| 1. |
- Eliasson, Ann-Christin, et al.
(författare)
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Longitudinal development of hand use in children with unilateral spastic cerebral palsy from 18 months to 18 years.
- 2023
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Ingår i: Developmental Medicine & Child Neurology. - : Mac Keith Press. - 0012-1622 .- 1469-8749. ; 65:3, s. 376-384
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To describe the development of the use of the affected hand in bimanual tasks in children with unilateral cerebral palsy (CP) from 18 months to 18 years. Specifically, whether early development can be confirmed in a larger cohort and how development progresses during adolescence.METHOD: In total, 171 participants (95 males, 76 females; mean age 3 years 1 month [SD 3 years 8 months], range 18 months-16 years at inclusion) were classified in Manual Ability Classification System (MACS) levels I (n = 41), II (n = 91), and III (n = 39). Children were assessed repeatedly (median 7, range 2-16 times) with the Assisting Hand Assessment: in total 1197 assessments. Developmental trajectories were estimated using a nonlinear mixed effects model. To further analyse the adolescent period, a linear mixed model was applied.RESULTS: The developmental trajectories were different between participants in MACS levels (MACS I-II, II-III) in both rate (0.019, 95% confidence interval [CI] 0.006-0.031, p = 0.034; 0.025, 95% CI 0.015-0.037, p < 0.001) and limit (19.9, 95% CI 16.6-23.3, p = 0.001; 7.2, 95% CI 3.3-11.2, p < 0.003). The individual variations were large within each level. The developmental trajectories were stable over time for all MACS levels between 7 and 18 years (p > 0.05).INTERPRETATION: Children and adolescents with unilateral CP have considerable development at an early age and a stable ability to use their affected hand in bimanual activities from 7 to 18 years in all MACS levels.
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| 2. |
- Förberg, Ulrika, et al.
(författare)
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Relationship between work context and adherence to clinical practice guideline for peripheral venous catheters among registered nurses in paediatric care
- 2014
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Ingår i: Worldviews on Evidence-Based Nursing. - : John Wiley & Sons. - 1545-102X .- 1741-6787. ; 11:4, s. 227-239
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Tidskriftsartikel (refereegranskat)abstract
- Background: It is known that registered nurses' (RNs') work context is related to their use of research and that it can affect nurse and patient satisfaction, as well as the outcomes of care. However, little is known about the relationship between work context and nurses' adherence to clinical practice guidelines. The aim of this study was to describe RNs' adherence to a clinical practice guideline (CPG) on the management of peripheral venous catheters (PVCs), their perceptions of work context, and how nurses' work context and characteristics relate to guideline adherence. Methods: This cross-sectional survey was conducted at a large pediatric university hospital in Sweden. Data were collected through a questionnaire on RNs' adherence to components of a CPG and by using the Alberta Context Tool to assess the nurses' perceptions of work context, including leadership, culture, feedback processes, and other organizational characteristics. Results: Work context-in the form of structural and electronic resources, information sharing activities, and feedback processes-was in different ways associated with the adherence to the CPG components. The RNs' adherence on unit level varied: half the units demonstrated complete adherence on disinfection of hands, whereas a majority of the units reported less than 70% adherence on the use of disposable gloves and the daily inspection of a PVC site. Linking Evidence to Action: Our findings indicate that components in one CPG might require diverse implementation strategies because they are linked to different contextual factors.
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| 3. |
- Hadadgar, Arash, et al.
(författare)
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A Theory-Based Study of Factors Explaining General Practitioners' Intention to Use and Participation in Electronic Continuing Medical Education
- 2016
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Ingår i: Journal of Continuing Education in the Health Professions. - : Lippincott Williams & Wilkins. - 0894-1912 .- 1554-558X. ; 36:4, s. 290-294
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Electronic modes of continuing medical education (eCME) can provide an appropriate and scalable way of updating the knowledge and skills of general practitioners (GPs). To optimize the adoption of eCME and develop efficient and cost-effective eCME programs, factors explaining GPs' intention to use eCME must first be elucidated. Methods: Using the Theory of Planned Behavior as a framework, we developed a questionnaire and administered it to GPs in seven CME seminars in Isfahan, Iran, in 2014. Three domains of GPs' intention to use eCME were measured: attitudes, perceived behavioral control, and subjective norms. We used linear and logistic regression to identify the main predictors of intention and behavior. Results: GPs who had high score in perceived behavioral control and a more positive attitude toward e-learning had a higher intention to adopt it for CME. In contrast, subjective norms (eg, social pressures to use eCME) were not a predictor. Attitude toward usefulness of eCME was the main predictor of being an actual eCME user. Discussion: Perceived behavioral control and attitude constitute the main predictors of the intention to use eCME. Establishing discussions forums and strengthening organizational support for eCME through an increased awareness among clinical superiors and CME managers would be expected to increase GPs' intention to use eCME.
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| 4. |
- Hässler, Signe, et al.
(författare)
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Aire deficient mice develop hematopoetic irregularities and marginal zone B cell lymphoma
- 2006
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Ingår i: Blood. - : American Society of Hematology. - 0006-4971 .- 1528-0020. ; 108:6, s. 1941-1948
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Tidskriftsartikel (refereegranskat)abstract
- Autoimmune polyendocrine syndrome type I (APS I) is an inherited recessive disorder with a progressive immunological destruction of many tissues including the adrenal cortex, the parathyroid glands, and the gonads. APS I is caused by mutations in the AIRE gene (autoimmune regulator), expressed in cells of the thymus and spleen, suggesting a role in central and peripheral tolerance. Aire(-/-) mice replicate the autoimmune features of APS I patients with the presence of multiple autoantibodies and lymphocytic infiltrates in various tissues, but young mice appear clinically healthy. We here report the investigation of 15- to 24-month-old Aire(-/-) mice. We did not observe any endocrinological abnormalities, nor did sera from these mice recognize known APS I autoantigens. Interestingly, however, there was a high frequency of marginal zone B-cell lymphoma in Aire(-/-) mice and liver infiltrates of B cells, suggesting chronic antigen exposure and exaggerated activation. Furthermore, increased numbers of monocytes in blood were identified as well as augmented numbers of metallophilic macrophages in the spleen. We propose that Aire, in addition to its function in the thymus, also has a peripheral regulatory role by controlling the development of antigen-presenting cells (APCs) and marginal zone B-cell activation.
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| 5. |
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| 6. |
- Mittendorfer-Rutz, Ellenor, et al.
(författare)
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Determinants in adolescence for adult sickness absence in women and men: a 26-year follow-up of a prospective population based cohort (Northern Swedish cohort).
- 2013
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Ingår i: BMC public health. - : Springer Science and Business Media LLC. - 1471-2458. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Background: To date little is known regarding how factors measured in adolescence predict sickness absence in adulthood, and whether different patterns of factors exist for women and men that could contribute to an explanation of adult gender differences in sickness absence. Methods: All pupils in the last year of compulsory school in the municipality of Luleå with complete information from surveys (questionnaires) in 1981 and 1983 (compulsory and upper-secondary schooling; 16 and 18 years of age, N=719) were followed with register data on medically certified sickness absence (1993–2007). Generalised linear models were applied to calculate Risk Ratios with 95% Confidence Intervals (CI) comparing annual mean numbers of sickness absence spells in exposed versus unexposed groups. Results: In the multivariate model, the following factors were found to be predictive of future sickness absence in women: participating in an upper secondary school program in 1983 dominated by women (> 60%): 1.41 (95% CI 1.00 – 1.97); sometimes sickness absence from school in 1981: 1.60 (95% CI 1.18 – 2.17) and low parental socioeconomic status in 1981: 2.20 (95% CI 1.44 – 3.38). In men, low school grades in 1981: 4.36 (95% CI 2.06 – 9.22) and fathers not in gainful employment in 1981: 2.36 (95% CI 1.53 – 3.66) were predictive. Conclusion: The findings suggest that sickness absence in adulthood is predicted by factors measured in adolescence. These predictors may differ for women and men. For women, early life absence and social environmental factors, for men low achievements at school and lack of employment of their father seem to be predictive.
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