SIBS Søskenprosjektet

Denne artikkelen oppsummerer kunnskapen om effekten av søskenintervensjonen SIBS til barn med kroniske helsetilstander. Intervensjonen baserer seg på familiesystemisk teori med elementer fra resiliensteori, familiekommunikasjon, forståelse av sykdom og helsekunnskap samt kognitiv atferdsterapi. Intervensjonen er et manualbasert gruppetiltak der søsken og en forelder deltar over fem økter. Tre av de fem øktene er separate barne- og foreldregrupper. Det overordnede målet er å styrke kvaliteten på kommunikasjonen mellom foreldre og barn for slik å redusere risiko for utvikling av psykiske plager hos søsken som pårørende. Tiltaket tilbys av Frambu kompetansesenter for sjeldne diagnoser som gir opplæring i tiltaket og utdanner gruppeledere. Det eies av Frambu og Universitetet i Oslo

Kunnskapsoppsummering og klassifisering av tiltaket: Telemarksmodellen: Vegen blir til mens vi går den sammen (1.utg.)

Source at https://ungsinn.no/post_tiltak_arkiv/telemarksmodellen-vegen-blir-til-mens-vi-gar-den-sammen/.Bakgrunn - Telemarksmodellen er en kursrekke utviklet for å fremme psykisk helse og forebygge sosiale vansker for barn som har forståelsesvansker i form av en lett psykisk utviklingshemming. Kursene gis når barnet går på mellomtrinnet i barneskole, ungdomstrinnet og i videregående skole. Formen er psykoedukativ hvor en veksler mellom informasjon, råd, veiledning og samtale om et hverdagsliv med forståelsesvansker. En slik terapeutisk kunnskapsformidling og møte med andre i samme situasjon, ansees å bidra til økt mestring og kompetanse. Denne artikkelen beskriver Telemarksmodellen. Det er et tiltak som tilbys barn som får diagnosen lett psykisk utviklingshemming og deres foresatte. Tiltaket gis i etterkant av diagnostisk utredning i Habilitering for barn og unge (HABU) i Sykehuset Telemark. Kursrekken gis i separate grupper hvor barna, ungdommene og foresatte har hvert sitt kursprogram. Tema i kursene er knyttet til aktuelle livsfaser og omhandler kropp, hygiene, fritid, vennskap, pubertet, seksuell helse, arbeid og hjelpestønader. Tiltaket er utviklet av og driftes av HABU Sykehuset Telemark. Metode - Denne gjennomgangen er basert på tilsendt informasjon fra utvikleren av Telemarksmodellen, i tillegg til litteratursøk etter studier om tiltaket. Søket ble gjennomført i databasene Embase, Medline og Psykinfo, NORART, Cochrane, Google Scholar, Cristin, NORA, Norart, SCOPUS, SweMed+, Cambell, NREPP, NICE, Blueprint, Helsebiblioteket.no, CEBC, Vidensportalen, Metodeguiden og CINAHL plus with Full Text. Resultater - Resultatene består av en vurdering av tiltakets beskrivelse, foreliggende effektstudier, forskningsmetodisk kvalitet og implementeringskvalitet. Det ble ikke identifisert noen studier som har undersøkt effekt eller evalueringer av Telemarksmodellen. I materialet som foreligger fremstår ikke Telemarksmodellen å være beskrevet for å gi ekstern opplæring i metoden. Tiltaket virker kun å være gjennomført ved Sykehuset Telemark. Det foreligger ingen implementeringsplaner og derfor heller ikke noen beskrevet implementeringsstrategi. Konklusjon - Basert på Ungsinn sine kriterier klassifiseres Telemarksmodellen på evidensnivå 1- godt beskrevne tiltak

Impact supplement of the strengths and difficulties questionnaire in the assessment of functional impairment in children with ADHD or ASD in a mixed neuropediatric sample: A partial validation study

Background: In addition to symptoms of neurodevelopmental disorders, functional impairment is crucial to the determination of clinical significance. The aim of this study was to examine partial validity and usefulness of the Strengths and Difficulties Questionnaire’s (SDQ) impact supplement (SDQ impact) in measuring functional impairment in children and adolescents diagnosed with attention deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD) in neuropediatric clinics. Methods: Participants were children and adolescents (N = 337) referred to neuropediatric outpatient clinics for neurodevelopmental assessment. Functional impairment was evaluated using three instruments: the SDQ impact, the Vineland Adaptive Behavior Scale (VABSII), and the Children’s Global Assessment Scale (CGAS). Mental health symptoms and intellectual function were also assessed. We investigated convergent and concurrent validity of the SDQ impact. Results: The convergent validity of the SDQ impact was shown by its significant correlations with the VABS-II composite score and the CGAS total score. The concurrent validity of the SDQ impact was demonstrated by its significant relationship with ADHD and ASD diagnoses in logistic regression analyses. Using established cutoffs, the sensitivity of the SDQ impact to reveal functional impairment in children with ADHD and ASD diagnoses was demonstrated in this neuropediatric sample, but at the cost of low specificity. Conclusion: The SDQ impact is an easy-to-use tool, and the overall study results indicate that it is partially valid, suggesting it may be used for the screening of general functional impairment in the neuropediatric population

Invisible emotional expressions influence social judgments and pupillary responses of both depressed and non-depressed individuals.

We used filtered low spatial frequency images of facial emotional expressions (angry, fearful, happy, sad, or neutral faces) that were blended with a high-frequency image of the same face but with a neutral facial expression, so as to obtain a “hybrid” face image that “masked” the subjective perception of its emotional expression. Participants were categorized in three groups of participants: healthy control participants (N = 49), recovered previously depressed (N = 79), and currently depressed individuals (N = 36), All participants were asked to rate how friendly the person in the picture looked. Simultaneously we recorded, by use of an infrared eye-tracker, their pupillary responses. We expected that depressed individuals (either currently or previously depressed) would show a negative bias and therefore rate the negative emotional faces, albeit the emotions being invisible, as more negative (i.e., less friendly) than the healthy controls would. Similarly, we expected that depressed individuals would overreact to the negative emotions and that this would result in greater dilations of the pupil's diameter than those shown by controls for the same emotions. Although we observed the expected pattern of effects of the hidden emotions on both ratings and pupillary changes, both responses did not differ significantly among the three groups of participants. The implications of this finding are discussed

Visual problems are associated with long-term fatigue after stroke

Objective: Post-stroke fatigue may be associated with functioning even in patients with mild stroke. In order to guide rehabilitation, the aim of this study was to investigate the independent contribution of 12 function-related domains to severe long-term fatigue. Design: Observational follow-up study. Subjects: A total of 144 stroke survivors (mean age 67.3, standard deviation (SD) 10.9 years) were included. Methods: Fatigue 3–4 years post-stroke was measured with the Fatigue Severity Scale (cut-off ≥5). Independent variables were the multidimensional Stroke-Specific Quality of Life scale with 12 domains, demographics, and baseline stroke characteristics. Results: Most of the participants had mild and moderate stroke. Thirty-five percent (n = 51) reported severe fatigue 3–4 years after stroke. Those living with a significant other, and working participants reported significantly less fatigue. All domains of the Stroke-specific Quality of Life scale were significantly associated with the Fatigue Severity Scale. Adjusted for age, sex, marital status, and work status, the domains “energy”, “mood”, and, unexpectedly, the domain “vision”, were all variables independently associated with severe long-term fatigue. Conclusion: Stroke survivors with prominent self-reported visual problems were more likely to experience fatigue. This finding should be verified in further studies. Visual examination and visual rehabilitation may reduce fatigue in selected stroke survivors

Cortisol levels and cognitive profile in major depression: A comparison of currently and previously depressed patients

Source at https://doi.org/10.1016/j.psyneuen.2018.08.024.The association between depressive symptoms and elevated cortisol levels, and depression and cognitive functioning, has been less robust in outpatients with symptoms in the mild to moderate range. Furthermore, the association between elevated cortisol levels and cognitive functioning is unclear. In the present study, currently depressed (n = 37), previously depressed (n = 81) and never depressed controls (n = 50) were assessed on a range of neuropsychological measures. Salivary cortisol was measured in the morning and evening. Participants with current depression were non-hospitalized and had symptoms predominately in the mild to moderate range. Elevated salivary evening cortisol, but not morning cortisol, was significantly related to depressive symptoms. The difference in cortisol levels between the previously depressed group and the never depressed controls was not significant. The groups had significantly different cognitive profiles, with the currently depressed performing poorer on tasks related to working memory compared to the never depressed controls. Both the currently and previously depressed performed worse on attentional tasks. The findings indicate that outpatients with mild to moderate depression have elevated cortisol levels and limited mild cognitive impairments. Furthermore, mild impairments in attention may persist after remission, indicating that this could be a trait-marker in depression. The present study did not find support for a significant relationship between cortisol and cognitive functioning

Use of health and dental care services in adults with intellectual disability in relation to age and intellectual disability levels

Background - This study investigates the use of health and dental care services in adults with intellectual disability in the last 12 months according to Norwegian recommendations and in relation to age and intellectual disability levels. Method - A cross-sectional community-based survey including 214 participants (56% men). POMONA health indicators were used for data collection. Results - Health checks and contact with general practitioners in the last year increased with age but were less frequent in those with more severe intellectual disability. Hospital admissions were age independent. Less than one-fifth of women had undergone cancer screening, with small variations according to intellectual disability severity levels. Few had an individual plan. More than one-third experienced poor dental health despite frequent controls. Conclusions - The use of health checks was lower than recommended, especially in individuals with more severe intellectual disability. Service access and individual plan use need to be enhanced, and dental care services should be improved

Reliability of maximum oxygen uptake in cardiopulmonary exercise testing with continuous laryngoscopy

Aims: A cardiopulmonary exercise test (CPET) is the gold standard to evaluate symptom-limiting exercise intolerance, while continuous laryngoscopy performed during exercise (CLE) is required to diagnose exercise-induced laryngeal obstruction. Combining CPET with CLE would save time and resources; however, the CPET data may be distorted by the extra equipment. We therefore aimed to study whether CPET with CLE influences peak oxygen uptake (V′O2peak) and other gas exchange parameters when compared to a regular CPET. Methods: Forty healthy athletes without exercise-related breathing problems, 15–35 years of age, performed CPET to peak exercise with and without an added CLE set-up, in randomised order 2–4 days apart, applying an identical computerised treadmill protocol. Results: At peak exercise, the mean difference (95% confidence interval) between CPET with and without extra CLE set-up for V′O2peak, respiratory exchange ratio (RER), minute ventilation (V′E) and heart rate (HR) was 0.2 (−0.4 to 0.8) mL·kg−1·min−1, 0.01(−0.007 to 0.027) units, 2.6 (−1.3 to 6.5) L·min−1 and 1.4 (−0.8 to 3.5) beats·min−1, respectively. Agreement (95% limits of agreement) for V′O2peak, RER and V′E was 0.2 (±3.7) mL·kg−1·min−1, 0.01 (±0.10) units and 2.6 (±24.0) L·min−1, respectively. No systematic or proportional bias was found except for the completed distance, which was 49 m (95% CI 16 to 82 m) longer during CPET. Conclusion: Parameters of gas exchange, including V′O2peak and RER, obtained from a maximal CPET performed with the extra CLE set-up can be used interchangeably with data obtained from standard CPET, thus preventing unnecessary additional testing.publishedVersio

Validering av den norske foreldreversjonen av Developmental Behavior Checklist (DBC-P)

This study examined the psychometric properties of the Norwegian version of the Developmental Behavior Checklist – Parent (DBC-P) in an intellectual and developmental disabilities (IDD) sample of children and adolescents (N = 168). Internal consistency was adequate to excellent for all scales (Cronbach’s alpha ranged between .70–.96). The DBC-P showed meaningful overlap with and differentiation from the Aberrant Behavior Checklist, clinical diagnoses, the Vineland Adaptive Behavior Scales, and the Full Scale IQ. The Norwegian scale scores for a mild IDD level were comparable with the American norms. Further research including severe IDD levels is needed on the Norwegian DBC-P. In summary, the study shows that the Norwegian DBC-P has both adequate reliability and validity

Opplæring i ikke-eksperimentelle funksjonelle analyser eller FAK-analyser

Funksjonelle analyser er metoder som avdekker sammenhenger mellom atferd og miljøhendelser. En variant er deskriptive funksjonelle analyser der observatørene registrerer hendelser i miljøet i forkant og etterkant av den angitte atferden. Denne varianten kalles FAK-analyser (Foranledning-Atferd-Konsekvens). I studien undersøker vi om en opplæringspakke har effekt på deltagernes ferdigheter i FAK-analyser. Deltagerne hadde ikke tidligere mottatt systematisk opplæring i FAK-analyser. Deltagerne gjennomførte FAK-analyser basert på video-opptak av personer med utfordrende atferd. Første opplæringssekvens viser lav effekt, og data fra observatørene kunne ikke brukes til å trekke slutninger om atferdsfunksjoner. En ny og forenklet opplæring ble gjennomført. Deltagerne ble testet som tidligere, men skulle kun beskrive foranledninger og konsekvenser av atferd og ikke trekke slutninger om atferdens funksjon. Andelen av FAK-analyser som var korrekt utfylte etter andre opplæring var 90 %. Studien indikerer at det er mulig å lære opp personalet raskt i observasjon og objektive beskrivelser av foranledninger og konsekvenser av atferd