Search

Many children with complex right ventricle outflow tract anomalies such as Tetralogy of Fallot, common arterial trunk, and pulmonary atresia with ventricular septal defect require repeated heart surgeries early in life, but also later throughout their lifetime, thereby emphasising the importance of careful life-long follow-up. The need for repeated heart surgeries during childhood is recognised as a heavy burden on the child. Optimising the time point for re-intervention is important, since delaying re-intervention for these children can lead to complications such as ventricular arrhythmias, heart failure, and death. To this purpose, thorough pre-operative assessment (henceforth named as assessment) including clinical examination, echocardiography, MRI, and exercise test need to be performed whenever the indication for reoperation is suspected. It is likely to believe that children who are going through this kind of assessment that may lead to heart surgery need extra support. According to previous research, children with complex heart disease fear for the possibility of surgery and the thought of future repeated heart surgery is associated with anxiety. This might have an impact on children's everyday life and in research nowadays involving children with CHD, the focus has changed from survival to how these children experience their everyday life. Earlier studies have shown that they experience physical activities limitation and feelings of isolation, but no study has yet studied how children with right ventricle outflow tract anomalies experience their everyday life. To be able to provide support, studies are needed to explore how these children experience the period from assessment to decision, as well as the months thereafter. Therefore, the aim of this study was to explore how children diagnosed with complex right ventricle outflow tract anomalies experience their heart disease and their everyday life during the assessment and after the decision on whether to p, This study was supported by Swedish Heart- and Lung Foundation (PL), the Pediatric Heart center at the Skåne University Hospital (BS), and Lund University (PL).CC BY 4.0

Background: Parents of children with complex right ventricular outflow tract ( RVOT) anomalies are confronted with their child's need for heart surgery early in life and repeated reoperations later on. Preoperative assessment needs to be performed whenever an indication for reoperation is suspected. The aim was to illuminate the experiences of parents of children diagnosed with RVOT anomalies, in particular, how they experience their child's heart disease and everyday life during the assessment and after the decision on whether to perform a reoperation. Method: Individual interviews (n = 27) were conducted with nine parents on three occasions between 2014 and 2016 and analyzed using reflexive thematic analysis. Results: The analysis resulted in the following five main coexisting themes: The heart surgery keeps my child alive illuminates parents' experiences during and after the assessment and emphasizes that heart surgery, although dreaded, is central for their child's survival; Everyday struggles illuminates the different struggles parents had to face to ensure that their child would be in the best possible condition; the remaining three themes, Unconditional love, Trust in life, and Togetherness, illuminate the ways in which the parents gained inner strength and confidence in their everyday lives. Conclusion: Although the parents were grateful for the assessment and had learned to navigate among the fears it aroused, they experienced several distressing situations during the assessment process that should be addressed. By inviting both the parents and their child to participate in the child's care, individualized support can take into account the needs of both parents and child.

Background: Children with right ventricular outflow tract (RVOT) anomaliestypically undergo surgical repair during their first months of life and thereafter they will need one or more reoperations through their life.Aims: The overall aim was to describe health-related quality of life (HRQoL) forchildren with congenital heart disease (CHD) with a special focus on children withRVOT anomalies and to explore children’s and their parents’ experiences ofeveryday life during assessment that could result in a new heart surgery.Methods: Two quantitative studies with HRQoL assessment for 337 children withCHD and 97 children with RVOT anomalies were performed. Another twoqualitative interview studies were conducted, in which nine children with RVOTanomalies and their parents were interviewed at three time points (at start of thepreoperative assessment, at the assessment decision and around 11 months after the decision).Results: Children with three or more surgeries had lower HRQoL than children with fewer heart surgeries. Children with RVOT anomalies rated their lowest HRQoL for cognitive function, as did their parents. The agreement for HRQoL between children with RVOT anomalies and their parents was strong for 13 of 22 items. The thematic analysis of the interviews with children resulted in three themes and eight subthemes: Me and my heart disease explores the children’s experiences of their heart disease; Being me explores their sense of self; Being placed in someone else’s hands describes how the assessment was a safety net for the child, at least until the decision for heart surgery. The interviews with parents resulted in five themes: The heart surgery keeps my child alive illuminates’ parents’ experiences related to the assessment: Everyday struggles illuminates the struggles parents had to face on behalf of their child in everyday life; Unconditional love, Trust in life and Togetherness illuminates the ways in which the parents gained inner strength in their everyday l

The primary aim of this paper is to examine students´ relational engagement in a short story, as well as their use of mental state expressions in responding to it in three different writing assignments, one of which involved photo elicitation. A secondary aim is to examine and compare the relational engagement between students reading the story in Swedish (i.e., their L1) and English (i.e., their L2), respectively. The theoretical framework draws on research in relational engagement/transactional theory, the Appraisal system, Dual Code Theory (DCT), and the Linguistic Threshold Hypothesis. Both qualitative and quantitative methods were used. A total of 33 students participated in the study, half of whom read the story in Swedish, and half in English. The results show that the students used a wide range of mental state expressions, but also that these expressions changed in accordance with task formulation. The results also show that the photo-elicitation assignment yielded the strongest relational engagement. Furthermore, students reading the story in Swedish generally demonstrated a stronger relational engagement than students reading the story in English. © 2020 IJLS; Printed in the USA by Lulu Press Inc.

The negative effects of proteases produced by psychrotrophic bacteria on dairy products, especially ultra-high-temperature (UHT) milk, are drawing increasing attention worldwide. These proteases are especially problematic, because it is difficult to control psychrotrophic bacteria during cold storage and to inactivate their heat-resistant proteases during dairy processing. The predominant psychrotrophic species with spoilage potential in raw milk, Pseudomonas, can produce a thermostable extracellular protease, AprX. A comprehensive understanding of AprX on the aspects of its biological properties, regulation, proteolytic potential, and its impact on UHT milk can contribute to finding effective approaches to minimize, detect, and inactivate AprX. AprX also deserves attention as a representative of all extracellular metalloproteases produced by psychrotrophic bacteria in milk. The progress of current research on AprX is summarized in this review, including a view on the gap in current understanding of this enzyme. Reducing the production and activity of AprX has considerable potential for alleviating the problems that arise from the instability of UHT milk during shelf-life.