District heating and cooling systems can aid in decarbonisation and the provision of efficient heating and cooling in Europe. However, whereas these systems have achieved high penetration rates in colder climates of Northern, Central and Eastern Europe, they remain marginal in milder climates of Southern Europe. In terms of network design, district heating and cooling systems can be configured in

Background: Platelet transfusions are given to preterm infants with severe thrombocytopenia aiming to prevent haemorrhage. The PlaNeT2/MATISSE trial revealed higher rates of mortality and/or major bleeding in preterm infants receiving prophylactic platelet transfusions at a platelet count threshold of 50 × 109/L compared to 25 × 109/L. The extent to which this evidence has been incorporated into c

Breastfeeding provides many health benefits, but its impact on respiratory health remains unclear. This study addresses the complex and dynamic nature of the mother-milk-infant triad by investigating maternal genomic factors regulating human milk oligosaccharides (HMOs), and their associations with respiratory health among human milk-fed infants. Nineteen HMOs are quantified from 980 mothers of th

Säkerheten om demokratins robusthet har gett vika för en allmänt diagnostiserad demokratikris. Allt fler röster höjs för att försvara de demokratiska institutionerna mot dem som vill avskaffa dem på formellt demokratisk väg. Men för att värna demokratin, hävdas det, krävs paradoxalt nog att man håller tillbaka den demokratiska omvandlingen. I denna avhandling hävdas att denna ”demokratiska paradoxCertainty about the robustness of democracy has given way to a widely diagnosed crisis of democracy. There are increasing calls to defend democratic institutions against those who seek their formally democratic abolishment. But safeguarding democracy, it is argued, paradoxically requires restraining democratic transformation. This dissertation argues that this ‘democratic paradox’ is misconceived.

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BACKGROUND: We designed group coaching calls to reinforce communication skill acquisition and Serious Illness Care Program uptake in adult primary care.MEASURES: Percentage of primary care physicians (PCPs) who have documented a serious illness conversation in the electronic health record (EHR) approximately three and six months after the coaching intervention. Participant feedback surveys to bett

BACKGROUND: We aim to address palliative care workforce shortages by teaching clinicians how to provide primary palliative care through peer coaching.INTERVENTION: We offered peer coaching to internal medicine residents and hospitalists (attendings, nurse practioners, and physician assistants).MEASURES: An audit of peer coaching encounters and coachee feedback to better understand the applicabilit

BACKGROUND: Early palliative care provides better quality of life, increased prognostic awareness, and even improved survival for patients with advanced cancer but how the integrated care model achieves these outcomes has not been completely explained.METHODS: To better understand the clinical approach to early outpatient care from the clinicians' perspective, we conducted focus groups with the pa

BACKGROUND: Growing evidence demonstrates the benefits of early, integrated palliative care (PC) for patients with advanced cancer and their caregivers. Yet, data are lacking on the communication patterns within this model of care.OBJECTIVE: The goals of this study were to describe the content of patient-clinician discussions among patients receiving PC and to compare differences in discussion con

Advanced cancer, with its considerable physical symptoms and psychosocial burdens, represents an existential threat and major stressor to patients and their caregivers. In response to such stress, patients and their caregivers use a variety of strategies to manage the disease and related symptoms, such as problem-focused, emotion-focused, meaning-focused, and spiritual/religious coping. The use of

Purpose The early integration of oncology and palliative care (EIPC) improves quality of life (QOL) and mood for patients with advanced cancer. However, the mechanisms by which EIPC benefits these outcomes remain unclear. We therefore examined whether EIPC improved patients' coping strategies and if changes in coping accounted for intervention effects on QOL and depressive symptoms. Patients and M

Several studies have shown that the symptoms of grief are different from symptoms of depression among bereaved family members. This study is an attempt to replicate this finding among advanced cancer patients and examine clinical correlates of patient grief and depression. Analyses were conducted on data from interviews with 123 advanced cancer patients. Grief was measured using symptoms from the