15,337 results on '"PEDIATRICS"'
Search Results
2. Estudio epidemiológico de salud bucodental en escolares de colegios públicos de Bilbao.
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Lertxundi Manterola, Aitana, Marichalar Mendia, Xabier, Medicina preventiva y salud pública, Prebentzio medikuntza eta osasun publikoa, Fernández Bonet, Jon, Lertxundi Manterola, Aitana, Marichalar Mendia, Xabier, Medicina preventiva y salud pública, Prebentzio medikuntza eta osasun publikoa, and Fernández Bonet, Jon
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238 p., Antecedentes: La caries dental y la mordida abierta anterior afectan negativamente a la calidad de vida de los escolares causando dolor y afectando tanto a la estética como a la futura oclusión.Objetivos: Los objetivos de este estudio son describir el estado de salud bucodental de los escolares de 5a 8 años de una muestra tomada en colegios públicos de Bilbao, identificar la relación entre las variables sociodemográficas y el desarrollo de caries dental y mordida abierta anterior, así como comparar estos resultados con los obtenidos en la Comunidad Autónoma del País Vasco (España). Métodos: Se trata de un estudio epidemiológico descriptivo de diseño transversal con una muestra representativa (n = 1682) de escolares entre marzo de 2016 y octubre de 2017. Las variables dependientes fueron los índices de caries dental y la prevalencia de mordida abierta anterior, determinadas mediante exploraciones bucodentales realizadas por un único dentista. Por otro lado, las variables independientes se obtuvieron mediante cuestionarios cumplimentados por las familias y el alumnado, con ayuda del profesorado si fuera necesario. Se utilizaron contrastes no paramétricos para realizar el análisis descriptivo con las variables explicativas y posteriormente se construyeron modelos de regresión logística para formar modelos predictivos. El nivel de significación utilizado fue de ¿=0,05 para la toma de decisiones.Resultados: Las medias y desviación estándar (DE) de los índices de caries dental cod, CAOD, CAOS y CAOM fueron 1,25±2,20, 0,16±0,61, 0,20±0,90 y 0,15±0,58, respectivamente. Entre todos los escolares,los pertenecientes a la clase manual y a familias con estudios inferiores, así como los pertenecientes al grupo étnico de origen romaní, obtuvieron los índices de caries más elevados tanto en la dentición primaria como en la permanente.La prevalencia de mordida abierta anterior fue del 2,3% en el total de la muestra, del 3,9% en los escolares <6 años y del 1,7% en los ¿6 años. Manten
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- 2025
3. Exploring challenges in the diagnosis and management of congenital heart disease: innovative approaches and current p
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Gutiérrez Ramírez, Gennys María, Rodríguez Suárez, Carlos Omar, Villamizar Cáceres, Angie Carolina, Andrade Riera, Susan Marcela, Rocha H, Ana Gabriela, Montenegro Salas, Daniela Stephanie, Diaz Parra, María Elena, Gutiérrez Ramírez, Gennys María, Rodríguez Suárez, Carlos Omar, Villamizar Cáceres, Angie Carolina, Andrade Riera, Susan Marcela, Rocha H, Ana Gabriela, Montenegro Salas, Daniela Stephanie, and Diaz Parra, María Elena
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Introduction: Congenital heart disease is believed to be one of the most common chronic diseases in children; with a complex set of symptoms, treatments, emotional and social variables, these variables affect not only the mental health of the child, but also that of his or her entire family. In health, these variables have a significant impact on the dynamic and functional processes of family life. Development: The development addresses everything related to the diagnosis of congenital heart disease. In addition, the diagnosis, treatment and innovative approaches and current perspectives in pediatrics are addressed. Reaching the conclusion. with future lines of research with respect to the subject matter addressed in the article. Conclusions: Congenital heart disease in childhood presents many different symptoms and signs. The resulting complications can have serious and even fatal consequences, so early and timely diagnosis, especially in the prenatal period, is very important. It is important for pediatricians to monitor morbidity and mortality due to this cause and to take measures that help guide health priorities based on the evaluation of the results of programs and services for these diseases., Introducción: Se cree que las cardiopatías congénitas son una de las enfermedades crónicas más comunes en los niños; con un conjunto complejo de síntomas, tratamientos, variables emocionales y sociales, estas variables afectan no sólo la salud mental del niño o niña, sino también de toda su familia. En la salud, estas variables inciden significativamente en los procesos dinámicos y funcionales de la vida familiar Desarrollo: El desarrollo aborda todo lo relacionado con el diagnostico de las cardiopatías congénitas. Además, se aborda el diagnóstico, tratamiento y los enfoques innovadores y perspectivas actuales en pediatría. Llegando a la conclusión. con las futuras líneas de investigación con respecto a la temática abordada en el artículo. Conclusiones: Las cardiopatías congénitas en la infancia presentan muchos síntomas y signos diferentes. Las complicaciones resultantes pueden tener consecuencias graves e incluso mortales, por lo que el diagnóstico temprano y oportuno, especialmente en el período prenatal, es muy importante. Es importante que los pediatras monitoreen la morbilidad y mortalidad por esta causa y tomen medidas que ayuden a orientar las prioridades de salud a partir de la evaluación de los resultados de los programas y servicios para estas enfermedades.
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- 2024
4. Fear, coping and support- from the perspective of children aged 10-17-year old having acute lymphoblastic leukemia
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Leibring, Ingela, Kihlgren, Annica, Anderzén Carlsson, Agneta, Leibring, Ingela, Kihlgren, Annica, and Anderzén Carlsson, Agneta
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Purpose: To describe experiences of fear, coping, and support in 10–17-year-old children under treatment for acute lymphoblastic leukaemia (ALL). Methods: A longitudinal descriptive qualitative design was adopted. Ten children participated in one to three interviews each (24 interviews in all). Interviews were analysed using a matrix-based qualitative method. Results: The variety of fears described related to uncertainty, pain and medical procedures, bodily changes and loss of control, complications, professionals’ attitudes, affected school results, and social isolation. Children used various strategies to deal with fear: some more general, to cope with the whole situation, and others more related to specific events such as treatment and tests. The most reported strategies we labelled Accepting the situation, Positive thinking, and Being an active agent. Less favourable strategies were also reported. Health care professionals, families, and friends offered valuable, but different kinds of, support. Conclusions: Children aged 10 to 17 undergoing treatment for ALL experience various fears. Each experience is individual and changes over time, but there are common patterns. Most children used problem-solving or emotional-regulation strategies, but withdrawal was also reported. Even children who can deal with fear need support from their health care professionals, families, and friends.
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- 2024
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5. Clonidine as analgesia during retinopathy of prematurity screening in preterm infants -cloROP
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Carlsen Misic, Martina, Eriksson, Mats, Normann, Erik, Pettersson, Miriam, Thernström-Blomqvist, Ylva, Olsson, Emma, Carlsen Misic, Martina, Eriksson, Mats, Normann, Erik, Pettersson, Miriam, Thernström-Blomqvist, Ylva, and Olsson, Emma
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Background Preterm infants are vulnerable and sensitive to stimuli, during their stay in neonatal intensive care they undergo frequent stressful and painful procedures. One of these painful procedures is the screening for retinopathy of prematurity, ROP. In Sweden all preterm infants born before gestation week 30 undergo ROP-screening. The screening involves regular eye examinations to detect ROP at the early stages and these examinations are both stressful and painful. Several studies have investigated different ways of pain management during eye examinations with inconsequent results. No study has investigated Clonidine as pain management during ROP-screening. Aim The aim of this clinical trial is to investigate the analgesic effect of clonidine during ROP eyeexaminations. Method This study is a multicenter randomized controlled clinical trial with a crossover design. Infants born before gestation week 30 and therefore undergoing ROP-screening, will be eligible for inclusion in the study. Infants will be recruited from two Swedish NICUs (neonatal intensive care units). The NICUs use different examination techniques, where NICU A uses indirect ophthalmoscopy while NICU B uses RetCam. A total of 50 infants will be recruited (25 at each NICU). During the first eye examination the infant will be randomized to either clonidine 4mcg/kg or sterile water in the equivalent dose 60 minutes before the eye examination. The order of the treatment is blinded for everyone except the nurse preparing the study solution. During the second eye examination the infant will receive the study solution, (intervention or placebo) that he/she did not receive the first time. The primary outcome of the study is pain assessment with the Premature Infant Pain Profile – Revised. The infants´ face and monitor showing oxygen saturation and heart rate will be videorecorded to be able to assess the pain afterwards. The secondary outcome is Galvanic Skin Response where three probes are attached
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- 2024
6. Fear, coping and support : from the perspective of children aged 10-17-year old having acute lymphoblastic leukemia
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Leibring, Ingela, Kihlgren, Annica, Anderzen-Carlsson, Agneta, Leibring, Ingela, Kihlgren, Annica, and Anderzen-Carlsson, Agneta
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Purpose: To describe experiences of fear, coping, and support in 10-17-year-old children under treatment for acute lymphoblastic leukaemia (ALL). Methods: A longitudinal descriptive qualitative design was adopted. Ten children participated in one to three interviews each (24 interviews in all). Interviews were analysed using a matrix-based qualitative method. Results: The variety of fears described related to uncertainty, pain and medical procedures, bodily changes and loss of control, complications, professionals' attitudes, affected school results, and social isolation. Children used various strategies to deal with fear: some more general, to cope with the whole situation, and others more related to specific events such as treatment and tests. The most reported strategies we labelled Accepting the situation, Positive thinking, and Being an active agent. Less favourable strategies were also reported. Health care professionals, families, and friends offered valuable, but different kinds of, support. Conclusions: Children aged 10 to 17 undergoing treatment for ALL experience various fears. Each experience is individual and changes over time, but there are common patterns. Most children used problem-solving or emotional-regulation strategies, but withdrawal was also reported. Even children who can deal with fear need support from their health care professionals, families, and friends.
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- 2024
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7. Global cross-sectional survey on neonatal pharmacologic sedation and analgesia practices and pain assessment tools : impact of the sociodemographic index (SDI)
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Arribas, Christina, Cavallaro, Giacomo, Gonzalez, Juan-Luis, Lagares, Carolina, Raffaeli, Genny, Smits, Anne, Simons, Sinno H. P., Villamor, Eduardo, Allegaert, Karel, Garrido, Felipe, Arribas, Christina, Cavallaro, Giacomo, Gonzalez, Juan-Luis, Lagares, Carolina, Raffaeli, Genny, Smits, Anne, Simons, Sinno H. P., Villamor, Eduardo, Allegaert, Karel, and Garrido, Felipe
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Background: There is variability in the use of sedatives and analgesics in neonatal intensive care units (NICUs). We aimed to investigate the use of analgesics and sedatives and the management of neonatal pain and distress. Methods: This was a global, prospective, cross-sectional study. A survey was distributed May–November 2022. The primary outcome of this research was to compare results between countries depending on their socio-sanitary level using the sociodemographic index (SDI). We organized results based on geographical location. Results: The survey collected 1304 responses, but we analyzed 924 responses after database cleaning. Responses from 98 different countries were analyzed. More than 60% of NICUs reported having an analgosedation guideline, and one-third of respondents used neonatal pain scales in more than 80% of neonates. We found differences in the management of sedation and analgesia between NICUs on different continents, but especially between countries with different SDIs. Countries with a higher SDI had greater availability of and adherence to analgosedation guidelines, as well as higher rates of analgosedation for painful or distressing procedures. Countries with different SDIs reported differences in analgosedation for neonatal intubation, invasive ventilation, and therapeutic hypothermia, among others. Conclusions: Socio-economic status of countries impacts on neonatal analgosedation management.
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- 2024
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8. Family-centered Music Therapy as Procedural Support in the Pediatric Outpatient Unit : A Mixed Methods Pilot Study
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Silberstein Katzeff, Aviva, Ligård, Emmy, Edlund, Sara M., Ullsten, Alexandra, Silberstein Katzeff, Aviva, Ligård, Emmy, Edlund, Sara M., and Ullsten, Alexandra
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Needle procedures are one of the most common reasons for children to visit hospitals. If unaddressed, negative needle experiences can worsen over time and lead to needle noncompliance, needle fears, and healthcare avoidance. This mixed methods pilot study tested the effect of combined music therapy and standard pharmacological care compared to standard care alone on fear and discomfort in children in connection to a scheduled needle procedure. Children and their parents were also interviewed on their general experience of music therapy and how they regulated fear and discomfort during needle procedures while participating in music therapy. Thirty children aged 0 to 15 and their parents were recruited at the pediatric outpatient unit at The Central Hospital in Karlstad, Sweden. The participants were randomized to an intervention group with music therapy and to a control group that received standard care alone. The children rated their fear and discomfort before, during and after a needle procedure on a child-friendly visual analogue scale. The children and parents who were randomized to the music therapy condition were interviewed about their experiences of music therapy as procedural support. No significant differences between the intervention group and the group with standard care alone were found, indicating that the two groups were equivalent with regard to experienced fear and discomfort. The content analysis of the interviews indicated that the children and their parents considered that the music therapy intervention promoted the participants’ emotion regulation, promoted adaptive coping strategies for both children and the parents, and favorably but also ambivalently affected the context and interactions in the procedural room., This work was supported by the Paediatric Clinic at the Central Hospital in Karlstad, Region Värmland, Sweden, Centre for Clinical Research and Education, Region Värmland, Karlstad, Sweden.
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- 2024
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9. Parents' live singing is a preventive and protective intervention for infants during painful procedures
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Ullsten, Alexandra and Ullsten, Alexandra
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- 2024
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10. Universal healthy school start intervention reduced the body mass index of young children with obesity.
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Patterson, Emma, Nyberg, Gisela, Norman, Åsa, Schäfer Elinder, Liselotte, Patterson, Emma, Nyberg, Gisela, Norman, Åsa, and Schäfer Elinder, Liselotte
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AIM: To evaluate the effect of a universal, school-based family support programme on body mass index (BMI) of children aged 5-7 years, using pooled data from three trials. METHODS: The programme has three to four components and is delivered during the first school year. It aims to promote healthy dietary and physical activity behaviours, and secondarily prevent unhealthy weight gain. Three cluster-randomised controlled trials were conducted between 2010 and 2018 in low and mixed socioeconomic status areas in Sweden. Weight and height were measured. Multiple mixed linear regression analysis was performed on the pooled data. RESULTS: In total, 961 children were included (50% girls, mean age 6.3 years). The post-intervention effect on BMI z-score in all children was small, but in those with obesity at baseline, we observed a significant, clinically relevant, decrease in BMI z-score (-0.21). This was most pronounced in children with a non-Nordic born parent (-0.24). Five to six months after the intervention, decreases were no longer statistically significant. CONCLUSION: The intervention resulted in changes in BMI comparable to obesity treatment programmes focusing on behaviour change. However, the effect attenuated with time suggesting the programme should be sustained and evaluated for a longer time.
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- 2024
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11. Infant feeding : a scoping review for Nordic Nutrition Recommendations 2023
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Hörnell, Agneta, Lagström, Hanna, Hörnell, Agneta, and Lagström, Hanna
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The 2012 edition of the Nordic Nutrition Recommendations (NNR) included recommendations on breastfeeding, based on the most recent guidelines and recommendations from major national food and health authorities and organizations, systematic reviews, and some original research. For NNR 2023, the scope has been expanded and also includes formula feeding and the introduction of solid food. The main focus in this scoping review is on infants aged 0-12 months but also considers parts both before and beyond the first year, as the concept of 'the first 1000 days' emphasizes the importance of factors during pregnancy and the first 2 years of life for immediate and later health: physical as well as emotional and mental health. Breastmilk is the natural and sustainable way to feed an infant during the first months of life. Numerous studies have indicated immediate as well as long-term beneficial effects of breastfeeding on health for both the infant and the breastfeeding mother, and from a public health perspective, it is therefore important to protect, support, and promote breastfeeding. For full-term, normal weight infants, breastmilk is sufficient as the only form of nutrition for the first 6 months, except for vitamin D that needs to be given as supplement. The World Health Organization (WHO) and several other authoritative bodies therefore recommend exclusive breastfeeding during the first 6 months. Starting solids at about 6 months is necessary for both nutritional and developmental reasons. According to the European Food Safety Authority (EFSA) and the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN), solid foods are safe to give from 4 months although exclusive breastfeeding until 6 months is the desirable goal. Breastfeeding can continue together with complementary foods as long as it is mutually desired by the mother and child. If breastfeeding is not enough or for some reason discontinued before the infant is 4 months of age, the
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- 2024
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12. Increased risk of long-term disabilities following childhood bacterial meningitis in Sweden
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Mohanty, Salini, Johansson Kostenniemi, Urban, Silfverdal, Sven-Arne, Salomonsson, Stina, Iovino, Federico, Sarpong, Eric M., Bencina, Goran, Bruze, Gustaf, Mohanty, Salini, Johansson Kostenniemi, Urban, Silfverdal, Sven-Arne, Salomonsson, Stina, Iovino, Federico, Sarpong, Eric M., Bencina, Goran, and Bruze, Gustaf
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IMPORTANCE: Few studies have examined the incidence of long-term disabilities due to bacterial meningitis in childhood with extended follow-up time and a nationwide cohort. OBJECTIVE: To describe the long-term risks of disabilities following a childhood diagnosis of bacterial meningitis in Sweden. DESIGN, SETTING, AND PARTICIPANTS: This nationwide retrospective registry-based cohort study included individuals diagnosed with bacterial meningitis (younger than 18 years) and general population controls matched (1:9) by age, sex, and place of residence. Data were retrieved from the Swedish National Patient Register from January 1, 1987, to December 31, 2021. Data were analyzed from July 13, 2022, to November 30, 2023. EXPOSURE: A diagnosis of bacterial meningitis in childhood recorded in the National Patient Register between 1987 and 2021. MAIN OUTCOMES AND MEASURES: Cumulative incidence of 7 disabilities (cognitive disabilities, seizures, hearing loss, motor function disorders, visual disturbances, behavioral and emotional disorders, and intracranial structural injuries) after bacterial meningitis in childhood. RESULTS: The cohort included 3623 individuals diagnosed with bacterial meningitis during childhood and 32 607 controls from the general population (median age at diagnosis, 1.5 [IQR, 0.4-6.2] years; 44.2% female and 55.8% male, median follow-up time, 23.7 [IQR, 12.2-30.4] years). Individuals diagnosed with bacterial meningitis had higher cumulative incidence of all 7 disabilities, and 1052 (29.0%) had at least 1 disability. The highest absolute risk of disabilities was found for behavioral and emotional disorders, hearing loss, and visual disturbances. The estimated adjusted hazard ratios (HRs) showed a significant increased relative risk for cases compared with controls for all 7 disabilities, with the largest adjusted HRs for intracranial structural injuries (26.04 [95% CI, 15.50-43.74]), hearing loss (7.90 [95% CI, 6.68-9.33]), and motor function disorders (4
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- 2024
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13. Allergic sensitization among schoolchildren in northern Sweden : time trends, risk factors and relation to asthma, allergic rhinitis and lung function.
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Bunne, Joakim and Bunne, Joakim
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Background: Asthma and allergic rhinitis are common chronic diseases of childhood.Their prevalence has increased globally in the 20th century, with regionally diverging trends in recent years. Allergic sensitization (AS) is strongly associated with asthma and allergic rhinitis (AR), with similar trends over time and uncertainty of development in recent years. AS increases in childhood until young adulthood. Risk factors for AS are not as well characterized as for asthma and AR, and important aspects of the relation between AS and disease are not known. This includes why some sensitized children do not develop disease and how common this is in a longitudinal perspective. While many studies have assessed AS in the first years of life, fewer have focused on school age, and none have focused on the effect of age at onset of AS. Further, the association between AS and lung function is unknown. Aims: To assess time trends in prevalence, incidence and factors associated with AS in schoolchildren. Further, to assess the association between AS and asthma, allergic rhinitis and lung function, with special interest in age at onset of sensitization. Methods: Children in grades 1 and 2 (median age 8 years) in two municipalities in northern Sweden were invited to a questionnaire study of allergic diseases and skin prick tests to common aeroallergens in 1996. The cohort was reassessed at 12 and at 19 years also including spirometry. Identical methods were used to recruit a second and third cohort in 2006 and 2017. Results: The prevalence of AS at 8 years was 21% (1996), 30% (2006) and 30% (2017). Patterns of sensitization and risk factors for sensitization were similar. In the second cohort, the incidence between 8-12 years of 18% and prevalence of 41% at 12 years were higher than in the first cohort. Compared with later onset, sensitization ≤8 years was more strongly associated with asthma and allergic rhinitis at 19 years. AS was not independently associated with lung function a, The obstructive lung disease in northern Sweden thesis XXV
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- 2024
14. Validation of red flags in the workup of children with long-term abdominal pain : a retrospective study
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Delin, Malin, Berglund, Staffan K., Delin, Malin, and Berglund, Staffan K.
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Aim: To evaluate red flags as an instrument to distinguish other medical conditions from Functional Gastrointestinal Disorders (FGID) in children with long-term abdominal pain. Methods: In a retrospective follow-up, data were collected from 317 children who were referred for medical assessment due to long-term abdominal pain between the years 2011 and 2012 at three Swedish paediatric open clinic units in Sweden. Throughout the review of medical records, any documented red flags at the primary consultation and finally set diagnosis after 1 year were noted for all cases. Results: A non-FGID disease was diagnosed in 32 cases (10.1%). The sensitivity of red flags to predict inflammatory bowel disease (IBD) was 100% and the specificity 64.1%. The sensitivity of red flags to predict celiac disease was 45.5% and the specificity 63.7%. The sensitivity of red flags to predict any non-FGID disease was 59.4%, and the specificity was 65.6%. Conclusion: The use of red flags is a sensitive instrument to identify patients with IBD but less applicable when identifying celiac disease and other organic diseases. Specificity is generally low and future biomarkers for assessing children with long-term abdominal pain is needed.
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- 2024
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15. Effect of human milk-based fortification in extremely preterm infants fed exclusively with breast milk : a randomised controlled trial
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Jensen, Georg Bach, Domellöf, Magnus, Ahlsson, Fredrik, Elfvin, Anders, Navér, Lars, Abrahamsson, Thomas, Jensen, Georg Bach, Domellöf, Magnus, Ahlsson, Fredrik, Elfvin, Anders, Navér, Lars, and Abrahamsson, Thomas
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Background: Mortality and severe morbidity remain high in extremely preterm infants. Human milk-based nutrient fortifiers may prevent serious complications and death. We aimed to investigate whether supplementation with human milk-based fortifier (HMBF), as compared to bovine milk-based fortifier (BMBF), reduced the incidence of the composite outcome of necrotising enterocolitis (NEC), sepsis, and mortality in extremely preterm infants exclusively fed human milk. Methods: In this multicentre, randomised controlled trial at 24 neonatal units in Sweden, extremely preterm infants born between gestational week 22 + 0 and 27 + 6 fed exclusively human breast milk (mother's own and/or donor milk), were randomly assigned (1:1) to receive targeted fortification with either HMBF or BMBF. Randomisation was conducted before the enteral feeds reached 100 mL/kg/day, and was stratified by enrolment site, gestational age, singleton/twin, and sex. The allocation was concealed before inclusion, but after randomisation the study was not blinded for the clinical staff. For the NEC diagnosis, the study group was masked to an independent radiologist, and the final assessment of NEC and culture-proven sepsis was done by a blinded consensus panel review. The primary outcome was the composite of NEC stage II–III, culture-proven sepsis, and mortality from inclusion to discharge, no longer than postmenstrual week 44 + 0, in the intention-to-treat population (ClinicalTrials.gov, NCT03797157). Findings: Between February 21st, 2019, and May 21st, 2021, 229 neonates were randomly assigned (115 HMBF, 114 BMBF). After exclusion of one infant due to parents’ withdrawal of consent, 228 infants were included in the intention-to-treat analysis. Of the 115 infants assigned to HMBF, 41 (35.7%) fulfilled the criteria of either NEC, sepsis, or death, compared with 39 (34.5%) of 113 infants assigned to BMBF (OR 1.05, 95% CI 0.61–1.81, p = 0.86). Adverse events did not differ significantly between groups. In
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- 2024
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16. Caregiver strategies supporting community participation among children and youth with or at risk for disabilities : a mixed-methods study
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Kaelin, Vera C., Saluja, Shivani, Bosak, Dianna L., Anaby, Dana, Werler, Martha, Khetani, Mary A., Kaelin, Vera C., Saluja, Shivani, Bosak, Dianna L., Anaby, Dana, Werler, Martha, and Khetani, Mary A.
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Introduction: The purpose of this mixed-methods study is to examine the role of caregiver strategies to support community participation among children and youth with disabilities and those at risk, from the caregiver perspective. For the quantitative phase, we tested the hypothesized positive effect of participation-focused caregiver strategies on the relationship(s) between participation-related constructs and community participation attendance and involvement. For the qualitative phase, we solicited caregiver perspectives to explain the quantitative findings. Methods: An explanatory sequential mixed-methods design (QUAN > qual) was used. For the quantitative phase, we conducted secondary analyses of data collected during a second follow-up phase of a longitudinal cohort study, including 260 families of children and youth (mean age: 13.5 years) with disabilities and those at risk [i.e., 120 families of children and youth with craniofacial microsomia (CFM); 140 families of children and youth with other types of childhood-onset disabilities]. Data were collected through the Participation and Environment Measure—Children and Youth, the Pediatric Quality of Life Inventory, and the Child Behavior Checklist and analyzed using structural equation modeling. For the qualitative phase, we conducted semi-structured interviews with eight caregivers of children and youth with disabilities and those at risk (i.e., three caregivers of children and youth with CFM; five caregivers of children and youth with other childhood-onset disabilities). Interviews were transcribed verbatim and inductively content-analyzed. Results: Our model reached acceptable to close model fit [CFI = 0.952; RMSEA = 0.068 (90% CI = 0.054–0.082); SRMR = 0.055; TLI = 0.936], revealing no significant effect of the number of participation-focused caregiver strategies on the relationships between participation-related constructs (e.g., activity competence, environment/context) and community participation in t
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- 2024
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17. Risk factors for isolated atrial septal defect secundum morbidity
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Tanghöj, Gustaf, Naumburg, Estelle, Tanghöj, Gustaf, and Naumburg, Estelle
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Atrial septal defect secundum is a common type of congenital heart defect and even more common among children born premature. The aim of this study was to assess premature birth as a potential associated risk factors for cardiac morbidity in children with isolated ASD II. In this retrospective national registry-based case–control study all children born in Sweden between 2010 and 2015 with an isolated ASD II diagnosis were included. Association between premature birth and cardiac morbidity in children with isolated ASD II was assessed by different outcomes-models using conditional logistic regression and adjustments were made for confounding factors. Overall, 11% of children with an isolated ASD II received treatment for heart failure. Down syndrome was the only independent risk factors for associated with cardiac morbidity in children with ASD II (OR = 2.25 (95%CI 1.25–4.07). Preterm birth in children was not associated with an increased risk of ASD II cardiac morbidity.
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- 2024
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18. Forearm and elbow secondary surgical procedures in neonatal brachial plexus palsy : a systematic scoping review
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Azer, Amanda, Hanna, Aedan, Shihora, Dhvani, Saad, Anthony, Duan, Yajie, McGrath, Aleksandra M, Chu, Alice, Azer, Amanda, Hanna, Aedan, Shihora, Dhvani, Saad, Anthony, Duan, Yajie, McGrath, Aleksandra M, and Chu, Alice
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Background: Neonatal Brachial plexus palsy is an injury during delivery that can lead to loss of motor function and limited range of motion in patients due to damage of nerves in the brachial plexus. This scoping review aims to explore types of procedures performed and assess outcomes of forearm and elbow secondary surgery in pediatric patients. Methods: Searches of PubMed, Cochrane, Cumulative Index to Nursing and Allied Health Literature, Web of Sciences, and Scopus were completed to obtain studies describing surgical treatment of elbow and forearm in pediatric patients with neonatal Brachial plexus palsy. 865 abstracts and titles were screened by two independent reviewers resulting in 295 full text papers; after applying of inclusion and exclusion criteria 18 articles were included. The level of evidence of this study is level IV. Results: Ten main procedures were performed to regain function of the forearm and elbow in neonatal brachial plexus birth palsy patients. Procedures had different aims, with supination contracture (6) and elbow flexion restoration (5) being the most prevalent. The variance between preoperative and postoperative soft tissue and bony procedures outcomes decreased and showed improvement with respect to the aim of each procedure category. For soft tissue procedures, a statistically significant increase was found between preoperative and postoperative values for active elbow flexion, passive supination, and active supination. For bony procedures, there was a statistically significant decrease between preoperative and postoperative values of passive and active supination. Conclusion: Overall, all procedures completed in the assessed articles of this study were successful in their aim. Bony procedures, specifically osteotomies, were found to have a wider range of results, whereas soft tissue procedures were found to be more consistent and reproducible with respect to their outcomes. Bony and soft tissue procedures were found vary in their aims
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- 2024
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19. Insulin resistance prior to term age in very low birthweight infants : a prospective study
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Zamir, Itay, Stoltz Sjöström, Elisabeth, van den Berg, Johannes, Naumburg, Estelle, Domellöf, Magnus, Zamir, Itay, Stoltz Sjöström, Elisabeth, van den Berg, Johannes, Naumburg, Estelle, and Domellöf, Magnus
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Objective: To explore the glucose-related hormone profile of very low birthweight (VLBW) infants and assess the association between neonatal hyperglycaemia and insulin resistance during the admission period. Design: A prospective observational study—the Very Low Birth Weight Infants, Glucose and Hormonal Profiles over Time study. Setting: A tertiary neonatal intensive care unit and four neonatal units in county hospitals in Sweden. Patients: 48 infants born <1500 g (VLBW) during 2016–2019. Outcome measures: Plasma concentrations of glucose-related hormones and proteins (C-peptide, insulin, ghrelin, glucagon-like peptide 1 (GLP-1), glucagon, leptin, resistin and proinsulin), insulin:C-peptide and proinsulin:insulin ratios, Homoeostatic Model Assessment 2 (HOMA2) and Quantitative Insulin Sensitivity Check (QUICKI) indices, measured on day of life (DOL) 7 and at postmenstrual age 36 weeks. Results: Lower gestational age was significantly associated with higher glucose, C-peptide, insulin, proinsulin, leptin, ghrelin, resistin and GLP-1 concentrations, increased HOMA2 index, and decreased QUICKI index and proinsulin:insulin ratio. Hyperglycaemic infants had significantly higher glucose, C-peptide, insulin, leptin and proinsulin concentrations, and lower QUICKI index, than normoglycaemic infants. Higher glucose and proinsulin concentrations and insulin:C-peptide ratio, and lower QUICKI index on DOL 7 were significantly associated with longer duration of hyperglycaemia during the admission period. Conclusions: VLBW infants seem to have a hormone profile consistent with insulin resistance. Lower gestational age and hyperglycaemia are associated with higher concentrations of insulin resistance markers.
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- 2024
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20. Lower bone strength in young patients with Fontan circulation compared to controls
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Wikner, Anna, Johansson, Karna, Enocson, Elin, Sthen Bergdahl, Magne, Hansson, Lena, Rydberg, Annika, Sandberg, Camilla, Wikner, Anna, Johansson, Karna, Enocson, Elin, Sthen Bergdahl, Magne, Hansson, Lena, Rydberg, Annika, and Sandberg, Camilla
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Objectives: Previous reports indicate bone deficits in patients with Fontan circulation. However, the consequences of these deficits on bone strength and when these changes occur are unclear. Aim: To compare the tibial bone strength-strain index between young patients (6-19 years) with Fontan circulation and age- and sex-matched controls, and to determine strength-strain-index in subgroups of children (6-12 years) and adolescents (13-19 years) versus controls. Method: The tibia was examined with peripheral quantitative CT. Based on the assessed data, bone strength-strain index was calculated in the lateral and anterior-posterior directions. Results: Twenty patients with Fontan and twenty controls (mean age 13.0 ± 4.4 years; 50% females) were examined. Patients had a lower strength-strain index in the lateral direction compared to controls (808.4 ± 416.8mm3 versus 1162.5 ± 552.1mm3, p = 0.043). Subgroup analyses showed no differences regarding strength-strain index in children (6-12 years) with Fontan circulation compared to controls. However, the adolescents (13-19 years) with Fontan circulation had lower strength-strain indexes in both the lateral and anterior-posterior directions compared to controls (1041.4 ± 299.8mm3 versus 1596.4 ± 239.6mm3, p < 0.001, and 771.7 ± 192.4mm3 versus 1084.9 ± 215.0mm3, p = 0.004). When adjusted for height, there were differences between patients (6-19 years) and controls in strength-strain indexes in both the lateral and anterior-posterior directions. In subgroup analyses, the results remained robust. Conclusion: Young patients (6-19 years) with Fontan circulation have a lower strength-strain index in the tibia compared to controls. Subgroup analyses show that this deficit is mainly driven by the differences in adolescents (13-19 years), which might suggest that bone strength decreases with age.
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- 2024
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21. Decreasing prevalence of atopic dermatitis in Swedish schoolchildren : three repeated population-based surveys
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af Klinteberg, Maja, Winberg, Anna, Andersson, Martin, Rönmark, Eva, Hedman, Linnea, af Klinteberg, Maja, Winberg, Anna, Andersson, Martin, Rönmark, Eva, and Hedman, Linnea
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Background: The prevalence of atopic dermatitis (AD) has increased over several decades and now affects about one-fifth of all children in high-income countries (HICs). While the increase continues in lower-income countries, the prevalence of AD might have reached a plateau in HICs. Objectives: To investigate trends in the prevalence of AD and atopic comorbidity in schoolchildren in Sweden. Methods: The study population consisted of three cohorts of children (median age 8 years) in Norrbotten, Sweden, for 1996 (n = 3430), 2006 (n = 2585) and 2017 (n = 2785). An identical questionnaire that included questions from the International Study of Asthma and Allergies in Childhood (ISAAC) protocol was used in all three cohorts. Trends in AD prevalence were estimated, as well as trends in atopic comorbidity. AD prevalence was estimated both according to the ISAAC definition of AD and by adding the reported diagnosis by a physician (D-AD). Results: The prevalence of AD decreased in the last decade, from 22.8% (1996) and 21.3% (2006) to 16.3% (2017; P < 0.001). The prevalence of D-AD was lower, but the same pattern of decrease was seen, from 9.3% (1996) and 9.4% (2006) to 5.7% (2017; P < 0.001). In all three cohorts, AD was more common among girls than boys (18.9% vs. 13.8% in 2017; P < 0.001). Children from the mountain inlands had a higher prevalence of AD than children from coastal cities (22.0% vs. 15.1% in 2017; P < 0.001). In comparing D-AD, there were no significant differences between the sexes or between inland or coastal living. Concomitant asthma increased over the years from 12.2% (1996) to 15.8% (2006) to 23.0% (2017; P < 0.001). Concomitant allergic rhinitis and allergic sensitization increased from 1996 (15.0% and 27.5%) to 2006 (24.7% and 49.5%) but then levelled off until 2017 (21.0% and 46.7%). Conclusions: The prevalence of AD among schoolchildren in Sweden decreased over the study period, whereas atopic comorbidity among children with AD incr
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- 2024
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22. Disguised incorporation bias and meta-analysis of diagnostic accuracy studies
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Lynøe, Niels, Eriksson, Anders, Lynøe, Niels, and Eriksson, Anders
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- 2024
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23. First Real-Life Data on the Diving Response in Healthy Children
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Rixen, M., Weickmann, J., Gebauer, R. A., Weidenbach, M., Markel, F., Michaelis, A., Dähnert, I., Wüstenfeld, J., Münch, D., Poschart, M., Sieber, A., Schagatay, Erika, Paech, C., Rixen, M., Weickmann, J., Gebauer, R. A., Weidenbach, M., Markel, F., Michaelis, A., Dähnert, I., Wüstenfeld, J., Münch, D., Poschart, M., Sieber, A., Schagatay, Erika, and Paech, C.
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Swimming and diving are popular recreational activities, representing an effective option in maintaining and improving cardiovascular fitness in healthy people. To date, only little is known about the cardiovascular adaption to submersion in children. This study was conducted to improve an understanding thereof. We used a stepwise apnea protocol with apnea at rest, apnea with facial immersion, and at last apnea during whole body submersion. Continuous measurement of heart rate, oxygen saturation, and peripheral resistance index was done. Physiologic data and analysis of influencing factors on heart rate, oxygen saturation, and peripheral vascular tone response are reported. The current study presents the first data of physiologic diving response in children. Data showed that facial or whole body submersion leads to a major drop in heart rate, and increase of peripheral resistance, while the oxygen saturation seems to be unaffected by static apnea in most children, with apnea times of up to 75 s without change in oxygen saturation.
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- 2024
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24. Strategies Used by Professionals in Pediatric Rehabilitation to Engage the Child in the Intervention Process : A Scoping Review
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Antoniadou, Marianna, Granlund, Mats, Andersson, Anna Karin, Antoniadou, Marianna, Granlund, Mats, and Andersson, Anna Karin
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AimTo investigate strategies used by professionals in pediatric rehabilitation to engage children in every step of the intervention process, including assessment, goal setting, planning and implementation of the intervention, and results evaluation.MethodsA scoping literature review was conducted, and seven databases were searched, including CINAHL and MEDLINE, ProQuest Central, PsycINFO, Social Science Premium Collection, PubMed, and Web of Science. A citation search of included articles was completed. Predetermined criteria, quality standards, and PIO framework guided the selection process. Results were presented in relation to Self-Determination Theory (SDT) and the contextual model of therapeutic change.ResultsIn total, 20 studies were included in the review. Pediatric professionals reported that therapeutic use of self and their own engagement in the intervention facilitated the establishment of a supportive relationship. Providing clear explanations about their role and therapy rationale developed positive expectations. By making the child feel successful within-session and outside-session activities, professionals enhanced child mastery. Professionals' strategies were abstractly described.ConclusionsFurther research is needed to investigate strategies that are effective in the different steps of the intervention. More observational, longitudinal studies are required to capture fluctuations in in-session engagement.
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- 2024
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25. Universal healthy school start intervention reduced the body mass index of young children with obesity.
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Patterson, Emma, Nyberg, Gisela, Norman, Åsa, Schäfer Elinder, Liselotte, Patterson, Emma, Nyberg, Gisela, Norman, Åsa, and Schäfer Elinder, Liselotte
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AIM: To evaluate the effect of a universal, school-based family support programme on body mass index (BMI) of children aged 5-7 years, using pooled data from three trials. METHODS: The programme has three to four components and is delivered during the first school year. It aims to promote healthy dietary and physical activity behaviours, and secondarily prevent unhealthy weight gain. Three cluster-randomised controlled trials were conducted between 2010 and 2018 in low and mixed socioeconomic status areas in Sweden. Weight and height were measured. Multiple mixed linear regression analysis was performed on the pooled data. RESULTS: In total, 961 children were included (50% girls, mean age 6.3 years). The post-intervention effect on BMI z-score in all children was small, but in those with obesity at baseline, we observed a significant, clinically relevant, decrease in BMI z-score (-0.21). This was most pronounced in children with a non-Nordic born parent (-0.24). Five to six months after the intervention, decreases were no longer statistically significant. CONCLUSION: The intervention resulted in changes in BMI comparable to obesity treatment programmes focusing on behaviour change. However, the effect attenuated with time suggesting the programme should be sustained and evaluated for a longer time.
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- 2024
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26. Fear, coping and support- from the perspective of children aged 10-17-year old having acute lymphoblastic leukemia
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Leibring, Ingela, Kihlgren, Annica, Anderzén Carlsson, Agneta, Leibring, Ingela, Kihlgren, Annica, and Anderzén Carlsson, Agneta
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Purpose: To describe experiences of fear, coping, and support in 10–17-year-old children under treatment for acute lymphoblastic leukaemia (ALL). Methods: A longitudinal descriptive qualitative design was adopted. Ten children participated in one to three interviews each (24 interviews in all). Interviews were analysed using a matrix-based qualitative method. Results: The variety of fears described related to uncertainty, pain and medical procedures, bodily changes and loss of control, complications, professionals’ attitudes, affected school results, and social isolation. Children used various strategies to deal with fear: some more general, to cope with the whole situation, and others more related to specific events such as treatment and tests. The most reported strategies we labelled Accepting the situation, Positive thinking, and Being an active agent. Less favourable strategies were also reported. Health care professionals, families, and friends offered valuable, but different kinds of, support. Conclusions: Children aged 10 to 17 undergoing treatment for ALL experience various fears. Each experience is individual and changes over time, but there are common patterns. Most children used problem-solving or emotional-regulation strategies, but withdrawal was also reported. Even children who can deal with fear need support from their health care professionals, families, and friends.
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- 2024
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27. Infant feeding : a scoping review for Nordic Nutrition Recommendations 2023
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Hörnell, Agneta, Lagström, Hanna, Hörnell, Agneta, and Lagström, Hanna
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The 2012 edition of the Nordic Nutrition Recommendations (NNR) included recommendations on breastfeeding, based on the most recent guidelines and recommendations from major national food and health authorities and organizations, systematic reviews, and some original research. For NNR 2023, the scope has been expanded and also includes formula feeding and the introduction of solid food. The main focus in this scoping review is on infants aged 0-12 months but also considers parts both before and beyond the first year, as the concept of 'the first 1000 days' emphasizes the importance of factors during pregnancy and the first 2 years of life for immediate and later health: physical as well as emotional and mental health. Breastmilk is the natural and sustainable way to feed an infant during the first months of life. Numerous studies have indicated immediate as well as long-term beneficial effects of breastfeeding on health for both the infant and the breastfeeding mother, and from a public health perspective, it is therefore important to protect, support, and promote breastfeeding. For full-term, normal weight infants, breastmilk is sufficient as the only form of nutrition for the first 6 months, except for vitamin D that needs to be given as supplement. The World Health Organization (WHO) and several other authoritative bodies therefore recommend exclusive breastfeeding during the first 6 months. Starting solids at about 6 months is necessary for both nutritional and developmental reasons. According to the European Food Safety Authority (EFSA) and the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN), solid foods are safe to give from 4 months although exclusive breastfeeding until 6 months is the desirable goal. Breastfeeding can continue together with complementary foods as long as it is mutually desired by the mother and child. If breastfeeding is not enough or for some reason discontinued before the infant is 4 months of age, the
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- 2024
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28. Forearm and elbow secondary surgical procedures in neonatal brachial plexus palsy : a systematic scoping review
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Azer, Amanda, Hanna, Aedan, Shihora, Dhvani, Saad, Anthony, Duan, Yajie, McGrath, Aleksandra M, Chu, Alice, Azer, Amanda, Hanna, Aedan, Shihora, Dhvani, Saad, Anthony, Duan, Yajie, McGrath, Aleksandra M, and Chu, Alice
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Background: Neonatal Brachial plexus palsy is an injury during delivery that can lead to loss of motor function and limited range of motion in patients due to damage of nerves in the brachial plexus. This scoping review aims to explore types of procedures performed and assess outcomes of forearm and elbow secondary surgery in pediatric patients. Methods: Searches of PubMed, Cochrane, Cumulative Index to Nursing and Allied Health Literature, Web of Sciences, and Scopus were completed to obtain studies describing surgical treatment of elbow and forearm in pediatric patients with neonatal Brachial plexus palsy. 865 abstracts and titles were screened by two independent reviewers resulting in 295 full text papers; after applying of inclusion and exclusion criteria 18 articles were included. The level of evidence of this study is level IV. Results: Ten main procedures were performed to regain function of the forearm and elbow in neonatal brachial plexus birth palsy patients. Procedures had different aims, with supination contracture (6) and elbow flexion restoration (5) being the most prevalent. The variance between preoperative and postoperative soft tissue and bony procedures outcomes decreased and showed improvement with respect to the aim of each procedure category. For soft tissue procedures, a statistically significant increase was found between preoperative and postoperative values for active elbow flexion, passive supination, and active supination. For bony procedures, there was a statistically significant decrease between preoperative and postoperative values of passive and active supination. Conclusion: Overall, all procedures completed in the assessed articles of this study were successful in their aim. Bony procedures, specifically osteotomies, were found to have a wider range of results, whereas soft tissue procedures were found to be more consistent and reproducible with respect to their outcomes. Bony and soft tissue procedures were found vary in their aims
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- 2024
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29. Allergic sensitization among schoolchildren in northern Sweden : time trends, risk factors and relation to asthma, allergic rhinitis and lung function.
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Bunne, Joakim and Bunne, Joakim
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Background: Asthma and allergic rhinitis are common chronic diseases of childhood.Their prevalence has increased globally in the 20th century, with regionally diverging trends in recent years. Allergic sensitization (AS) is strongly associated with asthma and allergic rhinitis (AR), with similar trends over time and uncertainty of development in recent years. AS increases in childhood until young adulthood. Risk factors for AS are not as well characterized as for asthma and AR, and important aspects of the relation between AS and disease are not known. This includes why some sensitized children do not develop disease and how common this is in a longitudinal perspective. While many studies have assessed AS in the first years of life, fewer have focused on school age, and none have focused on the effect of age at onset of AS. Further, the association between AS and lung function is unknown. Aims: To assess time trends in prevalence, incidence and factors associated with AS in schoolchildren. Further, to assess the association between AS and asthma, allergic rhinitis and lung function, with special interest in age at onset of sensitization. Methods: Children in grades 1 and 2 (median age 8 years) in two municipalities in northern Sweden were invited to a questionnaire study of allergic diseases and skin prick tests to common aeroallergens in 1996. The cohort was reassessed at 12 and at 19 years also including spirometry. Identical methods were used to recruit a second and third cohort in 2006 and 2017. Results: The prevalence of AS at 8 years was 21% (1996), 30% (2006) and 30% (2017). Patterns of sensitization and risk factors for sensitization were similar. In the second cohort, the incidence between 8-12 years of 18% and prevalence of 41% at 12 years were higher than in the first cohort. Compared with later onset, sensitization ≤8 years was more strongly associated with asthma and allergic rhinitis at 19 years. AS was not independently associated with lung function a, The obstructive lung disease in northern Sweden thesis XXV
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- 2024
30. Fear, coping and support- from the perspective of children aged 10-17-year old having acute lymphoblastic leukemia
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Leibring, Ingela, Kihlgren, Annica, Anderzén Carlsson, Agneta, Leibring, Ingela, Kihlgren, Annica, and Anderzén Carlsson, Agneta
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Purpose: To describe experiences of fear, coping, and support in 10–17-year-old children under treatment for acute lymphoblastic leukaemia (ALL). Methods: A longitudinal descriptive qualitative design was adopted. Ten children participated in one to three interviews each (24 interviews in all). Interviews were analysed using a matrix-based qualitative method. Results: The variety of fears described related to uncertainty, pain and medical procedures, bodily changes and loss of control, complications, professionals’ attitudes, affected school results, and social isolation. Children used various strategies to deal with fear: some more general, to cope with the whole situation, and others more related to specific events such as treatment and tests. The most reported strategies we labelled Accepting the situation, Positive thinking, and Being an active agent. Less favourable strategies were also reported. Health care professionals, families, and friends offered valuable, but different kinds of, support. Conclusions: Children aged 10 to 17 undergoing treatment for ALL experience various fears. Each experience is individual and changes over time, but there are common patterns. Most children used problem-solving or emotional-regulation strategies, but withdrawal was also reported. Even children who can deal with fear need support from their health care professionals, families, and friends.
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- 2024
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31. Çocuk sporcu sağlığı
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Anlar, Yaşar, Atalay, Semra, Ulukol, Betül, Suskan, Emine, Uysal, Zümrüt, Ömeroğlu, Hakan, Bayrak, Mehtap Ersin, Anlar, Yaşar, Atalay, Semra, Ulukol, Betül, Suskan, Emine, Uysal, Zümrüt, Ömeroğlu, Hakan, and Bayrak, Mehtap Ersin
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- 2024
32. Zavallı çocuklar annelere ve anne olacaklara >
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Akar, Nejat and Akar, Nejat
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- 2024
33. Continuous movement quantification in preterm infants using fiber mat: Advancing long-term monitoring in hospital settings
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Peng, Zheng, Zhao, Yidan, Kommers, Deedee, van den Boom, Henrie P.A., Liang, J. (Rong-Hao), Long, Xi, Niemarkt, Hendrik J., Andriessen, Peter, van Pul, Carola, Peng, Zheng, Zhao, Yidan, Kommers, Deedee, van den Boom, Henrie P.A., Liang, J. (Rong-Hao), Long, Xi, Niemarkt, Hendrik J., Andriessen, Peter, and van Pul, Carola
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Movement patterns in preterm infants can offer crucial insights into their physiological state including maturational development and sleep. These patterns can also serve as early indicators for potential deteriorations, such as cerebral palsy, sepsis, and epilepsy. In this study, we investigated a novel 2-D optical fiber mat system for the automated monitoring of infant movement, thereby enhancing the efficiency and safety of neonatal care in both the neonatal intensive care unit (NICU) and neonatal medium care unit (NMCU). The 20 preterm infants admitted to both NICU and NMCU were enrolled in the study. They underwent monitoring for a duration of 2–5 h using both an optical fiber mat and a camera which provided valuable movement annotations. The signals from the fiber mat were quantified, selected, and then integrated into a consolidated movement signal. This signal was subsequently transformed into binary states, distinguishing between “movement” and “still” based on the distribution of the movement signal. The proposed fiber mat system achieved a mean [standard deviation (SD)] area under the receiver operating curve (AUC) of 0.91 (0.05), and an F-score of 0.73 (0.09), when compared with manually annotated video recordings. This study demonstrates the feasibility of continuous movement monitoring for preterm infants within hospital settings. It illustrates the promising potential to evolve into a predictive tool for monitoring patient deterioration through the fusion of physiological information in both hospital environments and within the comfort of homes.
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- 2024
34. Universal healthy school start intervention reduced the body mass index of young children with obesity.
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Patterson, Emma, Nyberg, Gisela, Norman, Åsa, Schäfer Elinder, Liselotte, Patterson, Emma, Nyberg, Gisela, Norman, Åsa, and Schäfer Elinder, Liselotte
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AIM: To evaluate the effect of a universal, school-based family support programme on body mass index (BMI) of children aged 5-7 years, using pooled data from three trials. METHODS: The programme has three to four components and is delivered during the first school year. It aims to promote healthy dietary and physical activity behaviours, and secondarily prevent unhealthy weight gain. Three cluster-randomised controlled trials were conducted between 2010 and 2018 in low and mixed socioeconomic status areas in Sweden. Weight and height were measured. Multiple mixed linear regression analysis was performed on the pooled data. RESULTS: In total, 961 children were included (50% girls, mean age 6.3 years). The post-intervention effect on BMI z-score in all children was small, but in those with obesity at baseline, we observed a significant, clinically relevant, decrease in BMI z-score (-0.21). This was most pronounced in children with a non-Nordic born parent (-0.24). Five to six months after the intervention, decreases were no longer statistically significant. CONCLUSION: The intervention resulted in changes in BMI comparable to obesity treatment programmes focusing on behaviour change. However, the effect attenuated with time suggesting the programme should be sustained and evaluated for a longer time.
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- 2024
- Full Text
- View/download PDF
35. Çocuk sporcu sağlığı
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Suskan, Emine, Ulukol, Betül, Atalay, Semra, Anlar, Yaşar, Uysal, Zümrüt, Bayrak, Mehtap Ersin, Ömeroğlu, Hakan, Suskan, Emine, Ulukol, Betül, Atalay, Semra, Anlar, Yaşar, Uysal, Zümrüt, Bayrak, Mehtap Ersin, and Ömeroğlu, Hakan
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- 2024
36. Zavallı çocuklar annelere ve anne olacaklara >
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Akar, Nejat and Akar, Nejat
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- 2024
37. Use of rasburicase to improve kidney function in children with hyperuricemia and acute kidney injury
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Pediatría, Pediatria, Herrero Goñi, María, Zugazabeitia Irazábal. Amaia, Madariaga Domínguez, Leire, Chavarri Gil, Estibaliz, Gondra Sangroniz, Leire, Aguirre Meñica, Mireia, Pediatría, Pediatria, Herrero Goñi, María, Zugazabeitia Irazábal. Amaia, Madariaga Domínguez, Leire, Chavarri Gil, Estibaliz, Gondra Sangroniz, Leire, and Aguirre Meñica, Mireia
- Abstract
Background Hyperuricemia contributes to decrease in kidney function and induces additional renal damage in children with acute kidney injury (AKI). Rasburicase oxidizes uric acid (UA), decreasing its serum quantities in less than 24 h. Methods This is a retrospective study involving hospitalized patients under 18 years of age with underlying pathology diagnosed with AKI and severe hyperuricemia treated with rasburicase over a 4-year period. Results We describe 15 patients from 4 days of life to 18 years (median: 4.4 years). Seventy-three percent had known underlying pathologies. All presented worsening of basal renal function or AKI data. All received the usual medical treatment for AKI without response. Twenty percent received an extrarenal depuration technique. All had hyperuricemia with a mean (± SD) of 13.1 (± 2.19) mg/dl. After rasburicase administration UA levels fell to a mean (± SD) of 0.76 (± 0.62) mg/dl (p < 0.001) in less than 24 h. In parallel, a decrease in the mean plasma creatinine was observed (2.92 mg/dl to 1.93 mg/dl (p = 0.057)) together with a significant improvement of the mean glomerular filtration rate (16.3 ml/min/1.73 m2 to 78.6 ml/min/1.73 m2) (p = 0.001)). No side effects were recorded. Kidney function normalized in all cases or returned to baseline levels. Conclusions Although the use of rasburicase is not routinely approved in pediatric patients with severe hyperuricemia and AKI, it has been used successfully without complications, and helped prevent progressive kidney damage. This study could serve as a basis for suggesting the off-label use of rasburicase for the management of complex pediatric patients in whom UA plays an important role in the development of AKI.
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- 2024
38. Educational readiness among health professionals in rheumatology : low awareness of EULAR offerings and unfamiliarity with the course content as major barriers – results of a EULAR-funded European survey
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Ritschl, Valentin, Sperl, Lisa, Andrews, Margaret Renn, Björk, Mathilda, Boström, Carina, Cappon, Jeannette, Davergne, Thomas, de la Torre-Aboki, Jenny, de Thurah, Annette, Domján, Andrea, Dragoi, Razvan Gabriel, Estévez-López, Fernando, Ferreira, Ricardo J. O., Fragoulis, George E., Grygielska, Jolanta, Kõrve, Katti, Kukkurainen, Marja Leena, Madelaine-Bonjour, Christel, Marques, Andréa, Meesters, Jorit, Moe, Rikke Helene, Moholt, Ellen, Mosor, Erika, Naimer-Stach, Claudia, Ndosi, Mwidimi, Pchelnikova, Polina, Primdahl, Jette, Putrik, Polina, Rausch Osthoff, Anne-Kathrin, Smucrova, Hana, Testa, Marco, van Bodegom-Vos, Leti, Peter, Wilfred F., Zangi, Heidi A., Zimba, Olena, Vliet Vlieland, Theodora P. M., Stamm, Tanja A., Ritschl, Valentin, Sperl, Lisa, Andrews, Margaret Renn, Björk, Mathilda, Boström, Carina, Cappon, Jeannette, Davergne, Thomas, de la Torre-Aboki, Jenny, de Thurah, Annette, Domján, Andrea, Dragoi, Razvan Gabriel, Estévez-López, Fernando, Ferreira, Ricardo J. O., Fragoulis, George E., Grygielska, Jolanta, Kõrve, Katti, Kukkurainen, Marja Leena, Madelaine-Bonjour, Christel, Marques, Andréa, Meesters, Jorit, Moe, Rikke Helene, Moholt, Ellen, Mosor, Erika, Naimer-Stach, Claudia, Ndosi, Mwidimi, Pchelnikova, Polina, Primdahl, Jette, Putrik, Polina, Rausch Osthoff, Anne-Kathrin, Smucrova, Hana, Testa, Marco, van Bodegom-Vos, Leti, Peter, Wilfred F., Zangi, Heidi A., Zimba, Olena, Vliet Vlieland, Theodora P. M., and Stamm, Tanja A.
- Abstract
Background: Ongoing education of health professionals in rheumatology (HPR) is critical for high-quality care. An essential factor is education readiness and a high quality of educational offerings. We explored which factors contributed to education readiness and investigated currently offered postgraduate education, including the European Alliance of Associations for Rheumatology (EULAR) offerings. Methods and participants: We developed an online questionnaire, translated it into 24 languages and distributed it in 30 European countries. We used natural language processing and the Latent Dirichlet Allocation to analyse the qualitative experiences of the participants as well as descriptive statistics and multiple logistic regression to determine factors influencing postgraduate educational readiness. Reporting followed the Checklist for Reporting Results of Internet E-Surveys guideline. Results: The questionnaire was accessed 3589 times, and 667 complete responses from 34 European countries were recorded. The highest educational needs were ‘professional development’, ‘prevention and lifestyle intervention’. Older age, more working experience in rheumatology and higher education levels were positively associated with higher postgraduate educational readiness. While more than half of the HPR were familiar with EULAR as an association and the respondents reported an increased interest in the content of the educational offerings, the courses and the annual congress were poorly attended due to a lack of awareness, comparatively high costs and language barriers. Conclusions: To promote the uptake of EULAR educational offerings, attention is needed to increase awareness among national organisations, offer accessible participation costs, and address language barriers.
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- 2024
39. The Family Talk Intervention in Pediatric Oncology : Potential Effects Reported by Parents
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Ayoub, Maria, Udo, Camilla, Årestedt, Kristofer, Kreicbergs, Ulrika, Lövgren, Malin, Ayoub, Maria, Udo, Camilla, Årestedt, Kristofer, Kreicbergs, Ulrika, and Lövgren, Malin
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- 2024
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40. Factors associated with the increased incidence of necrotising enterocolitis in extremely preterm infants in Sweden between two population-based national cohorts (2004-2007 vs 2014-2016)
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Challis, Pontus, Kallen, Karin, Bjorklund, Lars, Elfvin, Anders, Farooqi, Aijaz, Hakansson, Stellan, Ley, David, Norman, Mikael, Normann, Erik, Serenius, Fredrik, Savman, Karin, Hellstrom-Westas, Lena, Um-Bergstrom, Petra, Ådén, Ulrika, Abrahamsson, Thomas, Domellof, Magnus, Challis, Pontus, Kallen, Karin, Bjorklund, Lars, Elfvin, Anders, Farooqi, Aijaz, Hakansson, Stellan, Ley, David, Norman, Mikael, Normann, Erik, Serenius, Fredrik, Savman, Karin, Hellstrom-Westas, Lena, Um-Bergstrom, Petra, Ådén, Ulrika, Abrahamsson, Thomas, and Domellof, Magnus
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Objective To investigate potential risk factors behind the increased incidence of necrotising enterocolitis (NEC) in Swedish extremely preterm infants.Design Registry data from two population-based national cohorts were studied. NEC diagnoses (Bell stage >= II) were validated against hospital records.Patients All liveborn infants <27 weeks of gestation 2004-2007 (n=704) and 2014-2016 (n=895) in Sweden.Main outcome measures NEC incidence.Results The validation process resulted in a 28% reduction of NEC cases but still confirmed a higher NEC incidence in the later epoch compared with the earlier (73/895 (8.2%) vs 27/704 (3.8%), p=0.001), while the composite of NEC or death was lower (244/895 (27.3%) vs 229/704 (32.5%), p=0.022). In a multivariable Cox regression model, censored for mortality, there was no significant difference in early NEC (0-7 days of life) between epochs (HR=0.9 (95% CI 0.5 to 1.9), p=0.9), but being born in the later epoch remained an independent risk factor for late NEC (>7 days) (HR=2.7 (95% CI 1.5 to 5.0), p=0.001). In propensity score analysis, a significant epoch difference in NEC incidence (12% vs 2.8%, p<0.001) was observed only in the tertile of infants at highest risk of NEC, where the 28-day mortality was lower in the later epoch (35% vs 50%, p=0.001). More NEC cases were diagnosed with intramural gas in the later epoch (33/73 (45.2%) vs 6/26 (23.1%), p=0.047).Conclusions The increase in NEC incidence between epochs was limited to cases occurring after 7 days of life and was partly explained by increased survival in the most extremely preterm infants. Misclassification of NEC is common., Funding Agencies|ALF grants from Region Vasterbotten; Region Stockholm [2020-0443]; Region Skane; Swedish Research Council [2019-01005, 2020-01236]; Swedish Heart-Lung Foundation [20200808]; Childhood Foundation of the Swedish Order of Freemasons
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- 2024
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41. Factors associated with children's cognitive, language, and motor development in deprived urban settings in Bangladesh
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Hossain, Sheikh Jamal, Hamadani, Jena Derakhshani, Tofail, Fahmida, Fisher, Jane, Rahman, Anisur, Moshfiqur Rahman, Syed, Hossain, Sheikh Jamal, Hamadani, Jena Derakhshani, Tofail, Fahmida, Fisher, Jane, Rahman, Anisur, and Moshfiqur Rahman, Syed
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Background: Children's development is multifactorial. Although there have been several studies exploring the association of children's development with maternal, child, and environmental factors, we are unaware of any study that assessed those factors in children whose mothers were enrolled in a social safety net programme in low- and middle-income countries. This study aimed to identify the factors associated with disadvantaged children's cognitive, language, and motor development at age 6-16 months in deprived settings of urban Bangladesh and to identify relative importance of these factors of children's development. We also explored if there were any gender differences in child development. Methods: This cross-sectional study was conducted in a deprived setting of urban Bangladesh. Bayley III was used for assessing children's cognitive, language, and motor development. Multivariable linear regression model was used to find the factors associated with children's development, and dominance analysis was used to explore the relative importance of the factors. Results: Out of the total 599 mother-child dyads, 303 (50.58%) were girls. The factors associated with children's development were length-for-age Z-score (cognitive: B = 1.21 [95% CI = 0.31, 2.11], P = 0.008; language: 1.67 [0.79, 2.55] P < 0.001; motor: 2.15 [1.01, 3.29] P < 0.001) and home environment (cognitive: 0.58 [0.27, 0.89] P < 0.001; language: 0.59 [0.27, 0.92], P < 0.001; motor: 0.44 [0.09, 0.79] P = 0.013). Girls had higher cognitive (1.90 [0.17, 3.6], P = 0.031) and language (2.53 [0.55, 4.51], P = 0.013) development compared with boys. Families with a higher number of under five children within the households had lower language (-1.57 [-2.78, -0.36], P = 0.011) development. Violence against the mother and the families' food security status were not associated with the children's development. Children's length-for-age Z-score (27%) and home stimulation environment (23%) were the most imp
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- 2024
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42. The Family Talk Intervention in Pediatric Oncology : Potential Effects Reported by Parents
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Ayoub, Maria, Udo, Camilla, Årestedt, Kristofer, Kreicbergs, Ulrika, Lövgren, Malin, Ayoub, Maria, Udo, Camilla, Årestedt, Kristofer, Kreicbergs, Ulrika, and Lövgren, Malin
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Background: Childhood cancer impacts the family system and has psychosocial consequences for all family members. For the parents, the ill child, and the siblings to be able to adjust to this challenging situation, the whole family needs access to psychosocial support. However, only a few such family interventions in pediatric oncology have been evaluated. The aim of this study was to explore the potential effects of a family-centered intervention, the Family Talk Intervention (FTI), in pediatric oncology from the parents' perspectives. Methods: A concurrent mixed methods design was used for this study. Data were derived from a pilot study of 26 families recruited from one pediatric oncology center in Sweden. This study focused on questionnaire and interview data from 52 parents. Results: After participation in FTI, the parents felt more satisfied with the conversations within the family about the illness. FTI also contributed to strengthened family togetherness, including more open communication and improved family relations, as described by the parents. Parents further expressed that they felt more empowered in their parenting role following FTI. Conclusions: The findings regarding FTI's ability to improve family communication and family relations, thus strengthening family togetherness in families with childhood cancer, are promising. This provides motivation for a large-scale study of FTIs in pediatric oncology.
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- 2024
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43. Barriers to appropriate complementary feeding and the use of ultra-processed foods : A formative qualitative study from rural Oromia, Ethiopia
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Tadesse, Elazar, Abdirahman, Ibrahim, Letta, Shiferaw, Kirby, Miles, Mamo, Tigist, Metaferia, Henok, Oranga, Beryl, Leight, Jessica, Tadesse, Elazar, Abdirahman, Ibrahim, Letta, Shiferaw, Kirby, Miles, Mamo, Tigist, Metaferia, Henok, Oranga, Beryl, and Leight, Jessica
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Children's consumption of ultra-processed foods (UPF) is increasing in Ethiopia, but relatively little is known about the specific feeding practices that underlie this pattern. The objective of this study was to explore patterns of consumption of UPF by infants and young children within a broader context of inappropriate complementary feeding practices in extremely poor households in rural Oromia, Eastern Ethiopia. A formative qualitative study was conducted using semistructured interview questionnaires developed drawing on a socioecological model. A total of 16 focus group discussions with mothers (45 respondents), fathers (21 respondents) and grandmothers (23 respondents) of children aged 6-23 months in households that were beneficiaries of the Productive Safety Net Program were conducted, along with four key informant interviews with health workers. Qualitative transcripts were complemented with field notes before qualitative content analysis was applied. The key findings suggest that UPF were widely provided to infants and young children as part of a pattern of suboptimal complementary feeding, including both early and late initiation of complementary foods. In particular, UPF (including juice, biscuits and lipid-based nutrient supplements) were diluted with or dissolved in water and fed to infants via bottle, often before the recommended age of initiation of 6 months. Mothers and caregivers reported that they perceived the products to be affordably priced and packaged, ready to use and convenient given their time constraints. The level of consumption of UPF and its effects on infant and young child feeding feeding practices and children's nutritional status in rural Ethiopia should be further explored. This qualitative analysis explored patterns of complementary feeding and consumption of ultra-processed foods by infants and young children in poor rural households that are beneficiaries of the Productive Safety Net Program in Ethiopia. The evidence shows that t
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- 2024
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44. Experiences and satisfaction of video follow up of children with paediatric gastrointestinal conditions linking tertiary centre with guardians and clinicians at the local hospital : a cross-sectional study
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Kassa, Ann-Marie, Nyström, Niklas, Waldenvik, Kajsa, Engstrand Lilja, Helene, Kassa, Ann-Marie, Nyström, Niklas, Waldenvik, Kajsa, and Engstrand Lilja, Helene
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Background Children with complicated gastrointestinal conditions are dependent on follow up by tertiary care specialists throughout childhood to prevent and treat complications. In Sweden, paediatric surgical- and intestinal rehabilitation centres are centralised which means that many patients and guardians have to travel long distances to access tertiary referral centres. Our tertiary referral centre has developed a model of shared care with video conferences for follow up with our centre and the patient and guardians attending together with the responsible professionals at the local hospital. This study aimed to investigate the experiences and satisfaction with video follow-up visits (VFV) between a tertiary referral centre and guardians and clinicians at their local hospital. Methods Eligible participants were families with children with oesophageal atresia, intestinal failure and intestinal motility disorders and their local clinicians attending VFV with our tertiary referral centre from 2015 to 2020. Questionnaires included fixed-response alternatives, a 6-point Likert scale and open questions. Results Fifty-seven out of 102 families (56%) and 19 out of 27 local clinicians (70%) responded the questionnaires. In 68% of the VFV, two guardians attended compared to 35% in the physical visits. Of the guardians attending VFV, 82% lost ≤ half a working day and 91% attending physical visits lost ≥ one full working day. Median distance to the tertiary referral centre was 267 km and attending VFV avoided emissions of 7.2 metric tonnes of CO2. Of the guardians, 90% and of the clinicians 95% were satisfied with VFV. Advantages were avoidance of travelling and the participants shared the same information. Conclusions VFV is an appropriate alternative to physical visits with a high grade of satisfaction among the guardians and clinicians. VFV was time-saving for the families and reduced CO2 emissions.
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- 2024
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45. Instrument development and an intervention to increase parents' self-efficacy regarding their infant's sleep
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Cato, Karin, Funkquist, Eva-Lotta, Rosenblad, Andreas, Cato, Karin, Funkquist, Eva-Lotta, and Rosenblad, Andreas
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Objective Many Swedish parents experience that their infant has sleeping problems. Parents’ self-efficacy regarding their infants’ sleep may play an important role in how they perceive these problems. This pilot study aimed to develop an instrument measuring parents’ self-efficacy regarding their infant’s sleep and to examine if parents’ self-efficacy was affected by an intervention focusing on parental education. Method Mothers and fathers, at a maternity unit in Sweden, were drawn into either an intervention (n = 46) or a control (n = 42) group. The intervention group received a home visit from a nurse who provided information about infant sleep; the importance of attachment; and advice regarding sleep, breastfeeding and bed sharing, including guidelines for safe bed sharing. Three months later, the participants answered questions on background data, breastfeeding, sleep and self-efficacy. Results The 11-item two-factor Uppsala Parental Self-Efficacy about Infant Sleep Instrument (UPPSEISI) was constructed to measure parents’ perceived self-efficacy. In adjusted analyses, being in the intervention group was associated with a higher self-efficacy (P = 0.035), as were being a mother (P = 0.003) and being satisfied with one’s own sleep (P = 0.007), while parents’ own sleeping problems were associated with a lower self-efficacy (P = 0.015). Conclusion Importantly, parental education may increase parents’ self-efficacy regarding their infant’s sleep.
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- 2024
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46. Significant effects of childhood obesity treatment with a web-based component in a randomised controlled study (Web-COP)
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Thorén, Annelie, Filipsson, Tobias, Englund, Erling, Sandström, Olof, Janson, Annika, Silfverdal, Sven-Arne, Thorén, Annelie, Filipsson, Tobias, Englund, Erling, Sandström, Olof, Janson, Annika, and Silfverdal, Sven-Arne
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Aim: We evaluated the effect on body mass index standard deviation score (BMI-SDS) of a combined treatment (Web-COP) for children with obesity, including a web-based component targeting their parents. Methods: This randomised controlled trial recruited children 5–12 years of age with obesity (International Obesity Task Force BMI [IOTF-BMI] ≥30 kg/m2) from school health care and outpatient paediatric clinics in in Northern Sweden from 1 June 2019 to 21 June 2020. The children were randomised to Web-COP, an intervention with group sessions and a 12-week web-based component, or standard care. The primary outcome was the change in IOTF BMI-SDS after 6 months. Results: In total, 75 children (33 girls), mean age 9.5 years, were randomised, and 65/75 (87%) children and their parents completed the study, 35/39 (90%) in the Web-COP intervention and 30/36 (83%) in the standard care group. BMI-SDS at 6 months was changed from 3.08 to 2.81 in the intervention group compared to an increase from 3.07 to 3.16 in the standard care group, representing a significant difference between groups (p < 0.001). In the intervention group, 14/30 (47%) reduced their BMI-SDS ≥0.25, compared to none in the standard care group. Conclusion: The parent-focused intervention significantly improved BMI-SDS in children with obesity as compared to children in standard care.
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- 2024
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47. Socioeconomic circumstances, health-related behaviours and paediatric infections : a mediation analysis
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Videholm, Samuel, Silfverdal, Sven-Arne, Gustafsson, Per E., Videholm, Samuel, Silfverdal, Sven-Arne, and Gustafsson, Per E.
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Objective: To examine how the effect of disadvantaged socioeconomic circumstances on the risk of paediatric infections is mediated by pregnancy smoking, excess weight during pregnancy and breast feeding in children under 5 years of age. Design: A population-level, retrospective cohort study. The Swedish Medical Birth Register was combined with the National Patient Register, the longitudinal integration database for health insurance and labour market studies, the Cause of Death Register and a local register held by the Child Health Care Unit in Uppsala Region. Setting: Uppsala Region, Sweden. Patients: 63 216 term and post-term singletons born to women who resided in Uppsala Region, Sweden between 1997 and 2015. Main outcome measures: Number of hospital admissions for infectious diseases. Secondary outcomes were the number of hospitalisations for respiratory and enteric infections, respectively. Results: The effect of disadvantaged socioeconomic circumstances, that is, low maternal education on the overall risk of paediatric infections was mediated to a considerable (33%-64%) proportion by pregnancy smoking, excess weight during pregnancy and breast feeding. Conclusions: Pregnancy smoking, excess weight during pregnancy and breast feeding mediate a considerable proportion of the association between deprived socioeconomic circumstances and paediatric infectious diseases. Therefore, inequalities in paediatric infectious diseases may be reduced by public health policies addressing these health-related behaviours.
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- 2024
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48. Insulin resistance prior to term age in very low birthweight infants : a prospective study
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Zamir, Itay, Stoltz Sjöström, Elisabeth, van den Berg, Johannes, Naumburg, Estelle, Domellöf, Magnus, Zamir, Itay, Stoltz Sjöström, Elisabeth, van den Berg, Johannes, Naumburg, Estelle, and Domellöf, Magnus
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Objective: To explore the glucose-related hormone profile of very low birthweight (VLBW) infants and assess the association between neonatal hyperglycaemia and insulin resistance during the admission period. Design: A prospective observational study—the Very Low Birth Weight Infants, Glucose and Hormonal Profiles over Time study. Setting: A tertiary neonatal intensive care unit and four neonatal units in county hospitals in Sweden. Patients: 48 infants born <1500 g (VLBW) during 2016–2019. Outcome measures: Plasma concentrations of glucose-related hormones and proteins (C-peptide, insulin, ghrelin, glucagon-like peptide 1 (GLP-1), glucagon, leptin, resistin and proinsulin), insulin:C-peptide and proinsulin:insulin ratios, Homoeostatic Model Assessment 2 (HOMA2) and Quantitative Insulin Sensitivity Check (QUICKI) indices, measured on day of life (DOL) 7 and at postmenstrual age 36 weeks. Results: Lower gestational age was significantly associated with higher glucose, C-peptide, insulin, proinsulin, leptin, ghrelin, resistin and GLP-1 concentrations, increased HOMA2 index, and decreased QUICKI index and proinsulin:insulin ratio. Hyperglycaemic infants had significantly higher glucose, C-peptide, insulin, leptin and proinsulin concentrations, and lower QUICKI index, than normoglycaemic infants. Higher glucose and proinsulin concentrations and insulin:C-peptide ratio, and lower QUICKI index on DOL 7 were significantly associated with longer duration of hyperglycaemia during the admission period. Conclusions: VLBW infants seem to have a hormone profile consistent with insulin resistance. Lower gestational age and hyperglycaemia are associated with higher concentrations of insulin resistance markers.
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- 2024
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49. Decreasing prevalence of atopic dermatitis in Swedish schoolchildren : three repeated population-based surveys
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af Klinteberg, Maja, Winberg, Anna, Andersson, Martin, Rönmark, Eva, Hedman, Linnea, af Klinteberg, Maja, Winberg, Anna, Andersson, Martin, Rönmark, Eva, and Hedman, Linnea
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Background: The prevalence of atopic dermatitis (AD) has increased over several decades and now affects about one-fifth of all children in high-income countries (HICs). While the increase continues in lower-income countries, the prevalence of AD might have reached a plateau in HICs. Objectives: To investigate trends in the prevalence of AD and atopic comorbidity in schoolchildren in Sweden. Methods: The study population consisted of three cohorts of children (median age 8 years) in Norrbotten, Sweden, for 1996 (n = 3430), 2006 (n = 2585) and 2017 (n = 2785). An identical questionnaire that included questions from the International Study of Asthma and Allergies in Childhood (ISAAC) protocol was used in all three cohorts. Trends in AD prevalence were estimated, as well as trends in atopic comorbidity. AD prevalence was estimated both according to the ISAAC definition of AD and by adding the reported diagnosis by a physician (D-AD). Results: The prevalence of AD decreased in the last decade, from 22.8% (1996) and 21.3% (2006) to 16.3% (2017; P < 0.001). The prevalence of D-AD was lower, but the same pattern of decrease was seen, from 9.3% (1996) and 9.4% (2006) to 5.7% (2017; P < 0.001). In all three cohorts, AD was more common among girls than boys (18.9% vs. 13.8% in 2017; P < 0.001). Children from the mountain inlands had a higher prevalence of AD than children from coastal cities (22.0% vs. 15.1% in 2017; P < 0.001). In comparing D-AD, there were no significant differences between the sexes or between inland or coastal living. Concomitant asthma increased over the years from 12.2% (1996) to 15.8% (2006) to 23.0% (2017; P < 0.001). Concomitant allergic rhinitis and allergic sensitization increased from 1996 (15.0% and 27.5%) to 2006 (24.7% and 49.5%) but then levelled off until 2017 (21.0% and 46.7%). Conclusions: The prevalence of AD among schoolchildren in Sweden decreased over the study period, whereas atopic comorbidity among children with AD incr
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- 2024
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50. Arachidonic and docosahexaenoic acid supplementation and brain maturation in preterm infants : a double blind RCT
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Moltu, Sissel J., Nordvik, Tone, Rossholt, Madelaine E., Wendel, Kristina, Chawla, Maninder, Server, Andres, Gunnarsdottir, Gunnthorunn, Pripp, Are Hugo, Domellöf, Magnus, Bratlie, Marianne, Aas, Marlen, Hüppi, Petra S., Lapillonne, Alexandre, Beyer, Mona K., Stiris, Tom, Maximov, Ivan I., Geier, Oliver, Pfeiffer, Helle, Moltu, Sissel J., Nordvik, Tone, Rossholt, Madelaine E., Wendel, Kristina, Chawla, Maninder, Server, Andres, Gunnarsdottir, Gunnthorunn, Pripp, Are Hugo, Domellöf, Magnus, Bratlie, Marianne, Aas, Marlen, Hüppi, Petra S., Lapillonne, Alexandre, Beyer, Mona K., Stiris, Tom, Maximov, Ivan I., Geier, Oliver, and Pfeiffer, Helle
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Background: Arachidonic acid (ARA) and docosahexaenoic acid (DHA) are important structural components of neural cellular membranes and possess anti-inflammatory properties. Very preterm infants are deprived of the enhanced placental supply of these fatty acids, but the benefit of postnatal supplementation on brain development is uncertain. The aim of this study was to test the hypothesis that early enteral supplementation with ARA and DHA in preterm infants improves white matter (WM) microstructure assessed by diffusion-weighted MRI at term equivalent age. Methods: In this double-blind, randomized controlled trial, infants born before 29 weeks gestational age were allocated to either 100 mg/kg ARA and 50 mg/kg DHA (ARA:DHA group) or medium chain triglycerides (control). Supplements were started on the second day of life and provided until 36 weeks postmenstrual age. The primary outcome was brain maturation assessed by diffusion tensor imaging (DTI) using Tract-Based Spatial Statistics (TBSS) analysis. Results: We included 120 infants (60 per group) in the trial; mean (range) gestational age was 26+3 (22+6 - 28+6) weeks and postmenstrual age at scan was 41+3 (39+1 - 47+0) weeks. Ninety-two infants underwent MRI imaging, and of these, 90 had successful T1/T2 weighted MR images and 74 had DTI data of acceptable quality. TBSS did not show significant differences in mean or axial diffusivity between the groups, but demonstrated significantly higher fractional anisotropy in several large WM tracts in the ARA:DHA group, including corpus callosum, the anterior and posterior limb of the internal capsula, inferior occipitofrontal fasciculus, uncinate fasciculus, and the inferior longitudinal fasciculus. Radial diffusivity was also significantly lower in several of the same WM tracts in the ARA:DHA group. Conclusion: This study suggests that supplementation with ARA and DHA at doses matching estimated fetal accretion rates improves WM maturation compared to control treatment
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- 2024
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