature search using selected databases was conducted. Data was synthesised using narrative synthesis. RESULTS We found that features of mHealth apps designed to help promote and maintain diabetes self-care could be categorized into self-care data monitoring, app display, feedback & reminders, data entry, data sharing, and additional features. Factors affecting the use of mHealth apps reported in the literature were personal factors, app design or usability factors, privacy and safety factors, or socioeconomic factors. Quality of life and diabetes distress were the most commonly reported PROMs in the included studies. CONCLUSION We are unable to reach a conclusive result due to the heterogeneity of the included studies as well as the limited number of studies reporting on these areas among adults with type 1 diabetes. We therefore recommend further large-scale studies looking into these areas that can ultimately improve mHealth app use in type 1 diabetes self-care. SYSTEMATIC REVIEW REGISTRATION Prospero CRD42020157620 .
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Affiliation(s)
- Divya Anna Stephen
- Department of Health Sciences, Faculty for Health, Science And Technology, Karlstad University, Karlstad, Sweden.
| | - Anna Nordin
- Department of Health Sciences, Faculty for Health, Science And Technology, Karlstad University, Karlstad, Sweden
- Department of Health, Learning and Technology, Nursing and Medical Technology, Luleå University of Technology, Luleå, Sweden
| | - Jan Nilsson
- Department of Health Sciences, Faculty for Health, Science And Technology, Karlstad University, Karlstad, Sweden
- Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Mona Persenius
- Department of Health Sciences, Faculty for Health, Science And Technology, Karlstad University, Karlstad, Sweden
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Abstract
In recent years, telemedicine has been increasingly incorporated into medical practice, a process which has now been accelerated by the COVID-19 pandemic. As telemedicine continues to progress, it is necessary for medical institutions to incorporate telemedicine into their curricula, and to provide students with the necessary skills and experience to effectively carry out telemedicine consultations. The purposes of this study are to review the involvement of medical students with telemedicine and to determine both the benefits and the challenges experienced. A literature review on the MEDLINE; CINAHL Plus; APA PsychInfo; Library, Information Science and Technology Abstracts; and Health Business Elite databases was performed on September 7, 2020, yielding 561 results. 33 manuscripts were analysed, with the main benefits and challenges experienced by medical students summarized. In addition to increasing their understanding of the importance of telemedicine and the acquisition of telemedicine-specific skills, students may use telemedicine to act as a valuable workforce during the COVID-19 pandemic. Challenges that students face, such as discomfort with carrying out telemedicine consults and building rapport with patients, may be addressed through the incorporation of telemedicine teaching into the medical curricula through experiential learning. However, other more systemic challenges, such as technical difficulties and cost, need to be examined for the full benefits of telemedicine to be realized. Telemedicine is here to stay and has proven its worth during the COVID-19 pandemic, with medical students embracing its potential in assisting in medical clinics, simulation of clinical placements, and online classrooms.
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Affiliation(s)
- Chelsea Cheng
- School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Hilary Humphreys
- Department of Clinical Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Microbiology, Beaumont Hospital, Dublin, Ireland
| | - Bridget Kane
- Karlstad University Business School, Karlstad, Sweden
- Centre for Health Policy, Management, Trinity College Dublin, Dublin, Ireland
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Svensson K, Tanner E, Gennings C, Lindh C, Kiviranta H, Wikström S, Bornehag CG. Prenatal exposures to mixtures of endocrine disrupting chemicals and children's weight trajectory up to age 5.5 in the SELMA study. Sci Rep 2021; 11:11036. [PMID: 34040006 PMCID: PMC8155069 DOI: 10.1038/s41598-021-89846-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 04/21/2021] [Indexed: 12/16/2022] Open
Abstract
Exposure to endocrine disrupting chemicals (EDCs) may impact early growth, although information is limited on exposure to combination of multiple EDCs. We aimed to evaluate the effect of prenatal exposure to EDC mixtures on birthweight z-scores and childhood weight trajectories. Twenty-six proven and suspected EDCs, were analyzed in prenatal urine and blood samples from 1118 mothers participating in the Swedish Environmental Longitudinal Mother and child Asthma and allergy (SELMA) study. Two growth parameters were estimated from each child's weight trajectory from birth to 5.5 years of age: infant growth spurt rate and age at infant peak growth velocity (PGV). Weighted quantile sum (WQS) regression was used to estimate the mixture effect and identify chemicals of concern. A one-unit increase in the EDC mixture WQS index, was associated with decreased birthweight z-scores of 0.11 (95% CI - 0.16, - 0.06), slower infant growth spurt rate of 0.01 (95% CI - 0.03, - 0.01, on the log10 scale), and delayed age at infant PGV of 0.15 months (95% CI 0.07, 0.24) after adjusting for potential confounders. Stratified analysis by sex, showed that delayed age at infant PGV was mostly observed in girls with 0.51 months (95% CI 0.26, 0.76). Identified chemicals of concern included perfluorinated alkyl substances (PFAS), Triclosan, phthalates, non-phthalate plasticizers, bisphenols, polycyclic aromatic hydrocarbons, pesticides and PCBs. Prenatal exposure to EDC mixtures was associated with lower birthweight and altered infant weight gain trajectories.
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Affiliation(s)
- Katherine Svensson
- Department of Health Sciences, Karlstad University, Universitetsgatan 2, 651 88, Karlstad, Sweden
| | - Eva Tanner
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Chris Gennings
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Christian Lindh
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Hannu Kiviranta
- Environmental Health Unit, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Sverre Wikström
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Carl-Gustaf Bornehag
- Department of Health Sciences, Karlstad University, Universitetsgatan 2, 651 88, Karlstad, Sweden.
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Gustavsson J, Carlsson G, McNamee MS. Barriers and Facilitators for Implementation of Individualized Fire Safety (IFS) in Sweden. Fire Technol 2021; 57:2707-2736. [PMID: 34054135 PMCID: PMC8149138 DOI: 10.1007/s10694-021-01138-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 04/30/2021] [Indexed: 06/12/2023]
Abstract
In 2010, the Swedish Civil Contingencies Agency (MSB) announced a "vision zero" of zero fire deaths in Sweden by 2050. Studies into fire deaths have identified that certain risk groups, including but not limited to older people, are overrepresented in fire death statistics in Sweden. The MSB has developed guidelines for how individualised fire safety (IFS) can be implemented in local communities for risk groups, in support of their vision zero for fire deaths. This paper presents the results of an interview study with a selection of Swedish municipalities to further explore how municipalities are working with IFS programs for community dwelling older people. The Consolidated Framework for Implementation Research has been used to analyse data developed through semi-structured interviews, from an analysis of the delegation of authority from MSB to local level and assessment of secondary documentation from national, regional and local organisations. The analysis has identified that IFS has, indeed, been implemented to varying degrees in Sweden, but that there are both facilitators and barriers which can be further leveraged to improve the implementation of IFS in the future.
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Affiliation(s)
- Johanna Gustavsson
- Risk and Environmental Studies, Centre for Societal Risk Research, Karlstads Universitet, Universitetsgatan 2, 651 88 Karlstad, Sweden
| | - Gunilla Carlsson
- Active and Healthy Ageing Research Group, Department of Health Sciences, HSC, Lunds Universitet, Margaretavägen 1 B, 22240 Lund, Sweden
| | - Margaret S. McNamee
- Division of Fire Safety Engineering, Lund University, John Ericssons väg 1, 221 00 Lund, Sweden
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