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(Re)visiting the testimony exhibition part of Women’s Active Museum on War and Peace in Tokyo, I focus on one testimony in particular. This testimony was given by a survivor of the “comfort women” system, a state-sponsored regime of military sexual exploitation and core institution in the Empire of Japan’s expansion 1932–1945. The testimony was then withheld before the exhibition opened. I approach this “withheld testimony” as an invocation of rupture to the time, space, and positionalities informing the museum narrative. The paper interrogates the interplay of the survivor’s act of withholding her testimony, the curatorial decision to represent the absence that followed on the withholding, and the disruption to the museum narrative that the withholding prompts. By exploring the withheld testimony as a speaking silence, visible emptiness, and present absence, the paper offers a rethinking of model victimhood under the comfort women system.
Current ketamine-based therapies for treatment-resistant depression (TRD) often induce dissociative effects. A novel oral PR ketamine formulation (KET01) results in a low and delayed peak concentration of ketamine, high hydroxynorketamine concentration, and is associated with limited dissociative properties.
Objectives
To investigate efficacy, safety, and pharmacokinetics of KET01 in TRD.
Methods
KET01-02 was a randomized, double-blind phase 2 trial in outpatients with TRD comparing adjunct 120 mg (n=42) or 240 mg (n=40) oral KET01 once-daily for 3 weeks to placebo (PBO, n=40). The primary endpoint was change from baseline in the MADRS mean score on Day 21. KET01-03 was a randomized, double-blind, cross-over phase I trial in 26 healthy volunteers comparing single doses of 240 mg oral KET01 and 84 mg an approved intranasal formulation of eketamine. The primary endpoint was maximum change of Clinician-Administered Dissociative States Scale (CADSS) score from baseline.
Results
KET01-03 trial; the mean (±SD) maximum change of CADSS score within 24 hours after dosing was 29.6±12.5 for intranasal eketamine and 0.7±1.7 for KET01 (p<0.00000000001). KET01-02 trial; no differences in CADSS score (range: 0.2 to 1.3), and heart rate and blood pressure were observed between the groups on Day 1 and beyond. 10%, 12%, and 15% of patients in the PBO, 120 mg/day, and 240 mg/day KET01 groups, respectively had CADSS score >4 and increase from baseline. At 7 hours post first KET01 dose (240 mg), plasma concentration of ketamine (38.7±27.0 ng/ml) was lower than its metabolites norketamine (267.5±81.6 ng/ml) and hydroxynorketamine (190.2±85.5 ng/ml). 240 mg/day KET01 induced clinically relevant reduction from baseline in MADRS score already within the first 7 hours of treatment (-7.65; Δ vs PBO: -2.22, n.s.), with a statistically significant separation on Day 4 (-10.02; Δ vs PBO: -3.66, p=0.020) and Day 7 (-12.21; Δ vs PBO: -3.95, p=0.042). MADRS score decrease was sustained throughout Day 21 (-13.15; Δ vs PBO: -1.82, n.s.), and during 4-week follow-up (-12.51; Δ vs PBO: -3.35, n.s.). Treatment-emergent adverse events occurred in 47.5%, 50.0%, and 62.5% of patients in the PBO, 120 mg/day, and 240 mg/day KET01 group, respectively.
Conclusions
Oral 240 mg/day KET01 induces a rapid, and clinically relevant reduction of depressive symptoms with only minimal signs of dissociation, potentially due to lower ketamine levels and increased norketamine and hydroxynorketamine levels compared to intravenous administration. Our results suggest that KET01 may be an efficacious and safe take-at-home adjunct treatment for TRD.
Disclosure of Interest
C. zu Eulenburg Employee of: HMNC Brain Health, E. Papanastasiou Employee of: HMNC Brain Health, K. Schmid Employee of: Develco Pharma, A. Damyanova Employee of: HMNC Brain Health, A. Glas Employee of: HMNC Brain Health, C. Strote Employee of: HMNC Brain Health, L. Arvastson Employee of: HMNC Brain Health, H. Eriksson Employee of: HMNC Brain Health
This study emphasizes the importance of automatic synthetic data generation in data-driven applications, especially in the development of a 3D computer vision system for engineering contexts such as brownfield factory projects, where no data is readily available. Key points: (1) A successful integration of a synthetic data generator with the S3DIS dataset, leading to a significant enhancement in object detection of previous classes and enabling recognition of new ones; (2) A proposal for a CAD-based configurator for efficient and customizable scene reconstruction from LiDAR scanner point clouds.
The frequency of disasters world-wide has significantly increased in recent years, leading to an increase in the number of mass-casualty incidents (MCIs). These MCIs can overwhelm health care systems, requiring hospitals to respond quickly and effectively, often with limited resources. While numerous studies have identified the challenges in managing MCIs and have emphasized the importance of hospital disaster preparedness, there is a research gap in the preparedness level and response capacities of district hospitals in Nepal.
Study Objective:
This study attempts to fill this gap by understanding the perception of hospital staff in managing MCIs in district hospitals of Nepal.
Methods:
A qualitative case study was conducted in three district hospitals in Nepal. Semi-structured interviews were conducted with the hospital personnel, using an interview guide. An inductive thematic analysis was carried out to understand their perception on the most recent MCI management.
Results:
Three themes emerged from the data analysis: enablers in MCI management, barriers in MCI management, and recommendations for the future. Use of multiple communication channels, mobilization of entire hospital teams, mobilization of police in crowd control, presence of disaster store, and pre-identified triage areas were the major enablers that facilitated successful MCI management. Nonetheless, the study also revealed challenges such as a lack of knowledge on MCI response among new staff, disruptions caused by media and visitors, and challenges in implementing triage.
Conclusion:
This study emphasized the importance of hospital disaster preparedness in managing MCIs and highlighted the significance of overcoming barriers and utilizing enablers for an efficient response. The findings of this study can provide the basis for the Ministry of Health and Population Nepal and district hospitals to plan initiatives for the effective management of MCIs in the future.
An outbreak of SARS-CoV-2 was confirmed after an academic party in Helsinki, Finland, in 2022. All 70 guests were requested to fill in follow-up questionnaires; serologic analyses and whole-genome sequencing (WGS) were conducted when possible.
Of those participating – all but one with ≥3 vaccine doses – 21/53 (40%) had test-confirmed symptomatic COVID-19: 7% of those with earlier episodes and 76% of those without. Half (11/21) were febrile, but none needed hospitalisation. WGS revealed subvariant BA.2.23.
Compared to vaccination alone, our data suggest remarkable protection by hybrid immunity against symptomatic infection, particularly in instances of recent infections with homologous variants.
Design representations are important tools for designers in the design process. To help designers choose the appropriate representation, taxonomies have been proposed based on type, degree of fidelity, and when to use them. However, Design representations may also play an important role in designers' communication with users and enabling users as co-designers. Therefore, new taxonomies, focusing on design representations’ potential mediating roles in collaborative design processes with users, have been developed. The purpose of this interview study, with twelve designers within Swedish industry, was thus to investigate how designers use design representations in communication with users in the design process. The study indicates that the designers mainly interacted with users in order for them to answer specific design questions or to evaluate design solutions. If design representations’ value for facilitating communication and collaboration with users should be emphasized, we need to shift from teaching mainly taxonomies related to fidelity levels or when to use them in the design process, and rather educate future designers about design representations inherent potential to mediate and enhance the dialogue with users.
In order to better understand the stakeholder choices of knowledge-based organisational actors, this study focuses on a novel application of Huber's (2012) dimensions of proximity salience, namely spatial proximity, social proximity and cognitive proximity. The population of the study is made up of knowledge-based organisational actors involved in developing an innovation ecosystem, in terms of stakeholder network creation. The extent to which the three proximity dimensions of stakeholder salience is evident in the stakeholder choices of these innovation-focused actors seeking knowledge-based collaborators is explored. Our findings show how various forms of proximity prompt the decision of who to work with among a diverse population of experts involved in building a cross-national innovation ecosystem. The various explanations that motivate stakeholder choice matched Huber's proximity dimensions. The findings provide new insight into stakeholder choice among knowledge-based organisations, and highlight a new proximity dimension indirectly linked to cognition proximity. Termed the “potential proximity” dimension, it involves attraction to stakeholders that represent strategic value.
This is a brief presentation of the evidence from a systematic literature review of the diagnostic accuracy in suspected traumatic shaking. The national and international reaction to this systematic literature review is also addressed, along with rebuttal of the criticism and an interpretation of the hostile reception of the review. We argue that despite the fact that a scientific controversy often includes competing theories about mechanisms, the shaken baby controversy also includes a controversy about correlation knowledge, because its function is to corroborate (or falsify) the applied theories about mechanisms. Moreover, we argue that long personal experience and groupthink within child protection teams have influenced the development of biased gold standards, resulting in turn in circular reasoning: hence most of the shaken baby literature is flawed.
The chapter describes the main nature conservation challenges in Sweden, its main policy responses and actions, and their achievements and lessons, primarily over the last 40 years. This covers the country’s natural characteristics, habitats and species of particular importance; the status of nature and main pressures affecting it; nature conservation policies (including biodiversity strategies), legislation, governance and key actors; species measures; protected areas and networks; general conservation measures (e.g. development planning, offsetting and compensation measures, management of natural forest habitats, and hydropower permitting); nature conservation costs, economic benefits and funding sources; and biodiversity monitoring. Likely future developments are also identified. Conclusions are drawn on what measures have been most effective and why, and what is needed to improve the implementation of existing measures and achieve future nature conservation goals.
Death literacy is a recent conceptualization representing both individual and community competence, for example, a set of knowledge and skills for engaging in end-of-life-related situations. Little is yet known about which factors are associated with death literacy. A cross-sectional survey using the Swedish version of the Death Literacy Index, the DLI-S, was therefore conducted to explore associations between death literacy and sociodemographic, health, and experience variables.
Methods
A quota sample of 503 adults (mean age 49.95 ± 17.92), recruited from an online Swedish survey panel, completed a survey comprising the DLI-S and background questions.
Results
A hierarchical regression model with 3 blocks explained 40.5% of the variance in death literacy, F(22, 477) = 14.75. The sociodemographic factors age, gender, education, widowhood, and religious/spiritual belief accounted for 13.7% of the variance. Adding professional care factors contributed to an additional 15.8% of variance, with working in health care being significantly associated with death literacy. Including experiential factors explained another 11.0% of the variance, of which experiences of caring for and supporting dying and grieving people, both in a work, volunteer, or personal context, were positively associated with death literacy.
Significance of results
This study contributes a tentative explanatory model of the influence of different factors on death literacy, outlining both direct and indirect associations. Our findings also support the hypothesized experiential basis for death literacy development in the Swedish context. The moderate degree of overall variance explained suggests there may be additional factors to consider to better understand the death literacy construct and how its development may be supported.
Considering the need for hospital disaster preparedness post-Nepal earthquake 2015, the Ministry of Health and Population of Nepal developed a Hospital Disaster Preparedness and Response Plan (HDPRP) for mass casualty management. However, until now, there is no scientific literature on how the district hospitals, which are the major health service providers in Nepal, implemented their HDPRP during mass casualty incidents (MCIs). So, this study aims to understand how the HDPRP was implemented during MCIs in three district public hospitals of Nepal.
Method:
A mixed sequential QUANT-QUAL study was designed. Out of seven districts under the severely hit category by Nepal Earthquake 2015, three districts were selected randomly. For the quantitative component, the WHO hospital emergency response checklist was adapted which was self-administered in each hospital. Based on a scoring system, each hospital was placed in one of three categories (effective, insufficient, unacceptable), to assess the level of HDPRP implementation. For the qualitative component, semi-structured interviews were conducted to understand how the HDPRP was implemented in each hospital. An inductive thematic analysis was carried out. All information was collected for the most recent management of MCI reported in the hospital.
Results:
Out of three hospitals, two hospitals have effectively implemented their HDPRP, whereas one has insufficient implementation. Three themes emerged during the data analysis: enablers in implementation of HDPRP, barriers in implementation of HDPRP, and recommendations for the future. Multiple enablers and barriers were identified for the implementation of HDPRP, and the recommendations were identified for the hospital, hospital staff, and external stakeholders.
Conclusion:
Implementation of HDPRP as per the protocol is difficult due to many external and internal factors that arise while managing the MCIs. The findings of this study provide the basis for the Ministry of Health and Population and district hospitals for the future update of HDPRP and planning of MCIs.
We use historical census data to show that Sweden exhibited high levels of intergenerational occupational mobility several decades before the rise of the welfare state. Mobility rates were higher than in other nineteenth- and twentieth-century European countries, closer to those observed in the highly mobile nineteenth-century United States. We leverage mobility variation across Swedish municipalities to shed light on potential determinants: economic growth and migration are positively correlated with mobility, consistent with the patterns observed across countries.
Artistic activities provide the possibility for self-expression, to help reinforce one’s sense of competence and enhance a general feeling of content in life (Eisenhauer 2007). That is also the case with those affected by profound intellectual and multiple disabilities (henceforth PIMD) to whom such activities are extremely enjoyable (Levy and Young 2020). However, their opportunities for recreational activities are limited by different social and cultural ideologies based on ableism, such as assumptions that physical strength is always essential to have capabilities for hobbies. Opportunities for meaningful recreational activities are much fewer for young people beset by PIMD, than for their non-disabled peers or for those with better functional abilities (Eriksson and Saukkonen 2021).
The aim of this chapter is to look at the role of artistic elements and sensory experiences in those physical activities that are currently provided for young people faced with PIMD. The study is a part of a three-year academic research project (2019–2022) dealing with opportunities of young people affected by PIMD to physical activities in their daily lives. It has been found out in the research that opportunities for these young people for recreational activities are often dependent on institutional practices of residential and disability services. For example, the practice of professional physiotherapy provides a possibility for physical exercise, while physical activities are enabled in sports events arranged in housing units (Eriksson and Saukkonen 2021).
Educational institutions, such as vocational schools, provided physical education according to the curriculum. Careful attention was paid to equal opportunities of children and young disabled people despite the level of their development. Various physical activities, such as adaptive sports were also provided for young PIMD afflicted people according to their interests and individual abilities. In edcational institutions they were also open to new, artistic types of sports activities, such as those undertaken in circus acts and other performative arts: an openness that enables schools to combine physical activities with drama education. As the role of arts has been often forgotten in the discussion on sports and physical activities of young people facing PIMD, this chapter provides an insight into the reality of their lives when such practices of physical recreation – in which artistic expression and multiple sensory experiences are crucial – are applied.
The bacterium Neisseria meningitidis causes life-threatening disease worldwide, typically with a clinical presentation of sepsis or meningitis, but can be carried asymptomatically as part of the normal human oropharyngeal microbiota. The aim of this study was to examine N. meningitidis carriage with regard to prevalence, risk factors for carriage, distribution of meningococcal lineages and persistence of meningococcal carriage. Throat samples and data from a self-reported questionnaire were obtained from 2744 university students (median age: 23 years) at a university in Sweden on four occasions during a 12-month period. Meningococcal isolates were characterised using whole-genome sequencing. The carriage rate among the students was 9.1% (319/3488; 95% CI 8.2–10.1). Factors associated with higher carriage rate were age ≤22 years, previous tonsillectomy, cigarette smoking, drinking alcohol and attending parties, pubs and clubs. Female gender and sharing a household with children aged 0–9 years were associated with lower carriage. The most frequent genogroups were capsule null locus (cnl), group B and group Y and the most commonly identified clonal complexes (cc) were cc198 and cc23. Persistent carriage with the same meningococcal strain for 12 months was observed in two students. Follow-up times exceeding 12 months are recommended for future studies investigating long-term carriage of N. meningitidis.
Iodine deficiency may cause thyroid dysfunction. The iodine intake in a population is measured by urinary iodine concentration (UIC) in spot samples or 24-h urinary iodine excretion (24UIE). 24UIE is considered the gold standard and may be estimated using an equation including UIC, urinary creatinine concentration, sex and age (e24UIE). The aims of this study were to evaluate the preferable timing of UIC when using this equation and assess the variability of UIE. Sixty healthy non-smoking women (n 31) and men (n 29) were included in Gothenburg, Sweden. Twelve urine samples were collected at six fixed times on two separate days. Variability was calculated for UIC, 24UIE, e24UIE, iodine excretion per hour (iHr) and UIC adjusted for creatinine and specific gravity. Median 24UIE was 156 µg/24 h and the median UIC (all spot samples) was 104 µg/l. UIC (P < 0·001), 24UIE (P = 0·001) and e24UIE (P < 0·001) were significantly higher in men. e24UIE was relatively similar to 24UIE. However, when e24UIE was calculated from UIC in the first void, it was about 15 % lower than 24UIE (P < 0·001). iHr was lowest in the morning and highest in the afternoon. Median iHr was higher in men (7·4 v. 5·3 µg/h, P < 0·001). The variability of UIE was higher within individuals than between individuals. This study suggests that most time points for estimation of individual 24UIE are appropriate, but they should preferably not be collected in the first void.
Mathematics is a fundamental tool of research. Although potentially applicable in every discipline, the amount of training in mathematics that students typically receive varies greatly between different disciplines. In those disciplines where most researchers do not master mathematics, the use of mathematics may be held in too much awe. To demonstrate this I conducted an online experiment with 200 participants, all of which had experience of reading research reports and a postgraduate degree (in any subject). Participants were presented with the abstracts from two published papers (one in evolutionary anthropology and one in sociology). Based on these abstracts, participants were asked to judge the quality of the research. Either one or the other of the two abstracts was manipulated through the inclusion of an extra sentence taken from a completely unrelated paper and presenting an equation that made no sense in the context. The abstract that included the meaningless mathematics tended to be judged of higher quality. However, this “nonsense math effect” was not found among participants with degrees in mathematics, science, technology or medicine.
A gender difference in risk preferences, with women being more averse to risky choices, is a robust experimental finding. Speculating on the sources of this difference, Croson and Gneezy recently pointed to the tendency for women to experience emotions more strongly and suggested that feeling more strongly about negative outcomes would lead to greater risk-aversion. Here we test this hypothesis in an international survey with 424 respondents from India and 416 from US where we ask questions about a hypothetical lottery. In both countries we find that emotions about outcomes are stronger among women, and that this effect partially mediates gender difference in willingness to enter the lottery.
Although cats are extremely common, pet owners seem to have a poor understanding of their natural behaviour and needs and a large number end up in cat shelters. In Sweden, no records exist of the number of cat shelters or their activities. The aim of this study was to investigate the occurrence of cat shelters in Sweden. We found 62 cat shelters during 2006; the year in which this study was conducted. Questionnaires were sent to these shelters with questions concerning: received animals, reasons for relinquishing cats, cat husbandry and how the shelter was run. The most common reason for relinquishing a cat was that the cat was homeless; another common reason was that the owner had an allergy to cats. The shelters had, on average, space for 29 cats, but this varied from six-to-100, and they received on average ten cats per month. This means that a total of around 7,400 cats enter the 62 shelters in Sweden each year. On average, the cats stayed more than three months in the shelter. Less than 10% of the relinquished cats were euthanised. Our study reveals that there are shelters that continuously receive unwanted cats. The majority of these cats are said to be homeless, therefore in order to minimise the number of cats in shelters in Sweden, the focus should be on reducing the number of homeless cats.
In this reply, we reiterate the main point of our 2012 paper, which was that the measure of inequality used by Norton and Ariely (2011) was too difficult for it to yield meaningful results. We describe additional evidence for this conclusion, and we also challenge the conclusion that political differences in perceived and desired inequality are small.