Music education contributes to development and personal change in young adults with disabilities.

In Sweden as in many other countries, there has been increasing recognition of the importance of health, social participation, and active leisure time for people with disabilities. Against this background, a three-year music education was started for a group of young adults with disabilities in order to enhance their wellbeing, learning, and emotional and social development. The aim of the study was to evaluate the results of a 3-year education program with set goals for young adults with disabilities using a qualitative method. The study was conducted from autumn 2014 to 2018. Four semi-structured interviews were conducted with the participants, the first at the beginning of the education, after the first year, second, and third year respectively. The interviews were tape recorded and transcribed verbatim. The teachers and care staff made process notes about the development of each participant. The transcribed interviews and process notes were analyzed using Thematic Content Analysis. The education achieved its purpose and goals as evidenced by participants, teachers, and staff. It showed that music education training may revitalize people with disabilities. Furthermore, it demonstrated that persons with disabilities can learn, develop, and even change on a personal level, if they are given the right conditions.

Long-chain saturated and monounsaturated fatty acids associate with development of premature infants up to 18 months of age.

Myelination is important perinatally and highly dependent on long-chain saturated and monounsaturated fatty acids. Long-chain polyunsaturated fatty acids, nowadays often supplemented, inhibit oleic acid synthesis. Using data from a premature cohort, we studied if nervonic, lignoceric and oleic acids correlated to growth and early development up to 18 months corrected age. Small for gestational age infants had lower concentrations than infants appropriate for gestational age. Only oleic acid was negatively correlated to long-chain polyunsaturated fatty acids. Oleic and lignoceric acids correlated to social interaction at one month, and nervonic acid to mental, psychomotor and behavioral development at 6, 10 and 18 months, also when adjusted for several confounders. Negative association between oleic acid and long-chain polyunsaturated fatty acids suggests inhibition of delta-9 desaturase, and nervonic acid´s divergent correlation to lignoceric and oleic acids suggests different metabolism in neonatal period. Our results may have implications for the supplementation of premature infants.

Is there evidence for the use of art therapy in treatment of psychosomatic disorders, eating disorders and crisis? A comparative study of two different systems for evaluation.

A comparative study of two different systems for evaluation. Scandinavian Journal of Psychology 53, 47-53. As with any type of treatment the requirement for evidence based practice (EBP) has also affected art therapy (AT) when used as an intervention. This review evaluates the available evidence for using AT for psychosomatic disorders, eating disorders and crisis. The search in Cochrane, Best Practice, AMED, CINAHL, PION, PsycINFO and PubMed from 1987 until now resulted in a huge number of articles but only 32 articles met our criteria for evaluations. The articles were assessed with two evaluation systems, the GRADE system used by the Swedish Council on Health Technology Assessment (SBU) and the US Preventive Services Task Force (USPSTF/Task Force). When comparing the results we found that the GRADE evaluation system rejected the quality in 84% of the 32 studies and the USPSTF/Task Force 41% of these studies. An evidence base for AT was found only according to the criteria of USPSTF/Task Force. Hence, the evidence concept is not explicit, which means that effective treatments run a risk of not being implemented in health care. We suggest a broader view of what constitutes evidence in order to make it possible to include different types of research designs and methods.

Preterm infants' early developmental status is associated with later developmental outcome.

AIM: To assess the development of preterm infants from 40 weeks gestational age to 18 months corrected age to identify early predictors of later development. METHODS: Fifty-one infants were involved. Infant development was assessed at 40 and 44 weeks gestational age with the Brazelton neonatal behavioral assessment scale and a self-regulation scale and at 3, 6, 10, 18 months corrected age with the Bayley Scales of Infant Development. The quality of general movements was assessed at 1 and 3 months corrected age and maternal attachment style at infant's age of 6 months corrected age with the Relation Scale Questionnaire. RESULTS: At term age and 1-month corrected age, preterm infants were less mature and had lower levels of self-regulation than full-term infants. At 3 months corrected age, a higher proportion of preterm infants (43%) had mildly abnormal motor quality compared to the general population (25%). At all follow-ups, preterm infants had delayed mental, motor and behavioural development, which was associated with the level of self-regulation, motor quality and maternal attachment style. Maternal education level was the most predominant background factor related to infant development. CONCLUSION: Preterm infants show early-in-life deviations in self-regulation, motor quality and development. These deviations are risk factors for later optimal functioning.

Early behaviour and development in breast-fed premature infants are influenced by omega-6 and omega-3 fatty acid status.

BACKGROUND: The requirement of essential fatty acids (EFA) for the development of the brain is well documented. OBJECTIVE: To investigate the early neurological development at term and 44 weeks gestational age in preterm infants in relation to EFA concentrations in breast milk and in infants' and mothers' plasma phospholipids. METHOD: Fifty-one premature infants and their mothers were consecutively included in the study. The median gestational age was 34 weeks (range 24-36). The motor quality, motor and behavioural development were assessed by General Movements (GMs), the Brazelton Neonatal Behavioral Assessment Scale (BNBAS) and a Self Regulation Scale. RESULTS: Mother's education and gestational age correlated to several outcome variables. Multiple regression with correction for background factors showed negative associations between early breast milk concentrations of Mead acid and GMs and between AA and the BNBAS clusters Orientation and Range of States, respectively. Between 40 and 44 weeks gestational age, no expected increased scores were observed for Regulation of States, Range of States and Self Regulation. During the corresponding time, increased concentration of linoleic acid in mothers' plasma was negatively associated with improvement in Orientation and increased concentration of EPA in the infants' plasma was positively associated with improvement in Autonomic Stability. CONCLUSIONS: The major omega-6 fatty acids and Mead acid were negatively associated with early development and omega-3 fatty acids positively associated. Mother's education and the gestational age influenced the outcome more strongly than mother's and infant's morbidities. Further follow-up will elucidate the significance of these early findings.

Fatty acid patterns early after premature birth, simultaneously analysed in mothers' food, breast milk and serum phospholipids of mothers and infants.

BACKGROUND: The supply of long-chain polyunsaturated fatty acids via the placenta is interrupted in premature infants, making them exclusively dependent on breast milk, which varies in fatty acid (FA) concentrations depending on the mother's diet. OBJECTIVE: To in a longitudinal study explore the relation between FA status in mothers and infants from an unselected cohort of prematures, not requiring intensive care. DESIGN: Breast milk and mothers' and infants' plasma phospholipid FA concentrations from birth to 44 weeks of gestational age were analysed and compared with mothers' food intake, assessed using a 3-day diary. Fatty acids were analysed by capillary gas-liquid chromatography. RESULTS: The energy intake was low in 75% of mothers, and 90% had low intake of essential FAs (EFAs). Dietary linoleic acid (LA, 18:2w6), but not w3 FAs, correlated to concentrations in breast milk. Infants' plasma and breast milk correlated for arachidonic (AA, 20:4w6), eicosapentaenoic (EPA, 20:5w3) and docosahexaenoic (DHA, 22:6w3) acids. A high concentration of mead acid (20:3w9) in the infants at birth correlated negatively to the concentrations of LA, AA and w3 FAs. Infants of mothers who stopped breastfeeding during the study period showed decreased DHA concentrations and increased w6/w3 ratios, with the opposite FA pattern seen in the mothers' plasma. CONCLUSION: Although dietary w3 FAs were insufficient in an unselected cohort of mothers of premature infants, breastfeeding resulted in increased levels of DHA in the premature infants at the expense of the mothers, suggesting a general need to increase dietary w3 FAs during pregnancy and lactation.

The validity of obesity based on self-reported weight and height: Implications for population studies.

OBJECTIVE: To validate self-reported information on weight and height in an adult population and to find a useful algorithm to assess the prevalence of obesity based on self-reported information. RESEARCH METHODS AND PROCEDURES: This was a cross-sectional survey consisting of 1703 participants (860 men and 843 women, 30 to 75 years old) conducted in the community of Vara, Sweden, from 2001 to 2003. Self-reported weight, height, and corresponding BMI were compared with measured data. Obesity was defined as measured BMI > or = 30 kg/m2. Information on education, self-rated health, smoking habits, and physical activity during leisure time was collected by a self-administered questionnaire. RESULTS: Mean differences between measured and self-reported weight were 1.6 kg (95% confidence interval, 1.4; 1.8) in men and 1.8 kg (1.6; 2.0) in women (measured higher), whereas corresponding differences in height were -0.3 cm (-0.5; -0.2) in men and -0.4 cm (-0.5; -0.2) in women (measured lower). Age and body size were important factors for misreporting height, weight, and BMI in both men and women. Obesity (measured) was found in 156 men (19%) and 184 women (25%) and with self-reported data in 114 men (14%) and 153 women (20%). For self-reported data, the sensitivity of obesity was 70% in men and 82% in women, and when adjusted for corrected self-reported data and age, it increased to 81% and 90%, whereas the specificity decreased from 99% in both sexes to 97% in men and 98% in women. DISCUSSION: The prevalence of obesity based on self-reported BMI can be estimated more accurately when using an algorithm adjusted for variables that are predictive for misreporting.