| 1. |
- Ullenhag, Anna, et al.
(författare)
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An international comparison of patterns of participation in leisure activities for children with and without disabilities in Sweden, Norway and the Netherlands
- 2012
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Ingår i: Developmental Neurorehabilitation. - : Informa UK Limited. - 1751-8423 .- 1751-8431. ; 15:5, s. 369-385
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To investigate whether there are differences in participation in leisure activities between children with and without disabilities in Sweden, Norway and the Netherlands and how much personal and environmental factors explain leisure performance.Methods: In a cross-sectional analytic design, the Children's Assessment of Participation and Enjoyment, CAPE, was performed with 278 children with disabilities and 599 children without disabilities aged 6–17 years. A one-way between-groups ANOVA explored the differences in participation between the countries. Hierarchical multiple regression analysis assessed if age, gender, educational level, living area and country of residence explained the variance in participation.Results: Scandinavian children with disabilities participated in more activities with higher frequency compared to Dutch children. The strongest predictor was country of residence. For children without disabilities, differences existed in informal activities, the strongest predictor was gender.Conclusion: Differences in school- and support systems between the countries seem to influence patterns of participation, affecting children with disabilities most.
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| 3. |
- Eliasson, Ann-Christin, 1950-, et al.
(författare)
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Mini-MACS : development of the Manual Ability Classification System for children younger than 4 years of age with signs of cerebral palsy
- 2017
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Ingår i: Developmental Medicine & Child Neurology. - : Mac Keith Press. - 0012-1622 .- 1469-8749. ; 59:1, s. 72-78
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To develop the Mini-Manual Ability Classification System (Mini-MACS) and to evaluate the extent to which its ratings are valid and reliable when children younger than 4 years are rated by their parents and therapists.METHOD: The Mini-MACS was created by making adjustments to the MACS. The development involved a pilot project, consensus discussions within an expert group, and the creation of a test version of the Mini-MACS that was evaluated for content validity and interrater reliability. A convenience sample of 61 children with signs of cerebral palsy aged 12 to 51 months (mean age 30.2mo [SD 10.1]) were classified by one parent and two occupational therapists across a total of 64 assessments. Agreement between the parents' and therapists' ratings was evaluated using the intraclass correlation coefficient (ICC) and the percentage of agreement.RESULTS: The first sentence of the five levels in the MACS was kept, but other descriptions within the Mini-MACS were adjusted to be more relevant for the younger age group. The ICC between parents and therapists was 0.90 (95% confidence interval [CI] 0.79-0.92), and for the two therapists it was 0.97 (95% CI 0.78-0.92). Most parents and therapists found the descriptions in the Mini-MACS suitable and easy to understand.INTERPRETATION: The Mini-MACS seems applicable for children from 1 to 4 years of age.
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| 4. |
- Helmerson, Birgitta, et al.
(författare)
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A pilot study of the feasibility of a Swedish multimodal group intervention for severe migraine - The migraine patient school
- 2021
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Ingår i: Cephalalgia Reports. - : SAGE. - 2515-8163. ; 4, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To evaluate a multidisciplinary group intervention, the migraine patient school (MPS), for patients with severe, mostly chronic migraine. Method: A 13-week group intervention program including seven sessions of patient education, practical body awareness and relaxation exercises, and home assignments was performed in small groups with 5–11 participants. Four groups were consecutively included from spring 2014 to fall 2015. Headache diaries and standardized and study-specific questionnaires were used for evaluation at baseline before MPS (pre-interventional phase), and at follow-up. Results: Twenty-four of 30 included patients completed the study, i.e. attended ≥ four sessions. Most participants found it rewarding to participate in the MPS and easy to take part in, understand and complete home assignments. Validated standardized questionnaires delivered before, and after (follow-up) MPS showed that the impact on life (HIT-6) and avoidance behavior (PIPS-A) were significantly improved whereas quality of life (MSQL), anxiety and depression (HAD) and perceived stress (PSS-14) did not show a statistically significant change. Conclusion: The Migraine patient school with a multimodal educational and behavioral group intervention program was feasible to perform and seem to benefit patients with severe (high-frequency or chronic) migraine. © The Author(s) 2021.
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| 5. |
- Sundholm, Anna
(författare)
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Idiopathic intracranial hypertension in Sweden : epidemiological studies focused on incidence and risk factors
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Idiopathic intracranial hypertension (IIH) is a disorder which is not that unusual for neurologists and ophthalmologists to meet in clinical practice even though it only affects around 1 per 100,000 individuals. It gives rise to symptoms of headache and visual disturbances caused by high intracranial pressure (ICP). The first recorded patient with this disorder was described by Quicke in 1893, followed by 22 cases reported by Dandy in 1937, who later summarized the common diagnostic characteristics of the disorder (1). Even though we have known about this disorder for far more than 100 years and several studies have been performed to investigate its origin, we still don’t know what causes the increased pressure. We know that it more commonly affects females of reproductive age, in particular those who are obese. But why this is the case is not known. Several hypotheses have been suggested and studied over the years. Additionally, several risk factors that could be involved in the development of high intracranial pressure have been proposed. However, since the disorder and some of its risk factors are rare, there have been conflicting findings as to the strength of some of the proposed associations between such risk factors and IIH development. The intension of this thesis was to conduct studies investigating the incidence of IIH in Sweden as well as describing a Swedish cohort to shed light onto potential different risk factors. We used Swedish large national registers to investigate if risk factors were more common in IIH cases compared to controls prior to diagnosis. Study I is a descriptive study of all patients with a diagnosis code for IIH in Stockholm County during 2006-2013.We included 207 individuals ≥18 years of age with the diagnosis code G93.2 registered in the national patient register during these years. We validated the diagnosis coding by review of medical records and found that only 65% fulfilled the modified Dandy diagnostic criteria for IIH. The incidence was 0.65 per 100,000 individuals, in the lower range of most reported incidence studies on IIH. Among those fulfilling IIH diagnosis criteria, as reported in other studies, most patients were females (F/M ratio of 6:1) and females were slightly younger than men at time of diagnosis (mean age women 31 (CI 29-33) compared to 43 (CI 36-50) in men). These results provided the motivation to improve finding correctly diagnosed IIH patients to include in register studies. In study II we therefore developed algorithms, that included parameters thought to improve prediction by using data which are possible to extract from registers, to better predict which patients to include as “true” IIH cases. We developed the algorithms by testing these parameters using a stepwise logistic regression model on a randomized one half of study I individuals and then tested how well they predicted on the other half. By using parameters age, receiving 3 or more registrations of the diagnosis code G93.2, and in the second algorithm also adding acetazolamide treatment (needing use of drug register data) prediction of true cases improved to 86% and 88%, respectively. With use of the developed algorithms we continued to do the national case-control register studies looking at exposure to risk factors in the year prior to the first IIH diagnosis to undertake study III and IV. We looked at the whole population over 18 years during 2000-2016. In study III and IV 902 IIH cases and 4510 matched general population (GP) controls and 4510 obese controls were included. Matching factors were age, sex, and region of residence at the time the IIH patient in the matched group was diagnosed. When analyzing drug dispensations, we had 654 IIH cases and 3270 corresponding GP and obese controls, respectively included. In study I, we found that conditions causing an inflammatory response were common. In study III we therefore wanted to analyze this in a larger population. The results from study III showed increased OR for both infectious (OR = 4.3; 95% CI 3.3-5.6) and inflammatory disorders (OR = 3.2; 95% CI 2.4-4.3) the year prior to the first IIH diagnosis compared to GP controls. Similarly, OR were significantly increased though of slightly lower magnitude compared to the obese controls. In Study IV we investigated the incidence of IIH in Sweden and evaluated risk factors previously proposed in the literature. The mean incidence in the adult population over the study period was similar to study I; 0.71 per 100,000 individuals. The incidence showed however a steady increase which we believe is related to increasing obesity worldwide, as well as in Sweden. Regarding risk factors we could conclude that we saw a significant increased risk of exposure to several disorders, especially kidney failure, SLE, PCOS, tetracyclines, and lithium and systemic corticosteroid treatments. We also found surprisingly high OR for arterial hypertension which in recent years has not been considered a risk factor although it has been described. Equally important, our results confirm that hormonal contraceptives and pregnancy are not likely to be risk factors for IIH. In this study and this thesis, we discuss common denominators regarding risk factors for IIH and proposed three main hypotheses; an inflammation theory, an androgen theory and an ICP regulatory mechanism theory to be of interest for further research.
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| 6. |
- Ullenhag, Anna, et al.
(författare)
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A Strength-Based Intervention to Increase Participation in Leisure Activities in Children with Neuropsychiatric Disabilities: A Pilot Study
- 2020
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Ingår i: Occupational therapy international. - : Hindawi Limited. - 1557-0703 .- 0966-7903. ; 2020, s. 1358707-
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Tidskriftsartikel (refereegranskat)abstract
- The aim is to evaluate the feasibility of an intervention model with a client-centered goal-directed approach with the aim to enhance the child’s participation in leisure activities, self-efficacy, and activity performance. A pilot intervention using a client-centered goal-directed approach and a single-subject design was performed. Two Swedish boys with neuropsychiatric diagnosis aged 12 and 14 years old were included, and 3 leisure activity goals were identified. The intervention was carried out over 8 weeks and took place in the adolescent’s everyday environment and at the pediatric rehabilitation center. The goal attainment of participation goals (GAS), the perceived performance ability according to the Canadian Occupational Performance Measure (COPM), the self-efficacy, and the participants’ satisfaction were used to study the effect. The participants succeeded in attaining their leisure goals as specified by the GAS by achieving +2 on one goal and +1 on the other two goals. They estimated higher performance ability and self-efficacy in their goal performance. Participants, parents, and therapists were overall satisfied and found the intervention to be applicable and helpful in optimizing leisure participation. The intervention model with a client-centered goal-directed approach in which participants define their own leisure activity goals appears to be effective in increasing participation in leisure activities.
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| 7. |
- Ullenhag, Anna, et al.
(författare)
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Cultural validity of the children's assessment of participation and enjoyment/preferences for activities of children : CAPE/PAC
- 2012
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 19:5, s. 428-438
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim was to evaluate whether the activity items of the Children's Assessment of Participation and Enjoyment/Preferences for Activities of Children (CAPE/PAC) were relevant for Swedish children. Subjects: A total of 337 typically developed children aged 6–17 years old. Methods: The CAPE/PAC was translated into Swedish in accordance with accepted translation procedures. By means of 14 group interviews with children with and without disabilities aged 6–15 years old and parents, available leisure activities were listed. These were matched to the items in the CAPE/PAC. Sixteen new potential activities were added and tested on 337 typical developed children from different regions of Sweden. A cutoff level of activities performed by >10% was set to identify relevant activities. Differences between the original and a proposed Swedish version were analysed using paired-samples t-tests of standardized mean scores. Results: Three new activity items were included, for 10 items new activity examples were added, and three not relevant items were excluded. In the Swedish version the outcome of standardized mean diversity score was significantly higher compared with the outcome of the original version. Conclusions:When using instruments in new contexts, it is not enough simply to translate; validation of the item relevance to the new context is essential.
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| 8. |
- Ullenhag, Anna, et al.
(författare)
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Interrater and test-retest reliability of the Hand Assessment for Infants
- 2021
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Ingår i: Developmental Medicine & Child Neurology. - : WILEY. - 0012-1622 .- 1469-8749. ; 63:12, s. 1456-1461
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Tidskriftsartikel (refereegranskat)abstract
- Aim To evaluate the interrater and test-retest reliability, standard error of measurement (SEM), and the smallest detectable difference (SDD) of the Hand Assessment for Infants (HAI). Method HAI assessments of 55 infants (26 females, 29 males), 25 with clinical signs of unilateral cerebral palsy (CP) and 30 typically developing (mean [SD] age 6.8mo [2.4], range 3-11mo), were scored individually by three therapists. Three clinically experienced occupational therapists (OT 1-OT 3) with extensive experience in using the HAI, independently scored the video recorded HAI play sessions. Analysis of the combined group of infants and just the infants with clinical signs of unilateral CP (12 females, 13 males; mean age 7.6mo [2.1]) were conducted. Intraclass correlation coefficients (ICC, 2.1), Bland-Altman plots, SEM, and SDD were calculated. Results Interrater and test-retest reliability were excellent for the Both Hands Measure (BoHM) and the Each Hand Sum score (EaHS), with ICCs of 0.96 to 0.99. For individual items, the interrater and test-retest reliability was good to excellent (ICC 0.81-0.99). The SDD for the EaHS was 2 points, and for the BoHM the SDD it was 3 HAI units for infants with signs of unilateral CP. Interpretation The HAI results showed good to excellent reliability. The SDDs were low, indicating that results beyond these levels exceed the measurement error and, thus, can be considered true changes.
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