”ETT ENKELT LITET TRÄD” Arbetsterapeuters upplevelser av The Tree Theme Method® som behandlingsmetod vid stressrelaterad psykisk ohälsa.

Bakgrund En grundläggande princip inom arbetsterapi är behovet av balans i aktivitetslivet för en god hälsa. Stress är en bidragande faktor till psykisk ohälsa i dagens samhälle. Det finns en tydlig koppling mellan en obalans i vardagliga aktiviteter och ökad stress. En metod som har visat sig användbar vid behandling av stressrelaterad ohälsa är kreativa aktiviteter. En arbetsterapeutisk kreativ behandlingsmetod är The Tree Theme Method (TTM) där fokus ligger på att patienten får måla träd för att symbolisera aktivitetslivet. Ett fåtal studier har genomförts gällande TTM metoden, men ingen som tidigare fokuserat på arbetsterapeuters upplevelse av metodens effekter hos personer med stressrelaterad ohälsa. Syfte Syftet med studien var att undersöka arbetsterapeuters upplevelser av TTM som behandlingsmetod för personer med stressrelaterad psykisk ohälsa. Metod Studien är utförd enligt kvalitativ metod utifrån ett hermeneutiskt synsätt. Urvalsgruppen utgjordes av legitimerade arbetsterapeuter som använder TTM metoden i sitt dagliga arbete samt hade arbetat med personer som lider av stressymptom. Urvalet utgjordes av fem arbetsterapeuter och studien genomfördes med semistrukturerade individuella intervjuer via Skype eller telefon. Datan analyserades enligt metoden för systematisk textkondensering. Resultat Resultatet delades upp i huvudkategorierna Metodens användbarhet, Effekter under behandling, Påverkan i vardagen samt Det professionella förhållningssättet. TTM metoden ansågs lämplig för att stödja personer med stressrelaterad psykisk ohälsa då den upplevdes ge arbetsterapeuten mycket information om personen. Bildskapandet sågs kunna vara lugnande och öppna upp för känslor samt leda till insikt i vad som är orsakerna till stressen utifrån personens aktivitetsliv, roller och relationer genom livet. Metoden ansågs även kunna resultera i starka känslor hos personen som arbetsterapeuten var tvungen att klara av att bemöta. I vissa fall upplevde arbetsterapeuterna att kompetensen inte räckte till för att bemöta detta och i de fallen efterfrågades stöd från andra yrkesgrupper. Slutsats Trots att TTM metoden upplevdes innebära en del negativa aspekter för personer med stressrelaterad ohälsa, såsom ökad stress och prestationskrav i skapandet, så framgick det tydligt i resultatet att arbetsterapeuterna ansåg att fördelarna övervägde nackdelarna. TTM metoden kan sägas utgöra ett relevant arbetsterapeutiskt behandlingsalternativ vid stressrelaterad psykisk ohälsa. För att bekräfta resultat krävs ytterligare studier

En intervjustudie om och med ungdomar och gruppledare vid BIM : Socialtjänsten i Oskarshamn

There are many children in Sweden today, approximately between 100 000 and 200 000, who have parents or a parent that abuses alcohol or other drugs. In this research paper we have reviewed some of the literature concerning these children and their situation. The purpose of this research paper was to make an interview study of a group activity for children that have parents or a parent, who abuses alcohol or other drugs. This research paper is based on interviews conducted with two children and four group leaders. We compared the children's opinions about the group activity to the opinion of the group leaders of what the group activity has given the children. We also wanted to compare our interview study with other similar studies that has been made within this subject. We also wanted to retain information of how the group leaders defined addiction and in their opinion what constitutes abuse. The results show that the two children are satisfied with the group activity, they also had an enjoyable time and a learning experience. The group leaders were satisfied with the activities, they especially enjoyed the opportunity to work with the children in the group environment. The interviewees, both the children and the leaders, agree that two essential advantages with participating in the group activity were learning to express your self, and the feeling of not being alone. In our study we found that there were variations in the definition of addiction and abuse amongst group leaders

Logopediskt omhändertagande vid primär progressiv afasi (PPA) – en pilotstudie

Primär progressiv afasi (PPA) är ett kliniskt syndrom som orsakas av neurodegenerativ sjukdom och karakteriseras av progredierande språkstörning. Trots stora språkliga och kommunikativa svårigheter arbetar logopeder idag inte systematiskt med patienter med PPA. Det finns inte heller någon medicinsk behandling att tillgå. Vi fokuserar särskilt på varianten progressiv icke-flytande afasi (PNFA). För att ta reda på hur patienter och anhöriga har användning av och förhåller sig till logopedisk intervention har vi genomfört en fallbaserad pilotstudie. Vi utvärderar en träningsmodell för benämning av verb, ett informationsmaterial med kommunikationsråd och ett förslag till alternativ och kompletterande kommunikation (AKK) som vi själva har tagit fram. Fyra patienter med PNFA vid Minneskliniken, Skånes Universitetssjukhus, Lund medverkade i studien. Samtliga tog del av informationsmaterialet och AKK. Två av fyra patienter genomförde benämningsträningen. Resultaten visar att benämningsträning är genomförbar enligt vår modell. Ytterligare forskning krävs för att kunna utvärdera träningens effekter på benämningsförmågan. Resultaten tyder även på att patienter och anhöriga är positivt inställda till logopedisk intervention och att det finns ett behov av omhändertagande. Studien talar för att logopeder behövs i verksamheter som arbetar med patienter med PPA

Ammonia formation from nitric oxide over Pd-based catalysts in multicomponent feed gas compositions

Using multicomponent gas feeds, the formation of ammonia from nitric oxide over Pd/Al2O3 and Pd/Ce/Al2O3 model catalysts was compared to that of a commercially-available three-way catalyst. Steady- state oxygen-sweep experiments show that the highest activity for ammonia formation is obtained over the Pd/Ce/Al2O3 catalyst whilst the lowest activity is observed for the three-way catalyst. The latter is consid- ered to be linked to the incorporation of rhodium, a component that promotes the NOx reduction selectivity towards N2. Also, lean/rich cycling experiments were carried out to simulate the cycling conditions that passive-SCR after treatment systems depend upon. High activity is again seen over the Pd/Ce/Al2O3 cata- lyst during short periodic switches. For the three-way catalyst, longer periodic switches are required for the onset of ammonia formation due to the high oxygen storage capacity of this sample as compared to the other two. Hence, a future direction of investigation could be to develop materials with equivalent water- gas shift properties of ceria, but with reduced oxygen storage capacity so as to provide hydrogen for reaction without incurring a significant delay in ammonia formation

Overweight, obesity and the risk of LADA : results from a Swedish case-control study and the Norwegian HUNT Study

Aims/hypothesis Excessive weight is a risk factor for type 2 diabetes, but its role in the promotion of autoimmune diabetes is not clear. We investigated the risk of latent autoimmune diabetes in adults (LADA) in relation to overweight/obesity in two large population-based studies. Methods Analyses were based on incident cases of LADA (n = 425) and type 2 diabetes (n = 1420), and 1704 randomly selected control participants from a Swedish case-control study and prospective data from the Norwegian HUNT Study including 147 people with LADA and 1,012,957 person-years of follow-up (1984-2008). We present adjusted ORs and HRs with 95% CI. Results In the Swedish data, obesity was associated with an increased risk of LADA (OR 2.93, 95% CI 2.17, 3.97), which was even stronger for type 2 diabetes (OR 18.88, 95% CI 14.29, 24.94). The association was stronger in LADA with low GAD antibody (GADA; Conclusions/interpretation Overweight/obesity is associated with increased risk of LADA, particularly when in combination with FHD. These findings support the hypothesis that, even in the presence of autoimmunity, factors linked to insulin resistance, such as excessive weight, could promote onset of diabetes.Peer reviewe

Combined lifestyle factors and the risk of LADA and type 2 diabetes - Results from a Swedish population-based case-control study

Aims: We investigated the risk of latent autoimmune diabetes in adults (LADA) and type 2 diabetes in relation to a healthy lifestyle, the proportion of patients attributable to an unhealthy lifestyle, and the influence of family history of diabetes (FHD) and genetic susceptibility. Methods: The population-based study included incident LADA (n = 571), type 2 diabetes (n = 1962), and matched controls (n = 2217). A healthy lifestyle was defined by BMI < 25 kg/m2, moderate-to-high physical activity, a healthy diet, no smoking, and moderate alcohol consumption. We estimated odds ratios (OR) with 95% confidence intervals (CIs) adjusted for age, sex, education, and FHD. Results: Compared to a poor/moderate lifestyle, a healthy lifestyle was associated with a reduced risk of LADA (OR 0.51, CI 0.34-0.77) and type 2 diabetes (OR 0.09, CI 0.05-0.15). A healthy lifestyle conferred a reduced risk irrespective of FHD and high-risk HLA genotypes. Having a BMI < 25 kg/m2 conferred the largest risk reduction for both LADA (OR 0.54, CI 0.43-0.66) and type 2 diabetes (OR 0.12, CI 0.10-0.15) out of the individual items. Conclusion: People with a healthy lifestyle, especially a healthy body weight, have a reduced risk of LADA including those with genetic susceptibility to diabetes. (C) 2021 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).Peer reviewe

Physical Activity, Genetic Susceptibility, and the Risk of Latent Autoimmune Diabetes in Adults and Type 2 Diabetes

Purpose: Physical activity (PA) has been linked to a reduced risk of type 2 diabetes by reducing weight and improving insulin sensitivity. We investigated whether PA is associated with a lower incidence of latent autoimmune diabetes in adults (LADA) and whether the association is modified by genotypes of human leukocyte antigen (HLA), transcription factor 7-like 2 ( TCF7L2)-rs7903146, or the fat mass and obesity-associated gene, FTO-rs9939609. Methods: We combined data from a Swedish case-control study and a Norwegian prospective study including 621 incident cases of LADA and 3596 cases of type 2 diabetes. We estimated adjusted pooled relative risks (RRs) and 95% CI of diabetes in relation to high (>= 30 minutes of moderate activity 3 times/ week) self-reported leisure time PA, compared to sedentariness. Results: High PA was associated with a reduced risk of LADA (RR 0.61; CI, 0.43-0.86), which was attenuated after adjustment for body mass index (BMI) (RR 0.90; CI, 0.63-1.29). The reduced risk applied only to noncarriers of HLA-DQB1 and -DRB1 (RR 0.49; CI, 0.33-0.72), TCF7L2 (RR 0.62; CI, 0.45-0.87), and FTO (RR 0.51; CI, 0.32-0.79) risk genotypes. Adjustment for BMI attenuated but did not eliminate these associations. For type 2 diabetes, there was an inverse association with PA (RR 0.49; CI, 0.42-0.56), irrespective of genotype. Main Conclusions: Our findings indicate that high PA is associated with a reduced risk of LADA in individuals without genetic susceptibility.Peer reviewe

Consumption of red meat, genetic susceptibility, and risk of LADA and type 2 diabetes

Purpose Red meat consumption is positively associated with type 1 (T1D) and type 2 (T2D) diabetes. We investigated if red meat consumption increases the risk of latent autoimmune diabetes in adults (LADA) and T2D, and potential interaction with family history of diabetes (FHD), HLA and TCF7L2 genotypes. Methods Analyses were based on Swedish case-control data comprising incident cases of LADA (n = 465) and T2D (n = 1528) with matched, population-based controls (n = 1789; n = 1553 in genetic analyses). Multivariable-adjusted ORs in relation to self-reported processed and unprocessed red meat intake were estimated by conditional logistic regression models. Attributable proportion (AP) due to interaction was used to assess departure from additivity of effects. Results Consumption of processed red meat was associated with increased risk of LADA (per one servings/day OR 1.27, 95% CI 1.07-1.52), whereas no association was observed for unprocessed red meat. For T2D, there was no association with red meat intake once BMI was taken into account. The combination of high (> 0.3 servings/day vs. less) processed red meat intake and high-risk HLA-DQB1 and -DRB1 genotypes yielded OR 8.05 (95% CI 4.86-13.34) for LADA, with indications of significant interaction (AP 0.53, 95% CI 0.32-0.73). Results were similar for the combination of FHD-T1D and processed red meat. No interaction between processed red meat intake and FHD-T2D or risk variants of TCF7L2 was seen in relation to LADA or T2D. Conclusion Consumption of processed but not unprocessed red meat may increase the risk of LADA, especially in individuals with FHD-T1D or high-risk HLA genotypes.Peer reviewe

Ammonia formation over Pd/Al2O3 modified with cerium and barium

We report experimental results for ammonia formation from nitric oxide and either a direct source of hydrogen or from a mixture of carbon monoxide and water over palladium based catalysts. Specifically, the addition of barium or cerium into an alumina supported palladium sample was studied. Static and transient flow reactor experiments were performed in order to identify the effects of temperature and the presence of oxygen on the activity for ammonia formation. Modification of Pd/Al2O3 with cerium proved to be beneficial for the activity due mainly to its enhancement of the water-gas-shift reaction, thus providing a higher availability of hydrogen for ammonia formation, but also because it remains active in the presence of slightly oxidizing global conditions when hydrogen is provided directly to the feed. Although the modification of Pd/Al2O3 with barium did not affect the ammonia formation during static conditions, the activity during lean/rich cycling increased. This is important for applications of passive selective catalytic reduction

Interaction Between Overweight and Genotypes of HLA, TCF7L2, and FTO in Relation to the Risk of Latent Autoimmune Diabetes in Adults and Type 2 Diabetes

Objective: We investigated potential interactions between body mass index (BMI) and genotypes of human leukocyte antigen (HLA), TCF7L2-rs7903146, and FTO-rs9939609 in relation to the risk of latent autoimmune diabetes in adults (LADA) and type 2 diabetes. Methods: We pooled data from two population-based studies: (i) a Swedish study with incident cases of LADA [positive for glutamic acid decarboxylase autoantibodies (GADA); n = 394) and type 2 diabetes (negative for GADA; n = 1290) and matched controls without diabetes (n = 2656) and (ii) a prospective Norwegian study that included incident cases of LADA (n = 131) and type 2 diabetes (n = 1901) and 886,120 person-years of follow-up. Analyses were adjusted for age, sex, physical activity, and smoking. Interaction between overweight (BMI >= 25 kg/m(2)) and HLA/TCF7L2/FTO high-risk genotypes was assessed by attributable proportion due to interaction (AP). Results: The combination of overweight and high-risk genotypes of HLA, TCF7L2, and FTO was associated with pooled relative risk (RRpooled) of 7.59 (95% CI, 5.27 to 10.93), 2.65 (95% CI, 1.97 to 3.56), and 2.21 (95% CI, 1.60 to 3.07), respectively, for LADA, compared with normal-weight individuals with low/intermediate genetic risk. There was a significant interaction between overweight and HLA (AP, 0.29; 95% CI, 0.10 to 0.47), TCF7L2 (AP, 0.31; 95% CI, 0.09 to 0.52), and FTO (AP, 0.38; 95% CI, 0.15 to 0.61). The highest risk of LADA was seen in overweight individuals homozygous for the DR4 genotype [RR, 26.76 (95% CI, 15.42 to 46.43); AP, 0.58 (95% CI, 0.32 to 0.83) (Swedish data)]. Overweight and TCF7L2 also significantly interacted in relation to type 2 diabetes (AP, 0.26; 95% CI, 0.19 to 0.33), but no interaction was observed with high-risk genotypes of HLA or FTO. Conclusions: Overweight interacts with HLA high-risk genotypes but also with genes associated with type 2 diabetes in the promotion of LADA.Peer reviewe