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- Engh, Lisbet, 1954-
(författare)
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Skolsköterskans möjlighet att upptäcka och stödja barn som far illa eller riskerar att fara illa
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Since children are a vulnerable group, the society has a special responsibility to protect them. The school nurse sees all pupils at school at regular health visits and thereby gains knowledge of their health and living conditions. The overall aim of the thesis was to develop empirical knowledge and understanding of the ability of the school nurse to detect and support children who are maltreated or at risk to be maltreated. The thesis is based on four studies. Study I was based on focus group interviews with school nurses. Data was analysed in accordance with Grounded Theory. Study II was a secondary analysis of study I and performed with Thematic Analysis. Studies III and IV were based on population data which was analysed by univariate and multivariate logistic regressions. The results showed that the school nurse has ability to detect children who are maltreated or at risk to be maltreated. However, also obstacles for detection were found such as lack of trust, avoidance, strong feelings and insufficient documentation. The obstacles were partly due to organisational shortcomings and dearth of resources affecting also internal and external collaboration. The school nurse strived for building trustful relations to pupils, to parents and to professionals. If the school nurse failed to report suspected child maltreatment to the child protection services it was because of worries that the reporting did not benefit the child. The school nurse avoided addressing child sexual abuse because of its particular sensitiveness, which affected the possibility to detect the abuse. Pupils in foster care were at higher risk of health problems, a more risky lifestyle, a lower degree of school attachment and lower school performance compared to pupils not in foster care. The results emphasize the potential of the school nurse to detect and support maltreated children through regular contacts with pupils, their confidence in the school nurse and trustful relations with other professionals.
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| 2. |
- Svensson, Katherine
(författare)
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Early life environmental exposures and children's growth : A longitudinal study evaluating prenatal exposure for endocrine disrupting chemicals and nutrition in relation to children's growth up to seven years of age
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Endocrine disrupting chemicals (EDCs) have the potential to disrupt the endocrine system in humans and animals with importance for health and development. Additionally, optimal nutrition during pregnancy is critical for fetal growth and pregnancy outcomes. However, further knowledge on the importance of EDC mixtures and nutrition, on birthweight and growth during childhood is needed. The overall aim of this thesis was to evaluate the associations between prenatal exposure to EDC mixtures and nutrition respectively, with birthweight, growth and body composition in early- and mid-childhood, and to determine if these associations differed by sex. Data from mother-child pairs in the Swedish Environmental Longitudinal, Mother and child, Asthma and allergy (SELMA) study was analyzed, including 26 EDCs in prenatal urine and serum samples, children’s anthropometric and body composition measures up to seven years of age, and sociodemographic data from questionnaires and registers.Results suggest that higher prenatal exposure to EDC mixtures were associated with lower birthweight, and slower weight gain in early childhood, including a later peak growth velocity among girls. At 5.5 and 7 years of age, EDC mixtures were associated with lower BMI, less odds of overweight and less body fat among girls, but more body fat among boys at 7 years of age. Chemicals of concern in the mixtures were e.g., phthalates, bisphenols, perfluorinated alkyl substances (PFASs) and pesticides. Finally, maternal nutrition during pregnancy, i.e., better adherence to nutritional guidelines, was associated with more body fat for boys but less body fat for girls.In conclusion, prenatal exposure to both EDC mixtures and nutrition suggests to have an influence on birthweight, and children´s growth. Several of the found associations also differed by sex.
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