Anita Berlin

Plasma protein binding of diphenylhydantoin in patients with epilepsy. Agreement between the unbound fraction in plasma and the concentration in the cerebrospinal fluid.

The plasma protein binding and the cerebrospinal fluid (CSF)‐plasma ratio of diphenyhydantoin (DPH) was determined in 8 patients with epilepsy treated only with DPH and in steady‐state conditions. The unbound fraction of DPH showed only minor interindividual differences and did not differ from the values in drug‐free volunteers. The CSF‐plasma ratio also varied very little interindividually and agreed well with the values of the unbound fraction. The discrepancy between our results and those of previous investigators is discussed.

Updated Swedish advice on reducing the risk of sudden infant death syndrome

This article reviews updated advice and factual material from the Swedish National Board of Health and Welfare on reducing the risk of sudden infant death syndrome. Issues covered by the guidance for parents and healthcare professionals include sleeping positions, smoking, breastfeeding, bed sharing and using pacifiers.

One size does not fit all–qualitative process evaluation of the Healthy School Start parental support programme to prevent overweight and obesity among children in disadvantaged areas in Sweden

BackgroundParental support interventions have shown some effectiveness in improving children’s dietary and physical activity habits and preventing overweight and obesity. To date, there is limited research on barriers and facilitators of school-based parental support interventions targeting overweight and obesity. This study aimed to describe barriers and facilitators influencing implementation of the Healthy School Start (HSS) intervention in disadvantaged areas in Stockholm, Sweden, from the perspective of parents and teachers.MethodsFocus groups and individual interviews with teachers (n = 10) and focus groups with parents (n = 14) in the intervention group of the HSS were undertaken, guided by the Consolidated Framework for Implementation Research (CFIR). Transcriptions were analysed using qualitative content analysis in two steps: deductive sorting in two domains of the CFIR (intervention characteristics and process), and subsequent inductive analysis.ResultsThe overarching theme “tailoring the intervention to increase participant engagement” was found. Among teachers, barriers and facilitators were related to how the intervention was introduced, perceptions of the usefulness of the classroom material, preparation ahead of the start of the intervention, cooperation between home and school and children’s and parents’ active engagement in the intervention activities.For parents, barriers and facilitators were related to the perceived relevance of the intervention, usefulness of the material, experiences of the Motivational Interviewing (MI) sessions, the family member targeted by the intervention, cooperation between home and school and parents’ ability to act as good role models.ConclusionIt seems important to tailor the intervention to the abilities of the target group in order to increase participant engagement. Including activities that focus on parents as role models and cooperation between parents seems important to bring about changes in the home environment. It also appears important to include activities that target cooperation between home and school.

Content and Presentation of Content in Parental Education Groups in Sweden.

ABSTRACT This study investigated parents’ experiences of parental education groups at antenatal and child health care centers, including content, presentation of content, the leader’s role, and the importance of other participating parents. Twenty-one interviews with 26 parents from 6 cities across Sweden were analyzed with 3 content analysis approaches. Parents expressed both satisfaction and dissatisfaction with the content, presentation of content, and the leader’s role. They reported that social contact with other parents was important, that parenthood topics were covered less frequently than child and childbirth-related topics, and that group activities were less frequent than lectures. When designing future parental education groups, it is important to consider expanding parenthood topics and group activities because this structure is considered to provide support to parents.

Leaders’ limitations and approaches to creating conditions for interaction and communication in parental groups: A qualitative study

The aim of this study was to describe and understand parental group (PG) leaders’ experiences of creating conditions for interaction and communication. The data consisted of 10 interviews with 14 leaders. The transcribed interviews were analysed using thematic analysis. The results showed that the leaders’ ambition was to create a parent-centred learning environment by establishing conditions for interaction and communication between the parents in the PGs. However, the leaders’ experience was that their professional competencies were insufficient and that they lacked pedagogical tools to create constructive group discussions. Nevertheless, they found other ways to facilitate interactive processes. Based on their experience in the PG, the leaders constructed informal socio-emotional roles for themselves (e.g. caring role and personal role) and let their more formal task roles (e.g. professional role, group leader and consulting role) recede into the background, so as to remove the imbalance of power between the leaders and the parents. They believed this would make the parents feel more confident and make it easier for them to start communicating and interacting. This personal approach places them in a vulnerable position in the PG, in which it is easy for them to feel offended by parents’ criticism, questioning or silence.

Parental strategies for influencing the diet of their children – A qualitative study from disadvantaged areas

BACKGROUND A social gradient is evident in the prevalence of childhood overweight and obesity, to the disadvantage of children with low socioeconomic status (SES). Parents have a substantial influence on their childrens dietary behaviours and weight development through the way they interact with the children around food. This study aims to explore the variation of how parents with low SES influence their childs dietary behaviours. METHODS A phenomenographic design and analysis was used on 29 sessions of motivational interviewing with mothers and fathers participating in the Healthy School Start intervention study in 2012. The parents had a maximum of 12 years of education and resided in areas targeted for socioeconomic development. In the sessions, parents explored changes that they wanted to make in the home environment regarding their childs dietary behaviours. RESULTS Five categories of guidance of childrens dietary habits were found ranging from silently guiding to enforcement. The categories of guidance were structurally related to each other through positive to negative impact of parental recognition of responsibility for the childs behaviours, level of trust in the childs satiety response, and level of parental emotional distress. CONCLUSION The results suggest that parents use situation-specific guidance with both negative and positive impacts on child behaviours. Depending on the type of guidance used, parents are in need of different supporting strategies to enhance positive parent-child interplay. Suggestions for intervention strategies are provided where specific focus on parental responsibility recognition, emotional self-regulation, increased responsiveness, and cooperation between parents are highlighted.

Experiences and consequences of living with extended-spectrum β-lactamase–producing bacteria: A qualitative study

Background: The number of people who become carriers of antibiotic‐resistant extended‐spectrum &bgr;‐lactamase (ESBL)–producing bacteria is steadily increasing. A carrier of ESBL can potentially be stressful for individuals, affecting their daily lives. Methods: The purpose of this study was to increase the understanding of experiences and consequences of being an ESBL carrier. A modified version of the grounded theory was used to analyze 16 open interviews. Results: The analysis resulted in the core category “to handle the new life situation.” The results showed a lack of information being passed by attending doctors to study participants about ESBL and the consequences for their daily lives. This insufficient information initially caused fear and anxiety, leading to participants instead searching for information themselves using the Internet. Armed with this information, they developed strategies to continue with their lives as before. As patients they experienced staff that were respectful, showed no stigmatization toward ESBL carriership, and used correct hygiene routines. Conclusions: When the information from the attending doctor about ESBL carriers is insufficient, patients often use the Internet to obtain additional information. With the use of this information, patients develop strategies to cope with their lives.

Psychometric characteristics of a modified Sympathy-Acceptance-Understanding-Caring competence model questionnaire among foreign-born parents encountering nurses in primary child health care services.

AIM To determine the psychometric properties of the Sympathy-Acceptance-Understanding-Caring Competence (SAUC) model questionnaire for foreign-born parents evaluating nursing encounters in the Swedish Primary Child Health Care (PCHC) services. BACKGROUND Multicultural encounters in child health care from the nursing perspective are challenging and problematic worldwide. A suitable theory-based and validated questionnaire is needed for foreign-born parents to assess the quality of their encounters with nurses. METHODS The SAUC questionnaire, modified for use by new, foreign-born parents using the Swedish PCHC services, was evaluated for its congruence with the theory of Confirming Encounter. The study was ethically approved and data were collected between March and August 2009 from 83 new, foreign-born parents seen at 50 clinics. Exploratory factor analysis was used to identify related factors, and goodness-of-fit tests were used to estimate theoretical consistency. Confirmatory Factor Analysis was used to verify the results. FINDINGS The questionnaire had satisfactory theoretical consistency with the theory of Confirming Encounter. Three factors identified by exploratory factor analysis and confirmed by confirmatory factor analysis - person support, self-support, and self-perspective support - indicated internal consistency and validated the three factors implicit in the theory Confirming Encounter. In addition, a new factor, concordance, was identified that is compatible with the theory. To conclude, despite the fact that a modified questionnaire have its limitations results demonstrate that the SAUC-model questionnaire seems to be a reliable and valid nursing quality-control measure with which foreign-born parents can evaluate the qualities of a confirming encounter with nurses. However, we suggest the need for testing the questionnaire in a larger population.