| 1. |
- Bröms, Kristina, 1954-, et al.
(författare)
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Effect of degree of urbanisation on age and sex-specific asthmaprevalence in Swedish preschool children
- 2009
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 9, s. 303-
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Tidskriftsartikel (refereegranskat)abstract
- Background: There are few studies on age and sex-specific asthma prevalence in the age range 1-6 years. The purpose of this report was to estimate age and sex specific asthma prevalence in preschool children and to analyse the influence of possible demographic and geographic determinants. Methods: All 70 allergen avoidance day-care centres and 140 matched ordinary day-care centres across Sweden were sampled. The parents of all 8,757 children attending these day-care centres received the International Study of Asthma and Allergies in Childhood (ISAAC) written questionnaire, supplemented with questions on medical treatment, physician assessed asthma diagnosis, and other asthma related questions. The response rate was 68%. Results: The age specific asthma prevalence, adjusted for the underlying municipality population size, was among boys 9.7% at age 1, 11.1% at age 2, 11.4 at age 3, 10.5 at age 4, 8.7 at age 5, and 6.4 at age 6. The corresponding proportions among girls were 8.9%, 9.9%, 9.8%, 8.8%, 7.0%, and 5.0%, on average 9.6% for boys and 8.2% for girls, altogether 8.9%. In addition to age and sex the prevalence increased by municipality population density, a proxy for degree of urbanisation. Moreover, there was a remaining weak geographical gradient with increasing prevalence towards the north and the west. Conclusion: The age-specific asthma prevalence was curvilinear with a peak around age 3 and somewhat higher for boys than for girls. The asthma prevalence increased in a slowly accelerating pace by municipality population density as a proxy for degree of urbanisation.
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| 2. |
- Bröms, Kristina, 1954-, et al.
(författare)
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Prevalence and co-occurrence of asthma and allergic manifestations in preschool children
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Background: It has been claimed that preschool children may embark on ‘the atopic march’, which means that atopic manifestations show up one after another in a certain order. The aim of this study was to make an in-depth analysis of the co-occurrence of asthma and atopic manifestations. Methods: Parents of 5886 children 1-6 years of age, sampled from day-care centres in 62 municipalities all over Sweden, responded to a postal questionnaire regarding symptoms indicating prevalent asthma, allergic rhinitis, eczema, food allergy, furred pet and pollen allergy and other data in their children. Age specific prevalence of asthma, rhinitis, eczema, and food allergy was computed, adjusted for municipality population size. Results: The overall prevalence of asthma was 8.9%, of eczema 21.7%, of rhinitis 8.1%, and of food allergy 6.6%. There was a highly significant co-occurrence between all asthma-atopic manifestations. Presence of pet allergy was the manifestation showing the closest co-occurrence with presence of asthma, presence of pollen allergy with presence of rhinitis, and presence of food allergy with presence of eczema. Assessed from plots of age specific prevalence of asthma, rhinitis, eczema and food allergy the prevalence of all manifestations increased from one to three years of age and then decreased, except for rhinitis where the prevalence increased until six years of age. There was no evidence of a rank order of asthma and allergy manifestation onset. Conclusions: There was close co-occurrence between all asthma-atopic manifestations but no evidence of a rank order of onsets.
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| 3. |
- Holmberg, Kirsten, 1952-, et al.
(författare)
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Routine developmental screening at 5.5 and 7 years of age is not an efficient predictor of attention-deficit / hyperactivity disorder at age 10
- 2010
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 99:1, s. 112-120
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim of this study was to assess the efficiency of developmental screening for deficits in attention, motor control and perception or attention-deficit/hyperactivity disorder (DAMP/ADHD) at 5.5 and 7 years of age for diagnosing ADHD in grade 4. METHOD: The study population consisted of 442 children from a cohort study of ADHD in 10-year olds in one municipality in Stockholm County. Sensitivity, specificity and positive predictive value of a developmental screening at 5.5 and at 7 years of age for being diagnosed with ADHD at 10 years of age was calculated. RESULTS: The sensitivity was 44%, the specificity 85% and the positive predictive value for having a diagnosis of pervasive ADHD in 4th grade was 15%, when at least two deviations in nine items was used as the cut-off point in 5.5-year screening at Child Health Centres (CHCs). With a cut-off score of at least two deviations in four items rated by parents or and teachers in 1st grade, these estimates were 58%, 81% and 15% respectively. CONCLUSION: This study demonstrates that developmental screening for DAMP/ADHD at 5.5 and 7 years of age does not identify children who are diagnosed with ADHD in grade 4 with a high degree of selectivity.
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| 4. |
- Holmberg, Kirsten, 1952-, et al.
(författare)
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Screening for attention-deficit/hyperactivity disorder (ADHD) : can high-risk children be identified in first grade?
- 2013
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Ingår i: Child Care Health and Development. - : Wiley. - 0305-1862 .- 1365-2214. ; 39:2, s. 268-276
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Tidskriftsartikel (refereegranskat)abstract
- Aim Recent studies have demonstrated the beneficial long-term effects of an indicated parent support programme for acting out behaviour in pre-school children with attention-deficit/hyperactivity disorder (ADHD) traits. In this study we wanted to assess different thresholds for screening with the Conners scale for hyperactive-inattentive behaviours in first grade for ADHD in grade four.Method The study population consisted of 422 first graders (6- to 7-year-olds) in one municipality in Stockholm County who were screened with Conners 10-item scale and followed up by ADHD assessment in grade four. Sensitivity, specificity, likelihood ratios, and positive predictive value (PPV) of the screening by parents and teachers in first grade for being diagnosed with ADHD in fourth grade were calculated.Results The prevalence of pervasive and situational ADHD was 5.7% and 5.9% respectively. A score ≥10 on the Conners scale in first grade in teachers' reports identified 63% [95% confidence interval (CI): 43-79] of children diagnosed with pervasive ADHD in grade four (P < 0.001) with a PPV of 29% and a positive likelihood ratio (LR+) of 6.72. Parental reports of a score ≥10 yielded a lower sensitivity (29%; 95% CI: 15-49), PPV of 20% and LR+ of 4.24 for pervasive ADHD. The best predictor was a combination of parent and teacher scores ≥10 with a PPV of 50% and LR+ of 16.63. Associations with situational ADHD were weak with LR+ of 1.81 and 2.49, respectively, for teachers' and parental scores ≥10.Conclusions This study indicates a strong association between a teacher's report of a score ≥10 on the Conners scale in first grade and pervasive ADHD in grade four, while parental reports were less predictive.
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| 5. |
- Kristjánsdóttir, Jóna, et al.
(författare)
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Health-related quality of life in young women starting hormonal contraception : a pilot study
- 2018
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Ingår i: European journal of contraception & reproductive health care. - : TAYLOR & FRANCIS LTD. - 1362-5187 .- 1473-0782. ; 23:3, s. 171-178
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Our purpose was to study whether there is a difference in self-rated health-related quality of life (HRQOL) and changes in HRQOL perception after 3 months of hormonal contraceptive use in adolescents. Seasonal variations in symptoms of depression were also studied. Methods: A test group (T1) (n=193) and a selected control group (n=238) of women aged 14-20 years who were visiting a young person's clinic completed the 36-item short-form health survey (SF-36) and answered additional questions on menstrual history and pattern, need for menstrual pain relief medication, and other regular medication. The test group was reassessed after 3 months of hormonal contraception (T2). Seasonal variations in reported SF-36 scores were studied for the whole group. Results: The selected control group and test group at T1 were similar with regard to age at menarche and menstrual pattern. The duration of bleeding and use of painkillers were significantly reduced and the impact on everyday life was significantly improved after 3 months of hormonal contraception (p=.000, two-tailed). No changes in HRQOL or symptoms of possible depression were found after 3 months of hormonal contraception. The highest prevalence odds ratio for possible depression (SF-36 mental health scale score <= 48), adjusted for group, season and age, for spring vs winter, was 2.15 (95% confidence interval 0.95, 4.85). Conclusions: After 3 months of hormonal contraception both the number of days of menstrual bleeding and the use of medication to relieve menstrual pain were reduced, but there were no significant changes in self-rated HRQOL perception. Seasonal effects on HRQOL were reported.
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| 6. |
- Kristjansdottir, Jona, et al.
(författare)
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Self-reported health in adolescent girls varies according to the season and its relation to medication and hormonal contraception : A descriptive study
- 2013
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Ingår i: European journal of contraception & reproductive health care. - : Informa UK Limited. - 1362-5187 .- 1473-0782. ; 18:5, s. 343-354
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To study seasonal variations in self-rated health and depressive symptoms in adolescent girls and possible differences in reported health with regard to use of medications. Method The SF-36 questionnaire was completed by 1250 girls with a mean age of 17 years, who visited a health centre in the course of one year. From January to July inclusive, depressive symptoms in 453 of the participants were also assessed using MADRS-S. Age and regular medication data were recorded. Results Significantly better mental health and less depressive symptoms were reported during the summer, than in winter months. Seasonality was more related to the SF-36 mental, than physical health subscales. Respondents treated with hormonal contraceptives (HCs) only and those not taking any medication scored better on several SF-36 subscales, than girls on antidepressives and other medications. Respondents taking HCs tended to report better physical health and less depressive symptoms on MADRS-S than those taking no medication. Conclusions Adolescent girls showed seasonal variations in self-reported health and depressive symptoms, with more symptoms during winter months. HC users tended to report better physical health and less depressive symptoms than those on no medication. The high prevalence of suspected depression during the winter months deserves attention.
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| 7. |
- Lagerberg, Dagmar, 1941-, et al.
(författare)
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Child health and maternal stress : does neighbourhood status matter?
- 2011
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Ingår i: International Journal of Adolescent Medicine and Health. - : Walter de Gruyter GmbH. - 0334-0139 .- 2191-0278. ; 23:1, s. 19-25
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this cross-sectional questionnaire study was to explore neighbourhood-level differences in health behaviour, maternal stress and sense of coherence, birth weight, child health and behaviour, and children's television watching habits. In total, 2006 pairs of Swedish mothers and children, aged approximately 20 months, from the general population participated in the study. A total of 1923 lived in neighbourhoods of average socioeconomic status in six counties, and 83 in a high-status neighbourhood in one of the counties. Data were collected in 2002-2003 and 2004-2005 through the Child Health Services. Socio-demographic confounders were adjusted for in multiple logistic regressions (maternal age, country of birth, education, marital status and parity). Compared with their counterparts in average neighbourhoods, mothers in the high-status neighbourhood were less frequently smokers and had been breastfeeding their children more. They felt less stress from social isolation and had a higher sense of coherence. All these differences except lower social isolation were non-significant after adjusting for socio-demographic characteristics. Privileged mothers felt more restricted by their parenting tasks (unadjusted comparison), and more privileged children were frequent television watchers. Child birth weight, health and behaviour were no better in the privileged than in average neighbourhoods. This paper adds to previous knowledge by showing that status-based geographic differences in important parenting and health parameters can be non-significant in an equitable society such as Sweden, where all families with young children have access to free high-quality health services. Individual characteristics could provide better explanations than neighbourhood status.
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| 8. |
- Lagerberg, Dagmar, 1941-, et al.
(författare)
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Child health services in transition : II. Mothers´ perceptions of 18-month-old children in the light of socio-economic status and some subjective factors
- 2005
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 94:3, s. 337-344
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To analyse mothers' self-assessed quality of interaction with their children and their opinions about child difficulty with respect to socio-economic status and subjective factors: postnatal depression, social isolation, sense of coherence and locus of control. METHODS AND MATERIAL: A comprehensive questionnaire was completed by 1039 mothers of 18-mo-old children participating in the baseline measurements of a Swedish multicentre study developing and testing a new psychosocial model for the child health services. RESULTS: All subjective factors, including the number of factors, showed significant associations with perceived interaction and difficultness. Effect sizes of subjective factors ranged from about 0.3 to 1 SD for interaction, and from about 0.2 to 0.8 SD for difficultness. As for difficultness, effect sizes were larger for boys. There were no associations between high socio-economic status and high-quality interaction or low child difficultness: the few significant differences in fact favoured low-status children. CONCLUSION: The results provided some contradictory findings to the well-known association between high socio-economic status and favourable outcome. This result is of practical relevance for interventions: supportive programmes cannot be limited to areas and families of low socio-economic status. Positive effects may ensue if subjective factors like those studied here can be promoted among parents and children through the child health services.
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| 9. |
- Lagerberg, Dagmar, 1941-, et al.
(författare)
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Drawing the line in the Edinburgh Postnatal Depression Scale (EPDS) : a vital decision
- 2011
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Ingår i: International Journal of Adolescent Medicine and Health. - : Walter de Gruyter GmbH. - 0334-0139 .- 2191-0278. ; 23:1, s. 27-32
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The Edinburgh Postnatal Depression Scale (EPDS) is widely used in early child health care. This study examined the appropriateness of the recommended EPDS cut-off score 11/12. METHODS: Two main analyses were performed: 1. Associations between EPDS scores and maternal health behaviour, stress, life events, perceived mother-child interaction quality and child behaviour. 2. Screening parameters of the EPDS, i.e., sensitivity, specificity and positive predictive value. EPDS scores were available for 438 mothers and maternal questionnaires for 361 mothers. RESULTS: Already in the EPDS score intervals 6-8 and 9-11, there were notable adversities, according to maternal questionnaires, in stress, perceived quality of mother-child interaction, perceived child difficultness and child problem behaviours. Using maternal questionnaire reports about sadness/distress postpartum as standard, the recommended EPDS cut-off score 11/12 resulted in a very low sensitivity (24%). The cutoff score 6/7 yielded a sensitivity of 61%, a specificity of 82% and a positive predictive value of 61%. CONCLUSIONS: In terms of both clinical relevance and screening qualities, an EPDS cut-off score lower than 11/12 seems recommendable.
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| 10. |
- Lagerberg, Dagmar, 1941-, et al.
(författare)
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Hörnfeldt bortser från viktiga perspektiv
- 2009
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Ingår i: Tvärsnitt. - Stockholm : Vetenskapsrådet. - 0348-7997. ; :1, s. 22-23
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Tidskriftsartikel (populärvet., debatt m.m.)
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| 11. |
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| 12. |
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| 13. |
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| 14. |
- Magnusson, Margaretha, 1950-, et al.
(författare)
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How can we identify vulnerable mothers who do not reach the cut off 12 points in EPDS?
- 2011
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Ingår i: Journal of Child Health Care. - : SAGE Publications. - 1367-4935 .- 1741-2889. ; 15:1, s. 39-49
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to investigate the correspondence between 352 mother's self-reports about postpartum distress in a questionnaire including an item about distress 18 months after birth and their earlier scores within, on average, 2.5 months of childbirth from a screening with the Edinburgh Postnatal Depression Scale (EPDS). Mothers who did not reach the EPDS score of 12 points, but reported that they had been sad/depressed after childbirth, were similar in socio-demographic variables to mothers with no outcomes in sadness/depression issues. In items related to negative parenting and perceptions of the child, they presented the same picture as those with high EPDS scores who also reported having been depressed. These results suggest that EPDS does not identify all vulnerable mothers. Complementary methods for detecting mothers at risk of stress and depression need to be developed.
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| 15. |
- Magnusson, Margaretha, 1950-, et al.
(författare)
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Organizational differences in early child health care : mothers' and nurses' experiences of the services
- 2012
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 26:1, s. 161-168
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of this study was to evaluate parents' and nurses' perceptions of the child health services (CHS) in relation to whether the nurse worked exclusively with children (focused-child health centre, CHC) vs. with people of all ages (mixed-CHC).Method: Information about parents' perceptions about the CHS was acquired by a questionnaire intended for the mothers of 18-month-old children. One thousand thirty-nine answered in the baseline 2002-2003 and 996 in the follow-up 2004-2005. The nurses answered a special questionnaire aimed to obtain knowledge about their satisfaction with their work. Eighteen CHCs were chosen from the county of Uppsala and eighteen from other Swedish counties. The CHCs were chosen from areas with poor psycho-social status. The data were collected by questionnaires to mothers and nurses, and the analysis used the chi-square test, t-test and logistic regression. The study was approved by the Research Ethics Committees of the universities involved.Results: Mothers were more satisfied, and the nurses found their work tasks easier, at CHCs where the child health nurse worked exclusively with children, compared with mothers and nurses belonging to CHCs where the nurses provided care to people of all ages.Conclusion: The findings indicated that nurses working exclusively with children, being able to concentrate their time and knowledge on a specialized field, develop a more solid child health competence. There are strong reasons to consider introducing 'exclusive' CHCs in psycho-socially vulnerable areas, which would probably make the services more effective. However, intensified education may modify the drawbacks of mixed-CHCs.
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| 16. |
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| 17. |
- Sundelin, Claes, 1939-, et al.
(författare)
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Child health services in transition : I. Theories, methods and launching
- 2005
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 94:3, s. 329-336
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To describe an evidence-based model for preventive child health care and present some findings from baseline measurements. METHODS: The model includes: parent education; methods for interaction and language training; follow-up of low birthweight children; identification and treatment of postnatal depression, interaction difficulties, motor problems, parenthood stress, and psychosocial problems. After baseline measurements at 18 mo (cohort I), the intervention was tested on children from 0 to 18 mo at 18 child health centres in Uppsala County (cohort II). Eighteen centres in other counties served as controls. Two centres from a privileged area were included in the baseline measurements as a "contrasting" sample. Data are derived from health records and questionnaires to nurses and mothers. RESULTS: Baseline experiment (n = 457) and control mothers (n = 510) were largely comparable in a number of respects. Experiment parents were of higher educational and occupational status, and were more frequently of non-Nordic ethnicity. Mothers in the privileged area (n = 72) differed from other mothers in several respects. Experiment nurses devoted considerably fewer hours per week to child health services and to child patients than did control nurses. CONCLUSIONS: Despite certain differences, experiment and control samples appeared comparable enough to permit, in a second step, conclusions about the effectiveness of the intervention.
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| 18. |
- Sundelin, Claes, 1939-, et al.
(författare)
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Measurement and Monitoring
- 2002
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Ingår i: Conference Report, Measurement and Monitoring. - 917257156X
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Konferensbidrag (populärvet., debatt m.m.)
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| 19. |
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| 20. |
- Sundelin, Claes, 1939-, et al.
(författare)
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Svar : Läs vad som står!
- 2000
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 97:32, s. 3504-3505
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 21. |
- Westerlund, Monica, 1942-, et al.
(författare)
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Comorbidity in children with severe developmental language disability
- 2002
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 91:5, s. 529-534
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Tidskriftsartikel (refereegranskat)abstract
- In a cohort of 2359 children, screened for severe developmental language disability (DLD) at 3 y of age, 45 children were identified as true positives. The development, concerning DLD and comorbidity of 41 of these children still living in the municipality of Uppsala was followed up to school start. Criteria for comorbidity were: (a) suspected or diagnosed neuropsychiatric/neurodevelopmental disability according to information from the Child Habilitation Centre and the Child Psychiatric Centre or (b) low performance IQ, signs of activity/distractibility problems according to a psychologist's examination. By school start, 61% of the children with severe DLD were identified with comorbidity. Conclusion: Severe DLD is often combined with other disabilities within the neuropsychiatric/neurodevelopmental spectra. The comorbidity might not be obvious at 3 y of age--the age at which severe DLD is effectively identified by the 3-y screening programme. This in turn stresses the necessity of multidisciplinary teamwork both at the referral level and during the therapy work.
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