Barnbok om AST – Autismspektrumtillstånd : Processen bakom skapandet av en informativ barnbok

Idag finns det mycket litteratur om Autismspektrumtillstånd att läsa, men det mesta är riktat till dem som redan har diagnosen eller föräldrar och bekanta. Det finns även många med AST som själva har skrivit böcker om sin diagnos. Det som saknas är en bok för barn utan AST men som möter barn med AST i vardagen och därför valde vi att skapa en bok om AST för barn. Detta för att barn utan kunskap kanske inte vet hur de ska bemöta sina klasskompisar med diagnosen. På ett lärorikt sätt ska barn utan AST kunna läsa och uppleva boken för att få en ökad förståelse om vad det innebär att ha AST. En bakgrundsstudie genomfördes för att få en ökad förståelse för AST och hur man skriver en barnbok. En webbenkätundersökning genomfördes för att ta reda på människors generella uppfattning och kunskaper om AST. Därefter skapade vi en barnbok för målgruppen 7–9 år med all den bakgrundskunskap vi fick fram. Vi testade vår slutprodukt med klass 3A och 3B på Hälsinggårdsskolan i Falun. De fick själva läsa boken och svara på en enkät med frågor om vad de tyckte om boken och om de hade lärt sig något nytt. Testet av vår bokprototyp visade att målgruppen uppskattade bokprototypen och att de elever som deltog lärde sig något om AST.

The most severe parkinsonian patients are most improved with duodenal levodopa infusion

Objectives:To find variables correlated to improvement with intraduodenal levodopa/carbidopa infusion (Duodopa) in order to identify potential candidates for this treatment. Two clinical studies comparing Duodopa with oral treatments in patients with advanced Parkinson’s disease have shown significant improvement in percent on-time on a global treatment response scale (TRS) based on hourly and half-hourly clinical ratings and in median UPDRS scores.Methods:Data from study 1 comparing infusion with Sinemet CR (12 patients, Nyholm et al, Clin Neuropharmacol 2003; 26(3): 156-163) and study 2 comparing infusion with individually optimised conventional combination therapies (18 patients, Nyholm et al, Neurology, in press) were used. Measures of severity were defined as total UPDRS score and scores for sections II and III, percent functional on-time and mean squared error of ratings on the TRS and as mean of diary questions about mobility and satisfaction (only study 2). Absolute improvement was defined as difference in severity, and relative improvement was defined as percent absolute improvement/severity on oral treatment. Pearson correlation coefficients between measures of improvement and other variables were calculated.Results:Correlations (r2>0.28, p<0.05) between severity during oral treatment and absolute improvement on infusion were found for: Total UPDRS, UPDRS III and TRS ratings (studies 1 and 2) and for diary question 1 (mobility) and UPDRS II (study 2). Correlation to relative improvement was found for total UPDRS (study 2, r2=0.47). Figure 1 illustrates absolute improvement in total UPDRS vs. total UPDRS during oral treatment (study 2).Conclusion:Correlating different measures of severity and improvement revealed that patients with more severe symptoms were most improved and that the relation between severity and improvement was linear within the studied groups. The result, which was reproducible between two clinical studies, could be useful when deciding candidates for the treatment.

Analysis of response to enteral infusion of levodopa in patients with Parkinson's disease

Objective: We present a new evaluation of levodopa plasma concentrations and clinical effects during duodenal infusion of a levodopa/carbidopa gel (Duodopa ) in 12 patients with advanced Parkinson s disease (PD), from a study reported previously (Nyholm et al, Clin Neuropharmacol 2003; 26(3): 156-163). One objective was to investigate in what state of PD we can see the greatest benefits with infusion compared with corresponding oral treatment (Sinemet CR). Another objective was to identify fluctuating response to levodopa and correlate to variables related to disease progression. Methods: We have computed mean absolute error (MAE) and mean squared error (MSE) for the clinical rating from -3 (severe parkinsonism) to +3 (severe dyskinesia) as measures of the clinical state over the treatment periods of the study. Standard deviation (SD) of the rating was used as a measure of response fluctuations. Linear regression and visual inspection of graphs were used to estimate relationships between these measures and variables related to disease progression such as years on levodopa (YLD) or unified PD rating scale part II (UPDRS II).Results: We found that MAE for infusion had a strong linear correlation to YLD (r2=0.80) while the corresponding relation for oral treatment looked more sigmoid, particularly for the more advanced patients (YLD>18).