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  • 1. Bergström, Malin
    et al.
    Fransson, Emma
    Fabian, Helena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Hjern, Anders
    Sarkadi, A
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Salari, Raziye
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Preschool children living in joint physical custody arrangements show less psychological symptoms than those living mostly or only with one parent2017In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, ISSN 0803-5253, Vol. 107, p. 294-300Article in journal (Refereed)
  • 2.
    Bergström, Malin
    et al.
    Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden; Clinical Epidemiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
    Fransson, Emma
    Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden.
    Fabian, Helena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Hjern, Anders
    Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden; Clinical Epidemiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Salari, Raziye
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Preschool children living in joint physical custody arrangements show less psychological symptoms than those living mostly or only with one parent2018In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 107, no 2, p. 294-300Article in journal (Refereed)
    Abstract [en]

    AIM: Joint physical custody (JPC), where children spend about equal time in both parent's homes after parental separation, is increasing. The suitability of this practice for preschool children, with a need for predictability and continuity, has been questioned.

    METHODS: In this cross-sectional study, we used data on 3656 Swedish children aged three to five years living in intact families, JPC, mostly with one parent or single care. Linear regression analyses were conducted with the Strengths and Difficulties Questionnaire, completed by parents and preschool teachers, as the outcome measure.

    RESULTS: Children in JPC showed less psychological problems than those living mostly (adjusted B 1.81; 95% CI [0.66 to 2.95]) or only with one parent (adjusted B 1.94; 95% CI [0.75 to 3.13]), in parental reports. In preschool teacher reports, the adjusted Betas were 1.27, 95% CI [0.14 to 2.40] and 1.41, 95% CI [0.24 to 2.58], respectively. In parental reports, children in JPC and those in intact families had similar outcomes, while teachers reported lower unadjusted symptom scores for children in intact families.

    CONCLUSION: Joint physical custody arrangements were not associated with more psychological symptoms in children aged 3-5, but longitudinal studies are needed to account for potential preseparation differences.

  • 3.
    Bokström, Pär
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Fängström, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Calam, Rachel
    The University of Manchester.
    Lucas, Steven
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics. Uppsala University, National Centre for Knowledge on Men.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    'I felt a little bubbly in my tummy': Eliciting pre-schoolers' accounts of their health visit using a computer-assisted interview method.2016In: Child Care Health and Development, ISSN 0305-1862, E-ISSN 1365-2214, Vol. 42, no 1, p. 87-97Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: In the health care services, children's rights to participate in all matters that concern them are considered important. However, in practice this can be challenging with young children. In My Shoes (IMS) is a computer-assisted interview tool developed to help children talk about their experiences. The aim of the study was to evaluate the IMS' ability to elicit pre-schoolers' subjective experiences and accurate accounts of a routine health visit as well as the children's engagement in the interview process.

    METHODS: Interviews were conducted with 23 children aged 4-5 years, 2-4 weeks after their health visit. The interviews were transcribed verbatim and analysed using a method inspired by Content Analysis to evaluate IMS's ability to elicit accounts about subjective experiences. Accurate accounts were assessed by comparing the transcribed interviews with the filmed visits at the child health centre. The children's engagement was defined by the completion and length of the interviews, and the children's interaction with the software.

    RESULTS: All children gave accounts about their subjective experiences, such as their emotional state during the visit, available toys or rewards they received. All children related to the correct event, they all named at least one person who was present and 87% correctly named at least one examination procedure. The majority of children (91%) completed the interview, which lasted 17-39 min (M = 24), and 96% interacted with the IMS software.

    CONCLUSIONS: IMS was feasible to help children describe their health care experiences, in both detail and depth. The children interacted with the software and maintained their interest for an extended period of time.

  • 4.
    Bokström, Pär
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Föräldrastöd i förskolan2013In: Föräldrar, förskola och skola: om mångfald, makt och möjligheter / [ed] Anne Harju, Ingegerd Tallberg Broman, Lund: Studentlitteratur, 2013, 1, p. 193-207Chapter in book (Other (popular science, discussion, etc.))
    Abstract [sv]

    Trots att utvecklingen mot en socialt ansvarstagande skola har pågått under lång tid, så är föräldrastödsprogram som levereras i förskolans regi någonting nytt i Sverige. Närheten till både barn och föräldrar har visat sig vara en utmärkt utgångspunkt för den här typen av verksamhet. Föräldrarna litar på pedagogernas kompetens och känner en trygghet i att de känner deras barn väl. Men det medför också utökade arbetsuppgifter och fördjupade ansvarsområden för pedagogerna, då föräldrastöd går utanför den traditionella verksamheten. Det medför i sin tur att pedagogerna i viss mån får en ny roll i sitt arbete med barnen, och även gentemot föräldrarna. Forskning på området är ytterst sparsam, både i Sverige och internationellt. Anledningen till det är att föräldrastöd på förskola är ovanligt, med hittills endast ett genomfört projekt i Sverige.

  • 5.
    Cederblad, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Nevéus, Tryggve
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Ahman, Annika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Österlund Efraimsson, E.
    School of Health and Social Studies, Dalarna University, Falun, Sweden.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    "Nobody Asked Us if We Needed Help": Swedish parents experiences of enuresis2014In: Journal of Pediatric Urology, ISSN 1477-5131, E-ISSN 1873-4898, Vol. 10, no 1, p. 74-79Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To explore the everyday dilemmas of parents living with a child with nocturnal enuresis and to describe their support needs in relation to healthcare professionals.

    SUBJECTS AND METHODS: The study was conducted in 2011 in Uppsala County, Sweden. Parents of 13 children with enuresis, 10 mothers and three fathers, participated in qualitative semi-structured in-depth interviews, which were analysed using systematic text condensation.

    RESULTS: The analysis of the material resulted in six themes: enuresis is socially stigmatising and handicapping; all practices and home remedies are tested; it creates frustration in the family; protecting the child from gossip or teasing; support from healthcare providers would have helped; it's something we just have to live with. Two patterns of coping were identified: the Unworried wet-bed-fixers and the Anxious night-launderers.

    CONCLUSION: Having a child with enuresis can be stressful for parents, although they tried hard not to blame their child. Because parents can feel reluctant to bring up enuresis themselves, they want child health nurses to routinely raise the issue of bedwetting at the yearly check-up. Parents' information needs included causes of and available treatment options for enuresis as well as access to aids and other support for affected families.

  • 6.
    Cederblad, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Engvall, Gunn
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Nevéus, Tryggve
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Infrequent enuresis, the uninvestigated majority: comparisons between children with enuresis of varying severity.2015In: Journal of Pediatric Urology, ISSN 1477-5131, E-ISSN 1873-4898, Vol. 11, no 1, p. 24.e1-24.e6Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The main objective was to compare children with frequent enuresis (FE) and children with infrequent enuresis (IE) using anamnestic data and variables related to bladder and kidney function. A secondary aim was to look at the group of children who wet their beds every single night, a phenomenon we chose to call constant enuresis (CE).

    SUBJECTS AND METHODS: The parents recorded the number of wet and dry nights for a period of 14 days, and measured the voided volumes as well as nocturnal urine production for 48 h. History data relevant to bladder and bowel function was also recorded.

    RESULTS: The children could be grouped as follows: IE, n = 14; FE, n = 18; and CE, n = 22. The children with IE were slightly older than the other groups, IE mean 7.57; FE mean 6.22; CE, mean 6.56 (p = 0.004). When comparing the groups in terms of the measured parameters, only one significant difference was found: the FE group had larger average daytime voided volumes, but only when the first morning void was included. The only significantly differing anamnestic variable was previous daytime incontinence, which was more common among the children in the IE group.

    CONCLUSIONS: When comparing children with varying enuresis severity, no major differences regarding bladder function and urine production were found. Furthermore, children with infrequent enuresis tend to be slightly older when they seek medical help.

  • 7.
    Cederblad, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Engvall, Gunn
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Nevéus, Tryggve
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    No effect of basic bladder advice in enuresis: a randomised controlled trial2015In: Journal of Pediatric Urology, ISSN 1477-5131, E-ISSN 1873-4898, Vol. 11, no 3, article id 153.e1Article in journal (Refereed)
    Abstract [en]

    Background

    There are two firstline, evidence-based treatments available for nocturnal enuresis: desmopressin and the enuresis alarm. Prior to use of these therapies, international experts usually recommend that the children also be given basic bladder training during the daytime. The rationale behind this recommendation is that daytime bladder training or urotherapy, is a mainstay in the treatment of daytime incontinence caused by detrusor overactivity. Still, there is, as yet, no firm evidence that daytime bladder training is useful against nocturnal enuresis.

    Aim

    To explore whether basic bladder advice has any effect against nocturnal enuresis.

    Study design

    The study was prospective, randomized, and controlled. The evaluated intervention was bladder advice, given in accordance with ICCS guidelines and focused on regular voiding, sound voiding posture, and sufficient fluid intake. Forty children aged 6 years or more with previously untreated enuresis, but no daytime incontinence, were randomized (20 in each group) to receive either first basic bladder advice for 1 month and then alarm therapy (group A) or just the alarm therapy (group B). Based on power calculations, the minimum number of children required in each treatment arm was 15.

    Results

    The basic bladder advice did not reduce the enuresis frequency in group A (p = 0.089) and the end result after alarm therapy did not differ between the two groups (p = 0.74) (see Table). Only four children in group A had a partial or full response to bladder training, and two of these children relapsed immediately during alarm therapy.

    Discussion

    This was the first study to evaluate, in a prospective, randomized manner, the value of daytime basic bladder training as a treatment of enuresis. It was found that the treatment neither resulted in a significant reduction in the number of wet nights, nor did it improve the success of subsequent alarm therapy.

    Conclusions

    The recommendation that all children with enuresis be given bladder training as a firstline therapy can no longer be supported. Instead, we recommend that treatment of these children start with the enuresis alarm or desmopressin without delay.

  • 8.
    Dahlberg, Anton
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Ghaderi, A.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Salari, Raziye
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Validity of Strengths and Difficulties Questionnaire in non-clinical samples of parents and teachers2017In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 27Article in journal (Other academic)
  • 9.
    Engsheden, Natalie
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Fabian, Helena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Offering Relationship Education (PREP) for Couples During Pregnancy: Self-Selection Patterns2013In: Family Relations, ISSN 0197-6664, E-ISSN 1741-3729, Vol. 62, no 4, p. 676-685Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to investigate patterns of self-selection into the Prevention and Relationship Education Program (PREP) as it was offered universally to expectant couples attending maternity services in a Swedish town. The baseline questionnaire was answered by 141 couples, of whom 63% later participated in PREP, and 37% served as a comparison group. The results showed that couples who chose to participate in PREP had a shorter relationship, were more often unmarried first-time parents, and reported lower levels of relationship adjustment. PREP participants also had higher scores of depressive symptoms and poorer self-rated health. It seems that expectant couples are interested in preventive relationship education and that couples with more risk factors for vulnerable relationships self-selected into PREP when the program was offered universally during pregnancy. The selection pattern into PREP has interesting implications for public health interventions and their dissemination.

  • 10.
    Fabian, Helena
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Åhman, Annika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Challenges and benefits of conducting parental classes in Sweden: Midwives’ perspectives2015In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 6, no 4, p. 236-242Article in journal (Refereed)
    Abstract [en]

    Objective

    There is lack of knowledge regarding antenatal care midwives' perspectives concerning parental classes provided during pregnancy, and this study aimed to explore midwives' experiences and thoughts about these parental class activities.

    Methods

    Twenty-six semi-structured, individual, telephone interviews were carried out with midwives at antenatal clinics across Sweden, and the data were analysed using systematic text condensation (STC).

    Results

    The midwives noted that parental classes were a demanding task, and they appeared to lack the confidence and skills required to manage the classes. They expressed a “need for collaborators to achieve the objectives” (theme 1). The midwives felt that “creating new networks is most valuable for parents” (theme 2), and they were also “striving to give the ‘whole picture’ to both parents” (theme 3), i.e. looking beyond just the delivery. Although they had the ambition, midwives realised it was “not possible to reach all” (theme 4).

    Conclusions

    Organisational resources as well as developing skills to lead groups are imperative for midwives to fulfil the goals of the parental classes. The midwives are aware that they cannot reach all parents with the group format; thus, it is important to acknowledge the needs of minority populations and develop multidisciplinary collaborations to be able to better address their needs.

    Abbreviation

    STC, Systematic Text Condensation

  • 11.
    Fabian, Helena
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP. Uppsala Univ, Uppsala, Sweden..
    Ssegonja, Richard
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Salari, Raziye
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Feldman, Inna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Mental health and academic failure in Swedish adolescents2017In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 27, p. 388-388Article in journal (Other academic)
  • 12.
    Feldman, Inna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Cost-effectiveness of public health interventions - a new methodological approach2014Conference paper (Other academic)
  • 13.
    Feldman, Inna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Sampaio, Filipa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Kelly, Michael P
    Response to Invited Commentary: Methods to address control for confounding and nonperfect randomization when using outcome distribution curves to estimate the population-level impact of a public health intervention.2014In: Journal of Clinical Epidemiology, ISSN 0895-4356, E-ISSN 1878-5921, Vol. 67, no 11, p. 1286-1288Article in journal (Refereed)
  • 14.
    Fransson, Emma
    et al.
    Stockholm Univ, Ctr Hlth Equ Studies CHESS, S-10691 Stockholm, Sweden.;Karolinska Inst, S-10691 Stockholm, Sweden..
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Hjern, Anders
    Stockholm Univ, Ctr Hlth Equ Studies CHESS, S-10691 Stockholm, Sweden.;Karolinska Inst, S-10691 Stockholm, Sweden.;Karolinska Inst, Karolinska Univ Hosp, Dept Med, Clin Epidemiol, S-17176 Stockholm, Sweden..
    Bergstrom, Malin
    Stockholm Univ, Ctr Hlth Equ Studies CHESS, S-10691 Stockholm, Sweden.;Karolinska Inst, S-10691 Stockholm, Sweden..
    Why should they live more with one of us when they are children to us both?: Parents' motives for practicing equal joint physical custody for children aged 0-42016In: Children and youth services review, ISSN 0190-7409, E-ISSN 1873-7765, Vol. 66, p. 154-160Article in journal (Refereed)
    Abstract [en]

    Joint physical custody, i.e., children spending an equal amount of time in both parents' home after a separation or divorce, is increasing in many countries. In line with the national policy to promote paternal involvement in parenting, two-thirds of Swedish preschoolers with non-cohabiting parents live in two homes. Internationally, there has been a debate regarding the benefits or risks with joint physical custody for infants and toddlers. The aim of this qualitative study was to explore the reasons given by divorced parents for sharing joint physical custody of children 0-4 years of age. Interviews were conducted with 46 parents (18 fathers and 28 mothers) and analyzed using systematic text condensation. Two themes emerged in response to the research question. In the theme Same rights and responsibilities, parents described that joint physical custody was 'a given' as both parents were seen to have equal rights to and responsibility for the children. Both men and women described involved fatherhood as an ideal goal. In the theme For the sake of the child, parents emphasized that joint physical custody was in the best interest of the child. Some parents had conflicts with their ex-spouses, but were still convinced of the benefits of joint physical custody and strove to make it work.

  • 15.
    Fält, Elisabet
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Fabian, Helena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Exploring Nurses', Preschool Teachers' and Parents' Perspectives on Information Sharing Using SDQ in a Swedish Setting - A Qualitative Study Using Grounded Theory2017In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, no 1, article id e0168388Article in journal (Refereed)
    Abstract [en]

    Evidence-based methods to identify behavioural problems among children are not regularly used within the Swedish Child healthcare. A new procedure was therefore introduced to assess children through parent- and preschool teacher reports using the Strengths and Difficulties Questionnaire (SDQ). This study aims to explore nurses', preschool teachers' and parents' perspectives of this new information sharing model. Using the grounded theory methodology, semi-structured interviews with nurses (n = 10) at child health clinics, preschool teachers (n = 13) and parents (n = 11) of 3-, 4- and 5-year-old children were collected and analysed between March 2014 and June 2014. The analysis was conducted using constant comparative method. The participants were sampled purposively within a larger trial in Sweden. Results indicate that all stakeholders shared a desire to have a complete picture of the child's health. The perceptions that explain why the stakeholders were in favour of the new procedure-the 'causal conditions' in a grounded theory model included: (1) Nurses thought that visits after 18-months were unsatisfactory, (2) Preschool teachers wanted to identify children with difficulties and (3) Parents viewed preschool teachers as being qualified to assess children. However, all stakeholders had doubts as to whether there was a reliable way to assess children's behaviour. Although nurses found the SDQ to be useful for their clinical evaluation, they noticed that not all parents chose to participate. Both teachers and parents acknowledged benefits of information sharing. However, the former had concerns about parental reactions to their assessments and the latter about how personal information was handled. The theoretical model developed describes that the causal conditions and current context of child healthcare in many respects endorse the introduction of information sharing. However, successful implementation requires considerable work to address barriers: the tension between normative thinking versus helping children with developmental problems for preschool teachers and dealing with privacy issues and inequity in participation for parents.

  • 16.
    Fält, Elisabet
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Wallby, Thomas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation Research.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Salari, Raziye
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Fabian, Helena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Inter-rater agreement between parent and teacher SDQ ratings in Swedish 3-5-year-olds2017In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 27Article in journal (Other academic)
  • 17.
    Fängström, Karin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Salari, Raziye
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Eriksson, Maria
    Ersta Sköndal Bräcke University College.
    Sarkadi, A
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    The computer-assisted interview In My Shoes can benefit shy preschool children's communication2017In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, no 8, article id e0182978Article in journal (Refereed)
    Abstract [en]

    Interviewing children is a cognitively, socially, and emotionally challenging situation, especially for young and shy children. Thus, finding methods that aid rapport and increase these children's communication is important. The present study investigated whether children's verbal and non-verbal communicative behavior developed differently during the rapport phase, depending on whether children were situationally shy or not, and whether the interview was conducted using the computer-assisted interview In My Shoes (IMS) or a Standard verbal interview. The sample consisted of 60 children aged 4 to 5-years-old. The results showed that for the shy children in the IMS group their talkativeness increased and their answer latency decreased including the amount of encouragement the child needed to talk, while no changes were observed for the shy children in the Standard verbal interview group. There were no significant differences in the non-verbal behavior for the shy children regardless of the interview method used. For the non-shy children, overall, the interview method did not affect either the verbal or the non-verbal outcomes. Our findings indicate that IMS can be a useful tool during the rapport-building phase with shy children as it helps these children to improve their verbal communication.

  • 18.
    Fängström, Karin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Lucas, Steven
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Calam, Rachel
    Univ Manchester, Sch Hlth Sci, Div Psychol & Mental Hlth, 2nd Floor,Zochonis Bldg,Brunswick St, Manchester M13 9PL, Lancs, England.
    Eriksson, Maria
    Ersta Skondal Bracke Univ Coll, Dept Social Sci, Box 11189, S-10061 Stockholm, Sweden.
    “And they gave me a shot, it really hurt” – Evaluative content in investigative interviews with young children2017In: Children and youth services review, ISSN 0190-7409, E-ISSN 1873-7765, Vol. 82, p. 434-443Article in journal (Refereed)
    Abstract [en]

    Research is scarce on the suitability of the evidence-based components of child investigative interviews when used in non-forensic contexts such as social work or school, particularly in relation to children’s reports on emotional content.

    This explorative study investigated to what extent a structured forensic interview protocol aids children in verbalizing negative emotional experiences of distress or discomfort. To do this we assessed and compared children’s displayed distress or discomfort during a video-recorded health visit with the verbalized distress or discomfort in interviews 2-4 weeks later about this visit. The children, aged 4 and 5 years (N = 26), were interviewed with a forensic interview protocol. Children’s statements regarding distress and discomfort and the interviewer questions preceding these statements were analyzed qualitatively.

    The results showed that 46% of the 4-year-olds and 39 % of the 5-year-olds displayed discomfort or distress during their health visit. In the interviews, open-ended questions were posed to all children, however, these questions were sufficient to aid only some children (n = 6) to share evaluative content. None of the children who displayed distress or discomfort during the visit verbalized such experiences after an invitation only. Most children who described experiences of distress or discomfort did so in relation to evaluative questions.

    The results suggest that more research is warranted to investigate exactly how and when evaluative questions should be posed and whether this differs depending on severity of experience or the child’s age. The need for protocol development and its suitability when used in other fields of practice is discussed.

  • 19.
    Gavra, P.
    et al.
    Uppsala University.
    Salari, Raziye
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Qualitative evaluation of a group intervention for unaccompanied refugee minors with PTSD symptoms2017In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 27Article in journal (Other academic)
  • 20.
    Jingxiong, Jiang
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Rosenqvist, Urban
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Huishan, Wang
    Greiner, Ted
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Guangli, Lian
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Influence of grandparents on eating behaviors of young children in Chinese three-generation families2007In: Appetite, ISSN 0195-6663, E-ISSN 1095-8304, Vol. 48, no 3, p. 377-83Article in journal (Refereed)
    Abstract [en]

    Aim: To investigate how grandparents influence their young grandchildren's eating behaviors in Chinese three-generation families. Methods: This qualitative study used semi-structured in-depth interviews with 12 parents (3 male and 9 female) and 11 grandparents (4 male and 7 female) in Beijing, China. Results: Three domains emerged in this study: (1) grandparents were the primary caretakers of children in the three-generation families. They played an important role in planning and cooking family meals; (2) grandparents' attitudes influenced young children's nutrition and eating habits. They held the belief that children being heavy at a young age would assure that they had a good nutrition status and would become tall in the future. They showed a tendency towards urging the children to eat more meals and larger portions at served meals; (3) grandparents used food as an educational and emotional tool. They shaped the behavior of their grandchildren and expressed love and caring through food. Conclusions: Grandparents were dominant in shaping children's eating behavior in some three-generation families in Chinese urban areas. Nutrition education involving grandparents is a potential framework for developing a healthy dietary behavior in young children.

  • 21.
    Johansen, Kine
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Lucas, Steven
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Bokström, Pär
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Persson, Kristina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Sonnander, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Disability and Habilitation.
    Magnusson, Margaretha
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    'Now I use words like asymmetry and unstable': nurses' experiences in using a standardized assessment for motor performance within routine child health care2016In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 22, no 2, p. 227-234Article in journal (Refereed)
    Abstract [en]

    RATIONALE, AIMS AND OBJECTIVES:

    There is an increasing recognition that early intervention is important for children with motor disorders. The use of standardized assessment methods within the Swedish Child Health Services (CHS) may improve early identification of these children and thereby their development and quality of care. Given the key role of nurses within the CHS, we explored their experiences of using a structured assessment of motor performance (SOMP-I) in a clinical setting, and investigated possible barriers and facilitators for implementation of the method within the CHS.

    METHODS:

    The study was conducted in 2013 in Uppsala County, Sweden. Ten child health nurses participated in two focus group interviews, which were analysed using systematic text condensation.

    RESULTS:

    The analysis yielded three themes: (1) increased knowledge and professional pride - nurses described their desire to provide high-quality care for which SOMP-I was a useful tool; (2) improved parent-provider relationship - nurses felt that using SOMP-I involved both the parents and their infant to a greater extent than routine care; and (3) conditions for further implementation - nurses described that the time and effort needed to master new skills must be considered and practical barriers, such as lack of examination space, resource constraints and difficulties in documenting the assessment must be addressed before implementing the SOMP-I method in routine care.

    CONCLUSION:

    Child health nurses felt that the SOMP-I method fitted well with their professional role and increased the quality of care provided. However, significant barriers to implementing SOMP-I into routine child health care were described.

  • 22.
    Johansen, Kine
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Persson, Kristina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Sonnander, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Disability and Habilitation.
    Magnusson, Margaretha
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Lucas, Steven
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Can nurses be key players in assessing early motor development using a structured method in the child health setting?2015In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 21, no 4, p. 681-687Article in journal (Refereed)
    Abstract [en]

    Rational, aims and objectivesIncreasing evidence highlights the importance of early interventions for motor disorders in children. Given the key medical role of the nurse within the Swedish Child Health Service (CHS), we aimed to examine if nurses could apply a structured assessment of early motor development at the child health centre to enable early identification of children at risk. MethodsStructured Observation of Motor Performance in Infants (SOMP-I) assesses infant's level of motor development and quality of motor performance using subscales converted to total scores. The total score for both level and quality can then be plotted within the SOMP-I percentile distribution at the child's age for comparison with a reference population. Fifty-five infants (girls: 30) were assessed according to SOMP-I at three child health centres. Assessments were performed by nurses (n=10) in a clinical setting; one nurse performed the assessment while another nurse and a physiotherapist observed. ResultsAgreement for the assessment of level as a continuous variable was excellent [intraclass correlation coefficient (ICC) 0.97-0.98], but was lower for quality (ICC 0.02-0.46). When the children were categorized according to the percentile range categories, the assessors were in agreement for the majority of the children, with respect to both level (78-82%) and quality (78-87%). ConclusionDespite brief experience with SOMP-I, the agreement was excellent when assessing the level of motor development, but was less satisfactory for the assessment of quality of motor performance. More extensive education and training may be necessary to improve the nurses' ability to assess quality, as this domain was an entirely new concept to the nurses. Further research is warranted to determine the applicability of SOMP-I as a standardized method for nurses to assess motor development within the CHS.

  • 23.
    Johansen, Kine
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Persson, Kristina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Sonnander, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Disability and Habilitation.
    Magnusson, Margaretha
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Lucas, Steven
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Clinical utility of the Structured Observation of Motor Performance in Infants within the child health services2017In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, no 7, article id e0181398Article in journal (Refereed)
    Abstract [en]

    Aim: This study aimed to evaluate the clinical utility of the Structured Observation of Motor Performance in Infants (SOMP-I) when used by nurses in routine child healthcare by analyzing the nurses' SOMP-I assessments and the actions taken when motor problems were suspected.

    Method: Infants from three child health centers in Uppsala County, Sweden, were consecutively enrolled in a longitudinal study. The 242 infants were assessed using SOMP-I by the nurse responsible for the infant as part of the regular well-child visits at as close to 2, 4, 6 and 10 months of age as possible. The nurses noted actions taken such as giving advice, scheduling an extra follow-up or referring the infant to specialized care. The infants' motor development was reassessed at 18 months of age through review of medical records or parental report.

    Results: The assessments of level of motor development at 2 and 10 months showed a distribution corresponding to the percentile distribution of the SOMP-I method. Fewer infants than expected were assessed as delayed at 4 and 6 months or deficient in quality at all assessment ages. When an infant was assessed as delayed in level or deficient in quality, the likelihood of the nurse taking actions increased. This increased further if both delay and quality deficit were found at the same assessment or if one or both were found at repeated assessments. The reassessment of the motor development at 18 months did not reveal any missed infants with major motor impairments.

    Interpretation: The use of SOMP-I appears to demonstrate favorable clinical utility in routine child healthcare as tested here. Child health nurses can assess early motor performance using this standardized assessment method, and using the method appears to support them the clinical decision-making.

  • 24.
    Le, Ha Nd
    et al.
    Deakin Health Economics, Population Health SRC, Deakin University, Geelong, Victoria, Australia.; Centre for Community Child Health, The Royal Children's Hospital, Melbourne, Victoria, Australia..
    Gulenc, Alisha
    Centre for Community Child Health, The Royal Children's Hospital, Melbourne, Victoria, Australia.; Murdoch Childrens Research Institute, Melbourne, Victoria, Australia..
    Gold, Lisa
    Deakin Health Economics, Population Health SRC, Deakin University, Geelong, Victoria, Australia.; Centre for Community Child Health, The Royal Children's Hospital, Melbourne, Victoria, Australia..
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Ukoumunne, Obioha C.
    NIHR CLAHRC South West Peninsula (PenCLAHRC), University of Exeter Medical School, Exeter, United Kingdom..
    Bayer, Jordana
    Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.; School of Psychological Science, LaTrobe University, Melbourne, Victoria, Australia..
    Wake, Melissa
    Centre for Community Child Health, The Royal Children's Hospital, Melbourne, Victoria, Australia.; Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.; Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia..
    Hiscock, Harriet
    Centre for Community Child Health, The Royal Children's Hospital, Melbourne, Victoria, Australia.; Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.; Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia..
    Utility-based quality of life in mothers of children with behaviour problems: A population-based study2016In: Journal of Paediatrics and Child Health, ISSN 1034-4810, E-ISSN 1440-1754, Vol. 52, no 12, p. 1075-1080Article in journal (Refereed)
    Abstract [en]

    AIM: To examine the relationship between mothers' health-related quality of life (HRQoL) and child behaviour problems at age 2 years. To investigate whether the relationship between maternal HRQoL and child behaviour problems is independent of maternal mental health.

    METHODS: Cross-sectional survey nested within a population-level, cluster randomised trial, which aims to prevent early child behaviour problems. One hundred and sixty mothers of 2-year-old children, in nine local government areas in Victoria, Australia. HRQoL was measured using the Assessment of Quality of Life 6D and child behaviour was measured using the child behaviour checklist (CBCL/1.5-5 years). Maternal mental health was measured using the Depression Anxiety Stress Scale. Data were collected at child age 2 years; demographic data were collected at child age 8 months.

    RESULTS: HRQoL was lower for mothers with children that had borderline/clinical behaviour problems compared to those with children without problems (mean difference -0.14, 95% confidence interval (CI): -0.16 to -0.12, P < 0.001). The finding did not markedly change when adjusting for household income, financial security, child gender, child temperament and intervention group status at child age 8 months (mean difference -0.12, 95% CI: -0.15 to -0.09, P < 0.001), but did attenuate when additionally adjusting for concurrent maternal mental health (mean difference -0.03, 95% CI: -0.05 to -0.02, P < 0.001).

    CONCLUSIONS: Child behaviour problems were associated with lower maternal HRQoL. Child behaviour problems prevention programmes could consider this association with maternal HRQoL and be designed to improve and report both mothers' and their child's health and wellbeing.

  • 25.
    Maria, Cederblad
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Engsheden, Natalie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Gaderi, Ata
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Enebrink, Pia
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Engvall, Gunn
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Nevéus, Tryggve
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    No difference in relationship satisfaction between parents of children with enuresis and normative data2016In: Journal of Child and Family Studies, ISSN 1062-1024, E-ISSN 1573-2843, Vol. 25, no 4, p. 1345-1351Article in journal (Refereed)
    Abstract [en]

    The aim of this cross-sectional study was to evaluate relationship satisfaction in parents of children with nocturnal enuresis and put it in context by comparisons with normative data. The secondary aim was to investigate the potential differences in feelings of incompetence in the parenting role and parental conflict among parents of children with enuresis of varying severity. Parents (n = 52) of 41 children with enuresis aged between 6 and 12 years participated. The questionnaire consisted of five components: demographic background, The Dyadic Adjustment Scale, The Swedish Parent Stress Questionnaire, The Parent Problem Checklist, and The Depression, Anxiety, and Stress Scale. Normative data was used to provide an age- and gender-stratified sample, with adequate distribution and representation of both sexes and all ages. This sample consisted 1411 parents of 1411 children aged 6-9 years. Parents of children with enuresis reported similar relationship quality as a representative sample of parents with children of the same age. The parents' report of feeling of incompetence and parental conflict were similar among children with enuresis of varying frequency. Mothers reported more problematic areas related to child rearing than fathers. This study shows that to have a child with enuresis doesn't necessarily affect the parents' feeling of competence or the quality of the intra-parental relationship.

  • 26.
    Nayeb, Laleh
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Wallby, Thomas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Westerlund, Monica
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Salameh, Eva-Kristina
    Speech and Language Service, Malmö University hospital, Sweden.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Child healthcare nurses believe that bilingual children show slower language development, simplify screening procedures and delay referrals2015In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 104, no 2, p. 198-205Article in journal (Refereed)
    Abstract [en]

    AIM:

    A significant number of children living in Sweden are bilingual, but how language screening is performed in this group is unknown. We investigated child healthcare nurses' perceptions of the language screening of bilingual children aged 30-36 months, together with their clinical practices.

    METHOD:

    An online questionnaire was completed by 863 nurses who performed language screening of bilingual children in Sweden at least once a month, corresponding to 89% of the target population. Cox regression identified predictors of the nurses' tendency to simplify the screening of bilingual children.

    RESULTS:

    The nurses reported a greater lack of confidence and more difficulties in interpreting screening outcomes for bilingual than monolingual children (p < 0.001). Half of the nurses simplified the screening processes for bilingual children and 74% postponed referrals to speech and language services, basing these adaptations on their perceptions of the children's Swedish language skills (p < 0.001). Most nurses (82%) believed that language development was slower in bilingual children, and this was the strongest predictor of simplified screening practices (RR=2.00, 95% CI 1.44-2.77).

    CONCLUSION:

    Child healthcare nurses need easily accessible information and clear guidelines on the language development of bilingual children to ensure that bilingual and monolingual children receive equitable language screening services.

  • 27.
    Nystrand, Camilla
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Jonsson, U.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Feldman, Inna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Langenskiöld, Sophie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Economics.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Ssegonja, Richard
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Indicated preventive interventions for depression in Children and Adolescents: A meta-analysis2017In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 27, p. 371-371Article in journal (Other academic)
  • 28.
    Otterman, Gabriel
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Jalsenius, Marie
    Maguire, Sabine
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Janson, Staffan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Paediatric approaches to child maltreatment are subject to wide organisational variations across Europe.2017In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 106, no 7, p. 1110-1117Article in journal (Refereed)
    Abstract [en]

    AIM: Little is known about the organisation of child maltreatment practice in Europe. We therefore explored medical child protection systems and training across Europe.

    METHODS: An online survey was completed by physicians working in child maltreatment, identified through professional organisations in 28 member countries of the European Union, Iceland, Norway and Switzerland in 2012-2013. Respondents were questioned regarding management of suspected child maltreatment, mandatory reporting, professional training, patient referral and physician roles in multidisciplinary investigations. Responses underwent a narrative synthesis and descriptive enumerations.

    RESULTS: The survey was completed by 88 individuals, unevenly distributed in 22 of 31 countries. Physicians were mandated to report child maltreatment in 16 of 22 countries. All of 88 responding physicians described multidisciplinary involvement in the clinical and forensic management of suspected child maltreatment. Practitioners involved in physical examinations included general physicians, paediatricians, forensic medical examiners, gynaecologists and paediatric surgeons. Paediatricians were required to undergo child protection training according to 30 of 86 respondents in 14 of 22 countries.

    CONCLUSION: This survey demonstrates that there were wide variations in the organisation of child maltreatment paediatrics in Europe. The differing legislative frameworks and models of care are pertinent to consider when comparing epidemiology of maltreatment reported from across European countries.

  • 29.
    Rahmqvist, Johanna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Wells, Michael
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Conscious Parenting: A Qualitative Study on Swedish Parents’ Motives to Participate in a Parenting Program2014In: Journal of Child and Family Studies, ISSN 1062-1024, E-ISSN 1573-2843, Vol. 23, no 5, p. 934-944Article in journal (Refereed)
    Abstract [en]

    Triple P is a parenting program that aims to prevent behavioral, emotional, and developmental problems in children. Because Triple P is a new parenting program in Sweden, it is important to see how parents felt about the intervention. The aim of this study was to find out why parents of preschool children chose to participate in Triple P in Sweden, what they thought of the Triple P curriculum, and how the program related to their parenting philosophy in general. This is a qualitative study using semi-structured interviews with seven mothers and three fathers who participated in Triple P. The interviews were transcribed verbatim and were analysed using Malterud's method of Systematic Text Condensation. Parents chose to participate in Triple P for several reasons: they wanted to learn more about the intervention; they had specific problems that they sought help for; or they felt encouraged to participate due to advertisements and recommendations from friends. Of the Triple P curriculum, the participants especially enjoyed the "directed discussion" technique, the positive reinforcement sections, and the instructions on how to communicate effectively with their child by staying calm, close, and maintaining eye contact. It was important for many of the parents to feel validated and respected, and they liked having discussions with the preschool teacher rather than being told what to do. Parents in this Swedish sample generally liked and selectively used the strategies they learned from participating in Triple P, depending on how well these fit with their own parenting experiences and philosophy.

  • 30.
    Salari, Raziye
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Fabian, Helena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Prinz, Ron
    Univ S Carolina, Parenting & Family Res Ctr, Columbia, SC 29208 USA.
    Lucas, Steven
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Feldman, Inna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Fairchild, Amanda
    Univ S Carolina, Parenting & Family Res Ctr, Columbia, SC 29208 USA.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    The Children and Parents in Focus project: a population-based cluster-randomised controlled trial to prevent behavioural and emotional problems in children.2013In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 13, no 1, article id 961Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: There is large body of knowledge to support the importance of early interventions to improve child health and development. Nonetheless, it is important to identify cost-effective blends of preventive interventions with adequate coverage and feasible delivery modes. The aim of the Children and Parents in Focus trial is to compare two levels of parenting programme intensity and rate of exposure, with a control condition to address impact and cost-effectiveness of a universally offered evidence-based parenting programme in the Swedish context.

    METHODS/DESIGN: The trial has a cluster randomised controlled design comprising three arms: Universal arm (with access to participation in Triple P - Positive Parenting Program, level 2); Universal Plus arm (with access to participation in Triple P - Positive Parenting Program, level 2 as well as level 3, and level 4 group); and Services as Usual arm. The sampling frame is Uppsala municipality in Sweden. Child health centres consecutively recruit parents of children aged 3 to 5 years before their yearly check-ups (during the years 2013--2017). Outcomes will be measured annually. The primary outcome will be children's behavioural and emotional problems as rated by three informants: fathers, mothers and preschool teachers. The other outcomes will be parents' behaviour and parents' general health. Health economic evaluations will analyse cost-effectiveness of the interventions versus care as usual by comparing the costs and consequences in terms of impact on children's mental health, parent's mental health and health-related quality of life.

    DISCUSSION: This study addresses the need for comprehensive evaluation of the long-term effects, costs and benefits of early parenting interventions embedded within existing systems. In addition, the study will generate population-based data on the mental health and well-being of preschool aged children in Sweden.Trial registration: ISRCTN: ISRCTN16513449.

  • 31.
    Salari, Raziye
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Malekian, Cariz
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Linck, Linda
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Kristiansson, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Screening for PTSD symptoms in unaccompanied refugee minors: a test of the CRIES-8 questionnaire in routine care2017In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 45, no 6, p. 605-611Article in journal (Refereed)
    Abstract [en]

    Aims: The dramatic increase in the number of refugees in Europe presents a major public health challenge. The limited existing evidence indicates that the mental health needs of refugees are significant; unaccompanied refugee minors (URMs) constitute a particularly vulnerable group. In this study, we aimed to investigate whether a short questionnaire (Children's Revised Impact of Event Scale; CRIES-8) could be used as a screening tool for PTSD symptoms in URMs, 8-18 years old, during their routine health check-up.

    Methods: Data were collected at the healthcare centre for asylum-seekers in Uppsala, Sweden. In total, 208 URMs completed the CRIES-8 during their health assessment.

    Results: The CRIES-8 was feasible to use, showed good internal consistency and its factor structure was confirmed. Children with less than four years of education often had difficulties completing the questionnaire by themselves and needed help reading the questions. Almost all the respondents were male (98%), aged 9-18 years. The majority (81%) came from Afghanistan. About 76% scored above the cut-off and therefore were considered to be at risk of PTSD. The proportion of children who screened positive did not differ based on age, country of origin or current living arrangements.

    Conclusions: The CRIES-8 is a useful tool in clinical settings, however, children should be provided with reading support and instructions about how to complete the questionnaire. The high number of children who screened positive for PTSD symptoms indicates the need for a more thorough mental health assessment, and early prevention/intervention programmes to address URMs' mental health issues.

  • 32.
    Salari, Raziye
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Malekian, Cariz
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Linck, Linda
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Using CRIES-8 to screen for post-traumatic stress disorder in unaccompanied refugee minors2016In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 26, no s1Article in journal (Other academic)
  • 33.
    Salari, Raziye
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Ssegonja, Richard
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Pilot study of a group intervention for unaccompanied refugee minors with symptoms of PTSD in Sweden2017In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 27, p. 120-120Article in journal (Other academic)
  • 34.
    Salari, Raziye
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Terreros, Cathrine
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Parenting Scale: Which version should we use?2012In: Journal of Psychopathology and Behavioral Assessment, ISSN 0882-2689, E-ISSN 1573-3505, Vol. 34, no 2, p. 268-281Article in journal (Refereed)
    Abstract [en]

    Factor analytic studies of one of the widely used measurements of parental discipline, the Parenting Scale (PS), have yielded ambiguous results. The purpose of this study was to compare various forms of the PS in terms of factor structure and other psychometric properties. The sample consisted of 617 mothers and 430 fathers of 2 to 5-year-olds. Confirmatory factor analysis indicated that shorter structural models provided a better fit compared to the original model; however, none led to an optimal fit. Other psychometric properties such as internal consistency, test-retest reliability, concurrent and predictive validity were slightly higher for the original Laxness and Overreactivity subscales. The findings from this study and previous studies suggest that the inter-item relationship in the scale might be too sensitive to sample characteristics, implying that factor analysis might not be the best way to measure the scale's validity. Nevertheless, other psychometric properties support the use of the Parenting Scale in the assessment of dysfunctional parenting practices. We recommend using the original Laxness and Overreactivity subscales rather than the later models, especially for research purposes.

  • 35.
    Salari, Raziye
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Wells, Michael B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Child behaviour problems, parenting behaviours and parental adjustment in mothers and fathers in Sweden2014In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 42, no 7, p. 547-553Article in journal (Refereed)
    Abstract [en]

    Aims: We aim to examine the relationship between child behavioural problems and several parental factors, particularly parental behaviours as reported by both mothers and fathers in a sample of preschool children in Sweden. Methods: Participants were mothers and fathers of 504 3- to 5-year-olds that were recruited through preschools. They completed a set of questionnaires including the Eyberg Child Behavior Inventory, Parenting Sense of Competence Scale, Parenting Scale, Parent Problem Checklist, Dyadic Adjustment Scale and Depression Anxiety Stress Scale. Results: Correlational analyses showed that parent-reported child behaviour problems were positively associated with ineffective parenting practices and interparental conflicts and negatively related to parental competence. Regression analyses showed that, for both mothers and fathers, higher levels of parental over-reactivity and interparental conflict over child-rearing issues and lower levels of parental satisfaction were the most salient factors in predicting their reports of disruptive child behaviour. Conclusions: This study revealed that Swedish parents' perceptions of their parenting is related to their ratings of child behaviour problems which therefore implies that parent training programs can be useful in addressing behavioural problems in Swedish children.

  • 36.
    Sampaio, Filipa
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Feldman, Inna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    A Cost-Effectiveness Analysis of the Triple P Program in Uppsala Municipality, Sweden2012In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 22, no S2, p. 101-101Article in journal (Other academic)
  • 37.
    Sampaio, Filipa
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Salari, Raziye
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Zethraeus, Niklas
    Feldman, Inna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Cost and effects of a universal parenting programme delivered to parents of preschoolers2015In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 25, no 6, p. 1035-1042Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Parenting programmes are effective in improving child behaviour and parental well-being, but long follow-up studies of universally offered programmes are scarce.

    METHODS:

    A cluster randomized controlled trial was conducted to assess the costs and effects of Triple P levels 2-3 on child externalizing behaviours and parental mental health. The programme was offered universally to parents of preschoolers (self-selection allowed). Preschools were randomized to Triple P or a waitlist control. Health outcomes were reduction in externalizing behaviours measured on the Eyberg Child Behaviour Inventory-22 and improvement in parental mental health measured on the Depression Anxiety Stress Scales collected at baseline, 6-, 12- and 18-month follow-up. Child outcomes were based on 355 children aged 3-5 years (child sample) and parental outcomes on 759 parents (parental sample) with baseline data. Costs were collected from a municipality perspective, including 312 children and 488 parents with baseline data in the intervention preschools.

    RESULTS:

    Sixty-seven (29%) parents attended the intervention. Triple P showed no significant improvement in child externalizing behaviours or parental mental health at either of the follow-up points. Triple P had an average yearly total cost of 3007 Swedish Krona (SEK) (€323) per child or 1922 SEK (€207) per parent. Running Triple P cost 227 SEK (€24) per child or 145 SEK (€16) per parent yearly.

    CONCLUSION:

    Offering low intensity levels of Triple P with 29% attendance may not be a reasonable use of public resources, as no evidence of improvement in child externalizing behaviours or parental mental health was found.

  • 38.
    Sarkadi, A
    et al.
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Bremberg, S
    Socially unbiased parenting support on the Internet: a cross-sectional study of users of a large Swedish parenting website.2005In: Child Care Health Dev, ISSN 0305-1862, Vol. 31, no 1, p. 43-52Article in journal (Refereed)
  • 39.
    Sarkadi, A
    et al.
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Widmark, C
    Tarnberg, S
    Tishelman, C
    The 'hows', 'whos', and 'whens' of screening: gynaecologists' perspectives on cervical cancer screening in urban Sweden.2004In: Soc Sci Med, ISSN 0277-9536, Vol. 58, no 6, p. 1097-108Article in journal (Refereed)
  • 40.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Familjemiljön 0-2 år2010In: Investera i barns hälsa / [ed] Bremberg Sven, Eriksson Lilly, Gothia förlag , 2010Chapter in book (Other academic)
  • 41.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Föräldrastöd i förskolan - ett lyckat koncept2011In: Psykisk HälsaArticle in journal (Other (popular science, discussion, etc.))
  • 42.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Metod efter syfte och inte tvärtom: Föräldrastödjande program tidigt i föräldraskapet2010In: BarnläkarenArticle in journal (Other (popular science, discussion, etc.))
  • 43.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    The invisible father: How can child healthcare services help fathers to feel less alienated?2014In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 103, no 3, p. 234-235Article in journal (Other academic)
  • 44.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Uppsala universitet.
    Use it or lose it: Barns hjärnor som samhällsinvestering2015In: Kungliga Vetenskapssamhället i Uppsalas Årsbok 40/2013-2014 / [ed] Lars-Gunnar Larsson, Uppsala: Kungliga Vetenskapssamhället i Uppsala , 2015, p. 159-172Chapter in book (Other academic)
  • 45.
    Sarkadi, Anna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Uppsala universitet.
    Abbasian, Said
    Co-producing parenting support in sparsely populated areas: a successful Swedish example2012In: Barn, ISSN 0800-1669, Vol. 30, no 4, p. 129-48Article in journal (Refereed)
  • 46.
    Sarkadi, Anna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Almqvist, YB.
    Relationer avgör resultat2014In: Uppsala Nya TidningArticle in journal (Other (popular science, discussion, etc.))
  • 47.
    Sarkadi, Anna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Bremberg, S.
    Hök, L. Sanandaji
    Både S och M har fel lösning för skolan2014In: Svenska DagbladetArticle in journal (Other (popular science, discussion, etc.))
  • 48.
    Sarkadi, Anna
    et al.
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Bremberg, Sven
    KI.
    Socially unbiased parenting support on the Internet:: A cross-sectional study of users of a large Swedish parenting website2004In: Child: Care, Health, and Development: Special Issue on Parenting and Child HealthArticle in journal (Refereed)
  • 49.
    Sarkadi, Anna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Feldman, Inna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Sociala ivesteringar lönar sig - en satsad krona ger fem tillbaka på 15 års sikt!2015Report (Other (popular science, discussion, etc.))
  • 50.
    Sarkadi, Anna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Goldfeld, Sharon
    Efron, Daryl
    How the system failed Dylan: About the effects of fragmented community child health-care services on patient safety2015In: Journal of Paediatrics and Child Health, ISSN 1034-4810, E-ISSN 1440-1754, Vol. 51, no 12, p. 1148-1151Article in journal (Refereed)
12 1 - 50 of 77
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