Without exception : How parents to children with intellectual disability describe their children’s spare time with focus on meaningfulness and participation

I följande studie har tio föräldrar som har barn med intellektuell funktionsnedsättning intervjuats för att undersöka hur föräldrarna beskriver sina barns fritid med fokus på meningsfullhet och delaktighet. Föräldrarna är boende i olika stora kommuner och barnen är i olika åldrar. Metoden består av semistrukturerade intervjuer som spelats in och transkriberats. Materialet från intervjuerna har sammanställts och analyserats genom innehållsanalys. Resultatet har presenterats och delats in i sex olika kategorier.  Socialkonstruktivism och delaktighet är den teori och det begrepp som använts för att tolka och förstå resultatet. Berger och Luckmanns begrepp roller, den signifikanta andra, commonsense-kunskap, face-to-face-interaktion och institutioner samt Harts Delaktighetens stege använde vi oss framför allt av. Av intervjuerna framgick att föräldrarna upplever att fritidsaktivitetsutbudet är för litet och särskilt för barnen som är bosatta i en mindre kommun och att delaktighet och meningsfullhet är viktiga komponenter i fritiden.

Living as a person requiring prosthetics in Nepal

Background: The landlocked mountain country of Nepal has an extreme topography and is one of the poorest and least developed countries in the world. Nepal has ratified and signed the Convention on the Rights of Persons with Disabilities (CRPD). To understand what is required to improve prosthetic provision and services for persons living with an amputation in low-income countries, it is of interest to explore their experiences of ability to participate in daily life activities. Aim: The aim of this study was to explore experiences of persons requiring prosthetic services in Nepal, in relation to specific articles of the CRPD that consider mobility, education, health, rehabilitation, and work and employment.Method: Data were collected through qualitative interviews using an interview guide and an interpreter at the Green Pastures Health and Rehabilitation Centre in Pokhara, Nepal. Sixteen persons above 18 years with a lower limb amputation in the western region of Nepal were interviewed. Content analysis was applied to the data.Results: Five themes emerged during data analysis: The prosthesis is essential for mobility and daily life; The prosthesis and vocational training are essential for work; Comprehensive gait training together with other persons with amputations; Satisfied with health care but struggling with finances; and Negative self-image and varied attitudes of others.Discussion & Conclusion: Participants were limited by poverty and wanted increased independence. Rehabilitation contributed to enabling persons with amputations. Participants stressed that access to education and vocational training had the potential to improve their living situation. Lack of adjusted employment opportunities contributed to unemployment and low socio-economic status. Prostheses were essential, but more advanced technology was requested. The study population did not includepersons with amputations who had not received rehabilitation or a prosthesis, which limits generalization to all persons with amputations in Nepal.Reference: Fransson A, Andersson B, Wagle P R, Magnusson L. Living as a person requiring prosthetics in Nepal. Submitted for publication 2016

Association of Diabetes Mellitus in Pregnancy and Perinatal Depression

Objective  Diabetes is frequently linked with depression, and both conditions are common complications during pregnancy. However, research findings exploring the relationship between diabetes mellitus in pregnancy (DMP) and perinatal depression (PND) have been inconsistent. Thus, this study seeks to examine the association between DMP and PND in a prospective population-based cohort. Methods  Women aged 18 to 48 years (n = 4459) were identified from the Biology, Affect, Stress, Imaging and Cognition study. The diagnosis of DMP was based on International Classification of Diseases code O24 from medical records and was classified as pregestational, gestational, or unspecified diabetes. PND was assessed using psychometric instruments, clinical interviews, and/or register data and categorized into antepartum or postpartum depression. Multivariable logistic regressions were used to study the associations of DMP with antepartum and postpartum depression. The association between DMP and continuous depression scores, antepartum and postpartum, was investigated with multivariable linear regressions. Results  Of 4459 pregnancies, 949 women had antepartum depression (21.2%) and 1123 had postpartum depression (25%). DMP had a prevalence of 1.2%. Women with DMP had twofold higher odds for postpartum depression compared with women without DMP. Although no association was observed between DMP and antepartum depression, DMP was associated with higher antepartum depression scores. Conclusions  Our study shows an association between DMP and PND, which might be considered a risk factor when screening for high-risk groups

Clinical characteristics and factors associated with COVID-19-related death and morbidity among hospitalized patients with cancer : a Swedish cohort study

Introduction: Cancer patients are considered to have a higher risk of dying and developing severe Coronavirus Disease 2019 (COVID-19). To date, there are few studies including co-morbidities and sociodemographic factors when investigating the outcome of COVID-19 in a cohort of cancer patients. In this study, we analyzed cancer patients that have been hospitalized due to COVID-19 during the first wave of the pandemic in Sweden to investigate the impact of COVID-19 on mortality and morbidity. Patients and methods: We retrospectively collected data on all patients with cancer that were hospitalized due to COVID-19-related symptoms at Uppsala University Hospital and Karolinska University Hospital between 1 March and 31 August 2020. The primary endpoint was COVID-19-related death and the secondary endpoint was to describe COVID-19 severity, defined as symptom severity (grades 0–4) and length of stay (LOS) at the university hospitals. Results: In total, 193 patients were included among which 31% died due to COVID-19 and 8% died of other causes. In a multivariable analysis, older age >70 (OR 3.6; 95% CI [1.8–7.3], p < 0.001) and male gender (OR 2.8 [1.4–5.8], p = 0.005) were factors associated with higher likelihood of COVID-19-related death. Several comorbidities ≥2 (OR 5.4 [2.0–14.3], p = 0.001) was independently associated with COVID-19 severity. Treatment with chemotherapy within 90 days prior to COVID-19 diagnosis were not associated with COVID-19-related death or severity. Conclusion: Factors associated with higher likelihood of COVID-19-related death were older age and male gender. More severe COVID-19 symptoms were seen in patients with multiple comorbidities. We did not see any associations between COVID-19-related death or severity and recent treatment including chemotherapy. In summary, this supports a thorough assessment regarding potential risks with COVID-19 infection in patients with cancer, with a combination of individual risk factors in addition to cancer treatments

Inactivation of Capicua drives cancer metastasis

Metastasis is the leading cause of death in lung cancer patients, yet the molecular effectors underlying tumor dissemination remain poorly defined. Through development of an in vivo spontaneous lung cancer metastasis model, we show that the developmentally-regulated transcriptional repressor Capicua (CIC) suppresses invasion and metastasis. CIC inactivation relieves repression of its effector ETV4, driving ETV4-mediated upregulation of MMP24 that is necessary and sufficient for metastasis. Loss of CIC, or increased levels of its effectors ETV4 and MMP24, is a biomarker of tumor progression and worse outcomes in lung and gastric cancer patients. Our findings uncover CIC as a conserved metastasis suppressor, revealing new anti-metastatic strategies to improve patient outcomes