| 1. |
- Eliasson, Ann-Christin, et al.
(författare)
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Efficacy of the small step program in a randomised controlled trial for infants below age 12 months with clinical signs of CP; a study protocol
- 2016
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Ingår i: BMC Pediatrics. - London : Springer Science and Business Media LLC. - 1471-2431. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- Background: Children with cerebral palsy (CP) have life-long motor disorders, and they are typically subjected to extensive treatment throughout their childhood. Despite this, there is a lack of evidence supporting the effectiveness of early interventions aiming at improving motor function, activity, and participation in daily life. The study will evaluate the effectiveness of the newly developed Small Step Program, which is introduced to children at risk of developing CP during their first year of life. The intervention is based upon theories of early learning-induced brain plasticity and comprises important components of evidence-based intervention approaches used with older children with CP.Method and design: A two-group randomised control trial will be conducted. Invited infants at risk of developing CP due to a neonatal event affecting the brain will be randomised to either the Small Step Program or to usual care. They will be recruited from Astrid Lindgren Children's Hospital at regular check-up and included at age 3-8 months. The Small Step Program was designed to provide individualized, goal directed, and intensive intervention focusing on hand use, mobility, and communication in the child's own home environment and carried out by their parents who have been trained and coached by therapists. The primary endpoint will be approximately 35 weeks after the start of the intervention, and the secondary endpoint will be at 2 years of age. The primary outcome measure will be the Peabody Developmental Motor Scale (second edition). Secondary assessments will measure and describe the children's general and specific development and brain pathology. In addition, the parents' perspective of the program will be evaluated. General linear models will be used to compare outcomes between groups.Discussion: This paper presents the background and rationale for developing the Small-Step Program and the design and protocol of a randomized controlled trial. The aim of the Small Step Program is to influence development by enabling children to function on a higher level than if not treated by the program and to evaluate whether the program will affect parent's ability to cope with stress and anxiety related to having a child at risk of developing CP.
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| 2. |
- Holmström, Linda, et al.
(författare)
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Efficacy of the Small Step Program in a Randomized Controlled Trial for Infants under 12 Months Old at Risk of Cerebral Palsy (CP) and Other Neurological Disorders
- 2019
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Ingår i: Journal of Clinical Medicine. - : MDPI. - 2077-0383. ; 8:7
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Tidskriftsartikel (refereegranskat)abstract
- The objective was to evaluate the effects of the Small Step Program on general development in children at risk of cerebral palsy (CP) or other neurodevelopmental disorders. A randomized controlled trial compared Small Step with Standard Care in infants recruited at 4-9 months of corrected age (CA). The 35-week intervention targeted mobility, hand use, and communication during distinct periods. The Peabody Developmental Motor Scales2ed (PDMS-2) was the primary outcome measure. For statistical analysis, a general linear model used PDMS-2 as the main outcome variable, together with a set of independent variables. Thirty-nine infants were randomized to Small Step (n = 19, age 6.3 months CA (1.62 SD)) or Standard Care (n = 20, age 6.7 months CA (1.96 SD)). Administering PDMS-2 at end of treatment identified no group effect, but an interaction between group and PDMS-2 at baseline was found (p < 0.02). Development was associated with baseline assessments in the Standard Care group, while infants in the Small Step group developed independent of the baseline level, implying that Small Step helped the most affected children to catch up by the end of treatment. This result was sustained at 2 years of age for PDMS-2 and the PEDI mobility scale.
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| 3. |
- Sahli, David, et al.
(författare)
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Assessment of toe blood pressure is an effective screening method to identify diabetes patients with lower extremity arterial disease.
- 2004
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Ingår i: Angiology. - : SAGE Publications. - 0003-3197 .- 1940-1574. ; 55:6, s. 641-51
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Tidskriftsartikel (refereegranskat)abstract
- The authors evaluated a screening program for lower extremity arterial disease (LEAD) in diabetic patients and focused on the value of toe blood pressure assessment. They recruited 437 subjects, ages 30-70 years (134 healthy controls, 166 type 1 and 137 type 2 diabetic patients; control [Ctr], DM1, and DM2) with no previous history of LEAD. They were enrolled in a longitudinal study with a planned follow-up of 10 years. Patients were consecutively enrolled from outpatient diabetes units of 2 university hospitals. Subjects were screened with respect to peripheral circulation by use of established noninvasive techniques. These included arm, ankle (AP), and toe (TP) blood pressure measurements; evaluation of peripheral neuropathy; and a standardized physical examination. Results from the baseline examination are presented in this report. The number of patients who presented peripheral pressures or indices below normal (< mean -2 SD for controls) was higher among diabetic patients; 24% of DM1 and 31% of DM2, as compared to 6% of Ctr, had at least 1 lower limb with a low TP, AP, toe/arm index (TI), or ankle/arm index (AI), and these subjects were mainly identified by using the toe/arm index. TI was independently and negatively associated with fasting blood glucose in both patient groups, and with smoking, age, and diabetes duration in DM1. The mean AP was higher in the DM1 and DM2 groups compared to Ctr, whereas overall TP, TI, and AI were similar in the groups. It was also shown that abnormally low TI was significantly more common than low AI among diabetics (p<0.001), and this was true for TP vs AP as well (p<0.05). It is beneficial to include assessment of toe blood pressure and toe/arm blood pressure index to detect early LEAD in diabetic patients. Ankle blood pressure and indices alone are less efficient, owing probably to medial sclerosis in diabetic patients. Up to 30% of diabetic patients with no ischemic symptoms may have signs of impaired arterial circulation.
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| 4. |
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| 5. |
- Branzén, Marie, et al.
(författare)
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Implant-Supported Single Crowns Replacing Congenitally Missing Maxillary Lateral Incisors : A 5-Year Follow-Up
- 2015
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Ingår i: Clinical Implant Dentistry and Related Research. - : Wiley-Blackwell. - 1523-0899 .- 1708-8208. ; 17:6, s. 1134-1140
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Tidskriftsartikel (refereegranskat)abstract
- Background: Knowledge of the long-term survival of single implants in cases of congenitally missing lateral incisors in the maxilla is limited.Purpose: This retrospective study aimed to evaluate the 5-year survival of implants and implant-supported crowns (ISCs) and to assess the functional and aesthetic outcomes from the professional and patient perspectives.Materials and Methods: From a total of 46 patients with congenitally missing upper lateral incisors, 36 patients treated with 54 Branemark (R) (Nobel Biocare AB, Goteborg, Sweden) implants and ISCs participated in the study. A clinical examination, California Dental Association (CDA) evaluation, and patient questionnaire were used to rate and compare the objective and subjective evaluations of the ISCs.Results: The survival of implants and ISCs was 100%. The CDA ratings were satisfactory for all ISCs, with 70% being rated excellent. The patient rating was also high for the overall satisfaction item, with 21 being completely satisfied and 14 fairly satisfied. However, 12 patients wished for the replacement of their ISCs. Logistic regression analysis indicated that a less optimal embrasure fill was the most discriminating factor though not statistically significant (p = .082).Conclusions: One-third of the patients wished for the replacement of their ISCs. Soft tissue adaptation seems to be an important factor for overall satisfaction.
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| 6. |
- Efe, C., et al.
(författare)
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Validation of Risk Scoring Systems in Ursodeoxycholic Acid-Treated Patients With Primary Biliary Cholangitis
- 2019
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Ingår i: American Journal of Gastroenterology. - : Ovid Technologies (Wolters Kluwer Health). - 0002-9270 .- 1572-0241. ; 114:7, s. 1101-1108
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Risk stratification based on biochemical variables is a useful tool for monitoring ursodeoxycholic acid (UDCA)-treated patients with primary biliary cholangitis (PBC). Several UDCA response criteria and scoring systems have been proposed for risk prediction in PBC, but these have not been validated in large external cohorts. METHODS: We performed a study on data of 1746 UDCA-treated patients with PBC from 25 centers in Europe, United States, and Canada. The prognostic performance of the risk scoring systems (GLOBE and UK-PBC) and the UDCA response criteria (Barcelona, Paris I, Paris II, Rotterdam, and Toronto) were evaluated. We regarded cirrhosis-related complications (ascites, variceal bleeding, and/or hepatic encephalopathy) as clinical end points. RESULTS: A total of 171 patients reached a clinical end point during a median 7 years (range 1-16 years) of follow-up. The 5-, 10- and 15-year adverse outcome-free survivals were 95%, 85%, and 77%. The GLOBE and UK-PBC scores predicted cirrhosis-related complications better than the UDCA response criteria. The hazard ratio (HR) for a 1 standard deviation increase was HR 5.05 (95% confidence interval (CI): 4.43-5.74, P < 0.001) for the GLOBE score and HR 3.39 (95% CI: 3.10-3.72, P < 0.001) for the UK-PBC score. Overall, the GLOBE and UK-PBC risk scores showed similar and excellent prognostic performance (C-statistic, 0.93; 95% CI: 0.91%-95% vs 0.94; 95% CI: 0.91%-0.96%). DISCUSSION: In our international, multicenter PBC cohort, the GLOBE and UK-PBC risk scoring systems were good predictors of future cirrhosis-related complications.
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| 7. |
- Eliasson, Ann-Christin, 1950-, et al.
(författare)
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Efficacy of baby-CIMT : study protocol for a randomised controlled trial on infants below age 12 months, with clinical signs of unilateral CP
- 2014
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Ingår i: BMC Pediatrics. - : BioMed Central. - 1471-2431. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Infants with unilateral brain lesions are at high risk of developing unilateral cerebral palsy (CP). Given the great plasticity of the young brain, possible interventions for infants at risk of unilateral CP deserve exploration. Constraint-induced movement therapy (CIMT) is known to be effective for older children with unilateral CP but is not systematically used for infants. The development of CIMT for infants (baby-CIMT) is described here, as is the methodology of an RCT comparing the effects on manual ability development of baby-CIMT versus baby-massage. The main hypothesis is that infants receiving baby-CIMT will develop manual ability in the involved hand faster than will infants receiving baby-massage in the first year of life.METHOD AND DESIGN: The study will be a randomised, controlled, prospective parallel-group trial. Invited infants will be to be randomised to either the baby-CIMT or the baby-massage group if they: 1) are at risk of developing unilateral CP due to a known neonatal event affecting the brain or 2) have been referred to Astrid Lindgren Children's Hospital due to asymmetric hand function. The inclusion criteria are age 3-8 months and established asymmetric hand use. Infants in both groups will receive two 6-weeks training periods separated by a 6-week pause, for 12 weeks in total of treatment. The primary outcome measure will be the new Hand Assessment for Infants (HAI) for evaluating manual ability. In addition, the Parenting Sense of Competence scale and Alberta Infant Motor Scale will be used. Clinical neuroimaging will be utilized to characterise the brain lesion type. To compare outcomes between treatment groups generalised linear models will be used.DISCUSSION: The model of early intensive intervention for hand function, baby-CIMT evaluated by the Hand Assessment for Infants (HAI) will have the potential to significantly increase our understanding of how early intervention of upper limb function in infants at risk of developing unilateral CP can be performed and measured.TRIAL REGISTRATION: SFO-V4072/2012, 05/22/2013.
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| 8. |
- Eliasson, Ann-Christin, 1950-, et al.
(författare)
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The effectiveness of Baby-CIMT in infants younger than 12 months with clinical signs of unilateral-cerebral palsy : an explorative study with randomized design
- 2018
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Ingår i: Research in Developmental Disabilities. - : Elsevier. - 0891-4222 .- 1873-3379. ; 72, s. 191-201
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To explore the effectiveness of baby-CIMT (constraint-induced movement therapy) and baby-massage for improving the manual ability of infants younger than 12 months with unilateral cerebral palsy (CP).METHOD: Infants eligible for inclusion were 3-8 months old with asymmetric hand function and at high risk of developing unilateral CP. Thirty-seven infants were assigned randomly to receive baby-CIMT or baby-massage. At one year of age 31 children were diagnosed with unilateral CP, 18 (8 boys, 6.1±1.7months) of these had received baby-CIMT and 13 (8 boys, 5.0±1.6months) baby-massage. There were two 6-week training periods separated by a 6-week pause. The Hand Assessment for Infants (HAI), Assisting Hand Assessment (AHA), the Parenting Sense of Competence Scale (PSCS) and a questionnaire concerning feasibility were applied.RESULTS: There was improvement in the "Affected hand score" of HAI from median 10 (6;13 IQR) to 13 (7;17 IQR) raw score in the baby-CIMT group and from 5 (4;11 IQR) to 6 (3;12 IQR) for baby-massage with a significant between group difference (p=0.041). At 18-month of age, the median AHA score were 51 (38;72 IQR) after baby-CIMT (n=18) compared to 24 (19;43 IQR) baby-massage (n=9). The PSCS revealed an enhanced sense of competence of being a parent among fathers in the baby-CIMT group compared to fathers in the baby-massage (p=0.002). Parents considered both interventions to be feasible.CONCLUSION: Baby-CIMT appears to improve the unimanual ability of young children with unilateral CP more than massage.
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| 9. |
- Eliasson, Kristina, et al.
(författare)
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A user-centred development process for an equipment vest for the Swedish police force
- 2024
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Ingår i: International Journal of Human Factors and Ergonomics. - : InderScience Publishers. - 2045-7804 .- 2045-7812. ; 11:1, s. 56-77
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this paper is to describe a user-centred development process for an equipment vest for police officers on active duty. Development and evaluation of the vest were conducted through a multidisciplinary collaboration between the police organisation and external researchers with expertise in ergonomics and biomechanics. The development process was initiated with a user needs analysis, followed by pilot testing of the initial vest prototype. In the extensive usability test, 95 police officers participated. Interviews, focus group discussions, and pressure measurements were conducted to assess the vest’s functionality, impact on physical load, safety aspects, and signal value. Throughout the process, several important aspects were identified. Researchers delivered results iteratively to the designers and project manager. The results from the user evaluation guided further development, resulting in an equipment vest tailored to the needs and requirements of Swedish police officers on active duty.
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| 10. |
- Eliasson, Kristina, et al.
(författare)
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A user-centred development process for an equipment vest for the Swedish police force
- 2024
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Ingår i: INTERNATIONAL JOURNAL OF HUMAN FACTORS AND ERGONOMICS. - : InderScience Publishers. - 2045-7804 .- 2045-7812. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this paper is to describe a user-centred development process for an equipment vest for police officers on active duty. Development and evaluation of the vest were conducted through a multidisciplinary collaboration between the police organisation and external researchers with expertise in ergonomics and biomechanics. The development process was initiated with a user needs analysis, followed by pilot testing of the initial vest prototype. In the extensive usability test, 95 police officers participated. Interviews, focus group discussions, and pressure measurements were conducted to assess the vest's functionality, impact on physical load, safety aspects, and signal value. Throughout the process, several important aspects were identified. Researchers delivered results iteratively to the designers and project manager. The results from the user evaluation guided further development, resulting in an equipment vest tailored to the needs and requirements of Swedish police officers on active duty.
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