Post epidemic giardiasis and gastrointestinal symptoms among preschool children in Bergen, Norway. A cross-sectional study

<p>Abstract</p> <p>Background</p> <p>A surprisingly low number of children became ill with giardiasis during the large waterborne outbreak of <it>Giardia lamblia </it>in Bergen, Norway during autumn 2004. The aim of the present study was to evaluate the prevalence of giardiasis among exposed children one year after an outbreak and compare faecal carriage of <it>Giardia </it>and abdominal symptoms among exposed versus unexposed children one year after the epidemic.</p> <p>Methods</p> <p>Children between 1 and 6 years old were recruited from the local health care centres in Bergen municipality in the period between June 2005 and January 2006. One faecal sample per child was collected and examined for presence of <it>Giardia </it>with a rapid immunoassay antigen test, and parents were asked to answer a questionnaire. A total of 513 children participated, 378 in the group exposed to contaminated water, and 135 in the in the group not exposed.</p> <p>Results</p> <p>In the exposed group eleven children had been treated for giardiasis during the epidemic and none in the unexposed group. <it>Giardia </it>positive faecal tests were found in six children, all in the exposed group, but the difference between the groups did not reach statistical significance. All six <it>Giardia </it>positive children were asymptomatic. No differences were found between the groups regarding demographic data, nausea, vomiting, different odour from stools and eructation. However, the reported scores of abdominal symptoms (diarrhoea, bloating and stomach ache) during the last year were higher in the exposed group than in the unexposed group.</p> <p>Conclusions</p> <p>A low prevalence of asymptomatic <it>Giardia </it>infection (1.7%) was found among exposed children around one year after the epidemic (1.2% overall prevalence in the study). In the present setting, pre-school children were therefore unlikely to be an important reservoir for continued transmission in the general population.</p

Sounds of silence. The “special grief” of drug-death bereaved parents: a qualitative study

Background: Drug-death bereavement is an understudied topic. We explore what bereaved parents experience after losing their child to drug use. The aim of the paper is to provide knowledge about what drug-death bereaved parents go through and study the kinds of help and support they receive. Method: Reflexive thematic analysis is used to analyze 14 semi-structured in-depth interviews with Norwegian parents. Results: We generated four main themes: (I) ‘constant preparedness’ describes the burdensome overload that the parents experienced before death; (II) ‘stigmatization’ represents public and self-induced stigma; (III) ‘emotional overload’ refers to the parents’ complex and ambivalent emotions, such as anger, guilt and shock after the loss; and (IV) ‘complex relations’ describes the parents’ relations with public services and their personal social networks. Discussion: We discuss how overload, before and after the loss experience, causes a special grief. How this overload, silence from helpers, self-stigma and complicated interactions with social networks contribute to the grief of these parents is also discussed. Potential implications for policy and practice are subsequently outlined

Effects of environmental enrichment at ages 3-5 years on schizotypal personality and antisocial behavior at ages 17 and 23 years

OBJECTIVE: Methods to prevent two major mental disorders, schizophrenia and conduct disorder, have been elusive. This study assessed the effects of an early nutritional, educational, and physical exercise enrichment program on adult outcome for schizotypal personality, conduct disorder, and criminal behavior. METHOD: Eighty-three children were assigned to an experimental enrichment program from ages 3 to 5 years and matched on temperament, nutritional, cognitive, autonomic, and demographic variables with 355 children who experienced usual community conditions (control group). Both self-report and objective measures of schizotypal personality and antisocial behavior were obtained when the subjects were ages 17 and 23 years. RESULTS: Subjects who participated in the enrichment program at ages 3–5 years had lower scores for schizotypal personality and antisocial behavior at age 17 years and for criminal behavior at age 23 years, compared with the control subjects. The beneficial effects of the intervention were greater for children who showed signs of malnutrition at age 3 years, particularly with respect to outcomes for schizotypy at ages 17 and 23 and for antisocial behavior at age 17. CONCLUSIONS: The results are consistent with an increasing body of knowledge that implicates an enriched, stimulating environment in beneficial psychological and behavioral outcomes. These findings have potential implications for the prevention of schizophrenia and criminal behavio

Early educational and health enrichment at age 3-5 years is associated with increased autonomic and central nervous system arousal and orienting at age 11 years: Evidence from the Mauritius Child Health Project

Little is known about the effects of environmental enrichment on psychophysiological measures of arousal and orienting in humans. This study tests the hypothesis that early educational and health enrichment is associated with long-term increases in psychophysiological orienting and arousal. One hundred children were experimentally assigned to a two-year enriched nursery school intervention at ages 3–5 years and matched at age 3 years on psychophysiological measures, gender, and ethnicity to 100 comparisons who received the normal educational experience. Children were retested 6–8 years later at age 11 years on skin conductance (SC) and electroencephalogram (EEG) measures of arousal and attention during pre- and postexperimental rest periods and during the continuous performance task. Nursery enrichment was associated with increased SC amplitudes, faster SC rise times, faster SC recovery times, and less slow-wave EEG during both rest and CPT conditions. This is believed to be the first study to show that early environmental enrichment is associated with long-term increases in psychophysiological orienting and arousal in humans. Results draw attention to the important influence of the early environment in shaping later psychophysiological functioning

Sounds of silence. The “special grief” of drug-death bereaved parents: a qualitative study

Background: Drug-death bereavement is an understudied topic. We explore what bereaved parents experience after losing their child to drug use. The aim of the paper is to provide knowledge about what drug-death bereaved parents go through and study the kinds of help and support they receive. Method: Reflexive thematic analysis is used to analyze 14 semi-structured in-depth interviews with Norwegian parents. Results: We generated four main themes: (I) ‘constant preparedness’ describes the burdensome overload that the parents experienced before death; (II) ‘stigmatization’ represents public and self-induced stigma; (III) ‘emotional overload’ refers to the parents’ complex and ambivalent emotions, such as anger, guilt and shock after the loss; and (IV) ‘complex relations’ describes the parents’ relations with public services and their personal social networks. Discussion: We discuss how overload, before and after the loss experience, causes a special grief. How this overload, silence from helpers, self-stigma and complicated interactions with social networks contribute to the grief of these parents is also discussed. Potential implications for policy and practice are subsequently outlined

Quality of medication information in discharge summaries from hospitals: an audit of electronic patient records

Background: Low quality of medication information in discharge summaries from hospitals may jeopardize optimal therapy and put the patient at risk for medication errors and adverse drug events. Objective: To audit the quality of medication information in discharge summaries and explore factors associated with the quality. Setting Helgelandssykehuset Mo i Rana, a rural hospital in central Norway. Method: For each month in 2013, we randomly selected 60 discharge summaries from the Department of Medicine and Surgery (totally 720) and evaluated the medication information using eight Norwegian quality criteria. Main outcome measure: Mean score per discharge summary ranging from 0 (lowest quality) to 16 (highest quality). Results: Mean score per discharge summary was 7.4 (SD 2.8; range 0–14), significantly higher when evaluating medications used regularly compared to mediations used as needed (7.80 vs. 6.52; p < 0.001). Lowest score was achieved for quality criteria concerning generic names, indications for medication use, reasons why changes had been made and information about the source for information. Factors associated with increased quality scores are increasing numbers of medications and male patients. Increasing age seemed to be associated with a reduced score, while type of department was not associated with the quality. Conclusion: In discharge summaries from 2013, we identified a low quality of medication information in accordance with the Norwegian quality criteria. Actions for improvement are necessary and follow-up studies to monitor quality are needed