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Hermansson, LiselotteORCID iD iconorcid.org/0000-0003-4247-2236
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Publications (10 of 99) Show all publications
Jarl, G. & Hermansson, L. (2018). A modified walk-in system versus scheduled appointments in a secondary-care prosthetic and orthotic clinic. Prosthetics and orthotics international, 42(5), 483-489
Open this publication in new window or tab >>A modified walk-in system versus scheduled appointments in a secondary-care prosthetic and orthotic clinic
2018 (English)In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 42, no 5, p. 483-489Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Waiting is common in health care, delays intervention, and has negative effects on satisfaction with services.

OBJECTIVES: To evaluate effects of a modified walk-in system, where patients were invited consecutively from the waiting list to attend the clinic on a walk-in basis, on waiting times, services, and work environment.

STUDY DESIGN: Parallel-group trial.

METHODS: In all, 1286 consecutive patients in need of shoe insoles were randomized to waiting lists for modified walk-in ( n = 655) or a scheduled appointment ( n = 631). Seven staff members also participated.

RESULTS: The median indirect waiting time to first appointment was 40 days shorter for modified walk-in (135 days) than for scheduled appointment (175 days; p < 0.001); 17% of those randomized to modified walk-in did not attend the clinic compared to 6% for scheduled appointment ( p < 0.001). Mean direct waiting time in the waiting room was 9.9 min longer for modified walk-in than for scheduled appointment ( p < 0.001). Patients attending modified walk-in or a scheduled appointment reported similar levels of satisfaction with services. Staff reported more support from co-workers with modified walk-in than with scheduled appointment ( p = 0.041).

CONCLUSION: The modified walk-in can reduce indirect waiting times without any substantial worsening of direct waiting times, service quality, or work environment. Studies are needed to investigate why many patients drop out from modified walk-in. Clinical relevance A modified walk-in system can cut the queues and create more timely interventions by reducing indirect waiting times. This system can therefore be recommended in secondary-care prosthetic and orthotic clinics to reduce patients' suffering from their health condition.

Place, publisher, year, edition, pages
Sage Publications, 2018
Keywords
Rehabilitation, lower limb orthotics, orthotics
National Category
Orthopaedics
Identifiers
urn:nbn:se:oru:diva-69230 (URN)10.1177/0309364617728120 (DOI)000444981600003 ()28905683 (PubMedID)2-s2.0-85041927809 (Scopus ID)
Note

Funding Agency:

Region Örebro County, Sweden

Available from: 2018-10-04 Created: 2018-10-04 Last updated: 2018-10-04Bibliographically approved
Mastinu, E., Ahlberg, J., Lendaro, E., Hermansson, L., Håkansson, B. & Ortiz-Catalan, M. (2018). An Alternative Myoelectric Pattern Recognition Approach for the Control of Hand Prostheses: A Case Study of Use in Daily Life by a Dysmelia Subject. IEEE Journal of Translational Engineering in Health and Medicine, 6, Article ID 2600112.
Open this publication in new window or tab >>An Alternative Myoelectric Pattern Recognition Approach for the Control of Hand Prostheses: A Case Study of Use in Daily Life by a Dysmelia Subject
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2018 (English)In: IEEE Journal of Translational Engineering in Health and Medicine, E-ISSN 2168-2372, Vol. 6, article id 2600112Article in journal (Refereed) Published
Abstract [en]

The functionality of upper limb prostheses can be improved by intuitive control strategies that use bioelectric signals measured at the stump level. One such strategy is the decoding of motor volition via myoelectric pattern recognition (MPR), which has shown promising results in controlled environments and more recently in clinical practice. Moreover, not much has been reported about daily life implementation and real-time accuracy of these decoding algorithms. This paper introduces an alternative approach in which MPR allows intuitive control of four different grips and open/close in a multifunctional prosthetic hand. We conducted a clinical proof-of-concept in activities of daily life by constructing a self-contained, MPR-controlled, transradial prosthetic system provided with a novel user interface meant to log errors during real-time operation. The system was used for five days by a unilateral dysmelia subject whose hand had never developed, and who nevertheless learned to generate patterns of myoelectric activity, reported as intuitive, for multi-functional prosthetic control. The subject was instructed to manually log errors when they occurred via the user interface mounted on the prosthesis. This allowed the collection of information about prosthesis usage and real-time classification accuracy. The assessment of capacity for myoelectric control test was used to compare the proposed approach to the conventional prosthetic control approach, direct control. Regarding the MPR approach, the subject reported a more intuitive control when selecting the different grips, but also a higher uncertainty during proportional continuous movements. This paper represents an alternative to the conventional use of MPR, and this alternative may be particularly suitable for a certain type of amputee patients. Moreover, it represents a further validation of MPR with dysmelia cases.

Place, publisher, year, edition, pages
Institute of Electrical and Electronics Engineers (IEEE), 2018
Keywords
Prosthetic control, electromyogram (emg), myoelectric pattern recognition (MPR), dysmelia, assessment of capacity for myoelectric control (ACMC)
National Category
Occupational Therapy Electrical Engineering, Electronic Engineering, Information Engineering
Identifiers
urn:nbn:se:oru:diva-66718 (URN)10.1109/JTEHM.2018.2811458 (DOI)000429075900001 ()29637030 (PubMedID)2-s2.0-85043451693 (Scopus ID)
Funder
Swedish Research CouncilVINNOVA
Note

Funding Agencies:

Stiftelsen Promobilia

European Commission (H, DeTOP project)

Available from: 2018-04-24 Created: 2018-04-24 Last updated: 2018-08-30Bibliographically approved
Sjöberg, L., Hermansson, L. & Fredriksson, C. (2018). Children with congenital limb deficiency: Parent’s experiences of their role in decision and treatment. In: : . Paper presented at ISPO International Central European Conference 2018, Portoroz, Slovenia, September 20-22, 2018.
Open this publication in new window or tab >>Children with congenital limb deficiency: Parent’s experiences of their role in decision and treatment
2018 (English)Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Introduction: In the past decade, the relationship between parents, families and health service providers has changed. Parents are being increasingly involved in decision-making and treatment processes. A family-centered approach indicates the importance of providers to understand family belief systems with respect to the involvement of family members. Parents to children with congenital limb deficiency are facing many decisions related to their ideological standpoints and their child during the child’s first years; decisions about e.g. when or if to start interventions. Usually the interventions concern surgical and/or prosthetic treatment.

Aim: The aim of this study was to describe parent´s experiences of their role in decision-making and treatment for children with congenital limb deficiency. 

Method: A descriptive, qualitative design was used. Data were collected through semi-structured individual interviews. We used a convenience sample to comprise parents from a variety of geographical settings within Sweden. Parents to children from 1 to 10 years, with upper and/or lower limb deficiency were included. Interviews were conducted with 17 parents, including 12 mothers and 5 fathers. Mean age of their child was 5.9 years. Data was analyzed using qualitative content analysis with inductive approach.    

Results: The resulting categories are showing parents’ experiences from raising a child with limb deficiency. Categories related to the role in making decisions were feelings about and resources in decision making process, facing unwanted decisions, and, trust to the experts. Categories related to the treatment were being a collaborator within the family and between health care providers and family, being a constant supporter for challenges in everyday life, and, handling a variety of needs based on psychosocial issues.

Conclusion: The results contribute to new knowledge and understanding of parents’ as individual persons handling their role in decision-making process in different ways. The parental role in treatment shows satisfaction in collaboration with health care providers but indicate need of psychosocial support as their child grows. The results may improve family centered health service and enhance the care for children with congenital limb deficiency.

National Category
Occupational Therapy
Identifiers
urn:nbn:se:oru:diva-70786 (URN)
Conference
ISPO International Central European Conference 2018, Portoroz, Slovenia, September 20-22, 2018
Available from: 2018-12-17 Created: 2018-12-17 Last updated: 2018-12-18Bibliographically approved
Sjöberg, L., Lindner, H. Y. & Hermansson, L. (2018). Long term results of early myoelectric prosthesis fittings: a prospective case-control study. In: : . Paper presented at WFOT Congress 2018, Cape Town, South Africa, May 21-25, 2018.
Open this publication in new window or tab >>Long term results of early myoelectric prosthesis fittings: a prospective case-control study
2018 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Introduction:  Different recommendations exist on what age is best for first-time fitting of myoelectric hand prosthesis (MEP) in children.

Objectives: To compare prosthetic skill, prosthetic use and risk for rejection over time between children fitted with MEP before or after 2½ years of age.

Method: A prospective case-control design was chosen. Cases were children fitted with MEP before age 2½ years (median 17 months, range 8-22) whereas controls were fitted with MEP from age 2½ years (median 36 months, range 33-42). The Skills Index Ranking Scale was used to classify prosthetic skill and prosthetic use was categorised based on wearing time and pattern. Independent samples tests were used to compare data based on age, prosthetic skill and prosthetic use at certain ages. To estimate and compare risk of prosthesis rejection between groups and over time, survival analysis was used.

Results: Cases showed prosthetic skill early, but controls did catch up at age 3½. Cases had a significant (p= 0.046) decrease in prosthetic use at age 9. In the long term, cases had a higher percentage of rejecting their prosthesis. 

Conclusion: Considering a young child’s development of prosthetic skill and prosthetic use over time, this study shows no additional advantages from fitting a myoelectric hand prosthesis very early. So, in conclusion, a recommended age for fitting myoelectric hand prosthesis in children is from 2½ years of age, with further consideration taken to the individual psychosocial and motor development.

National Category
Occupational Therapy
Identifiers
urn:nbn:se:oru:diva-70784 (URN)
Conference
WFOT Congress 2018, Cape Town, South Africa, May 21-25, 2018
Available from: 2018-12-17 Created: 2018-12-17 Last updated: 2018-12-18Bibliographically approved
Sjöberg, L., Lindner, H. Y. & Hermansson, L. (2018). Long-term results of early myoelectric prosthesis fittings: A prospective case-control study. Prosthetics and orthotics international, 42(5), 527-533
Open this publication in new window or tab >>Long-term results of early myoelectric prosthesis fittings: A prospective case-control study
2018 (English)In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 42, no 5, p. 527-533Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Different recommendations exist regarding what age is best for first-time fitting of myoelectric hand prostheses in children.

OBJECTIVES: To compare prosthetic skill, prosthetic use and risk for rejection over time between children fitted with myoelectric hand prostheses before or after 2½ years of age.

STUDY DESIGN: Prospective case-control design.

METHODS: The cases were nine children fitted with myoelectric hand prostheses before the age of 2½ years, whereas the controls were 27 children who were fitted with myoelectric hand prostheses after the age of 2½ years. The Skills Index Ranking Scale was used to classify prosthetic skill, and prosthetic use was categorised based on wearing time and pattern. Independent samples tests were used to compare data between groups. To estimate and compare the risk of prosthesis rejection between groups and over time, survival analysis was used.

RESULTS: Cases showed prosthetic skill early, but controls had caught up by the age of 3½ years. Cases had a significant ( p = 0.046) decrease in prosthetic use at the age of 9 years. In the long term, cases had a higher percentage of prosthesis rejection.

CONCLUSIONS: Considering young children's development of prosthetic skill and prosthetic use over time, this study shows no additional advantages from fitting a myoelectric hand prosthesis before 2½ years of age. Clinical relevance Children may be fitted with myoelectric hand prostheses to assist in daily tasks and to prevent future over-use problems. Most children fitted with myoelectric hand prostheses before 4 years of age become regular users. No advantages of fitting myoelectric hand prostheses before 2½ years of age were observed.

Place, publisher, year, edition, pages
London, United Kingdom: Sage Publications, 2018
Keywords
Children, fitting time, limb deficiency, myoelectric prosthesis
National Category
Other Health Sciences Orthopaedics
Research subject
Occupational therapy; Medicine
Identifiers
urn:nbn:se:oru:diva-63815 (URN)10.1177/0309364617729922 (DOI)000444981600009 ()28905686 (PubMedID)2-s2.0-85041903423 (Scopus ID)
Available from: 2018-01-04 Created: 2018-01-04 Last updated: 2018-10-04Bibliographically approved
Sjöberg, L., Hermansson, L. & Fredriksson, C. (2018). Parent’s experiences of their role in decision and treatment for children with congenital limb deficiency. In: : . Paper presented at WFOT Congress 2018, Cape Town, South Africa,May 21-25, 2018.
Open this publication in new window or tab >>Parent’s experiences of their role in decision and treatment for children with congenital limb deficiency
2018 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Introduction: In the past decade the relationship between parents, families and health service providers has changed. Parents are increasingly involved in decision making and treatment processes. Parents to children with congenital limb deficiency are facing many decisions related to their child during the child’s first years; decisions about e.g. when or if to start interventions. Usually interventions concern surgical and/or prosthetic treatment.

Objectives: The aim of this study is to describe parent´s experiences of their role in decision-making and treatment for children with congenital limb deficiency. 

Method: Qualitative data were collected through semi-structured individual interviews. The interviews were conducted with parents to children, one to ten year of age, with some kind of congenital limb deficiency. The data was analyzed using qualitative content analysis with inductive approach.    

Results: The result from the analysis shows themes revealing parents’ experiences of being a collaborator within the family and between health providers and family, facing and handling early decisions for the child, and, being and acting as a supporter in everyday life.

Conclusion: The results contribute to new knowledge and understanding of parents’ role in decision and treatment of children with congenital limb deficiency. This may help to further improvement of family centered health service for families with children with congenital disabilities.

National Category
Occupational Therapy
Identifiers
urn:nbn:se:oru:diva-70785 (URN)
Conference
WFOT Congress 2018, Cape Town, South Africa,May 21-25, 2018
Available from: 2018-12-17 Created: 2018-12-17 Last updated: 2018-12-18Bibliographically approved
Lendaro, E., Hermansson, L., Burger, H., van der Sluis, C. K., McGuire, B. E., Pilch, M., . . . Ortiz-Catalan, M. (2018). Phantom motor execution as a treatment for phantom limb pain: protocol of an international, double-blind, randomised controlled clinical trial. BMJ Open, 8(7), Article ID e021039.
Open this publication in new window or tab >>Phantom motor execution as a treatment for phantom limb pain: protocol of an international, double-blind, randomised controlled clinical trial
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2018 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 8, no 7, article id e021039Article in journal (Refereed) Published
Abstract [en]

Introduction: Phantom limb pain (PLP) is a chronic condition that can greatly diminish quality of life. Control over the phantom limb and exercise of such control have been hypothesised to reverse maladaptive brain changes correlated to PLP. Preliminary investigations have shown that decoding motor volition using myoelectric pattern recognition, while providing real-time feedback via virtual and augmented reality (VR-AR), facilitates phantom motor execution (PME) and reduces PLP. Here we present the study protocol for an international (seven countries), multicentre (nine clinics), double-blind, randomised controlled clinical trial to assess the effectiveness of PME in alleviating PLP.

Methods and analysis: Sixty-seven subjects suffering from PLP in upper or lower limbs are randomly assigned to PME or phantom motor imagery (PMI) interventions. Subjects allocated to either treatment receive 15 interventions and are exposed to the same VR-AR environments using the same device. The only difference between interventions is whether phantom movements are actually performed (PME) or just imagined (PMI). Complete evaluations are conducted at baseline and at intervention completion, as well as 1, 3 and 6 months later using an intention-to-treat (ITT) approach. Changes in PLP measured using the Pain Rating Index between the first and last session are the primary measure of efficacy. Secondary outcomes include: frequency, duration, quality of pain, intrusion of pain in activities of daily living and sleep, disability associated to pain, pain self-efficacy, frequency of depressed mood, presence of catastrophising thinking, health-related quality of life and clinically significant change as patient’s own impression. Follow-up interviews are conducted up to 6 months after the treatment.

Ethics and dissemination: The study is performed in agreement with the Declaration of Helsinki and under approval by the governing ethical committees of each participating clinic. The results will be published according to the Consolidated Standards of Reporting Trials guidelines in a peer-reviewed journal.

Trial registration number: NCT03112928; Pre-results.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2018
Keywords
neurological pain, clinical trials, rehabilitation medicine
National Category
Occupational Therapy Other Medical Engineering
Identifiers
urn:nbn:se:oru:diva-66722 (URN)10.1136/bmjopen-2017-021039 (DOI)000446181900099 ()30012784 (PubMedID)2-s2.0-85050255576 (Scopus ID)
Funder
VINNOVA, 2016-02290
Note

Funding Agencies:

Promobilia foundation  F16501 

EFIC Grunenthal Grant  358041552 

Integrum AB 

Available from: 2018-04-24 Created: 2018-04-24 Last updated: 2018-10-22Bibliographically approved
Lindner, H. Y., Hiyoshi, A. & Hermansson, L. (2018). Relation between capacity and performance in paediatric upper limb prosthesis users. Prosthetics and orthotics international, 42(1), 14-20
Open this publication in new window or tab >>Relation between capacity and performance in paediatric upper limb prosthesis users
2018 (English)In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 42, no 1, p. 14-20Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The International Classification of functioning, disability and health refers capacity to what an individual can do in a standardised environment and describes performance as what an individual really does and whether the individual encounters any difficulty in the real-life environment. Measures of capacity and performance can help to determine if there is any gap between them that may restrict participation. The aim of this study was to explore the relationship between capacity scores obtained in a standardised clinical setting and proportional ease of performance obtained from a real-life environment.

METHODS: The Assessment of Capacity for Myoelectric Control and the Prosthetic Upper Extremity Functional Index were used to assess capacity and performance in 62 prosthetic users (age 3-17). Spearman coefficient and generalised linear model were used to examine the association between these measures.

RESULTS: A strong correlation (Spearman = 0.75) was found between the capacity scores and the ease of performance. In both unadjusted and adjusted models, capacity was significantly associated with proportional ease of performance. The adjusted model showed that, by 1 unit increase in the Assessment of Capacity for Myoelectric Control score, the ratio of proportional ease of performance increases by 45%.

CONCLUSION: This implies that Assessment of Capacity for Myoelectric Control can be a predictor for ease of performance in real-life environment.

Clinical relevance: The ACMC scores may serve as an indicator to predict the difficulties that the children may encounter in their home environment. This prediction can help the clinician to make decisions, such that if the child requires more control training or is ready to move on to learn more complex tasks.

Place, publisher, year, edition, pages
Sage Publications, 2018
Keywords
Upper limb prosthetics, prosthetics, rehabilitation, rehabilitation of prostheses users
National Category
Occupational Therapy Orthopaedics
Identifiers
urn:nbn:se:oru:diva-59060 (URN)10.1177/0309364617704802 (DOI)000424669100003 ()28639478 (PubMedID)2-s2.0-85041794635 (Scopus ID)
Available from: 2017-08-15 Created: 2017-08-15 Last updated: 2018-08-16Bibliographically approved
Widehammar, C., Pettersson, I., Janeslätt, G. & Hermansson, L. (2018). The influence of environment: experiences of users of myoelectric arm prosthesis - a qualitative study. Prosthetics and orthotics international, 42(1), 28-36
Open this publication in new window or tab >>The influence of environment: experiences of users of myoelectric arm prosthesis - a qualitative study
2018 (English)In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 42, no 1, p. 28-36Article in journal (Refereed) Published
Abstract [en]

Background: Prostheses are used to varying degrees; however, little is known about how environmental aspects influence this use.

Objectives: To describe users" experiences of how environmental factors influence their use of a myoelectric arm prosthesis.

Study design: Qualitative and descriptive.

Methods: A total of 13 patients previously provided with a myoelectric prosthetic hand participated. Their age, sex, deficiency level, etiology, current prosthesis use, and experience varied. Semi-structured interviews were audiotaped, transcribed, and analyzed through inductive content analysis.

Results: Four categories were created from the data: "Prosthesis function," "Other people's attitudes," "Support from family and healthcare," and "Individual's attitude and strategies." The overarching theme, "Various degrees of embodiment lead to different experiences of environmental barriers and facilitators," emerged from differences in individual responses depending on whether the individual was a daily or a non-daily prosthesis user. Environmental facilitators such as support from family and healthcare and good function and fit of the prosthesis seemed to help the embodiment of the prosthesis, leading to daily use. This embodiment seemed to reduce the influence of environmental barriers, for example, climate, attitudes, and technical shortcomings.

Conclusion: Embodiment of prostheses seems to reduce the impact of environmental barriers. Support and training may facilitate the embodiment of myoelectric prosthesis use.

Clinical relevance: For successful prosthetic rehabilitation, environmental factors such as support and information to the patient and their social network about the benefits of prosthesis use are important. Local access to training in myoelectric control gives more people the opportunity to adapt to prosthesis use and experience less environmental barriers.

Place, publisher, year, edition, pages
Sage Publications, 2018
Keywords
Upper limb prosthetics; prosthetics; rehabilitation of prostheses users; rehabilitation; qualitative methods; rehabilitation; environment; amputation; upper extremity deformities; congenital
National Category
Orthopaedics
Identifiers
urn:nbn:se:oru:diva-59041 (URN)10.1177/0309364617704801 (DOI)000424669100005 ()28470129 (PubMedID)
Note

Funding Agencies:

Uppsala-Örebro Regional Research Council  

Research committee of Örebro County Council, Sweden 

Available from: 2017-08-02 Created: 2017-08-02 Last updated: 2018-08-16Bibliographically approved
Amer, A., Kakooza-Mwesige, A., Jarl, G., Tumwine, J. K., Forssberg, H., Eliasson, A.-C. & Hermansson, L. (2018). The Ugandan version of the Pediatric Evaluation of Disability Inventory (PEDI-UG). Part II: Psychometric properties. Child Care Health and Development, 44(4), 562-571
Open this publication in new window or tab >>The Ugandan version of the Pediatric Evaluation of Disability Inventory (PEDI-UG). Part II: Psychometric properties
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2018 (English)In: Child Care Health and Development, ISSN 0305-1862, E-ISSN 1365-2214, Vol. 44, no 4, p. 562-571Article in journal (Refereed) Published
Abstract [en]

Background: The Pediatric Evaluation of Disability Inventory (PEDI) has been recommended as a gold standard in paediatric rehabilitation. A Ugandan version of PEDI (PEDI-UG) has been developed by culturally adapting and translating the original PEDI. The aim of this study was to investigate the psychometric properties of the PEDI-UG in Ugandan children by testing the instrument's rating scale functioning, internal structure, and test-retest reliability.

Methods: Two hundred forty-nine Ugandan children (125 girls) aged 6 months to 7.5 years (Mean = 3.4, SD = 1.9) with typical development were tested using the PEDI-UG. Forty-nine children were tested twice to assess test-retest reliability. Validity was investigated by Rasch analysis and reliability by intraclass correlation coefficient.

Results: The PEDI-UG domains showed good unidimensionality based on principal component analysis of residuals. Most activities (95%) showed acceptable fit to the Rasch model. Six misfit items were deleted from the Functional Skills scales and one from the Caregiver Assistance scales. The category steps on the Caregiver Assistance scales' rating scale were reversed but functioned well when changed from a 6-point to 4-point rating scale. The reliability was excellent; intraclass correlation coefficient was 0.87-0.92 for the domains of the Functional Skills scales and 0.86-0.88 for the domains of the Caregiver Assistance scales.

Conclusion: The PEDI-UG has good to excellent psychometric properties and provides a valid measure of the functional performance of typically developing children from the age of 6 months to 7.5 years in Uganda. Further analysis of all items, including misfit and deleted items, in children with functional disability is recommended.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
children, disability, PEDI, Uganda, validation studies
National Category
Pediatrics Psychology (excluding Applied Psychology)
Identifiers
urn:nbn:se:oru:diva-65823 (URN)10.1111/cch.12562 (DOI)000435441700007 ()29532497 (PubMedID)2-s2.0-85043570914 (Scopus ID)
Funder
Sida - Swedish International Development Cooperation AgencySwedish Research Council, 5925
Note

Funding Agencies:

Frimurare Barnhus Foundation  

African Population and Health Research Center (APHRC)  

International Development Research Center (IDRC)  

Ford Foundation  

Karolinska Institutet  

Belgian Technical Cooperation (BTC)  L07UGA023 

Available from: 2018-03-15 Created: 2018-03-15 Last updated: 2018-08-20Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0003-4247-2236

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