Search Results (832)

Background: Very preterm infants are at increased risk of impairment. The objective was to explore the effect of immediate parent–infant skin-to-skin contact at very preterm birth on cognition, motor, social, and language development during the two first years. Methods: The Immediate Parent-Infant Skin-To-Skin Study (IPISTOSS) was a clinical trial with inclusions between April 2018 to June 2021, in three Scandinavian neonatal intensive care units. Infants were randomised at gestational age 28 + 0 to 32 + 6 weeks plus days, to immediate and continuous skin-to-skin contact at birth or conventional care, during the first six hours of life. Results: At three months, 42 infants underwent a General Movement Assessment. At four and 12 months, 69 and 62 infants, respectively, were assessed with the Alberta Motor Infant Scale. At 24 months, language and cognition were tested in 62 infants with the Bayley Scales of Infant and Toddler Development, third edition. Parents completed the Modified Checklist for Autism in Toddlers for 57 infants. There were no significant differences in motor development, cognition, or autism spectrum disorders. A significant difference in language scores in favour of immediate skin-to-skin contact, was found, when adjusted for fathers’ education, mothers’ education, and infants’ sex, Beta (95% CI): 32.00 (7.57, 56.43) p = 0.01, 11.51 (8.94, 55.06) p = 0.007, and 32.00 (7.85, 56.15) p = 0.01, respectively. Conclusions: Skin-to-skin contact immediately at birth did not enhance cognition, motor, or social development during the first two years of life but may have been important for language skills. Our findings support the World Health Organisation guidelines recommending iSSC for preterm born infants in all settings. Full article

School development is important in society. This study investigates how questions work as an information carrier between different levels in a school organization. The questions are organized in a hierarchy, with the regional steering committee’s overarching question at the top and then distributed further on to the municipalities to interpret the questions that engage with their practice management. At the bottom of the hierarchy are the schools, and they create the final professional research questions that engage with day-to-day practice. Previous studies show that supporting and challenging each other can lead to the development of new knowledge in the organization. This is an empirical study based on documents with questions from the three levels (regional, municipal, and school). The questions were collected and the content in the questions was analyzed. The results show that it is possible to develop an organization by asking development-related questions, from top to bottom, in a hierarchical organization. However, problems arise when the developing questions require interpretation, and the interpretation leads to the shifting of the original goal. In this study, the aim at regional-level students and knowledge/learning was shifted to a focus on teachers and teaching especially at school level. Full article

Background: After an older person moves into a nursing home, the next of kin often continues to participate in the care provided there. This participation in care may contribute valuable knowledge of the preferences and wishes of the older person, thereby helping nursing staff deliver personalised care. Objectives: The aim of this study was to explore how next of kin experience their participation in the care of older persons residing in nursing homes after educating nursing staff about participation in palliative care. Methods: This follow-up study used a qualitative design based on semi-structured interviews with 37 next of kin. A thematic analysis was applied. Results: Participation of the next of kin involved active communication and collaboration with nursing staff, expressed in three themes: striving to achieve co-created care, navigating involvement through presence, and building commitment through communication and information. The dual role of being an emotionally close next of kin and a participant in the relative’s care was challenging and became increasingly burdensome and often overwhelming when the older person’s health deteriorated. Conclusions: This study reveals the need to develop and implement a policy for the participation of next of kin in the care of older people living in nursing homes. In addition, support groups can increase well-being through dialogue with other next of kin, thereby alleviating emotional strain. Increased implementation of life stories and the use of digital communication would keep the next of kin informed about the older person’s condition, especially when they cannot be present in person. Life story is a valuable tool for person-centred care and strengthens the relationships between the next of kin, the older person, and the nursing staff. Full article

Background/Objectives: Outdoor office work (OOW) has been shown to promote health and well-being and to reduce stress. However, few empirical studies have examined research-based, simple approaches to implementing OOW. In preparation for a larger study, we conducted a feasibility study focusing on limited efficacy testing of potentially relevant outcomes for future OOW research. Methods: The simple Pop Out OOW programme consists of three workshops and access to online tutorials designed to support employees in transitioning relevant everyday office tasks outdoors. Before and after a 12-week intervention, employees from five small- and medium-sized Danish companies (N = 70) reported their weekly number of days including OOW, connectedness to nature (CNS and INS), Perceived Stress Scale (PSS), and well-being (WHO-5) scores. Results: At baseline, higher CNS scores were associated with a greater number of days including OOW per week (r = 0.25, p = 0.020). Following the intervention, participants reported a significant increase in the number of days per week with OOW (p < 0.01, d = 0.65). CNS scores also increased significantly (p = 0.019, d = 0.32). No significant changes were observed in stress or well-being scores across the entire sample. However, participants with PSS scores exceeding a national Danish criterion for high stress (n = 11) exhibited a significant and substantial reduction in perceived stress (p < 0.01, d = 1.00). Conclusions: Days including OOW, along with PSS and CNS scores, may serve as relevant outcome measures in future studies evaluating interventions aimed at promoting OOW. These outcomes should be assessed in larger and more diverse and controlled samples to establish generalisability. Full article

Background/Objectives: Worldwide, men experience a higher incidence of pancreatic cancer (PC) than women. Methods: To increase understanding of the underlying reasons for this sex-related difference, we analysed general and sex-related risk factors for PC in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort (women/men No. = 293,682/136,728; 717/577 PC-cases). Results: Cox proportional hazards models showed a 1.31-fold higher risk of developing PC for men compared to women (HR, 95% CI 1.15–1.49) after adjustment for age, smoking history, BMI, diabetes, and alcohol consumption. Associations of PC with established risk factors did not differ between men and women, with the exception of a greater risk of PC among women with greater attained body height, meat consumption and cigarettes smoked (1.12 (1.05–1.19) per 5 cm, 1.18 (1.02–1.36) per 100 g/d, 1.42 (1.27–1.59) per 10/d; respectively). Among child-bearing women, long cumulative duration of breastfeeding was inversely associated with risk of PC (HR 0.74, 95% CI 0.61–0.89) for >5.7 months of breastfeeding (median) relative to ≤5.7 months and among HRT users, cumulative duration of HRT use was inversely associated with PC risk (HR 0.71, 95% CI 0.53–0.95, >2.4 versus ≤2.4 years). Further reproductive and hormonal factors, such as age at menarche, number of full-term pregnancies, age at menopause, or use of oral contraceptives, were not significantly associated with PC risk. Conclusions: Pooled analyses of large cohort studies are needed to confirm these results, and detailed data on the type and intensity of HRT are required to better evaluate its effect. Full article

Many meals are consumed in public settings such as schools, hospitals, and elderly care. These meals have the potential to impact public health as well as promote sustainable lifestyles. However, gastronomic values can be important for loading the meals with other dimensions. The aim of this article is to explore how the concept of gastronomy is understood, used, and described in the scientific literature in the context of public meals. For this scoping review, a systematic approach was adopted, including articles that use the concept of gastronomy in the context of public meals, as defined in this paper. A total of 3676 articles were initially identified, of which eight were finally included for assessment in this review. Three main themes emerged in the analysis, illustrating how the concept of gastronomy was used: gastronomy as local food and national cuisine; gastronomy as ideas of ‘the good’; and gastronomy as a framework. The concept of gastronomy is seldom clearly defined but is often used to emphasize ideas of ‘the good’, local food, and culinary traditions. Through gastronomy, healthy and sustainable public meals can be loaded with additional value, creativity, and innovation, enhancing the overall meal experience. Full article

Iron has many important functions related to energy metabolism. However, hemoglobin synthesis is always a priority. Iron deficiency can be caused by increased loss, insufficient intake, or decreased absorption from the intestine and reduced release from depots in systemic inflammation. Anemia appears when stores are depleted or when utilization of iron from the stores is impaired. Treatment with oral iron is the first choice when the intestine is healthy, and the patient is free of inflammation. Intravenous iron is indicated when oral iron is ineffective or not tolerated and if more rapid correction is clinically indicated as in severe anemia not requiring transfusion. Full article

Endocrine-disrupting chemicals (EDCs) are exogenous compounds that interfere with the endocrine system by mimicking or blocking the action of endogenous hormones such as estrogens, androgens, and thyroid hormones. This systematic review aims to evaluate the current epidemiological evidence linking EDC exposure with adverse reproductive outcomes in males and females of reproductive age. A total of 14 observational studies published between 2014 and 2024 were included following structured searches in PubMed, Scopus, and Google Scholar. The most commonly studied EDCs included bisphenol A (BPA), its analogs (such as bisphenol S, BPS), phthalates, parabens, per- and polyfluoroalkyl substances (PFAS), and persistent organic pollutants (POPs). The review found consistent associations between EDC exposure and multiple reproductive endpoints, such as impaired semen quality, decreased ovarian reserve, infertility, polycystic ovary syndrome (PCOS), altered hormone levels—specifically estradiol (E2), luteinizing hormone (LH), and follicle-stimulating hormone (FSH)—and adverse outcomes in assisted reproductive technologies (ART), including in vitro fertilization (IVF). Despite methodological heterogeneity, the findings support the biological plausibility of EDCs in disrupting reproductive function. The review highlights the urgent need for regulatory measures, increased public awareness, and longitudinal studies to assess the cumulative effects of chronic EDC exposure on human fertility. Full article

Background: Associations between high physical activity (PA) levels and incident atrial fibrillation (AF) is found in some earlier studies. We aim to study the association between levels of PA and AF in two cohorts. Methods: We used data from the Uppsala Longitudinal Study of Adult Men (ULSAM) study, initiated in 1970, included men aged 50 years, with 2202 included in the study. Examinations were reiterated three times, with follow-up after in median 33 years, with 3.8–6.0% on the highest PA level. We also used data from the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS; with women 50%); mean age 70 years, baseline 2001–2004, median follow-up 15 years, with 961 included in the study, with 4.8% on the highest PA level. Cox regression analysis with hazard ratios (HRs) was used to study association between PA levels and incident AF, adjusted for CV risk factors: systolic blood pressure, LDL- and HDL-cholesterol, BMI, diabetes, and smoking. Results: Totally, in ULSAM 504 men during 59,958 person-years at risk, and in PIVUS 204 individuals during a follow-up of 11,293 person-years experienced an AF. Neither in ULSAM, PIVUS, nor in the meta-analysis of both cohorts, individuals with the highest PA level showed an increased AF risk, compared to individuals with lowest level of PA. Conclusions: The benefits of PA in community dwelling individuals for its benefits to mental, metabolic, and cardiovascular health should guide public recommendations, rather than a possible risk of AF. Lay Summary: We studied the risk of incident atrial fibrillation at various levels of physical activity in two cohorts and found no statistically significant increased risk after adjusting for cardiovascular risk factors (systolic blood pressure, LDL- and HDL-cholesterol, BMI, diabetes, and smoking). Full article

The need to prevent crossing planetary boundaries has accelerated sustainable product development and production research. This resulted in the introduction of tools and methods to support the development of sustainable products. However, practice is still challenged by changing requirements, regulations, guidelines, and a plethora of tools. This study aims to identify different tools and methods that support transferring sustainability aspects into technical requirements during product and production development through a systematic literature review in Scopus. The search was limited to articles in the engineering, manufacturing sector, and journal or conference publications in the period between 2014 and 2024. Multiple authors were involved in the selection process to avoid bias. 56 articles were selected and analyzed based on purpose, user, production support, and utilization of the requirements management process. Results indicated that good support for product development and design engineers exists, but not for production, product production co-development, and other stakeholders. A need for a requirements management-based method to support the integration of sustainability aspects during product production co-development is identified. A research framework and three research strands are proposed based on this identified need, which will be developed as future work. Exclusion criteria can introduce some limitations, but the review provides an extensive overview of existing methods and gaps. Full article

Purpose: Preeclampsia is a serious pregnancy complication without curative treatment. The central nervous system (CNS) is affected in severe cases of preeclampsia. Until now, no biomarker or other predictive method has been established for predicting severe CNS injury, including the development of eclampsia and/or long-term complications. In this systematic review, we aimed to investigate the association between maternal blood (serum or plasma) S100B levels and preeclampsia, focusing on its predictive value and correlation with the severity of the disease, with a particular focus on neurological symptoms. Methods: A search of online databases, including Medline via PubMed, Scopus databases, and Web of Science, was performed based on the PRISMA guidelines for systematic reviews. Results: Ten case–control studies that met the inclusion criteria were identified and further evaluated according to the Newcastle–Ottawa Scale (NOS). All of the studies revealed that S100B blood levels were higher in preeclampsia compared to uncomplicated pregnancies before onset, after its diagnosis, and one year postpartum. Its predictive value seems to be adequate long before the onset of preeclampsia, especially in the early third trimester. Furthermore, its levels seem to correlate with severe complications during pregnancy, such as eclampsia and HELLP syndrome, as well as neurological dysfunction postpartum. Conclusions: S100B is a promising biomarker for the prediction of acute and long-term CNS injury in preeclampsia. Still, additional studies should be conducted in order to establish a standard method of measurement and solidify its clinical use in preeclampsia management, providing individualized care in order to improve perinatal outcomes and provide personalized follow-up postpartum. Full article

Gastrointestinal (GI) cancers, including esophageal, gastric, pancreatic, liver, and colorectal malignancies, represent a major global health burden due to their high incidence, aggressive nature, and limited treatment outcomes. This review explores the therapeutic potential of carvacrol, a naturally occurring monoterpenoid phenol predominantly found in oregano and other aromatic plants. Carvacrol has demonstrated strong anticancer properties by modulating multiple molecular pathways governing apoptosis, inflammation, angiogenesis, and metastasis. Preclinical studies have revealed its ability to selectively target cancer cells while sparing healthy tissue. Advances in nanotechnology have further enhanced its pharmacological profile by improving solubility, stability, and tumor-targeted delivery. Additionally, carvacrol shows synergistic effects when used in combination with conventional chemotherapeutics. While the evidence is promising, clinical studies are needed to validate its translational potential. This review aims to consolidate current findings and encourage further investigation into carvacrol’s application as an adjunct or alternative therapeutic agent in GI cancer management. Full article

In response to global concerns about climate change and decarbonization across every sector, pressure has mounted on the maritime industry to reduce its environmental impacts, specifically its greenhouse gas (GHG) emissions, representing around 2.8% of the global total. As such, it prompts new alternative fuels that align with the International Maritime Organization (IMO)’s 2050 net-zero target. In recent years, several alternative fuels, such as hydrogen, ammonia, and methanol, have been proposed. However, alternative fuels face many challenges regarding cost, safety, and efficiency compared to traditional fossil fuels. Currently, methanol is considered one of the most promising alternatives since it is available, easy to store, and can take full advantage of existing infrastructure in situ. Moreover, methanol has a lower carbon intensity than conventional fossil fuels. However, its usage poses related risks of toxicity and flammability; thus, this area still needs in-depth research regarding hazard control. This study implements a systematic five-step methodology. Through a comprehensive literature review, the predominant hazards are delineated. To systematically analyze these risks, this study introduces a novel hazard-based coding system developed to categorize hazards into three classifications: toxicity, flammability, and explosivity. This system is specifically designed to analyze qualitative reports from thirty methanol accident investigations utilizing MAXQDA software. Subsequently, safety barriers related to methanol are identified, followed by a gap analysis to evaluate the effectiveness of existing safety measures. The findings indicate that physical hazards, including flammability and explosivity, represented the majority of identified risks. Furthermore, tank explosions emerged as a prominent sub-hazard, frequently linked to the highest number of reported fatalities. A gap analysis delineates the identified barriers related to Equipment and Personal Protective Equipment (PPE), Human Error Reduction, the Legal Framework, and First Aid, comparing them against the current measures outlined in IMO Circular 1621 and other legislative frameworks. Consequently, the analysis highlights critical gaps in technical guidelines and operational procedures related to methanol use. The study recommends the development of fuel-specific safety protocols, mandatory training for seafarers, and regulatory updates to address the unique hazards of methanol. These measures are necessary to create higher safety standards and make methanol a viable alternative fuel by ensuring its safe integration into the industry. Full article

Background: Customer orders are key in developing logistics processes and in strategic developments of customer orientation. This paper investigates the notion of customer orientation. In the literature, the concept of customer is underdeveloped in that it is seen as a single object rather than how it is enacted in multiple ways. The study examines a customer-oriented production process managed in the supply chain of an automotive manufacturer. Methods: Based on a longitudinal study we explain what constitutes customer knowledge and what processes are involved in constructing this knowledge. Results: The study shows that in a supply chain, multiple versions of customers coexist and overlap that have implications on how multiple-customer orientation is performed and aligned in the supply chain. Conclusions: We find that customer representations proliferate as a result of multiple objectives; we demonstrate what objects and assemblages bring particular customer representation to life and show that these are used to shape customer orientation. Full article

Background: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are increasingly used in patients with type 2 diabetes, chronic kidney disease, and heart failure. However, their safety and efficacy in patients with congenital or surgically altered urogenital anatomy remains underexplored. Methods: We conducted a narrative review of current evidence regarding the use of SGLT2i in patients with urinary tract malformations, urinary diversions, and functional voiding disorders. Key risks, clinical considerations, and management strategies were synthesized from the existing literature and case reports. Results: Patients with benign prostatic hyperplasia, vesicoureteral reflux, neurogenic bladder, nephrostomies, and ileal conduits may face increased risks of urinary tract infections, fungal colonization, and therapy-related complications due to persistent glycosuria and altered urinary flow. Nevertheless, these patients may still benefit from SGLT2i’s systemic renal and cardiovascular effects. Individualized risk assessment, close monitoring, and multidisciplinary management are essential. Conclusions: Patients with urological abnormalities represent a high-risk but potentially high-reward population for SGLT2i therapy. A cautious, tailored approach is necessary, and future dedicated research is urgently needed to better guide clinical practice. Full article