Social capital and the life cycle model: The transformation of the destination of Åre

This article analyzes the development of the Swedish tourism destination of Åre and its transformation from one of many mountain villages into Scandinavia’s leading alpine ski resort. In reference to Butler’s life cycle model, this evolution is analyzed and some historical turning points in Åre’s development identified. The role of social capital is added to the historical analysis, based on the assumption that there is a link between a destination’s development and its ability to reproduce its social capital. The analysis shows that the social capital at the early stage was, to a large extent, built by and around local actors which predominated the village. The transformation to an international ski resort was possible only by the entrance of new actors, increasingly from the national and international arenas. These new actors have largely come to play leading roles in Åre’s development. At the same time, the new actors’ different values and networks have impacted Åre’s social capital

A pilot trial of \u27panic online\u27 as a self-guided treatment for panic disorder

Panic Online (PO) is a well-established evidence-based internet intervention program for panic disorder (PD) (with or without agoraphobia), when supported by a therapist (email or face-to-face). However, there has been no exploration to date as to whether PO is also effective when administered in a self-guided format (i.e. with no therapist assistance provided). The objective of this pilot trial was to examine whether PO as a self-guided program was effective at reducing panic symptomatology and furthermore, whether participants found the program format satisfactory. Pre- and post-treatment clinical interviews were conducted by telephone with six participants and experience of using the self-guided PO program was also explored. Paired samples t-tests revealed that PD and agoraphobia were significantly reduced by post-treatment, but panic frequency (over the previous month) did not significantly change. Qualitatively, all participants reported being satisfied with the program, however all participants reported that access to human support during the intervention (e.g. to answer questions, to be heard, to help motivate) was preferable. Initial pilot data suggests that PO self-guided works effectively as a stand-alone clinical internet-based treatment program for PD, however additional research is required to definitively establish its efficacy

Determinants of Consumers’ Willingness to Purchase Generic Medicines

In Malaysia healthcare costs have posed challenges to the sustainability of the country's dual healthcare system, it is crucial to learn about the factors influencing consumer preferences for generic medicines. The public healthcare system predominantly uses generic drugs, private healthcare providers often prescribe originator brands to their patients. This practice places financial burdens on patients who must fund their medication independently or through private medical insurance. Therefore, the main objective of this paper is to investigate the determinants affecting consumers' willingness to purchase generic medicine in Malaysia. Using convenience sampling, a total of 436 responses was obtained. Descriptive statistics and bivariate logistic regression analysis were employed to examine the influence of sociodemographic factors and individual knowledge on the willingness to purchase generic medicine. The results indicate that age, ethnicity, marital status, education level, household size and income significantly influence the consumers' willingness to purchase generic medicine. Notably, higher education levels and greater income were associated with a higher willingness to opt for generic medicine. Unexpectedly, variables measured by the Theory of Planned Behavior did not contribute substantially to the findings of this study. Nonetheless, individual knowledge was revealed as a significant determinant. To increase the uptake of generic medicines, this study recommends educational programs for both healthcare providers and patients, emphasizing the benefits and safety of generic medicine. This research contributes to the broader discussion on cost-effective healthcare solutions and informs policymakers and healthcare stakeholders in Malaysia

Performance and user-friendliness of the rapid antigen detection tests QuickVue Dipstick Strep A test and DIAQUICK Strep A Blue Dipstick for pharyngotonsillitis caused by Streptococcus pyogenes in primary health care

Sensitivity and specificity of rapid antigen detection tests (RADTs) for detection of group A hemolytic streptococcus (GAS) vary. The purpose is to present the first SKUP (Scandinavian evaluation of laboratory equipment for point of care testing) evaluations concerning the assessment of the diagnostic performance and user-friendliness of two RADTs for detection of GAS when used under real-life conditions in primary health care. Throat samples were collected in duplicates at primary health care centers (PHCCs) from patients with symptoms of pharyngitis. The performance of QuickVue Dipstick Strep A test (307 samples) and DIAQUICK Strep A Blue Dipstick (348 samples) was evaluated using culture results at a clinical microbiology laboratory as comparison. The user-friendliness was evaluated using a questionnaire. The diagnostic sensitivity was 92% (90% confidence interval (CI) 87–96%) and 72% (90% CI 65–79%), while the diagnostic specificity was 86% (90% CI 81–90%) and 98% (90% CI 96–99%) for QuickVue Dipstick Strep A test and DIAQUICK Strep A Blue Dipstick, respectively. Both RADTs obtained acceptable assessments for user-friendliness and fulfilled SKUP’s quality goal for user-friendliness. The diagnostic sensitivity for QuickVue Dipstick Strep A test and the diagnostic specificity for DIAQUICK Strep A Blue Dipstick in this objective and supplier-independent evaluation were higher compared with previous meta-analyses of RADTs. However, the diagnostic specificity for QuickVue Dipstick Strep A test and the diagnostic sensitivity for DIAQUICK Strep A Blue Dipstick were lower compared with previous meta-analyses of RADTs.publishedVersio

Decreased levels of stem cell factor in subjects with incident coronary events.

It has been proposed that vascular progenitor cells play an important role in vascular repair, but their possible clinical importance in cardiovascular disease has not been fully characterized. Vascular endothelial growth factor A, placental growth factor and stem cell factor (SCF) are three growth factors that are important in recruiting vascular progenitor cells. In this study, we investigated the association between the plasma levels of these growth factors and incident coronary events (CEs)

IL-22 affects smooth muscle cell phenotype and plaque formation in apolipoprotein E knockout mice.

IL-22 is a recently discovered cytokine that belongs to the family of IL-10 related cytokines. It is produced by activated T-cells and innate lymphoid cells and has been suggested to be involved in tissue repair. As both inflammation and repair play important roles in atherosclerosis we investigated if IL-22 deficiency influences the disease process in Apoe(-/-) mice

Effects of gestational diabetes mellitus on the quality and quantity of blood hematopoietic stem cells: a case-control study

Aim: To evaluate the effects of gestational diabetes mellitus (GDM) on the quantity and quality of hematopoietic stem cells (HSC). Methods: In this case-control study, HSC were isolated from umbilical cord blood (UCB) procured at delivery from 63 mothers with GDM and 67 healthy mothers. Total nucleated cells (TNC) and CD34+ cells were quantified using BD FACSCalibur flow cytometer. The quantity and quality of stem cells were determined. Results: The GDM group had lower total cord blood volume and lower number of nucleated HSC compared with healthy mothers. Regarding stem cell quantity parameters, they had significantly lower UCB volume (P=0.041), TNC count (P=0.022), total viable NC count (P=0.014), and CD34+ percentage (P=0.014). Regarding the quality of stem cells, they had significantly lower viable TNC percentage (P=0.015). The predictors for total TNC count were longer labor duration (adjusted B coefficient [p]: 0.031 [0.046]), greater estimated blood loss (0.089 [0.005]), female neonates (12.322 [0.049]), and higher placenta weight (0.080 [0.033]). The predictors of total viable NC count were greater estimated blood loss (0.092 [0.003]), female neonates (13.16 [0.035]), and greater placenta weight (0.083 [0.026]). Conclusion: The GDM group had much lower quantity and quality of UCB stem cells. Our results should be taken into consideration when drawing cord blood for unrelated stem cell banking in an obstetric unit to ensure the obtaining of optimal cord blood samples and to avoid unnecessary expenses

Sixteen-year longitudinal evaluation of blood-based DNA methylation biomarkers for early prediction of Alzheimer\u27s disease

BACKGROUND: DNA methylation (DNAm), an epigenetic mark reflecting both inherited and environmental influences, has shown promise for Alzheimer\u27s disease (AD) prediction. OBJECTIVE: Testing long-term predictive ability ( \u3e 15 years) of existing DNAm-based epigenetic age acceleration (EAA) measures and identifying novel early blood-based DNAm AD-prediction biomarkers. METHODS: EAA measures calculated from Illumina EPIC data from blood were tested with linear mixed-effects models (LMMs) in a longitudinal case-control sample (50 late-onset AD cases; 51 matched controls) with prospective data up to 16 years before clinical onset, and post-onset follow-up. Novel DNAm biomarkers were generated with epigenome-wide LMMs, and Sparse Partial Least Squares Discriminant Analysis applied at pre- (10-16 years), and post-AD-onset time-points. RESULTS: EAA did not differentiate cases from controls during the follow-up time (p \u3e 0.05). Three new DNA biomarkers showed in-sample predictive ability on average 8 years pre-onset, after adjustment for age, sex, and white blood cell proportions (p-values: 0.022- \u3c 0.00001). Our longitudinally-derived panel replicated nominally (p = 0.012) in an external cohort (n = 146 cases, 324 controls). However, its effect size and discriminatory accuracy were limited compared to APOE 4-carriership (OR = 1.38 per 1 SD DNAm score increase versus OR = 13.58 for 4-allele carriage; AUCs = 77.2% versus 87.0%). Literature review showed low overlap (n = 4) across 3275 AD-associated CpGs from 8 published studies, and no overlap with our identified CpGs

Seventeen Tidal Disruption Events from the First Half of ZTF Survey Observations: Entering a New Era of Population Studies

While tidal disruption events (TDEs) have long been heralded as laboratories for the study of quiescent black holes, the small number of known TDEs and uncertainties in their emission mechanism have hindered progress towards this promise. Here present 17 new TDEs that have been detected recently by the Zwicky Transient Facility along with Swift UV and X-ray follow-up observations. Our homogeneous analysis of the optical/UV light curves, including 22 previously known TDEs from the literature, reveals a clean separation of light curve properties with spectroscopic class. The TDEs with Bowen fluorescence features in their optical spectra have smaller blackbody radii, as well as longer rise times and higher disruption rates compared to the rest of the sample. The Bowen fluorescence mechanism requires a high density which can be reached at smaller radii, which in turn yields longer diffusion timescales. Thus, the difference in rise times suggests the pre-peak TDE light curves are governed not by the fallback timescale, but instead by the diffusion of photons through the tidal debris. The small subset of TDEs that show only helium emission lines in their spectra have the longest rise times, the highest luminosities and the lowest rates. We also report, for the first time, the detection of soft X-ray flares from a TDE on day timescales. Based on the fact the flares peak at a luminosity similar to the optical/UV blackbody luminosity, we attribute them to brief glimpses through a reprocessing layer that otherwise obscures the inner accretion flow