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Purpose We tested “the Galker test”, a speech reception in noise test developed for primary care for Danish preschool children, to explore if the children's ability to hear and understand speech was associated with gender, age, middle ear status, and the level of background noise. Methods The Galker test is a 35-item audio-visual, computerized word discrimination test in background noise. Included were 370 normally developed children attending day care center. The children were examined with the Galker test, tympanometry, audiometry, and the Reynell test of verbal comprehension. Parents and daycare teachers completed questionnaires on the children's ability to hear and understand speech. As most of the variables were not assessed using interval scales, non-parametric statistics (Goodman–Kruskal's gamma) were used for analyzing associations with the Galker test score. For comparisons, analysis of variance (ANOVA) was used. Interrelations were adjusted for using a non-parametric graphic model. Results In unadjusted analyses, the Galker test was associated with gender, age group, language development (Reynell revised scale), audiometry, and tympanometry. The Galker score was also associated with the parents’ and day care teachers’ reports on the children's vocabulary, sentence construction, and pronunciation. Type B tympanograms were associated with a mean hearing 5–6 dB below that of than type A, C1, or C2. In the graphic analysis, Galker scores were closely and significantly related to Reynell test scores (Gamma ( G ) = 0.35), the children's age group ( G = 0.33), and the day care teachers’ assessment of the children's vocabulary ( G = 0.26). Conclusions The Galker test of speech reception in noise appears promising as an easy and quick tool for evaluating preschool children's understanding of spoken words in noise, and it correlated well with the day care teachers’ reports and less with the parents’ reports. [ABSTRACT FROM AUTHOR]

Objective . To explore situations in which parents with an ill child consult a physician and to identify trigger factors for consultation. Design and settings . Qualitative interviews with parents of young children. Parents were asked to describe the situation in which the decision to contact the physician was made. Subjects . A total of 20 families selected from a birth cohort from Frederiksborg County. The cohort numbered 194 of 389 children born between 1 and 28 February 2001. The cohort was followed prospectively from the age of 9 to 12 months by diary (January–April), and retrospectively from birth to the age of 9 months by questionnaire. Families were chosen on the basis of information provided in a questionnaire, diary illness pattern and a telephone conversation. Results . Nine trigger factors associated with physician contacts were identified. Parents’ answers demonstrated how their feelings and logical reasoning while caring for an ill child led them to consult the physician. The main reasons for consultation were children's protracted or aggravated symptoms. Parents initially tried to handle the situation but when unsuccessful information and advice was sought by consulting a physician. Conclusions . Parents consult the physician when they feel overtaxed, afraid, or inadequately prepared to care for their ill child. They considered seriously whether to consult a physician or not. [ABSTRACT FROM AUTHOR]

In this study we describe and analyse the health status, health-care consumption and the characteristics of persons visiting the primary care centre because of frequent symptoms of respiratory tract infections (RTI) (n = 83) and disorders related to the musculoskeletal system (DMS) (n = 166) as described in medical records for a three-year period. When all the medical diagnoses, health-care consumption, sick leave and other information had been gathered, the findings were that more women (73%) than men fulfilled the inclusion criteria. On average, the group with the highest frequency of symptoms paid 8.3 visits/three years to the physician compared with 1.0 for the controls (p0.05). The average total sick-leave attributable to RTI was 29.4 days/3 years and 8.1 days/3 years for the controls. Forty percent of patients in the frequent symptoms group had regular contact with children at work compared with only 18% of the controls. Subjects in the former group were usually manual workers with an increased physical and psychological workload compared with the controls. This group of subjects probably represents a category of vulnerable patients and their total situation should be further investigated. [ABSTRACT FROM AUTHOR]

The article talks about keeping preschool children away from infections, which includes immunization and hand hygiene, stating that outdoor environment could help in keeping infections at bay; and being outdoors help offers shady vegetation, slimmer waists and improved sleep at night.

The author reflects on the occurrence of diarrhoea among preschool children attending child day care. She discusses the study by B. Jensen et al. within the issue which determines the aetiology of diarrhoea episodes among children in day care and the risk factors for diarrhoea. Among the risk factors for diarrhoea mentioned include a history of infant colic and growing up with a pet in the house.

More scheduled outdoor stay is increasingly advocated for school children. This study measured 2nd, 5th and 8th graders' erythemal UV-exposure in September, March and May at four Swedish schools. We related those exposures, as fractions of total available ambient radiation, to the schools outdoor environments differing in amount of shade, vegetation, and peripheral city-scape quantified as percentage of free sky view calculated from fish-eye photographs. Exposures correlated with the sky views (with exceptions in May) and were suberythemal. The exposures were also below the threshold limit of the International Commission on Non-Ionizing Radiation Protection ( ICNIRP) for hazard evaluation of UVR but were potentially enough for adequate vitamin D formation according to a cited model calculation - as illustrated in the results and discussed. The school environments, typical in southern and middle Sweden, offer enough shade to protect children from overexposure during seasons with potentially harmful solar UV radiation. Pupils' outdoor stay may be extended during September and March. In May extended outdoor stay of the youngest pupils requires a more UVR-protective environment. [ABSTRACT FROM AUTHOR]

Purpose This study evaluates initial validity and reliability of the “Galker test of speech reception in noise” developed for Danish preschool children suspected to have problems with hearing or understanding speech against strict psychometric standards and assesses acceptance by the children. Methods The Galker test is an audio-visual, computerised, word discrimination test in background noise, originally comprised of 50 word pairs. Three hundred and eighty eight children attending ordinary day care centres and aged 3–5 years were included. With multiple regression and the Rasch item response model it was examined whether the total score of the Galker test validly reflected item responses across subgroups defined by sex, age, bilingualism, tympanometry, audiometry and verbal comprehension. Results A total of 370 children (95%) accepted testing and 339 (87%) completed all 50 items. The analysis showed that 35 items fitted the Rasch model. Reliability was 0.75 before and after exclusion of the 15 non-fitting items. In the stepwise linear regression model age group of children could explain 20% of the variation in Galker-35-score, sex 1%, second language at home 4%, tympanometry in best ear 2%, and parental education another 2%. Other variable did not reach significance. Conclusion The Galker-35 was well accepted by children down to the age of 3 years and results indicate that the scale represents construct valid and reliable measurement. [ABSTRACT FROM AUTHOR]

Objectives. Parents of sick children frequently visit their general practitioners (GPs). The aim was to explore parents' interpretation of their child's incipient signs and symptoms when falling ill and their subsequent unsatisfactory experience with the GP in order to make suggestions for improvements in the medical encounter. Design. Semi-structured interviews. Setting and subjects. Twenty strategically selected families with a child from a birth cohort in Frederiksborg County, Denmark were interviewed. Results. Parents wanted to consult their GP at the right time, i.e. neither too early nor too late. Well-educated parents experienced a discrepancy between their knowledge about their child, the information they had sought about the illness and the consultation with the GP, when they were dismissed with phrases such as ''it will disappear'' or ''it is just a virus''. The parents went along with the GP's advice if the child only occasionally became sick. However, parents of children with recurrent illnesses seemed very frustrated. During the course of several consultations with their GP, they started to question the GP's competence as the child did not regain health. Conclusions. Parents want to be acknowledged as competent collaborators. The GP's failure to acknowledge the parents' knowledge of their child's current illness, and the parents' attempt to identify what is wrong with the child and make the child feel better before the encounter may have consequences for the GP's credibility. It is therefore recommended that parents of children with recurrent illnesses receive extra attention and information. [ABSTRACT FROM AUTHOR]

Objective. The sale of paracetamol products for children is increasing, and more children are accidentally given overdoses, even though the use of paracetamol against fever is still under discussion. This study explores Danish parents’ use of paracetamol for feverish children and their motives for this use. Design. A cross-sectional survey using structured interviews. Setting. Four general practices located in city, suburb, and rural area. Subjects. A total of 100 Danish parents with at least one child under the age of 10 years. Main outcome measures. Number of parents administering paracetamol to feverish children, situations triggering medication of a child, parental views regarding fever and effects of paracetamol, and sources of information on fever treatment. Results. Three in four parents use paracetamol for feverish children, mainly to reduce temperature, to decrease pain, and to help the child fall asleep. Highly educated parents medicate more often than less educated. Parents often fear fever but this does not clearly affect their use of paracetamol. Many parents believe in perceived beneficial effects of paracetamol, such as increased appetite and well-being, better sleep, and prevention of fever seizures. These expectations of paracetamol influence parental use of the drug. Parents’ main source of information on fever and paracetamol is their general practitioner (GP). Conclusions. Danish parents regularly treat feverish children with paracetamol. Although parents contact their GP for advice on fever treatment, paracetamol is sometimes given to children on vague indications. Clearer information for parents on when to give paracetamol as fever treatment may help regulate its use. [ABSTRACT FROM AUTHOR]

While there is growing awareness of the importance of gender issues in medicine, with new knowledge and new perspectives intensely debated, reports on the implementation of gender issues into medical curricula are scarce. In 1996, the Medical Faculty of Göteborg University, Sweden, determined that a gender-issues perspective be included in medical education. In 1999, course organizers from preclinical and clinical departments of the faculty were interviewed to determine whether they felt that a gender-issues perspective had contributed to their scientific field and, if so, how they implemented it in their teaching. The interviews revealed varied opinions on the relevance of this perspective in medicine. These variations followed gender division rather titan that of preclinicians/clinicians. Thus, female gender was overwhelming for inspiring and introducing a gender-issues perspective both scientifically and practically. Positivism is firmly established in medicine and this must be taken into consideration when introducing a more culturally- and socially-based understanding of sex/gender issues. Female gender is important in this process, but successful implementation requires thorough faculty support and participation of male colleagues and students. [ABSTRACT FROM AUTHOR]

Objective - To elucidate the prevalence of potential pathogenic bacteria in nasopharyngeal samples from healthy individuals, and the influence on the carrier rate of age, season of the year, and type of child day care. Design - Nasopharyngeal swab samples obtained in routine medical care from individuals with no sign of infection were studied in 159 pre-school children aged below 7 years, 198 schoolchildren aged 7-15 years, and 261 adults (· 16 years). Results - The prevalence of pathogenic bacteria in healthy individuals decreased with age. The overall isolation frequencies for pre-schoolchildren, schoolchildren, and adults, respectively, were: Moraxella catarrhalis (27%, 4% and 2%); Streptococcus pneumoniae (19%, 6% and 0.8%); Haemophilus influenzae (13%, 6% and 3%). The prevalence of S. pneumoniae in children 7-15 years was higher during the summer than in the winter. We could not confirm any variation in the carrier rate due to the type of child day care. Conclusion - Potentially pathogenic bacteria are often present in nasopharyngeal samples taken from healthy pre-school children, but rarely from people ≥ 16 years of age. This means that the use of nasopharyngeal samples to discriminate between bacterial and viral respiratory tract infection needs to be evaluated further in patients < 16 years. The importance of the seasonal variation in the prevalence of potential pathogenic bacteria in the nasopharynx needs further study. [ABSTRACT FROM AUTHOR]

Background: Long outdoor stay may cause hazardous exposure to ultraviolet radiation (UVR) from the sun even at high latitudes as in Sweden (Spring to Autumn). On the other hand, long outdoor stay is a strong predictor of primary school children´s free mobility involving moderate to vigorous physical activity (MVPA). UV‐protective outdoor environments enable long outdoor stay. We investigated the concurrent impact of different school outdoor play settings upon pupils´ sun exposure and levels of physical activity across different ages, genders, and seasons. Method: During 1 week each in September, March, and May, UVR exposure and MVPA were measured in pupils aged 7‐11 years. Erythemally effective UVR exposure was measured by polysulphone film dosimeters and MVPA by accelerometers. Schoolyard play was recorded on maps, and used areas defined as four play settings (fixed play equipment, paved surfaces, sport fields, and green settings), categorized by season and gender. Results: During the academic year, sport fields yielded the highest UVR exposures and generated most time in MVPA. In March, time outdoors and minutes in MVPA dropped and UVR exposures were suberythemal at all play settings. In May, green settings and fixed play equipment close to greenery promoted MVPA and protected from solar overexposure during long outdoor stays. Conclusion: More outdoor activities in early spring are recommended. In May, greenery attractive for play could protect against overexposure to UVR and stimulate both girls and boys to vigorous play. [ABSTRACT FROM AUTHOR]

Objectives. Some parents with a sick infant contact a doctor, while others do not. The reasons underlying such parental decisions have not been thoroughly studied. The purpose of this study was to explore how the actual symptoms in the infant were associated with parent-rated illness, illness severity, and the probability of the parents contacting a doctor. Design. A retrospective questionnaire and a prospective diary study covering 14 months of the participating infants'' lives. Setting and subjects. The 194 participating infants were followed for three months prospectively from the age of 11 to 14 months using diary cards, and retrospectively from birth until the age of 11 months by a questionnaire. Results. During the three months of the diary card prospective follow-up, the infants had symptoms on average every second day, and the vast majority (92%) had 10 or more days with at least one symptom; 38% of the infants were reported to have had five or more symptoms for more than five days. Fever, earache, and vomiting were the symptoms most likely to cause parents to rate their infant as ill. Earache was the symptom that triggered doctor contact most immediately. The parent-rated illness severity was strongly related to the tendency to contact a doctor. However, this association was markedly weaker when adjustment was made for the infant not eating normally, having a cough, or running a fever. Conclusion. Specific symptoms such as fever, earache, and vomiting were strongly associated with the probability of parents rating the infant as ill. An earache would cause the parents to contact a doctor. Fever and vomiting were other symptoms triggering doctor contacts. First, these symptoms could cause the parents to want a doctor's expert evaluation of the infant's illness; second, the parents could expect medication to be necessary; or third, it could just be difficult for the parents to handle the ill infant. [ABSTRACT FROM AUTHOR]