| 1. |
- Sellgren, C. M., et al.
(författare)
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GRK3 deficiency elicits brain immune activation and psychosis
- 2021
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Ingår i: Molecular Psychiatry. - : Springer Science and Business Media LLC. - 1359-4184 .- 1476-5578. ; 26, s. 6820-6832
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Tidskriftsartikel (refereegranskat)abstract
- The G protein-coupled receptor kinase (GRK) family member protein GRK3 has been linked to the pathophysiology of schizophrenia and bipolar disorder. Expression, as well as protein levels, of GRK3 are reduced in post-mortem prefrontal cortex of schizophrenia subjects. Here, we investigate functional behavior and neurotransmission related to immune activation and psychosis using mice lacking functional Grk3 and utilizing a variety of methods, including behavioral, biochemical, electrophysiological, molecular, and imaging methods. Compared to wildtype controls, the Grk3(-/-) mice show a number of aberrations linked to psychosis, including elevated brain levels of IL-1 beta, increased turnover of kynurenic acid (KYNA), hyper-responsiveness to D-amphetamine, elevated spontaneous firing of midbrain dopamine neurons, and disruption in prepulse inhibition. Analyzing human genetic data, we observe a link between psychotic features in bipolar disorder, decreased GRK expression, and increased concentration of CSF KYNA. Taken together, our data suggest that Grk3(-/-) mice show face and construct validity relating to the psychosis phenotype with glial activation and would be suitable for translational studies of novel immunomodulatory agents in psychotic disorders.
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| 5. |
- Ahlinder, J., et al.
(författare)
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Use of metagenomic microbial source tracking to investigate the source of a foodborne outbreak of cryptosporidiosis
- 2022
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Ingår i: FOOD AND WATERBORNE PARASITOLOGY. - : Elsevier. - 2405-6766. ; 26
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Tidskriftsartikel (refereegranskat)abstract
- Cryptosporidium is a protozoan parasite of global public health importance that causes gastroenteritis in a variety of vertebrate hosts, with many human outbreaks reported yearly, often from ingestion of contaminated water or food. Despite the major public health implications, little is typically known about sources of contamination of disease outbreaks caused by Cryptosporidium. Here, we study a national foodborne outbreak resulted from infection with Cryptosporidium parvum via romaine lettuce, with the main goal to trace the source of the parasite. To do so, we combined traditional outbreak investigation methods with molecular detection and characterization methods (i.e. PCR based typing, amplicon and shotgun sequencing) of romaine lettuce samples collected at the same farm from which the contaminated food was produced. Using 18S rRNA typing, we detected C. parvum in two out of three lettuce samples, which was supported by detections in the metagenome analysis. Microbial source tracking analysis of the lettuce samples suggested sewage water as a likely source of the contamination, albeit with some uncertainty. In addition, the high degree of overlap in bacterial species content with a public human gut microbial database corroborated the source tracking results. The combination of traditional and molecular based methods applied here is a promising tool for future source tracking investigations of food- and waterborne outbreaks of Cryptosporidium spp. and can help to control and mitigate contamination risks.
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| 6. |
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| 8. |
- Svedberg, Marcus, 1975, et al.
(författare)
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Chest X-rays are less sensitive than multiple breath washout examinations when it comes to detecting early cystic fibrosis lung disease
- 2022
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 111:6, s. 1253-1260
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Tidskriftsartikel (refereegranskat)abstract
- Aim Annual chest X-ray is recommended as routine surveillance to track cystic fibrosis (CF) lung disease. The aim of this study was to investigate the clinical utility of chest X-rays to track CF lung disease. Methods Children at Gothenburg's CF centre who underwent chest X-rays, multiple breath washouts and chest computed tomography examinations between 1996 and 2016 were included in the study. Chest X-rays were interpreted with Northern Score (NS). We compared NS to lung clearance index (LCI) and structural lung damage measured by computed tomography using a logistic regression model. Results A total of 75 children were included over a median period of 13 years (range: 3.0-18.0 years). The proportion of children with abnormal NS was significantly lower than the proportion of abnormal LCI up to the age of 4 years (p < 0.05). A normal NS and a normal LCI at age 6 years were associated with a median (10-90th percentile) total airway disease of 1.8% (0.4-4.7%) and bronchiectasis of 0.2% (0.0-1.5%). Conclusion Chest X-rays were less sensitive than multiple breath washout examinations to detect early CF lung disease. The combined results from both methods can be used as an indicator to perform chest computed tomography less frequently.
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| 9. |
- Vallo Hult, Helena, 1976-, et al.
(författare)
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Egenmonitorering : evidenskartläggning genom sammanställning av systematiska översikter för utvalda diagnosgrupper
- 2023
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- BackgroundIn Region Västra Götaland (VGR), the development of remote patient monitoring is given high priority, aiming for improvements for patients and reduction of healthcare costs. In this report we defined remote patient monitoring as continuous follow-up of relevant health-related parameters of patients located outside healthcare facilities (e.g. at home). Measurements taken by analogue or digital devices, objective and/or subjective assessments, are delivered digitally to the patient and to a healthcare professional. The healthcare professional provides the patient with feedback on the reported data (feedback may be automatically generated if data are within a predefined range). The plan in VGR is to introduce remote monitoring in selected diagnosis groups – some of which already started using remote monitoring.AimThe aim of this report was to provide an overview of systematic reviews regarding remote monitoring(as add on or replacement of visits in current standard of care) compared to standard of care in 25 selected diagnosis groups.MethodIn order to clarify how remote monitoring is intended to be used in the 25 diagnosis groups, representatives from the respective clinical areas were interviewed. As the scope of this project covered many diagnosis groups, the search was limited to systematic reviews (SRs) of randomised (RCTs) or non-randomised clinical trials. The relevance of each identified SR for our PICO(Population, Intervention, Comparator and Outcomes) was assessed by at least two project members (one clinical representative and one from HTA-centrum). Relevant SRs were assessed by at least two project members using SNABBSTAR, a tool developed by The Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) for assessment of risk of bias/systematic errors in SRs. The tool consists of six steps and assessment of an SR is stopped as soon as the criteria for a specific level are not met.The steps are: 1. Definition of PICO and literature search; 2. Inclusion/exclusion according to PICO, listing of included studies; 3. Risk of bias assessments; 4. Evidence synthesis/meta-analyses; 5. Certainty of evidence consideration; 6. Documentation of excluded studies, conflicts of interest, and an a priori published SR protocol.SNABBSTAR evaluates how useful an SR is by assessing the methodology used in the SR. In the current project, SRs reaching at least SNABBSTAR level 4 were considered to provide relevant data synthesis. As reaching SNABBSTAR level 5 or 6 is considered necessary for reliable conclusions, we cited key conclusions only from SRs reaching these levels. We did not extract any data from the included SRs.ResultsThe literature search resulted in 3,332 hits. Of these, 279 were read in full text to assess their relevance for the PICO. Seventy-five SRs were considered relevant and were included; these were assessed by SNABBSTAR.
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| 10. |
- Ahlborg, Mikael, 1985-, et al.
(författare)
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Current Conceptualization and Operationalization of Adolescents’ Social Capital : A Systematic Review of Self-Reported Instruments
- 2022
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Ingår i: International Journal of Environmental Research and Public Health. - Basel : MDPI. - 1661-7827 .- 1660-4601. ; 19:23
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Forskningsöversikt (refereegranskat)abstract
- There is a great heterogeneity in the conceptualization and operationalization of social capital in empirical research targeting adolescents. There has not yet been an attempt to systematically map and psychometrically evaluate the existing instruments for measuring social capital that have been developed and validated for adolescent samples. The aim of this systematic review was to identify and evaluate the design and psychometric properties of self-reported instruments for social capital, specifically developed and validated for use among adolescents. The design of this study was a systematic review guided by the COSMIN methodology for systematic reviews of Patient Reported Outcome Measures. The search included six electronic databases and no time frame was applied. Twenty studies were identified as describing the development and validation of a social capital instrument for adolescent samples. The results reveal common denominators, but also great variation in the design and validation of the instruments. Adolescents were only involved in the development procedures of four instruments. There is a lack of social capital instruments that cover both the multidimensionality of social capital and contextual relevance in relation to adolescents. Careful examination of instruments should thus precede a decision when designing studies and further instrument development involving the target group is encouraged. © 2022 by the authors.
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| 11. |
- Ahlborg, Mikael G., et al.
(författare)
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SoCap YMH - youth mental health, social capital and help-seeking : a study protocol
- 2024
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Ingår i: Frontiers in Public Health. - : Frontiers Media S.A.. - 2296-2565. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Background: The increase in adolescents reporting mental health problems presents a major public health challenge. The complex association between mental health and social capital motivates further investigation of social capital as a crucial aspect in shaping adolescents' help-seeking knowledge, attitudes, and behaviours.Aim: This protocol presents a project that aims to investigate social capital in relation to help-seeking and mental health in close collaboration with adolescents and key stakeholders in the school setting, in the southern part of Sweden.Methods: A mixed-method design with three interconnected work packages (WP) will be undertaken with an emphasis on co-production where adolescents are involved throughout the process. WP1 is a development and validation of two questionnaire instruments for assessing social capital and help-seeking in adolescence. WP2 is a longitudinal quantitative study involving 1,500 adolescents from two regions representing rural and suburban/urban settings. Adolescents aged 15 will be asked to complete questionnaires concerning social capital, mental health, and help-seeking in a baseline and one-year follow-up, allowing for investigation of the role of social capital for help-seeking. WP3 is designed to elucidate experiences and knowledge of adolescents and key stakeholders via collaborative World Café workshops. These will be held along the project to evolve the generated knowledge and maximize it's applicability during and after the project is finalized.Conclusion: The results are expected to further the understanding of the relationship between adolescents' social capital, mental health, and help-seeking, to contribute to a deeper understanding of the mechanisms behind the paradoxical help-seeking patterns among adolescents today and to narrow the gap between research and practice to produce sustainable and efficient strategies, which may facilitate help-seeking and improve the mental health of adolescents within existing organizational structures.
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| 12. |
- Ahlborg, Mikael, 1985-, et al.
(författare)
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Resilience in children of parents with mental illness, alcohol or substance misuse—An integrative review
- 2024
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Ingår i: Nursing Open. - Hoboken : John Wiley & Sons. - 2054-1058. ; 11:6
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Forskningsöversikt (refereegranskat)abstract
- Aim: The aim of this integrative review was to investigate how resilience has been researched and explore experiences of resilience, in children of parents with mental illness or alcohol or substance misuse. Design: An integrative review. Method: The search included three major electronic databases, PubMed, Scopus and PsycINFO with the aim of identifying peer-reviewed studies where the concept of resilience was explored as resilience, coping, adaptation or protective factors. Results: Out of 4016 studies, 14 were included after meeting predetermined criteria and methodological quality evaluation. The findings are presented in five categories: characteristics of the studies, operationalization and interpretation of resilience, individual resources, family resources and resources outside the family. Patient or public contribution: Resilience in children of parents with mental illness or substance misuse refers to coping strategies, protective factors and absence of symptoms or risk behaviour despite being exposed to risk. We suggest a three-level approach for mapping of resilience resources in the target group: the individual level, family level and outside of the family that includes both non-professionals and professionals. The use of disengagement or avoidance strategies implies poor resilience but may be necessary in absence of support, as acts of self-preservation during chaotic periods or harmful situations. © 2024 The Author(s). Nursing Open published by John Wiley & Sons Ltd.
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| 13. |
- Ahlborg, Mikael, 1985-
(författare)
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Social capital and inequalities in mental health among young adolescents in Sweden
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis was to explore social capital and inequalities in mental health among young adolescents in Sweden. This is a compilation thesis comprising four studies. Studies I and II are quantitative studies of crosssectional data from the Swedish Health Behaviour in School-aged Children survey. The aim of Study I was to investigate socioeconomic inequalities in health using both a subjective and an objective measure of socioeconomic status among Swedish adolescents. The findings showed that subjective socioeconomic status robustly and independently predicted mental health problems, poor life satisfaction and poor general health perception. The association between objective socioeconomic status and mental health was weakened, and even reversed, when subjective socioeconomic status was accounted for in regression models. A Latent Profile Analysis was applied in Study II with the aim of identifying distinct profiles of family, school and peer social capital in a nationally representative sample of adolescents and to explore health outcomes in those profiles. The findings showed that five distinct profiles best represented the data for 11 and 15-year olds, while a four-profile model was optimal for 13-year olds. Significant inequalities were identified between profiles when these were examined in terms of mental health problems and life satisfaction. The design of Study III was a qualitative semi-structured interview study. The aim was to explore social capital from the perspective of adolescents in relation to mental health. Adolescents spoke of having access to a safe space, feeling connected to others and predictability as important aspects of social relationships and networks in relation to mental health. The aim of Study IV was to identify and evaluate the design and psychometric properties of instruments for assessing social capital specifically developed and validated for self-reporting among adolescents (10-19 years). The design was a systematic review, in which 20 instruments were identified. The results revealed a lack of instruments that covered both the multidimensionality of social capital and contextual relevance in relation to adolescents. The conclusion from this thesis is that social capital may be useful for identifying vulnerable individuals and for differentiating between the natural imbalance of adolescence and what may lead to serious illness. Longitudinal research and refinement of the operationalization of the concept are, however, needed to enhance the understanding of these findings.
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| 14. |
- Ahlborg, Mikael, 1985-, et al.
(författare)
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Social Capital in Relation to Mental Health—The Voices of Adolescents in Sweden
- 2023
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Ingår i: International Journal of Environmental Research and Public Health. - Basel : MDPI. - 1661-7827 .- 1660-4601. ; 20:13
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Tidskriftsartikel (refereegranskat)abstract
- The social environment that adolescents interact in has undoubtedly changed over the past decades. The latent constructs of social capital that have been described in theory may be universal, but it is necessary to reveal sociocultural specific pathways and manifestation in order to validly operationalize social capital for adolescents. There is a call for qualitative data to enhance our understanding of social capital for adolescents today and the specific sociocultural context they live in. The aim of this study was to explore social capital from the perspective of adolescents in relation to mental health. Twenty-three semi-structured interviews were conducted in a school setting with a sample of adolescents aged 11 and 15 years. Qualitative content analysis was applied, and analysis remained on a manifest level. From having adolescents describe their social relations and networks in relation to mental health, three main categories were formed: accessing a safe space, with sub-categories of trusting enough to share, having someone close to you, and being part of an inclusive and honest environment; feeling connected to others, with sub-categories of hanging out and having things in common; and maintaining control, with sub-categories of deciding for yourself, dealing with change, and having social skills. Having access to a safe space is vital for adolescents’ mental health, by providing resources such as mutual trust, honesty, and unconditional access. Feeling connected to others is important in close relationships and reveals the glue that holds networks together, but also links to sociability in a wider sense. Predictability in adolescents’ social relationships and networks, influenced by internal and external factors, may be a resource of increasing importance in todays’ society and an interesting subject for intervention and future research on social capital and adolescent mental health. © 2023 by the authors.
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| 15. |
- Angerfors, Annelie, et al.
(författare)
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Proteomic profiling identifies novel inflammation-related plasma proteins associated with ischemic stroke outcome
- 2023
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Ingår i: Journal of Neuroinflammation. - 1742-2094. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- Background The inflammatory response to cerebral ischemia is complex; however, most clinical studies of stroke outcome focus on a few selected proteins. We, therefore, aimed to profile a broad range of inflammation-related proteins to: identify proteins associated with ischemic stroke outcome that are independent of established clinical predictors; identify proteins subsets for outcome prediction; and perform sex and etiological subtype stratified analyses.Methods Acute-phase plasma levels of 65 inflammation-related proteins were measured in 534 ischemic stroke cases. Logistic regression was used to estimate associations to unfavorable 3-month functional outcome (modified Rankin Scale score > 2) and LASSO regressions to identify proteins with independent effects.Results Twenty proteins were associated with outcome in univariable models after correction for multiple testing (FDR < 0.05), and for 5 the association was independent of clinical variables, including stroke severity (TNFSF14 [LIGHT], OSM, SIRT2, STAMBP, and 4E-BP1). LASSO identified 9 proteins that could best separate favorable and unfavorable outcome with a predicted diagnostic accuracy (AUC) of 0.81; three associated with favorable (CCL25, TRAIL [TNFSF10], and Flt3L) and 6 with unfavorable outcome (CSF-1, EN-RAGE [S100A12], HGF, IL-6, OSM, and TNFSF14). Finally, we identified sex- and etiologic subtype-specific associations with the best discriminative ability achieved for cardioembolic, followed by cryptogenic stroke.Conclusions We identified candidate blood-based protein biomarkers for post-stroke functional outcome involved in, e.g., NLRP3 inflammasome regulation and signaling pathways, such as TNF, JAK/STAT, MAPK, and NF-kappa B. These proteins warrant further study for stroke outcome prediction as well as investigations into the putative causal role for stroke outcome.
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| 16. |
- Carlsson, Ing-Marie, 1961-, et al.
(författare)
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Creating a communication space in the healthcare context : Children’s perspective of using the eHealth service, Sisom
- 2021
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Ingår i: Journal of Child Health Care. - London : Sage Publications. - 1367-4935 .- 1741-2889. ; 25:1, s. 31-43
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Tidskriftsartikel (refereegranskat)abstract
- According to the United Nation’s Convention of the Rights of the Child, children have the right to participate in their own healthcare and make their opinions heard. The aim of this study was thus to explore the impact of using an eHealth service, Sisom, to gain the children’s perspectives during their healthcare appointments. Data were gathered through individual interviews with a purposeful sample of 16 children, aged 6–13 years old, treated for different diseases and using the eHealth service, Sisom, during their healthcare appointments. The interviews were analysed using a constructivist grounded theory. The results showed that using Sisom made children’s voice heard by creating a communication space in the healthcare setting. This meant that the children got involved in the communication, were acknowledged as an important person who could give the answers to questions and were given time. Implementing the use of Sisom is a way to make children’s needs and preferences explicitly visible for decision-making in practice and thereby supporting the further development of child-centred care in practice. © The Author(s) 2020.
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| 17. |
- Gama, Fábio, Ass. Professor, 1980-, et al.
(författare)
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Implementation Frameworks for Artificial Intelligence Translation Into Health Care Practice : Scoping Review
- 2022
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Ingår i: Journal of Medical Internet Research. - Toronto, ON : JMIR Publications. - 1438-8871. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Significant efforts have been made to develop artificial intelligence (AI) solutions for health care improvement. Despite the enthusiasm, health care professionals still struggle to implement AI in their daily practice.Objective: This paper aims to identify the implementation frameworks used to understand the application of AI in health care practice.Methods: A scoping review was conducted using the Cochrane, Evidence Based Medicine Reviews, Embase, MEDLINE, and PsycINFO databases to identify publications that reported frameworks, models, and theories concerning AI implementation in health care. This review focused on studies published in English and investigating AI implementation in health care since 2000. A total of 2541 unique publications were retrieved from the databases and screened on titles and abstracts by 2 independent reviewers. Selected articles were thematically analyzed against the Nilsen taxonomy of implementation frameworks, and the Greenhalgh framework for the nonadoption, abandonment, scale-up, spread, and sustainability (NASSS) of health care technologies.Results: In total, 7 articles met all eligibility criteria for inclusion in the review, and 2 articles included formal frameworks that directly addressed AI implementation, whereas the other articles provided limited descriptions of elements influencing implementation. Collectively, the 7 articles identified elements that aligned with all the NASSS domains, but no single article comprehensively considered the factors known to influence technology implementation. New domains were identified, including dependency on data input and existing processes, shared decision-making, the role of human oversight, and ethics of population impact and inequality, suggesting that existing frameworks do not fully consider the unique needs of AI implementation.Conclusions: This literature review demonstrates that understanding how to implement AI in health care practice is still in its early stages of development. Our findings suggest that further research is needed to provide the knowledge necessary to develop implementation frameworks to guide the future implementation of AI in clinical practice and highlight the opportunity to draw on existing knowledge from the field of implementation science. ©Fábio Gama, Daniel Tyskbo, Jens Nygren, James Barlow, Julie Reed, Petra Svedberg.
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| 18. |
- Gilljam, Britt-Mari, 1957-
(författare)
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Barns delaktighet i pediatrisk vård – perspektiv, erfarenheter och möjligheter till förändring utifrån barn med långvarig sjukdom
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Bakgrund: Det senaste decenniet har patientens delaktighet fått en allt större uppmärksamhet i forskning, riktlinjer, lagar och klinisk vård. Men många barn känner sig inte delaktiga i sin vård. Vårdpersonal och föräldrar talar ofta över huvudet på barn och ofta förstår barnen inte vad de vuxna pratar om. Barn har också svårt att själva uttrycka sig verbalt i vårdsituationer. Det saknas studier som undersöker långvarigt sjuka barns perspektiv på främjande faktorer för barns delaktighet i vården. Det saknas också användarvänliga svenska validerade verktyg och frågeformulär där barn självständigt kan uttrycka sig och interagera med vårdpersonal, för att mäta barns delaktighet och för att tillämpa delaktighet praktiskt i vården. Både patientlagen och lagen om Förenta nationernas barnkonvention deklarerar att alla barn har rätt att vara delaktiga i sin vård. Denna rättighet behöver överföras till praktisk handling och både vårdpersonal och hälso- och sjukvården som organisation behöver utvecklas.Syfte: Det övergripande syftet med avhandlingen var att utforska barns perspektiv på delaktighet i sin vård, hos barn med långvarig sjukdom och att utveckla och validera verktyg och instrument för att stödja pediatriska verksamheter i tillämpning av barns delaktighet.Metod: I delstudie I användes en konstruktivistisk grundad teori för att utforska barns perspektiv, erfarenheter och önskemål om delaktighet samt främjande faktorer för att öka barns delaktighet. Datainsamlingen skedde genom intervjuer och fokusgrupper med barn med reumatisk sjukdom. I delstudie II användes en konvergent parallell mixad metod för att undersöka om det digitala kommunikationsverktyg Sisom påverkade delaktigheten hos barn med cancer under läkarbesök. I delstudie III användes en participatorisk design där det digitala kommunikationsverktyg Sisom vidareutvecklades och validerades i en svensk kontext. Metoden som användes var iterativ utvärdering genom low- and high-fidelity med friska barn och barn med cancer som deltagare. I delstudie IV användes en instrumentutvecklings design för att utveckla, validera och psykometriskt testa ett frågeformulär om barns delaktighet i vården. I studien deltog friska barn och barn med olika långvariga sjukdomar i utvecklingsarbetet.Resultat: I delstudie I framkom kärnkategorin Att släppa rädsla och osäkerhet öppnar för tillit och delaktighet med Att omges av trygga relationer och miljöer och Att bli stärkt och att få stöd för att kunna vara delaktig som tillhörande koder från den fokuserade kodningen. Dessa koder framkom från med barn med långvarig sjukdom som främjande faktorer för barns delaktighet i vården. Det kvalitativa resultatet i delstudie II visade att barns delaktighet ökade vid användning av det digitala kommunikationsverktyget Sisom. Det kvantitativa resultatet visade att läkarna tilltalade barnen oftare och att barnen talade något mer. I delstudie III utvecklades Sisom, tillsammans med barn, till ett användarvänligt digitalt verktyg på svenska. Verktyget utvecklades från problem fokuserat till salutogenetiskt och påståenden ändrades till frågor. Frågeformuläret (ChiPaC) som utvecklades i delstudie IV resulterade i ett frågeformulär där barn själva kan uttrycka sin uppfattning av delaktighet. Statistiska beräkningar resulterade i en faktoranalys med en fyra-faktorlösning, där 12 frågor inkluderades som förklarade 59,47 % av variansen. De fyra faktorerna benämndes: Att få vara med, Att lita på personalen, Att ta kontroll och Att förstå information. Intra Class Correlation visade stark och måttlig samstämmighet mellan sex av frågorna, svag samstämmighet mellan fem frågor och otillräcklig på en. Chronbach´s alpha beräknades till 0,76. Konklusion: Främjande faktorer för barns delaktighet i sin egen vård vid långvarig sjukdom är trygga relationer och miljöer samt att få stöd i att kunna vara delaktiga. Det digitala kommunikationsverktyget Sisom möjliggör för barn 6–12 år med långvarig sjukdom att självständigt uttrycka sina uppfattningar om hur de mår och sina upplevelser kring sin situation. Sisom främjar också barns delaktighet i form av att de blir lyssnade till, får uttrycka sina åsikter och synpunkter samt får dessa beaktade i samtal med vårdpersonal. Frågeformuläret ChiPaC visade tillfredställande psykometriska egenskaper för att kunna användas vid utvärdering av barns delaktighet i vården. Sisom och ChiPaC utvecklades från barns perspektiv med barn med långvarig sjukdom och friska barn som medaktörer. Denna avhandling bidrar även till kunskap om hur barn med långvarig sjukdom kan engageras som medaktörer i forskning.
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| 19. |
- Gilljam, Britt-Mari, 1957-, et al.
(författare)
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Child participation in health care (ChiPaC)—Development and psychometric evaluation of a self‐report instrument for children's participation in health care
- 2020
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Ingår i: Journal of Clinical Nursing. - Chichester : Wiley-Blackwell. - 0962-1067 .- 1365-2702. ; 29:1-2, s. 107-118
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives: To develop and evaluate the psychometric properties of a self‐report instrument measuring 6‐ to 12‐year‐old children's own experiences of participation in health care.Background: Validated measures to evaluate children's participation in health care can play a critical role in strategic work towards supporting children's participation at an individual level and in working towards quality improvements at an organisational level. There are, however, no available instruments to achieve this.Methods: An instrument development design was used, together with the TRIPOD checklist. Item construction was based on research about children's perspectives on participation in health care and Shier's model for participation. The face and content validity was evaluated by 14 healthy children, 9 paediatric nurses and 8 children with different diseases. The construct validity, internal consistency and stability reliability were evaluated based on data from 138 children visiting a paediatric clinic.Results: The testing of the face and content validity resulted in an instrument with child‐friendly language, additional instructions and visual attractive presentation. The principle component analysis resulted in the four‐factor solution: “To be included,” “To trust professionals,” “To take control,” and “To understand information.” Internal consistency and intraclass correlation coefficients were acceptable.Conclusion: We conclude that the child participation in health care (ChiPaC) instrument has adequate reliability and validity when used to evaluate children's participation in health care. The involvement of children in the development of ChiPaC resulted in a brief, colourful and user‐friendly instrument for use in paediatric health care.Relevance to clinical practice: This new questionnaire, ChiPaC, is adapted for children between 6–12 years measuring participation in health care from a child perspective. ChiPaC can be used in the practical work of supporting individual children's participation in health care as well as in the strategical work towards quality improvements on an organisational level.What does this paper contribute to the wider global clinical community?The instrument provides a contribution for the practical implementation of the Convention on the Rights of the Child in health care.The high degree of involvement of children in the development of the instrument resulted in a brief, colourful and user‐friendly instrument that can be used in paediatric health care.The instrument can play a critical role in the practical work of supporting individual children's participation in health care as well as in the strategical work of quality improvement on an organisational level.
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| 20. |
- Gilljam, Britt-Mari, 1957-, et al.
(författare)
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Impact of an Electronic Health Service on Child Participation in Pediatric Oncology Care : Quasiexperimental Study
- 2020
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Ingår i: Journal of Medical Internet Research. - Toronto : J M I R Publications. - 1438-8871. ; 22:7
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is a shortage of electronic Health (eHealth) services for children 6-12 years old, which promotes their participation in healthcare. Children with long-term diseases want to be more involved in their healthcare, and have the right to receive information, to be listened to, to express their opinions and to participate in decision-making in healthcare.Objective: The aim of this study was to investigate children’s participation during appointments with pediatricians at pediatric oncology clinics, with or without the use of the eHealth service Sisom.Method: A quasi-experimental design with mixed methods was used. Twenty-seven appointments with pediatricians for 14 children aged 6-12 years (mean 8.3) with a cancer diagnosis were filmed and analyzed. The intervention group consisted of children who used an eHealth service prior their appointments with pediatricians at a pediatric oncology clinic and the control group consisted of children during their appointments with pediatricians at four other pediatric oncology clinics. The data from the observations from the films were analyzed with quantitative and qualitative analysis. The quantitative analysis included manual calculations of how many times the pediatricians spoke directly to the children, of the proportion of the appointment time that the children were talking and their levels of participation. The qualitative analysis included directed content analysis included observations of the video films to assess the children´s levels of participation manifested themselves.Results: A greater proportion of what the pediatrician said in the intervention group was addressed to the child than occurred in the control group, but the proportion of the appointment time the children talked was almost the same for both the intervention and the control groups. The levels of participation corresponded to the first three levels of Shier´s participation model: Children were listened to, Children were supported to express their views and Children´s views were taken into account. The results showed an increased level of the children´s participation in the intervention group. Several codes were found about information, which did not fit into any of the existing categories, and a new category was thus formed: Children received information. Situations were also identified where children were actively excluded from participation; these were presented as negative codes.Conclusions: This study shows that the eHealth service Sisom can increase children´s participation during appointments with healthcare professionals. Future research should focus on evaluating outcomes on individual and organizational levels and in different healthcare contexts. © The authors. All rights reserved
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| 21. |
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| 22. |
- Harris, Ulrika, et al.
(författare)
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Parents’ Experiences of Direct and Indirect Implications of Sleep Quality on the Health of Children with ADHD : A Qualitative Study
- 2022
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Ingår i: International Journal of Environmental Research and Public Health. - Basel : MDPI. - 1661-7827 .- 1660-4601. ; 19:22
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Tidskriftsartikel (refereegranskat)abstract
- Sleep problems represent a significant challenge for children with ADHD. However, lack of knowledge about how sleep affects children with ADHD in terms of their health and everyday life prevents the development and implementation of interventions to promote sleep. The aim of this study was to explore parents’ experiences of direct and indirect implications of sleep quality onthe health of children with ADHD. The study used an abductive qualitative design, with Tengland’s two-dimensional theory of health as a deductive analysis framework. Semi-structured interviews were conducted with 21 parents of children aged 6–13 with ADHD and sleep problems. The parents experienced that sleep influenced their children’s abilities to control emotional behaviour relatedto ADHD and to manage everyday life. Sleep also had an impact on the children’s well-being,in relation to both vitality and self-esteem. In conclusion, the results show important direct and indirect implications of sleep quality on the health of children with ADHD. This implies a need forgreater focus on sleep, to target both abilities and well-being in promoting health among childrenwith ADHD. © 2022 by the authors
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| 23. |
- Hashas, A. S. K., et al.
(författare)
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A new diagnostic method for retinal breaks in patients with posterior vitreous detachment: Ultra-wide-field imaging with the Zeiss Clarus 700
- 2023
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Ingår i: Acta Ophthalmologica. - : Wiley. - 1755-375X .- 1755-3768. ; 101:6, s. 627-635
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Tidskriftsartikel (refereegranskat)abstract
- PurposeThis study was performed with the aim of finding a more convenient and less time-consuming method to diagnose retinal breaks in posterior vitreous detachment (PVD) patients. MethodsA prospective double-blind observational case study was performed with patients who were admitted to the Eye Emergency Department Sahlgrenska University Hospital with PVD symptoms and approved to participate in the study (n = 128). Standard slit lamp examination was compared with images from a Zeiss Clarus 700 ultra-wide-field camera (UWFC). Patients were examined and photographed by an independent operator. Data and image review was performed by three independent reviewers with varying experience. Retinal break detection with the two different methods (detailed eye examination by well-trained ophthalmologist and UWFC evaluations) was analysed statistically. ResultsAfter excluding diagnoses other than PVD as well as unclear images due to cataracts, vitreous bleeding, etc., a total of 103 eyes with PVD were evaluated. A total of 38 ruptures in 25 patients were detected by routine examination and were subjected to laser treatment. UWFC images were reviewed by three ophthalmology consultants and compared with routine examinations. Sensitivity values in detecting retinal ruptures in UWFC images of the three reviewers were 0.89, 0.87 and 0.79, and specificity values were 0.88, 0.86 and 0.93 (kappa values: 0.742, 0.689 and 0.728) respectively. ConclusionAlthough there have been rapid developments in imaging with UWFC in recent years and it is a very promising method for the future, routine clinical examination is still the only valid method for the detection of retinal tears today.
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| 24. |
- Häggström Westberg, Katrin, 1968-
(författare)
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Exploring mental health and potential health assets in young people
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Young people in Sweden generally claim to have a good quality of life, but also report increasing mental health problems. It is a concern that only a minority of young people seek and/or access support when encountering mental health problems as mental health is a fundamental human right and integral to a positive development in both childhood and throughout the lifespan. There are uncertainties as to how to facilitate help-seeking and promote mental health among young people and previous studies have often focused on risk-reduction. A shift from a pathological view to a resource-based perspective of mental health can be achieved by adopting a health assets’ approach. This approach also ascribes due emphasis to the fact that mental health is developed within a social context, where both individual and structural health assets, such as the support system, are of importance. With this in mind, the overall aim of this thesis was to explore individual and structural health assets in relation to the mental health of young people.This thesis is based on four studies using both quantitative (Studies I and II) and qualitative (Study III) methods as well as a scoping review method with a qualitative synthesis (Study IV). Studies I and II had a cross-sectional design and utilized data from self-reported health-related ratings collected in schools in 2011. The association between socio-economic determinants and self-rated mental health in two age groups (11-13 and 14-16) was explored in Study I, and optimism and pessimism as a bi-dimensional construct, and its impact on health-related quality of life and potential to function as a health asset was explored in Study II. In Studies III and IV, the help- seeking process was explored from the perspective of young people, firstly with constructivist grounded theory in Study III based on interviews of young people seeking help for mental health problems within a local setting, and secondly, through a scoping review examination and qualitative synthesis of national and international literature on help-seeking in Study IV.The results identified potential health assets on both individual and structural levels. The explored health assets on an individual level were socio-economic status and socio-demographic factors (Study I), dispositional optimism (Study II) and individual resources for help-seeking (Studies III and IV), while health assets on a structural level were explored through the experience of and perceptions of young people’s help-seeking process(Studies III and IV). The individual health assets of socio-economic status and migratory background were seen to affect mental health differently for boys and girls with the boys being susceptible to an accumulation of socio-economic risk factors including family wealth affecting their mental health negatively, and the mental health of the young girls with a migratory background being affected positively (Study I).The individual health asset of optimism was found to be potentially supportive for help-seeking and mental health (Study II). Young people were optimistic about their future but there was a significant decrease in optimism and health-related quality of life, and a significant increase in pessimism, with age. Optimism was independently and positively associated with a high level of health-related quality of life among young people, even when adjusting for parents’ marital status, family country background and gender. Knowledge and a desire for self-reliance were identified as potential individual health assets mainly in regard to the help-seeking process (Studies III and IV). Young people expressed how their knowledge of mental health and the support system was inadequate, rendering a feeling of insecurity, however, they also expressed a strong desire for self-reliance in regard to their mental health. Help-seeking was characterised as a dynamic and psychosocial process without sequentially fixed stages. Potential health assets on a structural level were identified as support through social networks, and a responsive, collective and accessible support system. However, young people perceived the support system as unresponsive, focused on protocol instead of person, fragmented and spread, and lacking in accessibility. The results implied that equipping young people with sufficient knowledge would capitalize on the individual health assets of self-reliance and optimism, conducive to help-seeking and mental health, but that the support system needs to improve in order to meet the particular needs of young people.
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| 25. |
- Häggström Westberg, Katrin, 1968-, et al.
(författare)
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Lost in Space - an exploration of help-seeking among young people with mental health problems : a constructivist grounded theory study
- 2020
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Ingår i: Archives of Public Health. - Brussels : Institut Scientifique de Sante Publique / Scientific Institut of Public Health. - 0778-7367 .- 2049-3258. ; 78
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Tidskriftsartikel (refereegranskat)abstract
- Background: Mental health problems among young people is a worldwide public health concern. There has been an increase in mental health problems among young people in the Nordic countries in the last 25 years, particularly in Sweden. Despite this increase, international research has repeatedly shown that young people do not access or receive support when encountering mental health problems. The purpose of this study was to explore the process of help-seeking for professional support among young people with mental health problems. Methods: The study used qualitative constructivist Grounded Theory and open-ended interviews. Thirteen young people between 15 and 23, recruited from two local support clinics, were interviewed. Results: Lost in space emerged as the core category, capturing aspects of both the experience of self and mental health problems as well as the process of seeking and acquiring help from professional support systems. The study identified several prominent barriers for seeking and acquiring professional help for mental health problems. The young people expressed a lack of knowledge on mental health issues and support services and substantial efforts were made to try to cope with problems on one’s own. Lost in space involved Drifting - trying to make sense of own experiences and struggling to cope with problems, Navigating - searching for help through multiple attempts and contacts and Docking - finding support with something/somebody that feels right. Conclusions: The theoretical model sheds light on how young people with mental health problems were met with fragmented support services. Society needs to provide encompassing, youth-friendly and flexible support services, so that attempts at help-seeking are not missed. © The Author(s). 2020
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| 26. |
- Häggström Westberg, Katrin, 1968-, et al.
(författare)
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Mental Health Problems among Young People—A Scoping Review of Help-Seeking
- 2022
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Ingår i: International Journal of Environmental Research and Public Health. - Basel : MDPI. - 1661-7827 .- 1660-4601. ; 19:3
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Forskningsöversikt (refereegranskat)abstract
- Young people’s mental health is a public health priority, particularly as mental health problems in this group seem to be increasing. Even in countries with supposedly good access to healthcare, few young people seek support for mental health problems. The aim of this study was twofold, firstly to map the published literature on young people’s experiences of seeking help for mental health problems and secondly to validate whether the Lost in Space model was adaptable as a theoretical model of the help-seeking process described in the included articles in this scoping review. A scoping review was conducted in which we searched for literature on mental health help-seeking with a user perspective published between 2010 and 2020 in different databases. From the 2905 studies identified, we selected 12 articles for inclusion. The review showed how young people experience unfamiliarity and insecurity with regard to issues related to mental health and help-seeking. A strong wish for self-reliance and to safe-guard one’s own health were consistent among young people. Support structures were often regarded as inaccessible and unresponsive. There was a high level of conformity between the model on help-seeking and the analysed articles, reinforcing that help-seeking is a dynamic and psychosocial process. © 2022 by the authors.
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| 27. |
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| 28. |
- Kronsell, Lisa, et al.
(författare)
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Parents’ Perceptions of the Value of Children’s Participation in Pediatric Rehabilitation Services : A Phenomenographic Study
- 2021
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Ingår i: International Journal of Environmental Research and Public Health. - Basel : MDPI. - 1661-7827 .- 1660-4601. ; 18:20
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Tidskriftsartikel (refereegranskat)abstract
- Ensuring that children have opportunities to be involved in decision-making regarding their own care is associated with quality improvement in pediatric rehabilitation. The aim of the study was to explore parents’ perceptions of the value of children’s participation in pediatric rehabilitation services. Semi-structured interviews were conducted with 17 parents of children with disabilities who visited pediatric rehabilitation services. A phenomenographic analysis method was used. Three categories developed from the analysis describing how participation generated value in terms of empowerment, self-awareness, and independence. The outcome space describes a hierarchical relationship between the categories and their influence on each other. Independence achieved through participation was a core aspect and is at the highest level in the hierarchy since it includes and depends on the outcomes from both empowerment and self-awareness. Parents’ perceptions of the value of children’s participation in pediatric rehabilitation services include the possibility for the child to use their entire capacity through values created in terms of empowerment, self-awareness, and independence, in order to live the best life possible. Children with disabilities are diverse as a group, and further research to identify barriers and facilitators of participation is needed to adjust interventions within pediatric rehabilitation services to ensure that children with disabilities can be increasingly empowered, self-aware, and independent. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
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| 29. |
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| 30. |
- Larsson, Ingrid, 1968-, et al.
(författare)
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Parents’ Experiences of Weighted Blankets’ Impact on Children with Attention-Deficit/Hyperactivity Disorder (ADHD) and Sleep Problems—A Qualitative Study
- 2021
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Ingår i: International Journal of Environmental Research and Public Health. - Basel : MDPI. - 1661-7827 .- 1660-4601. ; 18:24
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Tidskriftsartikel (refereegranskat)abstract
- Sleep disturbances are common among children with attention-deficit/hyperactivity disorder (ADHD). While pharmacological treatment has increased dramatically, parents often prefer non-pharmacological interventions. Research on experiences of weighted blankets and their effect in sleep improvement is scarce. The aim of this study was to explore parents’ experiences of weighted blankets for children with ADHD and sleep problems, and the impact on their children’s sleep. The explorative design was based on qualitative content analysis. Interviews were conducted with a purposeful sample of 24 parents of children with ADHD and sleep problems, after completing a sleep intervention with weighted blankets for 16 weeks. Parents reported that children sleeping with weighted blankets: (1) achieved satisfactory sleep, including improved sleep onset latency, sleep continuity, and sleep routines; (2) achieved overall well-being, including improved relaxation and reduced anxiety; and (3) mastered everyday life, including improved balance in life, family function, and participation in school and leisure activities. This study brings forward novel aspects of the effects of improved sleep among children with ADHD. The findings contribute to the understanding of potential positive effects of an intervention with weighted blankets critical for clinical practice to improve sleep, well-being, and everyday life of children with ADHD and their families. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
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| 31. |
- Larsson, Ingrid, 1968-, et al.
(författare)
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SLEEP : intervention with weighted blankets for children with attention deficit hyperactivity disorder (ADHD) and sleep problems
- 2022
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Ingår i: BMJ Open. - London : BMJ Publishing Group Ltd. - 2044-6055. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION AND OBJECTIVES: Children with attention deficit hyperactivity disorder (ADHD) have an increased risk of sleep problems. Weighted blankets are one possible non-pharmacological intervention for these problems in this group of children. However, the effectiveness of weighted blankets is insufficiently investigated. This study aims to investigate the effectiveness of weighted blankets in terms of sleep, health-related outcomes and cost-effectiveness as well as to explore children's and parents' experiences of a sleep intervention with weighted blankets.METHODS AND ANALYSIS: This study is a randomised placebo-controlled crossover trial comparing the effect of weighted fibre blankets (active) with fibre blankets without weight (control). Children aged 6-13 years, recently diagnosed with uncomplicated ADHD with verified sleep problems, were included in the study. The study period is 4 weeks for each condition, respectively, and then an 8-week follow-up. A total of 100 children diagnosed with ADHD and sleep problems will enter the study. The primary outcomes are sleep and cost per quality-adjusted life years. The secondary outcomes are health-related quality of life, ADHD symptoms, psychological distress and anxiety. Interviews with a subsample of the participating children and parents will be conducted for exploring the experiences of the intervention.ETHICS AND DISSEMINATION: Ethical approval of the trial has been obtained from the Swedish Ethical Review Authority (number 2019--2158) and conforms to the principles outlined in the Declaration of Helsinki (WMA, 2013). Results will be reported as presentations at peer-review conferences, in articles in peer-review journals and meetings with healthcare providers.TRIAL REGISTRATION NUMBER: NCT04180189. © Author(s) (or their employer(s)) 2022.
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| 32. |
- Larsson, Ingrid, et al.
(författare)
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SLEEP : Intervention with weighted blankets for children with attention deficit hyperactivity disorder (ADHD) and sleep problems: Study protocol for a randomised control trial
- 2022
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- Introduction and objectives Children with attention deficit hyperactivity disorder (ADHD) have an increased risk of sleep problems. Weighted blankets are one possible non-pharmacological intervention for these problems in this group of children. However, the effectiveness of weighted blankets is insufficiently investigated. This study aims to investigate the effectiveness of weighted blankets in terms of sleep, health-related outcomes and cost-effectiveness as well as to explore children's and parents' experiences of a sleep intervention with weighted blankets. Methods and analysis This study is a randomised placebo-controlled crossover trial comparing the effect of weighted fibre blankets (active) with fibre blankets without weight (control). Children aged 6-13 years, recently diagnosed with uncomplicated ADHD with verified sleep problems, were included in the study. The study period is 4 weeks for each condition, respectively, and then an 8-week follow-up. A total of 100 children diagnosed with ADHD and sleep problems will enter the study. The primary outcomes are sleep and cost per quality-adjusted life years. The secondary outcomes are health-related quality of life, ADHD symptoms, psychological distress and anxiety. Interviews with a subsample of the participating children and parents will be conducted for exploring the experiences of the intervention. Ethics and dissemination Ethical approval of the trial has been obtained from the Swedish Ethical Review Authority (number 2019 - 2158) and conforms to the principles outlined in the Declaration of Helsinki (WMA, 2013). Results will be reported as presentations at peer-review conferences, in articles in peer-review journals and meetings with healthcare providers. Trial registration number NCT04180189.
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| 33. |
- Larsson, Ingrid, 1968-, et al.
(författare)
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Sleep interventions for children with attention deficit hyperactivity disorder (ADHD) : A systematic literature review
- 2023
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Ingår i: Sleep Medicine. - Amsterdam : Elsevier. - 1389-9457 .- 1878-5506. ; 102, s. 64-75
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Forskningsöversikt (refereegranskat)abstract
- Objective/background: Healthy sleep is particularly important for children with attention deficit hyperactivity disorder (ADHD), as sleep disturbances might aggravate disease symptoms. This review aims to synthesize and report evidence on the effectiveness of sleep interventions in increasing sleep, quality of life (QoL), and ADHD symptoms among children with ADHD. Patients/methods: The systematic literature review follows the Cochrane Collaboration methodology recommendations for literature reviews. Four databases were used based on the population, intervention, control and outcome (PICO) framework. Controlled trials with minimum 20 children in each group, aged 6–18, and published from 2005 and onwards were included. Results from the studies were reported in forest plots and three of the seven review outcomes were synthesized in meta-analyses. Results: The search identified 7710 records; of which 4808 abstracts were screened. After fulltext-screening of 99 papers, eight papers from five studies were included. The studies included behavioral sleep interventions and pharmacological interventions using melatonin and eszopiclone. For six of the seven outcomes, the effect sizes were small to moderate and the certainty of the evidence was low. For one outcome, sleep disturbances, the effect size was a moderate −0.49 standardized mean differences (95% confidence interval −0.65;-0.33), with a moderate certainty of evidence for the behavioral interventions for children aged 5–13 years with ADHD. Conclusions: This review identified few and heterogeneous studies. A moderate certainty of evidence for a moderate effect size was only obtained for sleep disturbances from the behavioral interventions. A low certainty of the evidence for a moderate effect size was found for the total sleep time from the pharmacological intervention using melatonin and one behavioral intervention, which indicates that these sleep interventions impact sleep quantity and quality among children with ADHD. © 2022 The Authors
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| 34. |
- Larsson, Ingrid, 1968-, et al.
(författare)
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Validity and reliability of the Swedish version of the Children’s Sleep Habits Questionnaire (CSHQ-SWE)
- 2024
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Ingår i: BMC Pediatrics. - London : BioMed Central (BMC). - 1471-2431. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: To translate and culturally adapt the Children’s Sleep Habits Questionnaire (CSHQ) to a Swedish version, CSHQ-SWE, and to assess its validity and reliability for use with children with attention deficit hyperactivity disorder (ADHD). Methods: A total of 84 children with ADHD (51 boys and 33 girls; 6–12 years) and parents (7 men and 77 women; 28–51 years) were included in the study. CSHQ was translated and culturally adapted to Swedish, and assessed for concurrent validity with sleep actigraphy (analyzed by Kendall’s Tau) and for reliability by internal consistency (analyzed by McDonald’s Omega H). Face and content validity was evaluated by parents (n = 4) and healthcare professionals (n = 6) qualitatively (comprehensiveness, relevance, and comprehensibility assessed by interviews and analyzed by thematic analysis) and quantitatively (analyzed by content validity ratio and content validity index for 33 items and four non-scored inquiries). Results: Parent-reported sleep problems (CSHQ-SWE total score) were moderately correlated with less “Sleep Efficiency” (Tau = −0.305; p < 0.001) measured by sleep actigraphy. Parent-reported problems with “Sleep Onset Delay” was moderately correlated with measured time for ”Sleep Onset Latency” (Tau = 0.433; p < 0.001). Parent-reported problems with “Night Wakings” were weakly correlated with measured time for “Wake After Sleep Onset” (Tau = 0.282; p < 0.001). Parents estimation of “Total daily sleep duration” was moderately correlated with measured “Total Sleep Time” (Tau = 0.386; p < 0.001). Five of the seven subscales reached an acceptable level for internal consistency (McDonald’s Omega H > 0.700). Comprehensiveness, relevance, and comprehensibility of CSHQ-SWE were satisfactory overall. Content validity ratio was 0.80 to 1.00 for six items, 0.00 to 0.60 for 22 items, and < 0.00 for nine items. Content validity index was 0.22. Conclusions: CSHQ-SWE demonstrated acceptable concurrent validity with objectively measured sleep and internal consistency, whereas the overall results of face and content validity assessment varied. The instrument needs to be further evaluated regarding construct validity, responsiveness, test-retest reliability, and its generalization to other populations. © The Author(s) 2024
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| 35. |
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| 36. |
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| 37. |
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| 38. |
- Lindholm, Annelie, 1975-, et al.
(författare)
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Sex Differences in Children with Uncomplicated Attention Deficit/Hyperactivity Disorder and Sleep Problems
- 2024
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Ingår i: Children. - Basel : MDPI. - 2227-9067. ; 11:6
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Tidskriftsartikel (refereegranskat)abstract
- Background: Approximately 7.6% of children are diagnosed with attention deficit/hyperactivity disorder (ADHD), and sleep impairments affect 25–85%. There is a noticeable lack of research on girls and sex differences. The aim of this study was to examine sex differences in children with uncomplicated ADHD and sleep problems. Methods: Cross-sectional baseline data were retrieved from a randomized controlled trial with weighted blankets (55 boys and 41 girls, 6–14 years) on a cohort recently diagnosed with uncomplicated ADHD and sleep problems. Differences between boys and girls in ADHD symptoms, objectively and subjectively measured sleep, anxiety, and functioning were examined via parent- or self-reported validated instruments. Results: Girls reported significantly lower (worse) satisfaction with well-being, life overall, and school, but not for family. Parents reported more sleep anxiety and night-time wakings among boys, but no sex differences in other measures and also not in self-reported measures or objective sleep measures. Children who reported worry, sadness, or unhappiness had more sleep problems. Conclusions: Boys with ADHD and sleep problems may need support with sleep-related anxiety and night-time wakings, while girls may require support with overall functioning. Additionally, children who express feelings of worry, sadness, or unhappiness alongside their ADHD symptoms should have attention given to their sleep. © 2024 by the authors. Licensee MDPI, Basel, Switzerland.
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| 39. |
- Lynn Radlick, Rebecca, et al.
(författare)
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Digitally enhanced mentoring for immigrant youth social capital : Protocol for a mixed-methods pilot study and randomized controlled trial
- 2020
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Ingår i: JMIR Research Protocols. - Toronto : J M I R Publications, Inc.. - 1929-0748. ; 9:3
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Tidskriftsartikel (refereegranskat)abstract
- Background: There are large disparities between immigrants and native Norwegians in domains such as health, education, and employment. Reducing such disparities is essential for individual and societal well-being. Social capital is associated with positive effects on these domains, and mentoring programs have the potential to boost social capital. However, few studies have assessed mentoring as a social capital intervention among youth or the potential barriers and facilitators of implementing digitally augmented mentoring.Objective: The goal of this paper is to describe a protocol for assessing the implementation and effectiveness of a digitally augmented mentoring program for immigrant youth as a health intervention to promote social capital. The two-stage analytical framework for a pilot study followed by a randomized controlled trial (RCT) is presented. The pilot aims to assess program fidelity and make necessary intervention adjustments before the RCT. The RCT aims to assess the effects of the implemented intervention program on social capital and the relationship between program fidelity and effects.Methods: Both the pilot and RCT will use mixed methods with a process evaluation approach used to structure the intervention and a pre-post test survey component to measure social capital and fidelity of program implementation. Interviews will also be used to enrich the quantitative data from the survey.Results: The pilot study is scheduled to begin in fall 2019. Based on data analyses in spring 2020, potential adjustments will be made to the intervention, with findings used in preparation for the full-scale RCT study.Conclusions: Digitally enhanced mentoring programs may be a helpful intervention for providing immigrant youth with tools for increasing their social capital and indirectly improving health outcomes. This protocol provides new knowledge about the implementation and evaluation of such programs.
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| 40. |
- Lönn, Maria, Doktorand, 1981-, et al.
(författare)
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Changed sleep according to weighted blanket adherence in a 16-week sleep intervention among children with attention-deficit/hyperactivity disorder
- 2024
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Ingår i: Journal of Clinical Sleep Medicine (JCSM). - Darien : The American Academy of Sleep Medicine. - 1550-9389 .- 1550-9397.
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Tidskriftsartikel (refereegranskat)abstract
- Study objectives: To examine differences in sample characteristics and longitudinal sleep outcomes according to weighted blanket adherence.Methods: Children with attention-deficit/hyperactivity disorder (ADHD) (n =94), mean age 9.0 (sd 2.2, range 6-14) participated in a 16-week sleep intervention with weighted blankets (WB). Children were classified as WB adherent (use of WB ≥ 4 nights/week) or non-adherent (use of WB ≤ 3 nights/week). Changes in objectively measured sleep by actigraphy, parent-reported sleep problems (Children's Sleep Habits Questionnaire (CSHQ)) and child-reported Insomnia Severity Index (ISI) were evaluated according to adherence with mixed effect models. Gender, age, and ADHD subtype were examined as potential moderators.Results: Children adherent to WBs (48/94) showed an early response in sleep outcomes and an acceptance of the WB after four weeks of use as well as a decrease in parent- (CSHQ) (-5.73, P = .000) and child-reported sleep problems (ISI) (-4.29, P = .005) after 16 weeks. The improvement in sleep was larger among WB adherent vs. non-adherent (between-group difference: CSHQ: -2.09, P = .038; ISI: -2.58, P =.007). Total sleep time was stable for children adherent to WB but decreased for non-adherent (between-group difference: +16.90, P = .019).Conclusions: An early response in sleep and acceptance of the WB predicted later adherence to WBs. Improvements in sleep were more likely among WB adherents vs. non-adherents. Children with ADHD may thus benefit from using WBs to handle their sleep problems.© 2024 American Academy of Sleep Medicine
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| 41. |
- Lönn, Maria, Doktorand, 1981-, et al.
(författare)
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Experiences of Using Weighted Blankets among Children with ADHD and Sleeping Difficulties
- 2023
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Ingår i: Occupational Therapy International. - Oxford : John Wiley & Sons. - 0966-7903 .- 1557-0703. ; 2023, s. 1-12
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Tidskriftsartikel (refereegranskat)abstract
- Introduction. Sleeping difficulties are common in children with attention deficit hyperactivity disorder (ADHD). A sleep intervention with weighted blankets was designed to increase current understanding of using weighted blankets to target children’s individual needs in connection with sleep and daytime functioning. Aim. To explore how children with ADHD and sleeping difficulties experience the use of weighted blankets. Methods. An explorative qualitative design in which 26 children with ADHD and sleeping difficulties, 6-15 years old, were interviewed about a sleep intervention with weighted blankets. Four categories emerged from qualitative content analysis. Results. Children’s experiences revealed that the use of weighted blankets 1) requires a commitment, by adjusting according to needs and preferences and adapting to the environment; 2) improves emotional regulation by feeling calm and feeling safe; 3) changes sleeping patterns by creating new routines for sleep and improving sleep quality; and 4) promotes everyday participation by promoting daily function and balancing activity and sleep. Conclusions. Using weighted blankets promoted children’s management of daily life with ADHD and sleeping difficulties. Occupational therapists can improve the assessment and delivery of weighted blankets tailored to individual needs based on increased knowledge from the children themselves. Copyright © 2023 Maria Lönn et al.
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| 42. |
- Lönn, Maria, Doktorand, 1981-, et al.
(författare)
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The efficacy of weighted blankets for sleep in children with attention-deficit/hyperactivity disorder—A randomized controlled crossover trial
- 2024
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Ingår i: Journal of Sleep Research. - Chichester : Wiley-Blackwell Publishing Inc.. - 0962-1105 .- 1365-2869.
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Tidskriftsartikel (refereegranskat)abstract
- Weighted blankets are a non-pharmacological intervention for treating sleep and anxiety problems in children with attention-deficit/hyperactivity disorder. However, research on the efficacy of weighted blankets is sparse. The aim of this randomized controlled trial with a crossover design (4 + 4 weeks) was to evaluate the efficacy of weighted blankets on sleep among children with attention-deficit/hyperactivity disorder and sleeping problems. Children diagnosed with uncomplicated Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition attention-deficit/hyperactivity disorder with verified sleep problems were randomized to start with either a weighted blanket or a lighter control blanket. Data collection was performed at weeks 0, 4 and 8 using actigraphy, questionnaires and a daily sleep diary. T-tests were used to evaluate efficacy. The study included 94 children with attention-deficit/hyperactivity disorder (mean age 9.0 [sd 2.2] years; 54 [57.4%] boys). Weighted blankets had a significant effect on total sleep time (mean diff. 7.72 min, p = 0.027, Cohen's d = 0.24), sleep efficiency (mean diff. 0.82%, p = 0.038, Cohen's d = 0.23) and wake after sleep onset (mean diff. −2.79 min, p = 0.015, Cohen's d = −0.27), but not on sleep-onset latency (p = 0.432). According to our exploratory subgroup analyses, weighted blankets may be especially beneficial for improving total sleep time in children aged 11–14 years (Cohen's d = 0.53, p = 0.009) and in children with the inattentive attention-deficit/hyperactivity disorder subtype (Cohen's d = 0.58, p = 0.016). Our results suggest that weighted blankets may improve children's sleep and could be used as an alternative to pharmacological sleep interventions. © 2023 The Authors. Journal of Sleep Research published by John Wiley & Sons Ltd on behalf of European Sleep Research Society.
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| 43. |
- Malmborg, Julia S., PhD, 1988-, et al.
(författare)
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Parents' health experiences after their child with ADHD and sleep problems underwent a sleep intervention with a weighted blanket
- 2023
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Konferensbidrag (refereegranskat)abstract
- Background: Being a parent of a child with attention deficit hyperactivity disorder (ADHD) and sleep problems can be challenging and stressful. Weighted blankets have the potential to improve sleep and health in these children, but less is known about the potential effects the child's use of a weighted blanket may have on parents' health.Purpose of the study: To explore parents' health experiences after their child with ADHD and sleep problems underwent a sleep intervention with a weighted blanket.Methods: This study is a part of a randomized, controlled crossover trial with a 16-week sleep intervention with weighted blankets for children with ADHD and sleep problems. A total of 24 parents of children who preferred sleeping with a weighted blanket were interviewed about how the sleep intervention influenced their health. An inductive qualitative content analysis resulted in seven subcategories and two categories.Findings: Children's sleep with weighted blankets influenced parents experienced health in terms of 1) coping with everyday life, including finding harmony, nurturing family relationships, and maintaining a sustainable structure, and 2) feeling well-being, including being well rested, sustaining energy, reaching calm, and achieving meaningful leisure time.Conclusion: A sleep intervention with weighted blankets in children with ADHD and sleep problems influenced parents' health positively by improving management of life and well-being. For parents who struggle to meet the everyday challenges of their child's ADHD, this sleep intervention may contribute to a sustainable health.
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| 44. |
- Morgan, Antony, et al.
(författare)
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Advancing knowledge on social capital for young people's mental health
- 2021
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Ingår i: Health Promotion International. - Oxford : Oxford University Press. - 0957-4824 .- 1460-2245. ; 36:2, s. 535-547
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Tidskriftsartikel (refereegranskat)abstract
- Inequalities in young people's mental health have been documented according to social class but less is known about determinants that can buffer or mediate the relationship. Social capital has the potential to contribute to alleviating observed health inequalities. However, clarity about how it can be understood and measured in relation to mental health among younger populations remains inconsistent. This scoping review examined published literature to investigate how social capital has been researched for young people's mental health. An established framework was used to guide the methodology. Studies were included: on age (10-19 years); publication year (since 2000); language (English). Only studies using social capital as a central theme were included. No restriction was placed on mental health outcomes. Nine bibliographic databases were interrogated. Articles (1541) were screened, 793 retained for analysis and 73 articles were included. Most studies were conducted in North America and Europe. Twenty per cent provided insights into how social capital should be described in relation to young people. A majority of the studies provided links between varying social capital indicators and a range of mental health outcomes (70%), however such evidence was associational. Only few studies inferred the causal direction between social capital and health (10%) and there were no dedicated studies on measurement. Findings suggest that literature on social capital and young people's mental health has grown but continues to be variously described and measured. It requires better utilization of existing knowledge and new research to improve its application in practice. © The Author(s) 2020. Published by Oxford University Press. All rights reserved.
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| 45. |
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| 46. |
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| 47. |
- Narusyte, J, et al.
(författare)
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Sickness absence among young employees in private and public sectors with a history of depression and anxiety
- 2022
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Ingår i: Scientific reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 12:1, s. 18695-
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to investigate occurrence and duration of sickness absence (SA) among young employees with previous depression/anxiety in private and public sectors. This population-based prospective study included 11,519 Swedish twin individuals of age 19–29 years that were followed regarding SA during 2006–2016. Data on previous depression/anxiety came from two screening surveys in 2005. Data on SA and employment sector were received from national registries. Descriptive statistics and logistic regression were used, also controlling for familial factors. Proportion of employees with SA was significantly higher among those with, as compared to those without, previous depression/anxiety, regardless the employment sector. Individuals with previous depression/anxiety had increased risk for future SA, in both private (OR 2.25, 95% CI 1.90–2.66) and public sectors (OR 2.10, 95% CI 1.73–2.54). Familial factors played a role in the association among employees in the private sector. A higher proportion of long-term SA was observed among employees with previous depression/anxiety in the private as compared to the public sector. To conclude, previous depression/anxiety tends to increase risk for SA among young employees in both employment sectors, whereas long-term SA seemed to be more prevalent among those in the private as compared to the public sector.
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| 48. |
- Neher, Margit, 1959-, et al.
(författare)
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Innovation in healthcare : leadership perceptions about the innovation characteristics of artificial intelligence—a qualitative interview study with healthcare leaders in Sweden
- 2023
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Ingår i: Implementation Science Communications. - London : BioMed Central (BMC). - 2662-2211. ; 4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Despite the extensive hopes and expectations for value creation resulting from the implementation of artificial intelligence (AI) applications in healthcare, research has predominantly been technology-centric rather than focused on the many changes that are required in clinical practice for the technology to be successfully implemented. The importance of leaders in the successful implementation of innovations in healthcare is well recognised, yet their perspectives on the specific innovation characteristics of AI are still unknown. The aim of this study was therefore to explore the perceptions of leaders in healthcare concerning the innovation characteristics of AI intended to be implemented into their organisation.Methods: The study had a deductive qualitative design, using constructs from the innovation domain in the Consolidated Framework for Implementation Research (CFIR). Interviews were conducted with 26 leaders in healthcare.Results: Participants perceived that AI could provide relative advantages when it came to care management, supporting clinical decisions, and the early detection of disease and risk of disease. The development of AI in the organisation itself was perceived as the main current innovation source. The evidence base behind AI technology was questioned, in relation to its transparency, potential quality improvement, and safety risks. Although the participants acknowledged AI to be superior to human action in terms of effectiveness and precision in some situations, they also expressed uncertainty about the adaptability and trialability of AI. Complexities such as the characteristics of the technology, the lack of conceptual consensus about AI, and the need for a variety of implementation strategies to accomplish transformative change in practice were identified, as were uncertainties about the costs involved in AI implementation.Conclusion: Healthcare leaders not only saw potential in the technology and its use in practice, but also felt that AI’s opacity limits its evidence strength and that complexities in relation to AI itself and its implementation influence its current use in healthcare practice. More research is needed based on actual experiences using AI applications in real-world situations and their impact on clinical practice. New theories, models, and frameworks may need to be developed to meet challenges related to the implementation of AI in healthcare. © 2023, The Author(s).
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| 49. |
- Nilsen, Per, 1960-, et al.
(författare)
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A Framework to Guide Implementation of AI in Health Care : Protocol for a Cocreation Research Project
- 2023
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Ingår i: JMIR Research Protocols. - Toronto : JMIR Publications. - 1929-0748. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Background: Artificial intelligence (AI) has the potential in health care to transform patient care and administrative processes, yet health care has been slow to adopt AI due to many types of barriers. Implementation science has shown the importance of structured implementation processes to overcome implementation barriers. However, there is a lack of knowledge and tools to guide such processes when implementing AI-based applications in health care.Objective: The aim of this protocol is to describe the development, testing, and evaluation of a framework, “Artificial Intelligence-Quality Implementation Framework” (AI-QIF), intended to guide decisions and activities related to the implementation of various AI-based applications in health care.Methods: The paper outlines the development of an AI implementation framework for broad use in health care based on the Quality Implementation Framework (QIF). QIF is a process model developed in implementation science. The model guides the user to consider implementation-related issues in a step-by-step design and plan and perform activities that support implementation. This framework was chosen for its adaptability, usability, broad scope, and detailed guidance concerning important activities and considerations for successful implementation. The development will proceed in 5 phases with primarily qualitative methods being used. The process starts with phase I, in which an AI-adapted version of QIF is created (AI-QIF). Phase II will produce a digital mockup of the AI-QIF. Phase III will involve the development of a prototype of the AI-QIF with an intuitive user interface. Phase IV is dedicated to usability testing of the prototype in health care environments. Phase V will focus on evaluating the usability and effectiveness of the AI-QIF. Cocreation is a guiding principle for the project and is an important aspect in 4 of the 5 development phases. The cocreation process will enable the use of both on research-based and practice-based knowledge.Results: The project is being conducted within the frame of a larger research program, with the overall objective of developing theoretically and empirically informed frameworks to support AI implementation in routine health care. The program was launched in 2021 and has carried out numerous research activities. The development of AI-QIF as a tool to guide the implementation of AI-based applications in health care will draw on knowledge and experience acquired from these activities. The framework is being developed over 2 years, from January 2023 to December 2024. It is under continuous development and refinement.Conclusions: The development of the AI implementation framework, AI-QIF, described in this study protocol aims to facilitate the implementation of AI-based applications in health care based on the premise that implementation processes benefit from being well-prepared and structured. The framework will be coproduced to enhance its relevance, validity, usefulness, and potential value for application in practice. © 2023 The Author(s).
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| 50. |
- Nilsen, Per, 1960-, et al.
(författare)
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Accelerating the impact of artificial intelligence in mental healthcare through implementation science
- 2022
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Ingår i: Implementation Research and Practice. - Thousand Oaks, CA : Sage Publications. - 2633-4895 .- 2633-4895. ; 3
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Tidskriftsartikel (refereegranskat)abstract
- Background: The implementation of artificial intelligence (AI) in mental healthcare offers a potential solution to some of the problems associated with the availability, attractiveness, and accessibility of mental healthcare services. However, there are many knowledge gaps regarding how to implement and best use AI to add value to mental healthcare services, providers, and consumers. The aim of this paper is to identify challenges and opportunities for AI use in mental healthcare and to describe key insights from implementation science of potential relevance to understand and facilitate AI implementation in mental healthcare.Methods: The paper is based on a selective review of articles concerning AI in mental healthcare and implementation science.Results: Research in implementation science has established the importance of considering and planning for implementation from the start, the progression of implementation through different stages, and the appreciation of determinants at multiple levels. Determinant frameworks and implementation theories have been developed to understand and explain how different determinants impact on implementation. AI research should explore the relevance of these determinants for AI implementation. Implementation strategies to support AI implementation must address determinants specific to AI implementation in mental health. There might also be a need to develop new theoretical approaches or augment and recontextualize existing ones. Implementation outcomes may have to be adapted to be relevant in an AI implementation context.Conclusion: Knowledge derived from implementation science could provide an important starting point for research on implementation of AI in mental healthcare. This field has generated many insights and provides a broad range of theories, frameworks, and concepts that are likely relevant for this research. However, when taking advantage of the existing knowledge basis, it is important to also be explorative and study AI implementation in health and mental healthcare as a new phenomenon in its own right since implementing AI may differ in various ways from implementing evidence-based practices in terms of what implementation determinants, strategies, and outcomes are most relevant.
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