| 1. |
- Persson, Eva-Kristina, et al.
(författare)
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Fathers' sense of security during the first postnatal week-A qualitative interview study in Sweden
- 2012
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Ingår i: Midwifery. - : Elsevier BV. - 0266-6138 .- 1532-3099. ; 28:5, s. e697-e704
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Tidskriftsartikel (refereegranskat)abstract
- Background father's sense of security in the early postnatal period is important for the whole family. An instrument, which measures Parents' Postnatal Sense of Security (the PPSS instrument), is under development.Objective to explore and describe factors, which influence fathers' sense of security during the first postnatal week.Methods an explorative design with a qualitative approach was used. Thirteen fathers from three hospital uptake areas in Southern Sweden were interviewed using focus group discussions and individual interviews. Analysis was carried out using qualitative content analysis.Findings participation in the processes of pregnancy birth and early parenthood emerged as the main category for fathers' postnatal sense of security. The emergent categories were; ‘willingness to participate and take responsibility’, ‘being given the opportunity to take responsibility’, ‘being assured about mother's and baby's well-being’, ‘having someone to turn to—knowing who to ask’, ‘being met as an individual’ and ‘being met by competent and supporting staff’.Key conclusions and implications for practice new and specific items of importance when investigating fathers' sense of security during the early postnatal period have been pinpointed. Fathers' sense of early postnatal security may be enhanced by giving them a genuine opportunity to participate in the whole process and by giving them the opportunity to stay overnight at the hospital after the birth. Midwives and care organisations need to give clear information about where competent help and advice can be obtained at all hours. Midwives should strengthen the fathering role by acknowledging and listening to the father as an individual person.
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| 2. |
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| 3. |
- Andersson, Susann, 1965, et al.
(författare)
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Vision in children with hydrocephalus.
- 2006
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Ingår i: Developmental medicine and child neurology. - 0012-1622. ; 48:10, s. 836-41
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Hydrocephalus in children has many aetiologies, and can cause multiple ophthalmic and visual disorders. This study sets out to detect and quantify visual and visuoperceptual dysfunction in children who have received surgical treatment for hydrocephalus with and without myelomeningocele, and to relate the results to the associated diagnoses and results from a comparison group. Seventy-five school-aged children (41 males, 34 females) with surgically-treated hydrocephalus and 140 comparison children (76 males, 64 females) matched for age and sex underwent comprehensive ophthalmologic examination. Median age at examination was 9 years and 4 months (range 7 y 4 mo-12 y 10 mo). Visual function deficits were identified in 83% (62/75) of the children with hydrocephalus. Visual impairment (binocular visual acuity <0.3) was found in 15% (11/73; comparison group 0%) but in none with myelomeningocele. Strabismus was found in 69% (51/74; comparison group 4% [5/140], p < 0.001), and refractive errors were found in 67% (47/70; comparison group 20% [28/140], p < 0.001). Cognitive visual dysfunction was identified in 59% (38/64; comparison group 3% [4/140], p < 0.001). These disorders were identified in various combinations and comprised impaired ability to plan movement through depth (e.g. going down a stair), impaired simultaneous perception, impaired perception of movement, impaired orientation, and (least frequently) impaired recognition. In this study, children with hydrocephalus associated with myelomeningocele were least commonly affected. Visual disorders were most frequent in those with epilepsy, cerebral palsy, and/or cognitive disability.
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| 4. |
- Aring, Eva, 1959, et al.
(författare)
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Strabismus, binocular functions and ocular motility in children with hydrocephalus.
- 2007
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Ingår i: Strabismus. - : Informa UK Limited. - 0927-3972 .- 1744-5132. ; 15:2, s. 79-88
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To investigate heterotropia, heterophoria, head posture, nystagmus, stereo acuity, ocular motility and near point of convergence (NPC) in children with hydrocephalus treated surgically before 1 year of age. In addition, the effects of being born with hydrocephalus, the effect of the etiology of hydrocephalus, number of shunt revisions and the size of the ventricles on these variables were studied. METHODS: A population-based study was performed in 75 children and the results were compared with the results of an age- and sex-matched group (comp group) (n = 140). RESULTS: Heterotropia 68.9% (comp group 3.6%; p < 0.001), abnormal head posture 41.3% (comp group 0; p < 0.001), nystagmus 44.0% (comp group 0; p < 0.001), stereo acuity < or =60'' 33.8% (comp group 97.1%; p < 0.001) and ocular motility defects 69.7% (comp group 0.7%; p < 0.001) were more common among children with hydrocephalus than in the comparison group. Children with overt hydrocephalus at birth had significantly more heterotropia (p = 0.0006), esotropia (p = 0.002), abnormal head posture (p = 0.02) and motility defects (p = 0.003) compared to those with hydrocephalus developing during the first year of life. The etiology, number of shunt revisions and the size of the ventricles had no significant effect on any of the investigated variables. CONCLUSIONS: Children with hydrocephalus surgically treated before the age of one year commonly present orthoptic abnormalities. The etiology of hydrocephalus, number of shunt revisions and ventricle size seem to be of minor importance compared with the age of onset of hydrocephalus with regard to the risk for orthoptic abnormalities.
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| 6. |
- Lindberg, Sara, et al.
(författare)
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Expanded HILUS Trial: A Pooled Analysis of Risk Factors for Toxicity From Stereotactic Body Radiation Therapy of Central and Ultracentral Lung Tumors
- 2023
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Ingår i: INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS. - 0360-3016 .- 1879-355X. ; 117:5, s. 1222-1231
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Stereotactic body radiation therapy for tumors near the central airways implies high-grade toxic effects, as concluded from the HILUS trial. However, the small sample size and relatively few events limited the statistical power of the study. We therefore pooled data from the prospective HILUS trial with retrospective data from patients in the Nordic countries treated outside the prospective study to evaluate toxicity and risk factors for high-grade toxic effects. Methods and Materials: All patients were treated with 56 Gy in 8 fractions. Tumors within 2 cm of the trachea, the mainstem bronchi, the intermediate bronchus, or the lobar bronchi were included. The primary endpoint was toxicity, and the secondary endpoints were local control and overall survival. Clinical and dosimetric risk factors were analyzed for treatment-related fatal toxicity in univariable and multivariable Cox regression analyses.Results: Of 230 patients evaluated, grade 5 toxicity developed in 30 patients (13%), of whom 20 patients had fatal bronchopul-monary bleeding. The multivariable analysis revealed tumor compression of the tracheobronchial tree and maximum dose to the mainstem or intermediate bronchus as significant risk factors for grade 5 bleeding and grade 5 toxicity. The 3-year local control and overall survival rates were 84% (95% CI, 80%-90%) and 40% (95% CI, 34%-47%), respectively.Conclusions: Tumor compression of the tracheobronchial tree and high maximum dose to the mainstem or intermediate bronchus increase the risk of fatal toxicity after stereotactic body radiation therapy in 8 fractions for central lung tumors. Simi-lar dose constraints should be applied to the intermediate bronchus as to the mainstem bronchi.
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| 7. |
- Lindquist, Barbro, 1950, et al.
(författare)
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Behavioural problems and autism in children with hydrocephalus : a population-based study
- 2006
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Ingår i: Eur Child Adolesc Psychiatry. - : Springer Science and Business Media LLC. - 1018-8827 .- 1435-165X. ; 15:4, s. 214-9
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate the prevalence of behavioural problems and autism in a population-based group of children with hydrocephalus and to see whether learning disabilities, cerebral palsy (CP), epilepsy, myelomeningocele (MMC) or preterm birth increase the risk of these problems. METHOD: In the 107 children with hydrocephalus born in western Sweden in 1989-1993, behaviour was assessed using the Conners' parent rating scales in 66 and the teacher's rating scales in 57. Autism was investigated using the Childhood Autism Rating Scale. RESULTS: Parents rated 67% of the children and teachers 39% of the children as having behavioural problems (>1.5 SD, or T score >65). Learning disabilities increased the risk significantly and almost all the children with CP and/or epilepsy had behavioural problems. Autism was present in nine children (13%), in 20% of those without MMC and in one of 26 with MMC. Autism was significantly more frequent in children with learning disabilities (27% vs. 7%) and in children with CP and/or epilepsy (33% vs. 6%). CONCLUSION: The majority of children with hydrocephalus have behavioural problems and many have autism. It is therefore important to assess and understand all the aspects of cognition and behaviour in these children in order to minimise disability and enhance participation for the child.
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| 8. |
- Lindquist, Barbro, 1950, et al.
(författare)
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Learning disabilities in a population-based group of children with hydrocephalus
- 2005
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Ingår i: Acta Paediatr. - 0803-5253. ; 94:7, s. 878-83
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To assess cognitive functions in a population-based group of children with hydrocephalus and to analyse differences between children with and without myelomeningocoele (MMC); with hydrocephalus already present at birth and those who developed it later; children born at full term and those born preterm. METHODS: Of 103 children with hydrocephalus born in the western-Swedish region in 1989-1993, 73 were assessed using the Wechsler Intelligence Scales or the Griffith Developmental Scales. RESULTS: One-third of the children were normally gifted (IQ >85), another 30% had a low average IQ of 70-84 and 37% had learning disabilities with an IQ of <70. The median IQ was 75, verbal IQ 90 and performance IQ 76 (p<0.001). An IQ of <70 was found in 19 of 45 (42%) children without MMC and in 8 of 28 (29%) of those with MMC. Children born preterm had a lower IQ of 68 than those born at full term with an IQ of 76, while children with hydrocephalus present at birth but without MMC had a lower IQ of 60 than the others with an IQ of 77. Children with cerebral palsy and/or epilepsy (n=22) had a lower IQ of 66 than the IQ of 78 in those without these impairments (p<0.01). CONCLUSION: Cognitive functions in children with hydrocephalus need to be carefully assessed before school age to ensure adequate support and education. Even the one-third near normally gifted children with an IQ of 70-85 require special attention, due to the profile of relatively well-preserved verbal functions but greatly impaired perceptual and non-verbal abilities.
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| 9. |
- Lindquist, Barbro, 1950, et al.
(författare)
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Learning, memory and executive functions in children with hydrocephalus.
- 2008
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Ingår i: Acta paediatrica (Oslo, Norway : 1992). - : Wiley. - 0803-5253 .- 1651-2227. ; 97:5, s. 596-601
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To explore learning, memory and executive abilities in children with hydrocephalus without learning disabilities, and to find out whether children with an isolated hydrocephalus differed from those with hydrocephalus in combination with myelomeningocele (MMC). METHODS: Thirty-six children with an intelligence quotient (IQ) of >or=70 from a population of all the 107 children with hydrocephalus born in western Sweden in 1989-1993 were examined and compared with age- and gender-matched controls. The neuropsychological assessment of the school-aged child (NIMES) test battery was used. RESULTS: The children with hydrocephalus differed significantly from controls in all functions apart from registration skills and recognition. Learning, memory and executive functions were all impaired. Twenty children with infantile hydrocephalus did not differ from those with hydrocephalus associated with MMC. Also, children with an IQ of >84 performed significantly worse than controls. CONCLUSIONS: Despite an IQ of >or=70, children with hydrocephalus had significantly impaired learning, memory and executive functions. When major brain lesions resulting in learning disability had been excluded, the hydrocephalus, rather than the underlying aetiology, was most important for the development of cognitive functions.
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| 10. |
- Lindquist, Barbro, 1950, et al.
(författare)
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Very long-term follow-up of cognitive function in adults treated in infancy for hydrocephalus.
- 2011
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Ingår i: Child'S Nervous System. - : Springer Science and Business Media LLC. - 1433-0350 .- 0256-7040. ; 27:4, s. 597-601
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The aim was to investigate the very long-term cognitive outcome in adults who had been shunt treated for hydrocephalus during their first year of life. METHODS: In a population-based series of 72 children born in 1967-1978 and shunt treated for infantile hydrocephalus, 43 were found to have a normal cognitive function when assessed at 6-17years of age. Twenty-five of them agreed to participate in a follow-up study of cognition at a mean age of 35years (range, 30-41years). The Wechsler Adult Intelligence Scale (WAIS-III) was used. RESULTS: The median full-scale IQ was 101 (range, 83-120), median verbal IQ was 104 (81-115) and performance IQ was 99 (80-127). The corresponding IQs in childhood in the 16 subjects who had been tested previously with the WISC were 101 (84-124), 108 (86-135), and 101 (73-124). Specific cognitive deficits were found for working memory and processing speed. Shunt complications did not affect IQ. CONCLUSION: This very long-term follow-up study of normally gifted children with hydrocephalus revealed that, as adults, they still had preserved cognitive functions despite recurrent shunt dysfunction. The results are encouraging and represent a tribute to neurosurgical intervention. Continued follow-up studies are needed since the etiological panorama and treatment procedures of children with hydrocephalus are changing over time.
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