为环境战略研究设计一个多重目标方法:伦讷河流域对话

伦讷(Rnnea)河流域对话作为与利益相关者有关的、多学科研究的多目标方法而发展起来。本文描述了流域对话的背景及其设计的多重目标,并评价了对话设计。流域对话作为一种方法,其预期的三个平行目标是:1)收集定性研究数据;2)推进利益相关者参加水管理;3)提供一个学科综合的实例。吸取来自类似研究或利用焦点群体和类似技术的利益相关者参加的项目的经验,该文对研究目标如何实现以及如何取得实现不同目标之间的平衡进行了评定。它考虑了流域对话作为回答我们研究问题的一项成功的研究方法,尤其表现在其"新的"构思特征上,如异质的群体,(长时间的)有组织的采访,以及外部的调节。结论是流域对话是实现瑞典多学科水体管理研究计划(VASTRA)多重目标的一个有效方法。

A Craniometer with a Headband Can Be a Reliable Tool to Measure Plagiocephaly and Brachycephaly in Clinical Practice

Objective: The aim of the study was to determine the intra- and inter-reliability for measuring infants with plagiocephaly and brachycephaly with a craniometer when using a marked headband as landmarks. Subjects: Six physiotherapists and eight infants participated in the study. Methods: The physiotherapists measured all infants twice;each infant was measured with the same headband and craniometer. The physiotherapists were blinded to measurements carried out by their colleagues. The infants with their parents changed places in the room to minimize the possibility that the physiotherapists would remember their first measurements of any infant. Results: There was a high intra- and inter-reliability, for intra-reliability ICC 0.96 to 0.99 and for inter-reliability ICC 0.98. Conclusion: It is possible to achieve a high intra- and inter-reliability when using a headband and craniometer when measuring cranial vault asymmetry for plagiocephaly and cephalic ratio for brachycephaly.

High birth weight is a risk factor of dental caries increment during adolescence in Sweden

This study aimed to assess whether birth weight is associated with dental caries during the teenage period. In this register-based cohort study, all children of 13 yrs of age (n = 18,142) who resided in the county of Stockholm, Sweden, in 2000 were included. The cohort was followed until individuals were 19 yrs of age. Information regarding dental caries was collected from the Public Health Care Administration in Stockholm. Data concerning prenatal and perinatal factors and parental socio-demographic determinants were collected from the Swedish Medical Birth Register and National Registers at Statistics Sweden. The final logistic regression model showed that birth weight (≥4000 g), adjusted for potential confounders, was significantly associated with caries increment (DMFT ≥ 1) between 13 and 19 yrs of age (OR: 1.29, 95% CI = 1.13 - 1.48). The relatively enhanced risk OR was further increased from 1.29 to 1.52 in sub- jects with birth weight (≥4600 g). On the contrary, subjects with birth weight (<2500 g) exhibited a sig- nificantly lower risk (OR: 0.67, 95% CI = 0.50 - 0.89) for exhibiting caries experience (DMFT ≥4) at 19 yrs of age. In conclusion, birth weight can be regarded as a predictor for dental caries and birth weight (≥4000 g) is especially a risk factor for caries increment during adolescence.

富养化问题的综合治理:公众参与、价格政策和流域模型

瑞典水管理研究计划（VASTRA）第二阶段的工作重点在于分析水体富养化问题以及瑞典水资源有效、可持续管理的可行性及不足之处。本项目由瑞典环境战略研究基金会（MISTRA）资助。本研究围绕以下三个方向进行：

Patient Experiences of Medical Screening Performed by the Dental Services:A Qualitative Study

Objective: To explore how medical screening performed by the dental service was perceived from the patient’s perspective. Material and methods: Medical screening for high blood pressure and high plasma glucose was performed on 170 patients at a dental clinic in a small town in central Sweden. Seventeen individual interviews were conducted with a strategic sampling of these patients. The interviews were recorded and transcribed. The transcriptions were coded and categorized in a manifest analysis, followed by a latent, interpretive analysis. Results: The manifest analysis resulted in three categories: Positive attitude to screening and dental professionals which need to have specific knowledge of medical screening;Dental care which provides continuity but is not a neutral environment;and Feedback on the medical screening results and desired cooperation between dental and health care services. The latent analysis pointed out the importance of the patient’s feeling that the procedure is carried out properly and safely, and requests for clear feedback concerning the results of the screening. Conclusions: The interviewees experienced the dental care service as providing continuity. They would like to have regular medical screenings at their regular dental appointments to identify risks of cardiovascular diseases and diabetes. However, they expressed that it was important for the dental care staff to have the necessary medical knowledge. They also wanted good cooperations between the dental and health care services, with clear feedback to the patients about both positive and negative results and, when appropriate, referrals to the health care service.

Factors That Promote Remission in Individuals with Schizophrenia

The knowledge about factors contributing to remission among individuals with schizophrenia is still missing. Studies show that the number of individuals’ reaching remission is varying among psychiatric outpatient care centres. Therefore, the purpose was to investigate case managers (CM) perception of care interventions promoting remission. Semi-structured interviews were conducted with CM (n = 12) and data were analysed with qualitative content analysis. The results show that CM needs to possess competence, master assessment structure and process. These key-points appear to be of crucial importance for a successful promotion of remission among individuals with schizophrenia.

Opposite latitudinal gradients for species richness and phylogenetic diversity of endemic snakes in the Atlantic Forest

The decrease in species richness toward higher latitudes is an expected biogeographical pattern.This pattern could be related to particular envi-ronmental constraints and the evolutionary history of clades.However,species richness does not fully represent the evolutionary history of the clades behind their distributions.Phylogenetic diversity better clarifies the role of historical factors in biogeographical patterns.We analyzed envi-ronmental and historical drivers related to latitudinal variation in species richness and phylogenetic diversity of Atlantic Forest endemic snakes.We implemented species distribution models,from voucherbased locality points,to map the snake ranges and diversity.We used generalized additive mixed models to evaluate the relationships among the diversity metrics and area,topographical roughness,and past climate change velocity since the Last Maximum Glacial in the Atlantic Forest latitudinal gradient.Contrary to the expected general pattern,species richness was higher toward higher latitudes,being positively related to past climatic stability.Species richness also increased with total area and higher topographical roughness.Phylogenetic diversity,on the other hand,showed opposite relationships related to the same factors.Phylogenetic diversity increased with lower climatic stability in lower latitudes.Thus,dimensions of diversity were affected in different ways by historical and environmental constraints in this unique and threatened biodiversity hotspot.

Childhood overweight and risk of obesity-related adult cancer in men

Dear Editor,The global burden of cancer is significant.The list of malignancies regarded as obesity-related continues to expand as evidence accumulates[1,2].Fueled by the ongoing obesity epidemic,obesity has emerged as one of the most important preventable causes of cancerworldwide[1,3].Given the long latency periods of many obesity-related adult cancers,risk factors with onset during early age and accumulation of risks during one’s life course are likely to be of importance[4].