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Background Long outdoor stay may cause hazardous exposure to ultraviolet radiation (UVR) from the sun even at high latitudes as in Sweden (Spring to Autumn). On the other hand, long outdoor stay is a strong predictor of primary school children ' s free mobility involving moderate to vigorous physical activity (MVPA). UV-protective outdoor environments enable long outdoor stay. We investigated the concurrent impact of different school outdoor play settings upon pupils ' sun exposure and levels of physical activity across different ages, genders, and seasons. Method During 1 week each in September, March, and May, UVR exposure and MVPA were measured in pupils aged 7-11 years. Erythemally effective UVR exposure was measured by polysulphone film dosimeters and MVPA by accelerometers. Schoolyard play was recorded on maps, and used areas defined as four play settings (fixed play equipment, paved surfaces, sport fields, and green settings), categorized by season and gender. Results During the academic year, sport fields yielded the highest UVR exposures and generated most time in MVPA. In March, time outdoors and minutes in MVPA dropped and UVR exposures were suberythemal at all play settings. In May, green settings and fixed play equipment close to greenery promoted MVPA and protected from solar overexposure during long outdoor stays. Conclusion More outdoor activities in early spring are recommended. In May, greenery attractive for play could protect against overexposure to UVR and stimulate both girls and boys to vigorous play., Epub 2020

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

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

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

ADHD En funktionsnedsättning med debut i baranåren. Kärmsymtom karaktäriseras av uppmärksamhetsproblem, impulsivitet ioch hyperaktivitet. I ett antal fall sker en normalisering eller mognadsprocess, i andra fall kan någon form av psykisk ohälsa förekommma samtidigt. Den diagnostiska utredningen är omfattande, och både instrument för diagnostik och den diagnostiska processen bör undersökas bättre. Många olika insatser och behandlingar, förutom läkemedel förekommer idag, men kunskapen om eras nytta, risker och kostnader måste förbättras. Vissa läkemedel lindrar ADHD symtom vid korttidsbehandling, men nyttan av långtidsbehandling går inte att bedöma. Vanliga biverjkningar av dessa läkemedel är illamående och nedsatt aptit, för barn viktminskning och pulsökning.

Aim To test how the quality of the outdoor environment of child day care centres (DCCs) influences children's health. Methods The environment was assessed using the Outdoor Play Environmental Categories (OPEC) tool, time spent outdoors and physical activity as measured by pedometer. 172/253 (68%) of children aged 3.05.9 from nine DCCs participated in Southern Sweden. Health data collected were body mass index, waist circumference, saliva cortisol, length of night sleep during study, and symptoms and well-being which were scored (1-week diary 121 parent responders). Also, parent-rated well-being and health of their child were scored (questionnaire, 132 parent responders). MANOVA, ANOVA and principal component analyses were performed to identify impacts of the outdoor environment on health. Results High-quality outdoor environment at DCCs is associated with several health aspects in children such as leaner body, longer night sleep, better well-being and higher mid-morning saliva cortisol levels. Conclusion The quality of the outdoor environment at DCCs influenced the health and well-being of preschool children and should be given more attention among health care professionals and community planners., Kidscape

BACKGROUND: It is important to understand the correlates of physical activity in order to influence policy and create environments that promote physical activity among preschool children. We compared preschoolers' physical activity in Swedish and in US settings and objectively examined differences boys and girls indoor and outdoor physical activity regarding different intensity levels and sedentary behaviour. METHODS: Accelerometer determined physical activity in 50 children with mean age 52 months, (range 40-67) was recorded during preschool time for 5 consecutive weekdays at four sites. The children wore an Actigraph GTIM Monitor. RESULTS: Raleigh preschool children, opposite to Malmo preschoolers spent significantly more time indoors than outdoors (p

Objective.—To study the impact of preschool outdoor environments on children’s physical activity and solar ultraviolet (UV) exposure at different latitudes and countries. Methods. Outdoor environments of 11 preschools (two in Raleigh NC, USA, Lat.36¿N, nine in Malmö, Sweden, Lat.55¿N) were scored (OPEC) regarding space, vegetation, hilly terrain and level of integration between open spaces, vegetation and play structures. Free sky (%) was determined by imaging. Physical activity was measured by pedometers and solar UV-exposure by polysulphone dosimeters during 5 days in spring 2009, and individual background data gathered by questionnaires and anthropometric measurements. Global UV radiation was measured and available individual UV radiation (%) computed. Results.—In Malmö, mean step count/minute was 21.2 in preschools with high-scored environment vs. 17.6 in low-scored environments, and UV-exposure lower, 26% vs. 43% of available UV during outdoor stay. In Raleigh, step count/minute was 12.3 and UV-exposure of available UV 27% during outdoor stay. Conclusions.—Step count/minute was lower in Raleigh than in Malmö, but in Malmö children at low-scored environments ran a higher risk of sunburn than in Raleigh. Trees and shrubbery integrated in children’s playscape trigger both physical activity and sun-protective behaviour in Sweden, and previous measurements in Stockholm were confirmed. Such outdoor environment should be recommended, but the role of season and climate needs to be further explored.

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

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

Preschool children´s sun exposure was measured 2009 with UV-dosimeters at nine preschools in Malmö 55°N, in southern Sweden and at two in Raleigh 36°N, North Carolina, USA at comparable seasons. Outdoor playground environment was explored how play facilities, available space and vegetation influenced UV-exposure and also children´s physical activity measured with step-counters. In Malmö access to spacious outdoor play settings with vegetation decreased sunburn risk and increased physical activity during children´s free play in May - also during long stay outdoor. Results from Raleigh in April also indicate that vegetation is sunprotective when children play. Favourable outdoor environment may promote both sun protection and physical activity in a Nordic spring or summer climate, while for physical activity, this might not be so pronounced at a southern mid-latitude due to the role of climate and associated factors.

Kidscape

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

Udgivelsesdato: 16 july 2009

Udgivelsesdato: Dec

Udgivelsesdato: 2007/2/1