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- Ragnarsson, Susanne, et al.
(författare)
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Recurrent Pain and Academic Achievement in School-Aged Children : A Systematic Review
- 2020
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Ingår i: Journal of School Nursing. - : Sage Publications. - 1059-8405 .- 1546-8364. ; 36:1, s. 61-78
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Forskningsöversikt (refereegranskat)abstract
- Recurrent pain and school failures are common problems in children visiting the school nurses office. The overall aim of the current study was to investigate the relationship between recurrent pain and academic achievement in school-aged children. Literature was searched in seven electronic databases and in relevant bibliographies. Study selection, data extraction, and study and evidence quality assessments were performed systematically with standardized tools. Twenty-one studies met the inclusion criteria and 13 verified an association between recurrent pain (headache, stomachache, and musculoskeletal pain) and negative academic achievement. Two longitudinal studies indicated a likely causal effect of pain on academic achievement. All studies had substantial methodological drawbacks and the overall quality of the evidence for the identified associations was low. Thus, children’s lack of success in school may be partly attributed to recurrent pain problems. However, more highquality studies are needed, including on the direction of the association and its moderators and mediators.
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| 2. |
- Ragnarsson, Susanne, et al.
(författare)
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Recurrent pain in school-aged children : a longitudinal study focusing on the relation to academic achievement
- 2022
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Ingår i: Pain. - : Lippincott Williams & Wilkins. - 0304-3959 .- 1872-6623. ; 163:11, s. 2245-2253
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Tidskriftsartikel (refereegranskat)abstract
- Recurrent pain is an increasing public health problem among school-aged children, with potential negative impact on children's daily lives, such as schoolwork. The overall aim of this study was to investigate whether recurrent pain in school year 6 was associated with poorer academic achievement at the end of elementary school in school year 9. The study was a follow-up study based on data from "The Study of Health in School-Aged Children from Umeå". Participants were 1567 children aged 12 to 13 years who attended school year 6. A follow-up was performed in school year 9, when the children were 16 years old. The children answered a questionnaire about recurrent pain (headache, stomachache, and backache). Information about academic achievement was collected from school registers. The results showed that having weekly recurrent pain in school year 6 predicted lower final overall grade points in school year 9 than in children with no recurrent pain. This applied for recurrent headache, stomachache, backache, and multiple pains and for both girls and boys. Recurrent pain did not predict secondary school eligibility, however. Perceived problems with academic achievement and problems with concentration partly mediated the association between recurrent pain and lower final overall grade points. Sleep problems were not associated with academic achievement and were therefore not a mediator. Thus, the results suggest that recurrent pain may predict later impairment of academic achievement and that problems with concentration and children's perceived achievement in school, but not sleep problems, may partly explain this relationship.
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| 3. |
- Bull, Cecilia, 1977, et al.
(författare)
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A novel mouse model of radiation-induced cancer survivorship diseases of the gut
- 2017
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Ingår i: American journal of physiology. Gastrointestinal and liver physiology. - : American Physiological Society. - 1522-1547 .- 0193-1857. ; 313:5, s. G456-G466
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Tidskriftsartikel (refereegranskat)abstract
- A deeper understanding of the radiation-induced pathophysiological processes that develop in the gut is imperative to prevent, alleviate, or eliminate cancer survivorship diseases after radiotherapy to the pelvic area. Most rodent models of high-dose gastrointestinal radiation injury are limited by high mortality. We therefore established a model that allows for the delivering of radiation in fractions at high doses while maintaining long-term survival. Adult male C57/BL6 mice were exposed to small-field irradiation, restricted to 1.5 cm of the colorectum using a linear accelerator. Each mouse received 6 or 8 Gy, two times daily in 12-h intervals in two, three, or four fractions. Acute cell death was examined at 4.5 h postirradiation and histological changes at 6 wk postirradiation. Another group was given four fractions of 8 Gy and followed over time for development of visible symptoms. Irradiation caused immediate cell death, mainly limited to the colorectum. At 6 wk postirradiation, several crypts displayed signs of radiation-induced degeneration. The degenerating crypts were seen alongside crypts that appeared perfectly healthy. Crypt survival was reduced after the fourth fraction regardless of dose, whereas the number of macrophages increased. Angiogenesis was induced, likely as a compensatory mechanism for hypoxia. Four months postirradiation, mice began to show radiation-induced symptoms, and histological examination revealed an extensive crypt loss and fibrosis. Our model is uniquely suitable for studying the long-term trajectory and underlying mechanisms of radiation-induced gastrointestinal injury. NEW & NOTEWORTHY A novel mouse model for studying the long-term trajectory of radiation-induced gut injury. The method allows for the use of high doses and multiple fractions, with minor impact on animal health for at least 3 mo. Crypt loss and a slow progression of fibrosis is observed. Crypt degeneration is a process restricted to isolated crypts. Crypt degeneration is presented as a convenient proxy endpoint for long-term radiation-induced gut injury.
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| 5. |
- Ragnarsson, Susanne, 1966-
(författare)
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Att klara skolan när huvudet dunkar och kroppen värker : en studie om återkommande smärta och skolprestation bland skolbarn
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Bakgrund Återkommande smärta är ett av de vanligaste folkhälsoproblemen bland skolbarn. Den höga förekomsten är ingen ny kunskap, trots det finns det lite beskrivet hur smärtan påverkar barnens funktion och då särskilt om det får konsekvenser för barnens skolprestationer.Syfte Det övergripande syftet med avhandlingen var att studera och värdera evidensen för ett samband mellan återkommande smärta och skolprestation. Detta utifrån smärtans frekvens, lokalisation och utbredning, samt utifrån både subjektiva och objektiva mått på skolprestation. Därutöver studerades möjlig modertorer och mediatorer .Metod Processen delades in i två steg. Steg 1 utgjordes av en systematisk litteraturöversikt (delstudie 1) som studerade den tillgängliga evidensen för sambandet mellan återkommande smärta och skolprestation bland skolbarn mellan 4 och 18 år. Samtliga delar med urval, dataextraktion, kvalitets- och evidensbedömningar utfördes systematisk. Några av de kunskapsluckor som upptäcktes i steg 1 blev grunden till Steg 2 som utgjordes av delstudie 2 och 3. Dessa studier baserades på en longitudinell totalpopulationsstudie från Umeå “The Study of Health in School-aged children from Umeå”. Urvalet bestod av 1524 respektive 1567 barn. Oberoende variabeln var återkommande smärta och beroende variablerna var upplevda problem med skolprestation, meritvärde och gymnasiebehörighet. I studie 2 och 3 analyserades data med hjälp av logistisk och linjär regression.Resultat Steg 1: av 6 387 identifierade studier inkluderades 21 studier varav 13 kunde verifiera samband mellan återkommande smärta och nedsatta skolprestationer. Sammantaget fann översikten begränsat evidens för ett samband mellan återkommande smärta och objektiv skolprestation, samt otillräcklig evidens för ett samband mellan återkommande smärta och subjektiv skolprestation. Brister i de enskilda studiernas kvalitet och design bidrog till den låga evidensen. Steg 2: visade att smärta i årskurs 6 fördubblande oddsen för upplevda problem med skolprestation i årskurs 9, vilket gällde vid olika smärtfrekvenser, lokalisationer och antal smärtställen. Skolfrånvaro, koncentrations och sömnproblem kunde inte mediera sambandet mellan återkommande smärta och upplevda problem med skolprestation. Dessutom sågs ett samband mellan återkommande smärta i veckan i årskurs 6 och meritvärde i årskurs 9. Däremot fanns inget samband mellan smärta i årkurs 6 och gymnasiebehörighet, förutom bland flickor med magsmärta. Skolfrånvaro, koncentrationsproblem och upplevda skolprestation medierade delvis sambandet mellan smärta i årskurs 6 och lägre meritvärde i årskurs 9.Slutsats Resultaten indikationer att återkommande smärta kan predicerar nedsatta betyg och en upplevelse av problem med att prestera i skolan. Resultatet kan lägga till grund för prioriteringar av preventiva insatser i skolan och inom hälso-och sjukvården och kan också bidra med underlag inför utvecklandet av insatser riktade till barn med återkommande smärta.
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