Stress urinary incontinence is common and sometimes embarrassing. New, simple, and easily accessible treatments are needed. We telephone interviewed 21 women who participated in a randomized ...controlled study comparing two treatment programs based on instructions for pelvic floor muscle training. One program was Internet-based and included email support by a urotherapist; the other was sent by post. There was no face-to-face contact in either program. Our main aim was to explore the women’s experiences of the Internet-based treatment. Grounded theory analysis revealed three categories: hidden but present, at a distance but close, and by myself but not alone. These were incorporated in a core category: acknowledged but not exposed. The leakage was often a well-hidden secret, but the study treatments lowered the barrier for seeking care. In the Internet group, a supportive patient–provider relationship developed despite the lack of face-to-face contact. Internet-based treatment programs can increase access to care and empower women.
Highlights • Physicians with comprehensive experience of answering free-text medical inquiries at an official health portal in Sweden were interviewed. • Communication skills, also face-to-face, may ...be improved by formulating answers to text-based medical inquiries. • Lists of strategies developed while formulating answers to medical inquiries at an Ask the doctor service are presented.
Objective
To investigate prevalence of neurodevelopmental disorders in children with obesity and to compare body mass index (BMI) and metabolic profile in the children.
Methods
Seventy‐six children ...(37 girls, 39 boys) were consecutively recruited from a university outpatient clinic specialized in severe obesity. Neurodevelopmental disorders including attention‐deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and developmental coordination disorder (DCD) were assessed using interviews and questionnaires. Neurodevelopmental diagnoses were collected retrospectively in medical records.
Results
BMI ranged between 1.9 and 5.9 SDS and age between 5.1 and 16.5 years. In 13.2% and 18.4% ASD and ADHD was assigned, respectively. In addition, 25% screened positive for DCD, 31.6% had at least one neurodevelopmental disorder, and 18.4% had a parent who screened positive for adult ADHD. Girls with ASD/ADHD had higher BMI SDS than girls without neurodevelopmental disorder (P = 0.006).
Conclusions
One third of children with obesity referred to specialist centers have a neurodevelopmental disorder including deviant motor skills, and these problems may deteriorate weight status. One fifth of the parents exhibit ADHD symptomatology which could partly explain the poor adherence by some families in obesity units. Future obesity therapy could benefit from incorporating a neurodevelopmental treatment approach.
Worldwide, 1–2% of children are born with congenital heart disease (CHD) with 97% reaching adulthood.
This study aims to demonstrate the risk of diabetes in patients with CHD, and the influence of ...incident diabetes on mortality in CHD patients and controls.
By combining data from patient registries, the incidence of adult-onset diabetes registered at age 35 or older, and subsequent mortality risk were analysed in two successive birth cohorts (born in 1930–1959 and 1960–1983), by type of CHD lesion and sex, compared with population-based controls matched for sex and year of birth and followed until a maximum of 87 years of age.
Out of 24,699 patients with CHD and 270,961 controls, 8.4% and 5.6%, respectively, were registered with a diagnosis of diabetes at the age of 35 or older, hazard ratio (HR) 1.47 (95% CI 1.40–1.54). The risk of diabetes was higher in the second birth cohort (HR of 1.74, 95% CI 1.54–1.95) and increased with complexity of CHD. After onset of DM, the total mortality among patients with CHD was 475 compared to 411/ 10,000 person-years among controls (HR 1.16, 95% CI 1.07–1.25).
In this nationwide cohort of patients with CHD and controls, the incidence of diabetes was almost 50% higher in patients with CHD, with higher risk in the most recent birth cohort and in those with conotruncal defects, with the combination of CHD and diabetes associated with a significantly increased mortality compared to diabetic controls.
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•In patients with CHD, the risk of developing diabetes was almost 50 % higher in patients with CHD.•This was seen also if divided by birth cohort, gender and increased with severity of CHD.•The combination of CHD and diabetes may affect both mortality and morbidity more than each diagnosis on its own.•Further research is needed to clarify the findings of the present study.
The fight against imperialism and racism was central to the Comintern's political and cultural program of the interwar period. Although the more immediate interests of the Soviet state would come to ...overshadow such causes, the cultural and political connections forged during this time influenced later forms of organizing. Throughout the interwar period (1918-39), the Soviet Union served as the core location of a newly formed world-system of socialist and communist radicalism. The origin of Latin American Marxism in the work of the Peruvian theorist and political organizer José Carlos Mariátegui, as well as the politically committed literature associated with the interwar communist left in the Andean region of Latin America, shows how literature and theory devoted to the indigenous revolutionary contributed to interwar Marxist debates. The interwar influence of Mariátegui and César Vallejo makes clear the importance of resisting attempts to drive a wedge between the two authors and the broader communist movement at the time.
Introduction Wiesner, Claudia; Björk, Anna
Contributions to the history of concepts,
07/2014, Letnik:
9, Številka:
1
Journal Article
Recenzirano
Odprti dostop
The concept of citizenship in Europe after World War II faces two major challenges: migration and European integration. This introduction precedes a group of articles examining debates and law-making ...processes related to the concept of citizenship in Europe after World War II. The introduction sketches the historical development of citizenship in European representative democracies, taking into account four basic dimensions (access to citizenship, citizenship rights, citizenship duties, and the active content of citizenship) for analyzing changes in the concept of citizenship.
Inclusive education is affirmed in Icelandic laws and regulations although, at upper secondary school level, schools can apply to establish special programmes for students who have been labelled as ...disabled. The application process for these programs differs from the one in the mainstream regarding arrangement and time. In this article, special attention will be paid to the application process for Icelandic students with intellectual disabilities at upper secondary level. We use Alecia Jackson's and Lisa Mazzei's methodology of thinking with theory by 'plugging' Iris Marion Young's philosophical concepts of oppression regarding social justice into the text, and vice versa. This approach reveals a discriminatory application process where cultural imperialism has the upper hand causing a denial of group differences. Students are being marginalised based on their support needs which can, among other things, result in systemic violence.
This study aimed at assessing the prevalence of eating disorders (EDs) and ED symptomatology in children with obesity, and at investigating whether EDs occur more often among individuals with a ...comorbid attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Seventy-six children (37 girls, 39 boys, age 5-16 years) were recruited at an outpatient obesity clinic. The adolescents completed ED instruments including The Eating Disorder Examination Questionnaire (EDE-Q) and The Eating Disorder Inventory for children (EDI-C). The parents of all participants were interviewed regarding the child's psychiatric morbidity. Diagnoses of ADHD and ASD were collected from medical records. Anthropometric data were compiled. Eight participants (11%) fulfilled the criteria for a probable ED and 16 participants (21%) had ADHD and/or ASD. Two adolescent girls had a probable ED and coexistent ADHD and ASD. No other overlaps between EDs and ADHD/ASD were observed. Loss of control (LOC) eating was present in 26 out of 40 (65%) adolescents, seven of whom had ADHD, ASD or both. LOC eating was not overrepresented among teenagers with ADHD and/or ASD. Weight and shape concerns were on a par with age-matched adolescents with EDs. EDs and ED behavior are more common among children/adolescents with obesity than in the general population. There is no substantial overlap between EDs and ADHD/ASD in adolescents with obesity.
Aim
Treatment of childhood obesity is often insufficient and may be aggravated by high co‐occurrence of attention‐deficit/hyperactivity disorder (ADHD). We aimed to investigate whether children with ...overweight or obesity normalised in weight when receiving stimulant treatment for ADHD.
Methods
Growth data of 118 children were obtained from medical records at outpatient paediatric and children’s psychiatric services in the Gothenburg area, Sweden. The children were diagnosed with ADHD and were between 6 and 17 years at the start of stimulant treatment. The pre‐treatment data act as an internal control where every child is their own control.
Results
At the start of treatment, 74 children had normal weight and 44 had either overweight or obesity. During the year with stimulants, the mean (SD) body mass index (BMI) in standard deviation score (SDS) decreased significantly: −0.72 (0.66) compared with 0.17 (0.43) during the year before treatment (p < 0.01). After one year with treatment, 43% of those with overweight or obesity had reached normal weight.
Conclusions
Stimulant treatment for ADHD yields significant weight loss. In children with overweight or obesity and ADHD, this is an important finding showing additional benefit in terms of weight management.
1% of all live born children are born with a congenital heart defect (CHD) and currently 95% reach adulthood. Type 1 diabetes mellitus (T1DM) is an autoimmune disease that can develop due to i.e. ...heredity, exposure to infections and stress-strain. The incidence of T1DM in patients with CHD is unknown and we analysed the risk of developing T1DM for patients with CHD, and how this influences mortality.
By combining registries, the incidence of T1DM and the mortality was analysed in patients with CHD by birth cohort (1970–1993, 1970–1984 and 1984–1993) matched with population-based controls matched for sex, county and year of birth without CHD and followed from birth until a maximum of 42 years.
221 patients with T1DM among 21,982 patients with CHD and 1553 patients with T1DM among 219,816 matched controls were identified. The hazard ratio (HR) for developing T1DM was 1.50 (95%, CI 1.31–1.73) in patients with CHD compared to the controls and the first birth cohort (1970–1984) had the highest risk for T1DM, HR 1.87 (95%, CI 1.56–2.24). After onset, mortality risk was 4.21 times higher (95%, CI 2.40–7.37) in patients with CHD and T1DM compared to controls with T1DM.
From a nationwide cohort of patients with CHD and controls, the incidence of developing T1DM was 50% higher in patients with CHD, showing a significant increase in risk among birth cohort 1970–1984. The combination of CHD and T1DM was associated with a 4-fold increase in mortality compared to controls with only T1DM.
•This is the first large retrospective cohort study focusing on adults with congenital heart disease who also develop T1DM.•The incidence of developing T1DM was 50% higher in patients with CHD.•The combination of CHD and T1DM was associated with a 4-fold increase in mortality compared to controls with only T1DM.•The growing numbers of adult with CHD will significantly affect cardiologist practise in the years to come.