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Background: Children with long-gap esophageal atresia (LGEA) face a high risk of digestive and respiratory morbidity, but their mental health outcomes have not been investigated. We aimed to identify the prevalence of mental health problems in children with LGEA, associated factors and health-related quality of life (HRQOL). Methods: Twenty-six children with LGEA aged 3-17 were recruited nationwide in Sweden. One of their parents and adolescents aged 11-17 completed information on the child's mental health (Strength and Difficulties Questionnaire), generic (PedsQL 4.0) and condition-specific HRQOL (EA-QOL). Parents gave information on current child symptomatology. Mental health level was determined using validated norms; abnormal >= 90 percentile/borderline >= 80 percentile/normal. Elevated levels were considered borderline/abnormal. Data were analyzed using descriptives, correlation and Mann-Whitney-U test. Significance level was p < 0.05. Results: Twelve children with LGEA aged 3-17 (46%) had elevated scores of >= 1 mental health domain in parent-reports, whereas 2 adolescents (15%) in self-reports. In parent-reports, 31% of the children had elevated levels of peer relationship problems, with associated factors being child sex male (p = 0.037), airway infections (p = 0.002) and disturbed night sleep (p = 0.025). Similarly, 31% showed elevated levels of hyperactivity/inattention, and associated factors were male sex (p = 0.005), asthma (p = 0.028) and disturbed night sleep (p = 0.036). Elevated levels of emotional symptoms, seen in 20%, were related to swallowing difficulties (p = 0.038) and vomiting problems (p = 0.045). Mental health problems correlated negatively with many HRQOL domains (p < 0.05). Conclusions: Children with LGEA risk mental health difficulties according to parent-reports, especially peer relationship problems and hyperactivity/inattention, with main risk factors being male sex, airway problems and sleep disturbances. This should

Genom en kvalitativ text- och innehållsanalys studerades ett studieobjekt genom dess tillämpning av läsarter och framställning av mångfald (genus och etnicitet). Läsarten påverkar hur texten uppfattas och de mångfaldsbeskrivningar som texten tillämpar skapar förutsättningar för igenkänning och identitetskonstruktion. Studien synliggör texten i Skärmhjärnan junior (2021) som en faktionsbok som blandar utsagor om verkligheten och uppmaningar inom den fiktiva världen.Texten framställer personer och miljöer på ett övervägande stereotypt sätt med en behandling av främst överordnade maktpositioner vilket visar på en viss eftersatt framställning av individer i förhållande till dagens syn på demokratiska värden. Texten visar både på en estetisk och efferent läsart men har ett didaktiskt tonläge och ett tveksamt tilltal till karaktärerna i texten. Studien visar att material som används för undervisning behöver granskas då ett underliggande syfte kan antas i denna förmånliga bok. Valet av lärobok i skolan blir viktigt för att veta vad den innefattar, hur innehållet presenteras och hur det kan komma att påverka dem som läser., Slutgiltigt godkännandedatum: 2023-06-01

Congenital diaphragmatic hernia (CDH) is a developmental defect which occurs in approximately 1 per 3000 births. The incomplete development of the diaphragm early in gestation allows abdominal viscera to herniate into the thoracic cavity. The malformation differs in size and can occur on either one or both sides, but most commonly on the left. Normal lung development is impaired and the lungs become hypoplastic with an impaired lung structure, often causing acute respiratory distress shortly after birth. Children born with CDH, as well as their parents, very often experience a dramatic first period in life. There is also a large difference in the length of hospital stay and the initial care needed; where the size of the diaphragmatic defect seems to be crucial. The survival rate has increased over the last few decades and about 85% of all children born with CDH are discharged from hospital to their homes. Children born with CDH who survive often suffer from morbidities related to pulmonary hypoplasia and associated anomalies, but also from the sequelae resulting from the intensive care they were exposed to. The aim of this thesis was to study the long-term outcome of children and adolescents born with CDH in terms of perceived health, health-related quality of life (HRQoL) and psychosocial function. Further, the aim was to assess parental stress in parents of children born with CDH. All the studies were cross-sectional. In Study I, all children born with CDH between 1990 and 2009 who had been treated at Sankt Görans and Astrid Lindgren Children’s hospitals were asked to participate. Data from medical records were supplemented by a questionnaire consisting of questions regarding perceived physical function. Children born with CDH reported themselves as experiencing greater problems with asthma, developmental delay, seizure disorder, poor vision, and scoliosis compared with normal Swedish children. They also described a sense of having less strength and becoming breat

PURPOSE: The aim was to investigate social competence and behavioral and emotional problems in children and adolescents born with CDH. METHODS: All children born with CDH, treated in Stockholm 1990-2009, were invited to participate. After written consent, the Child Behavior Checklist or Adult Self-Report questionnaires were sent to participants. Of the 145 long-term survivors, 51% returned a completed questionnaire. Both the syndrome and competence scales were used and open-ended questions were analyzed with manifest content analysis. RESULTS: All parents of children aged 1.5-5 years and 90% of parents of children aged 6-18 years reported a normal range on the syndrome scale. Five parents indicated internalizing, but none externalizing behavior. All young adults achieved a normal score on the syndrome scale. Eighty-five percent had normal school achievement, 79% had normal social scores and 40% had normal activity levels. Significantly fewer boys (23%) were in the normal activity range compared with 67% of girls. CONCLUSIONS: The vast majority of all parents of children born with CDH scored no behavioral or emotional problems, furthermore, they reported normal social and school competence. However, the activity levels seemed to be reduced in children born with CDH.

PURPOSE: The aim of this study was to examine health-related quality of life (HRQoL) in children born with congenital diaphragmatic hernia (CDH). METHODS: Between 1993 and 2003, a total of 102 children born with CDH were treated at Astrid Lindgren Children's hospital in Stockholm. In 2012, long-term survivors (n = 77) were asked to participate in the present study, which resulted in a 46% (n = 35) response rate. The KIDSCREEN-52 questionnaire was used for measuring HRQoL and a detailed review of medical records was performed. RESULTS: The study participants did not differ from the non-participants in terms of prenatal diagnosis, gender, side of lesion, method of surgical repair, time to intubation, need for ECMO support, or way of discharge from the hospital. Children born with CDH considered themselves to have a good HRQoL, as good as healthy Swedish children. There were only a few significant HRQoL differences within the group of children with CDH, although several median scores in ECMO-treated patients were somewhat lower. Correlations between child and parent scores on HRQoL were low. CONCLUSIONS: Health-related quality of life in children born with CDH is good overall, however, a correlation between the severity of the malformation and HRQoL cannot be excluded., This study was supported by Grants from the Frimurare Barnhuset Foundation, The Clas Groschinsky Memorial Fund, and HRH Crown Princess Lovisa’s Foundation.