| 1. |
- Björk, Anna, et al.
(författare)
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High prevalence of neurodevelopmental problems in adolescents eligible for bariatric surgery for severe obesity
- 2021
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Ingår i: Acta Paediatrica, International Journal of Paediatrics. - : Wiley. - 0803-5253 .- 1651-2227. ; 110:5, s. 1534-1540
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To assess the prevalence of neurodevelopmental problems in adolescents with severe obesity and their associations with binge eating and depression. Methods: Data were collected at inclusion in a randomised study of bariatric surgery in 48 adolescents (73% girls; mean age 15.7 ± 1.0 years; mean body mass index 42.6 ± 5.2 kg/m2). Parents completed questionnaires assessing their adolescents’ symptoms of attention-deficit/hyperactivity disorder and autism spectrum disorder and reported earlier diagnoses. Patients answered self-report questionnaires on binge eating and depressive symptoms. Results: The parents of 26/48 adolescents (54%) reported scores above cut-off for symptoms of the targeted disorders in their adolescents, but only 15% reported a diagnosis, 32% of adolescents reported binge eating, and 20% reported symptoms of clinical depression. No significant associations were found between neurodevelopmental problems and binge eating or depressive symptoms. Only a third of the adolescents reported no problems in either area. Conclusion: Two thirds of adolescents seeking surgical weight loss presented with substantial mental health problems (reported by themselves or their parents). This illustrates the importance of a multi-professional approach and the need to screen for and treat mental health disorders in adolescents with obesity.
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| 2. |
- Bygdell, Maria, et al.
(författare)
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Prevalence of overweight and obesity from 5 to 19 years of age in Gothenburg, Sweden
- 2021
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 110:12, s. 3349-3355
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Tidskriftsartikel (refereegranskat)abstract
- Aim The aim of this study was to present prevalence data for overweight and obesity across school age in a large, recent, population-based cohort of children in Gothenburg, Sweden. Methods We included 66,807 children (48.5% girls) aged 5-18.9 years who had their height and weight measured in school health care 2015-2018. The BMI values were categorised according to the age-dependent cut-offs for overweight and obesity from the International Obesity Task Force (IOTF). Results Overall, the prevalence of overweight and obesity for girls and boys was 18.1% and 18.0%, respectively. We observed increasing proportions of overweight (girls 11.5-17.1% and boys 8.4-17.4%) and obesity (girls 3.0-4.2% and boys 2.7-6.1%) with increasing age (p < 0.001 for trend in both sexes). Moreover, girls had higher prevalence of overweight during ages 5.0 to 8.9 years compared with boys (p < 0.001), while boys had higher prevalence of obesity 15.0-18.9 years compared with girls (p < 0.001). Conclusion In conclusion, we demonstrate increasing prevalence of overweight and obesity across the entire school age range, as well as differences in prevalences between boys and girls, in a population-based sample of 67,000 children in Gothenburg city, Sweden. Continuous monitoring of schoolchildren, together with effective preventive measures, is crucial to curb the obesity epidemic and its consequences.
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| 3. |
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| 4. |
- Dellenmark-Blom, Maria, 1983, et al.
(författare)
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Family screening for neurodevelopmental problems and its associations with child cognitive function enable tailored treatment for childhood obesity
- 2024
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Ingår i: ACTA PAEDIATRICA. - 0803-5253 .- 1651-2227.
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To identify neurodevelopmental disorders in children with obesity, and investigate associations to cognitive functions as well as parents' self-reported neurodevelopmental problems. Methods: Eighty children were included at two outpatient obesity clinics in Sweden 2018-2019. Of these, 50 children without previously diagnosed neurodevelopmental disorders were screened, and so were their parents. Children who screened positive for neurodevelopmental problems were referred to a specialised psychiatry unit for further diagnosis. Test results of cognitive functioning were compared with the norm and between study groups by neurodevelopmental diagnoses. Results: Of the screened families, 17/50 children were diagnosed by the psychiatric unit with attention deficit-hyperactivity disorder (ADHD) and 15/82 parents screened positive for neurodevelopmental problems. Having a mother who screened positive for neurodevelopmental problems was associated with child ADHD (p < 0.05). The children's full-scale intelligence quotient (92.86 +/- 12.01, p < 0.001) and working memory index (90.62 +/- 12.17, p < 0.001) were lower than the norm. Working memory index was lower in children with ADHD compared to without ADHD: 84.76 +/- 9.58 versus 94.09 +/- 12.29 (p <= 0.01). Executive constraints were associated with verbal deviances. Conclusion: Increased awareness is needed about the overlap between neurodevelopmental problems and obesity in obesity clinics.
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| 5. |
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| 6. |
- Dellenmark-Blom, Maria, 1983, et al.
(författare)
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Neurodevelopmental disorders in children seeking obesity treatment- associations with intellectual ability and psychiatric conditions
- 2024
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Ingår i: FRONTIERS IN PSYCHIATRY. - 1664-0640. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- Background Neurodevelopmental disorders (NDD), psychiatric comorbidity and cognitive deficits are commonly seen in children with obesity; however, little is known about the overlap between these conditions. This study aimed to examine the undiagnosed and diagnosed frequency of NDDs and explore its association with psychiatric conditions and general intellectual ability (IQ) in children presenting for obesity treatment.Methods In this observational study at two outpatient obesity clinics during 2018-2019, 80 children (8-17 years) were consecutively recruited, and screened for NDD unless already diagnosed with an NDD. A psychiatric unit evaluated children who screened positive for NDD. Diagnoses and clinical background factors were collected from medical records. IQ was assessed with the Weschler Intelligence Scales and internalizing symptoms were assessed using the Beck Youth Inventories. Associations between background factors, IQ and internalizing symptoms were explored in relation to having an NDD or not.Results We found that 47/80 children had at least one NDD. Children with a diagnosed NDD before study start (n = 30) had significantly more comorbidities than children diagnosed after the study screening (n = 17) (P = .01). Greater cognitive impairment was seen in children with NDD compared with children without an NDD (P = .01). Also, 33/73 participants self-reported substantial internalizing symptoms. At follow-up, 21/79 participants, in addition to NDD, had been diagnosed with another psychiatric disorder. Ten of these were children that had been diagnosed with an NDD before study start.Conclusion The overlap between NDD, cognitive deficits and psychiatric conditions in children with obesity is an important consideration for clinical practice. Screening for these conditions may be necessary when providing targeted interventions.
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| 7. |
- Furingsten, Lovisa, 1974-, et al.
(författare)
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Caring for dying children in an acute paediatric ward
- 2013
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- IntroductionSwedish acute paediatric wards usually focuses on children with urgent and short-time illnesses and the care is not always suited for a dying child. Caring for dying children in this context therefor faces special challenges and needs to be further investigated through research from the health care professionals´ (HCP) perspective. PurposeThe aim was to describe caring as presented in professional caregivers’ experiences of caring for dying children in paediatric ward. MaterialFour HCP in a paediatric ward, which had been caring for at least one dying child during the last five years, participated. MethodsA phenomenological approach was chosen using qualitative in-depth interviews, starting with one opening question, continuing with follow-up questions according to responsive listening. Data were analysed following four steps suggested by Giorgi: reading to capture the global sense, constitution of parts into ‘meaning units’, transformation from implicit meaning to explicit constituents and gaining structure. ResultsThe findings are represented in five constituents. Presence is a prerequisite for caring when a child is dying. Self-knowledge and support from others are suggested to help when the HCP is suffering and struggling with the injustice in dying. The essence of caring for dying children is like a musical attuned composition. The moments are vulnerable and could easily be disrupted and turn into disharmony. ConclusionsThe HCP needs self-knowledge to be true and sensitive in the perceived situation of injustice when caring for dying children and their families. Caring assumes presence; however, caring for dying children is found to mean suffering to HCP and raises the need for support from others.
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| 8. |
- Furingsten, Lovisa, 1974-, et al.
(författare)
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Ethical challenges when caring for dying children
- 2015
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Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 22:2, s. 176-187
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Tidskriftsartikel (refereegranskat)abstract
- Background: Caring for dying children presents special challenges, according to the children themselves, their relatives and healthcare professionals. Objective: The aim of this study was to describe caring as represented in healthcare workers' experiences of caring for dying children. Method: A phenomenological approach was chosen, in-depth interviews were carried out and data were analysed in four steps focusing on (a) open reading, (b) meaning units, (c) constituents and (d) essence. Ethical considerations: Four nurses in a general acute paediatric care setting in Sweden participated after providing written informed consent. Voluntary participation and confidentiality were ensured, and the study was ethically approved. Findings: The essence of caring for dying children was likened to a musically attuned composition, comprising five constituents: presence, self-knowledge, injustice in dying, own suffering and in need of others. Presence was found to be a prerequisite for caring when a child is dying. Self-knowledge and support from others can be of help when struggling with emotional pain and injustice. Discussion: Caring for dying children has been found to be a delicate task for healthcare workers all over the world, and the ethical dimension is emphasized in international research. In this study, emotional pain and suffering accompanied caring, but an atmosphere in which it is possible to give and get support from colleagues and to have time to grieve and time to focus on the patient's needs may ease the burden, as can having time to process thoughts about life and death, and a possibility to grow in self-knowledge. Conclusion: Caring in ethically demanding situations may be facilitated through presence, atmosphere, self-knowledge and time. The challenge does not demand highly technological solutions; these assets are readily available, no matter where on earth. However, there is a need to further investigate these prerequisites for caring, particularly when a child is dying.
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| 10. |
- Janson, Annika, et al.
(författare)
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Metabolic and Bariatric Surgery in Adolescents: For Whom, When, and How?
- 2023
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Ingår i: HORMONE RESEARCH IN PAEDIATRICS. - : S. Karger AG. - 1663-2818 .- 1663-2826. ; 96:6, s. 609-619
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Forskningsöversikt (refereegranskat)abstract
- Severe obesity in adolescence profoundly impacts health and social well-being. Lifestyle modifications are seldom successful in maintaining sufficient weight loss to mitigate the risk of complications. Metabolic and bariatric surgery (MBS) is a standard treatment for adult patients and has emerged as an option for adolescent patients. Several high-quality studies of adolescent MBS show substantial and sustained improvements both in weight and cardiometabolic parameters, as well as a safety profile similar to that seen in adult patients. Patients report improvements in health- and weight-related quality of life. Concerns around adolescent MBS can be attributed to a fear of side effects on growth and puberty, risk of nutritional deficiencies and osteoporosis, alcohol abuse, psychosocial vulnerability, and the ability to consent in the decision process. Guidelines give somewhat different recommendations, but the most comprehensive guidelines from the American Society for Metabolic and Bariatric Surgery recommend MBS for class III obesity or class II obesity with comorbidity. This mini-review aimed to pre-sent published data on MBS in adolescents. We discuss indications for MBS and the optimal timing in the young person's life, the choice of surgical method, and MBS in relation to the new anti-obesity medications. Based on data primarily from the USA and Sweden, we conclude that MBS is a valuable treatment option for adolescents with severe obesity that appears underutilized against the backdrop of the poor prognosis of severe obesity. We argue for continued research, development of guidelines, multi-professional teamwork, long-term follow-up, and centralization of adolescent MBS.
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