Areas In Sweden Research Articles

Physical activity and influencing factors in people post stroke or transient ischemic attack across diverse regions in Sweden

Background and purposePhysical activity (PA) and sedentary behavior are key targets for secondary stroke prevention, yet their characteristics and contributing factors are not well understood. This study aims to explore PA and sedentary behavior in individuals' post-stroke or transient ischemic attack (TIA) and identify factors linked to low PA (≤5,000 steps/day) and prolonged sedentary time (≥8 h/day).MethodsA cross-sectional study comparing sensor-derived (activPAL) PA and sedentary time among community-dwelling individuals post stroke or TIA residing in diverse geographical regions of Sweden. Multiple logistic regression models were performed to determine potential factors associated with low PA and prolonged sedentary time.ResultsThe study included 101 participants post-stroke (n = 68) and TIA (n = 33), with a mean age of 70.5 years (65% female), mostly with no or mild disability (91%), living in metropolitan (69%) and rural (31%) areas of Sweden. Most participants (72%) had ≥ 8 h of sedentary time per day and 38% performed ≤5,000 steps per day. Using a walking aid (OR = 11.43, p = 0.002) was independently associated with low PA, whereas contextual factors; living alone (OR = 3.49, p = 0.029) and living in metropolitan areas (OR = 2.79, p = 0.036), were associated with prolonged sedentary time.Discussion and conclusionsIn this study encompassing people post stroke or TIA from diverse geographical regions across Sweden, PA was associated with mobility status whereas sedentary behavior was associated with contextual factors. The results also showed a large variation in PA highlighting the need for tailored strategies to promote PA post stroke or TIA.

Thrombolysis versus primary percutaneous coronary intervention in patients with suspected ST-elevation myocardial infarction - a SWEDEHEART observational study

Abstract Background Primary percutaneous coronary intervention (PCI) is the recommended reperfusion strategy in ST-elevation myocardial infarction (STEMI) patients provided time to reperfusion is ≤120 minutes. In patients presenting early with an estimated time to reperfusion >120 minutes, thrombolytic therapy should be considered according to European Society of Cardiology guidelines. However, there is a lack of contemporary data on patients treated with thrombolysis. Aims Our aim was to determine how often thrombolysis was administered in STEMI patients having an estimated time to reperfusion of >120 minutes and to study outcome differences between patients treated with thrombolysis compared to those treated with primary PCI. Methods We calculated transport times to nearest primary PCI centre using three-digit zip codes for each patient enrolled in the SWEDEHEART registry from 2008–2021 in the five geographic areas in Sweden routinely using thrombolysis and included those with >120 min estimated transportation time to reperfusion time. Patients without ST-elevations on prehospital ECG and ongoing chest pain as well as patients with left bundle branch block, pacemaker rhythm and patients with contraindications to thrombolysis were excluded. Patients were grouped by received reperfusion therapy with prehospital thrombolysis or no prehospital thrombolysis and studied with regard to 1- and 3-year mortality using Kaplan-Meier failure estimates and Cox regression adjusted for difference in baseline characteristics. Results A total of 1,840 patients were included of whom 1,381 (75.1%) received thrombolysis. A final diagnosis of STEMI was observed in 92.6% of patients receiving thrombolysis and 80.2% of patients treated with primary PCI. The median transport time estimate to a PCI centre was 153 minutes in both groups. Median time from onset of symptoms to reperfusion therapy was 131 minutes for the thrombolysis group and 255 minutes for the PCI group. Patients who received thrombolysis were on average 2 years younger and had fewer comorbidities such as diabetes, cancer and heart failure. Among patients treated with thrombolysis, a total of 42.7% of patients underwent rescue PCI. There was no significant difference in 365-day mortality (6.7% vs 11.8%, adjusted HR 0.84, 95% CI: 0.59-1.19, p=0.33) or 3-year mortality rates (10.3% vs 16.6%, adjusted HR 0.89, 95% CI: 0.66-1.19, p=0.44) between patients treated with thrombolysis and primary PCI groups. Conclusions In this population-based study of patients where primary PCI cannot be expeditiously used, we observed a commendable adherence rate of 75% to the ESC guidelines for thrombolysis treatment. Moreover, our findings revealed that the administration of thrombolysis was not associated with any discernible benefits or harm.Unadjusted and adjusted Cox-modelKaplan-Meier survival analysis

A brown bear population estimate for Finnmark County, North Norway

We have estimated the average number of brown bears Ursus arctos L. in Finnmark, the northernmost county in Norway. We started by estimating the number of bears where reproduction has been documented in the Pasvik Valley (1,330 km2) and published densities of brown bears from 1) female concentration areas in Sweden and northern Russia (ca. 5 bears per 1 000 km2), and 2) an intensively studied area in northern Sweden (12.6 bears per km2). We then expanded this estimate to all of Finnmark using observations of bears far from the Pasvik Valley. We estimate that there are on average 7 - 17 bears in Sør-Varanger Municipality, and totally 8 - 21 in Finnmark County. The brown bears in Finnmark comprise 31 - 38% of the total estimated number of bears in Norway of 26 - 55, respectively. An area of only 1,330 km2 in the Pasvik Valley is the major Norwegian brown bear area, contains about 30% of the bears in Norway, and is the area where reproduction is observed most regularly.

Examining senior citizens in public transport: The role of digitalization, environmental concern, and traveler satisfaction

Increasing the share of travelers using public transport is one way to address environmental problems such as carbon dioxide emissions. Senior citizens represent an increasingly important group in this transition, as they are increasingly mobile and make up a large share of the population. In this paper, we investigate senior citizen’s mobility decision-making, focusing on public transport. Through a survey of 5,000 people in three metropolitan areas in Sweden, we find that while senior citizens desire to live in harmony with nature, they are less likely to see car traffic as a cause of environmental problems. They also struggle with the development of digital service delivery options of public transport. For instance, they use apps less, and like using timetables on paper and signs at bus stops more than younger public transport users. Even so, they are more satisfied with public transport than younger travelers, indicating that many seniors like using public transport, despite lacking the environmental motivations to do so.

“Longing to be cared about and cared for” Exploring Experiences of Trauma Therapy and Views on Future Trauma Therapy (Including Digital) for Young People in Rural Northern Sweden

IntroductionYoung people in rural areas face challenges related to their living conditions, and unequal access to physical and mental healthcare. Despite the high prevalence of trauma exposure among young people, there is a significant lack of evidence-based treatment that is tailored to the needs of young people in rural parts of Northern Sweden. Barriers to accessing treatment include the need to travel long distances to access services, and a lack of educated, culturally competent therapists. Accordingly, this article aims to explore how young trauma patients in rural areas have experienced their trauma therapy, and their views on future trauma therapy (including digital forms). This knowledge will be used to develop trauma therapy that is adapted to the needs of young patients in rural areas in Sweden. MethodThe study included young trauma patients in rural areas in Northern Sweden between the ages of 15 and 21 (n = 14). Qualitative individual semi-structured interviews were performed and analyzed using reflexive thematic analysis. ResultsThe analysis resulted in one overarching theme, “Longing to be cared about and cared for,” and three themes: 1. “Rural circumstances matter,” 2. “Feeling understood and empowered”, and 3. “Ambivalence regarding digital trauma therapy”. The results show that rural contexts present both possibilities and challenges: new creative care landscapes are needed where young people are cared about and cared for (and with), including a deeper understanding of the multidimensional relationship between people, places, and care. ConclusionYoung trauma patients in rural areas want effective therapy with more knowledge and cultural sensitivity. The findings indicate that digital trauma therapy offers many benefits and reduces barriers. However, young people want future therapy to be provided both digitally and in person, and –importantly – individually adapted.

Tick-borne Encephalitis Clinical Characteristics in Adult Patients: A 10-year Retrospective Study in Stockholm, Sweden.

The incidence of Tick-borne encephalitis (TBE) has increased during the last decades in Europe. Our aim was to assess the clinical characteristics and outcome of TBE patients in Region Stockholm, as a high-risk area in Sweden. The notification database at the regional Department of Communicable Disease Control and Prevention was used to identify TBE cases during 2006-2015. Clinical data was retrieved from the included patients' medical records. The associations of specific variables to predefined outcomes of disease severity were evaluated with multivariate logistic regression models. Of 1004 identified TBE cases, 703 adult patients were included. Sixty-one percent were men, and the median age was 50 years (range 18-94). The majority were non-vaccinated. Comorbidity was present in 34%, and 4% had immunomodulatory therapy. Seventy-five percent were hospitalised, and 11% had severe disease. More than 70% of the 79 patients followed up for more than 6 months had persisting symptoms. The case fatality rate was 1.4%, with 15% in the group with immunomodulatory treatment. In the multivariate analysis, severe disease was associated with underlying comorbidities, age ≥50 years, and previous complete TBE vaccination. This is the largest cohort of TBE patients in Scandinavia. Our findings of a more severe course of disease in patients of older age, with immunomodulatory therapy, with comorbidities, and vaccination breakthrough infections must be interpreted in the context of hospitalised patients. Optimised prevention is needed for patients with immunomodulatory therapy, given the considerable case fatality rate. Follow-up visits and rehabilitation should be better standardised.

DEMOGRAPHIC PATTERNS IN HYLLIE MOSSE (SCANIA, SWEDEN): ESTIMATING ABSOLUTE POPULATION BETWEEN THE LATE NEOLITHIC AND THE EARLY BRONZE AGES

SummaryThis paper reconstructs the population dynamics within the Hyllie Mosse region (Scania, Sweden) from 2400 to 1600 BC. South‐western Scania is particularly well‐known thanks to extensive archaeological work in the past decades, making it one of the most thoroughly investigated areas in Sweden. The Late Neolithic and Early Bronze Age periods are of paramount importance in understanding the socio‐cultural transformations within the Baltic region. By integrating a comprehensive database of longhouses from Scania with the available archaeological data from the Hyllie Mosse area, this study provides absolute demographic estimates through a transparent and replicable methodology. It highlights that the region experienced a significant peak in human occupation between 2000 and 1800 BC, followed by a decline. In prehistoric times, the area was covered by a relatively large bog, and was therefore not uniformly settled. At its peak, it is estimated that the region, approximately 9.7 km2 in size – 4 km2 of which have been archaeologically investigated – could have supported 75 to 150 inhabitants.

Next generation gravel road profiling – The potential of advanced UAV drone in comparison with road surface tester and rotary laser levels

Over the last decades, significant progress has been made and new approaches have been proposed for efficient collection of road condition data. Gravel roads are crucial for connecting urban and rural areas in Sweden, constituting a significant portion of the road network. Therefore, this study addresses the use of a developed Unmanned Aerial Vehicle (UAV)-based digital imaging system focusing on efficient collection of surface condition data over gravel roads.The study focuses on in-situ profile measurements of a gravel road located in Trosa, Sweden, using three different profiling methods: UAV drone with RTK technology, Road Surface Tester (RST), and Rotary Laser Level (RLL) to explore the agreement between these methods.The UAV drone, equipped with Real-Time Kinematic (RTK) technology, captures high-resolution images to produce detailed 3D surface models, overcoming the challenges posed by adverse weather conditions. Notable outcomes reveal RTK technology's stability, maintaining a steady 3D position accuracy below 2 cm. To enhance synchronization and comparison between different profiling methods, efforts should be made to standardize coordinate systems and measurement analysis software.Minimum average absolute differences of 1.1 cm, 1 cm, and 0.7 cm were recorded for all profiles (from 1 m left to 1 m right of the road centerline) in the comparisons between UAV drone – RST, UAV drone – RLL, and RST – RLL methods, respectively. This underlines the significant advancement in UAV drone technology, enabling remarkably accurate measurements of vertical offsets for profiling the tested gravel road despite the high altitude at which the UAV drone operates.

Mapping the risk of introduction of highly pathogenic avian influenza to Swedish poultry

Outbreaks of highly pathogenic avian influenza (HPAI) have resulted in severe economic impact for national governments and poultry industries globally and in Sweden in recent years. Veterinary authorities can enforce prevention measures, e.g. mandatory indoor housing of poultry, in HPAI high-risk areas. The aim of this study was to conduct a spatiotemporal mapping of the risk of introduction of highly pathogenic avian influenza virus (HPAIV) to Swedish poultry from wild birds, utilising existing data sources. A raster calculation method was used to assess the spatiotemporal risk of introduction of HPAIV to Swedish poultry. The environmental infectious pressure of HPAIV was first calculated in each 5 km by 5 km cell using four risk factors: density of selected species of wild birds, air temperature, presence of agriculture as land cover and presence of HPAI in wild birds based on data from October 2016-September 2021. The relative importance of each risk factor was weighted based on opinion of experts. The estimated environmental infectious pressure was then multiplied with poultry population density to obtain risk values for risk of introduction of HPAIV to poultry. The results showed a large variation in risk both on national and local level. The counties of Skåne and Östergötland particularly stood out regarding environmental infectious pressure, risk of introduction to poultry and detected outbreaks of HPAI. On the other hand, there were counties, identified as having higher risk of introduction to poultry which never experienced any outbreaks. A possible explanation is the variation in poultry production types present in different areas of Sweden. These results indicate that the national and local variation in risk for HPAIV introduction to poultry in Sweden is high, and this would support more targeted compulsory prevention measures than what has previously been employed in Sweden. With the current and evolving HPAI situation in Europe and on the global level, there is a need for continuous updates to the risk map as the virus evolves and circulates in different wild bird species. The study also identified areas of improvement, in relation to data use and data availability, e.g. improvements to poultry registers, inclusion of citizen reported mortality in wild birds, data from standardised wild bird surveys, wild bird migration data as well as results from ongoing risk-factor studies.

Financialization the Swedish way: How Vonovia became the largest owner of former public housing estates through transaction pathways and calculative practices

ABSTRACT The Swedish rental housing market has been in transition. The once dominating municipal public housing sector has been steadily decreasing. International firms have increasingly taken over rental housing in so-called socially deprived areas. This article analyzes the financialization of the former public housing stock. It traces activities in two housing estates and outlines the history and operations of venture capital-based real estate companies focusing on deprived areas in Sweden. These companies have upgraded multifamily homes and thus increased rents, which resulted in large profits and a decrease in the affordable housing stock. In this new reality, venture capital actors have taken advantage of contextual conditions and applied powerful calculative devices. Drawing on studies of financialization as a socio-technical process, the article contributes to knowledge by de-mystifying financialization through a detailed study of specific practices undertaken by international investors who acquire former public housing units in Sweden.

Attitudes towards harm reduction amongst social work professionals in three geographical areas in Sweden

ABSTRACT Professionals’ understandings of substance use interventions and treatment goals impact treatment recommendations. We aimed to explore social work professionals’ (SWP) attitudes towards harm reduction philosophy and measures in three areas of Sweden with very differing development of their harm reduction: Malmö (most developed), Gothenburg (moderately developed), Gävleborg (least developed). We conducted a survey of SWP working with people who use drugs, utilizing the Harm Reduction Acceptability Scale (HRAS). An ANOVA with Bonferroni post-hoc correction was performed to assess for differences in mean HRAS score. There were 208 valid survey responses (Malmö: 79, Gothenburg: 82, Gävleborg: 47). The overall mean score indicated positive attitudes towards harm reduction. Means differed based on geographic location, with Malmö and Gothenburg scores indicating significantly more positive attitudes towards harm reduction than scores in Gävleborg. Opinions on implementation of new harm reduction measures such as heroin assisted treatment, supervised consumption sites, and decriminalization of drugs for personal use were more negative overall. These opinions followed the above trend, with regard to differences based on geography. Differences indicated that SWP who are more exposed to harm reduction have more positive attitudes. Increased knowledge of harm reduction among SWP could lead to improved access to interventions and reduced risks for people who use drugs.

#3003 Increased focus on peritoneal dialysis gives patients improved quality of life and saves millions for the region

Abstract Background and Aims Is it possible to improve PD patients' quality of life and everyday life in combination with the challenge of mastering large geographical distances and at the same time a desire to make healthcare more patient safe and enable patients to be co-creators in their dialysis care? With an area of 48,935 km2, which corresponds to 12% of Sweden's area and larger than the whole of Denmark, Östersund Hospital is the only hospital in a region that takes care of 132,670 inhabitants. In 2018, 85% of patients were dialyzed with hemodialysis at Östersund Hospital. Several of the patients had to travel 200-300 km one way, three to four times a week to receive their dialysis treatment. In addition to high medical travel costs for the region, this also contributed to a low quality of life for the patients. Patients of working age found it difficult to maintain their jobs due to long journeys to the hospital. In a study by (Van Bulck et al, 2018), he shows that patients on dialysis have low participation in their care compared to other patient groups. Method A first step towards a change to provide an increased quality of life for the patients was to invest in self-care with peritoneal dialysis. Several studies describe peritoneal dialysis as a treatment with increased freedom that offers the patient independence with the opportunity to continue working if they are of working age (IIkka et al, AJKD 2012). In addition, several studies show several medical benefits, such as preserving the patient's residual function, which indirectly associates with better patient survival (Van de Luijtgaarden et al, NDT 2011). To continue its work, the dialysis clinic needed approval from the region to start using a night machine connected to a cloud service. After a long wait, the dialysis clinic received approval to use the new technology. Results Since the digital platform was introduced, remote dialysis treatment has increased in the Jämtland Härjedalen region. Digitalization gives healthcare professionals the opportunity to follow the patient's treatment results daily and optimize dialysis treatments without the patient needing to visit the hospital. Today, work is more proactive and provides the conditions to prevent problems before they arise. Five years ago, 85% of dialysis treatments were performed at the hospital. Today, as many as 60% of dialysis treatments with peritoneal dialysis take place in the patient's home. Already in the first year of increased self-care, the region saved SEK 6 million on reduced patient travel. Success factors for a successful result and our way of working today: Conclusion With a patient centric approach, a clear goal focuses and collaboration between several different professional categories. Östersund Hospital has managed to increase the proportion of patients with home treatment from 15% to 60%. Through the implementation of new technology in the form of a digital platform tied to a dialysis machine, the patient's treatment can be evaluated and adjusted remotely. From previously working reactively and solving problems when they arise, now working proactively and planning care for the patient. Emergency hospitalizations can be avoided. In addition to reducing the patient's suffering and providing a better quality of life with fewer hospital visits, it also promotes the hospital's finances. By having the courage to dare to try when others say impossible, learn from their mistakes instead of seeing it as a failure, the clinic's work has improved self-care and participation for this patient group.

Everyday mobility and citizenship: a living lab approach

ABSTRACT In the context of a living lab that aimed to reduce everyday car use, citizens in a newly established semi-urban residential area in Sweden were asked to travel less by car, try mobility and accessibility services, and to reason about travelling and their own role in a future sustainable transport system. By analysing the participants’ written reports about mobility practices and mobility citizenship, collected through a living lab app, the paper explores links between everyday mobility and mobility citizenship. The analysis, which is based on theories on citizenship and mobility and social practice theory, shows that the participants’ reports provided context-specific knowledge regarding everyday mobility and citizenship. The participants expressed both knowledge about and engagement in their local environment. This opens new ways to understand, explore and make use of mobility citizenship, in research and in practice.

Selection of rural villages as volunteer centers for emergency response

Rural areas are typically sparsely populated, and coverage from emergency services is weak. In some such areas in Sweden, professional emergency services train civilian volunteers in providing help for certain types of emergencies. In case of an emergency, they are alerted on their mobile phones and are primarily expected to provide help in the vicinity of their homes. Due to limited resources, it is impossible to include all villages in the volunteer initiative, making the selection of the most beneficial villages for emergency response important. However, this decision is not always trivial to make. Therefore, we propose an optimization model to determine which villages should be included in this initiative to achieve the best possible emergency response coverage. The model is used in a case study for a large Swedish fire and rescue service organization, and based on the results, they have started volunteer centers in two villages.

Public transport provision and social sustainability in Sweden

ABSTRACT The provision of public transport is important for a sustainable society and is vital for many groups. Children, older people, and people from carless households are examples of such groups: they rely on public transport and risk social exclusion without it. The aim of this study is to identify areas in Sweden where an improved public transport system might enhance social sustainability. To this end, an index of public transport needs at a sub-municipality level was calculated along with an index of public transport provision using data from public transport authorities in Sweden. The results indicate that areas with a mismatch between the provision of and estimated demand for public transport are relatively heterogenous. High gaps exist both in rural and peripheral regions of Sweden as well as the suburbs of urban regions.

Insights from Health and Social Care Professionals Supporting Children and Young Adults with a Parent Diagnosed with Dementia: An Interview Study

Dementia is recognised as one of the major global health and social care challenges of present times. When the onset of dementia occurs in midlife, there is an increased possibility that there are children and young adults involved who are dependent on the parent concerned. The aim of the study was to describe health and social care professionals’ experiences of identifying and supporting children and young adults with a parent with dementia. A qualitative descriptive approach was carried out with individual interviews of health and social care professionals, using a semistructured interview guide. Thirteen participants in rural and urban areas in Sweden were interviewed. The overarching theme, advocating a forgotten group with three categories were identified. They combine and reflect health and social care professionals’ experiences of identifying and supporting children and young adults with a parent with dementia. Health and social care professionals who encountered children and young adults with a parent with dementia described how they were not sufficiently trained in supporting this group and identified a general shortage of available appropriate support services. The children and young adults were also described as a forgotten and overlooked group in need of affirmation and support in a more systematic way.

Evaluation of an early childhood caries preventive programme starting during pregnancy-Results after 3 and 6 years.

Early childhood caries (ECC) has been found to be up to five times more common among children living in areas of low socio-economic status (SES) than among children in areas of higher SES. To evaluate an ECC prevention programme from pregnancy to 3 and 6 years of age. A prospective, controlled, intervention cohort study was initiated in 2013 in a low-SES area in Sweden. The intervention group received an individual interdisciplinary ECC prevention programme starting pre-birth, consisting of supportive oral health-promoting talks using motivational interviewing techniques and individual ECC preventive actions. A control group, consisting of pregnant women living in a comparable area, received ordinary routines. Of the 336 pregnant women, 64 mothers (with 64 children) completed the programme, and 394 children were born in the control group. At the sixth year examination, the proportion of children with no caries was similar between the groups (53% resp. 52%, p = .976), whereas the proportion with decayed, missed, filled primary teeth (dmft = 1-5) was slightly lower (23% resp. 36%, p = .063), and the proportion with severe caries disease (dmft > 5) was higher (p = .013) in the intervention group (25%) than in the control group (12%). No preventive effect regarding caries can be demonstrated at sixth year of age. Maternal behavioural change in dental care was not sufficient to even out inequalities in oral health in children, eventually due to difficulties in reaching the target group and the lack of effects among the families reached.

High-resolution dispersion modelling of PM2.5, PM10, NOx and NO2 exposure in metropolitan areas in Sweden 2000‒2018 – large health gains due to decreased population exposure

Ambient air pollution remains the major environmental cause of disease. Accurate assessment of population exposure and small-scale spatial exposure variations over long time periods is essential for epidemiological studies. We estimated annual exposure to fine and coarse particulate matter (PM2.5, PM10), and nitrogen oxides (NOx, NO2) with high spatial resolution to examine time trends 2000‒2018, compliance with the WHO Air Quality Guidelines, and assess the health impact. The modelling area covered six metropolitan areas in Sweden with a combined population of 5.5 million. Long-range transported air pollutants were modelled using a chemical transport model with bias correction, and locally emitted air pollutants using source-specific Gaussian-type dispersion models at resolutions up to 50 × 50 m. The modelled concentrations were validated using quality-controlled monitoring data. Lastly, we estimated the reduction in mortality associated with the decrease in population exposure. The validity of modelled air pollutant concentrations was good (R2 for PM2.5 0.84, PM10 0.61, and NOx 0.87). Air pollution exposure decreased substantially, from a population weighted mean exposure to PM2.5 of 12.2 µg m−3 in 2000 to 5.4 µg m−3 in 2018. We estimated that the decreased exposure was associated with a reduction of 2719 (95% CI 2046–3055) premature deaths annually. However, in 2018, 65%, 8%, and 42% of residents in the modelled areas were still exposed to PM2.5, PM10, or NO2 levels, respectively, that exceeded the current WHO Air Quality Guidelines for annual average exposure. This emphasises the potential public health benefits of reductions in air pollution emissions.

Universal healthy school start intervention reduced the body mass index of young children with obesity.

To evaluate the effect of a universal, school-based family support programme on body mass index (BMI) of children aged 5-7 years, using pooled data from three trials. The programme has three to four components and is delivered during the first school year. It aims to promote healthy dietary and physical activity behaviours, and secondarily prevent unhealthy weight gain. Three cluster-randomised controlled trials were conducted between 2010 and 2018 in low and mixed socioeconomic status areas in Sweden. Weight and height were measured. Multiple mixed linear regression analysis was performed on the pooled data. In total, 961 children were included (50% girls, mean age 6.3 years). The post-intervention effect on BMI z-score in all children was small, but in those with obesity at baseline, we observed a significant, clinically relevant, decrease in BMI z-score (-0.21). This was most pronounced in children with a non-Nordic born parent (-0.24). Five to six months after the intervention, decreases were no longer statistically significant. The intervention resulted in changes in BMI comparable to obesity treatment programmes focusing on behaviour change. However, the effect attenuated with time suggesting the programme should be sustained and evaluated for a longer time.

Showcasing a digital twin for higher educational buildings: developing the concept toward human centricity

Digital twin technology is an emerging technology within the built environment. Yet, there are many unexplored opportunities to utilize digital twins for facilitating the transformation toward a climate-neutral building stock while also meeting the expectations from the building occupants. This article presents a case study of a digital twin, developed for an existing commercial building stock of campus areas in Sweden. The overarching purpose of the digital twin is to support both building occupants and building operators. This two-fold human-centric approach represents a novel approach for building digital twins. The digital twin is based on 3D scanning, and together with geospatial data, a real-like navigational indoor environment is created. Three innovative features are presented: the building analysis module, the digital twin mobile application, and the building operations module. The results show that the digital twin improves the building occupant’s experience by supporting navigation and providing access to the room booking system via this dedicated interface. Building management is also benefited by the digital twin through easier access to building data aggregated into one platform and a state-of-the-art analysis tool for optimizing the use of indoor space. The digital twin holds future potential to achieve operational excellence by incorporating feedback mechanisms and utilizing artificial intelligence to enable intelligent fault detection and prevention.