Metabolic impact of certain dietary proteins and/or amino acids - Glycaemic and hormonal responses to carbohydrate meals in healthy subject

Re-occurring hyperglycaemic episodes promote subclinical low-grade inflammation and CVD in type 2 diabetes, emphasising the therapeutic role of tight blood glucose regulation. A tight blood glucose regulation is probably beneficial also in healthy subjects and mild elevations in postprandial glycaemia and triglycerides are associated with impaired flow-mediated dilation and increased markers of oxidative stress in young healthy subjects. Certain dietary proteins and amino acids (AA) have insulinogenic properties and might facilitate glycaemic regulation following a carbohydrate challenge. However, there is a lack of knowledge regarding the impact of different food proteins, and to what extent their effects can be influenced by supplementation with AA. Also, limited information exists with respect to influence of proteins/AA on metabolic response to carbohydrates in a composite meal. The objective of the present thesis was to investigate the impact of whey and soy protein on postprandial blood glucose, plasma AA (p-AA) and hormonal responses when administered to healthy subjects in a glucose drink, as part of milk meals, or in combination with a composite carbohydrate meal. The effect of exchanging half of the protein for specific AA mixtures (5AA: isoleucine, leucine, lysine, threonine and valine) or (6AA: 5AA+arginine) was also examined. Additionally appetite rating in the postprandial phase was performed using VAS scales. Whey protein (4.5-18g) reduced postprandial glycaemia, and increased insulinaemia and p-AA in a dose dependent way to a glucose challenge, and the p-5AA (iAUC 0-60 min) correlated to the insulin response (iPeak; P < 0.009). Lactose-equivalent amounts of bovine and human milk resulted in similar postprandial glycaemia and insulinaemia. A rapid response in GIP, GLP-1 and p-AA correlated to an early insulinogenic effect that was associated to reduction of glycaemia (iAUC 0-90 min; P < 0.001). Hydrolysed and intact whey had similar effects on glycaemic responses when co-ingested with glucose, although hydrolysed way tended to be more insulinogenic, possible due to its higher early insulin and faster p-AA response compared with intact whey. Exchanging half of the intact or hydrolysed whey protein for 5AA magnified the insulinogenic effect and reduced postprandial glycaemia (iAUC 0-120min; P < 0.05). Intake of whey or soy protein with or without addition of 5AA or 6AA, as a pre-meal protein drink (PMPD) prior a composite meal, considerably attenuated postprandial blood glucose incremental peak value (iPeak; P < 0.05). Also, all whey PMPDs with or without added AA reduced glycaemia (iAUC 0-120min; P < 0.05) and increased the Glycaemic Profile (GP; P < 0.05). Arginine had no additional effect on glycaemic responses when added to the 5AA mixture. Early GLP-1 and p-AA responses (iAUC 0-15 min) were associated with early insulin response (iAUC 0-15min). Early increment in insulin possibly explain the attenuation of over-all course of post-prandial glycaemia to the composite carbohydrate meal post the PMPDs. Interestingly, the lowering of glycaemic excursions was observed in the absence of elevated insulinaemic peak. Intake of a PMPD prior a composite meal had no effects on appetite rating (VAS) or plasma ghrelin

Bilingualism : Advantages and Disadvantages in Cognitive Processing, Language and Reading Comprehension

PhD thesis in Reading researchThe overall aim of this study is, as suggested by Bialystok (2009), to investigate whether bilingual learners have an advantage in executive functions and a disadvantage in language compared to monolingual learners. In addition, the thesis examines whether the theory holds true for different groups of bilingual learners and different aspects of language and cognitive domains. The study has a multi-method approach. It consists of a meta-analysis investigating the bilingual advantage theory in executive functions (EF) and two studies based on data from the longitudinal study The Stavanger Project—The Learning Child (The Stavanger Project). Study 2 uses data from the first wave of The Stavanger Project. The study investigates Norwegian language comprehension in a monolingual control group and three different groups of bilingual children at 2 years and 9 months. The three bilingual groups had different amounts of exposure to Norwegian. The third article is based on data from the fourth wave of The Stavanger Project and investigates different aspects of Norwegian language and reading skills across bilingual learners and a monolingual control group of 5th graders. The sample in Study 3 is a subsample of the participants in Study 2; thus, the bilingual learners had been systematically exposed to Norwegian by early childhood education and care (ECEC) attendance and schools from at least the age of 2. The thesis contributes three main findings. The first article provides little support for a bilingual advantage in overall EF. Moderator analysis targeting sample characteristics of bilingual subgroups that are theorized to have the largest bilingual advantage in EF shows no relation to the overall outcome of the analysis of differences in executive functions between bilingual and monolingual learners. Furthermore, there is limited evidence for a bilingual advantage in any EF domain. There is an advantage in switching, but not for all populations of bilingual learners. he second article shows that bilingual toddlers have weaker second language comprehension skills than monolingual toddlers, but the differences in second language skills between different groups of bilingual learners are not fully explained by the time on task hypothesis. Bilingual children with mostly first language (L1) input at home had poorer Norwegian language comprehension than the two other bilingual groups. Bilingual toddlers with both first and second language input at home and bilingual toddlers with mostly second language input at home had equivalent second language skills. It therefore seems likely that a threshold value exists for the amount of second language input necessary to develop good second language skills rather than a direct relationship between the amount of input and language skills. The third article shows that even after long and massive exposure to the second language, early bilingual 5th graders have lower vocabulary depth, listening comprehension and reading comprehension in their second language than their monolingual peers. The difference cannot be explained by differences in socioeconomic status (SES). Their decoding and text cohesion vocabulary skills are equal to those of monolingual learners. In contrast to some other studies, the strength of the predictive path between different aspects of language skills and reading comprehension was found to be equal across language groups. In total, these findings contribute to the knowledge base of what is typical development of language, reading skills and executive functions for different groups of bilingual learners. Without information of what is typical development for different bilingual groups, it is difficult to identify atypical development. Hence, the knowledge this thesis provides can support educators in identifying bilingual learners with learning disabilities earlier and with greater certainty, thereby reducing the risk of both over- and under-identifying bilingual learners in need of special needs education

Læreres erfaringer med traumebevisst omsorg i skolen – en hurtigoversikt med metasyntese

Formålet med studien er å undersøke læreres erfaringer med traumebevisst omsorg i skolen, gjennom en systematisk hurtigoversikt over sentrale analytiske temaer i kvalitative studier på feltet. Oppgavens problemstilling er: Hvilke erfaringer har lærere i møte med traumebevisst omsorg i skolen? Det er foretatt systematisk litteratursøk i én norsk (Idunn) og en internasjonal database (Web of Science) med det formål å avdekke studier som har relevante data for å besvare denne problemstillingen. Tjuefem kvalitative studier med totalt 587 informanter, hvorav minst 225 lærere, møtte inklusjonskriteriene som var utarbeidet i forkant av screeningen, og ble selektert til å danne datagrunnlaget. Metasyntese i form av tematisk analyse ble benyttet for å analysere dataene, og tre forskningsspørsmål danner grunnlaget for analysen: a) lærernes opplevde kompetanse i møte med traumeutsatte elever; b) lærernes erfaringer med samarbeid andre aktører, i møte med traumeutsatte elever og; c) lærernes erfaringer med utøvelsen av de tre grunnpilarene i traumebevisst tilnærming; trygghet, relasjoner og regulering. Funn fra analysen impliserer at det er stor variasjon mellom lærere hva gjelder deres opplevde kompetanse og ressurser i møte med traumeutsatte elever. De har også ulike erfaringer med samarbeid i møte med andre aktører. Flere har gode erfaringer med implementeringen av økt traumebevisst kompetanse på sine arbeidsplasser. Studiene viser også at mange lærere i varierte former legger til rette for utøvelsen av traumebevisst tilnærming i hverdagslige interaksjoner med traumeutsatte elever. Nøkkelord: Spesialpedagogikk, traumer, traumebevisst omsorg, lærere, skole, systematisk hurtigoversikt, metasynteseThe aim of this study is to examine teachers´ experiences with trauma-informed care in school, through a systematic rapid review of central analytical themes in qualitative studies in the research field. The research question is: Which experiences do teachers have with dealing with trauma-informed care in schools? Systematic literature searches have been carried out in one Norwegian (Idunn) and one international database (Web of Science), with the aim of uncovering studies that contain relevant data to answer this question. Twenty-Five qualitative studies with data from 587 informants, and out of these a minimum of 225 teachers, were selected as eligible in line with the pre-defined inclusion criteria. Meta synthesis in the form of thematic analysis has been utilized in the study's analysis, and three main themes form the basis of the discussion: a) the teachers' perceived competence in dealing with students exposed to trauma; b) the teachers' experiences with collaboration with others in meeting with trauma-exposed students, and; c) the teachers' experiences with the implementation of the three pillars in trauma-informed care; safety, connections and managing emotions. Findings indicate that there is a variety in the informants perceived competence and resources when dealing with students exposed to trauma. They also have different experiences with cooperation with other partners. Several informants have good experiences with the implementation of increased knowledge on trauma-informed care. The studies also show that many teachers, in various ways, facilitate the practice of a trauma-aware approach in everyday interactions with trauma-exposed students. Keywords: Special needs education, trauma, trauma-informed care, teachers, school, systematic rapid review, meta synthesi

COPD and malnutrition – an increasing problem

Bachelor sykepleie, 2018Hensikt: Hensikten med denne oppgaven er å belyse hvilken rolle sykepleieren har i forhold til problemene med underernæring hos pasienter med kols grad 3-4 og eksaserbasjon og hvilke tiltak sykepleieren kan gjøre for å redusere antall underernærte. Problemstilling: Hvordan kan sykepleieren bidra til å forebygge underernæring hos pasienter med kols eksaserbasjon innlagt på sykehus. Teori: I dette kapittelet vil vi skrive om temaer som er relevante i forhold til vår problemstilling. Temaene vi utdyper er kols, underernæring, veiledning, brukermedvirkning og sykepleierens rolle. Metode: Bacheloroppgaven er et litteraturstudie. Det er blitt brukt pensumlitteratur, selvvalgt litteratur, forskningsartikler og erfaringer fra praksis Konklusjon: Hos pasienter med kols eksaserbasjon er det mange ulike årsaker som bidrar til underernæring. Ved hjelp av ernæringskartlegging kan sykepleieren raskt igangsette tiltak når en pasient kommer inn på medisinsk avdeling. Når sykepleieren har fokus på informasjon, undervisning og veiledning fremmer hun brukermedvirkning. Dette er noe som hjelper pasienten til å få en bedre forståelse av egen sykdom og hvorfor det er viktig med rett ernæring