Local alcohol prevention in Sweden : construction of a prevention index and assessments of prevention effects on consumption and harm

Background: Over the past 15–20 years, local alcohol and drug prevention has developed substantially in Sweden. This has largely been a planned strategy from the national level with channels through to the regional level and down to the local level, which should be seen as a reaction to Sweden joining the European Union in 1995. Following that event, the restrictive import quotas on alcohol from other member states were gradually abolished. This led to greater availability of cheaper alcohol in Sweden and alcohol consumption increased in the following years. This, in turn, put increased pressure on the restrictive Swedish national alcohol policy, especially to reduce the taxation of alcoholic beverages. Thus, the government searched for alternative prevention approaches, e.g., strengthening local alcohol and drug prevention. Aims: The aim of this thesis is two-fold: 1) to develop a composite measure (index) for monitoring local alcohol prevention, and 2) to investigate the effects of an increase in local alcohol prevention efforts on alcohol consumption and alcohol-related harm in Sweden, 2006–2014. Methods: A composite measure of local alcohol prevention, Alcohol Prevention Magnitude Measure (APMM), was constructed based on a systems model for alcohol prevention and community action. APMM was validated by comparing the change in APMM score in community intervention municipalities (where previous evaluations pointed at increased prevention) with that in non-intervention municipalities (studies I–II). Fixed effects models were used to analyse the prevention effects of a community intervention called LUMA and of APMM on consumption and harm (studies III–IV). Results: Studies I–II. Initially, indicators and data sources for monitoring alcohol development in Sweden were identified. An APMM was constructed with 37 indicators of local alcohol prevention. These indicators were divided into five main categories of prevention. Categories were scored with a maximum of 20 points each (i.e., maximum total 100 points). The validation of the APMM indicated that it reflected changes in local alcohol prevention. Another result was that local alcohol prevention, measured using APMM, increased among Swedish municipalities between 2006 and 2010. Studies III–IV. Findings revealed increased prevention activities in the LUMA municipalities compared with control municipalities. Positive developments for alcohol consumption and several alcohol-related harm indicators were found. When a weighted version of APMM (WPI, a combination of a direct and a lagged prevention effect of one year) was analysed in relation to consumption and harm, the main results suggested that an increase in APMM (WPI) by 1 percent yielded a decrease in alcohol-related mortality by 0.26 percent. However, the estimated effect of APMM (WPI) on alcohol consumption was very small, -0.02 percent. Unlike mortality, most of the effect estimates on morbidity revealed no effects of prevention. Implication and conclusion: This thesis has shown how a prevention index for monitoring local alcohol prevention can be constructed and applied. Furthermore, the findings suggested that the increased efforts on local alcohol prevention in Sweden have had some effect on alcohol consumption and related harm. However, given the identified limitations of the measures of local prevention, consumption, and harm, the results must be interpreted with caution. Additional studies on the effectiveness of local alcohol prevention are needed to assess the generalizability of the current findings

Enhanced pupillary light reflex in infancy is associated with autism diagnosis in toddlerhood.

Autism spectrum disorder (ASD) is a neurodevelopmental condition affecting around 1% of the population. We previously discovered that infant siblings of children with ASD had stronger pupillary light reflexes compared to low-risk infants, a result which contrasts sharply with the weak pupillary light reflex typically seen in both children and adults with ASD. Here, we show that on average the relative constriction of the pupillary light reflex is larger in 9-10-month-old high risk infant siblings who receive an ASD diagnosis at 36 months, compared both to those who do not and to low-risk controls. We also found that the magnitude of the pupillary light reflex in infancy is associated with symptom severity at follow-up. This study indicates an important role of sensory atypicalities in the etiology of ASD, and suggests that pupillometry, if further developed and refined, could facilitate risk assessment in infants

The ecology of exercise: mechanisms underlying Individual variation in behavior, activity, and performance: an introduction to symposium

Wild animals often engage in intense physical activity while performing tasks vital for their survival and reproduction associated with foraging, avoiding predators, fighting, providing parental care, and migrating. In this theme issue we consider how viewing these tasks as “exercise”—analogous to that performed by human athletes—may help provide insight into the mechanisms underlying individual variation in these types of behaviors and the importance of physical activity in an ecological context. In this article and throughout this issue, we focus on four key questions relevant to the study of behavioral ecology that may be addressed by studying wild animal behavior from the perspective of exercise physiology: (1) How hard do individual animals work in response to ecological (or evolutionary) demands?; (2) Do lab-based studies of activity provide good models for understanding activity in free-living animals and individual variation in traits?; (3) Can animals work too hard during “routine” activities?; and (4) Can paradigms of “exercise” and “training” be applied to free-living animals? Attempts to address these issues are currently being facilitated by rapid technological developments associated with physiological measurements and the remote tracking of wild animals, to provide mechanistic insights into the behavior of free-ranging animals at spatial and temporal scales that were previously impossible. We further suggest that viewing the behaviors of non-human animals in terms of the physical exercise performed will allow us to fully take advantage of these technological advances, draw from knowledge and conceptual frameworks already in use by human exercise physiologists, and identify key traits that constrain performance and generate variation in performance among individuals. It is our hope that, by highlighting mechanisms of behavior and performance, the articles in this issue will spur on further synergies between physiologists and ecologists, to take advantage of emerging cross-disciplinary perspectives and technologies

Physicians' attitudes towards ePrescribing – evaluation of a Swedish full-scale implementation

<p>Abstract</p> <p>Background</p> <p>The penetration rate of Electronic Health Record (EHR) systems in health care is increasing. However, many different EHR-systems are used with varying ePrescription designs and functionalities. The aim of the present study was to evaluate experienced ePrescribers' attitudes towards ePrescribing for suggesting improvements.</p> <p>Methods</p> <p>Physicians (n = 431) from seven out of the 21 Swedish health care regions, using one of the six most widely implemented EHR-systems with integrated electronic prescribing modules, were recruited from primary care centers and hospital clinics of internal medicine, orthopaedics and surgery. The physicians received a web survey that comprised eight questions on background data and 19 items covering attitudes towards ePrescribing. Forty-two percent (n = 199) of the physicians answered the questionnaire; 90% (n = 180) of the respondents met the inclusion criteria and were included in the final analysis.</p> <p>Results</p> <p>A majority of the respondents regarded their EHR-system easy to use in general (81%), and for the prescribing of drugs (88%). Most respondents believed they were able to provide the patients better service by ePrescribing (92%), and regarded ePrescriptions to be time saving (91%) and to be safer (83%), compared to handwritten prescriptions. Some of the most frequently reported weaknesses were: not clearly displayed price of drugs (43%), complicated drug choice (21%), and the perception that it was possible to handle more than one patient at a time when ePrescribing (13%). Moreover, 62% reported a lack of receipt from the pharmacy after successful transmission of an ePrescription. Although a majority (73%) of the physicians reported that they were always or often checking the ePrescription a last time before transmitting, 25% declared that they were seldom or never doing a last check. The respondents suggested a number of improvements, among others, to simplify the drug choice and the cancellation of ePrescriptions.</p> <p>Conclusion</p> <p>The Swedish physicians in the group studied were generally satisfied with their specific EHR-system and with ePrescribing as such. However, identified weaknesses warrant improvements of the EHR-systems as well as of their implementation in the individual health care organisation.</p

Редокс-регуляция динамического характера фенотипа эндотелиоцитов кровеносных сосудов

ЭНДОТЕЛИАЛЬНЫЕ КЛЕТКИКЛЕТКИЭНДОТЕЛИЙКРОВЕНОСНЫЕ СОСУДЫФЕНОТИПГЕНЕТИЧЕСКИЕ ФЕНОМЕНЫОКИСЛИТЕЛЬНО-ВОССТАНОВИТЕЛЬНЫЕ РЕАКЦИИЭНЕРГЕТИЧЕСКИЙ ОБМЕНПЕРЕКИСНОЕ ОКИСЛЕНИЕ ЛИПИДО

X-ray Free Electron Laser Studies of Electron and Phonon Dynamics of Graphene Adsorbed on Copper

We report optical pumping and X-ray absorption spectroscopy experiments at the PAL free electron laser that directly probe the electron dynamics of a graphene monolayer adsorbed on copper in the femtosecond regime. By analyzing the results with ab-initio theory we infer that the excitation of graphene is dominated by indirect excitation from hot electron-hole pairs created in the copper by the optical laser pulse. However, once the excitation is created in graphene, its decay follows a similar path as in many previous studies of graphene adsorbed on semiconductors, i e. rapid excitation of SCOPS (Strongly Coupled Optical Phonons) and eventual thermalization. It is likely that the lifetime of the hot electron-hole pairs in copper governs the lifetime of the electronic excitation of the graphene.Comment: 22 pages, 8 Figures including Supplementary Materia

Ultrafast adsorbate excitation probed with sub-ps resolution XAS

We use a pump-probe scheme to measure the time evolution of the C K-edge X-ray absorption spectrum (XAS) from CO/Ru(0001) after excitation by an ultrashort high-intensity optical laser pulse. Due to the short duration of the X-ray probe pulse and precise control of the pulse delay, the excitation-induced dynamics during the first ps after the pump can be resolved with unprecedented time resolution. By comparing with theoretical (DFT) spectrum calculations we find high excitation of the internal stretch and frustrated rotation modes occurring within 200 fs of laser excitation, as well as thermalization of the system in the ps regime. The ~100 fs initial excitation of these CO vibrational modes is not readily rationalized by traditional theories of nonadiabatic coupling of adsorbates to metal surfaces, e. g. electronic frictions based on first order electron-phonon coupling or transient population of adsorbate resonances. We suggest that coupling of the adsorbate to non-thermalized electron-hole pairs is responsible for the ultrafast initial excitation of the modes.Comment: 16 pages, 16 figures. To be published in Physical Review Letters: https://journals.aps.org/prl/accepted/c1070Y74M8b18063d9cd0221b000631d50ef7a24

Ultrafast Adsorbate Excitation Probed with Subpicosecond-Resolution X-Ray Absorption Spectroscopy

We use a pump-probe scheme to measure the time evolution of the C K-edge x-ray absorption spectrum from CO/Ru(0001) after excitation by an ultrashort high-intensity optical laser pulse. Because of the short duration of the x-ray probe pulse and precise control of the pulse delay, the excitation-induced dynamics during the first picosecond after the pump can be resolved with unprecedented time resolution. By comparing with density functional theory spectrum calculations, we find high excitation of the internal stretch and frustrated rotation modes occurring within 200 fs of laser excitation, as well as thermalization of the system in the picosecond regime. The ∼100  fs initial excitation of these CO vibrational modes is not readily rationalized by traditional theories of nonadiabatic coupling of adsorbates to metal surfaces, e.g., electronic frictions based on first order electron-phonon coupling or transient population of adsorbate resonances. We suggest that coupling of the adsorbate to nonthermalized electron-hole pairs is responsible for the ultrafast initial excitation of the modes

Atom-Specific Probing of Electron Dynamics in an Atomic Adsorbate by Time-Resolved X-Ray Spectroscopy

The electronic excitation occurring on adsorbates at ultrafast timescales from optical lasers that initiate surface chemical reactions is still an open question. Here, we report the ultrafast temporal evolution of x-ray absorption spectroscopy (XAS) and x-ray emission spectroscopy (XES) of a simple well-known adsorbate prototype system, namely carbon (C) atoms adsorbed on a nickel [Ni(100)] surface, following intense laser optical pumping at 400 nm. We observe ultrafast (∼100  fs) changes in both XAS and XES showing clear signatures of the formation of a hot electron-hole pair distribution on the adsorbate. This is followed by slower changes on a few picoseconds timescale, shown to be consistent with thermalization of the complete C/Ni system. Density functional theory spectrum simulations support this interpretation