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  • 1.
    Ahlborg, Mikael
    et al.
    Halmstad University, School of Health and Welfare.
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare.
    Social Capital in Relation to Mental Health—The Voices of Adolescents in Sweden2023In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 20, no 13, article id 6223Article in journal (Refereed)
    Abstract [en]

    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.

  • 2.
    Ahlborg, Mikael
    et al.
    Halmstad University, School of Health and Welfare.
    Nyholm, Maria
    Halmstad University, School of Health and Welfare.
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare.
    Current Conceptualization and Operationalization of Adolescents’ Social Capital: A Systematic Review of Self-Reported Instruments2022In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, no 23, article id 15596Article, review/survey (Refereed)
    Abstract [en]

    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.

  • 3.
    Ahlborg, Mikael
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Nyholm, Maria
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Morgan, Antony
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Glasgow Caledonian University in London, London, United Kingdom.
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Into the realm of social capital for adolescents: A latent profile analysis2019In: PLOS ONE, E-ISSN 1932-6203, Vol. 14, no 2, article id e0212564Article in journal (Refereed)
    Abstract [en]

    Background

    Recent reports of increasing prevalence of frequent health complaints and mental health problems among adolescents call for directing more attention on determinants of adolescent health. The relationship between health and social capital has gained increased attention since the early 2000’s and research at review level confirms the importance of social capital for health outcomes, despite methodological heterogeneity. The aim of this study was to identify distinct profiles of family, school and peer social capital in a nationally representative sample of adolescents and to explore health outcomes in those profiles.

    Method

    Cross-sectional data from the Swedish Health Behaviour of School-aged Children 2013/14 was used for this study. The analytical sample consisted of 7,804 adolescents aged 11-, 13- and 15-years. Items representing sense of belonging and emotional support were assessed in three contexts; family, school and among peers. Latent profile analyses (LPA) were run to determine social capital profiles. Health outcomes included frequent health complaints and life satisfaction, while socioeconomic status and genders were included as predictors.

    Results

    The results show that five distinct profiles best represent the data for 11- and 15-year olds, while a four-profile model was optimal for 13-year olds. Some profiles were recurrent between age groups but unique profiles were also found. Health outcomes were significantly different between profiles depending on levels of social capital in the different contexts.

    Conclusions

    This study provides novel insight into how social capital co-occurs among adolescents within the contexts of family, school and peers and how this translates into differences in health outcomes. The national representativeness of the sample increases the implications of the results and contributes to meaningful insights that help explain the interactions of social capital in multiple contexts, complementing what is previously known about the relationship with adolescent health. © 2019 Ahlborg et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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    published2019
  • 4.
    Ahlborg, Mikael
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Nyholm, Maria
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Morgan, Antony
    Glasgow Caledonian University, Glasgow, United Kingdom.
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Socioeconomic inequalities in health among Swedish adolescents - adding the subjective perspective2017In: BMC Public Health, E-ISSN 1471-2458, Vol. 17, article id 838Article in journal (Refereed)
    Abstract [en]

    Background

    Socioeconomic inequalities in adolescent health predict future inequalities in adult health. Subjective measures of socioeconomic status (SES) may contribute with an increased understanding of these inequalities. The aim of this study was to investigate socioeconomic health inequalities using both a subjective and an objective measure of SES among Swedish adolescents.

    Method

    Cross-sectional HBSC-data from 2002 to 2014 was used with a total sample of 23,088 adolescents aged 11–15 years. Three measures of self-rated health (dependent variables) were assessed: multiple health complaints, life satisfaction and health perception. SES was measured objectively by the Family Affluence Scale (FAS) and subjectively by “perceived family wealth” (independent variables). The trend for health inequalities was investigated descriptively with independent t-tests and the relationship between independent and dependent variables was investigated with multiple logistic regression analysis. Gender, age and survey year was considered as possible confounders.

    Results

    Subjective SES was more strongly related to health outcomes than the objective measure (FAS). Also, the relation between FAS and health was weakened and even reversed (for multiple health complaints) when subjective SES was tested simultaneously in regression models (FAS OR: 1.03, CI: 1.00;1.06 and subjective SES OR: 0.66, CI: 0.63;0.68).

    Conclusions

    The level of socioeconomic inequalities in adolescent health varied depending on which measure that was used to define SES. When focusing on adolescents, the subjective appraisals of SES is important to consider because they seem to provide a stronger tool for identifying inequalities in health for this group. This finding is important for policy makers to consider given the persistence of health inequalities in Sweden and other high-income countries. ©  The Author(s). 2017

  • 5.
    Aili, Katarina
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Sport. Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Arvidsson, Susann
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Health related quality of life and buffering factors in adult survivors of acute pediatric lymphoblastic leukemia and their siblings2021In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 19, no 1, article id 55Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The improvement in treatment of pediatric acute lymphatic leukemia (ALL) has introduced new challenges for pediatric oncology care in understanding and handling long-term treatment-related complications later in adult life. The aim of this study was to describe health related quality of life (HRQoL) and the relation to buffering factors among young adult (YA) pediatric ALL survivors and their siblings.

    METHODS: This cross-sectional study was performed among 227 adults, treated for pediatric ALL in Sweden between 1985 and 1997 and their siblings (n = 70). Group means of HRQoL (SF-36) were compared between YA ALL survivors and the siblings, as well as to normative values from the general population. Self-efficacy (GSES) and social support (SS-13 subscale AVSI) was considering potential buffering factors for HRQoL and mental health. Associations between HRQoL and mental health respectively and self-efficacy and social support was analyzed.

    RESULTS: The YA ALL survivors scored significantly lower on the HRQoL parameters general health (69.6 vs. 78.4, p = 0.004) and role emotional (77.1 vs. 88.1, p = 0.014), than the siblings. Further, they reported significantly lower general health (69.6 vs. 75.8), vitality (56.9 vs. 68.8), social functioning (84.5 vs. 88.6), role emotional (77.1 vs. 85.7) and mental health (71.3 vs. 80.9) compared with Swedish norms. Both YA ALL survivors and the siblings reported lower vitality and worse mental health than the general population. The HRQoL parameters, depression, stress and anxiety were all associated with both self-efficacy and social support among the YA ALL survivors. Among the siblings however, only general health, vitality, role emotional, mental health and depression were associated with social support, and only general health and mental health were associated with general self-efficacy.

    CONCLUSION: The results from this study show that buffering factors, like social support and self-efficacy, may play an important role for psychosocial outcomes and HRQoL among YA ALL survivors later in life. The results suggest that this group could benefit from continuous support in adult life to handle consequences of their pediatric disease. © 2021, The Author(s).

  • 6.
    Aili, Katarina
    et al.
    Halmstad University, School of Health and Welfare.
    Arvidsson, Susann
    Halmstad University, School of Health and Welfare.
    Olsson, Maria
    Sahlgrenska University Hospital, Gothenburg, Sweden; Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Jarfelt, Marianne
    Sahlgrenska University Hospital, Gothenburg, Sweden; Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare.
    Health-related quality of life in adults treated for paediatric acute lymphoblastic leukaemia: a cross-sectional and longitudinal cohort study2022In: BMJ Open, E-ISSN 2044-6055, Vol. 12, article id e048325Article in journal (Refereed)
    Abstract [en]

    Introduction: Acute lymphoblastic leukaemia (ALL) is the most common form of cancer in children. Although treatment methods have improved and resulted in significant improvement of survival and reduction in late effects and late mortality risk, the health-related quality of life (HRQOL) of survivors might be affected. To introduce new interventions in clinical practice with the potential to support positive HRQOL outcomes, more knowledge is needed on how HRQOL in this group is constructed and stimulated. The purpose of this study is to investigate how HRQOL is affected in adults treated for paediatric ALL, in a long-term perspective and possible factors influencing this relationship.

    Methods and analysis: This cohort of young adult ALL survivors allows for investigations of factors influencing HRQOL outcomes on a national level. Eligible participants are obtained from the Swedish Childhood Cancer quality registry. Data collection includes both a follow-up of data collected in 2012 (n=224) and recruitment of new eligible participants to the cohort (n=601). The cohort will cover survivors of paediatric ALL, diagnosed between 1985 and 2007, at an age between 0 and 15 years. Data will be collected using validated, multidimensional, self-administered instruments, designed to measure HRQOL (SF-36), social support, sense of coherence and resilience.

    Ethics and dissemination: The study will be carried out in accordance with the ethics permit obtained from the Swedish ethics review authority (Dnr 2019-05181). Dissemination of study results will take place through research articles and reports to the national patient organisation and the national network for consultancy nurses for this target group and to the working group for the Swedish national long-term care programme for childhood cancer. Results will also reach practical application within the follow-up clinic for adult childhood cancer survivors at Sahlgrenska Hospital in Gothenburg. © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

  • 7.
    Aili, Katarina
    et al.
    Halmstad University, School of Health and Welfare.
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare.
    Arvidsson, Susann
    Halmstad University, School of Health and Welfare.
    Olsson, Maria
    Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Jarfelt, Marianne
    Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Health Outcomes in Adult Survivors of Childhood All and Their Siblings – A National Long Term Follow Up2022In: Pediatric Blood & Cancer, ISSN 1545-5009, E-ISSN 1545-5017, Vol. 69, no S5, p. S173-S173, article id e29952Article in journal (Refereed)
  • 8.
    Almgren, Johanna
    et al.
    Halmstad University, School of Health and Welfare.
    Löfström, Emma
    Department of Clinical Microbiology, Hallands Hospital Halmstad, Halmstad, Sweden; Department of Clinical Sciences, Lund University, Lund, Sweden.
    Malmborg, Julia S
    Halmstad University, School of Health and Welfare.
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare.
    Undén, Johan
    Department of Clinical Sciences, Lund University, Lund, Sweden; Department of Operation and Intensive Care, Hallands Hospital Halmstad, Halmstad, Sweden.
    Larsson, Ingrid
    Halmstad University, School of Health and Welfare. Spenshult Research and Development Centre, Halmstad, Sweden; Section of Rheumatology, Department of Clinical Sciences, Lund University, Lund, Sweden.
    Patients' Health Experiences of Post COVID-19 Condition – A Qualitative Study2022In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, no 21, article id 13980Article in journal (Refereed)
    Abstract [en]

    Patients who suffer from long-term symptoms of COVID-19, described as post COVID-19 condition, are a new and large group of patients. There is a lack of knowledge concerning health experiences in this patient group. The aim of this study was to explore patients' health experiences of post COVID-19 condition. Data collection was performed through 14 semi-structured interviews. The qualitative content analysis resulted in six sub-categories, three categories, and an overall theme. Patients experienced symptoms of varying duration-ranging from 5-21 months. The results showed that patients' health experiences of post COVID-19 condition moved between uncertainty and new insights. This was shown by patients experiencing: (1) loss of abilities, including losing smell and taste and lacking energy, (2) loss of control, including being foreign to oneself and seeking answers, and (3) revaluation of life, including accepting the transformed body and prioritizing health. This study illustrates that patients living with post COVID-19 condition need to be treated with flexibility, based on each individual's unique challenges and experiences of the symptoms and the consequences for their health. © 2022 by the authors.

  • 9.
    Arnarsson, Arsaell
    et al.
    University of Iceland, Reykjavik, Iceland.
    Nygren, Jens
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Nyholm, Maria
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Torsheim, Torbjorn
    University of Bergen, Bergen, Norway.
    Augustine, Lilly
    University of Kristianstad, Kristianstad, Sweden.
    Bjereld, Ylva
    University of Gothenburg, Gothenburg, Sweden.
    Markkanen, Ilona
    University of Jyväskylä, Jyväskylä, Finland.
    Schnohr, Christina w.
    University of Copenhagen, Copenhagen, Denmark.
    Rasmussen, Mette
    University of Southern Denmark, Odense, Denmark.
    Nielsen, Line
    University of Southern Denmark, Odense, Denmark.
    Bendtsen, Pernille
    University of Southern Denmark, Odense, Denmark.
    Cyberbullying and traditional bullying among Nordic adolescents and their impact on life satisfaction2020In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 48, no 5, p. 502-510Article in journal (Refereed)
    Abstract [en]

    Aims: The aim of this study was to investigate the prevalence of cybervictimization in the six Nordic countries and to assess its overlap with traditional bullying. A further aim was to examine potential associations between life satisfaction, on the one hand, and traditional bullying and cyberbullying on the other. Methods: Analyses were based on data from the 2013⁄2014 Health Behaviour in School-aged Children study. It included 32,210 boys and girls, aged 11, 13, and 15, living in the six Nordic countries. Results: The prevalence of cyberbullying by both pictures and by messages was around 2% in all the Nordic countries except Greenland. There it was considerably higher. The prevalence of being bullied in a traditional manner varied widely by country. For boys, this type of bullying was most frequent in the youngest age group and then decreased steadily in the older age groups. Girls were on average more likely to be cyberbullied. Cyberbullying was more common among 13- and 15-year-olds than 11-year-olds. Higher family affluence was unrelated to the risk of cyberbullying. However, it was related to traditional bullying and combined forms of bullying. Compared with intact families, cybervictimization was commoner among single-parent families and stepfamilies. Adjusting for age, gender, family affluence, and family structure, those subjected to cyberbullying had lower life satisfaction than those who were not bullied. Conclusions: We found relatively little overlap between cyberbullying and traditional bullying, indicating that the two may be separate phenomena stemming from different mechanisms, at least in the Nordic context.

  • 10.
    Arvidsson, Susann
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Aili, Katarina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Karolinska Institutet, Stockholm, Sweden.
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Health-Related Quality of Life among Young Adult Acute Lymphoblastic Leukemia Survivors in Sweden2019Conference paper (Refereed)
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    sammanfattning
  • 11.
    Arvidsson, Susann
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Gilljam, Britt-Mari
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing. Region Halland, Halmstad, Sweden.
    Nygren, Jens
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Ruland, Cornelia Maria
    The Centre for Shared Decision Making and Collaborative Care Research (CSDM), Oslo University Hospital, Oslo, Norway & University of Oslo, Oslo, Norway.
    Nordby-Bøe, Trude
    The Centre for Shared Decision Making and Collaborative Care Research (CSDM), Oslo University Hospital, Oslo, Norway.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Redesign and Validation of Sisom, an Interactive Assessment and Communication Tool for Children With Cancer2016In: JMIR mhealth and uhealth, E-ISSN 2291-5222, Vol. 4, no 2, article id e76Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Children with cancer undergo intensive and long treatment periods that expose them and their families to a number of difficult physical, mental, and social challenges. Empowering children by actively involving them in their care can help them to cope with these challenges. It can, however, be difficult for children to be involved and talk about their illness experiences in a "traditional" conversation with health care professionals, especially for younger children. Sisom (Norwegian acronym "Si det som det er" or "Tell it how it is") is an interactive computer-based assessment and communication tool to give children (aged 6-12 years) with cancer a "voice" in their care. Because of technological advances and widespread use of mobile devices Sisom had to be redesigned to better meet the needs of children of today.

    OBJECTIVE: To redesign Sisom for use on mobile devices and to validate and adapt it for use in a Swedish population of children with cancer.

    METHODS: A user-experience design was used. Content adaptation included forward-backward translation by Swedish and Norwegian translators. Healthy children (n=5), children with experiences of cancer treatment (n=5) and their parents (n=5), and pediatric nurses (n=2) were then involved in culturally adapting Sisom to the Swedish context. The iterative low- and high-fidelity evaluation was supported by a think aloud method, semistructured interviews, and drawings to capture children's views of Sisom. The redesign and evaluation continued until no further changes or improvements were identified by the participants or the researchers.

    RESULTS: Children, parents, and pediatric nurses offered many suggestions for improvements to the original version in terms of content, aesthetics, and usability of Sisom. The most significant change that emerged through user input was a modification that entailed not using problem-focused statements in the assessment items. The parents and pediatric nurses considered the revised assessment items to be general and less diagnosis specific. The evaluation of aesthetics resulted in brighter colors and more positive and exciting details in the animations. The evaluation of usability included improvements of the verbal instructions on how to navigate in Sisom 2, and also that the answers to assessmentitems in Sisom 2 should be saved to provide the children with the option to pause and to continue answering the remaining assessment items at a later stage.

    CONCLUSIONS: Overall, this paper describes the process of using user-experience design with children in order to redesign and validate an interactive assessment and communication tool and how the outcomes of this process resulted in a new version, Sisom 2. All participants confirmed the usability and qualities of using the final version. Future research should be directed toward the implementation of Sisom 2 in clinical practice and to evaluate outcomes from individual and organizational levels.

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  • 12.
    Attema, Joanne L.
    et al.
    Immunology Unit, Institution for Experimental Medical Research, Lund University, Lund, Sweden.
    Pronk, Cornelis J. H.
    Immunology Unit, Institution for Experimental Medical Research, Lund University, Lund, Sweden.
    Norddahl, Gudmundur L.
    Immunology Unit, Institution for Experimental Medical Research, Lund University, Lund, Sweden.
    Nygren, Jens Martin
    Immunology Unit, Institution for Experimental Medical Research, Lund University, Lund, Sweden.
    Bryder, David
    Immunology Unit, Institution for Experimental Medical Research, Lund University, Lund, Sweden.
    Hematopoietic stem cell ageing is uncoupled from p16 INK4A-mediated senescence2009In: Oncogene, ISSN 0950-9232, E-ISSN 1476-5594, Vol. 28, no 22, p. 2238-2243Article in journal (Refereed)
    Abstract [en]

    Somatic stem cells are ultimately responsible for mediating appropriate organ homeostasis and have therefore been proposed to represent a cellular origin of the ageing process-a state often characterized by inappropriate homeostasis. Specifically, it has been suggested that ageing stem cells might succumb to replicative senescence by a mechanism involving the cyclin-dependent kinase inhibitor p16(INK4A). Here, we tested multiple functional and molecular parameters indicative of p16(INK4A) activity in primary aged murine hematopoietic stem cells (HSCs). We found no evidence that replicative senescence accompanies stem cell ageing in vivo, and in line with p16(INK4A) being a critical determinant of such processes, most aged HSCs (>99%) failed to express p16(INK4A) at the mRNA level. Moreover, whereas loss of epigenetically guided repression of the INK4A/ARF locus accompanied replicative senescent murine embryonic fibroblasts, such repression was maintained in aged stem cells. Taken together, these studies indicate that increased senescence as mediated by the p16(INK4A) tumor suppressor has only a minor function as an intrinsic regulator of steady-state HSC ageing in vivo.

  • 13.
    Bengtsson, Dennis
    et al.
    Halmstad University, School of Health and Welfare.
    Stenling, Andreas
    Umeå University, Umeå, Sweden; University of Agder, Kristiansand, Norway.
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare.
    Ntoumanis, Nikos
    Halmstad University, School of Health and Welfare. University of Southern Denmark, Odense, Denmark.
    Ivarsson, Andreas
    Halmstad University, School of Health and Welfare.
    The effects of interpersonal development programmes with sport coaches and parents on youth athlete outcomes: A systematic review and meta-analysis2024In: Psychology of Sport And Exercise, ISSN 1469-0292, E-ISSN 1878-5476, Vol. 70, article id 102558Article, review/survey (Refereed)
    Abstract [en]

    Interpersonal coach-and parent development programmes (CDP and PDP, respectively), have the goal to foster positive youth sport experiences through high-quality relations between coaches, parents, and youth athletes. In this paper we systematically reviewed the extant literature and estimate the overall magnitude of such programmes and how they can inform future interventions. Specifically, we aimed to: (a) conduct a systematic review on the literature of interpersonal CDPs and PDPs within the youth sport context; (b) examine the effects of such interventions on youth athlete outcomes via a meta-analysis. English written peer-reviewed publications and grey literature was identified through electronic search in databases and manual searches of reference lists. By utilising a priori criteria for inclusion and exclusion, 33 studies describing interpersonal CDPs, and PDPs were identified in the systematic review. Studies that presented required data for estimation of Hedge's g effect sizes were included in the meta-analysis (k = 27). By and large, the included studies used a quasi-experimental design (58%), sampled from team sports (79%), and reported several delivery methods (e.g., workshops, audio feedback, observations, peer group discussions) and outcome measures (e.g., anxiety, autonomous motivation, self-confidence). Some interventions were based on the same delivery protocols (e.g., Coach Effectiveness Training, Mastery Approach to Coaching) or theoretical frameworks (e.g., Achievement Goal Theory, Self-Determination Theory). The meta-analysis showed statistically significant small, and medium, effect sizes on a subsample of youth athlete outcomes (e.g., task-related climate, fun and enjoyment, anxiety), indicating that coach interpersonal skills can contribute to positive youth sport experiences. Theory-based interpersonal CDPs and PDPs are recommended to expand the knowledge in this field of research. © 2023 The Authors

  • 14.
    Breitbach, Martin
    et al.
    University of Bonn, Bonn, Germany.
    Bostani, Toktam
    University of Bonn, Bonn, Germany.
    Roell, Wilhelm
    University of Bonn, Bonn, Germany.
    Xia, Ying
    University of Cologne, Cologne, Germany.
    Dewald, Oliver
    University of Bonn, Bonn, Germany.
    Nygren, Jens Martin
    Lund Strategic Research Center for Stem Cell Biology and Cell Therapy, Lund University, Lund, Sweden.
    Fries, Jochen W. U.
    University of Cologne, Cologne, Germany.
    Tiemann, Klaus
    University of Bonn, Bonn, Germany.
    Bohlen, Heribert
    Axiogenesis AG, Cologne, Germany.
    Hescheler, Juergen
    University of Cologne, Cologne, Germany.
    Welz, Armin
    University of Bonn, Bonn, Germany.
    Bloch, Wilhelm
    German Sport University, Cologne, Germany.
    Jacobsen, Sten Eirik W
    Lund Strategic Research Center for Stem Cell Biology and Cell Therapy, Lund University, Lund, Sweden.
    Fleischmann, Bernd K
    University of Bonn, Bonn, Germany.
    Potential risks of bone marrow cell transplantation into infarcted hearts2007In: Blood, ISSN 0006-4971, E-ISSN 1528-0020, Vol. 110, no 4, p. 1362-1369Article in journal (Refereed)
    Abstract [en]

    Cellular replacement therapy has emerged as a novel strategy for the treatment of heart failure. The aim of our study was to determine the fate of injected mesenchymal stem cells (MSCs) and whole bone marrow (BM) cells in the infarcted heart. MSCs were purified from BM of transgenic mice and characterized using flow cytometry and in vitro differentiation assays. Myocardial infarctions were generated in mice and different cell populations including transgenic MSCs, unfractionated BM cells, or purified hematopoietic progenitors were injected. Encapsulated structures were found in the infarcted areas of a large fraction of hearts after injecting MSCs (22 of 43, 51.2%) and unfractionated BM cells (6 of 46, 13.0%). These formations contained calcifications and/or ossifications. In contrast, no pathological abnormalities were found after injection of purified hematopoietic progenitors (0 of 5, 0.0%), fibroblasts (0 of 5, 0.0%), vehicle only (0 of 30, 0.0%), or cytokine-induced mobilization of BM cells (0 of 35, 0.0%). We conclude that the developmental fate of BM-derived cells is not restricted by the surrounding tissue after myocardial infarction and that the MSC fraction underlies the extended bone formation in the infarcted myocardium. These findings seriously question the biologic basis and clinical safety of using whole BM and in particular MSCs to treat nonhematopoietic disorders.

  • 15.
    Buza-Vidas, Natalija
    et al.
    Hematopoietic Stem Cell Laboratory, Lund Strategic Research Center for Stem Cell Biology and Cell Therapy, Lund University, Sweden.
    Antonchuk, Jennifer
    Hematopoietic Stem Cell Laboratory, Lund Strategic Research Center for Stem Cell Biology and Cell Therapy, Lund University, Sweden.
    Qian, Hong
    Hematopoietic Stem Cell Laboratory, Lund Strategic Research Center for Stem Cell Biology and Cell Therapy, Lund University, Sweden.
    Månsson, Robert
    Hematopoietic Stem Cell Laboratory, Lund Strategic Research Center for Stem Cell Biology and Cell Therapy, Lund University, Sweden.
    Luc, Sidinh
    Hematopoietic Stem Cell Laboratory, Lund Strategic Research Center for Stem Cell Biology and Cell Therapy, Lund University, Sweden.
    Zandi, Sasan
    Hematopoietic Stem Cell Laboratory, Lund Strategic Research Center for Stem Cell Biology and Cell Therapy, Lund University, Sweden.
    Anderson, Kristina
    Hematopoietic Stem Cell Laboratory, Lund Strategic Research Center for Stem Cell Biology and Cell Therapy, Lund University, Sweden.
    Takaki, Satoshi
    Department of Community Health and Medicine, Research Institute, International Medical Center of Japan, Tokyo, Japan.
    Nygren, Jens Martin
    Hematopoietic Stem Cell Laboratory, Lund Strategic Research Center for Stem Cell Biology and Cell Therapy, Lund University, Sweden.
    Jensen, Christina T.
    Hematopoietic Stem Cell Laboratory, Lund Strategic Research Center for Stem Cell Biology and Cell Therapy, Lund University, Sweden.
    Jacobsen, Sten Eirik W.
    Hematopoietic Stem Cell Laboratory, Lund Strategic Research Center for Stem Cell Biology and Cell Therapy, Lund University, Sweden.
    Cytokines regulate postnatal hematopoietic stem cell expansion: Opposing roles of thrombopoietin and LNK2006In: Genes & Development, ISSN 0890-9369, E-ISSN 1549-5477, Vol. 20, no 15, p. 2018-2023Article in journal (Refereed)
    Abstract [en]

    The role of cytokines as regulators of hematopoietic stem cell (HSC) expansion remains elusive. Herein, we identify thrombopoietin (THPO) and the cytokine signaling inhibitor LNK, as opposing physiological regulators of HSC expansion. Lnk(-/-) HSCs continue to expand postnatally, up to 24-fold above normal by 6 mo of age. Within the stem cell compartment, this expansion is highly selective for self-renewing long-term HSCs (LT-HSCs), which show enhanced THPO responsiveness. Lnk(-/-) HSC expansion is dependent on THPO, and 12-wk-old Lnk(-/-)Thpo(-/-) mice have 65-fold fewer LT-HSCs than Lnk(-/-) mice. Expansions of multiple myeloid, but not lymphoid, progenitors in Lnk(-/-) mice also proved THPO-dependent.

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  • 16.
    Carlsson, Ing-Marie
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Arvidsson, Susann
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Viklund, Åsa
    Department of Social Work, Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden.
    Birkeland, Anna-Lena
    Department of Social Work, Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden.
    Larsson, Ingrid
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Creating a communication space in the healthcare context: Children’s perspective of using the eHealth service, Sisom2021In: Journal of Child Health Care, ISSN 1367-4935, E-ISSN 1741-2889, Vol. 25, no 1, p. 31-43Article in journal (Refereed)
    Abstract [en]

    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.
    Carlsson, Ing-Marie
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Patient participation, a prequisite for care: A grounded theory study of healthcare professionals’ perceptions of what participation means in a paediatric care context2018In: Nursing Open, E-ISSN 2054-1058, Vol. 5, no 1, p. 45-52Article in journal (Refereed)
    Abstract [en]

    Aims

    To explore healthcare professionals’ perceptions of what patient participation means in a paediatric care context.

    Design

    A qualitative explorative design with grounded theory.

    Methods

    Fifteen healthcare professionals who worked in paediatric care settings were either interviewed or asked open-ended questions in a survey, during December 2015–May 2016. Grounded theory was used as a method.

    Results

    The study results provide a theoretical conceptualization of what patient participation meant for healthcare professionals in paediatric care and how participation was enabled. The core category “participation a prerequisite for care” emerged as the main finding explaining the concept as ethical, practical and integrated in the care givers way of working. However, the concept was implicit in the organization. Four additional categories illustrated the healthcare professionals’ different strategies used to enhance patient participation; “meeting each child where the child is,” “building a relationship with the child,” “showing respect for each individual child” and “making the most of the moment.” © 2017 The Authors. Nursing Open published by John Wiley & Sons Ltd

  • 18.
    Einberg, Eva-Lena
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Kadrija, Ibadete
    Halmstad University, School of Social and Health Sciences (HOS).
    Brunt, David
    Institutionen för Hälsa och Vårdvetenskap, Linnéuniversitetet, Växjö, Sweden.
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Psychometric evaluation of a Swedish version of Minneapolis-Manchester quality of life-youth form and adolescent form2013In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 11, article id 79Article in journal (Refereed)
    Abstract [en]

    Background: It has become important to measure long-term effects and quality of life in survivors of childhood cancer. The Minneapolis- Manchester Quality of Life (MMQL) instrument has been proven to better capture the quality of life (QoL) perspective of health than other instruments. The instrument has age appropriate versions and is therefore favourable for longitudinal studies of QoL of children surviving from cancer. The aim of this study was to evaluate the psychometric properties of the Swedish version of MMQL-Youth Form and the Adolescent Form focusing on: 1) face and content validity 2) the internal consistency and 3) the test-retest reliability. Methods: The sample consisted of 950 pupils (11–16years old) from 7 schools in the western Sweden who completed the questionnaire. For the test-retest evaluation 230 respondents completed the questionnaire two weeks later. Results: Face and content validity was supported and internal consistency was found to be acceptable for the total scale for both the MMQL-Youth Form (8–12years of age) and the Adolescent Form (13–20years of age). Test-retest reliability for the MMQL-Youth Form was moderate for 50% of the items and good for the remaining. For the MMQL-Adolescent Form the test-retest showed moderate or good agreement for 80% of the items and fair for 20%. Conclusions: The result indicated that the Swedish version of the MMQLYouth Form and Adolescent Form was valid and reliable in a sample of healthy children in a Swedish context. It is recommended to test the instrument among diverse samples of children such as survivors of childhood cancer in order to validate its usefulness in research and clinical settings. © 2013 Einberg et al.; licensee BioMed Central Ltd.

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  • 19.
    Einberg, Eva-Lena
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Enskär, Karin
    Jönköping University, Jönköping, Sweden.
    'Through my eyes': children with experience of cancer describing through photography what promotes their health2014In: Health Promotion Research - An International Forum <<Next Health>>, August 25-27,  2014, Trondheim, Norway, Trondheim: Senter for helsefremmende forskning HiST/NTNU , 2014, p. 33-33Conference paper (Refereed)
  • 20.
    Einberg, Eva-Lena
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention. School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Nygren, Jens
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Enskär, Karin
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    ‘Through my eyes’: health-promoting factors described by photographs taken by children with experience of cancer treatment2016In: Child Care Health and Development, ISSN 0305-1862, E-ISSN 1365-2214, Vol. 42, no 1, p. 76-86Article in journal (Refereed)
    Abstract [en]

    Background

    Health promotion for children with cancer should be based on the children's own needs and desires. Because there is a lack of knowledge in this area, the aim of this study was to explore what promotes health from the perspective of children with experience of cancer treatment.

    Methods

    Fifteen children between 8 and 12 years of age participated in focus groups with three children in each group. The children were given a camera and instructions to photograph subjects that promote their health. Focus group discussions were based on the photographs and the children's own description of those photographs. The analysis of focus group discussions and photographs was conducted using inductive content analysis.

    Results

    According to the children, health-promoting factors are defined as meaningful relationships, recreational activities and a trustful environment. Meaningful relationships include togetherness within the family, affection for pets and friendship with peers. Recreational activities include engagement in play and leisure, withdrawal for relaxation and feeling enjoyment. Trustful environment includes confidence in significant others and feeling safe.

    Conclusions

    Knowledge from this study can contribute to health promotion interventions and quality improvements in the health care of children with experience of cancer treatment. Children's experiences with what promotes health in their everyday lives provide a better understanding of the type of support children prefer when promoting their own health. © 2015 John Wiley & Sons Ltd.

  • 21.
    Einberg, Eva-Lena
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Enskär, Karin
    Hälsohögskolan i Jönköping, Jönköping, Sweden.
    Nygren, Jens
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Friendship from the perspective of children with experience of cancer: A focus group study2013In: Pediatric Blood & Cancer, ISSN 1545-5009, E-ISSN 1545-5017, Vol. 60, no suppl. 3, p. 43-43Article in journal (Refereed)
  • 22.
    Einberg, Eva-Lena
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention. School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Enskär, Karin
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Friendship Relations From the Perspective of Children With Experience of Cancer Treatment: A Focus Group Study With a Salutogenic Approach2015In: Journal of Pediatric Oncology Nursing, ISSN 1043-4542, E-ISSN 1532-8457, Vol. 32, no 3, p. 153-164Article in journal (Refereed)
    Abstract [en]

    Friendships are significant to child development and health but diseases such as cancer can interrupt the contact with friends. The purpose of this study was to describe perceptions of friendship from the perspective of children undergoing cancer treatment, in order to build knowledge that can be used in a health promotion intervention for these children. Fifteen children between 8 and 12 years of age participated in focus groups, where a mixture of informative and creative techniques were used. The focus group discussions were analyzed using qualitative content analysis. The analysis resulted in three generic categories, “Common interests and experiences,” “Mutual empathic actions.” and “Mutual trust and understanding,” incorporating seven subcategories. Based on children’s descriptions from a salutogenic perspective, friendship emerged as An equal and mutual commitment that evolves over time and with interactions face-to-face and digitally, a child perspective on friendship should be central to the development of health promotion interventions designed to support friendship relations of children treated for cancer. © 2014 by Association of Pediatric Hematology/Oncology Nurses

  • 23.
    Einberg, Eva-Lena
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Wärnestål, Pontus
    Thomsen, Michel
    Stigmar, Jennie
    Barnonkologiskt centra, Skånes Universitetssjukhus i Lund, Lund, Sverige.
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, Jönköping, Sverige.
    Åkesson, Maria
    Nygren, Jens
    Hur gör man barn delaktiga i forsknings- och innovationsprocesser vid utveckling av digitala hälsoinnovationer2013Conference paper (Refereed)
    Abstract [sv]

    Att drabbas av en svår eller kronisk sjukdom under barndomen kan bidra till fysiska och psykosociala svårigheter senare i livet. Kamratstöd mellan individer som delar samma erfarenhet är en viktig främjande faktor till hälsa och välbefinnande och kan verka som en buffert mot stress och motgångar. Empirisk evidens som kan vägleda utveckling av digitala och interaktiva lösningar för kamratstöd mellan barn som drabbas av sjukdom i skolåldern är idag begränsad. Den process som presenteras här är fokuserad på att etablera metodologi för barns delaktighet i innovationsprocesser och att fånga barns bakomliggande beteenden och mål relaterat till kamratstödjande processer och hälsa. Intervjuer i fokusgrupper är en teknik som främjar barns deltagande och fångar barns perspektiv, förståelse och erfarenhet relaterat till deras hälsa. Friska barn (8-12 år) rekryterades från en lokal grundskola till fyra fokusgrupper med fyra barn i varje grupp. Barnen träffades två gånger med en intervall på 1-2 veckor. Förändringar gjordes mellan varje fokusgrupp för att anpassa strukturen på träffarna till en nivå motsvarande barnens erfarenheter, ålder och förmåga och för att fokusera diskussionerna på innovationsprocessen. En blandning av informativa och kreativa tekniker som öppna frågor, brainstorming, rita och måla och fotografering användes för att underlätta för barnen att uttrycka sig. Barnen framförde efter deltagandet att de tyckte om att delta och ville träffas igen i den här formen av grupp. Vår anpassade struktur på fokusgrupper används idag med barn med erfarenhet av svår sjukdom (cancer) för att ta fram typanvändare (Personas) i innovationsprocessen. Barnen rekryterades från Barnonkologiskt centra i Lund och Hallands sjukhus i Halmstad till fem fokusgrupper med tre barn i varje grupp. Barns delaktighet genom vår metod har förbättrat förutsättningarna att fånga barns mål och beteende och tillfört unikt material till den fortsatta designprocessen.

  • 24.
    Einberg, Eva-Lena
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Wärnestål, Pontus
    Halmstad University, School of Information Science, Computer and Electrical Engineering (IDE), Halmstad Embedded and Intelligent Systems Research (EIS), Man and Information technology laboratory (MI-lab).
    Thomsen, Michel
    Halmstad University, School of Information Science, Computer and Electrical Engineering (IDE), Halmstad Embedded and Intelligent Systems Research (EIS), Man and Information technology laboratory (MI-lab).
    Stigmar, Jennie
    Barnonkologiskt centra, Skånes Universitetssjukhus i Lund, Lund, Sverige.
    Enskär, Karin
    Avd. för omvårdnad, Hälsohögskolan, Högskolan i Jönköping, Jönköping, Sverige.
    Åkesson, Maria
    Halmstad University, School of Information Science, Computer and Electrical Engineering (IDE), Halmstad Embedded and Intelligent Systems Research (EIS), Man and Information technology laboratory (MI-lab).
    Nygren, Jens
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Hur gör man barn delaktiga i forsknings- och innovationsprocesser vid utveckling av digitala hälsoinnovationer2012Conference paper (Refereed)
    Abstract [sv]

    Att drabbas av en svår eller kronisk sjukdom under barndomen kan bidra till fysiska och psykosociala svårigheter senare i livet. Kamratstöd mellan individer som delar samma erfarenhet är en viktig främjande faktor till hälsa och välbefinnande och kan verka som en buffert mot stress och motgångar. Empirisk evidens som kan vägleda utveckling av digitala och interaktiva lösningar för kamratstöd mellan barn som drabbas av sjukdom i skolåldern är idag begränsad. Den process som presenteras här är fokuserad på att etablera metodologi för barns delaktighet i innovationsprocesser och att fånga barns bakomliggande beteenden och mål relaterat till kamratstödjande processer och hälsa. Intervjuer i fokusgrupper är en teknik som främjar barns deltagande och fångar barns perspektiv, förståelse och erfarenhet relaterat till deras hälsa. Friska barn (8-12 år) rekryterades från en lokal grundskola till fyra fokusgrupper med fyra barn i varje grupp. Barnen träffades två gånger med en intervall på 1-2 veckor. Förändringar gjordes mellan varje fokusgrupp för att anpassa strukturen på träffarna till en nivå motsvarande barnens erfarenheter, ålder och förmåga och för att fokusera diskussionerna på innovationsprocessen. En blandning av informativa och kreativa tekniker som öppna frågor, brainstorming, rita och måla och fotografering användes för att underlätta för barnen att uttrycka sig. Barnen framförde efter deltagandet att de tyckte om att delta och ville träffas igen i den här formen av grupp. Vår anpassade struktur på fokusgrupper används idag med barn med erfarenhet av svår sjukdom (cancer) för att ta fram typanvändare (Personas) i innovationsprocessen. Barnen rekryterades från Barnonkologiskt centra i Lund och Hallands sjukhus i Halmstad till fem fokusgrupper med tre barn i varje grupp. Barns delaktighet genom vår metod har förbättrat förutsättningarna att fånga barns mål och beteende och tillfört unikt material till den fortsatta designprocessen.

  • 25.
    Einberg, Eva-Lena
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Wärnestål, Pontus
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Thomsen, Michel
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS).
    Stigmar, Jennie
    Barnonkologiskt centra, Skånes Universitetssjukhus i Lund, Sverige.
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, Avd. för omvårdnad, Jönköping, Sverige.
    Åkesson, Maria
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS).
    Nygren, Jens
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Involving children in research and innovation processes in the development of digital health promotion intervention2013Conference paper (Refereed)
    Abstract [en]

    Introduction

    Severe or chronic illness in childhood may contribute to physical and psychosocial problems later in life. Peer support among individuals who share the same experience is an important factor in promoting health and wellbeing and can act as a buffer against stress and adversities. Empirical evidence that could guide development of digital and interactive solutions for peer support between school-aged children affected by illness is limited.

    Purpose/Methods

    The process presented here is focused on establishing method- ology for children's participation in innovation processes and to capture the child's underlying behaviors and goals related to peer support processes and health. Focus group interview is a child-friendly method that promotes participation and access to children's perspectives, insights and experiences related to their health. Healthy children were recruited from a local elementary school. Focus groups were carried out in two sessions for each group with an interval of 1-2 weeks.

    Results

    Adjustments were made between each focus group to adapt the meeting structure to a level commensurate with the chil- dren's experience, age and abilities and to focus discussions on innovation incentives related to a digital peer support service. A mixture of informative and creative techniques such as open questions, brainstorming, drawing and painting and photog- raphy were used to assist the children to express themselves. The children were pleased to participate and wanted to meet again in this form of group.

    Conclusions

    Our adapted focus group structure are now being used with children with experience of severe illness (cancer) to develop Personas (fictitious characters of users) in the innovation pro- cess. Children's participation through our method has improved the chances of capturing children's goals and behavior, and added unique material for the continuing design process. 

  • 26.
    Einberg, Eva-Lena
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Wärnestål, Pontus
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS), Man and Information technology laboratory (MI-lab).
    Thomsen, Michel
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS), Man and Information technology laboratory (MI-lab).
    Stigmar, Jennie
    Skåne University Hospital, Lund, Sweden.
    Enskär, Karin
    Jönköping University, Jönköping, Sweden.
    Åkesson, Maria
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS), Man and Information technology laboratory (MI-lab).
    Nygren, Jens
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Participatory innovation process for development of a digital peer support service for children with cancer2012In: SIOP Publication Abstracts, Hoboken, NJ: John Wiley & Sons, 2012, p. 88-88Conference paper (Refereed)
    Abstract [en]

    Purpose: Surviving cancer during childhood imposes a number of difficulties later in life. Peer support has been recognised as an important contributor to health and well-being but empirical evidence that could guide development of peer support programs for school aged children is scarce. The process presented here is focused on generic exploration of children’s needs and expectations related to peer support innovations to promote health and wellbeing of children with cancer. The purpose of this study is to establish a participatory innovation process that grasps the underlying behaviours and goals of children that will affect the design of a digital peer support service.

    Methods: Focus group interview is a child-friendly technique that promotes participation and access to children’s perspectives, insights and experiences related to their health. Healthy children 8–12 years of age were recruited from a local elementary school. Focus groups (n = 5 groups) were carried out in two sessions for each group (n = 4 children per group) with an interval of 1–2 weeks. Adjustments were made between each focus group to adapt the meeting structure to a level commensurate with the children’s experience, age and abilities and to focus discussions on innovation incentives related to a digital peer support service.

    Results: The adaptation process involved adjustments of the focus group structure to match children in the selected age group and to the aims of the innovation process. A mixture of informative and creative techniques (open questions, brainstorming, drawing, photography) assisted the children in talking and expressing themselves. The children were pleased to participate and wanted to meet again in this kind of study group. The adapted focus group sessions are now being used in the research and innovation process with children (8–12 yrs) with experience of cancer treatment.

    Conclusion: The final focus group structure capture children’s perspectives for the design of a digital peer support service.

  • 27.
    Einberg, Eva-Lena
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Wärnestål, Pontus
    Thomsen, Michel
    Stigmar, Jennie
    Enskär, Karin
    Åkesson, Maria
    Nygren, Jens Martin
    Participatory innovation process for development of a digital peer support service for children with cancer2012In: NOPHO NOBOS Meeting and Congress Uppsala, Sweden, May 19 – 22, 2012: Programme and Abstract Book, 2012, p. 118-118Conference paper (Refereed)
  • 28.
    Gama, Fábio
    et al.
    Halmstad University, School of Business, Innovation and Sustainability. School of Administration and Economic Science, Santa Catarina State University, Florianópolis, Brazil.
    Tyskbo, Daniel
    Halmstad University, School of Health and Welfare.
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare.
    Barlow, James
    Centre for Health Economics and Policy Innovation, Imperial College Business School, London, United Kingdom.
    Reed, Julie
    Halmstad University, School of Health and Welfare.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare.
    Implementation Frameworks for Artificial Intelligence Translation Into Health Care Practice: Scoping Review2022In: Journal of Medical Internet Research, E-ISSN 1438-8871, Vol. 24, no 1, article id e32215Article in journal (Refereed)
    Abstract [en]

    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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  • 29.
    Garell, Cecilia
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Nygren, Jens
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    A Legal Framework to Support Development and Assessment of Digital Health Services2016In: JMIR Medical Informatics, E-ISSN 2291-9694, Vol. 4, no 2, p. e17-e17Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Digital health services empower people to track, manage, and improve their own health and quality of life while delivering a more personalized and precise health care, at a lower cost and with higher efficiency and availability. Essential for the use of digital health services is that the treatment of any personal data is compatible with the Patient Data Act, Personal Data Act, and other applicable privacy laws.

    OBJECTIVE: The aim of this study was to develop a framework for legal challenges to support designers in development and assessment of digital health services.

    METHODS: A purposive sampling, together with snowball recruitment, was used to identify stakeholders and information sources for organizing, extending, and prioritizing the different concepts, actors, and regulations in relation to digital health and health-promoting digital systems. The data were collected through structured interviewing and iteration, and 3 different cases were used for face validation of the framework.

    RESULTS: A framework for assessing the legal challenges in developing digital health services (Legal Challenges in Digital Health [LCDH] Framework) was created and consists of 6 key questions to be used to evaluate a digital health service according to current legislation.

    CONCLUSIONS: Structured discussion about legal challenges in relation to health-promoting digital services can be enabled by a constructive framework to investigate, assess, and verify the digital service according to current legislation. The LCDH Framework developed in this study proposes such a framework and can be used in prospective evaluation of the relationship of a potential health-promoting digital service with the existing laws and regulations.

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  • 30.
    Garell, Cecilia
    et al.
    Halmstad University, School of Health and Welfare.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Nygren, Jens
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Lagutrymmet för hälsofrämjande e-tjänster i förhållande till hälso- och sjukvården2014Report (Other academic)
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  • 31.
    Gietzen, Luke J.
    et al.
    Mankato State University, Mankato, United States.
    Ogilvie, Sarah J.
    Mankato State University, Mankato, United States.
    Steerling, Emilie
    Halmstad University, School of Health and Welfare.
    Houston, Rebecca
    Mankato State University, Mankato, United States.
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare.
    de Ruiter, Hans Peter
    Mankato State University, Mankato, United States.
    Ethics and New Health Technologies: An Innovative Descriptive Analysis of the State of the Literature2022In: Creative Nursing, ISSN 1078-4535, E-ISSN 1946-1895, Vol. 28, no 4, p. 221-227Article in journal (Refereed)
    Abstract [en]

    The exponential advancement of health technologies has led to an increasing need for awareness and critical thinking about the potential unintended consequences and ethical dilemmas that may arise from using new technologies. Unfortunately, many ethical issues arise post-implementation. Few researchers preemptively consider the ethical implications of health technologies. The current study located more than 24 million articles in PubMed that discussed common health technologies. Of these, 0.07% (n = 17,816) articles deeply considered the technology’s potential ethical implica-tions. Critical thinking and ethics are the mainstays of nursing practice. Thus, critically thinking about the potential ethical implications of relevant technologies should be at the forefront of research; we contend that this is not common practice. We hope to shed light on this issue to remind researchers to think like nurses when researching new health technologies. © 2022 Creative Health Care Management.

  • 32.
    Gilljam, Britt-Mari
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Arvidsson, Susann
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Child participation in health care (ChiPaC)—Development and psychometric evaluation of a self‐report instrument for children's participation in health care2020In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 29, no 1-2, p. 107-118Article in journal (Refereed)
    Abstract [en]

    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.
  • 33.
    Gilljam, Britt-Mari
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Arvidsson, Susann
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Nygren, Jens
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Involving Children with Juvenile Idiopathic Arthritis in Health-Related Research – Why and How?2015In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 74, no Suppl. 2, p. 1312-1312Article in journal (Refereed)
    Abstract [en]

    Background: Children with severe Juvenile idiopathic arthritis (JIA) are exposed to care situations and harsh treatments such as intra-articular corticosteroid injections (1). In order for these children to feel confidence, it is important they understand and feel they have control over the situation. To support the wellbeing of these children and their involvement in care, it is important to investigate their views of the care process and their everyday life (2).

    Objectives: The purpose of this study is to describe our experiences of using different activities and techniques during interviews with children with JIA.

    Methods: Children (n=23) from two rheumatic pediatric clinics in Sweden, age 8 - 17, diagnosed with JIA since at least two years were interviewed individually or in focus groups. All interviews focused on experiences and preferences of participating in care situations. Among the younger children, age 8 - 12, we used activities such as sentence completion, to express three wishes, draw and tell, and role-play with Barbie dolls. Among the older ones, age 13 – 17, we used sentence completion, to express three wishes and post-IT tabs for brainstorming and subsequent discussion. During all interviews we used open-ended questions.

    Results: Sentence completion and three wishes were two weak techniques for most of the children regardless of age. The younger children often responded to these techniques with silence or responses like “I don't know”. The older children responded with intense reflection and thinking, and predominately came up with one wish only. Techniques that were powerful in activating discussions were draw and tell and role-play with Barbie dolls for the younger children. Using Post-IT tabs and discussions was a good starter for discussions for the older children in focus groups.

    Conclusions: There is reason to reflect on what techniques researchers use when interviewing children, as the prospects of capturing children's perspectives in research is largely dependent on the researcher's ability to engage children in the interview situation. Different interview methods should be used depending on the age of the informants, the purpose of the investigation, and the capabilities, such as the health status, of the child. In this study, we experienced that the participants ability to express their experiences and preferences can be facilitated with practical techniques, like drawing and role-play with Barbie dolls for younger children and Post-IT tabs for children in older age groups.

    References:

    Bertilsson L. Andersson-Gäre B. Fasth A. Forsblad-d'Elia H. A 5-year prospective population-based study of juvenile chronic arthritis: onset, disease process, and outcome. Scandinavian journal of rheumatology 2012; 41(5): 379-382.

    Coyne I. Hayes E. Gallagher P. Regan G. Giving children a voice: investigation of children's experiences of participation in consultation and decision-making in Irish hospitals. Office of the Minister for Children 2006; 3576.

    Acknowledgements: Thanks to: The Swedish Rheumatic Foundation, Stig Thunes Foundation and Norrbacka Eugenia Foundation.

    Disclosure of Interest: None declared

  • 34.
    Gilljam, Britt-Mari
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Arvidsson, Susann
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Nygren, Jens
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Promoting participation in healthcare situations for children with JIA: a grounded theory study2016In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 11, article id 30518Article in journal (Refereed)
    Abstract [en]

    Children’s right to participate in their own healthcare has increasingly become highlighted in national and international research as well as in government regulations. Nevertheless, children’s participation in healthcare is unsatisfactorily applied in praxis. There is a growing body of research regarding children’s participation, but research from the children’s own perspective is scarce. The aim of this study was thus to explore the experiences and preferences for participation in healthcare situations among children with juvenile idiopathic arthritis (JIA) as a foundation for creating strategies to promote their participation in pediatric healthcare. Twenty children, aged 8 to 17 years, with JIA were interviewed individually and in focus groups. In order to increase the children’s opportunities to express their own experiences, different interview techniques were used, such as draw-and-tell and role play with dolls. The analysis was conducted with a constructivist grounded theory. The result explores children’s perspective of influencing processes promoting their participation in healthcare situations. The core category that emerged was, “Releasing fear and uncertainty opens up for confidence and participation,” and the categories related to the core category are, “surrounded by a sense of security and comfort,” and “strengthened and supported to become involved.” In conclusion, the knowledge gained in this study offers new insights from the perspective of children themselves, and can constitute a valuable contribution to the understanding of necessary conditions for the development of specific interventions that promote participation among children in healthcare situations.

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  • 35.
    Gilljam, Britt-Mari
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Region Halland, Halmstad Hospital, Halmstad, Sweden .
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Arvidsson, Susann
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Impact of an Electronic Health Service on Child Participation in Pediatric Oncology Care: Quasiexperimental Study2020In: Journal of Medical Internet Research, E-ISSN 1438-8871, Vol. 22, no 7, article id e17673Article in journal (Refereed)
    Abstract [en]

    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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  • 36.
    Harris, Ulrika
    et al.
    Halmstad University, School of Health and Welfare. Blekinge Centre of Competence, Karlskrona, Sweden.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare.
    Aili, Katarina
    Halmstad University, School of Health and Welfare.
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare.
    Larsson, Ingrid
    Halmstad University, School of Health and Welfare.
    Parents’ Experiences of Direct and Indirect Implications of Sleep Quality on the Health of Children with ADHD: A Qualitative Study2022In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, no 22, article id 15099Article in journal (Refereed)
    Abstract [en]

    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

  • 37.
    Hutton, Katrin
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention. Affecta Psychiatric clinic, Halmstad, Sweden.
    Nygren, Jens
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Nyholm, Maria
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Low self-rated mental health among Swedish adolescent boys and its relationship to socioeconomic factors2013Conference paper (Refereed)
    Abstract [en]

    Background

    Adolescents mental health is a major public health concern and studies have shown that socioeconomic factors contribute to the experienced health of adolescents. Girls’ mental health, more than boys’ mental health, is often discussed. Therefore, the aim of this study was to investigate the association between self-rated mental health and socioeconomic factors among boys and we hypothesized that household wealth influences the association.

    Methods

    In 2011, a cross-sectional study was conducted at seven junior high schools in a medium sized town in south western Sweden. The data collected was based on a self-administrated questionnaire regarding socioeconomic factors, household wealth and health related quality of life (Minnesota Minneapolis Quality of Life Instrument (MMQL). In all, 235 boys between 11-13 years old and 254 boys between 14-16 years participated. The items from MMQL were summarized into a total score and dichotomized by the median and low self-rated mental health was defined as below median. Logistic regression analysis was used.

    Results

    Among younger boys no association between low self-rated mental health and socioeconomic factors were seen. Among older boys with divorced parents, an increased risk of low mental health rating was seen OR: 1.83 (95%CI, 1.04;3.23), however when adjusting for household wealth the association disappeared (OR;1.76, CI 0.98;3.15). Also, having one or two parents born outside Sweden implied increased risk of a low self-rated mental health OR: 2.0 (CI; 1.15;3.47), which remained when adjusting for household wealth variables (OR; 2.16 CI; 1.17;3.99). Furthermore, having two or more negative socioeconomic variables increased the risk of low rated mental health (OR;2.60, CI 1.15;5.90) the association remained after adjusting for household wealth (OR;2.38, CI 1.03;5.33).

    Conclusions

    Boys with divorced parents, boys from migrant backgrounds and boys with several negative socioeconomic factors constituted the identified subgroups at risk. More research in public health is essential to meet the special needs of different age groups and backgrounds among adolescent boys.

    Key messages

    • Among older boys (14-16 years old) with divorced parents, an increased risk of low mental health rating was seen, however when adjusting for household wealth the association disappeared.
    • Among older boys (14-16 years old) having two or more negative socioeconomic variables increased the risk of low rated mental health, the association remained after adjusting for household wealth.

    © The Author 2013. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  • 38.
    Hutton, Katrin
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention. Affecta psychiatric out-patients clinic, Halmstad, Sweden.
    Nyholm, Maria
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Nygren, Jens
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Kadrija, Ibadete (Contributor)
    Halmstad University, School of Health and Welfare.
    Self-rated mental health and socio-economic background: a study of adolescents in Sweden2014In: BMC Public Health, E-ISSN 1471-2458, Vol. 14, no 1, article id 394Article in journal (Refereed)
    Abstract [en]

    Background: Adolescents' mental health is a major public health issue. Previous research has shown that socio-economic factors contribute to the health status of adolescents. The present study explores the association between socio-economic status and self-rated mental health among adolescents.

    Methods: Cross sectional data from the Halmstad Youth Quality of Life cohort was collected in a town in Sweden. In all, 948 adolescents (11-13 younger age group and 14-16 older age group) participated. Information on self-rated mental health was collected from the subscale Psychological functioning in the Minneapolis Manchester Quality of Life instrument. The items were summarized into a total score and dichotomized by the mean. Indicators measuring socio-economic status (SES) were collected in a questionnaire using the Family Affluence Scale (FAS) and additional factors regarding parents' marital status and migration were added. Logistic models were used to analyze the data.

    Results: Girls were more likely to rate their mental health below the mean compared to boys. With regard to FAS (high, medium, low), there was a significantly increased risk of self-rated mental health below the mean among younger boys in the medium FAS score OR; 2.68 (95% CI 1.35;5.33) and among older boys in the low FAS score OR; 2.37 (1.02;5.52) compared to boys in the high FAS score. No such trend was seen among girls. For younger girls there was a significant protective association between having parents born abroad and self-rated mental health below mean OR: 0.47 (0.24;0.91).

    Conclusions: A complex pattern of associations between SES and self-rated mental health, divergent between age and gender groups, was shown. The total FAS score was only associated with boys' self-rated mental health in both age groups, whereas parents' migratory status influenced only the girls' self-rated mental health. Because of the different association for girls' and boys' self-rated mental health and SES, other factors than SES should also be considered when investigating and exploring the mental health of adolescents in affluent communities. © 2014 Hutton et al.; licensee BioMed Central Ltd.

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  • 39.
    Häggström Westberg, Katrin
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Affecta Pscyhiatric Clinic, Halmstad, Sweden.
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Nyholm, Maria
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Carlsson, Ing-Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Lost in Space - an exploration of help-seeking among young people with mental health problems: a constructivist grounded theory study2020In: Archives of Public Health, ISSN 0778-7367, E-ISSN 2049-3258, Vol. 78, article id 93Article in journal (Refereed)
    Abstract [en]

    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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  • 40.
    Häggström Westberg, Katrin
    et al.
    Halmstad University, School of Health and Welfare.
    Nyholm, Maria
    Halmstad University, School of Health and Welfare.
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare.
    Mental Health Problems among Young People—A Scoping Review of Help-Seeking2022In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, no 3, article id 1430Article, review/survey (Refereed)
    Abstract [en]

    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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  • 41.
    Häggström Westberg, Katrin
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Wilhsson, Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Antony, Morgan
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Glasgow Caledonian University, Glasgow, United Kingdom.
    Nyholm, Maria
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Exploring the role of optimism as a protective factor for adolescent quality of lifeManuscript (preprint) (Other academic)
    Abstract [en]

    This study attempts to understand the role that optimism could play in the context of a health asset approach to promote (and protect) adolescent health related quality of life (HRQOL).  Two hypotheses were formulated, a) there is an association between adolescents’ self-rated optimism and pessimism and their HRQOL, (b) age, gender and socio-demographic characteristics influence this association. We explore optimism and pessimism as a bi-dimensional construct and its impact on HRQOL among adolescents in two age groups (11-13 years and 14-16 years). Adolescents answered a self-report questionnaire consisting of two validated scales for measuring HRQOL and the concepts of optimism and pessimism. This study has shown that optimism is an important protective factor for HRQOL and low levels of pessimism were also seen to be protective of HRQOL in both age groups.  This infers the potential of an optimistic orientation about future goals might function as a health asset during adolescence that could be useful in the planning of health promotion strategies.

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  • 42.
    Häggström Westberg, Katrin
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Affecta Psychiatric Out-Patients Clinic, Halmstad, Sweden.
    Wilhsson, Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Morgan, Antony
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Glasgow Caledonian University, Glasgow, United Kingdom.
    Nyholm, Maria
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Optimism as a Candidate Health Asset: Exploring Its Links with Adolescent Quality of Life in Sweden2019In: Child Development, ISSN 0009-3920, E-ISSN 1467-8624, Vol. 90, no 3, p. 970-984Article in journal (Refereed)
    Abstract [en]

    This study aims to understand the role that optimism could play in the context of a health asset approach to promote adolescent health-related quality of life (HRQOL). Adolescents (n = 948), between 11 and 16 years old from a medium-sized rural town in Sweden, answered questionnaires measuring optimism, pessimism, and HRQOL. The findings indicate a significant decrease in optimism and a significant increase in pessimism between early and mid adolescence. The study has allowed us to present associational evidence of the links between optimism and HRQOL. This infers the potential of an optimistic orientation about the future to function as a health asset during adolescence and by implication may provide additional intervention tools in the planning of health promotion strategies. © 2017 The Authors

  • 43.
    Kolossov, Eugen
    et al.
    Axiogenesis AG, 50931 Cologne, Germany.
    Bostani, Toktam
    Institute of Physiology I, University of Bonn, 53105 Bonn, Germany.
    Roell, Wilhelm
    Department of Cardiac Surgery, University of Bonn, 53105 Bonn, Germany.
    Breitbach, Martin
    Institute of Physiology I, University of Bonn, 53105 Bonn, Germany.
    Pillekamp, Frank
    Institute of Neurophysiology, University of Cologne, 50931 Cologne, Germany.
    Nygren, Jens Martin
    Hematopoietic Stem Cell Laboratory, Lund Strategic Research Center for Stem Cell Biology and Cell Therapy, Lund University, 221 00 Lund, Sweden .
    Sasse, Philipp
    Institute of Physiology I, University of Bonn, 53105 Bonn, Germany.
    Rubenchik, Olga
    Institute of Neurophysiology, University of Cologne, 50931 Cologne, Germany.
    Fries, Jochen W U
    Department Pathology, University of Cologne, 50931 Cologne, Germany.
    Wenzel, Daniela
    Institute of Physiology I, University of Bonn, 53105 Bonn, Germany.
    Geisen, Caroline
    Institute of Physiology I, University of Bonn, 53105 Bonn, Germany.
    Xia, Ying
    Institute of Neurophysiology, University of Cologne, 50931 Cologne, Germany.
    Lu, Zhongju
    Institute of Neurophysiology, University of Cologne, 50931 Cologne, Germany.
    Duan, Yaqi
    Institute of Neurophysiology, University of Cologne, 50931 Cologne, Germany.
    Kettenhofen, Ralf
    Axiogenesis AG, 50931 Cologne, Germany.
    Jovinge, Stefan
    Hematopoietic Stem Cell Laboratory, Lund Strategic Research Center for Stem Cell Biology and Cell Therapy, Lund University, 221 00 Lund, Sweden.
    Bloch, Wilhelm
    German Sports University, 50927 Cologne, Germany.
    Bohlen, Heribert
    Axiogenesis AG, 50931 Cologne, Germany.
    Welz, Armin
    Department of Cardiac Surgery, University of Bonn, 53105 Bonn, Germany.
    Hescheler, Jürgen
    Institute of Neurophysiology, University of Cologne, 50931 Cologne, Germany.
    Jacobsen, Sten Eirik
    Hematopoietic Stem Cell Laboratory, Lund Strategic Research Center for Stem Cell Biology and Cell Therapy, Lund University, 221 00 Lund, Sweden.
    Fleischmann, Bernd K
    Institute of Physiology I, University of Bonn, 53105 Bonn, Germany.
    Engraftment of engineered ES cell-derived cardiomyocytes but not BM cells restores contractile function to the infarcted myocardium2006In: Journal of Experimental Medicine, ISSN 0022-1007, E-ISSN 1540-9538, Vol. 203, no 10, p. 2315-2327Article in journal (Refereed)
    Abstract [en]

    Cellular cardiomyoplasty is an attractive option for the treatment of severe heart failure. It is, however, still unclear and controversial which is the most promising cell source. Therefore, we investigated and examined the fate and functional impact of bone marrow (BM) cells and embryonic stem cell (ES cell)-derived cardiomyocytes after transplantation into the infarcted mouse heart. This proved particularly challenging for the ES cells, as their enrichment into cardiomyocytes and their long-term engraftment and tumorigenicity are still poorly understood. We generated transgenic ES cells expressing puromycin resistance and enhanced green fluorescent protein cassettes under control of a cardiac-specific promoter. Puromycin selection resulted in a highly purified (>99%) cardiomyocyte population, and the yield of cardiomyocytes increased 6-10-fold because of induction of proliferation on purification. Long-term engraftment (4-5 months) was observed when co-transplanting selected ES cell-derived cardiomyocytes and fibroblasts into the injured heart of syngeneic mice, and no teratoma formation was found (n = 60). Although transplantation of ES cell-derived cardiomyocytes improved heart function, BM cells had no positive effects. Furthermore, no contribution of BM cells to cardiac, endothelial, or smooth muscle neogenesis was detected. Hence, our results demonstrate that ES-based cell therapy is a promising approach for the treatment of impaired myocardial function and provides better results than BM-derived cells.

  • 44.
    Kronsell, Lisa
    et al.
    Halmstad University, School of Health and Welfare.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Larsson, Ingrid
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Parents’ Perceptions of the Value of Children’s Participation in Pediatric Rehabilitation Services: A Phenomenographic Study2021In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, no 20, article id 10948Article in journal (Refereed)
    Abstract [en]

    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.

  • 45.
    Larsson, Ingrid
    et al.
    Halmstad University, School of Health and Welfare.
    Aili, Katarina
    Halmstad University, School of Health and Welfare.
    Lönn, Maria
    Halmstad University, School of Health and Welfare. Psychiatry Halland, Halmstad, Sweden.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare.
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare.
    Ivarsson, Andreas
    Halmstad University, School of Health and Welfare.
    Johansson, Pia
    Halmstad University, School of Health and Welfare.
    Sleep interventions for children with attention deficit hyperactivity disorder (ADHD): A systematic literature review2023In: Sleep Medicine, ISSN 1389-9457, E-ISSN 1878-5506, Vol. 102, p. 64-75Article, review/survey (Refereed)
    Abstract [en]

    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

  • 46.
    Larsson, Ingrid
    et al.
    Halmstad University, School of Health and Welfare.
    Aili, Katarina
    Halmstad University, School of Health and Welfare.
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare.
    Jarbin, Håkan
    Region Halland.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare.
    Parents’ Experiences of Weighted Blankets’ Impact on Children with Attention-Deficit/Hyperactivity Disorder (ADHD) and Sleep Problems—A Qualitative Study2021In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, no 24, article id 12959Article in journal (Refereed)
    Abstract [en]

    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.

  • 47.
    Larsson, Ingrid
    et al.
    Halmstad University, School of Health and Welfare. Spenshult Research and Development Centre, Halmstad, Sweden; Department of Clinical Sciences, Lund University, Lund, Sweden.
    Aili, Katarina
    Halmstad University, School of Health and Welfare.
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare.
    Johansson, Pia
    Halmstad University, School of Health and Welfare.
    Jarbin, Håkan
    Faculty of Medicine, Lund University, Lund, Sweden; Child and Adolescent Psychiatry, Region Halland, Halmstad, Sweden.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare.
    SLEEP: intervention with weighted blankets for children with attention deficit hyperactivity disorder (ADHD) and sleep problems2022In: BMJ Open, E-ISSN 2044-6055, Vol. 12, no 1, article id e047509Article in journal (Refereed)
    Abstract [en]

    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.

  • 48.
    Larsson, Ingrid
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Nyman, Carin
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Carlsson, Ing-Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Children and young people’s participation in developing interventions in health and well-being: a scoping review2018In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 18, no 507Article, review/survey (Refereed)
    Abstract [en]

    Background: Greater interest is being shown in participatory approaches, especially in research on interventions that concern children and young people'shealth and well-being. Although participatory approaches have user involvement in common, they differ in terms of the explicit guidance on how to actually involve and engage children and young people in health research. The aim of this scoping review was to systematically map recent research involving children and young people in the development of interventions targeting issues of health and well-being. Methods: An interpretative scoping literature review based on: a scientific literature search in (health and social science) databases, reference lists, a manual search in key journals and contact with existing networks was conducted. A total of 4458 references were identified through the literature search, of which 41 studies published between 2000 and 2017 were included in the review. The target population was children and young people under 25 years old. Level of participation was categorized according to Shier's Pathways to Participation Model. Results: The review showed that participatory approaches were most often used in the development of interventions in school settings and in community and healthcare settings and on issues concerning support in lifestyle or in managing illness or disease. The level of participation varied from children and young people taking part just as active informants, through stages of greater participation both in quantitative and qualitative terms, to children and youngpeople becoming an active agent involved as a co-researcher where the research process was shaped by views of a higher level of mutuality. Most of the studies were categorised at a medium level and only three studies were judged to involve the children and young people at the highest level. Conclusions: This scoping review showed that work remains in enabling children and young people to influence the development of interventions targeting health and well-being. In relation to level of sustainability in the interventions, it is relevant that goals, strategies and processes are formulated by those who can gain from the interventions. Participatory approaches aiming for a higher level of participation where children and young people work together with the researchers in partnerships are thus warranted. © 2018 The Author(s).

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  • 49.
    Larsson, Ingrid
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Arvidsson, Susann
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Carlsson, Ing-Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Parents’ experiences of an e-health intervention implemented in pediatric healthcare: a qualitative study2019In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 19, article id 800Article in journal (Refereed)
    Abstract [en]

    Background: The growing field of participation in healthcare has the potential to provide a number of benefits for children, patients, healthcare professionals and also the healthcare systems. According to the Convention on the Rights of the Child (UNCRC), children have the right to participate in their own healthcare and make their voice heard. Children’s opportunities for understanding their conditions, sharing their views and participating in decisions regarding their care depend on healthcare professionals but also on parents’ ability to communicate and include children. E-health solutions can remove barriers to children’s communication with healthcare professionals. The aim of this study was to explore parents’ perspectives on the outcomes of an e-health solution, Sisom, used by children during healthcare appointments.

    Methods: The empirical data is based on interviews with 16 parents. In the present study constructivist, grounded theory was chosen as the method.

    Results: The theory of enhancing participation, by orientating communication about healthcare towards the voice of the child instead of the parents, summarizes the process of how the outcome of Sisom for children lead to enhanced participation, by making the child the main actor and an agent in his/her own healthcare. The facilitators for achieving participation in Sisom were four interrelated outcomes; engaging, voice-guarding, raising awareness and integrity preserving. In addition to generating increased participation, it emerged that the use of Sisom also initiated a process, which was evident in all four subcategories that facilitated the child in coping with the experience of having an illness.

    Conclusions: We conclude, that Sisom orientated communication about healthcare towards the voice of the child instead of the parents as well as including the child in the dialogue with the healthcare professional and thus increasing the child’s participation and human rights. © 2019 The Author(s)

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  • 50.
    Lindberg, Susanne
    et al.
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS), Man and Information technology laboratory (MI-lab).
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Bergquist, Magnus
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS), Man and Information technology laboratory (MI-lab).
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Evaluating Digital Peer Support for Children Cured from Cancer2017In: International Journal of Human-Computer Interaction, ISSN 1044-7318, E-ISSN 1532-7590, Vol. 33, no 8, p. 664-676Article in journal (Refereed)
    Abstract [en]

    This article describes a case study of the challenges that emerged from a formative evaluation process with the purpose of evaluating a digital peer support (DPS) service for children between 8 and 12 cured from cancer. The evaluation of DPS for children is particularly challenging. While the literature on evaluation with children is extensive, challenges such as risk assessment that become prevalent in the evaluation of DPS are not highlighted. This case study analyzes how the DPS service was evaluated over the course of two usability tests, a two-week diary study, a focus group interview, and a survey. Challenges relating to ethics, trust, risk assessment, and recruitment emerged during the evaluation process. We identify key strategies to handle these challenges: progression, proxies, and reflection. Performing a multistage evaluation process with progressing sensitivity allowed control of some of the complexities of the context in order to balance the degree of the children’s involvement with the degree of sensitivity. © 2017 Taylor & Francis Group, LLC

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