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1.	Sarkadi, Anna, Professor, 1974-, et al. (författare) Are We Ready to Really Hear the Voices of Those Concerned? : Lessons Learned from Listening to and Involving Children in Child and Family Psychology Research 2023 Ingår i: Clinical Child and Family Psychology Review. - : Springer Nature. - 1096-4037 .- 1573-2827. Tidskriftsartikel (refereegranskat)abstract A changing view of children, accelerated by the Convention of the Rights of the Child (UN in Convention on the rights of the child, UN Doc. A/RES/44/25, 1989, http://www2.ohchr.org/english/law/pdf/crc.pdf) has shifted the landscape of child and family research over the last few decades. Once viewed with low credibility and operating outside the interpretive framework of adult researchers, the rights-bearing child is increasingly recognized not only as having the capacity but also the right to participate in research. More recently, this movement has transitioned from the direct engagement of children as research participants—now considered commonplace, although less so for those who are structurally vulnerable—to the involvement of children in research design, review, conduct, and dissemination. Yet, both practical and ethical challenges remain. While children have the right to participation, they also have the right to protection. In this commentary, we set out to: (i) lay forth epistemic, child rights, and child sociology arguments for doing research about, with and by children and youth; (ii) recount our own journey of including children and youth in research to demonstrate the unique knowledge and insights gained through these approaches; and (iii) offer lessons learned on how to engage children and youth in research, including the involvement of structurally vulnerable groups.
2.	Dahlberg, Anton, et al. (författare) A higher proportion of children aged 4 years were referred to speech and language therapists after the introduction of a new language screening tool 2024 Ingår i: Acta Paediatrica. - : John Wiley & Sons. - 0803-5253 .- 1651-2227. Tidskriftsartikel (refereegranskat)abstract Aim: Language difficulties in children can have enduring impacts on their academic and emotional well-being. Consequently, early identification and intervention are critical. This study aimed to investigate the impact of introducing Sprakfyran, a language screening tool, on the identification and referral rates for speech and language assessment compared to the previous method.Methods: An observational study was conducted in Gotland, Sweden, using the medical records of 3537 children (53% boys) who were 3-4 years of age. The study period lasted between 5 January 2016 and 29 April 2022, encompassing data collection both before and after the introduction of Sprakfyran.Results: Following the introduction of Sprakfyran, 15% failed the screening, compared to 20% with the previous speech test. However, referrals for assessment increased significantly with Sprakfyran, rising to 7% compared to 3% with the speech test.Conclusion: The proportion of children who failed the Sprakfyran screening was consistent with findings from previous studies. Children who failed the screening were more likely to be referred for speech and language assessment after the introduction of Sprakfyran. This indicates that Sprakfyran is a clinically relevant tool that promotes children's language development through increased referral rates.
3.	Dahlberg, Anton, et al. (författare) Implementation of the Infant-Toddler Checklist in Swedish child health services at 18 months : an observational study 2024 Ingår i: BMJ Paediatrics Open. - : BMJ Publishing Group Ltd. - 2399-9772. ; 8:1 Tidskriftsartikel (refereegranskat)abstract Background Communication and language disorders are common conditions that emerge early and negatively impact quality of life across the life course. Early identification may be facilitated using a validated screening tool such as the Infant-Toddler Checklist (ITC). We introduced the ITC at the 18-month visit to child health services (CHS) in a Swedish county. Using the RE-AIM implementation framework, this study assessed the implementation of the ITC according to five key dimensions: reach, effectiveness, adoption, implementation and maintenance.Methods This observational study used medical records at CHS as data source. Data were collected from children who visited a child health nurse at 17–22 months. The sample included 2633 children with a mean age of 17.8 months, 1717 in the pre-implementation group and 916 in the post implementation group. We calculated the ITC completion rate (reach) and use at each site (adoption). We compared rates of referral to speech and language therapy (effectiveness) before and after implementation of the ITC using OR and 95% CIs. We described actions to facilitate implementation and maintenance of ITC screening over time.Results The overall screening rate was 93% (reach) which increased from 80% initially to 94% at the end of the 2-year period (maintenance). All centres used the ITC (adoption). The ITC screen positive rate was 14%. Of children who had reached at least 24 months (n=2367), referral rate was 0.4% pre-implementation versus 6.9% post implementation (OR=18.17, 95% CI 8.15, 40.51, p<0.001) (effectiveness). Implementation strategies included training sessions, collaboration, written and automatic procedures and modifications to the medical records system.Conclusion The implementation of the ITC was associated with high reach, higher referral rate, complete adoption, and sustained maintenance over time.
4.	Fäldt, Anna, 1975-, et al. (författare) Experiences of children with disabilities during the COVID-19 pandemic in Sweden : a qualitative interview study 2022 Ingår i: BMJ Paediatrics Open. - : BMJ Publishing Group Ltd. - 2399-9772. ; 6:1 Tidskriftsartikel (refereegranskat)abstract BACKGROUND: The impact of the COVID-19 pandemic on people with disabilities has been described as a 'triple jeopardy'. Not only have they experienced the negative social impacts of disease control measures, but access to required health services has been affected, and, not least, they are at increased risk of severe outcomes from COVID-19. This study aimed to determine how children with disabilities have experienced the pandemic in Sweden and its impact on their lives.METHODS: Six children (5-13 years) were interviewed via video conferencing. An interview guide was adapted based on the children's communicative abilities and included augmentative and alternative communication support. Reflective field notes were included in the analysis. The data were analysed using qualitative content analysis.RESULTS: Two themes were identified: The child's knowledge of Corona raises anxiety and fear; and Boring Corona makes the child even lonelier. The children had knowledge about and were worried about COVID-19, primarily about illness and death of their grandparents. The children longed for their grandparents and other social contacts at school, and life was described as boring and lonely. Many families lacked adequate tools to communicate with their children about the pandemic.CONCLUSION: Given adequate support, children with disabilities and communication difficulties can give insights to their unique life situations. The interviewed children reported significant impact on their life and school life. Children were worried about their grandparents based on their knowledge about the virus. The enthusiasm with which the children engaged in the interviews is testament to the need and right of all children, regardless of communicative competence, to voice their experiences.
5.	Sarkadi, Anna, Professor, 1974-, et al. (författare) An Integrated Care Strategy for Pre-schoolers with Suspected Developmental Disorders : The Optimus Co-design Project that has Made it to Regular Care 2021 Ingår i: International Journal of Integrated Care. - : Ubiquity Press. - 1568-4156. ; 21:2 Tidskriftsartikel (refereegranskat)abstract Introduction: Multiple neurodevelopmental problems affect 7-8% of children and require evaluation by more than one profession, posing a challenge to care systems.Description: The local problem comprised distressed parents, diagnostic processes averaging 36 months and 28 visits with 42% of children >4 years at referral to adequate services, and no routines for patient involvement. The co-design project was developed through a series of workshops using standard quality improvement methodology, where representatives of all services, as well as parents participated. The resulting integrated care model comprises a team of professionals who evaluate the child during an average of 5.4 appointments (N = 95), taking 4.8 weeks. Parents were satisfied with the holistic service model and 70% of children were under 4 at referral (p < 0.05). While 75% of children were referred, 25% required further follow-up by the team.Discussion: The Optimus model has elements of vertical, clinical and service integration. Reasons for success included leadership support, buy-in from the different organisations, careful process management, a team co-ordinator, and insistent user involvement.Conclusion: Evaluating multiple neurodevelopmental problems in children requires an integrated care approach. The Optimus care model is a relevant showcase for how people-initiated integrated care reforms can make it into usual care.
6.	Tonér, Signe, 1979-, et al. (författare) DN Debatt. ”Obligatoriskt språktest saknar vetenskapligt stöd” 2022 Ingår i: Dagens nyheter. - 1101-2447. Tidskriftsartikel (populärvet., debatt m.m.)abstract Liberalernas förslag om obligatorisk språkbedömning av tvååringar som inte är inskrivna i förskolan saknar vetenskapligt stöd. I stället behövs fler utbildade förskollärare i utsatta områden och mer samarbete mellan föräldrar och samhällets instanser, skriver sju forskare.
7.	Wennergren, Mattias, 1993, et al. (författare) Swedish Child Health Services Register: a quality register for child health services and children's well-being. 2023 Ingår i: BMJ paediatrics open. - : BMJ. - 2399-9772. ; 7:1 Tidskriftsartikel (refereegranskat)abstract Swedish child health services (CHS) is a free-of-charge healthcare system that reaches almost all children under the age of 6. The aim for the CHS is to improve children's physical, psychological and social health by promoting health and development, preventing illness and detecting emerging problems early in the child's life. The services are defined in a national programme divided into three parts: universal interventions, targeted interventions and indicated interventions.The Swedish Child Health Services Register (BHVQ) is a national Quality Register developed in 2013. The register extracts data from the child's health record and automatically presents current data in real time. At present, the register includes 21 variables.We aim to describe data available in the BHVQ and the completeness of data in BHVQ across variables.Child-specific data were exported from the register, and data for children born in the regions were retrieved from Statistics Sweden to calculate coverage.The register includes over 110000 children born between 2011 and 2022 from 221 child healthcare centres in eight of Sweden's 21 regions. In seven of the eight regions, 100% of centres report data.The completeness of data differs between participating regions and birth cohorts. The average coverage for children born in 2021 is 71%.The BHVQ is a valuable resource for evaluating Child Health Services nationally, with high coverage for the youngest children. As a result of continuous improvement of the services, the possibility to follow the development of children's health in Sweden is possible through the register. When fully expanded, the register will be a natural and essential part of developing preventive services, improving healthcare for children below 6years of age and a tool for developing evidence-based child health interventions.
8.	Almkvist, Jenny, 1971, et al. (författare) Lipopolysaccharide-induced gelatinase granule mobilization primes neutrophils for activation by galectin-3 and formylmethionyl-Leu-Phe. 2001 Ingår i: Infection and immunity. - 0019-9567 .- 1098-5522. ; 69:2, s. 832-7 Tidskriftsartikel (refereegranskat)abstract We have earlier shown that galectin-3, a lactose-binding mammalian lectin that is secreted from activated macrophages, basophils, and mast cells, induces activation of the NADPH oxidase in exudated but not in peripheral blood neutrophils (A. Karlsson, P. Follin, H. Leffler, and C. Dahlgren, Blood 91:3430-3438, 1998). The alteration in responsiveness occurring during extravasation correlated with mobilization of the gelatinase and/or specific granules to the cell surface, indicating a role for mobilizable galectin-3 receptors. In this study we have investigated galectin-3-induced NADPH oxidase activation, measured as superoxide production, in lipopolysaccharide (LPS)-primed neutrophils. Upon galectin-3 challenge, the LPS-primed cells produced superoxide, both extracellularly and intracellularly. A primed extracellular response to formylmethionyl-Leu-Phe (fMLF) was also achieved. The exposure of complement receptors 1 and 3 as well as the formyl peptide receptor on the cell surface was markedly increased after LPS treatment, indicating that granule fusion with the plasma membrane had occurred. Further assessment of specific markers for neutrophil granules showed that the LPS treatment had mobilized the gelatinase granules but only a minor fraction of the specific granules. We thus suggest that the mechanism behind LPS priming lies at the level of granule (receptor) mobilization for galectin-3 as well as for fMLF.
9.	Almquist, Ann-Charlotte, et al. (författare) Host selection in Tomicus piniperda L. : Composition of monoterpene hydrocarbons in relation to attack frequency in the shoot feeding phase 2006 Ingår i: Zeitschrift fur Naturforschung - Section C Journal of Biosciences. - : Walter de Gruyter GmbH. - 0939-5075. ; 61:5-6, s. 439-444 Tidskriftsartikel (refereegranskat)abstract The aim of this study was to investigate the host selection capacity of the pine shoot beetle, Tomicus piniperda, in the shoot-feeding phase and analyze the chiral and non-chiral host volatiles by means of GC-MS and 2D-GC in five Pinus species originating from France (Pinus sylvestris, P. halepensis, P. nigra laricio, P. pinaster maritima, P. pinaster mesogeensis). Dominating monoterpenes were (-)-α-pinene, (+)-α-pinene, (-)-β-pinene and (+)-3-carene. The amounts of the enantiomers varied considerably within and among the species. In a principal component analysis-plot, based on the absolute amounts of 18 monoterpene hydrocarbons, separation of the pine species into two groups was obtained. P. halepensis and P. sylvestris were grouped according to the amount of (+)-α-pinene and (+)-3-carene, while P. nigra laricio, P. pinaster maritima and P. pinaster mesogeensis were grouped according to (-)-α-pinene and (-)-β-pinene. P. nigra laricio was the species most attacked and P. halepensis the one least attacked by T. piniperda.
10.	Fäldt, Anna, et al. (författare) "All of a sudden we noticed a difference at home too" : Parents' perception of a parent-focused early communication and AAC intervention for toddlers. 2020 Ingår i: Augmentative and Alternative Communication. - : Informa UK Limited. - 0743-4618 .- 1477-3848. ; 36:3, s. 143-154 Tidskriftsartikel (refereegranskat)abstract Augmentative and alternative communication (AAC) can enhance children's communication and is recommended to be introduced as soon as problems are identified. The aim of this interview study was to investigate how parents perceive the ComAlong Toddler intervention offered to parents of children with communication difficulties early in the diagnostic process. ComAlong Toddler consists of a 5-session, group-based, parental course, and two home visits that focus on responsive communication, enhanced milieu teaching, and multimodal AAC. Interviews were conducted 1 year after the intervention with 16 parents who had attended ComAlong Toddler. The data were analyzed through qualitative content analysis, resulting in four categories: (a) Development for us and the child, (b) acquiring useful tools, (c) useful learning strategies, and (d) benefits and challenges regarding intervention structure. Findings suggest that parents of toddlers with language or communication disorders learned and appreciated responsive communication and enhanced milieu teaching. All had used multimodal AAC and described its benefits. Parents emphasized the value of learning from other parents as well as from a speech-language pathologist who engaged with their child in the home environment. Parents suggest an enhanced family focus as a potential improvement.
11.	Fäldt, Anna, et al. (författare) Characteristics associated with parent’s exposure of a universal intervention to prevent language and literacy difficulties. Annan publikation (övrigt vetenskapligt/konstnärligt)abstract This study uses self-reported cross-sectional data to investigate which family and Swedish child health centre characteristics associated are associated with exposure to a universal intervention to prevent language and literacy difficulties, available on a digital video disc (DVD). Data were collected during three years, with 2,873 families answering a questionnaire. Only a few mothers (31%) and fathers (21%) reported that they received the intervention, and even fewer (mothers 12%, fathers 6%) reported that they had watched the intervention DVD or tried any of the activities presented in the intervention DVD (10% and 5%, respectively). Socio-demographic characteristics that were positively associated with whether parents received the intervention DVD were: being married or co-habiting, having university education or if the mother was native-born. Percentage of fathers receiving the intervention DVD differed between the child health centres. The child’s age at start of the intervention’s delivery period and the child’s birth order was also associated with whether the parent received the intervention DVD. The results indicate that the intervention seems to reach parents who are more socioeconomic advantaged, to a higher degree.
12.	Fäldt, Anna, 1975-, et al. (författare) Family and child health centre characteristics associated with exposure to universal language and literacy promotion 2023 Ingår i: Child Language Teaching and Therapy. - : Sage Publications. - 0265-6590 .- 1477-0865. ; 39:1, s. 5-15 Tidskriftsartikel (refereegranskat)abstract Aims: This study investigated which specific socio-demographic characteristics of the family and child health service centre are associated with parents receiving a video guide. The video guide, intended to be offered universally, aimed at promoting language and literacy development.Methods: The video guide included language and literacy activities and was offered through child healthcare centres to all visiting families. Cross-sectional data were collected during three years through parental self-reported questionnaires when the children were three years old, and families of 2512 children were included.Results: In 60% of the families, none of the parents reported receiving the video guide, and in 84%, none of the parents reported that they had watched the video guide. Most of the parents who watched the video guide reported having tried the presented activities. Socio-demographic characteristics associated with parents having received the video guide were: being married or cohabiting, having a university education, or if the mother was native-born. The child's age when the video guide was initially offered and the child's birth order were also factors associated with parents having received the video guide.Conclusions: The results indicate that few parents overall received the video guide. Socio-economically advantaged parents seemed to have received the video guide to a higher extent.
13.	Fäldt, Anna, 1975-, et al. (författare) Family-Based Intervention for Substance Using Parents : Experiences and Resource Use 2023 Ingår i: Research on social work practice. - : Sage Publications. - 1049-7315 .- 1552-7581. ; 33:7, s. 810-821 Tidskriftsartikel (refereegranskat)abstract Purpose: The study aimed to assess families? resource use and to explore parents? experiences of the Sofia model, a family-based intervention for parents with substance use disorder (SUD). Methods: Interviews were conducted with 14 parents. Data were analyzed with qualitative content analysis. The resource use assessment was estimated based on data for 40 families referred to the Sofia model and 30 reference families. Results: Parents described difficulties accessing family support and differences in received services in the Sofia model. The intervention lacked focus on the children. Families? communication regarding substance use did not increase. Resource use estimations indicated larger use of services by families in the Sofie model, but little co-parent and child-specific support. Conclusions: The intervention failed its aim to focus on the children, and enhance communication about SUD. Parents voiced a need for more long-term comprehensive support for their children and themselves.
14.	Fäldt, Anna, 1975-, et al. (författare) Increased incidence of overweight and obesity among preschool Swedish children during the COVID-19 pandemic 2022 Ingår i: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. Tidskriftsartikel (refereegranskat)abstract Background The COVID-19 pandemic has had wide effects on child health globally. Increased prevalence of childhood obesity has been observed by a number of countries during the pandemic. The absence of a formal societal lockdown during the pandemic, made Sweden stand out compared to other countries. This study aims to examine changes in BMI among preschool children in Sweden before and during COVID-19 pandemic. Methods Retrospective population-based cross-sectional study, with longitudinal follow-up for a portion of the children. The study included 25 049 children from three Swedish regions, with growth measures at 3- (n = 16 237), 4- (n = 14 437) and 5-years of age (n = 11 711). Care Need Index was used as a socioeconomic parameter at health centre level. Results There was an increase in BMI in children aged three (P = 0.028) and four (P<0.001) during the COVID-19 pandemic. Obesity in 3-year-old girls increased from 2.8% to 3.9%. Four-year-olds increased in obesity, and overweight (girls) and the prevalence of underweight decreased in boys. No change in BMI was observed in 5-year-olds. Children in areas of low socioeconomic status had higher risk of obesity. Conclusions Overweight and obesity increased among 3- and 4-year-old children in Sweden, findings that were accentuated in children attending child health centres in areas with lower socioeconomic status. The COVID-19 pandemic is likely to have affected health behaviours negatively in Swedish preschool children. Our results expose the need for extended efforts directed to prevent childhood obesity, especially targeting lower socioeconomic areas.
15.	Fäldt, Anna, et al. (författare) Infant-Toddler Checklist identifies 18-month-old children with communication difficulties in the Swedish child healthcare setting 2021 Ingår i: Acta Paediatrica. - : John Wiley & Sons. - 0803-5253 .- 1651-2227. ; 110:5, s. 1505-1512 Tidskriftsartikel (refereegranskat)abstract Aim: At present there is no reliable method to screen for communication difficulties at age 18-months in the Swedish child health care. This study examined the psychometric properties of the Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist (ITC) when used at the 18-month visit in the child health care setting.Method: Children aged 16 to 20 months (n=679) were screened. Children were referred for an assessment if they screened positive screen or if the parent or nurse was concerned about the child’s communicative development. Two groups of positive screens were used in the analysis (n=78 children), one based on the ITC result, and one combining the ITC with contradicting information from the nurses’ informal clinical assessment.Result: The AUC ranged from 0.68 to 0.84. The sensitivity was 0.85, and the specificity was 0.59. When the ITC result was combined with the nurses’ information, sensitivity increased to 0.88 and specificity to 0.63. The internal consistency was moderate to high, and fit indices were satisfactory.Conclusion: The results suggest that the ITC can be used to identify children in need of interventions to enhance communication at 18 months of age, especially in combination with the nurse’s assessment.
16.	Fäldt, Anna, et al. (författare) Nurses' experiences of screening for communication difficulties at 18 months of age 2019 Ingår i: Acta Paediatrica. - : WILEY. - 0803-5253 .- 1651-2227. ; 108:4, s. 662-669 Tidskriftsartikel (refereegranskat)abstract Aim: Early identification of communication disorders is important and may be possible through screening in the child health services. The aim of the study was to investigate nurses' experiences and sense of competence when using the Infant-Toddler Checklist (ITC) communication screening at the 18-month health visit.Methods: A mixed-methods design including three focus group interviews (n = 14) and a web-based survey (n = 22) among nurses using the ITC or the standard method. Interview data were analysed through systematic text condensation and a deductive analysis based on implementation theory. Groups were compared using Mann-Whitney tests.Result: Three themes emerged: Using a structured evaluation of communication changes, the dynamic, ITC is a beneficial tool and Implementation of the ITC faces a few challenges. Nurses who used the ITC perceived to a greater extent that they used a structured method (p = 0.003, r = 0.9) and felt more secure in describing the child's communication and language development to parents (p = 0.006, r = 0.83) compared to the standard method group.Conclusion: Using the ITC supported the nurses in their assessment of communication at 18 months. Nurses' sense of competence was higher when using the ITC, both in their assessment and in communicating with parents.
17.	Fäldt, Anna (författare) Targeting toddlers’ communication difficulties at the Swedish child health services – a public health perspective 2020 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract Communication is fundamental for human interaction. Communication difficulties have a negative impact on children’s learning, relations, and quality of life and are regarded as a public health problem. The Swedish child health services have a possibility to prevent communication difficulties and their consequences for the individual through universal interventions and identification of affected children. This thesis investigates interventions at the levels of universal prevention, identification, and indicated intervention for children with communication difficulties.Study I explored associations between family and child health centre characteristics and exposure to a universal preventive communication intervention. Questionnaires answered by 2326 mothers and 2077 fathers were analysed. Few parents reported that they had been exposed to the intervention. Positive associations were seen to high socioeconomic status and if the child was of low age at the start of the intervention or was oldest among siblings. Study II described the study design employed to investigate the identification and effects of an indicated intervention. Study III used a mixed-methods design to explore child health service nurses’ experiences and sense of competence when using the Infant-Toddler Checklist (ITC) at the 18-month health visit. The nurses considered the ITC to be a beneficial tool both in communicating with families and in identifying children with communication difficulties. The ITC seemed to enhance nurses’ and parents’ awareness of the child’s communication.In study IV, the psychometric properties of the ITC were analysed using data on 679 children. A sensitivity of 86% and specificity of 59% were found. These measures improved when combining the ITC with the child health service nurses’ informal developmental surveillance. Study V explored parents’ perceptions of the intervention ComAlong Toddler, consisting of five group sessions and two individual home visits. The parental intervention focused on responsive communication, enhanced milieu teaching and augmentative and alternative communication. Qualitative content analysis showed that parents appreciated the intervention and used the strategies taught. Parents described benefits of the combination of home visits and group sessions with peer learning through video recorded home assignments.In conclusion, the thesis shows that the ITC can be implemented in the child health services as the method identifies children with communication difficulties and seems to have preventive capabilities. ComAlong Toddler may help parents to implement communication-enhancing strategies with their children. When universal interventions are delivered through the child health services, implementation and distribution need to be carefully planned and carried out so that they reach all children.
18.	Fäldt, Anna, et al. (författare) The study design of ComAlong Toddler : a randomised controlled trial of an early communication intervention 2020 Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 48:4, s. 391-399 Tidskriftsartikel (refereegranskat)abstract AIMS: This study design article aims to describe a research study focused on evaluating the use of the Infant-Toddler Checklist to identify children at 18 months with early communication difficulties, and to study the ComAlong Toddler intervention for parents to support their child's communication development.BACKGROUND: Communication disorders are a common public health problem affecting up to 20% of children. Evidence points to the importance of early detection and intervention to improve young children's communicative abilities and decrease developmental delay. Early identification of communication difficulties is possible with instruments such as Infant-Toddler Checklist. The ComAlong Toddler intervention is tailored to the needs of parents of young children with communication delay before definitive diagnosis. The parents are provided with guidance in communication enhancing strategies during home visit and five group sessions.METHODS: The study uses a prospective cohort design. Children were consecutively recruited during 2015-2017, and data will be collected 2015-2023. The screening was performed at the child health centre through use of the Infant-Toddler Checklist. An assessment and first consultation were then performed by a speech and language therapist for children with suspected communication delay according to the screen as well as for children referred for other reasons before the age of 2.5 years. Children with confirmed communication delay were randomised between two interventions: the ComAlong Toddler parental course or a telephone follow-up. Outcome measures include child communication and language skills and use of augmentative and alternative communication. To gain insight into the participants' perspectives, surveys have been collected from parents.CONCLUSION: The study will provide information regarding identification and intervention for 18-month old children with communication delay.TRIAL REGISTRATION: ISRCTN13330627.
19.	Fäldt Beding, Anna, et al. (författare) Pan-cancer analysis identifies BIRC5 as a prognostic biomarker. 2022 Ingår i: BMC Cancer. - : Springer Science and Business Media LLC. - 1471-2407. ; 22:1 Tidskriftsartikel (refereegranskat)abstract The BIRC5 gene encodes for the Survivin protein, which is a member of the inhibitor of apoptosis family. Survivin is found in humans during fetal development, but generally not in adult cells thereafter. Previous studies have shown that Survivin is abundant in most cancer cells, thereby making it a promising target for anti-cancer drugs and a potential prognostic tool.To assess genetic alterations and mutations in the BIRC5 gene as well as BIRC5 co-expression with other genes, genomic and transcriptomic data were downloaded via cBioPortal for approximately 9000 samples from The Cancer Genome Atlas (TCGA) representing 33 different cancer types and 11 pan-cancer organ systems, and validated using the ICGC Data Portal and COSMIC. TCGA BIRC5 RNA sequencing data from 33 different cancer types and matching normal tissue samples for 16 cancer types were downloaded from Broad GDAC Firehose and validated using breast cancer microarray data from our previous work and data sets from the GENT2 web-based tool. Survival data were analyzed with multivariable Cox proportional hazards regression analysis and validated using KM plotter for breast-, ovarian-, lung- and gastric cancer.Although genetic alterations in BIRC5 were not common in cancer, BIRC5 expression was significantly higher in cancer tissue compared to normal tissue in the 16 different cancer types. For 14/33 cancer types, higher BIRC5 expression was linked to worse overall survival (OS, 4/14 after adjusting for both age and tumor grade and 10/14 after adjusting only for age). Interestingly, higher BIRC5 expression was associated with better OS in lung squamous cell carcinoma and ovarian serous cystadenocarcinoma. Higher BIRC5 expression was also linked to shorter progressive-free interval (PFI) for 14/33 cancer types (4/14 after adjusting for both age and tumor grade and 10/14 after adjusting only for age). External validation showed that high BIRC5 expression was significantly associated with worse OS for breast-, lung-, and gastric cancer.Our findings suggest that BIRC5 overexpression is associated with the initiation and progression of several cancer types, and thereby a promising prognostic biomarker.
20.	Fäldt, Jenny, 1971, et al. (författare) Activation of human neutrophils by mycobacterial phenolic glycolipids. 1999 Ingår i: Clinical and experimental immunology. - 0009-9104. ; 118:2, s. 253-60 Tidskriftsartikel (refereegranskat)abstract The interaction between mycobacterial phenolic glycolipids (PGLs) and phagocytes was studied. Human neutrophils were allowed to interact with each of four purified mycobacterial PGLs and the neutrophil production of reactive oxygen metabolites was followed kinetically by luminol-/isoluminol-amplified chemiluminescence. The PGLs from Mycobacterium tuberculosis and Mycobacterium kansasii, respectively, were shown to stimulate the production of oxygen metabolites, while PGLs from Mycobacterium marinum and Mycobacterium bovis BCG, respectively, were unable to induce an oxidative response. Periodate treatment of the M. tuberculosis PGL decreased the production of oxygen radicals, showing the importance of the PGL carbohydrate moiety for the interaction. The activation, however, could not be inhibited by rhamnose or fucose, indicating a complex interaction which probably involves more than one saccharide unit. This is in line with the fact that the activating PGLs from M. tuberculosis and M. kansasii contain tri- and tetrasaccharides, respectively, while the nonactivating PGLs from M. marinum and M. bovis BCG each contain a monosaccharide. The complement receptor 3 (CR3) has earlier been shown to be of importance for the phagocyte binding of mycobacteria, but did not appear to be involved in the activation of neutrophils by PGLs. The subcellular localization of the reactive oxygen metabolites formed was related to the way in which the glycolipids were presented to the cells.
21.	Fäldt, Jenny, 1971, et al. (författare) Priming of human neutrophils by mycobacterial lipoarabinomannans: role of granule mobilisation. 2001 Ingår i: Microbes and infection. - 1286-4579. ; 3:13, s. 1101-9 Tidskriftsartikel (refereegranskat)abstract Lipoarabinomannans (LAMs) from mycobacteria were investigated concerning their effect on human neutrophils. Two types of LAM, the mannose-capped ManLAM from the virulent Mycobacterium tuberculosis H37Rv and the mannose-lacking AraLAM from a rapidly growing mycobacterial strain were used. Neither AraLAM nor ManLAM induced any significant direct activation of the NADPH-oxidase. Both LAMs, however, primed the neutrophils so that subsequent stimulation with the peptide chemoattractants fMet-Leu-Phe (fMLF), Trp-Lys-Tyr-Met-Val-DMet (WKYMVm) and the mammalian lactose-binding lectin galectin-3 resulted in a markedly enhanced oxidative response. The LAM-induced priming was accompanied by an increased exposure of complement receptors 1 and 3 as well as the formyl peptide receptor on the neutrophil surface, suggesting that the enhanced oxidative response could be due to upregulation of receptors on the cell surface as a result of granule mobilisation. Since LAM-primed neutrophils released 65% of the cell content of gelatinase but showed no increased release of vitamin B(12)-binding protein, mobilisation of the gelatinase granules rather than the specific granules is concluded to be responsible for the priming effects. This is in agreement with the subcellular localisation of receptors for fMLF, WKYMVm, as well as galectin-3, which are stored in the secretory vesicles and gelatinase granules. The priming effect appeared very similar to that of Escherichia coli lipopolysaccharide, and since no differences in activity could be detected between AraLAM and ManLAM, we hypothesize that the lipid anchor of the LAM is responsible for the priming effects.
22.	Fäldt, Jenny, 1971, et al. (författare) The phagocyte chemiluminescence paradox: luminol can act as an inhibitor of neutrophil NADPH-oxidase activity. 1999 Ingår i: Luminescence : the journal of biological and chemical luminescence. - 1522-7235. ; 14:3, s. 153-60 Tidskriftsartikel (refereegranskat)abstract The chemiluminescence system amplified by luminol or isoluminol is a sensitive and widely used method for determination of respiratory burst products generated by the NADPH-oxidase in phagocytes. The present study shows that luminol, but not isoluminol, can inhibit the release of oxygen metabolites generated by human neutrophil NADPH-oxidase. The difference in structure between luminol and isoluminol (rendering luminol more lipophilic than isoluminol, and thereby membrane-permeable), is suggested to determine indirectly whether or not the molecule is inhibitory. Luminol was shown to have an increased inhibitory effect after preincubation of neutrophils on a surface of aggregated IgG, suggesting that the cells can be transferred from a 'luminol-insensitive' to a 'luminol-sensitive' state. Since luminol had no inhibitory effect in a cell-free NADPH-oxidase system, it is likely that it interferes with the signal transduction pathway, leading to assembly and/or activation of the oxidase. As a consequence of the present results, showing that luminol but not isoluminol can inhibit NADPH-oxidase activity, we suggest that isoluminol is used in future studies of superoxide anion release from phagocytes.
23.	Kullberg, Christian, Professor, 1957-, et al. (författare) Förståelse, bedömningar och hjälpinsatser : Socialarbetares arbete med män som våldsoffer 2015 Rapport (övrigt vetenskapligt/konstnärligt)abstract This report outlines the background to, and presents the results from the Crime Victim Compensation and Support Authority funded project "Social Workers' understanding of men as victims of crime". The project aimed at describing and analyzing how social workers understand and work with male victims of violence. More precisely, the research has focused on how social workers describe men's vulnerability and how they understand men's needs for assistance, what assistance that is provided and the way the constellations of perpetrators and victims of different gender and contexts in which the violence occurs in affect the understanding of male victims of violence. The study has also been devoted to the question of whether the Support Centers for young crime victims in Sweden provide different types of and different amount of help to young men and women afflicted of violence. The project was conducted in three substudies.The results from substudy 1 show that more young men than women seek support from the Support centers studied. Men predominate in number of cases and in the different categories of crime. The results also show that young men on average receive less assistance over a shorter average duration than young women. This applies irrespective of the category of offense that the vulnerability applies to. Furthermore, the young men, compared to the women, proportionally receive fewer interventions characterized as support and a greater proportion of interventions in the form of information. The results also show that the young men are referred on for further action to a lesser extent than is the case for women.The results from substudy 2 show that social workers tend to focus on whether, and to what extent, young men who are victims of violence themselves have behaved provocatively before the violence incident and if they have put themselves in a social situation that could be interpreted as having contributed to an escalation of the violence they have been subjected to. The results from substudy 2 also show that social workers talk about the men as active in the violent situations they have been involved in and dwell on the extent to which the young men's own actions have contributed to the violence. The results also show that young men who are victims of violence are described as "reluctant" victims who are trying to cope with their situation on their own without the involvement of professional or other helper. The young men are also described as reluctant to talk about their feelings.The results of substudy 3 show that social workers believe that young men, when they become victims of violence, risks losing their sense of autonomy, initiative and decisiveness, that is, attributes that are often linked to the dominating cultural image of masculinity. Furthermore, the results show that social workers estimate that men's practicing of their masculinity, but also the response that men who are traumatized get from society, creates difficulties for them to get help. The results from substudy 3 also shows that attributes and actions that can be connected to the masculinity of young men's, as well as a lack of such attributes and actions are considered to be adequate explanations for the violence the men has suffered. When it comes to violence in public places it is the masculinity that explains the violence and its escalation. When it comes to domestic violence it is the lack of expected male attributes and actions that are used as explanations for the violence that have occurred.The discussion is devoted to the question of how the results should be understood based on the concepts of self-performance, interpretation, negotiation and categorizations, and the consequences the results obtained should have for gender sensitive social work given to abused men.
24.	Nordlund, Hanna, et al. (författare) "They aren't waiting for an SLP, they think 'what can I as a parent do now?'" : course leaders' perceptions of AAC interventions targeting parents 2023 Ingår i: Augmentative and Alternative Communication. - : Taylor & Francis. - 0743-4618 .- 1477-3848. ; 39:4, s. 282-292 Tidskriftsartikel (refereegranskat)abstract Parental interventions can help parents use strategies to support their child's language and communication development. The ComAlong courses are parental interventions that focus on responsive communication, enhanced milieu teaching, and augmentative and alternative communication. This interview study aimed to investigate the course leaders' perceptions of the three ComAlong courses, ComAlong Habilitation, ComAlong Developmental Language Disorder, and ComAlong Toddler, and to evaluate their experiences of the implementation of the courses. Qualitative content analysis was used to analyze the interview data. Thereafter, three categories resulted from the findings: Impact on the Family, A Great Course Concept, and Accessibility of the Courses. The results indicate that participants perceived that the courses had positive effects on both parents and themself. Furthermore, it was described that parents gained knowledge about communication and strategies in how to develop their child's communication; however, the courses were not accessible to all parents. The collaboration between the parents and course leaders improved, and course leaders viewed the courses as an important part of their work. The following factors had an impact on the implementation: several course leaders in the same workplace, support from colleagues and management, and recruitment of parents to the courses.
25.	Nyström, Henrik, 1977, et al. (författare) Platelet-derived growth factor B retention is essential for development of normal structure and function of conduit vessels and capillaries 2006 Ingår i: Cardiovasc Res. - : Oxford University Press (OUP). - 0008-6363. ; 71:3, s. 557-65 Tidskriftsartikel (refereegranskat)abstract OBJECTIVE: Extracellular retention of PDGF-B has been proposed to play an important role in PDGF-B signalling. We used the PDGF-B retention motif knockout mouse (RetKO) to study the effects of retention motif deletion on development of micro- and macrovascular structure and function. METHODS: Passive and active properties of conduit vessels were studied using myograph techniques and histological examination. Capillary structure and function was studied using measurements of capillary density in skeletal muscle and by assessing aerobic physical performance in a treadmill setup. Cardiac function was assessed using echocardiography. RESULTS: Myograph experiments revealed an increased diameter and stiffness of the aorta in RetKO. Histological examination showed increased media collagen content and a decreased number of aortic wall layers, however with a similar number of vascular smooth muscle cells. This outward eutrophic remodelling of the aorta was accompanied by endothelial dysfunction. RetKO showed decreased capillary density in skeletal muscle and signs of a defective delivery of capillary oxygen to skeletal muscle, as shown by a decreased physical performance. In RetKO mice, echocardiography revealed an adaptive eccentric cardiac hypertrophy. CONCLUSION: We conclude that retention of PDGF-B during development is essential for a normal conduit vessel function in the adult mouse. Furthermore, PDGF-B retention is also necessary for the development of an adequate capillary density, and thereby for a normal oxygen delivery to skeletal muscle. The lack of primary effects on cardiac function supports the redundant role of PDGF-B in cardiac development.
26.	Oparina, Nina, et al. (författare) Prognostic Significance of BIRC5/Survivin in Breast Cancer: Results from Three Independent Cohorts. 2021 Ingår i: Cancers. - : MDPI AG. - 2072-6694. ; 13:9 Tidskriftsartikel (refereegranskat)abstract Breast cancer (BC) histological and molecular classifications significantly improved the treatment strategy and prognosis. Inhibitor of apoptosis BIRC5/survivin is often overexpressed in cancers, however, indications of its importance in BC are inconsistent. We integrate BIRC5 protein and mRNA measures with clinical associates and long-term outcome in three independent cohorts Protein levels of BIRC5 were measured in primary lysates of 845 patients of the West Swedish BC cohort (VGR-BC) and linked to 5- and 27-years survival. The results were externally validated in transcriptomic data from METABRIC and SCAN-B cohorts. Survival analysis showed that high levels of BIRC5 were consistently associated with a poor probability of 5-year overall survival. High BIRC5 in VGR-BC contributed negatively to the disease-specific survival at 5 and 27 years. Subsets with different status by ER (estrogen receptor) expression and presence of nodal metastasis supported independent association of high BIRC5 with poor prognosis in all cohorts. In METABRIC and SCAN-B cohorts, high levels of BIRC5 mRNA were associated with the basal-like and luminal B molecular BC subtypes and with increasing histologic grade. BIRC5 is a sensitive survival marker that acts independent of ER and nodal status, and its levels need to be considered when making treatment decisions.
27.	Wernstedt, Ingrid, 1978, et al. (författare) Reduced stress- and cold-induced increase in energy expenditure in interleukin-6-deficient mice. 2006 Ingår i: American journal of physiology. Regulatory, integrative and comparative physiology. - : American Physiological Society. - 0363-6119 .- 1522-1490. ; 291:3 Tidskriftsartikel (refereegranskat)abstract Interleukin-6 (IL-6) deficient (-/-) mice develop mature onset obesity. Pharmacological studies have shown that IL-6 has direct lipolytic effects and when administered centrally increases sympathetic outflow. However, the metabolic functions of endogenous IL-6 are not fully elucidated. We aimed to investigate the effect of IL-6 deficiency with respect to cold exposure and cage-switch stress, that is, situations that normally increase sympathetic outflow. Energy metabolism, core temperature, heart rate, and activity were investigated in young preobese IL-6-/- mice by indirect calorimetry together with telemetry. Baseline measurements and the effect of cage-switch stress were investigated at thermoneutrality (30 degrees C) and at room temperature (20 degrees C). The effect of cold exposure was investigated at 4 degrees C. At 30 degrees C, the basal core temperature was 0.6 +/- 0.24 degrees C lower in IL-6-/- compared with wild-type mice, whereas the oxygen consumption did not differ significantly. The respiratory exchange ratio at 20 degrees C was significantly higher and the calculated fat utilization rate was lower in IL-6-/- mice. In response to cage-switch stress, the increase in oxygen consumption at both 30 and 20 degrees C was lower in IL-6-/- than in wild-type mice. The increase in heart rate was lower in IL-6-/- mice at 30 degrees C. At 4 degrees C, both the oxygen consumption and core temperature were lower in IL-6-/- compared with wild-type mice, suggesting a lower cold-induced thermogenesis in IL-6-/- mice. The present results indicate that endogenous IL-6 is of importance for stress- and cold-induced energy expenditure in mice.

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