Students with disabilities in higher education - perceptions of support needs and received support: a pilot study

Students with disabilities in higher education frequently need support to succeed in their studies. Perceived problems in managing studies and everyday life may be the same for students with different disabilities although the reasons for support may vary between them. In this pilot study, a questionnaire aimed to survey everyday functioning in students with disabilities was tested. Thirty-four students with Asperger syndrome (AS), motor disabilities or deafness/hearing impairments were asked 55 close- and open-ended questions regarding participation restrictions and available support programmes. One aim was to test the usefulness of the questionnaire. Another aim was to identify students’ perceptions of their everyday student-life and the support they are offered, with a special focus on comparing perceptions of needs and support between student with AS and the other student groups. The results indicate the need to plan recruitment of participants carefully and that the questionnaire was useful. The descriptive analyses conducted, indicated that the groups primarily reported the same difficulties, but the open-ended comments indicated that the reasons for the problems vary between the groups. It indicates that likert type responses to questions concerning perceived difficulties need to be supplemented by open-ended questions concerning perceived reasons to problems

Discrepancies in Antimicrobial Susceptibility between the JP2 and the Non-JP2 Genotype of Aggregatibacter actinomycetemcomitans

The Aggregatibacter actinomycetemcomitans JP2 genotype is associated with high leukotoxin production and severe (aggressive) periodontitis. The aim of this study was to compare the antimicrobial susceptibility of JP2 and non-JP2 genotype strains. Minimal inhibitory concentrations (MICs) of 11 antimicrobials were determined for 160 A. actinomycetemcomitans of serotype a, b, or c, mostly isolated in Sweden or Ghana. MIC distributions for benzylpenicillin and fusidic acid revealed a more susceptible subpopulation for 38 serotype b strains, including the 32 of the JP2 genotype, with a benzylpenicillin MIC range of 0.125–0.5 mg/L. In contrast, benzylpenicillin MIC ≤ 16 mg/L was the estimated 99.5% epidemiological cutoff (ECOFF) of all strains. Beta-lactamase production was not detected. The fusidic acid MIC distribution of 11 strains of Aggregatibacter aphrophilus agreed with that found in non-JP2 strains. Cefotaxime, meropenem, levofloxacin, and trimethoprim–sulfamethoxazole MICs were all ≤0.25 mg/L, while MIC90 values for amoxicillin, azithromycin and tetracycline were 1 mg/L. Metronidazole MICs varied between 0.5 and &gt;256 mg/L. The discrepant findings indicate that A. actinomycetemcomitans may be divided into two separate wild types, with a suggested intrinsic reduced susceptibility for benzylpenicillin in the majority of non-JP2 genotype strains. Possible implications for the treatment of A. actinomycetemcomitans infections are discussed.(This article belongs to the Topic Emerging Material-Based Approaches to Chronic and Infectious Diseases).</p

Exploring changes over time in habilitation professionals' perceptions and applications of the International Classification of Functioning, Disability and Health, version for children and youth (ICF-CY)

Objective:This study explored how professionals in interdisciplinary teams perceived the implementation of the World Health Organization’s International Classification of Functioning, Disability and Health, version for Children and Youth (ICF-CY) in Swedish habilitation services. Design:Descriptive longitudinal mixed-methods design. Methods:Following participation in a 2-day in-service training on the ICF-CY, 113 professionals from 14 interdisciplinary teams described their perceptions of the implementation of the ICF-CY at 3 consecutive time-points: during in-service training, after 1 year, and after 2.5 years. Results:Implementation of the ICF-CY in daily work focused on assessment and habilitation planning and required adaptations of routines and materials. The ICF-CY was perceived as useful in supporting analyses and in communication about children’s needs. Professionals also perceived it as contributing to new perspectives on problems and a sharpened focus on participation. Conclusion:Professionals indicated that the ICF-CY enhanced their awareness of families’ views of child participation, which corresponded to organizational goals for habilitation services. An implementation finding was a lack of tools fitting the comprehensive ICF-CY perspective. The study points to the need for ICF-CY-based assessment and intervention methods focusing on child participation.I-CY-HA

Evaluation of in-service training in using the ICF and ICF version for children and youth

OBJECTIVE: To study the effects of in-service training on staff's self-reported knowledge, understanding use of the International Classification of Functioning, Disability and Health (ICF) and ICF Children and Youth version (ICF-CY). DESIGN: Quasi-experimental with a questionnaire prior to training and another one year after training. METHODS: Intervention was in-service training in using the ICF and ICF-CY. Subjects were 113 professionals working in habilitation services. Two subgroups were compared: (i) subjects who reported one year after the training that they had used the ICF and ICF-CY in daily practice; and (ii) subjects who had not used these frameworks. RESULTS: The gender, age, and years of work experience of the members in the subgroups were similar. The professionals who used what they learnt from the training, and who already had knowledge about and a positive attitude to the ICF/ICF-CY prior to the training, were found to benefit most from the training. They also increased their ability to apply it to statements about everyday work. These professionals should focus on increasing their understanding and use of the ICF/ICF-CY in their everyday work and in assessment, while those who have limited prior knowledge of the ICF/ICF-CY should focus on gaining knowledge and understanding the purpose, terms and components of the framework. CONCLUSION: It is recommended that in-service training in using the ICF and ICF-CY is tailored to different groups of professionals depending on their degree of knowledge of the ICF/ICF-CY

Using content analysis to link texts on assessment and intervention to the International Classification of Functioning, Disability and Health - version for Children and Youth (ICF-CY)

Objective: To explore how content analysis can be used together with linking rules to link texts on assessment and intervention to the International Classification of Functioning, Disability and Health – version for children and youth (ICF-CY). Methods: Individual habilitation plans containing texts on assessment and intervention for children with disabilities and their families were linked to the ICF-CY using content analysis. Texts were first divided into meaning units in order to extract meaningful concepts. Meaningful concepts that were difficult to link to ICF-CY codes were grouped, and coding schemes with critical attributes were developed. Meaningful concepts that could not be linked to the ICF-CY were assigned to the categories “not-definable” and “not-covered”, using coding schemes with mutually exclusive categories. Results: The size of the meaning units selected resulted in different numbers and contents of meaningful concepts. Coding schemes with critical attributes of ICF-CY codes facilitated the linking of meaningful concepts to the most appropriate ICF-CY codes. Coding schemes with mutually exclusive categories facilitated the classification of meaningful concepts that could or could not be linked to the ICF-CY. Conclusion: Content analysis techniques can be applied togetherwith linking rules in order to link texts on assessmentand intervention to the ICF-CY

High occurrence of Blastocystis sp subtypes 1-3 and Giardia intestinalis assemblage B among patients in Zanzibar, Tanzania

Background: Blastocystis is a common intestinal parasite with worldwide distribution but the distribution of Blastocystis and its subtypes in East Africa is largely unknown. In this study, we investigate the distribution of Blastocystis subtypes in Zanzibar, Tanzania and report the prevalence of intestinal parasites using both molecular methods and microscopy. Methods: Stool samples were collected from both diarrhoeic and non-diarrhoeic outpatients in Zanzibar. In addition to microscopy, real-time PCR for Blastocystis, Entamoeba histolytica and E. dispar, Giardia intestinalis, Cryptosporidium spp., and Dientamoeba fragilis was used. Blastocystis subtypes were determined by a conventional PCR followed by partial sequencing of the SSU-rRNA gene. Genetic assemblages of Giardia were determined by PCR with assemblage specific primers. Results: Intestinal parasites were detected in 85 % of the 174 participants, with two or more parasites present in 56 %. Blastocystis sp. and Giardia intestinalis were the most common parasites, identified by PCR in 61 and 53 % of the stool samples respectively, but no correlation between carriage of Blastocystis and Giardia was found. The Blastocystis subtype distribution was ST1 34.0 %, ST2 26.4 %, ST3 25.5 %, ST7 0.9 %, and 13.2 % were positive only by qPCR (non-typable). The Giardia genetic assemblages identified were A 6.5 %, B 85 %, A + B 4.3 %, and non-typable 4.3 %. The detection rate with microscopy was substantially lower than with PCR, 20 % for Blastocystis and 13.8 % for Giardia. The prevalence of Blastocystis increased significantly with age while Giardia was most prevalent in children two to five years old. No correlation between diarrhoea and the identification of Giardia, Blastocystis, or their respective genetic subtypes could be shown and, as a possible indication of parasite load, the mean cycle threshold values in the qPCR for Giardia were equal in diarrhoeic and non-diarrhoeic patients. Conclusions: Carriage of intestinal parasites was very common in the studied population in Zanzibar. The most commonly detected parasites, Blastocystis and Giardia, had different age distributions, possibly indicating differences in transmission routes, immunity, and/or other host factors for these two species. In the Blastocystis subtype analysis ST1-3 were common, but ST4, a subtype quite common in Europe, was completely absent, corroborating the geographical differences in subtype distributions previously reported

The relation between Blastocystis and the intestinal microbiota in Swedish travellers

Background: Blastocystis sp. is a unicellular eukaryote that is commonly found in the human intestine. Its ability to cause disease is debated and a subject for ongoing research. In this study, faecal samples from 35 Swedish university students were examined through shotgun metagenomics before and after travel to the Indian peninsula or Central Africa. We aimed at assessing the impact of travel on Blastocystis carriage and seek associations between Blastocystis and the bacterial microbiota. Results: We found a prevalence of Blastocystis of 16/35 (46%) before travel and 15/35 (43%) after travel. The two most commonly Blastocystis subtypes (STs) found were ST3 and ST4, accounting for 20 of the 31 samples positive for Blastocystis. No mixed subtype carriage was detected. All ten individuals with a typable ST before and after travel maintained their initial ST. The composition of the gut bacterial community was not significantly different between Blastocystis-carriers and non-carriers. Interestingly, the presence of Blastocystis was accompanied with higher abundances of the bacterial genera Sporolactobacillus and Candidatus Carsonella. Blastocystis carriage was positively associated with high bacterial genus richness, and negatively correlated to the Bacteroides-driven enterotype. These associations were both largely dependent on ST4 – a subtype commonly described from Europe – while the globally prevalent ST3 did not show such significant relationships. Conclusions: The high rate of Blastocystis subtype persistence found during travel indicates that long-term carriage of Blastocystis is common. The associations between Blastocystis and the bacterial microbiota found in this study could imply a link between Blastocystis and a healthy microbiota as well as with diets high in vegetables. Whether the associations between Blastocystis and the microbiota are resulting from the presence of Blastocystis, or are a prerequisite for colonization with Blastocystis, are interesting questions for further studies.Originally included in thesis in manuscript form</p

Antifungal Application of Nonantifungal Drugs

Candida species are the cause of 60% of all mycoses in immunosuppressed individuals, leading to similar to 150,000 deaths annually due to systemic infections, whereas the current antifungal therapies either have toxic side effects or are insufficiently efficient. We performed a screening of two compound libraries, the Enzo and the Institute for Molecular Medicine Finland (FIMM) oncology collection library, for anti-Candida activity based on the European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines. From a total of 844 drugs, 26 agents showed activity against Candida albicans. Of those, 12 were standard antifungal drugs (SADs) and 7 were off-target drugs previously reported to be active against Candida spp. The remaining 7 off-target drugs, amonafide, tosedostat, megestrol acetate, melengestrol acetate, stanozolol, trifluperidol, and haloperidol, were identified with this screen. The anti-Candida activities of the new agents were investigated by three individual assays using optical density, ATP levels, and microscopy. The antifungal activities of these drugs were comparable to those of the SADs found in the screen. The aminopeptidase inhibitor tosedostat, which is currently in a clinical trial phase for anticancer therapy, displayed a broad antifungal activity against different Candida spp., including Candida glabrata. Thus, this screen reveals agents that were previously unknown to be anti-Candida agents, which allows for the design of novel therapies against invasive candidiasis