| 1. |
- Orban, Kristina, et al.
(author)
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Changes in Parents' Time Use and Its Relationship to Child Obesity
- 2014
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In: Physical & Occupational Therapy in Pediatrics. - Philadelphia : Taylor & Francis. - 0194-2638 .- 1541-3144. ; 34:1, s. 44-61
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Journal article (peer-reviewed)abstract
- Objective: The aim was to explore any change in parents' time use together with their children, changes in their perceived occupational value, and its relationship to children's body mass index (BMI) over the course of a one-year occupation-focused family intervention. Method: The study sample consisted of participants in one arm of a randomized controlled trial, involving mothers and fathers (n = 30) of 17 children aged 4-6 years who were considered obese. Data were collected by time-geographical diaries during the intervention and by measuring the parents' occupational value and the children's BMI before and after the intervention. Results: At the end of the intervention, an increase was shown in the amount of time parents spent together with their children during weekdays (p = .042) and the parents perceived occupational value (p = .013). Children's BMI z-score changed with -0.11 units. Conclusion: Collaboration with parents may be useful in interventions aiming at facilitating a normal weight development among children. © 2014 Informa Healthcare USA, Inc.
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| 2. |
- Orban, Kristina, et al.
(author)
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Effect of an occupation-focused family intervention on change in parents’ time use and children’s body mass index
- 2014
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In: American Journal of Occupational Therapy. - 0272-9490. ; 68:6, s. e217-e226
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Journal article (peer-reviewed)abstract
- OBJECTIVE. This study explored factors related to changes in the time parents spent with their children with obesity and associated decreases in children’s body mass index (BMI) z-scores after an occupation-focused intervention.METHOD. Parents participated in a 1-yr occupation-focused intervention to promote healthy family lifestyles. Data on 40 parents of 22 children with obesity ages 4–6 yr were collected before and after intervention and analyzed using linear and multiple regression methods.RESULTS. Parents increased time spent with their children by an average of 91 min/day. Parents’ finances, perceived satisfaction in daily occupations, low BMI, and mastery at inclusion were associated with increased time spent with their children. Mothers’ subjective health and high mastery and fathers’ perceived occupational value and education explained 67% of the variance in children’s BMI z-scores.CONCLUSION. The results indicate important factors to consider in developing interventions that facilitate occupational engagement and health among children with obesity and their families.
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| 3. |
- Orban, Kristina, et al.
(author)
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Effect of an Occupation-Focused Family Intervention on Change in Parents' Time Use and Children's Body Mass Index.
- 2014
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In: American Journal of Occupational Therapy. - Bethesda : AOTA Press. - 0272-9490 .- 1943-7676. ; 68:6, s. 217-226
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Journal article (peer-reviewed)abstract
- OBJECTIVE. This study explored factors related to changes in the time parents spent with their children with obesity and associated decreases in children's body mass index (BMI) z-scores after an occupation-focused intervention. METHOD. Parents participated in a 1-yr occupation-focused intervention to promote healthy family lifestyles. Data on 40 parents of 22 children with obesity ages 4-6 yr were collected before and after intervention and analyzed using linear and multiple regression methods. RESULTS. Parents increased time spent with their children by an average of 91 min/day. Parents' finances, perceived satisfaction in daily occupations, low BMI, and mastery at inclusion were associated with increased time spent with their children. Mothers' subjective health and high mastery and fathers' perceived occupational value and education explained 67% of the variance in children's BMI z-scores. CONCLUSION. The results indicate important factors to consider in developing interventions that facilitate occupational engagement and health among children with obesity and their families.
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| 4. |
- Orban, Kristina, et al.
(author)
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Shared patterns of daily occupations among parents of children Aged 4-6 years old with obesity
- 2012
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In: Journal of Occupational Science. - Melbourne : Taylor & Francis. - 1442-7591 .- 2158-1576. ; 19:3, s. 241-257
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Journal article (peer-reviewed)abstract
- The prevalence of childhood obesity is increasing and is associated with how families manage their daily occupations. Previous studies suggest that it should be possible to identify patterns of daily occupations that promote health and prevent illness. However, it is unknown how family members' patterns are shared. This study aimed at gaining knowledge about parents' shared patterns of daily occupations. Thirty parents enrolled in a randomized controlled trial involving parents of children aged 4–6 years old with obesity, were included. The study used a mixed methods design. Data from time-geographical diaries describing daily occupations on one ordinary weekday were collected. A sequential exploratory strategy design was used, with qualitative and quantitative data analysis. Four main groups of family types were identified: the togetherness focused family, the child focused family, the individual focused family and the parent-child focused family. These groups' shared patterns of daily occupations differed in terms of divisions of household work, paid work and the amount of time spent together as a family. The results highlight and generate a new understanding of how parents' shared patterns of daily occupations are shaped in families. © 2012 Taylor & Francis Group, LLC. All rights reserved.
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| 5. |
- Önnerfält, Jenny, et al.
(author)
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A family-based intervention targeting parents of preschool children with overweight and obesity : Conceptual framework and study design of LOOPS- Lund Overweight and Obesity Preschool Study
- 2012
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In: BMC Public Health. - London, UK : BioMed Central. - 1471-2458. ; 12:1
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Journal article (peer-reviewed)abstract
- Background: As the rate of overweight among children is rising there is a need for evidence-based research that will clarify what the best interventional strategies to normalize weight development are. The overall aim of the Lund Overweight and Obesity Preschool Study (LOOPS) is to evaluate if a family-based intervention, targeting parents of preschool children with overweight and obesity, has a long-term positive effect on weight development of the children. The hypothesis is that preschool children with overweight and obesity, whose parents participate in a one-year intervention, both at completion of the one-year intervention and at long term follow up (2-, 3- and 5-years) will have reduced their BMI-for-age z-score.Methods/Design: The study is a randomized controlled trial, including overweight (n=160) and obese (n=80) children 4-6-years-old. The intervention is targeting the parents, who get general information about nutrition and exercise recommendations through a website and are invited to participate in a group intervention with the purpose of supporting them to accomplish preferred lifestyle changes, both in the short and long term. To evaluate the effect of various supports, the parents are randomized to different interventions with the main focus of: 1) supporting the parents in limit setting by emphasizing the importance of positive interactions between parents and children and 2) influencing the patterns of daily activities to induce alterations of everyday life that will lead to healthier lifestyle. The primary outcome variable, child BMI-for-age z-score will be measured at referral, inclusion, after 6 months, at the end of intervention and at 2-, 3- and 5-years post intervention. Secondary outcome variables, measured at inclusion and at the end of intervention, are child activity pattern, eating habits and biochemical markers as well as parent BMI, exercise habits, perception of health, experience of parenthood and level of parental stress.Discussion: The LOOPS project will provide valuable information on how to build effective interventions to influence an unhealthy weight development to prevent the negative long-term effects of childhood obesity.Trial registration: ClinicalTrials.gov NCT00916318© 2012 Önnerfält et al.; licensee BioMed Central Ltd.
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| 6. |
- Amer-Wåhlin, Isis, et al.
(author)
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Brain-specific NSE and S-100 proteins in umbilical blood after normal delivery
- 2001
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In: Clinica Chimica Acta. - 0009-8981. ; 304:1-2, s. 57-63
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Journal article (peer-reviewed)abstract
- BACKGROUND: To determine normal blood levels of brain-specific proteins S-100 and neuron specific enolase (NSE) in healthy newborns and their mothers following uncomplicated birth. METHODS: Umbilical artery and vein blood and maternal venous blood was collected at 112 consecutive uncomplicated deliveries. Venous blood samples were taken from 18 of the neonates 3 days after birth. S-100 and NSE were analyzed quantitatively by double antibody immunoluminometric assay (Sangtec Medical AB, Sweden). RESULTS: Compared with adults, healthy neonates had higher levels of both S-100 and NSE. For S-100, median levels (range) were 1.10 microg/l (0.38-5.50 microg/l and 0.98 microg/l (0.43-2.70 microg/l) in umbilical artery and vein, respectively. For NSE, median levels (range) in umbilical artery blood and vein were 27 microg/l (10-140 microg/l) and 10.75 microg/l (8.80->/=200 microg/l) respectively. The maternal venous blood levels of both S-100 and NSE were significantly lower than in their infants. At 3 days of life, neonatal venous levels of the proteins were still high: S-100, 0.48-9.70 microg/l; NSE, 17->/=200 microg/l. In contrast to adults, haemolysis affected the S-100 levels in umbilical blood significantly. CONCLUSION: Concentrations of both S-100 and NSE in blood are greater in newborns after normal birth than in healthy adults. The higher levels in umbilical artery blood than in umbilical vein blood are consistent with a fetal origin of these proteins. High levels in venous blood at 3 days of life suggest that the high levels at birth are not related to the birth process but reflect a high activity of these proteins during fetal development.
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| 7. |
- Hafström, Maria, 1962, et al.
(author)
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Cerebral Palsy in Extremely Preterm Infants
- 2018
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In: Pediatrics. - : American Academy of Pediatrics (AAP). - 0031-4005 .- 1098-4275. ; 141:1
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Journal article (peer-reviewed)abstract
- BACKGROUND AND OBJECTIVES: The risk of cerebral palsy (CP) is high in preterm infants and is often accompanied by additional neurodevelopmental comorbidities. The present study describes lifetime prevalence of CP in a population-based prospective cohort of children born extremely preterm, including the type and severity of CP and other comorbidities (ie, developmental delay and/or cognitive impairment, neurobehavioral morbidity, epilepsy, vision and hearing impairments), and overall severity of disability. In this study, we also evaluate whether age at assessment, overall severity of disability, and available sources of information influence outcome results.METHODS: All Swedish children born before 27 weeks' gestation from 2004 to 2007 were included (the Extremely Preterm Infants in Sweden Study). The combination of neonatal information, information from clinical examinations and neuropsychological assessments at 2.5 and 6.5 years of age, original medical chart reviews, and extended chart reviews was used.RESULTS: The outcome was identified in 467 (94.5%) of eligible children alive at 1 year of age. Forty-nine (10.5%) children had a lifetime diagnosis of CP, and 37 (76%) were ambulatory. Fourteen (29%) had CP diagnosed after 2.5 years of age, 37 (76%) had at least 1 additional comorbidity, and 27 (55%) had severe disability. The probability for an incomplete evaluation was higher in children with CP compared with children without CP.CONCLUSIONS: Children born extremely preterm with CP have various comorbidities and often overall severe disability. The importance of long-term follow-up and of obtaining comprehensive outcome information from several sources in children with disabilities is shown.
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| 8. |
- Hellström-Westas, Lena, et al.
(author)
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Early prediction of outcome with aEEG in preterm infants with large intraventricular hemorrhages
- 2001
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In: Neuropediatrics. - : Georg Thieme Verlag KG. - 0174-304X .- 1439-1899. ; 32:6, s. 319-324
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Journal article (peer-reviewed)abstract
- BACKGROUND: The electrocortical background contains prognostic information in full-term asphyxiated newborn infants already during the first postnatal hours. In preterm infants with intra-ventricular hemorrhages (IVH) the background activity in EEG and amplitude-integrated EEG (aEEG) is depressed during the first days of life, and the extent of the depression correlates with the degree of IVH. However, it has not been previously evaluated whether very early aEEG can predict later outcome also in pre-term infants. OBJECTIVE: To investigate if early prediction of outcome is possible from aEEG in preterm infants with large IVH. METHODS: aEEG recordings from the first postnatal week were investigated in 64 preterm infants with IVH grade III - IV. For every 24-hour period the aEEG background pattern was classified, and the maximum and minimum numbers of bursts/h, respectively,were counted. Outcome was divided into three categories: died (n = 36), survived (n = 28) with "poor" outcome, i.e., severe cerebral palsy and not able to walk and/or mental retardation (n = 8), and survived with "fair" outcome, i.e., healthy or mild cerebral palsy (n = 19). One surviving child was lost in the follow-up. RESULTS: There were significant differences in maximum bursts/h (MaxB) at 0-24 hours (p = 0.033), 24-48 hours (p = 0.011), 48-72 hours (p=0.049) and 72-96 hours (p=0.032), respectively, between the infants who died and the surviving infants. At 24-48 hours the median (range) MaxB in the surviving infants with "fair" outcome was 156 (103-179) versus 102 (73-156) in the surviving infants with "poor" outcome (p = 0.002). With the assumption that MaxB < 130 was predictive of death or survival with "poor" outcome, 68 % and 78% of infants were correctly predicted at 0-24 hours and 24-48 hours, respectively. CONCLUSIONS: This study shows that outcome may be predicted with aEEG already during the first days of life in preterm infants with large IVH. The findings should be confirmed in prospective studies since they may have clinical implications if specific medical interventions become available.
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| 9. |
- Herbst, Andreas, et al.
(author)
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Different types of acid-base changes at birth, fetal heart rate patterns, and infant outcome at 4 years of age
- 1997
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In: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 76:10, s. 953-958
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Journal article (peer-reviewed)abstract
- BACKGROUND: To study the relationship between different types of acidemia in umbilical artery blood at birth, fetal heart rate (FHR) patterns during labor, and infant long-term outcome. METHODS: Case-control study of 48 infants with pure high base deficit (base deficit (BD) > or = 12 mmol/L and pCO2 < 8.0 kPa), 51 with mixed acidemia (BD > or = 12 mmol/L and pCO2 > or = 8.0 kPa), born at or after term, and controls matched for maternal age, parity, and gestational age at birth. FHR patterns during labor and the results of developmental screening at age 4 were compared between the groups. RESULTS: Late decelerations were associated with pure high base deficit and complicated variable decelerations with mixed acidemia. Both types of acidemia were correlated with Apgar scores below 7 at 1 minute, and mixed acidemia with more admissions to the neonatal intensive care unit. Developmental screening at age 4 years showed no significant differences between infants with mixed acidemia or pure high base deficit and controls. Twelve infants with mixed acidemia and six controls had deficits in language/speech development. CONCLUSIONS: Late decelerations may be an indicator of a metabolic component of acidemia and complicated variable decelerations an indicator of mixed acidemia. The higher rate of admissions to the neonatal intensive care unit in cases with mixed acidemia may suggest that a concomitant hypercapnia (resulting in lower pH) in metabolic acidemia at birth may be of importance for the outcome. A possible relation between acidemia at birth and deficits in speech/language development should be further evaluated.
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| 10. |
- Herbst, Andreas, et al.
(author)
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Mode of delivery in breech presentation at term: increased neonatal morbidity with vaginal delivery
- 2001
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In: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 80:8, s. 731-737
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To compare the neonatal outcome in planned vaginal delivery and planned cesarean section in term singleton pregnancies with breech presentation in a Scandinavian clinic with a high rate of vaginal breech delivery. METHODS: A retrospective study including 1050 term singleton breech pregnancies delivered at a Swedish tertiary referral center during 1988 to 2000. For 699 patients (67%) a vaginal delivery was planned, of whom 603 (86%) were delivered vaginally. In 327 (31%) cases a cesarean section was planned and performed. These two groups were compared regarding rates of acidemia at birth (cord artery pH <7.05), low Apgar scores and neonatal neurological morbidity. Long term sequels among infants with a complicated neonatal course were also identified. RESULTS: Acidemia at birth, Apgar score below 7 at 5 minutes, and referral to neonatal intensive care unit all occurred at higher rates in planned vaginal delivery (5.3%, 3.6%, and 8.9%, respectively), than in planned cesarean delivery (0, 0, and 4.0%). The rate of neonatal neurological morbidity was 24/699 (3.4%) in planned vaginal delivery (18 cases with cerebral symptoms and six cases of brachial plexus palsy) compared to one case (cerebral symptoms) after a planned cesarean. These differences were all statistically significant (p< or =0.002). Of the neurologically affected neonates, two died and four had cerebral palsy (one delivered by planned cesarean section) at follow up. CONCLUSION: Neonatal morbidity may be reduced with planned cesarean delivery in breech presentation, also in a Scandinavian setting.
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