Noncommunicable disease are the leading cause of death and disability in the majority of theworld, and particularly for Sweden. Modifiable lifestyle behaviors such as smoking, alcohol consumption, unhealthy diets and lack of physical activity are main contributors and risk factors to acquiring these diseases. Despite the evidence linking these risk factors to the diseases, thehealthcare sector has often fallen short in implementing preventive strategies due to severalbarriers and factors within this setting. ICT in the health sector, known as eHealth, cancontribute greatly to relieve the burden in the health systems in implementing new prevention strategies, however eHealth has its own set of barriers hindering implementation that delayadoption of such interventions. In the context of Sweden, emphasis has been made to incorporate increase eHealth initiative to reach their Vision 2025. To investigate how implementing eHealth strategies have been experienced in Sweden, this research has conducted a case study on a specific intervention implemented in the Southern Region of Skåne that incorporated an eHealth tool to aid in the intervention called “health discussions with 40-yearolds” aimed to address the NCD burden. A qualitative case study methodology was taken to investigate how was implementing a new eHealth tool within a prevention and screening of NCDs intervention in the healthcare setting experienced by the project implementation team during its pilot phase. Key challenges and factors for implementing the eHealth tool were extracted from the four interviews and reportcollected on the case to increase understanding of how the implementation was experienced by the program implementors. By focusing on the organizational level of the implementation only, the results from this study aimed to provide insights to key aspects in implementing new eHealth tools within interventions in the healthcare settings with similar organizational structures. Results from the qualitative thematic analysis led to a series of categories subcategories and themes to describe the experiences from the interviewees. The theme to describe the overall experiences was labeled positive but demanding, while the theme for challenges was labeled dintricacies of the health system structure, and the theme for factors was eHealth contingent on the human-social interaction. Core components were summarized for future eHealth implementation implications in this setting and/or similar settings. Challenges faced in this case reflect similar challenges in implementing eHealth in Sweden due to the complex fragmented health system structure. Business modeling and agile project management approaches may aid future health organizational settings eHealth implementation process. Future research isrequired to provide clear frameworks that can be applied in more local fragmented healthsystems

A dissertation submitted in partial fulfillment of the requirements for the Degree of Applied Master of Arts in the Department of Psychology, Faculty of Arts at the University of Zululand, 2000. / This study was aimed at describing levels of AIDS knowledge, HIV infection and risk reduction, attitudes towards AIDS and people with AIDS (PWAs), sexual behaviour, condom use as well as attitudes, beliefs and perceptions about condoms, the impact which perceived norms and self-efficacy have on condom use, sexual behaviour and AIDS preventative behaviour(APB). Results of the study have shown that knowledge levels were high among Zululand university students. A comparison of the different sexes shows that females had a slightly higher level of knowledge than males. The three most popular choices identified as sources of AIDS knowledge were campus health, clinic/doctor and a friend. The majority of the sample was negative, rejecting and intolerant with regard to the proximity to PWAs. Many also held judgemental, fatalistic and moralistic attitudes with regard to AIDS and PWAs. Half of the respondents showed compassion with regard to the legal and social welfare of PWAs. The majority of the sample was sexually active, with a substantial number of subjects engaging in sexual intercourse with multiple partners. Condoms were least used among this latter group and only a third used condoms consistently. However, the majority intended to use condoms in future sexual encounters and this intention was stronger among students with one sexual partner. The Pearson product moment correlation revealed that attitudes, perceived norms and self-efficacy were associated with condom use and sexual behaviour. Knowledge of AIDS per se had no impact on sexual behaviour and condom use. The multiple regression analysis showed that attitudes and self-efficacy are the strongest predictor variables of condom use. Finally gender had no effect on sexual activity, number of sexual partners, condom use, perceived norms and self-efficacy.

Myocardial ischemia, infarction, heart failure and arrhythmias are the manifestations of coronary artery disease. Reduction of ischemic damage is a major concern of cardiovascular biology research. As per recent studies, the mitochondrial ATP-sensitive potassium channel (mitoKATP) opening is believed to play key role in the physiology of cardioprotection, protection against ischemia-reperfusion injury or apoptosis. However, the structural information of mitoKATP is not precisely known. Elucidating the structural integrity and functioning of the mitoKATP is therefore a major goal of cardiovascular biology research. The known structure and function of the cell ATP-sensitive potassium channel (cellKATP) is functional in interpreting the structural and functional properties of mitoKATP. The primary goal of my research was to characterize the activity of mitoKATP in the isolated mitochondria from the control mouse heart. The mitoKATP activity, if preliminarily characterized in the control strains through the light scattering technique, then the structure of the channel could possibly be established and analyzed by means of the transgenic model and with the help of immunological techniques such as western blotting and immunoflorescence. With this experimental model it was possible to demonstrate that the mitoKATP activity in control mouse heart mitochondria is activated by potassium channel openers (KCOs) such as diazoxide and cromakalim and activators of mitoKATP such as PMA (phorbol12 myristate-13-acetate), and inhibited by KATP inhibitors such as glibenc1amide and 5-hydroxydecanoate (5 HD). It was evident that the KATP activity in mouse heart mitochondria was comparable to that exhibited by the rat heart mitochondria. The various selective and non-selective activators and inhibitors of the channel elicited their activity at a similar concentration used for the rat heart mitochondria. The results were reproducible in five independent experiments for each combination, further reinforcing the significance of existing channel activity in the mouse heart mitochondria.

Syfte: Att studera hur tidigare kariesaktiva patienter har ändrat sina vanor med resultatet minskad kariesaktivitet. Frågeställningen var: ”Hur lyckas tidigare kariesaktiva patienter ändra sina vanor?”. Material och metod: Studien genomfördes på Tandvårdshögskolan i Malmö med ett slutgiltigt urval som bestod av sex informanter varav fyra var patienter på Tandvårdshögskolan och två på Folktandvården i Malmö. Inklusionskriterierna var tidigare kariesaktiva med nu avstannad kariessjukdom, fyllda 18 år och som talade flytande svenska. För datainsamlingen genomfördes kvalitativa semistrukturerade intervjuer med efterföljande dataanalys med kvalitativ innehållsanalys.     Resultat: Den ena kategorin som identifierades var: Den varierande drivkraften som omfattade subkategorierna den positiva drivkraften och den negativa drivkraften. Den andra kategorin var: Det externa stödets vara eller icke vara omfattande externt positivt inflytande och en önskan om externt stöd (under sårbara tider).  Slutsats: Informanterna lyckades med en beteendeförändring som initierades av stöd, i form av information, eller drivkrafter, i form av funktion, estetik eller rädsla. När informanterna kände sig lyssnade på, involverade, motiverade och handlingskraftiga kunde de förstå hur de skulle kunna förändras från att vara kariesaktiva till kariesinaktiva. / Aim: To study how previously caries-active patients have changed their habits with the result reduced caries activity. The research question was, "How does previous caries-active patients manage to change their habits?" Material and method: The study was conducted at The Faculty of Odontology at Malmö University with a final sample of six informants, of whom four were patients at the faculty and two at the Public Dental Health Service in Malmö. The inclusion criteria were previously caries-active with now arrested caries disease, 18 years and above and fluent in Swedish. For data collection, qualitative semi-structured interviews were conducted with subsequent data analysis using qualitative content analysis. Results: One category that was identified was: The varied driving force which included the subcategories the positive driving force and the negative driving force. The second category was: The presence or absence of external support including external positive influence and a desire for external support (during vulnerable times). Conclusion: The study showed that the informants managed a behavioral change which was initiated by support, in the form of information, or by driving force, in the form of function, aesthetics or fear. When the informants felt listened to, involved, motivated and driven, they could understand how they could change from being caries-active to caries-inactive.

Masks have become an important part of everyday life, protecting both the wearer and individuals nearby from the spread of infectious diseases, most notably severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the coronavirus that causes coronavirus disease 2019 (COVID-19). However, these masks are easily contaminated, whether through continued use or by the wearer touching the mask fabric with contaminated hands, therefore reducing the efficacy and exposing the user to these contagions. When the mask becomes contaminated, it can be discarded, which produces large amounts of waste that will end up in a landfill, or it can be washed, which is costly, wasteful, and time consuming. Our solution to this problem is a mask apparatus that can sanitize itself quickly on demand. The user wears the shell, which contains the fully retracted mask, on a string like they would a necklace. When the mask is required, it is easily pulled out of the shell and can be worn for as long as the user needs it. When it is safe to remove the mask, the user simply pushes a button and the mask retracts back into the shell, where it is then sanitized for the next use. The design of the apparatus features a retractable cloth mask that is sanitized using ultraviolet-C (UVC) radiation while confined safely within an outer shell, minimizing unwanted exposure to the wearer. UVC radiation at wavelength 222 nm has been shown to destroy the outer shell of coronaviruses similar to SARS-CoV-2, inactivating 99.9% of the virus when exposed at a dosage of 2 mJ/cm2. The 28 light-emitting diode (LED) lamps used in this prototype produce this specified wavelength UVC and are separated into 4 strips located in different locations within the shell. Glass rods were used within the shell to guide the mask fabric into a zig-zag shape when fully retracted to maximize exposure to the UVC. To further reduce waste, two lithium-ion rechargeable batteries were used as the power supply for the lamps. The efficacy of this design for inactivating the SARS-CoV-2 coronavirus on the mask was determined indirectly using nano membrane UV sensors placed on the mask fabric, showing that the specified wavelength of UVC radiation can be applied for the required time on all surfaces of the mask. This mask apparatus can directly benefit both front-line healthcare workers as well as individuals going about their daily lives by eliminating pathogens present on their masks, therefore reducing the spread of deadly infectious diseases.

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Bakgrund: Hjärt- och kärlsjukdom är den vanligaste dödsorsaken globalt och orsakas ofta av ohälsosamma levnadsvanor. Sekundärprevention med fokus på livsstilsförändringar är viktigt för att tidigt upptäcka och förebygga insjuknande och återinsjuknande.  Syfte: Att beskriva patienters upplevelse av att genomföra livsstilsförändringar vid sekundärprevention av hjärt- och kärlsjukdomar. Metod: En kvalitativ litteraturöversikt genomfördes med induktiv ansats. Artikelsökning gjordes i CINAHL, MEDLINE och PsycINFO. Totalt 14 kvalitetsgranskade artiklar analyserades enligt Fribergs fem-stegsmodell.  Resultat: Huvudkategorierna var “tankar och förutsättningar för livsstilsförändring vid sekundärprevention av hjärt- och kärlsjukdom”, “social och kulturell påverkan på levnadsvanor vid sekundärprevention av hjärt- och kärlsjukdom” och “omvårdnadens roll vid sekundärprevention av hjärt- och kärlsjukdom”. Underkategorierna beskrev sedan olika upplevelser av faktorer som patienter menade påverkade motivation och följsamhet till livsstilsförändringar. Slutsats: Sekundärprevention vid hjärt- och kärlsjukdom behöver anpassas för att utgå ifrån vad som motiverar och hindrar den enskilda patienten till livsstilsförändring. Genom att stärka patientens egenmakt och motivation ökar chanserna till följsamhet samt minskar risk för insjuknande och återinsjuknande. Hälso- och sjukvården behöver skapa bättre rutiner för feedback och uppföljning av patienters livsstilsförändringar. / Title: Lifestyle and cardiovascular disease: A literature review of patients’ experience of lifestyle change.  Background: Cardiovascular disease is the most common cause of death globally. Secondary prevention with a focus on lifestyle changes is important to detect and prevent early onset and re-onset of disease. Aim: To describe patients' experience of implementing lifestyle changes in secondary prevention of cardiovascular disease. Method: A qualitative literature review with inductive approach. A total of 14 articles from CINAHL, MEDLINE and PsycINFO were quality reviewed and analyzed using Friberg's five-step model.  Results: The main categories were “thoughts and prerequisites for lifestyle change in secondary prevention of cardiovascular disease”, “social and cultural impact on lifestyle in secondary prevention of cardiovascular disease” and “the role of nursing in secondary prevention of cardiovascular disease”. The subcategories then described different experiences of factors that patients believed influenced motivation and adherence to lifestyle changes. Conclusion: Secondary prevention in cardiovascular disease should be shaped after what motivates and hinders the individual towards lifestyle change. By strengthening the patient's autonomy and motivation chances for compliance increase, and risk of disease and re-onset of disease decreases. Healthcare needs to create better routines for feedback and follow-up of patients' lifestyle changes.

Yes / The on-going COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2) has posed an extraordinary threat to global public health, wealth and well-being. As the carrier of human life and production, infrastructures need to be upgraded to mitigate and prevent the spread of viral diseases. Developing multifunctional/smart civil engineering materials to fight viruses is a promising approach to achieving this goal. In this perspective, the basic introduction on virus and its structure is provided. Then, the current design principles of antiviral materials and structures are examined. Subsequently, the possibility of developing active/passive antiviral civil engineering materials (including cementitious composites, ceramics, polymers and coatings) is proposed and envisaged. Finally, the future research needs and potential challenges to develop antiviral civil engineering materials are put forward. The proposed strategies to develop multifunctional/smart antiviral civil engineering materials will aid in the construction of smart infrastructures to prevent the spread viruses, thus improving human life and health as well as sustainability of human society. / The authors would like to thank the National Science Foundation of China (51978127, 52178188, and 51908103) and the Fundamental Research Funds for the Central Universities (DUT21RC(3)039) for providing funding to carry out this investigation.

Cluster randomized controlled trials are increasingly used to assess the effectiveness of life-style interventions in improvement of health services or prevention of disease. However, statistical methods in the analysis of cluster randomized controlled trials are not well established especially for analyzing binary outcomes. This project is motivated by the Community Hypertension Assessment Trial (CHAT) to assess the effectiveness of a 12-month community-based blood pressure management program in improving the management and monitoring of high blood pressure (BP) among older people. The study is a paired cluster randomized controlled trial, where the family physicians' practices are the clusters randomly allocated to CHAT intervention or usual practice, and a random sample of 55 patients 65 years and older were selected from the 14 practices in each study arm for health record review. The primary outcome was controlled BP over 12 months defined as systolic BP c:; 140 and diastolic BP c:; 90 for patients without diabetes or target organ damage or systolic BP c:; 130 and diastolic BP c:; 80 for patients with diabetes or target organ damage. Secondary outcomes include frequency of BP monitoring and average BP over a 12 month period. The clinical objective of this project is to evaluate the effectiveness of the CHAT intervention. The statistical objective is to compare Bayesian and classical methods of analyzing cluster-randomized trials using CHAT study as an example. We compared the results of different cluster-level analysis methods: i) un-weighted regression, ii) weighted regression, iii) random-effects meta-analytic approach, and different individual-level analyses: i) standard logistic regression, ii) robust standard errors approach, iii) generalized estimating equations, iv) random-effect logistic regression, v) Bayesian random-effect regression. We find that there is no sufficient evidence in support of the effectiveness of the CHAT intervention on all outcomes. For BP control, odds ratio (95% confidence interval) is 1.14 (0.72, 1.80) from generalized estimating equations. This result remains robust under different methods. We also find that the results from different statistical methods are different. The results from cluster-level analysis methods are quite different, while the results from the individual-level analysis methods are similar. We conclude that using various methods to analyze the trial provide good sensitivity analyses to help in interpreting the results of cluster randomized trials. Extensive simulation studies comparing the statistical powers of the different methods in different situations are required. / Thesis / Master of Science (MS)

In the field of gerontology, there is a question regarding whether certain diseases can accelerate the progression of other diseases. Given that there is no existing cure for dementia, there is an undeniable upsurge in demand for research concerning identifying preventive measures that influence the onset or development of cognitive decline. Cerebral atherosclerosis is characterized by the thickening of artery walls within the brain. Many studies have shifted their focus on examining the role nutrients and food play in preventing cognitive decline, dementia, cerebral atherosclerosis, and Alzheimer’s disease (AD). This thesis provides a comprehensive overview of existing observational and clinical trial evidence published up to date for the association of dietary intervention between cognitive health, dementia, AD, and cerebral atherosclerosis.