RIDETERAPI FOR BØRN – I ET NARRATIVT PERSPEKTIV

Formålet med denne artikel er at beskrive en aktuelt benyttetmetode, hvori rideterapi indgår som det centrale omdrejningspunkti arbejdet med børn med vanskeligheder, ud fra ennarrativ forståelse og praksisramme. Beskrivelsen bruges efterfølgendesom grundlag for overvejelser omkring rideterapiensvirksomme komponenter og potentiale i forhold til at tilførenoget nyt til narrativ praksis.Metoden er udviklet igennem to års anvendelse og løbendeevaluering. Vi har erfaret, at børnene i rideterapien har haftudbytte i forhold til de vanskeligheder, de var beskrevet med,som rækker ud over det, vi kender fra den narrative metodealene. I artiklen vil vi redegøre for metodens centrale komponentergennem beskrivelse af praksis og casehistorier samtkomme med bud på, hvilke faktorer ved tilføringen af heste derkan antages at have betydning, såsom: relation, aktivitetsbaseretoplevelse, terapi uden stigmatisering, læring på flereniveauer og social støtte.Artiklen er et kvalitativt studie af en specifik praksis, somdanner baggrund for generelle overvejelser omkring rideterapiensmulige potentiale til at tilføre noget nyt til allerede eksisterendeterapi for børn

Broad-Spectrum Antibiotic Treatment and Subsequent Childhood Type 1 Diabetes: A Nationwide Danish Cohort Study

International audienceBackground: Treatment with antibiotics in early childhood is effective for bacterial infections but may have long-term side effects. We evaluated the effect of broad-spectrum antibiotics treatment during the first two years of life in association with mode of delivery on subsequent onset of childhood type 1 diabetes.Methods: A Danish Nationwide cohort study included all singletons born during 1997-2010. Five national registers provided information on antibiotic redemption, outcome and confounders. The risk of type 1 diabetes with onset before the age of 15 years was assessed by Cox regression. A total of 858,201 singletons contributed 5,906,069 person- years, during which 1,503 children were diagnosed with type 1 diabetes.Results: Redemption of broad-spectrum antibiotics during the first two years of life was associated with an increased rate of type 1 diabetes during the following 13 years of life (HR 1.13; 95% CI 1.02 to 1.25), however, the rate was modified by mode of delivery. Broad- spectrum antibiotics were associated with an increased rate of type 1 diabetes in children delivered by either intrapartum cesarean section (HR 1.70; 95% CI 1.15 to 2.51) or prelabor cesarean section (HR 1.63; 95% CI 1.11 to 2.39), but not in vaginally delivered children. Number needed to harm was 433 and 562, respectively. The association with broad-spectrum antibiotics was not modified by parity, genetic predisposition or maternal redemption of antibiotics during pregnancy or lactation.Conclusions: Redemption of broad-spectrum antibiotics during infancy is associated with an increased risk of childhood type 1 diabetes in children delivered by cesarean section

Supercykelstier i Danmark : Best practice og den fortsatte udvikling

Workshop - Supercykelstier i Danmark – Best practice og den fortsatte udvikling. Mødeleder: Tine Brandt-Nielsen, Sekretariatet for Cykelsuperstie

Differential adipokine DNA methylation and gene expression in subcutaneous adipose tissue from adult offspring of women with diabetes in pregnancy

Abstract Background Offspring of women with diabetes in pregnancy are at increased risk of type 2 diabetes mellitus (T2DM), potentially mediated by epigenetic mechanisms. The adipokines leptin, adiponectin, and resistin (genes: LEP, ADIPOQ, RETN) play key roles in the pathophysiology of T2DM. We hypothesized that offspring exposed to maternal diabetes exhibit alterations in epigenetic regulation of subcutaneous adipose tissue (SAT) adipokine transcription. We studied adipokine plasma levels, SAT gene expression, and DNA methylation of LEP, ADIPOQ, and RETN in adult offspring of women with gestational diabetes (O-GDM, N = 82) or type 1 diabetes (O-T1DM, N = 67) in pregnancy, compared to offspring of women from the background population (O-BP, N = 57). Results Compared to O-BP, we found elevated plasma leptin and resistin levels in O-T1DM, decreased gene expression of all adipokines in O-GDM, decreased RETN expression in O-T1DM, and increased LEP and ADIPOQ methylation in O-GDM. In multivariate regression analysis, O-GDM remained associated with increased ADIPOQ methylation and decreased ADIPOQ and RETN gene expression and O-T1DM remained associated with decreased RETN expression after adjustment for potential confounders and mediators. Conclusions In conclusion, offspring of women with diabetes in pregnancy exhibit increased ADIPOQ DNA methylation and decreased ADIPOQ and RETN gene expression in SAT. However, altered methylation and expression levels were not reflected in plasma protein levels, and the functional implications of these findings remain uncertain

Assessment of Attention Deficits in Adolescent Offspring Exposed to Maternal Type 1 Diabetes

The aim of this study was to examine the potential association between intrauterine exposure to maternal diabetes and attention deficits in the offspring.Adolescent offspring of a prospectively followed cohort of women with type 1 diabetes (n = 269) and a control group from the background population (n = 293) participated in a follow-up assessment in 2012-2013. We used scores from Conners Continuous Performance Test II to assess attention and based on a principal component analysis we evaluated scores on five different attention factors: focused attention, vigilance, hyperactivity/impulsivity, sustained attention and response style.A higher frequency of the exposed offspring had a parent/self-reported use of Attention Deficit Hyperactivity Disorder (ADHD) medication compared to the control group (2.2% vs. 0.0%, p = 0.01). Clinical significant differences between adolescents exposed to maternal diabetes and unexposed controls were not found in either single scores on Conners Continuous Performance Test or on any of the five attention factors identified.Exposure to maternal type 1 diabetes did not seem to increase the risk of attention deficits in the adolescent offspring. However, a higher self-reported use of ADHD medication in the exposed group could suggest a difference in attention not revealed by the applied test

Physical activity in pregnancy:a mixed methods process evaluation of the FitMum randomised controlled trial interventions

BACKGROUND: Physical activity (PA) at moderate intensity is recommended for healthy pregnant women. The three-arm FitMum randomised controlled trial showed that it was possible to increase PA level during pregnancy with structured supervised exercise training (EXE) compared to standard care. Motivational counselling on PA (MOT) did not increase PA. This process evaluation aims to understand the implementation and mechanisms of impact of EXE and MOT. METHODS: A mixed methods process evaluation was conducted using the UK Medical Research Council’s process evaluation framework by assessing implementation (reach, fidelity, and dose) and mechanisms of impact of the two interventions provided to pregnant women in FitMum. Data was collected both quantitatively (n = 220) and qualitatively (n = 20). RESULTS: The FitMum trial reached educated pregnant women (80% having an educational level ≥ bachelor’s degree) with high autonomy of everyday life. Most participants (58%) were recruited at their first-trimester ultrasonic scan. Reasons to participate were personal (91%) and altruistic (56%). The intervention dose was delivered as intended with high fidelity in the original physical intervention setup and in the altered online setup during the COVID-19 restrictions. A low dose received in EXE (1.3 [95% CI, 1.1; 1.5] sessions/week) was partly explained by the pre-scheduled EXE sessions favouring participants with a flexible everyday life and a supportive social network. Dose received in EXE increased during online intervention delivery. Participants in MOT received 5.2 [4.7; 5.7] of 7 sessions. Mechanisms of impact comprised a perception of intervention commitment among participants in EXE due to the scheduled EXE sessions, whereas participants in MOT considered themselves as PA self-determined. PA was considered as constrained activities in EXE and included in daily activities in MOT. CONCLUSION: The FitMum interventions was delivered with high fidelity. During COVID-19, the dose received in EXE increased compared to the previous physical setup. Mechanisms of impact as commitment, perception of empowerment and perception of PA as well as the paradox between prioritising PA and family and the need of a flexible everyday life need to be considered when offering pregnant women PA interventions. Future interventions should consider a combination of physical and online exercise training for pregnant women. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-022-14717-1