Healthy and organic food, more than just eating

The patterns of food consumption are changing among young people. It is expressed in their awareness of how food affects health in both positive and negative ways. The acts of buying, cooking and eating food are related to cultural values and the social and psychological life of the individual. References to identity formation and health are frequently made in consumer research. However there are also other perspectives to consider, which has not yet been looked upon. The aim of this study was to investigate young adults personal experience associated to the choice of organic food from a psychological perspective. In depth interviews were made with 30 young adults favouring organic food. The interviews were carried out in different parts of Sweden between 2011 and 2012. Questions where asked about their choice of healthy eating based on eating organic food. The interviews lasted between one and a half and two hours. The analysis followed the four steps of the descriptive phenomenological psychological method developed by Giorgi (2009). Preliminary results show that young adults experiences and explorations of organic food is related to the need to be both physically healthy and in the sense of subjective Well-being involving expressions of self though food. Further more also creating a sustainable future where they feel as individuals with their own identities

Young adults' use of food as a self-therapeutic intervention

The aim of this study was to investigate how young adults use their lived body as a starting point for lifestyle explorations and as a strategy for well-being. The transcripts of 10 interviews with persons 18 to 33 years old, collected in Sweden, were analysed for variation in the practises and experiences related to this way of using food. An application of the descriptive phenomenological psychological research method guided the process. The young adults were: (1) listening to the body; (2) moderating conditions and feelings; (3) developing vitality and resilience; (4) creating mindful space for rest, and (5) participating in creative activity. The results show how young adults perceive their choice of food and related practises associated with positive feelings and experiences as ways to promote well-being and mitigate different problems in life. The usefulness of knowledge about how young adults try to use food for self-therapy by enhancing mind-body awareness is discussed in relation to health issues and food-related interventions

Ekologisk mat och psykisk hälsa

Med utgångspunkt i eko-psykologin och ett livsvärldsfenomologiskt perspektiv beskrivs unga vuxnas val av ekologisk mat som en naturbaserad form av självterapeutisk intervention för att förbättra psykisk hälsa. Syftet med undersökningen var att försöka förstå hur unga vuxna aktivt använder relationen mellan kropp och mat i vardagen som del av en strategi för att uppnå välbefinnande och bättre hantera existentiella problem och ängslan inför framtiden. Med ett strategiskt urval av 30 unga vuxna i åldrarna 18-35 år gjordes semi-strukturerade intervjuer kring deras intresse för ekologisk mat. Analysen utgick från den deskriptiva fenomenologiska psykologiska forskningsmetoden och kompletterades med en fenomenologisk narrativ metod. I delstudie I undersöktes fenomenet ”unga vuxnas relation till ekologisk mat” på en generell nivå som visade hur relationen till ekologisk mat är ett mångdimensionellt fenomen med fyra konstituenter: 1) Den levda kroppen som utgångspunkt för utforskandet av livet, 2) Ett berättat själv genom emotionella-relationella matminnen, 3) En medveten livsstrategi för välbefinnande och vitalitet, och 4) En personlig uppsättning värderingar i förhållande till etiska normer. Delstudie II undersökte variationen av uttrycksformer i konstituenterna ett och tre, och beskriver hur de unga vuxna använder mat som självterapeutisk intervention via sin kropp och sina sinnen i relation till maten som verktyg genom att: 1) Lyssna på kroppen, 2) Moderera kroppstillstånd och känslor, 3) Finna kroppslig vitalitet och resiliens, 4) Skapa ett utrymme för stillhet och meditation och 5) Medverka i en kreativ process. Delstudie III beskriver hur relationen till mat utvecklas genom att matminnen knyts till olika personer, händelser och sammanhang, med tre livsberättelser som illustrerar hur denna relation kan utvecklas under perioden som ung vuxen: 1) Positiva emotionella matminnen kan vara förknippade med att använda mat som ett känslomässigt ankare. 2) Negativa emotionella matminnen kan vara förknippade med: a) en upptagenhet av mat, som innebär att individen byter ut eller kompenserar mellanmänskliga relationer, b) ett undvikande av mat, som handlar om minnen förknippade med en kontrollerad och undflyende relation till mat. Undersökningen visar också hur relationen till mat under ung vuxenperioden kan innebära en ”andra chans” att utveckla bra matvanor, men också hur deras starka fokus på att äta hälsosamt kan vara förenad med en personlig problematik

Översiktlig kartläggning av fyra miljökaraktärer i Skåne

Rapporten beskriver arbetet med samt resultatet av insamlingen av miljökaraktärer i Skånes samtliga 33 kommuner under våren 2008. Syftet med inventeringen var att kartlägga karaktärer för att kunna underlätta för fysisk planering i samband med hälsa. Karaktärerna var Allmänningen, Lustgården och Centrum, festen samt delvis en fjärde karaktär, Rymd. Inventeringen bygger på intervjuer med representanter från kommunen och på deras markering av de olika karaktärerna på kommunkartor. Dessa har sedan bearbetats via ArcView GIS. Resultatet finns redovisat som kartor i rapporten tillsammans med fotograferade exempel på karaktärerna samt en kortare beskrivning och analys av de olika karaktärernas innehåll. I slutet av rapporten finns en beskrivning av hur materialet har bearbetats

Mapping and assessment of forest ecosystems and their services - Applications and guidance for decision making in the framework of MAES

The aim of this report is to illustrate by means of a series of case studies the implementation of mapping and assessment of forest ecosystem services in different contexts and geographical levels. Methodological aspects, data issues, approaches, limitations, gaps and further steps for improvement are analysed for providing good practices and decision making guidance. The EU initiative on Mapping and Assessment of the state of Ecosystems and their Services (MAES), with the support of all Member States, contributes to improve the knowledge on ecosystem services. MAES is one of the building-block initiatives supporting the EU Biodiversity Strategy to 2020.JRC.H.3-Forest Resources and Climat

Machine learning algorithms performed no better than regression models for prognostication in traumatic brain injury

Objective: We aimed to explore the added value of common machine learning (ML) algorithms for prediction of outcome for moderate and severe traumatic brain injury. Study Design and Setting: We performed logistic regression (LR), lasso regression, and ridge regression with key baseline predictors in the IMPACT-II database (15 studies, n = 11,022). ML algorithms included support vector machines, random forests, gradient boosting machines, and artificial neural networks and were trained using the same predictors. To assess generalizability of predictions, we performed internal, internal-external, and external validation on the recent CENTER-TBI study (patients with Glasgow Coma Scale <13, n = 1,554). Both calibration (calibration slope/intercept) and discrimination (area under the curve) was quantified. Results: In the IMPACT-II database, 3,332/11,022 (30%) died and 5,233(48%) had unfavorable outcome (Glasgow Outcome Scale less than 4). In the CENTER-TBI study, 348/1,554(29%) died and 651(54%) had unfavorable outcome. Discrimination and calibration varied widely between the studies and less so between the studied algorithms. The mean area under the curve was 0.82 for mortality and 0.77 for unfavorable outcomes in the CENTER-TBI study. Conclusion: ML algorithms may not outperform traditional regression approaches in a low-dimensional setting for outcome prediction after moderate or severe traumatic brain injury. Similar to regression-based prediction models, ML algorithms should be rigorously validated to ensure applicability to new populations

Primary versus early secondary referral to a specialized neurotrauma center in patients with moderate/severe traumatic brain injury: a CENTER TBI study

Funder: ZNS - Hannelore Kohl Stiftung; doi: http://dx.doi.org/10.13039/501100007731Funder: Integra LifeSciences CorporationFunder: OneMindAbstract: Background: Prehospital care for patients with traumatic brain injury (TBI) varies with some emergency medical systems recommending direct transport of patients with moderate to severe TBI to hospitals with specialist neurotrauma care (SNCs). The aim of this study is to assess variation in levels of early secondary referral within European SNCs and to compare the outcomes of directly admitted and secondarily transferred patients. Methods: Patients with moderate and severe TBI (Glasgow Coma Scale < 13) from the prospective European CENTER-TBI study were included in this study. All participating hospitals were specialist neuroscience centers. First, adjusted between-country differences were analysed using random effects logistic regression where early secondary referral was the dependent variable, and a random intercept for country was included. Second, the adjusted effect of early secondary referral on survival to hospital discharge and functional outcome [6 months Glasgow Outcome Scale Extended (GOSE)] was estimated using logistic and ordinal mixed effects models, respectively. Results: A total of 1347 moderate/severe TBI patients from 53 SNCs in 18 European countries were included. Of these 1347 patients, 195 (14.5%) were admitted after early secondary referral. Secondarily referred moderate/severe TBI patients presented more often with a CT abnormality: mass lesion (52% vs. 34%), midline shift (54% vs. 36%) and acute subdural hematoma (77% vs. 65%). After adjusting for case-mix, there was a large European variation in early secondary referral, with a median OR of 1.69 between countries. Early secondary referral was not associated with functional outcome (adjusted OR 1.07, 95% CI 0.78–1.69), nor with survival at discharge (1.05, 0.58–1.90). Conclusions: Across Europe, substantial practice variation exists in the proportion of secondarily referred TBI patients at SNCs that is not explained by case mix. Within SNCs early secondary referral does not seem to impact functional outcome and survival after stabilisation in a non-specialised hospital. Future research should identify which patients with TBI truly benefit from direct transportation

How do 66 European institutional review boards approve one protocol for an international prospective observational study on traumatic brain injury? Experiences from the CENTER-TBI study

Abstract: Background: The European Union (EU) aims to optimize patient protection and efficiency of health-care research by harmonizing procedures across Member States. Nonetheless, further improvements are required to increase multicenter research efficiency. We investigated IRB procedures in a large prospective European multicenter study on traumatic brain injury (TBI), aiming to inform and stimulate initiatives to improve efficiency. Methods: We reviewed relevant documents regarding IRB submission and IRB approval from European neurotrauma centers participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI). Documents included detailed information on IRB procedures and the duration from IRB submission until approval(s). They were translated and analyzed to determine the level of harmonization of IRB procedures within Europe. Results: From 18 countries, 66 centers provided the requested documents. The primary IRB review was conducted centrally (N = 11, 61%) or locally (N = 7, 39%) and primary IRB approval was obtained after one (N = 8, 44%), two (N = 6, 33%) or three (N = 4, 23%) review rounds with a median duration of respectively 50 and 98 days until primary IRB approval. Additional IRB approval was required in 55% of countries and could increase duration to 535 days. Total duration from submission until required IRB approval was obtained was 114 days (IQR 75–224) and appeared to be shorter after submission to local IRBs compared to central IRBs (50 vs. 138 days, p = 0.0074). Conclusion: We found variation in IRB procedures between and within European countries. There were differences in submission and approval requirements, number of review rounds and total duration. Research collaborations could benefit from the implementation of more uniform legislation and regulation while acknowledging local cultural habits and moral values between countries

Occurrence and timing of withdrawal of life-sustaining measures in traumatic brain injury patients: a CENTER-TBI study

Funder: National Institute for Health Research (UK)Abstract: Background: In patients with severe brain injury, withdrawal of life-sustaining measures (WLSM) is common in intensive care units (ICU). WLSM constitutes a dilemma: instituting WLSM too early could result in death despite the possibility of an acceptable functional outcome, whereas delaying WLSM could unnecessarily burden patients, families, clinicians, and hospital resources. We aimed to describe the occurrence and timing of WLSM, and factors associated with timing of WLSM in European ICUs in patients with traumatic brain injury (TBI). Methods: The CENTER-TBI Study is a prospective multi-center cohort study. For the current study, patients with traumatic brain injury (TBI) admitted to the ICU and aged 16 or older were included. Occurrence and timing of WLSM were documented. For the analyses, we dichotomized timing of WLSM in early (< 72 h after injury) versus later (≥ 72 h after injury) based on recent guideline recommendations. We assessed factors associated with initiating WLSM early versus later, including geographic region, center, patient, injury, and treatment characteristics with univariable and multivariable (mixed effects) logistic regression. Results: A total of 2022 patients aged 16 or older were admitted to the ICU. ICU mortality was 13% (n = 267). Of these, 229 (86%) patients died after WLSM, and were included in the analyses. The occurrence of WLSM varied between regions ranging from 0% in Eastern Europe to 96% in Northern Europe. In 51% of the patients, WLSM was early. Patients in the early WLSM group had a lower maximum therapy intensity level (TIL) score than patients in the later WLSM group (median of 5 versus 10) The strongest independent variables associated with early WLSM were one unreactive pupil (odds ratio (OR) 4.0, 95% confidence interval (CI) 1.3–12.4) or two unreactive pupils (OR 5.8, CI 2.6–13.1) compared to two reactive pupils, and an Injury Severity Score (ISS) if over 41 (OR per point above 41 = 1.1, CI 1.0–1.1). Timing of WLSM was not significantly associated with region or center. Conclusion: WLSM occurs early in half of the patients, mostly in patients with severe TBI affecting brainstem reflexes who were severely injured. We found no regional or center influences in timing of WLSM. Whether WLSM is always appropriate or may contribute to a self-fulfilling prophecy requires further research and argues for reluctance to institute WLSM early in case of any doubt on prognosis

Frequency of fatigue and its changes in the first 6 months after traumatic brain injury: results from the CENTER-TBI study

Background: Fatigue is one of the most commonly reported subjective symptoms following traumatic brain injury (TBI). The aims were to assess frequency of fatigue over the first 6 months after TBI, and examine whether fatigue changes could be predicted by demographic characteristics, injury severity and comorbidities. Methods: Patients with acute TBI admitted to 65 trauma centers were enrolled in the study Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI). Subj