Disabilities exhibited by children and adolescents that refuse to go to school

The aim of the study was to investigate what functional difficulties young people who refuse to go to school experience in their everyday lives. Research questions where what difficulties do young people who refuse to go to school experience? Are there differences between boys and girls? The study is a retrospective journal study with 28 Swedish youngsters based on Strengths & Difficulties Questionnaire (SDQ). Major findings where about somatic symptoms, emotional distress, loneliness, distinct gender roles, less mature and risk behavior. Although the school, social services and children- and adolescent psychiatry largely agree on the complexity of adolescents being absent from school, it seems difficult for the organizations to agree on adequate solutions.publishedVersio

Taking Health Information Behaviour into Account in the design of e-health services

The aim of this article is to bring forward the benefits of a better integration of a comprehensive understanding of individuals’ information behaviour in the design and development of e-health services. This study is a descriptive review based on a non-exhaustive selection of literature that describes the state-of-the-art, problems and opportunities identified in e-health, health information behaviour and health information literacy research. By focusing on how to tailor the information provided and the technological devices to fit the information behaviour, the approach has also potential to uncover new insights into how to adequately implement and integrate ICTs into everyday life practices of other hard-to-reach groups in society. We presuppose that it will be possible to give practical recommendations based on a combined understanding of individual differences in health information behaviour and users’ expectations and experiences, acquired through empirical studies focusing on older adults. Moreover, the usefulness of health information literacy as an indicator of the patterns and competences related to health information behaviour is highlighted

Communicating diabetes and diets on Twitter – a semantic content analysis

This paper analyses: 1) the semantic content of tweets discussing diabetes and diets: 2) the conversational connections of those tweeting and those being mentioned in the tweets. The content analysis of the tweets aims at mapping what kinds of diets are mentioned in conversations about diabetes and in what context. Our data consists of 9,042 tweets containing the words &lsquo;diabetes&rsquo; and &lsquo;diet&rsquo;. The findings indicate that analysing Twitter conversations can be a fruitful and an efficient way to map public opinions about diabetes and diets, as well as other medical issues that concern many people. The results also showed that many private persons act as diabetes advocates spreading information and news about diabetes and diets. Surveying these topics can be useful for healthcare practitioners; as these are in contact with patients with diabetes, it is important that they are aware of both the most discussed topics and the most common information sources, who are often laymen.</div

Professioner, makt och samverkan mellan myndigheter: socialtjänstens, skolans och BUP:s arbete med ungdomar som inte går till skola

publishedVersio

Diagnosinflation inom Barn- och ungdomspsykiatrin

Syftet med studien var att undersöka skillnader i val av diagnos och behandling inom Barn- och ungdomspsykiatrin (BUP) beroende på vilken bedömningsmetod som används vid det första kartläggande nybesöket. Metod: Samtliga bedömningssamtal (234) som genomförts på en BUP-mottagning i Sverige under 2018. 98 av samtalen utfördes med MINI-KID medan 136 av samtalen var kliniska samtal. Barnen slumpades till vilken metod som användes, men då några behandlare på enheten saknar MINI-KID utbildning så är de kliniska samtalen fler. Resultat: Intervjuerna med MINI-KID ledde i högre utsträckning i att en psykiatrisk diagnos ställdes och förespråkade oftare kognitiv beteendeterapi. De kliniska intervjuerna förespråkade i större omfattning familjeterapi baserat på att de oftare uppfattade källan till barnets symtombild i kontexten snarare än i barnet självt. Några könsskillnader avseende ställd diagnos eller föreslagen behandlingsinsats kunde inte påvisas.The purpose of the study was to investigate differences in the choice of diagnosis and treatment in Child and Adolescent Psychiatry (BUP) depending on the assessment method used in the first mapping new visit. Method: All assessment interviews (234) conducted at a BUP clinic in Sweden in 2018. 98 of the interviews were conducted with MINI-KID while 136 of the interviews were clinical interviews. The children were randomized to the method used, but since some therapists at the unit lack MINI-KID training, the clinical conversations are more numerous. Results: The interviews with MINI-KID led to a greater extent in that a psychiatric diagnosis was made and more often advocated cognitive behavioral therapy. The clinical interviews to a greater extent advocated family therapy based on the fact that they more often perceived the source of the child's symptoms in the context rather than in the child himself. No gender differences regarding the diagnosis or proposed treatment intervention could be demonstrated.publishedVersio

Serum concentrations of the axonal injury marker neurofilament light protein are not influenced by blood-brain barrier permeability

A blood biomarker to monitor individual susceptibility to neuronal injury from cranial radiotherapy could potentially help to individualize radiation treatment and thereby reduce the incidence and severity of late effects. An important feature of such a blood biomarker is that its concentration is not confounded by varying degrees of release from the brain into the blood across the blood-brain barrier (BBB). In this study, we investigated serum neurofilament light protein (NFL) concentrations in 21-day old mice following a single dose of cranial irradiation (8 Gy). Cranial irradiation resulted in acute cell injury measured as a 12.9-fold increase in caspase activity 6 h after irradiation; activation of inflammation measured by levels of CCL2 and increased BBB permeability measured by 14C-sucrose concentration ratios in brain and cerebrospinal fluid (CSF). Serum levels of NFL peaked at 6 h after both anesthesia and cranial irradiation, but no timely correlation of serum NFL concentration with BBB permeability was found. Further, three groups of patients with different degrees of BBB impairment (measured as the CSF/serum albumin ratio) were investigated. There was no correlation between serum NFL concentration and CSF/serum albumin ratio (r = 0.139, p = 0.3513), however a strong correlation was found for NFL concentration in serum and NFL concentration in CSF (r = 0.6303, p < 0.0001). In conclusion, serum NFL appears to be a reliable blood biomarker for neuronal injury, and its concentration is not confounded by BBB permeability

Survival in severe alpha-1-antitrypsin deficiency (PiZZ)

<p>Abstract</p> <p>Background</p> <p>Previous studies of the natural history of alpha-1-antitrypsin (AAT) deficiency are mostly based on highly selected patients. The aim of this study was to analyse the mortality of PiZZ individuals.</p> <p>Methods</p> <p>Data from 1339 adult PiZZ individuals from the Swedish National AAT Deficiency Registry, followed from 1991 to 2008, were analysed. Forty-three percent of these individuals were identified by respiratory symptoms (respiratory cases), 32% by liver diseases and other diseases (non-respiratory cases) and 25% by screening (screened cases). Smoking status was divided into two groups: smokers 737 (55%) and 602 (45%) never-smokers.</p> <p>Results</p> <p>During the follow-up 315 individuals (24%) died. The standardised mortality rate (SMR) for respiratory cases was 4.70 (95% Confidence Interval (CI) 4.10-5.40), 3.0 (95%CI 2.35-3.70) for the non-respiratory cases and 2.30 (95% CI 1.46-3.46) for the screened cases. The smokers had a higher mortality risk than never-smokers, with a SMR of 4.80 (95%CI 4.20-5.50) for the smokers and 2.80(95%CI 2.30-3.40) for the never-smokers. The Rate Ratio (RR) was 1.70 (95% CI 1.35-2.20). Also among the screened cases, the mortality risk for the smokers was significantly higher than in the general Swedish population (SMR 3.40 (95% CI 1.98-5.40).</p> <p>Conclusion</p> <p>Smokers with severe AAT deficiency, irrespective of mode of identification, have a significantly higher mortality risk than the general Swedish population.</p