| 1. |
- Englund, Katarina, et al.
(författare)
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Beslutsstöd gav bättre diagnostik och vård av barn med fetma. : Decision support system improved the care of children and adolescents with obesity
- 2013
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Ingår i: Läkartidningen. - 0023-7205. ; 110:23-24, s. 1165-7
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Tidskriftsartikel (refereegranskat)abstract
- Ett webbaserat beslutsstöd för hälsofrämjande, förebyggande och behandlande insatser mot fetma bland barn och vuxna har utvecklats i Västra Götalandsregionen. Eventuella förändringar i omhändertagandet vid barn- och ungdomsmedicinska mottagningar av detta utvärderades. Vid samtliga mottagningar vägdes och mättes barn i större utsträckning 2011 än 2005, och fetmadiagnosen baserades oftast på BMI-uträkning. Andelen barn och ungdomar som fått diagnosen fetma mer än fördubblades under perioden 2005–2011. Fler barnmottagningar och fler yrkesgrupper deltog 2011 i vården av barn med fetma. Trots det var det fortfarande en majoritet av barnen och ungdomarna med fetma som inte uppmärksammades av hälso- och sjukvården.
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| 2. |
- Benson, Mikael, et al.
(författare)
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Interleukin (IL)-6 and IL-8 in children with febrile urinary tract infection and asymptomatic bacteriuria
- 1996
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Ingår i: Journal of Infectious Diseases. - : Oxford University Press (OUP). - 0022-1899 .- 1537-6613. ; 174:5, s. 1080-1084
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Tidskriftsartikel (refereegranskat)abstract
- Urine and serum interleukin (IL)-6 and IL-8 responses were higher in children with febrile urinary tract infection (n = 61) than in those with asymptomatic bacteriuria (n = 39). By univariate analysis, cytokine levels were related to age, sex, reflux, renal scarring, urine leukocytes, C- reactive protein (CRP), erythrocyte sedimentation rate (ESR), and bacterial properties (P fimbriae but not hemolysin). Multivariate modeling showed that urine IL-6 responds were higher in girls than boys, increased with age, and were positively associated with CRP, ESR, serum IL-6, and urine leukocyte counts. The urine IL-8 response was not influenced by age, but it was influenced by P fimbriae and was associated with ESR, CRP, urine leukocytes, and female sex. The results show that cytokine responses to urinary tract infection vary with the severity of infection and that cytokine activation is influenced by a variety of host and bacterial variables.
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| 5. |
- Normann, Erik, et al.
(författare)
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Association between Chlamydia pneumoniae antibodies and wheezing in young children and the influence of sex
- 2006
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Ingår i: Thorax. - : BMJ. - 0040-6376 .- 1468-3296. ; 61:12, s. 1054-1058
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The proposed association between Chlamydia pneumoniae (Cpn) infection and wheezing needs further clarification. METHODS: Serum samples obtained from 1581 children aged 4 years in a population based cohort were tested for antibodies to Cpn and IgE antibodies to common allergens. Data on environmental factors and disease were collected prospectively from birth. RESULTS: The occurrence of IgG antibodies to Cpn at 4 years of age was associated with reported wheezing at different ages; however, these findings were most often not significant. In girls, the occurrence of anti-Cpn IgG was associated with wheezing at the ages of 1, 2, and 4 years (odds ratios (ORs) 3.41 (95% confidence interval (CI) 1.46 to 7.96), 2.13 (95% CI 1.02 to 4.44), and 2.01 (95% CI 1.14 to 3.54), respectively), and even higher ORs were observed for each age category when only high level antibody responses to Cpn were analysed. At the time of blood sampling the association between anti-Cpn IgG and wheezing was restricted to girls without atopic sensitisation (OR 2.39 (95% CI 1.25 to 4.57). No associations with wheezing were detected in boys, in whom IgE sensitisation was inversely associated with the presence of anti-Cpn IgG (OR 0.49 (95% CI 0.26 to 0.90)). CONCLUSIONS: This study suggests an association between evidence of earlier Cpn infection and a history of wheezing in young girls. Infection with Cpn may be an important risk factor for wheezing and possibly for non-atopic asthma, predominantly in girls.
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| 8. |
- Normann, Erik, 1966-
(författare)
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Chlamydia pneumoniae in Children - Epidemiology and Clinical Implications
- 2003
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Chlamydia pneumoniae is a human respiratory tract pathogen. Seroepidemiological studies indicate that C. pneumoniae infection is most common in school-aged children and infrequently detected in younger children.The aims of this study were to further elucidate the prevalence of C. pneumoniae in paediatric populations and to describe the clinical implications of these infections.The study population consisted of 367 children with respiratory tract diseases, 453 presumed healthy children at day-care, 69 children undergoing adenoidectomy and 1585 children from a population based cohort. Family members to infected day-care children were investigated. The laboratory methods used were polymerase chain reaction (PCR) on specimen from upper respiratory tract, serology by microimmunofluorescence (MIF), and immunohistochemistry (IHC) on adenoid tissue specimen. Personal data and medical history were obtained by the means of questionnaires and by the study of patient records.In children younger than five years, the prevalence of C. pneumoniae was 17% as detected by PCR. This prevalence started to increase with increasing age from two years of age. The corresponding increase in serology as detected by MIF started at the age of four years. The prevalence at day-care centres varied from 4 to 39%. Both PCR and MIF underestimated the prevalence of C. pneumoniae detected by IHC. Families to infected children were investigated: mothers were more often infected than fathers were.Most C. pneumoniae infections in small children were confined to the upper respiratory tract. These infections were usually mild or asymptomatic. Symptomatic disease may be of prolonged nature. No subsequent illness after C. pneumoniae infection was detected at follow-up after four years. In general, no association between C. pneumoniae and asthma was found, but C. pneumoniae may be of importance for asthma in some susceptible individuals. Previous C. pneumoniae infection reduced the risk for later atopy.In conclusion, C. pneumoniae is a common finding in small children and most often causes relatively mild disease. If the acquisition of this infection early in life will have any implications for future health remains to be investigated.
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| 11. |
- Normann, Erik, et al.
(författare)
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Chlamydia pneumoniae infection predicts a reduced risk for subsequent atopic disease.
- 2005
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Ingår i: Acta Paediatr. - 0803-5253. ; 94:6, s. 705-10
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To investigate long-term effects on children previously infected with Chlamydia pneumoniae. METHODS: A follow-up questionnaire was sent to all participants from a former population-based study in order to investigate health status during the 4 y that had elapsed between the two studies. In the original study, the prevalence of C. pneumoniae infection was 23% as determined by PCR analyses on throat swab specimens. These PCR results were found to have no detectable correlation for clinical disease. The main outcome measures in this follow-up study were the reported prevalence of respiratory tract infections, asthma and allergy. RESULTS: Approximately 83% completed the follow-up questionnaire. No increase in respiratory tract infections was reported by children previously found to have C. pneumoniae infection. A diagnosis of allergy was more common in the former PCR-negative population (13.4% vs 4.7%, p<0.03). The differences were most apparent in the population with atopic heredity. In a logistic regression model with different suggested risk factors for allergy, earlier infection with C. pneumoniae reduced the risk for allergy (OR=0.13; 95% CI: 0.02-0.99). This was not found for asthma. CONCLUSION: A positive PCR test for C. pneumoniae in young children was associated with a lower risk of developing allergic airway disease in this study population, and did not predict an increase in respiratory tract infections.
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| 12. |
- Seferli, Jotta, et al.
(författare)
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Patients experiences of dental implant placement for treatment of partial edentulism in a student clinic setting
- 2014
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Ingår i: Swedish Dental Journal. - : Swedish dental association. - 0347-9994. ; 38:2, s. 77-86
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluate patients' experiences of oral implant surgery when performed in a student clinic setting and the potential impact on patients' daily life. Patient selection was carried out during a round, to which undergraduate students in semester 9 and 10 could bring patients that they considered eligible for one or two implants. Partial edentulous patients that fulfilled the inclusion criteria for implant installation at the student's clinic were consequently enrolled to implant surgery with either Astra Tech or 3i implants. The same surgeon accomplished all implant installations and the students were involved in the treatment, initially by assisting during the surgery and subsequently by performing the prosthetic restoration. After the surgery, a study-specific questionnaire was sent to patients for evaluation of discomfort, pain during the surgical procedure and postoperative symptoms. Thirty-six patients were included in the study, 30 patients answered the questionnaire (response rate 83%). When retrospectively assessed, more than half of the patients (60%) perceived discomfort in the course of the implant surgery and 29% reported pain during the surgical procedure. Impact on daily living and postoperative symptoms were rarely reported (most common were pain, swelling and difficulties with chewing) and had a short duration when they occurred. Based on the results of this study conducted at a student's clinic, the impact of implant surgery on daily living appears to be small. However, it is noteworthy that the perception of discomfort and pain during the surgical procedure was frequently reported. Continued research is recommended to expose the patient's experiences of implant surgery in an educational context as well as in general dental practice.
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| 13. |
- Stenhammar, Christina, 1969-, et al.
(författare)
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`Children are exposed to temptation all the time´ : parents’ lifestyle-related discussions in focus groups
- 2012
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 101:2, s. 208-215
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To explore parents' perspectives on providing their preschool child with a healthy lifestyle, including obstacles and resources.Methods: Five semi-structured focus group interviews were conducted, with 30 parents of 4-year-olds in Sweden. Interviews were transcribed verbatim and analysed using Systematic Text Condensation.Results: Four themes emerged from the qualitative analysis: Lifestyle -'The way you live is parents' responsibility', Challenges to promote children's healthy lifestyle, Support from professionals, and peers might facilitate, and Request for an overall responsibility from society. Parents felt that they were role models for their child's lifestyle, a concept including many factors. Attractive and tempting sedentary activities and unhealthy foods were perceived as obstacles, and parents were frustrated by the media's contradictory lifestyle messages. Child health services were expected to more actively invite parents to discuss their child's lifestyle issues. Parents desired some collective responsibility for children's lifestyles through agencies, services and media messages that support and promote healthy choices.Conclusion: Parents struggled to give their children a healthy lifestyle and the 'temptations' of daily unhealthy choices causing hassles and conflicts. Parents desired professional support from preschool, Child Health Care and a collective responsibility from society with uniform guidelines. Parents groups were mentioned as peer support.
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| 14. |
- Stenhammar, Christina, et al.
(författare)
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Family stress and BMI in young children
- 2010
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 99:8, s. 1205-1212
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of this study was to investigate if family stress and parental attachment style are associated with body mass index (BMI) in young children, and identify possible explanations. Methods: A cross-sectional survey with a two-stage design was used. Parents of 873 children participated. They completed a demographic questionnaire, the Swedish Parenthood Stress Questionnaire (SPSQ), the Relationship Questionnaire (RQ) and reported their children's television-viewing habits (as a marker of physical activity). Children's height, weight and BMI were obtained from a general population-based register, BASTA. Associations with over- and underweight in children were assessed using multiple logistic regression analysis. Results: Family stress indicated by SPSQ-score was associated with suboptimal BMI. Maternal, but not paternal, SPSQ-stress score was statistically significantly associated with overweight and underweight, with adjusted odds ratios (and 95% confidence interval) of 4.61 (3.11-6.84; p < 0.001) and 3.08 (1.64-5.81; p < 0.001) respectively. Associations between childhood BMI and parental attachment style were identified, but were not independent of maternal SPSQ-score. Conclusion: Our findings support a role for family stress in development of both overweight and underweight among young children. This is likely to be attributed to behavioural mechanisms but a more direct metabolic influence of stress could also be involved.
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| 15. |
- Stenhammar, Christina
(författare)
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Parental Perspectives on Preschool Children’s Lifestyle : quantitative and qualitative aspects
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Children’s lifestyle has changed significantly during the recent decades, with an increasing prevalence of obesity as one outcome. Parents are usually the most influential people in young children’s lives. The overall aim of this thesis was to investigate parental perspectives on factors associated with 3-6 year-old children’s lifestyle, regarding eating habits and physical activity. Another objective was to compare different approaches to conducting postal questionnaires in terms of response rate, time consumption and cost-efficiency. The samples in the four studies were parents of 6-year-olds (n=158), parents of 3-year-olds (n=873), parents of 4-year-olds (n=30) and parents of 3-year-olds (n=353). In the first study, a questionnaire regarding practices and attitudes towards their child’s lifestyle, perceived obstacles and desired support was used. The second study included the Swedish Parenthood Stress Questionnaire (SPSQ), the Relationship Questionnaire (RQ) and the CFQ (Child Feeding Questionnaire). Parents also reported their child’s TV-viewing habits. The child’s measured height, weight and BMI were obtained from a register, BASTA. In the third study, focus group interviews were performed. The fourth study investigated three types of consent given for participation in a survey. The results showed that parents’ attitudes towards children’s lifestyle, in general, were “healthier” than their reports of their child’s daily practices. The practices differed depending on the parents’ educational background. Significant and dose-dependant associations were found between perceived maternal stress and children’s overweight, but also underweight. Parents felt that they were mainly responsible for their preschool child’s lifestyle. However, parents described challenges that limited and obstructed them from providing their child with a healthy lifestyle, citing the need to receive professional and peer support, while also requesting support from society. Allowing respondents to actively decline participation yielded a higher response rate and proved to be the most cost-efficient method for conducting a postal questionnaire.
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| 16. |
- Wettergren, Björn, et al.
(författare)
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Child Health Systems in Sweden
- 2016
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Ingår i: Journal of Pediatrics. - New York, USA : Elsevier. - 0022-3476 .- 1097-6833. ; 177:Suppl., s. S187-S202
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Tidskriftsartikel (refereegranskat)abstract
- On a national level, several factors are responsible for Sweden's leading position in achieving the excellent health of children because Sweden has experienced a long history of peace and success in establishing a parliamentary democracy throughout the 20th century. Among the different sectors of society, Sweden has been able to focus on prevention and health promotion. The Swedish health care system is publicly financed based on local taxation. Pediatricians working in secondary and tertiary care are employed by the public sector, whereas family physicians are employed by both the private and public sectors. The pediatric departments at county and university levels provide a high quality of inpatient care for neonates and children. The county hospital pediatric departments typically include one neonatal ward and one ward for older children. Subspecialization exists even at the county level, and there is close cooperation between the county level and subspecialist units at the university level. Within the primary care sector, most children receive care from family physicians. The majority of family physicians have completed 3 months of pediatrics in their basic training program. In the more densely populated areas there are also pediatric ambulatory care centers working mostly with referrals from the family physicians. Preventive care is carried out at midwife-led maternity health centers, nurse-led Child Health Centers, and nurse-led school health care settings and reach almost everyone (99%). All health care for children and adolescents is free of charge up to 18 years of age.
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