Berit Nordström

Needs of young children with cancer during their initial hospitalization: an observational study.

The aim of this study was to describe young (under the age of 7) children’s needs as expressed by their behavior, body language and verbal expression through observations during their initial hospitalization after being diagnosed with cancer. Twelve children under the age of seven were followed during 26 hours with non-participant unstructured observations. Field notes were written after each observation and transcribed into a narrative text, which was analyzed by content analysis at both manifest and latent level. Five themes were identified, of which “need to have the parent close by” was the most prominent. The other themes were “need to play and feel joy,” “need for participation in care and treatment,” “need for a good relationship with the staff,” and “need for physical and emotional satisfaction.” The results indicate that the children needed their parents and the parents’ presence helped the children to express other needs. Professionals need to support the child and his or her parents so that the parents in their turn can support and alleviate their child’s hospitalization and cancer treatment.

Parents’ experience of having a child with autism and learning disabilities living in a group home: A case study

Some children with autism and learning disabilities also have aberrant behaviours that are difficult to regulate and stressful for both the child and family members. This case study concerns experiences of 10 parents from five families before and 2 years after entrusting their 10- to 11-year-old child with autism to a group home. Hermeneutic phenomenological analysis of narrative interviews with the parents before the child’s moving showed them experiencing grief and sorrow, total exhaustion because of inability to regulate their child’s behaviours, social isolation, and negative effects on the child’s siblings, but experiencing themselves as more sympathetic than previously towards other people with problems. Two years later they experienced relief for the family due to the group home arrangement and the child’s improvement, but with an ethical dilemma which made them feel guilty, despite increased hope for the future. Some also felt unhappy with the staff situation at the group home.

Alterations of prolyl endopeptidase activity in the plasma of children with autistic spectrum disorders.

BackgroundProlyl Endopeptidase (PEP, EC 3.4.21.26), a cytosolic endopeptidase, hydrolyses peptide bonds on the carboxyl side of proline residue in proteins with a relatively small molecular weight. It has been shown that altered PEP activity is associated with various psychological diseases such as schizophrenia, mania and depression. Autistic Spectrum Disorders (ASD) are neuropsychiatric and behavioural syndromes affecting social behaviours and communication development. They are classified as developmental disorders. The aim of this study was to examine the hypothesis that PEP activity is also associated with ASDs.MethodsFluorometric assay was used to measure PEP activity in EDTA plasma in children with ASD (n = 18) aged 4–12 years (mean ± SD: 7.9 ± 2.5). These results were then compared to PEP activity in a control group of non-ASD children (n = 15) aged 2–10 years (mean ± SD: 6.4 ± 2.2).ResultsAn alteration in PEP activity was found in the children with ASD compared to the control group. There was much greater variation of PEP activity in the group of ASD children when compared to the controls (SD= 39.9 and SD 9.6, respectively). This variation was significant (p < 0.0005), although the mean level of PEP activity in the group of ASD children was slightly higher than in the control group (124.4 and 134.1, respectively).ConclusionOur preliminary finding suggests a role for PEP enzyme in the pathophysiology of autism but further research should be conducted to establish its role in the aetiology of psychiatric and neurological disorders, including autism and related spectrum disorders.

High Complement Factor I Activity in the Plasma of Children with Autism Spectrum Disorders

Autism spectrum disorders (ASDs) are neurodevelopmental and behavioural syndromes affecting social orientation, behaviour, and communication that can be classified as developmental disorders. ASD is also associated with immune system abnormality. Immune system abnormalities may be caused partly by complement system factor I deficiency. Complement factor I is a serine protease present in human plasma that is involved in the degradation of complement protein C3b, which is a major opsonin of the complement system. Deficiency in factor I activity is associated with an increased incidence of infections in humans. In this paper, we show that the mean level of factor I activity in the ASD group is significantly higher than in the control group of typically developed and healthy children, suggesting that high activity of complement factor I might have an impact on the development of ASD.

Measuring care of the elderly: psychometric testing and modification of the Time in Care instrument for measurement of care needs in nursing homes

BackgroundAging entails not only a decrease in the ability to be active, but also a trend toward increased dependence to sustain basic life functions. An important aspect for appropriately elucidating the individuals care needs is the ability to measure them both simply and reliably. Since 2006 a new version of the Time in Care needs (TIC-n) instrument (19-item version) has been explored and used in one additional municipality with the same structure as the one described in an earlier study.MethodsThe TIC-n assessment was conducted on a total of 1282 care recipients. Factor analysis (principal component) was applied to explore the construct validity of the TIC-n. Cronbachs alpha was calculated to test reliability and for each of the items remaining in the instrument after factor analysis, an inter-rater comparison was carried out on all recipients in both municipalities. Independently of each other, a weighted Kappa (Kw) was calculated. Results. The mean of each weighted Kappa (Kw) for the dimensions in the two municipalities was 0.75 and 0.76, respectively. Factor analysis showed that all 19 items had a factor loading of ≥ 0.40. Three factors (General Care, Medical Care and Cognitive Care) were created.ConclusionThe TIC-n instrument has now been tested for validity and reliability in two municipalities with satisfactory results. However, TIC-n can not yet be used as a golden standard, but it can be recommended for use of measurement of individual care needs in municipal elderly care.

Screening of infants at eight months for atypical development in primary health care in southern Sweden

Screening studies of a population in primary health care are sparsely reported. The aim was to describe observed atypical behaviours that may be associated with autism spectrum conditions, in a population (n = 4329) of infants at eight months. Observations were performed by paediatric nurses. An observational instrument, named SEEK developed for child health care, was used focusing on social interaction, communication, motor skills, and an interview with parents. The analysis contains descriptive statistics, correlation analysis and a logistic regression model (cut-point 8 SEEK points). Infants scoring 8 points or more were observed a second time by psychologists and judged to be in the risk zone for atypical development. Delayed reaction to stimuli and preverbal language development were significant atypical behaviours together with deficits in communication skills, the latter more often among boys than girls. However, 7% scored 4 points or more indicating minor developmental problems. Catching early signs are crucial for both proactive care and intervention.

Staff Members' Views of the Work Climate in Sheltered Homes for Adults with Autism Spectrum Disorders

The mean scores of the Creative Climate Questionnaire for 152 staff members working in 58 sheltered homes for individuals with autism were rated closer to creative than to stagnant organizations. There was a significant difference between two types of settings. In sheltered homes, the persons with autism had their daily activity outside the home. Here staff members had higher scores in all creative dimensions compared to homes with daily activities. Staff in sheltered homes, where the residents leave the premises for their daily work or activities, perceived the work climate as significantly more creative and satisfying.

Psychosocial Risk Factors in Families with Infants: A Municipality Survey:

Difficulties in a familys psychosocial situation during the period of infancy are associated with mental problems and behavioural disorders in children. The aim of the study was to identify the extent and type of psychosocial factors in families with infants, including social aspects, mental problems and substance abuse as well as circumstances surrounding the birth. All infants born between March 1st 2000 and August 31st 2001 whose parents had adequate knowledge of the Swedish language (N=576) were included. Data were collected by means of a questionnaire. Psychosocial risk factors were found in the families of 24% of infants whose mothers were of Swedish origin and in the families of 58% of infants whose mothers were of foreign origin. The most common risk factors were: unemployment, premature birth, and one or both parents exhibiting signs of great worry and anxiety in relation to their child and parenthood. The study also shows that mental problems and substance abuse were only present in a very small number of parents. Furthermore, the study indicates the need to review the strategies used within child health care to identify families at risk of developing mental problems and behavioural disorders as a result of dysfunctionality in their psychosocial situation during their childs infancy. It is important to study the professional network surrounding families in more detail, both in order to detect psychosocial risk factors and to develop and evaluate interventions.