”My Child´s Medicine” : A qualitative study on how parents experience their children`s treatment with Modified Atkins Diet or Ketogenic Diet.

BAKGRUND Modifierad Atkins Diet (MAD) och ketogenkost är kostbehandlingar som ordineras till barn med svårbehandlad epilepsi. Andra patientgrupper som behandlas med dessa dieter är patienter med glukostransportprotein typ 1-brist. Kostbehandlingarna är kolhydratfattiga och fettrika. I Sverige finns fyra sjukhus som arbetar med MAD och ketogenkost. I dagsläget saknas studier som beskriver hur behandlingarna upplevs av berörda familjer. SYFTE Syftet med studien var att utforska hur föräldrar till barn som behandlas med MAD eller ketogenkost upplever kostbehandlingen. METOD Kvalitativa intervjuer baserade på en halvstrukturerad frågeguide har genomförts. Fem familjer från olika delar av landet deltog i studien. Intervjuerna spelades in med mp3-spelare för att sedan transkriberas ordagrant. Samtalen analyserades genom kvalitativ innehållsanalys. RESULTAT Föräldrarna berättade om en rädsla och oro inför behandlingsstarten och att introduktionsperioden som familjerna erbjöds inför kostbehandlingen visade sig vara mycket viktig för kommande behandlingsprocess. Föräldrarna upplevde det svårt att tillaga en varierad kost och att det var viktigt med adekvata hjälpmedel och regelbunden vårdkontakt för att kunna tillämpa kostbehandlingen i vardagslivet. Deras behov av stöd förändrades under behandlingsprocessen. Genomgående var att informanterna upplevde att de sociala aktiviteterna anpassades efter kostbehandlingen. Föräldrarna upplevde det som viktigt att ha kontakt med andra familjer i liknade situation. Trots att föräldrarna upplevde flera olika praktiska och sociala problem ansåg de ändå att det positiva, som var kopplat till behandlingens resultat övervägde. En förälder uttryckte sig med orden ”Vi fick tillbaka vårt barn”- vilket återspeglar många föräldrars åsikt om behandlingen. SLUTSATS MAD och ketogenkost kräver mycket tid och kunskap för berörda familjer och påverkar deras vardag både praktiska och socialt. Med stöd från vård, barnomsorg, familj och vänner upplevde föräldrarna att det var lättare att upprätthålla behandlingen. Det finns också ett behov av att få prata med andra föräldrar och familjer som är liknande situationer.BACKGROUND Modified Atkins Diet (MAD) and Ketogenic Diet are treatments prescribed to children suffering from refractory epilepsy. Patients with glucose transporter protein type 1 deficiency are also commonly treated with these diets, which are low in carbohydrates and high in fat. In Sweden, there are four hospitals implementing these treatments, but there is currently not sufficient information on how they are affecting the families. OBJECTIVE The purpose of this study was to explore how parents of children treated with MAD or Ketogenic Diet experience the treatment. METHOD Qualitative interviews based on a semi-structured topic guide was conducted. Five families from different parts of Sweden participated in this study. The interviews were recorded with an mp3 device and transcribed verbatim. Qualitative content analysis was used for data analysis. RESULT The parents disclosed anxiety before the start of the treatment and they acknowledged that the first week of introduction, which they, were offered before the start, proved to be essential for the rest of the treatment process. The families found it difficult to cook a balanced meal according to the dietary requriements, and also that it was important to have adequate resources and routine contact with health services to be able to apply the treatment to daily life. Their need for support changed during the treatment process. The informants believed their social activities were accommodated due to treatment. The parents felt the need to be in contact with other families in a similar situation. One parent expressed him-/herself with the words “We got our child back”, which reflects many parents view, regarding the treatment. CONCLUSION MAD and Ketogenic Diet require a lot of time and knowledge and affect practical and social aspects in daily living. With the support of health care, child care, family and friends, the parents felt it was easier to maintain treatment. The informants also shed light on the necessity of being in contact with other parents and families in similar situations

Hur förhåller sig pedagoger till kunskap som elever tillägnar sig utanför skolans ramar?

Syftet med det här examensarbetet är att undersöka hur pedagoger förhåller sig till de erfarenheter och kunskaper som elever tillägnar sig utanför skolans ramar, inte minst från populärkulturen, och hur detta tar sig uttryck i skolan.Intervjuer genomfördes med pedagoger i grundskolans tidigare år. För att få en motpol till resultatet som intervjuerna med pedagogerna gav, valde vi att göra två gruppintervjuer med elevinformanter

Biodiversity and seasonal variation of the cyanobacterial assemblage in a rice paddy field in Fujian,

Abstract Cyanobacteria are one of the main components of the microbiota in rice paddy fields and significantly contribute to its fertilization. The diversity and changes of the cyanobacterial assemblage were investigated during a rice growth season and after harvest in a paddy field located in Fujian Province, China. The cyanobacterial populations were analyzed by a semi-nested PCR, followed by denaturing gradient gel electrophoresis analysis. Twenty-four phylotypes were identified from the denaturing gradient gel electrophoresis profiles. The number of cyanobacterial phylotypes showed a seasonal variation and reached a peak in September, both in the upper (0-5 cm) and the deeper (10-15 cm) soil fractions. Some cyanobacterial sequences were only present during the rice growth season, while others were only found after harvest

Diazotrophic diversity, nifH gene expression and nitrogenase activity in a rice paddy field in Fujian, China

Abstract The diazotrophic communities in a rice paddy field were characterized by a molecular polyphasic approach including DNA/RNA-DGGE fingerprinting, real time RT-PCR analysis of nifH gene and the measurement of nitrogen fixation activities. The investigation was performed on a diurnal cycle and comparisons were made between bulk and rhizosphere / root soil as well as between fertilized / unfertilized soils. Real time RT-PCR showed no significant difference in the total quantity of nifH expression under the conditions investigated. The functional diversity and dynamics of the nifH gene expressing diazotroph community investigated using RT-PCR-DGGE revealed high diurnal variations, as well as variation between different soil types. Most of the sequence types recovered from the DGGE gels and clone libraries clustered within nifH Cluster I and III (65 different nifH sequences in total). Sequence types most similar to Azoarcus spp., Metylococcus spp., Rhizobium spp., Methylocystis spp., Desulfovibrio spp., Geobacter spp., Chlorobium spp., were abundant and indicate that these species may be responsible for the observed diurnal variation in the diazotrophic community structure in these rice field samples. Previously described diazotrophic cyanobacterial genera in rice fields, such as Nostoc and Cyanothece, were present in the samples but not detectable in RT-PCR assays

Occlusal traits and longitudinal dental changes in children and adolescents with congenital or childhood onset myotonic dystrophy

Background/objectives: This research aimed to study the malocclusions of children and adolescents with myotonic dystrophy type 1 (DM1), in respect to healthy individuals, and trace the occlusal changes that occurred in these individuals during growth. Materials/methods: Thirty-six dental casts, from children and adolescents with DM1 living in western and southern Sweden, were compared with a control group of 50 healthy individuals. To identify potential changes in occlusal traits, 26 casts were assessed and followed-up over a median time of 9 years. Independent samples t-tests were used to compare the two groups and their changes over time. Paired samples t-tests tested changes over time within each group (P &lt; 0.05). Results: DM1 patients had a higher prevalence of anterior open bite, posterior crossbite, and Class III malocclusions. When compared to controls, patients presented smaller upper and lower intermolar as well as intercanine widths. In both groups, the individuals revealed longitudinal changes with a decrease in both upper and lower arch lengths and an increase on the palatal vault height. During the follow-up period, the prevalence of malocclusions remained almost the same, only significantly differing regarding the changes that occurred between groups referred to the upper intermolar width, which decreased among DM1 patients. Conclusions/implications: In comparison to healthy controls, children and adolescents with DM1 have shown already at an early age a higher prevalence of both anterior open bite and posterior crossbite. These occlusal traits did not change with time apart from the upper narrow intermolar width, which further decreased with time.</p