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AIM To describe the process of linguistic and content validity of the Swedish version of the PedsQL™ Gastrointestinal Symptoms Scales and Symptoms Module, measuring health-related quality of life (HRQOL) in children with gastrointestinal (GI) disorders. METHODS The establishment of linguistic and content validity was carried out in compliance with international standards on patient-reported outcome measurements. The process included forward translation, expert review and reconciliation, backward translation, backward translation review and interviews with 15 children aged 5-18 years with GI tract symptoms and 20 parents of children with GI tract symptoms aged 2-18 years. RESULTS The Swedish version of the PedsQL™ Gastrointestinal Symptoms Scales and Symptoms Module (child report 5-18 years, parent report for children 2-18 years) was achieved without major difficulties. Eight issues needed discussion after forward translation, and there was one change after backward translation and three revisions following patient and parent testing. CONCLUSION A conceptually equivalent Swedish language version of PedsQL™ Gastrointestinal Symptoms Scale and Symptoms Module for children aged 2-18 years old was developed. This enables improved HRQOL evaluations in children with GI disorders in Sweden. Future research using a larger sample is recommended to evaluate validity and reliability of the Swedish language version of the module.

Aim This study focused on Swedish child health nurses’ attitudes and the support they provided to fathers and mothers, highlighting changes from 2004 to 2014. Method In 2014, 363 child health nurses in Stockholm County completed a 23-item questionnaire, similar to the questionnaire by Massoudi et al in 2004, on their attitudes and the support they gave to fathers and mothers. Analyses were completed using chi-square tests of nurses’ attitudes and support to fathers and mothers and the results from the 2004 and 2014 studies were compared. Results In 2014, the vast majority of nurses fully agreed that it was important to have close contact with both parents, but more than two-thirds did not feel they had the same competencies for mothers and fathers and three-quarters found it complicated to support both parents. The majority viewed fathers more equally in 2014 than in 2004 and although they did provide more support to both parents, mothers in 2014 still received more support than fathers. Conclusion While Swedish child health nurses viewed fathers as more equal to mothers in 2014 than 2004, mothers still received the majority of the parenting support. This article is protected by copyright. All rights reserved.

Little is known about the association between school experiences and mental health in young schoolchildren. This study explored the cross-sectional and prospective associations between children's school experiences and mental health in middle childhood.We gathered comprehensive population-based data on the school experiences and mental health of 592 schoolchildren attending grades three and six in Sweden (ages approximately nine and 12 years). The KIDSCREEN questionnaire was used to measure school experiences in both age groups while the Child Behavior Checklist and the Strengths and Difficulties Questionnaire measured mental health in grades three and six, respectively.Children with problematic school experiences in grade three had an approximately two times higher odds for concurrent total, internalised, externalised, attention-hyperactivity and social problems. They also had a 1.5-2.5 higher odds for these mental health problems three years later. Likewise, there was an association between problematic school experiences in grade three and lower levels of prosocial behaviour three years later. These associations were shown in both boys and girls, but were particularly pronounced in girls.This study indicated that school experiences in young schoolchildren may be important determinants of concurrent and later mental health problems.

Aim To replicate newly reported single nucleotide polymorphism (SNP) associations with adult lung function in a cohort of children and to investigate interactions with tobacco smoke exposure on lung function. Methods Of 37 reported SNPs in adults, 21 were available in our genome-wide association study data set, either directly genotyped or as proxy SNPs. We tested for association with lung function (FEV1, FVC, FEV1/FVC%) in 8-year-old children and analysed interaction with tobacco smoke exposure both prenatally and/or during infancy, as well as at the age of 8 years. Results SNPs in TNS1, ADAM19, THSD4 and ADCY2 showed significant association with lung function in children, although ADCY2 variants not in the expected direction. For example, variant allele A in THSD4 rs12899618 was associated with 50.2 mL higher FEV1 (p = 0.007) and variant allele C in ADAM19 rs2277027 with 1% unit lower FEV1/FVC% (p = 0.03) per allele. DAAM2 rs2395730 showed interaction with current tobacco smoke exposure, with variant C allele associated with 1.3% unit decrease in FEV1/FVC% in exposed children, but not in unexposed (p for interaction 0.04). Conclusion Our data replicate in children an association for TNS1, ADAM19, THSD4 and ADCY2 gene variants with lung function and suggest that interaction with tobacco smoke exposure may be of importance.

Aim: To elucidate the immediate maternal thermal skin response when placing the neonate on the mothers' chest, skin-to-skin (STS). Methods: Ugandan mothers with non-asphyxiated newborns after vaginal delivery (n = 39) were studied. Maternal skin and axillary temperatures were measured immediately before STS contact, then every 2 min for 20 min and finally 10 min after removing the neonate. Neonatal axillary/forehead temperatures were measured immediately before STS contact, and twice after initiating STS, followed by a measurement 10 min after the newborn had been removed. Results: A rapid thermal response was demonstrated in maternal breast skin immediately after STS contact. It rose by 0.5°C (p < 0.0001) on average the first 2 min after STS contact and fell by 0.5°C 10 min after we had removed the neonate (p < 0.0001). Maternal axillary temperature also rose 2 min after initiation of STS (p < 0.0001) but stayed constant 10 min after removal of the newborn from the STS position. Conclusion: The findings indicate that there is a rapid maternal, thermal response to the positioning of the newborn STS. The tactile contact may elicit a maternal adaptation enhancing the warming of the newborn. Possible mechanisms include maternal autonomic nerve-mediated skin vasodilatation.

Aim: To investigate the current prevalence and trend of overweight in young schoolchildren in Umea, Sweden. Methods: Two cross-sectional samples of children were studied: 1115 randomly selected chi ...

AIM To elucidate the impact of bathing on the prevalence of hypothermia among newborn babies exposed to the skin-to-skin (STS) care technique before and after bathing. METHODS Non-asphyxiated newborns after vaginal delivery (n = 249) in a Ugandan referral hospital were consecutively enrolled and randomized either to bathing at 60 min postpartum (n = 126) or no bathing (n = 123). All mothers practised skin-to-skin care of their newborns. Four rectal and tympanic registrations of newborn temperatures were carried out in both groups directly after drying at birth, and at 60, 70 and 90 min postpartum. RESULTS Bathing of newborns in the first hour after delivery resulted in a significantly increased prevalence of hypothermia, defined as temperature

To elucidate the impact of bathing on the prevalence of hypothermia among newborn babies exposed to the skin-to-skin (STS) care technique before and after bathing.Non-asphyxiated newborns after vaginal delivery (n = 249) in a Ugandan referral hospital were consecutively enrolled and randomized either to bathing at 60 min postpartum (n = 126) or no bathing (n = 123). All mothers practised skin-to-skin care of their newborns. Four rectal and tympanic registrations of newborn temperatures were carried out in both groups directly after drying at birth, and at 60, 70 and 90 min postpartum.Bathing of newborns in the first hour after delivery resulted in a significantly increased prevalence of hypothermia, defined as temperature36.5 degrees C, at 70 and at 90 min postpartum despite the use of warmed water and the application of the STS method. There was no neonatal mortality. Aside from the bathing procedure, no background factor potentially predisposing the newborns to hypothermia was identified.Bathing newborn babies shortly after birth increased the risk of hypothermia despite the use of warm water and STS care for thermal protection of the newborn.

The Swedish Enuresis Trial (SWEET) was conducted to evaluate the long-term safety and efficacy of intranasal desmopressin treatment in children with primary, monosymptomatic nocturnal enuresis (PMNE). The study had an open, multicentre design and comprised a 4-wk observation period, a 6-wk dose titration period (with 20-40 microg desmopressin) and a 1-y, long-term treatment period. A treatment-free week was introduced every 3 mo to identify dry patients. In total, 399 children aged 6-12 y with PMNE were recruited. Of these, 245 patients (61%) experienced > or = 50% reduction in the number of wet nights during the last 4 wk of dose titration compared with the observation period. These responders entered the long-term phase of the trial. The mean number of wet nights per week decreased from a median of 5.3 (range 1.3-7.0) during the observation period to a median of 0.8 (range 0.0-5.0) during the last 3-mo period. Seventy-seven children became dry, 63 (83%) within 6 mo of treatment initiation. The percentage of children who became dry was similar in all age groups. Significantly fewer children in the lowest age group were defined as responders (52%; 95% CI 45, 59) among the 6-7-y-olds compared to 65% (56, 74) and 81% (72, 90) in the two older age groups. Desmopressin was well tolerated. No serious drug-related adverse events were recorded and no clinical symptoms of hyponatraemia were reported. The SWEET trial has demonstrated that desmopressin is both safe and effective for the long-term treatment of PMNE, with a significant therapeutic effect also in children of 6-7 y of age.

Episodes of diarrhoea and nutritional status of 113 children in East Bhutan were recorded monthly from 7 to 36 months of age. A re-examination was carried out 20 months later. The load of diarrhoeal diseases in early childhood was negatively associated with the parameters of children's long-term nutritional status 20 months later. Also, when early nutritional status and socioeconomic factors are included in the model, the diarrhoea variable explains a significant part of the variation in height for age (p = 0.04, delta R 2 = 0.035), weight for age (p = 0.03, delta R 2 = 0.030) and head circumference (p = 0.0007, delta R 2 = 0.077). This is not so for the variation in weight for height or mid-upper arm circumference (p >0.1, delta R 2 < 0.005). Stunting is widespread in the area, and the effects of diarrhoea on nutritional status are more likely to be sustained in settings where dietary intake is marginal.

A school-based dietary survey, using seven-day records, was performed in two cohorts of Swedish adolescents; 14- and 17-year-olds. The study comprised 366 boys and 365 girls. When compared to previous studies in Sweden, a striking finding was a decrease in dietary fat intake and an increase in carbohydrate intake. However, the relative intake of saturated fat had not changed (15% of total energy). The dietary change was mainly due to an increased consumption of cereal products. There were no major differences in dietary habits or nutrient density of the food between the two age groups, or between boys and girls. The mean intakes of protein, fat and carbohydrate, expressed as a percentage of the total energy intake, were 15, 33 and 52%, respectively. The mean intakes of vitamins and minerals were low only for selenium. The boys had a high iron intake (1.5 and 1.7 times the recommended intake for 14- and 17-year-olds, respectively) while the mean iron intake for girls was 0.9 times the recommended dietary allowances in both age groups. The intake of dietary salt was higher in boys than in girls (7.7 g and 9.0 g per day in 14- and 17-year-old boys, respectively, and 5.8 g per day in both 14- and 17-year-old girls). In a long-term health perspective, this positive change in nutrient intake in adolescents may contribute to a reduction in the incidence of diet-related diseases in Sweden.(ABSTRACT TRUNCATED AT 250 WORDS)

By coining a new concept, "obstetric ectoscopy", attention is drawn to the fact that undergraduate and postgraduate training in obstetrics and perinatal medicine in low-income countries is not geared towards community obstetrics, rather to more prestigious and lucrative endoscopy. It is argued that the devastation of maternal mortality leaves the clinical profession inactive and indifferent and that a more ectoscopic spirit would better prepare future obstetricians in efforts to enhance maternal and perinatal survival.