Use of a Web-Based Dietary Assessment Tool (RiksmatenFlex) in Swedish Adolescents: Comparison and Validation Study

BACKGROUND: A Web-based dietary assessment tool-RiksmatenFlex-was developed for the national dietary survey of adolescents in Sweden. OBJECTIVE: This study aimed to describe the Web-based method RiksmatenFlex and to test the validity of the reported dietary intake by comparing dietary intake with 24-hour dietary recalls (recall interviews), estimated energy expenditure, and biomarkers. METHODS: Adolescents aged 11-12, 14-15, and 17-18 years were recruited through schools. In total, 78 students had complete dietary information and were included in the study. Diet was reported a few weeks apart with either RiksmatenFlexDiet (the day before and a random later day) or recall interviews (face-to-face, a random day later by phone) in a cross-over, randomized design. At a school visit, weight and height were measured and blood samples were drawn for biomarker analyses. Students wore an accelerometer for 7 days for physical activity measurements. Dietary intake captured by both dietary methods was compared, and energy intake captured by both methods was compared with the accelerometer-estimated energy expenditure (EEest). Intake of whole grain wheat and rye and fruit and vegetables by both methods was compared with alkylresorcinol and carotenoid concentrations in plasma, respectively. RESULTS: The mean of the reported energy intake was 8.92 (SD 2.77) MJ by RiksmatenFlexDiet and 8.04 (SD 2.67) MJ by the recall interviews (P=.01). Intake of fruit and vegetables was 224 (169) g and 227 (150) g, and whole grain wheat and rye intake was 12.4 (SD 13.2) g and 12.0 (SD 13.1) g, respectively; the intakes of fruit and vegetables as well as whole grain wheat and rye did not differ between methods. Intraclass correlation coefficients ranged from 0.57 for protein and carbohydrates to 0.23 for vegetables. Energy intake by RiksmatenFlexDiet was overreported by 8% (P=.03) but not by the recall interviews (P=.53) compared with EEest. The Spearman correlation coefficient between reported energy intake and EEest was 0.34 (P=.008) for RiksmatenFlexDiet and 0.16 (P=.21) for the recall interviews. Spearman correlation coefficient between whole grain wheat and rye and plasma total alkylresorcinol homologs was 0.36 (P=.002) for RiksmatenFlexDiet and 0.29 (P=.02) for the recall interviews. Spearman correlations between intake of fruit and vegetables and plasma carotenoids were weak for both dietary tools. The strongest correlations were observed between fruit and vegetable intake and lutein/zeaxanthin for RiksmatenFlexDiet (0.46; P<.001) and for recall interviews (0.28; P=.02). CONCLUSIONS: RiksmatenFlexDiet provides information on energy, fruit, vegetables, and whole grain wheat and rye intake, which is comparable with intake obtained from recall interviews in Swedish adolescents. The results are promising for cost-effective dietary data collection in upcoming national dietary surveys and other studies in Sweden. Future research should focus on how, and if, new technological solutions could reduce dietary reporting biases

Dielectric properties characterization of La- and Dy-doped BiFeO3 thin films

The dielectric response of La- and Dy- doped BiFeO3 thin films at microwave frequencies (up to 12 GHz) has been monitored as a function of frequency, direct current (dc) electric field, and magnetic field in a temperature range from 25 to 300 °C. Both the real and imaginary parts of the response have been found to be non-monotonic (oscillating) functions of measuring frequency. These oscillations are not particularly sensitive to a dc electric field; however, they are substantially dampened by a magnetic field. The same effect has been observed when the volume of the characterized sample is increased. This phenomenon is attributed to the presence of a limited number of structural features with a resonance type response. The exact origin of these features is unknown at present. Leakage current investigations were performed on the whole set of films. The films were highly resistive with low leakage current, thereby giving us confidence in the microwave measurements. These typically revealed ‘N'-type I-V characteristic

Microwave dielectric loss in oxides: Theory and experiment

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A genome-wide association study in Europeans and South Asians identifies five new loci for coronary artery disease

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Children with profound intellectual and multiple disabilities and their participation in family activities

Background. Families are essential parts of any community and throughout childhood one’s family serves as the central setting wherein opportunities for participation are offered. There is a lack of knowledge about participation of children with profound intellectual and multiple disabilities (PIMD) in family activities and how improved participation can be reached. Gathering such knowledge could enable an improvement in child functioning and wellbeing and also ease everyday life for families of a child with PIMD. Aim. The overall aim of this thesis was to explore participation seen as presence and engagement in family activities in children with PIMD and to find strategies that might facilitate this participation. Material and Methods. The research was cross-sectional and conducted with descriptive, explorative designs. First a quantitative, comparative design was used including questionnaire data from 60 families with a child with PIMD and 107 families with children with typical development (TD) (I, II). Following that, a qualitative, inductive design was used with data from individual interviews with parents of 11 children with PIMD and nine hired external personal assistants (III). Finally a mixed method design was conducted where collected quantitative data was combined with the qualitative data from the previous studies (IV). Results. It was found that children with PIMD participated less often, compared to children with TD, in a large number of family activities, however they participated more often in four physically less demanding activities. Children with PIMD also participated in a less diverse set of activities. Additionally, they overall had a lower level of engagement in the activities; however, both groups of children showed higher engagement in enjoyable, child-driven activities and lower engagement in routine activities. The motor ability of the child with PIMD was found to be the main child characteristic that affected their presence in the family activities negatively and child cognition was found to be the personal characteristic that affected their engagement in the activities. The child’s presence and engagement were influenced to a lesser extent by family socio-economic factors when compared to families with children with TD. Parents and hired external personal assistants described several strategies to be used to improve participation of the children with PIMD, such as by showing engagement in the activities oneself and by giving the child opportunities to influence the activities. The role of the hired external personal assistant, often considered as a family member for the child, was described as twofold: one supporting or reinforcing role in relation to the child and one balancing role in relation to the parents/the rest of the family, including reducing the experience of being burdened and showing sensitivity to family life and privacy. Conclusion. A child with PIMD affects the family’s functioning and the family’s functioning affects the child. Child and environmental factors can act as barriers that have the result that children with PIMD may experience fewer and less varied activities that can generate engaged interaction within family activities than children with TD do. Accordingly, an awareness and knowledge of facilitating strategies for improved participation in family activities is imperative. There needs to be someone in the child’s environment who sets the scene/stage and facilitates the activity so as to increase presence and engagement in proximal processes based on the child’s needs. The family, in turn, needs someone who can provide respite to obtain balance in the family system. External personal assistance includes these dual roles and is of importance in families with a child with PIMD

Nurses' experiences of a patient suicide during ongoing psychiatric care : An interview study

Bakgrund: Varje år avlider omkring 1500 personer i Sverige till följd av suicid. Cirka en tredjedel av de personer som suiciderar har en pågående kontakt med psykiatrisk vård. Således finns en stor andel sjuksköterskor som lämnas påverkade efter att en patient suiciderat. Syfte: Syftet med denna studie var att undersöka sjuksköterskors upplevelser och erfarenheter av att en patient suiciderat under pågående psykiatrisk vård. Metod: Studien har en kvalitativ design med en induktiv ansats. Tolv sjuksköterskor som alla erfarit att en patient de vårdat suiciderat intervjuades med semistrukturerade frågeformulär. Insamlad data analyserades sedan med kvalitativ innehållsanalys enligt Elo och Kyngäs. Som teoretisk utgångspunkt har Barker och Buchanan-Barkers tidvattenmodell använts i resultatdiskussion. Resultat: Analyserad data resulterade i sex huvudkategorier; Emotionell påverkan, Vad gjorde vi för fel?, Vikten av stöd efter händelsen, Hur händelsen påverkat yrkesrollen, Suicid sätter spår och Synen på suicid samt 13 tillhörande subkategorier. En patients suicid genererade ofta en emotionell påverkan för sjuksköterskan. Ifrågasättande av egen kompetens och organisation var vanligt. Vikten av individanpassat stöd efter händelsen är betydande. Utan tillräckligt stöd fanns en risk för negativa konsekvenser. Händelsen kunde generera obehagskänslor men i efterförloppet även en ökad trygghet i egen yrkesroll, ökad kompetens och ett ökat engagemang. Slutsats: Att en patient suiciderat under pågående psykiatrisk vård påverkar sjuksköterskan emotionellt och professionellt. Händelsen påverkar inte bara sjuksköterskan utan även hela arbetsplatsen. Behovet av stöd efter händelsen är individuellt och om det upplevs som bristande riskerar händelsen att få negativa konsekvenser för sjuksköterskan. Det finns ett behov av att belysa detta ämne ytterligare och vi behöver ha ett pågående forum för dessa frågor.Background: Annually, about 1500 people die in Sweden as a result of suicide. Approximately one third of the people who commit suicide have an ongoing contact with the psychiatric care. Therefore, a larger group of nurses are left emotionally affected. Aim: The aim of this study was to describe nurses' experiences of a patient suicide during ongoing psychiatric care. Method: The study has a qualitative design with an inductive approach. Twelve nurses who all experienced that a patient they cared for died through suicide was interviewed with a semi-structured questionnaire. Collected data was then analyzed with qualitative content analysis according to Elo and Kyngäs. As a theoretical framework Barker and Buchanan-Barker's tidal model have been used in the discussion of the result. Results: Analyzed data resulted in six main categories; Emotional impact, What did we do wrong?, The importance of post-event support, How the event affected the professional role, Suicide leave marks and The perception of suicide along with 13 associated subcategories. A patient suicide often generated an emotional impact for the nurse. Questioning one's own expertise and organization was common. The importance of personalized support after the event is significant. Without sufficient support, there was a risk of negative consequences. The event could generate feelings of discomfort, but in the aftermath also increased security in one's own professional role, increased competence and increased commitment. Conclusions: A patient suicide during ongoing psychiatric care affects the nurse emotionally and professionally. The incident not only affects the nurse but also the entire workplace. The need for support after the incident is individual and if it´s perceived as lacking the incident may have negative consequences for the nurse. There is a need to broach this topic and we need an ongoing forum for these issues