The Evidenced Effects of Early Childhood Interventions to Promote Mental Health and Parenting in the Nordic Countries: A Systematic Review

Thefirst years of life and the family context are key to the promotion and protection of children’s health and well-being,emphasizing the need for interventions aimed to support families with young children.This review aimed to explore the effectiveness of early childhood interventions developed for promoting mental health and parenting among families with young children in the Nordic countries.Six electronic databases were systematically searched,and 20 articles covering 16 studies applying various quantitative and qualitative methods met the study inclusion criteria.The studied interventions were assessed as universal health-promoting interventions and health-promoting interventions with elements of prevention.Outcomes of interest encompassed mental health,related risk and protective factors among the parents and/or the children,or child-parent interaction.The results from studies applying statistical methods show significant improvements in parents’self-efficacy,self-esteem,and parental satisfaction,while few improvements in parents’social support or parental relationship were identified.Improvements in social support and parental relationships were however reported in qualitative studies.Most quantitative studies reporting on parents’mental health problems and stress found a significant decrease,and qualitative studies highlighted experienced positive effects on mental health and well-being.The majority of stu-dies reporting on children’s mental health and/or development as well as strengths and difficulties indicated a statistically significant positive development.No significant changes were however found for existing behavioral problems.The majority of studies examining parenting strategies and/or parent-child interaction found signifi-cant positive changes after the interventions.In sum,althoughfindings are heterogeneous,early childhood inter-ventions show various positive effects on the parenting and mental health of both children and their parents.The fact that different types of initiatives have been developed and implemented can be seen as an advantage,con-sidering the varying needs and expectations of different families.

Impact of sustainability on financial distress in the air transport industry:the moderating effect of Asia–Pacific

The tremendous impact of the coronavirus pandemic on the global aviation industry has led to many cases of airline financial distress and bankruptcy.The Asia–Pacific region(APAC)contains more than half of the world’s population,and its airlines had the highest profit margin of any region.In this study,we investigate whether corporate sustainability practice can reduce the financial distress risk of air carriers,and,if so,what would the effect be in APAC?We first examine the relationship between environmental,social,and governance disclosure and the likelihood of financial distress of airlines as measured by the Altman Z″-score.Second,we analyze the moderating role of being an APAC airline in this relationship.The findings support the claim that implementing environmental actions may increase financial distress risk,and by improving social and governance activities,airlines can mitigate the risk of financial distress.The negative influence of the environmental pillar and the positive influence of the social pillar can be smaller for APAC airlines.Our study provides empirical evidence of the influence of environmental,social,and governance(ESG)on the likelihood of financial distress in the airline industry.Moreover,we analyze the moderating role of being an APAC airline in the relationship between sustainability and financial distress.This study has significant implications for executives,managers,and policymakers in the aviation industry on ESG strategy decisions and the general issue of sustainability.

“I Dread the Heart Surgery but it Keeps My Child Alive”—Experiences of Parents of Children with Right Ventricular Outflow Tract Anomalies during the Assessment for Cardiac Reoperation

Background:Parents of children with complex right ventricular outflow tract(RVOT)anomalies are confronted with their child’s need for heart surgery early in life and repeated reoperations later on.Preoperative assessment needs to be performed whenever an indication for reoperation is suspected.The aim was to illuminate the experiences of parents of children diagnosed with RVOT anomalies,in particular,how they experience their child’s heart disease and everyday life during the assessment and after the decision on whether to perform a reoperation.Method:Individual interviews(n=27)were conducted with nine parents on three occasions between 2014 and 2016 and analyzed using reflexive thematic analysis.Results:The analysis resulted in the following five main coexisting themes:The heart surgery keeps my child alive illuminates parents’experiences during and after the assessment and emphasizes that heart surgery,although dreaded,is central for their child’s survival;Everyday struggles illuminates the different struggles parents had to face to ensure that their child would be in the best possible condition;the remaining three themes,Unconditional love,Trust in life,and Togetherness,illuminate the ways in which the parents gained inner strength and confidence in their everyday lives.Conclusion:Although the parents were grateful for the assessment and had learned to navigate among the fears it aroused,they experienced several distressing situations during the assessment process that should be addressed.By inviting both the parents and their child to participate in the child’s care,individualized support can take into account the needs of both parents and child.

我国三级中医医院信息化人才队伍现状分析与思考

基于全国487家三级中医医院信息化建设情况调查数据,分析三级中医医院信息化人才队伍建设现状及存在的问题,提出发展中医医院信息化人才的建议,包括加强信息管理部门建设,优化专业人才配置,重视信息化人才培养,提升科研创新能力。

超越自我之像:瑞典动画纪录片的语境及发展

新千年的前几十年迎来了纪录片的某种复兴,特别是将真人实拍和动画影像相结合的纪录片,乃至完全通过动画呈现的纪录片。除加拿大和英国外,瑞典成为多产的动画电影国度,其动画电影特色正是纪录片与动画的融合。界定动画纪录片;框架式地梳理瑞典的动画和纪录片历史,强调其为后来动画纪录片发展提供的基础特征;关注动画纪录片制作和社会背景因素,分析动画纪录片为什么成为瑞典动画界的一个突出特征,并列举具有代表性的瑞典动画纪录片作品和电影人。

Shared Decision-Making after Implementation of the Chronic Care Model (CCM)—An Evaluative Approach

Background: In paternalistic models, healthcare providers’ responsibility is to decide what is best for patients. The main concern is that such models fail to respect patient autonomy and do not promote patient responsibility. Aim: To evaluate mental healthcare team members’ perceptions of their own role in encouraging elderly persons to participate in shared decision-making after implementation of the CCM. The CCM is not an explanatory theory, but an evidence-based guideline and synthesis of best available evidence. Methods: Data were collected from two teams that took part in a focus group interview, and the transcript was analysed by means of qualitative thematic analysis. Results: One overall theme emerged—Preventing the violation of human dignity based on three themes, namely, Changing understanding and attitudes, Increasing depressed elderly persons’ autonomy and Clarifying the mental healthcare team coordinator’s role and responsibility. The results of this study reveal that until recently, paternalism has been the dominant decision-making model within healthcare, without any apparent consideration of the patient perspective. Community mental healthcare can be improved by shared decision-making in which team members initiate a dialogue focusing on patient participation to prevent the violation of human dignity. However, in order to determine how best to empower the patient, team members need expert knowledge and intuition.

Cardiac Self-Efficacy and Fatigue One Year Post-Myocardial Infarction

Background: Patients and clinicians report that fatigue post-myocardial infraction (MI) is a bothersome symptom during recovery. Aim: The objective of this study was to explore whether there is a relationship between fatigue, cardiac self-efficacy, stress, breathlessness and physical activity one year post-MI. Method: Data were collected from a sample of patients diagnosed with MI one year earlier (n = 125) who responded to a questionnaire package measuring fatigue, cardiac self-efficacy, physical activity and the symptoms breathlessness and stress. Correlation and regression analyses were preformed to evaluate which factors were related to fatigue. Results: The results showed that cardiac self-efficacy was associated with fatigue (r = −0.611, p = 0.01) and the regression model, controlling for breathlessness and stress, showed an explained variance of 72% one year post-MI. Physical activity was not significant in this model and did not predict fatigue during this time period. Conclusion: Post-MI fatigue-relief support should rely not only on identification of fatigue and other concurrent symptoms, but also on identification of cardiac self-efficacy.

Unlicensed Personnel’s Experience of Digital Signing for Medication Administration in Municipal Healthcare

Aim: To describe unlicensed personnel’s experience of digital signing lists via a smartphone application for the distribution of medication in municipal healthcare in Western Sweden. Design: A qualitative and quantitative design was used. Methods: The study included 48 unlicensed personnel, 28 of whom answered an open-ended questionnaire, while an additional 20 volunteered for individual interviews. The material was analysed by qualitative content analysis. Results: The results indicate that digital signing lists via a smartphone application are feasible, and efficient and facilitate the work. However, some aspects negatively affected the sense of security, meetings with patients and quality of care, such as an insufficient internet signal in some rural areas, difficulty remembering the password, as well as the change of focus from patient to smartphone. To improve quality of care and the meeting with the patient, it is crucial that the technology works and that unlicensed personnel develop technical skills.

Social Capital and Depressive Ill-Health——An Evaluative Approach to the Implementation of the Chronic Care Model (CCM)

Background: Social capital has been described as a person’s sense of belonging as a result of the number and type of relationships she/he has, in which trust and reciprocity are especially important. Aim: To illuminate older persons’ experiences of social capital and depressive ill-health after implementation of the CCM. Methods: Data were collected from nine participants resident in two districts of Norway by means of individual in-depth interviews. A qualitative hermeneutic analysis was performed. Results: Two overall themes, desire for a guardian and a wish for independence despite being dependent, and two themes emerging from the analysis. The first theme—searching for protection was based on three sub-themes overwhelmed by the emotional pain of other people, a sense of exclusion and worries about the future, while the second theme—the need for a relationship with trustworthy persons comprised two sub-themes, namely, emotional pain was not understood and powerlessness to change the situation. The result of this study highlights the need for greater understanding on the part of healthcare professionals of how older persons manage their social relationships. Healthcare professionals require more knowledge about how negative self-beliefs held by older persons suffering from emotional pain, which can lead to reduced ability to trust other people. Another consequence is that fear of being dependent on other people can result in unwillingness to admit the need for help. Conclusion: This study highlights the lack of social capital in older persons who suffer from depressive ill-health. The implementation of the CCM does not appear to improve the situation. Older persons need to be more aware of their social needs and productive interactions in order to protect themselves and obtain support from their social network.

Men’s Experience of Difficulties during First Year Following Myocardial Infarction—Not Only Fatigue

Recovery from a myocardial infarction (MI) can be a very difficult process and some patients are also stricken by fatigue. The aim of the study was to describe the difficulties experienced by men with fatigue during the first year following their MI. The study was conducted using qualitative content analysis of semi-structured interviews with nine men in working age (mean age: 55 years) with verified fatigue (≥12 of 20 on the Multidimensional Fatigue Scale with a mean of 17) one year after their MI. During the first year after the MI the men suffering from fatigue experienced various difficulties in terms of both themselves and the care received. The analysis generated three themes with difficulties described by the interviewed men. 1) Going through involuntary change: not recognizing their body and the inability to recognize themselves. 2) Lacking individualized care: To be denied satisfactory health care treatment and to be denied respectful treatment. 3) Not being seen in the light of the social context: The MI affects the whole family and caregivers do not pay attention to the family. In order to make both the patient and relatives feel secure and cared for, it is essential that caregivers be aware of the importance of providing individualized care over time with particular attention for the patient’s social context.

Symptoms, Illness Perceptions, Self-Efficacy and Health-Related Quality of Life Following Colorectal Cancer Treatment

Introduction: Lower health-related quality of life (HRQoL) is associated with fatigue, poor mental and poor gastrointestinal health during the first three months after colorectal cancer (CRC) treatment. Research indicates that maintaining usual activities has a positive impact on HRQoL after treatment for CRC. Illness perceptions have been associated with HRQoL in other cancer diseases, and self-efficacy has been associated with HRQoL in gastrointestinal cancer survivors. Our knowledge about illness perceptions and self-efficacy in relation to maintaining everyday activities and HRQoL following CRC treatment is incomplete. Aim: To explore associations between HRQoL, fatigue, mental health, gastrointestinal health, illness perceptions and self-efficacy in relation to maintaining everyday activities, three months after surgical CRC treatment. A further aim was to test the Maintain Function Scale in a CRC population. Method: The study was cross-sectional. Forty-six persons participated. Data were collected using questionnaires. Descriptive and analytical statistics were used. Results: Persons who were more fatigued, depressed, worried, and had more diarrhea were more likely to report lower HRQoL. Increased fatigue and diarrhea were associated with decreased HRQoL. Concerning illness perceptions, persons who reported negative emotions and negative consequences of CRC were more likely to report lower HRQoL. Persons scoring higher on self-efficacy were more likely to report higher HRQoL. Increased self-efficacy was associated with increased HRQoL. The Maintain Function Scale was suitable for assessing self-efficacy in relation to maintaining everyday activities. Conclusions: Nursing support to improve self-efficacy and illness perceptions and to minimize symptoms during recovery should have a favorable impact on HRQoL.

Experimental Validation and Application of a Phased Array Ultrasonic Testing Model on Sound Field Optimization

In safety dominant industries, nondestructive evaluation (NDE) is crucial in quality assurance and assessment. Phased array ultrasonic testing (PAUT) as one of the NDE methods is more promising compared with conventional ultrasonic testing (UT) method in terms of inspection speed and flexibility. To incorporate PAUT, the techniques should be qualified, which traditionally is performed by extensive physical experiments. However, with the development of numerical models simulating UT method, it is expected to complement or partly replace the experiments with the intention to reduce costs and operational uncertainties. The models should be validated to ensure its consistency to reality. This validation work can be done by comparing the model with other validated models or corresponding experiments. The purpose of current work focuses on the experimental validation of a numerical model, simSUNDT, developed by the Chalmers University of Technology. Validation is conducted by comparing different data presentations (A-, B- and C-scan) from experimental and simulated results with some well-defined artificial defects. Satisfactory correlations can be observed from the comparisons. After the validation, sound field optimization work aiming at retrieving maximized echo amplitude on a certain defect can be started using the model. This also reveals the flexibility of parametric studies using simulation models.

Prospects of Robot Laser Cutting in the Era of Industry 4.0

Laser cutting is a non-contact thermal cutting process and an integral part of manufacturing. In metal processing, laser cutting is at the forefront of the manufacturing chain followed by joining and manufacturing processes like welding. The future of metal manufacturing processes like laser cutting shall rely on intelligent systems such as automation and robotics based on the advancement of technology and digital transformation spearheaded by Industry 4.0. Moreover, the digital transition where robots and automated systems are key drivers creates a broader platform to utilize energy-efficiency materials. Such energy-efficient materials include high-strength steels (HSS) for structural applications (e.g. bio-energy structures, wind turbines, ice-going vessels) onshore, offshore and in the Arctic region. The aim of this paper is to elucidate the prospects of robot laser cutting systems in the framework of integrated metal manufacturing in future factories. Previous studies on laser cutting technologies are examined based on scientific and industrial perspectives. Robot laser cutting system is compared with the well-known flat-bed laser cutting CNC machine in several aspects including flexibility in manufacturing, ease for digitalization, off-line capabilities and investment analysis. The findings shall help to determine the competitiveness of robot laser cutting systems with flat-bed laser cutting CNC machines, especially when considering metal manufacturing in small and medium-sized enterprises (SMEs). The outcome of this study is to stir up experimental and computational research on robot laser cutting systems of metals, and help companies in their decision-making process when deciding which laser cutting system will best suit their manufacturing operations in the future.

Microstructure of Plasma Sprayed Al2O3-3wt%TiO2 Coating Using Freeze Granulated Powder

This study is aiming at controlling the microstructure of plasma sprayed Al2O3-TiO2 composite coatings using freeze granulated powders. As sprayed and sintered Al2O3 + 3wt%TiO2 powders were air plasma sprayed with industry process parameters and compared with a commercial powder. The resulting coatings were investigated with respect to powder flowability, porosity and microstructure of the granules. The results showed that microstructure and melting fraction in the coatings could be tailored with the freeze granulation process and heat treatment conditions.

Experiences of Screening for Abdominal Aortic Aneurysm—In and Out on Five Minutes

Background: The purpose of AAA screening is to prevent rupture and mortality. Screening for life-threatening diseases is a double-edged sword. The aim of this study is to describe 65-year-old men’s experiences of health related quality of life and anxiety after screening for Abdominal Aortic Aneurysm, and experiences of information and reasons for not participating. Methods: 368 men answered Short Form 36 (SF-36), and anxiety and depression scale (HAD). 72 telephone interviews were conducted with the participants and 77 with those who declined to take part in the screening programme. Results: The SF-36 domains of Physical Function and Role limitations due to emotional health problems were significantly better for men who had undergone screening compared to a matched population. Compared to non-smokers, smokers had lower values in the SF-36 domains of general health perceptions, social functioning, role limitations due to emotional health problems and mental health. 80% of patients did not experience any form of anxiety/panic in connection with the screening invitation. Of the men who did not participate, 56% stated that they would like to be screened or had already undergone the examination. Conclusion: The men who underwent the investigation were healthier in some of the SF-36 domains than the general population. The participants did not experience any great anxiety before the screening and despite the short duration of the examination.

酸激发试验:对健康人群和患者食管黏膜上皮组织结构的影响

The histological changes that occur in the squamous epithelium in response to acute acid challenge was examined in healthy controls and proton pump inhibitor- treated gastroesophageal reflux disease (GERD) patients and related to the state of untreated erosive GERD in a saline- contro- lled, randomized perfusion study. In the basal state a stepwise significant increase in the thickness of the basal cell layer, papillary length, and dilatation of intercellular spaces (DIS) was seen when the three groups were compared. Acid perfusion induced a slight increase in the height of the basal cell layer mainly in healthy volunteers; this layer appears to be reactive to acute acid challenge as well as to acid suppressive therapy. DIS increases promptly in response to acute acid exposure in the healthy epithelium but no changes were seen in the lengths of the papillae or regarding DIS in the GERD patients. A protective effect of luminal nitric oxide on DIS development is suggested.

Eddy Current Losses in Solid Pole Shoes in a Two-Pole Permanent Magnet Motor

The aim of this paper is to present the eddy current losses in solid pole shoes in a permanent magnet two-pole electric motor. In the presented paper, the authors have chosen to work with three different analytical models, Carter’s theory, Gibb’s theory and Lawrenson’s theory, each with different degree of accuracy and simplifications. The results from the analytical models all present relatively low eddy current losses, giving the designer valuable arguments to utilize solid pole shoes, as a rotor with solid poles is from a construction point of view a more suitable choice, increasing the mechanical stability and reducing the production cost, compared to the laminated design.

The lived experience of a 24-hour support center for persons with psychiatric disabilities: Making me feel almost like an ordinary person

This study illuminates nine psychiatric disabled persons’ lived experience of a newly established community-based service center open around the clock. This new 24-hour support center (SC) was established in 2011 in a Swedish community to better match and facilitate the disabled persons’ needs. In order to illuminate the disabled person’s experiences individual interview was performed. A phenomenological-hermeneutical method inspired by Paul Ricoeur was used to interpret the texts. After a naive reading, a structural analysis revealed two themes: 1), becoming aware of myself as a person, and 2) having a lifeline and belongingness. The comprehensive understanding was interpreted as meaning “Making me feel almost like an ordinary person”, which incorporated the person’s past with their present together with a direction for the future and hope for a more fulfilling life.

Desorption Behavior and Thermogravimetric Analysis of Bio-Hardeners

In this work,the thermal degradation and drying of bio-hardeners are investigated.Four bio-hardeners based on exudates of Senegalia senegal,Vachellia nilotica,Vachellia seyal,and Acacia siebteriana were analyzed by FTIR and thermogravimetric analysis,and a desorption study was also conducted.The analysis by infrared spectroscopy indicates the existence of oligomers of different types all giving 5-hydroxy-2-hydroxymethylfuran and 2,5-dihydroxymethylfuran which are then the real hardening molecules.The pyrolysis of these extracts reveals three main regions of mass loss,a first region is located between 25℃and 110℃reflecting the loss of water from the adhesive and the formation of some traces of volatile organic compounds such as CO_(2)and CO,a second zone characterized by the release of CO,CO_(2)and CH4 gases with peaks between 110°and 798.8℃.At the end of the analysis,about 22%of the initial mass remains undecomposed,this mass corresponds to the rigid segments of the bio-hardener which are not completely decomposed.