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  • 1. Aronsson, B.
    et al.
    Wiberg, C.
    Sandstedt, P.
    Hjern, Anders
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
     Asylum-seeking children with severe loss of activities of daily living: clinical signs and course during rehabilitation2009Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 98, nr 12, s. 1977-1981Artikkel i tidsskrift (Fagfellevurdert)
  • 2.
    Berg, Lisa
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap.
    Ljunggren, Gunnar
    Hjern, Anders
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap. Karolinska Institutet, Sweden.
    Underutilisation of psychiatric care among refugee adolescents in Stockholm2021Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 110, s. 563-570Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: Refugee children have been shown to underutilise psychiatric services in Scandinavia. The aim of this study was to investigate determinants of psychiatric care utilisation in adolescents in refugee families.

    Methods: The study used regional data on healthcare use linked to sociodemographic data from national registers in a total population of 93 537 adolescents in the Stockholm County born in 1995‐2000, including 18 831 with a refugee background. Cox regression analyses were fitted to estimate Hazard ratios (HRs) of psychiatric care utilisation in the age‐span 11‐18 years.

    Results: Psychiatric care use was lower in the large majority of adolescents in refugee families that originated in low‐ and middle‐income countries, with adjusted HRs 0.34 (95% CI 0.28‐0.42) and 0.51 (95% CI 0.46‐0.56), respectively, compared with the Swedish majority population. Among the foreign‐born refugee adolescents, psychiatric care use increased with duration of residence in Sweden and was higher in children who obtained residency as asylum seekers compared with those who settled in family reunification.

    Conclusion: Adolescents in newly settled refugee families with a background in low‐ and middle‐income countries should be a priority in mental health assessment of refugee children and referral to psychiatric care facilitated for children in need.

  • 3. Bergh, Cecilia
    et al.
    Hiyoshi, Ayako
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap. Örebro University, Sweden.
    Eriksson, Mats
    Fall, Katja
    Montgomery, Scott
    Shared unmeasured characteristics among siblings confound the association of Apgar score with stress resilience in adolescence2019Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, nr 11, s. 2001-2007Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim

    We investigated the association between low Apgar score, other perinatal characteristics and low stress resilience in adolescence. A within‐siblings analysis was used to tackle unmeasured shared familial confounding.

    Methods

    We used a national cohort of 527 763 males born in Sweden between 1973 and 1992 who undertook military conscription assessments at mean age of 18 years (17–20). Conscription examinations included a measure of stress resilience. Information on Apgar score and other perinatal characteristics was obtained through linkage with the Medical Birth Register. Analyses were conducted using ordinary least squares and fixed‐effects linear regression models adjusted for potential confounding factors.

    Results

    Infants with a prolonged low Apgar score at five minutes had an increased risk of low stress resilience in adolescence compared with those with highest scores at one minute, with an adjusted coefficient and 95% confidence interval of −0.26 (−0.39, −0.13). The associations were no longer statistically significant when using within‐siblings models. However, the associations with stress resilience and birthweight remained statistically significant in all analyses.

    Conclusion

    The association with low Apgar score seems to be explained by confounding due to shared childhood circumstances among siblings from the same family, while low birthweight is independently associated with low stress resilience.

  • 4.
    Bergström, Malin
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS). Karolinska Institutet, Sweden.
    Fransson, Emma
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Fabian, Helena
    Hjern, Anders
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS). Karolinska Institutet, Sweden.
    Sarkadi, Anna
    Salari, Raziye
    Preschool children living in joint physical custody arrangements show less psychological symptoms than those living mostly or only with one parent2018Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 107, nr 2, s. 294-300Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AimJoint physical custody (JPC), where children spend about equal time in both parent's homes after parental separation, is increasing. The suitability of this practice for preschool children, with a need for predictability and continuity, has been questioned.

    MethodsIn this cross-sectional study, we used data on 3656 Swedish children aged three to five years living in intact families, JPC, mostly with one parent or single care. Linear regression analyses were conducted with the Strengths and Difficulties Questionnaire, completed by parents and preschool teachers, as the outcome measure.

    ResultsChildren in JPC showed less psychological problems than those living mostly (adjusted B 1.81; 95% CI [0.66 to 2.95]) or only with one parent (adjusted B 1.94; 95% CI [0.75 to 3.13]), in parental reports. In preschool teacher reports, the adjusted Betas were 1.27, 95% CI [0.14 to 2.40] and 1.41, 95% CI [0.24 to 2.58], respectively. In parental reports, children in JPC and those in intact families had similar outcomes, while teachers reported lower unadjusted symptom scores for children in intact families.

    ConclusionJoint physical custody arrangements were not associated with more psychological symptoms in children aged 3–5, but longitudinal studies are needed to account for potential preseparation differences.

  • 5.
    Bergström, Malin
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap, Centrum för forskning om ojämlikhet i hälsa (CHESS). Karolinska Institutet, Sweden; Sachs’ Children and Youth Hospital, Sweden.
    Gebreslassie, Mihretab
    Hedqvist, Maria
    Lindberg, Lene
    Sarkadi, Anna
    Hjern, Anders
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap, Centrum för forskning om ojämlikhet i hälsa (CHESS). Karolinska Institutet, Sweden; Sachs’ Children and Youth Hospital, Sweden.
    Narrative review of interventions suitable for well-baby clinics to promote infant attachment security and parents' sensitivity2020Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 109, nr 9, s. 1745-1757Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim The aim of this narrative review was to evaluate the evidence for interventions for children's secure attachment relationships and parents' caregiving sensitivity that could potentially be implemented in the context of a well-baby clinic. Methods Literature search on programmes for parental caregiving sensitivity and secure attachment for infants aged 0-24 months. Randomised controlled trials (RCTs) published 1995-2018 with interventions starting from one week postpartum, and with a maximum of 12 sessions (plus potential booster session) were included. Results We identified 25 studies, of which 22 studied effects of home-based programmes using video feedback techniques. Positive effects of these interventions in families at risk were found on parental caregiving sensitivity and to a lesser extent also on children's secure or disorganised attachment. The effects of two of these programmes were supported by several RCTs. Three intervention studies based on group and individual psychotherapy showed no significant positive effects. Most of the interventions targeted mothers only. Conclusions The review found some evidence for positive effects of selective interventions with video feedback techniques for children's secure attachment and strong evidence for positive effects on parental caregiving sensitivity. Important knowledge gaps were identified for universal interventions and interventions for fathers and parents with a non-Western background.

  • 6.
    Brolin Låftman, Sara
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Fransson, Emma
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Modin, Bitte
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Östberg, Viveca
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    National data study showed that adolescents living in poorer households and with one parent were more likely to be bullied2017Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 106, nr 12, s. 2048-2054Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim

    The aim of this study was to assess whether sociodemographic household characteristics were associated with which Swedish adolescents were more likely to be bullied.

    Methods

    The data were derived from the Swedish Living Conditions Survey and its child supplements from the survey years 2008-2011. The analyses included information on 3,951 adolescents aged 10-18 years. Exposure to bullying was reported by adolescents and information on sociodemographic household characteristics was reported by parents and obtained from official registers. Binary logistic regression was used to analyse the data.

    Results

    Adolescents were more likely to be bullied if they lived in households with no cash margin, defined as the ability to pay an unexpected bill of 8,000 Swedish Kronor or about 800 Euros, and if they lived with just one custodial parent. In the unadjusted analyses, elevated risks were identified if adolescents lived in working class households and had unemployed and foreign-born parents. However, these associations were at least partly accounted for by other sociodemographic household characteristics, in particular the lack of a cash margin.

    Conclusion

    This study showed that Swedish adolescents living in households with more limited financial resources had an increased risk of being bullied, supporting results from previous international research.

  • 7. Chen, Tian-Jiao
    et al.
    Modin, Bitte
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Ji, Cheng-Ye
    Hjern, Anders
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Regional, socioeconomic and urban-rural disparities in child and adolescent obesity in China: a multilevel analysis2011Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 100, nr 12, s. 1583-1589Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim:  To study socio-demographic patterns of obesity in Chinese children and adolescents. Methods:  Data came from the 2005 cycle of the Chinese National Survey on Student's Constitution and Health. In all, 231 326 subjects aged 7-18 years, distributed across 622 schools and 30 provinces, were analysed. Multilevel modelling was used to estimate variations at individual, school area and province levels. Results:  The prevalence of obesity varied enormously across different areas. Young people living in high socioeconomic and urban areas had higher body mass index (BMI) and higher odds of overweight and obesity than those living in lower socioeconomic and rural areas. Subjects living in provinces with a higher standard of living, as indicated by less perinatal mortality, lower Engel coefficient, and higher personal expenditure on health had higher BMI and higher odds of overweight and obesity than those living in less affluent provinces. An interaction between gender and urbanicity revealed that boys in urban areas were especially prone to obesity. Conclusion:  In contrast to most present-day high income countries, obesity among young people in China is associated with affluence and urban residence. Intervention and strategy for obesity prevention should be targeting high socioeconomic families in urban areas, perhaps with particular focus on boys.

  • 8. Dahl, Sara
    et al.
    Wickström, Ronny
    Ek, Ulla
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Specialpedagogiska institutionen.
    Fahnehjelm, Kristina Tear
    Children with optic nerve hypoplasia face a high risk of neurodevelopmental disorders2018Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 107, nr 3, s. 484-489Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: Optic nerve hypoplasia (ONH) is a congenital ocular malformation that has been associated with neurodevelopmental disorders, but the prevalence in unilateral disease and less severe visual impairment is unknown. We studied intellectual disability and autism spectrum disorders (ASDs) in patients with ONH.

    Methods: This was a population-based cross-sectional cohort study of 65 patients (33 female) with ONH below 20 years of age, living in Stockholm in December 2009, with data analysed in January 2016. Of these 35 were bilateral and 30 were unilateral. Neurodevelopmental disorders were diagnosed or confirmed by neurological assessments, the Five to Fifteen parent questionnaire and reviewing previous neuropsychological investigations or conducting neuropsychological tests.

    Results: Bilateral ONH patients had lower mean full scale intelligence quotient scores than unilateral patients (84.4 and 99.4, respectively, p = 0.049). We assessed intellectual disability in 55 eligible patients, and it was more common in patients with bilateral ONH (18 of 32, 56%) than unilateral ONH (two of 23, 9%, p < 0.001). ASDs were diagnosed in seven of 42 (17%) patients.

    Conclusion: Children with bilateral ONH had a high risk of neurodevelopmental disorders, especially intellectual disability. The risk was lower in unilateral ONH, but the levels of neurodevelopmental disorders warrant screening of both groups.

  • 9. Eide, Ketil
    et al.
    Hjern, Anders
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS). Karolinska Inst, Dept Med, Stockholm, Sweden .
    Unaccompanied refugee children - vulnerability and agency2013Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 102, nr 7, s. 666-668Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The numbers of refugee adolescents that arrive in Europe without their families has increased in recent years, particularly in Sweden. Research has demonstrated that these children have high rates of mental health problems, particularly depression and post-traumatic stress disorder, during the first years after resettlement. Despite this, there are also indications that many of these unaccompanied children are resourceful and arrive with a clear vision of a positive future in the new country. Follow-up studies in the United States and Norway have indicated fairly good social outcomes in the long term. Conclusion The education and care that unaccompanied minors receive during the first years after resettlement, together with their own drive to create a positive future, are key factors in their mental health and long-term adjustment.

  • 10.
    Ek, Ulla
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Specialpedagogiska institutionen.
    Westerlund, Joakim
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen.
    Holmberg, K.
    Fernell, E.
    Academic performance of adolescents with ADHD and other behavioural and learning problems: a population-based longitudinal study2011Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 100, nr 3, s. 402-406Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: To study academic performance (final grades at the age of 16 years) in individuals with i) attention-deficit/hyperactivity disorder (ADHD) and ii) other learning and/or behavioural problems. Methods: Of a total population of 591 children, originally assessed at the age of 10-11 years, it was possible to obtain final grades for 536 16-year-olds (in grade 9). Those fulfilling the criteria for ADHD/sub-threshold ADHD (n=39) and those with 'Behaviour and Learning Problems' (BLP group), (n=80) and a comparison group (n=417) were contrasted. Results: The ADHD and BLP groups had a significantly lower total mean grade at the age of 16 years than the comparison group. In addition, the ADHD and BLP groups also qualified for further studies in the upper secondary school to a significantly lesser extent than the controls (72%, 68% and 92%, respectively). All IQ measures (at the age of 10-11 years) were positively correlated with the overall grade after grade 9, with especially strong correlations for verbal capacity. Conclusion: ADHD and similar problems entail a risk of underachievement at school. The results indicate that pupils with ADHD underachieve in the school situation in relation to their optimal cognitive capacity. The contextual situation and the particular requirements should be considered in order for adequate educational measures to be undertaken.

  • 11.
    Ek, Ulla
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen.
    Westerlund, Joakim
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen.
    Holmberg, Kirsten
    Fernell, Elisabeth
    Self-esteem in children with attention and/or learning deficits: the importance of gender2008Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 97, nr 8, s. 1125-1130Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: Our objective was to analyze self-esteem in children within a spectrum of attention disorders, that is, besides attention deficit hyperactivity disorder (ADHD), also children with subthreshold ADHD and even milder attention deficits and/or learning problems.

    Methods: From a population-based group of 10–11-year-old children in a Swedish municipality those with ADHD/subthreshold ADHD (n = 30) and those with milder attention and/or learning problems (n = 64) were targeted for the study. The children completed the 'I think I am' scale, reflecting physical appearance, scholastic competence, mental well-being, relationships to parents and to others and global self-esteem. Data from boys and girls were compared and related to the parents' and teachers' ratings on the two dimensions of the Conners' 10-item questionnaire (impulsive-restless behaviour and emotional lability) and to the children's cognitive levels.

    Results: Significant gender differences were found, girls reporting lower self-esteem concerning mental well-being and poorer relationships with parents and peers. However, children with ADHD/subthreshold ADHD did not report significantly lower global self-esteem when compared to a reference population.

    Conclusion: Self-esteem in children with attention, behaviour and/or learning problems has to be carefully evaluated, especially in girls, and measures are needed to prevent a trajectory towards adolescent psychopathology.

  • 12. Engman, Mona-Lisa
    et al.
    Sundin, Mikael
    Miniscalco, Carmela
    Westerlund, Joakim
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen. University of Gothenburg, Sweden.
    Lewensohn-Fuchs, Ilona
    Gillberg, Christopher
    Fernell, Elisabeth
    Prenatal acquired cytomegalovirus infection should be considered in children with autism2015Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 104, nr 8, s. 792-795Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: The aim of the study was to evaluate the prevalence of congenital cytomegalovirus infection (CMV) in a representative sample of children with autism spectrum disorder. Methods: In a representative group of 115 preschool children with autism spectrum disorder, of whom 33 also had intellectual disability, the dried blood spots from the newborn metabolic screening were analysed for CMV DNA using TaqMan polymerase chain reaction. Results: One of the 33 children with autism spectrum disorder and intellectual disability - 3% of that group - had congenital CMV infection. The corresponding prevalence in newborn infants in Sweden is 0.2%. None of the 82 children without intellectual disability had congenital CMV. Conclusion: The finding lends some further support for congenital CMV being one of the many aetiologies underlying autism spectrum disorder with intellectual disability. The rate of 3% of congenital CMV in children with autism spectrum disorder with intellectual disability has implications for the medical work-up. The finding of congenital CMV also indicates the need for repeated hearing assessments in the child. There is a need for similar studies with much larger samples.

  • 13. Eriksson, Mats Anders
    et al.
    Lieden, Agne
    Westerlund, Joakim
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen.
    Bremer, Anna
    Wincent, Josephine
    Sahlin, Ellika
    Gillberg, Christopher
    Fernell, Elisabeth
    Anderlid, Britt-Marie
    Rare copy number variants are common in young children with autism spectrum disorder2015Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 104, nr 6, s. 610-618Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AimSeveral studies have suggested that rare copy number variants (CNVs) are an important genetic contributor to autism spectrum disorders. The aims of the study were to use chromosomal microarray to investigate the presence of rare copy number variants in a population-based cohort of well-characterised young children with autism spectrum disorders and to relate the genetic results to neurodevelopmental profiles and medical conditions. MethodsWe performed chromosomal microarray on samples from 162 children who had been referred to the Stockholm Autism Centre for Young Children in Sweden after being diagnosed with autism spectrum disorder between 20 and 54months of age. ResultsPathogenic aberrations were detected in 8.6% of the children and variants of uncertain significance were present in another 8.6%. CNVs were more frequent in children with congenital malformations or dysmorphic features as well as in the subgroup with intellectual disability. ConclusionOur results support the use of chromosomal microarray methods for the first tier genetic analysis of autism spectrum disorder. However, it is likely in the near future that chromosomal microarray methods will probably be replaced by whole-exome and whole-genome sequencing technologies in clinical genetic testing.

  • 14. Fernell, Elisabeth
    et al.
    Ek, Ulla
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Specialpedagogiska institutionen.
    Borderline intellectual functioning in children and adolescents - insufficiently recognized difficulties2010Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 99, nr 5, s. 748-753Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: To draw attention to groups of children and adolescents with borderline intellectual functioning, especially with respect to their school-situation. Methods: In one study, population-based, children with borderline intellectual functioning at age 10 years were followed until they finished compulsory school when their final certificates could be analysed. In a second study parents of 20 individuals in the upper secondary school for pupils with mild mental retardation were interviewed according to the Vineland adaptive scales and school health records were reviewed. In a third study pupils attending an individual programme in upper secondary school were assessed and we report one representative case. Results: (1) Pupils with borderline intellectual functioning, assessed in grade 4, received significantly lower grades when finishing the compulsory school. (2) In the group of pupils in the upper secondary school for the mildly mentally retarded, compiled data indicated that a considerable number did not fulfil the combined IQ and adaptive criteria for mild mental retardation. (3) The subtle nature of borderline intellectual functioning may delay appropriate measures at school, which our case illustrates. Conclusion: Borderline intellectual functioning seldom attracts attention. Our studies indicate that school and also society at large must be prepared to adapt educational and working conditions for the large minority of individuals with borderline intellectual functioning.

  • 15. Hedvall, Åsa
    et al.
    Westerlund, Joakim
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen.
    Fernell, Elisabeth
    Holm, Anette
    Gillberg, Christopher
    Billstedt, Eva
    Autism and developmental profiles in preschoolers: stability and change over time2014Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 103, nr 2, s. 174-181Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AimIncreasing numbers of young children are now being diagnosed with autism spectrum disorder (ASD). This study aimed to analyse developmental trajectories in a representative group of preschool children with ASD. MethodIn a naturalistic study, 208 preschool children with different subtypes of ASD were followed over a 2-year period. Their trajectories, as regards persistence of ASD diagnoses, developmental/intellectual levels, adaptive functioning and expressive speech, were monitored. ResultsDevelopmental profiles showed considerable change over time, especially in children with atypical autism and in those with developmental delay/borderline intellectual functioning at their first assessment. Approximately 50% of the children were found to have intellectual disability (ID) at follow-up and, of these, the majority had severe ID. This was in contrast to the first assessment by the referral team when ID had rarely been mentioned or discussed. ConclusionChanges in developmental profiles during preschool years are common in children with ASD. This implies that reassessments, covering different developmental areas, are needed. Such follow-up assessments prior to the start of school will yield a more valid estimation of the child's general cognitive level and a more accurate ASD diagnosis and thus form a better basis for realistic educational planning and intervention.

  • 16. Hirvikoski, Tatja
    et al.
    Lindholm, Torun
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen.
    Lajic, Svetlana
    Nordenström, Anna
    Gender role behaviour in prenatally dexamethasone-treated children at risk for congenital adrenal hyperplasia - a pilot study2011Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 100, nr 9, s. e112-E119Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: To investigate the effects of prenatal dexamethasone (DEX) exposure on gender role behaviour. Methods: The participants were 25 of the 40 children (62%, mean age 11 years) at risk for CAH treated with DEX prenatally during the years 1985-1995 in Sweden. The control group consisted of 35 sex- and age-matched healthy children. A new inventory, the Karolinska Inventory of Gender Role Behaviour (KI-GRB), was developed to assess directly school-age children's behaviour, and was evaluated using a separate sample of 160 school-age children. Results: DEX-treated CAH-unaffected boys showed more neutral behaviours than the controls (p = 0.04), while the DEX-treated CAH-unaffected girls did not differ from the controls after adjusting for the site of residence. There was a larger variation in the behaviour of the DEX-treated boys (p < 0.05) and a tendency for less-masculine behaviours in the DEX-treated CAH-unaffected children (p = 0.13). There were no between-group differences in the feminine behaviours. Recalculation of the analyses including the CAH-affected children showed analogous results. Conclusions: This pilot study indicates that the gender role behaviour may be affected in boys as an effect of DEX exposure in early pregnancy. Larger retrospective studies are needed for more conclusive results.

  • 17.
    Hjern, Anders
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap, Centrum för forskning om ojämlikhet i hälsa (CHESS). Karolinska Institutet, Sweden.
    Bergström, Malin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap, Centrum för forskning om ojämlikhet i hälsa (CHESS). Karolinska Institutet, Sweden.
    Fransson, Emma
    Kjaer Urhoj, Stine
    Living arrangements after parental separation have minimal impact on mental health at age 7 years2021Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 110, nr 9, s. 2586-2593Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: This study compared mental health after parental separation in 7-year-old children living in joint physical custody with sole physical custody family arrangements.

    Methods: The study population included 39 661 children from the Danish National Birth Cohort, living in a nuclear family at age 6 months. Child mental health was measured at age 7 years with maternal reports of the Strength and Difficulties Questionnaire (SDQ) operationalised as a high total score. Associations between living arrangements and mental health were analysed using logistic regression models, taking into account early childhood indicators of family relations, parental mental health and socioeconomic conditions.

    Results: There were no statistically significant differences between the living arrangements after parental separation with joint physical custody having an odds ratio (OR) of 1.37 (95% CI 1.10–1.70), sole physical custody without a new partner OR 1.33 (95% CI 1.19–1.47) and OR 1.55 (95% CI 1.30–1.84) for sole physical custody with new partner, with children in a nuclear family as reference.

    Conclusion: This study indicates that living arrangements after parental separation have a minimal influence on child mental health at age 7 years.

  • 18.
    Hjern, Anders
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap. Sachs Children's Hospital, Sweden; Karolinska Institutet, Sweden.
    Bergström, Malin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap. Sachs Children's Hospital, Sweden; Karolinska Institutet, Sweden.
    Fransson, Emma
    Lindfors, Anncharlotte
    Bergqvist, Kersti
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap. Sachs Children's Hospital, Sweden.
    Birth order and socioeconomic disadvantage predict behavioural and emotional problems at age 3 years2021Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 110, nr 12, s. 3294-3301Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: The aim of this study was to describe sociodemographic and family predictors for behavioural and emotional problems in pre-schoolers.

    Methods: This was a cross-sectional study including 30,795 children in the Stockholm region whose parents had completed the Strength and Difficulties Questionnaire (SDQ) prior to a routine visit to a well-baby clinic at age 3 years. Multivariate logistic regression was used to analyse predictors for having a high total SDQ difficulties score.

    Results: Young parental age and a low level of parental education predicted high total SDQ score in a stepwise pattern. Being a first-born child was associated with a high SDQ score with an adjusted odds ratio of 2.10 (95% C.I. 1.84-2.41), compared with having older siblings. A sole physical custody arrangement predicted a high total SDQ score after parental separation. The percentage of children with a high total SDQ score increased with the Care Need Index (CNI) of the well-baby clinic.

    Conclusions: This study identified socioeconomic disadvantage and being the first-born child as the main predictors of poor mental health at age 3 years. Well-baby clinics with socioeconomically disadvantaged catchment areas should be provided with adequate resources and methods for equitable prevention.

  • 19.
    Hjern, Anders
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap, Centrum för forskning om ojämlikhet i hälsa (CHESS). Karolinska Institutet, Sweden.
    Bergström, Malin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap, Centrum för forskning om ojämlikhet i hälsa (CHESS). Karolinska Institutet, Sweden.
    Kjaer Urhoj, Stine
    Nybo Andersen, Anne-Marie
    Early childhood social determinants and family relationships predict parental separation and living arrangements thereafter2021Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 110, nr 1, s. 247-254Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: Parental separation has been associated with poor mental health in children with better outcomes in children living in joint physical custody compared with those living with one parent after the separation. In this study, we investigated socioeconomic and relational predictors in early childhood of later parental separation and family arrangements thereafter. Methods: This study included 34 768 children from the Danish National Birth Cohort, who were living with both parents at the 6 months' data collection and followed up in 2010-2014 at age 11 years. Questionnaire data from the two data collections were linked with population registers in Statistics Denmark about parental income, education and psychiatric care and analysed in logistic regression models. Results: Socioeconomic indicators of the family and parental psychiatric disorders before birth of the child and family relationships in infancy predicted parental separation at age 11 year. For children with separated parents, a high family income and a high parental educational level were the main predictors of living in joint physical custody at the 11-year follow-up. Conclusion: Socioeconomic living conditions predict parental separation as well as living arrangements thereafter. Studies of consequences of living arrangements after parental separation should account for family factors preceding the separation.

  • 20.
    Hjern, Anders
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Brendler-Lindqvist, Maria
    Norredam, Marie
    Age assessment of young asylum seekers2012Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 101, nr 1, s. 4-7Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    During 2009, 15 100 unaccompanied children sought asylum in Europe. Many of them came from ‘failed states’ like Somalia and Afghanistan where official documents with exact birth dates are rarely issued. This has led to requests to health care professionals in many countries to assist migration authorities in determining whether a young asylum seeker is a child or an adult. Many different methods are currently employed in Europe for this purpose by dentists, paediatricians, radiographers and social workers, but no currently available method has been demonstrated to have the accuracy needed to be of real use in this decision. Unclear guidelines and arbitrary practices may lead to alarming shortcomings in the protection of this high-risk group of children and adolescents in Europe. Medical participation, as well as non-participation, in these dubious decisions raises a number of ethical questions.

    Conclusion: To improve care for young asylum seekers with undetermined age, we suggest better legal procedures for the determination of age and a more flexible approach to chronological age.

  • 21.
    Hjern, Anders
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS). National Board of Health and Welfare, Sweden.
    Ekeus, Cecilia
    Rasmussen, Finn
    Lindblad, Frank
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet. Uppsala University, Sweden.
    Educational achievement and vocational career in twins - a Swedish national cohort study2012Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 101, nr 6, s. 591-596Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: To investigate how being born and raised as a twin is associated with IQ, educational achievement and vocational career. Methods: Register study in a national birth cohort, complemented with a siblings study. The study population included 13 368 individuals born and raised as twins and 837 752 singletons, including 3019 siblings of twins, in the Swedish birth cohorts of 19731981. Our outcome measures were mean grade points on a five point scale from ninth grade of primary school at 1516 years, IQ tests on a nine grade point scale from male conscripts at 1819 years, highest completed education, disability benefits, work income and employment at 2735 years of age. Results: Twins had slightly better mean grade point averages in ninth grade; +0.08 (95% CI 0.040.11) and more often had completed a university education in young adulthood; OR 1.16 (1.021.21) compared with singleton siblings, despite male twins having a slightly lower IQ at military conscription compared with male singletons. Employment rates, mean income and disability benefits were similar in twins and singletons. Conclusions: Twins have slightly better educational careers and similar vocational careers compared with those born as singletons.

  • 22.
    Hjern, Anders
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS). Sachs’ Children and Youth hospital, Sweden; Karolinska Institutet, Sweden.
    Lindblom, Kristin
    Reuter, Antonia
    Silfverdal, Sven-Arne
    A systematic review of prevention and treatment of infantile colic2020Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 109, nr 9, s. 1733-1744Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Aim: The aim of this review was to evaluate the evidence for interventions for infantile colic.

    Methods: This was a systematic review based on a literature search in December 2017 for articles published during 2007-2017 about preventive and treatment interventions for infantile colic in infants. The review included original randomised controlled trials (RCTs) and meta-analyses with at least 20 infants in each study group that were assessed according to GRADE criteria.

    Results: The review found moderately strong evidence that administration of Lactobacillus reuteri DSM 17938 shortened the crying duration, with positive evidence from three out of four national contexts. There were four RCTs of acupuncture, all with no or minimal effect on crying duration. All studies reviewed with a follow-up until or beyond three months of age show a quite steep decline over time in crying duration in both treatment and control groups.

    Conclusion: Lactobacillus reuteri DSM 17938 is a promising treatment for infantile colic with moderately strong evidence in this review, but studies in more populations are needed. Acupuncture is not an effective treatment for infantile colic. Systematic support strategies to parents with infantile colic are important knowledge gaps.

  • 23.
    Hjern, Anders
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap, Centrum för forskning om ojämlikhet i hälsa (CHESS). Sachs Children's Hospital, Sweden; Karolinska Institutet, Sweden.
    Lindfors, Anncharlotte
    Sarkadi, Anna
    Bergqvist, Kersti
    Bergström, Malin
    Child behaviour is a main concern for parents of 3-year-olds2024Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: The aim of this study was to describe parental concerns about child health and behaviour and their sociodemographic predictors in 3-year-olds, in relation to the national guidelines of well-baby clinics.

    Methods: The study included parents of 33 526 children in Stockholm who had completed a questionnaire prior to a routine visit to a well-baby clinic at age 3 years. Multivariate regression was used to analyse predictors for concerns.

    Results: Child behaviour problems, defined as defiance and problem with adherence to daily routines, were the most common parental concerns (36.4%), with poor social skills and relations being second (21.8%). Regarding development, 9.6% had concerns about speech and 4.7% about motor development. Screen use (9.5%) and being underweight (6.3%) were other common parental concerns, while lifestyle concerns regarding physical activity and overweight were rare. Parents raised about twice as many concerns for first-born children compared with younger siblings. Child behaviour and developmental concerns were more frequent in families where the mother had primary education only and attended a well-baby clinic with a high Care Need Index.

    Conclusion: Parents' concerns reflected the national guidelines about child development and behaviour, but not its emphasis on a healthy lifestyle.

  • 24.
    Hjern, Anders
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap, Centrum för forskning om ojämlikhet i hälsa (CHESS). Karolinska Institutet, Sweden.
    Nyberg, Christine
    Burström, Bo
    Did the choice reform in Stockholm change social disparities in use of outpatient health services for children?2023Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 112, nr 9, s. 1973-1981Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: The aim of this study was to investigate whether the choice reforms in healthcare in Stockholm county in 2008 and 2013 changed the sociodemographic user patterns of outpatient healthcare services for children.

    Methods: The study used regional data on healthcare use linked to sociodemographic data from national registers in the total population of children 0–15 years in the Stockholm county. Change in use of healthcare services was analysed in multiple linear regression in a difference in differences approach of socio-economic indicators.

    Results: The choice reform of 2013 increased children's overall use of specialised care by around 30% until 2017 while primary care use decreased by the same degree. The mean number of physician visits in specialised care for children with severe asthma increased from 3.9 to 5.2 per year. Overall, children in families with low maternal education, low disposable income and a non-Western background increased their use of specialised care more than children from families with a more privileged socio-economic situation.

    Conclusion: There was no indication that the choice reform in Stockholm county increased the social disparities in use of primary and specialised outpatient care for children, rather the opposite.

  • 25.
    Hjern, Anders
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Weitoft, G.R.
    Lindblad, Frank
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    Social adversity predicts ADHD-medication in school children – a national cohort study2010Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 99, nr 6, s. 920-924Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aims: To test the hypothesis that psychosocial adversity in the family predicts medicated ADHD in school children.

    Method: ADHD-medication during 2006 was identified in the Swedish Prescribed Drug Register in national birth cohorts of 1.1 million 6–19 year olds. Logistic regression models adjusted for parental psychiatric disorders were used to test our hypothesis.

    Results: There was a clear gradient for ADHD medication with level of maternal education, with an adjusted odds ratio of 2.20 (2.04–2.38) for the lowest compared with the highest level. Lone parenthood and reception of social welfare also implied higher risks of ADHD-medication with adjusted ORs of 1.45 (1.38–1.52) and 2.06 (1.92–2.21) respectively. Low maternal education predicted 33% of cases with medicated ADHD and single parenthood 14%.

    Conclusions: Social adversity in the family predicts a considerable proportion of ADHD-medication in school children in Sweden.

  • 26. Holmberg, K.
    et al.
    Sundelin, C.
    Hjern, Anders
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Routine developmental screening at 5.5 and 7 years of age is not an efficient predictor of attention-deficit / hyperactivity disorder at age 102010Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 99, nr 1, s. 112-20Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: The aim of this study was to assess the efficiency of developmental screening for deficits in attention, motor control and perception or attention-deficit/hyperactivity disorder (DAMP/ADHD) at 5.5 and 7 years of age for diagnosing ADHD in grade 4.

    Method: The study population consisted of 442 children from a cohort study of ADHD in 10-year olds in one municipality in Stockholm County. Sensitivity, specificity and positive predictive value of a developmental screening at 5.5 and at 7 years of age for being diagnosed with ADHD at 10 years of age was calculated.

    Results: The sensitivity was 44%, the specificity 85% and the positive predictive value for having a diagnosis of pervasive ADHD in 4th grade was 15%, when at least two deviations in nine items was used as the cut-off point in 5.5-year screening at Child Health Centres (CHCs). With a cut-off score of at least two deviations in four items rated by parents or and teachers in 1st grade, these estimates were 58%, 81% and 15% respectively.

    Conclusion: This study demonstrates that developmental screening for DAMP/ADHD at 5.5 and 7 years of age does not identify children who are diagnosed with ADHD in grade 4 with a high degree of selectivity.

  • 27. Höglund Carlsson, Lotta
    et al.
    Westerlund, Joakim
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Kognitiv psykologi. Gothenburg University, Sweden.
    Barnevik Olsson, Martina
    Eriksson, Mats A.
    Hedvall, Åsa
    Gillberg, Christopher
    Fernell, Elisabeth
    Autism spectrum disorders before diagnosis: results from routine developmental surveillance at 18 months2016Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 105, nr 7, s. 823-828Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: This study investigated the results from the national, routine 18-month developmental surveillance at Child Healthcare Centres (CHCs) on children later diagnosed with autism spectrum disorder (ASD). Methods: Child Healthcare Centre records of 175 children, diagnosed with ASD before 4.5 years in Stockholm County, Sweden, were reviewed regarding the results of the eight-item neurodevelopmental surveillance. Results were contrasted with normative data from the general child population in Stockholm County. Results: More than one-third of the total ASD group, including half of the group with ASD and intellectual disability (ID), did not pass the required number of items, compared to one in 50 in the general child population. Of those with ASD and ID who had passed, more than one-third experienced developmental regression after 18 months of age. If the CHC surveillance had considered reported regulatory problems - crying, feeding and sleeping - then another 10% of the children with ASD and ID could have been identified during this surveillance. Conclusion: The existing CHC surveillance traced half of the group of children who were later diagnosed with ASD combined with intellectual disability. Adding an item on regulatory problems to the 18-month surveillance would have increased this number by another 10%.

  • 28.
    Ivarsson, Malena
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen. Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    Anderson, Martin
    Karolinska Institutet.
    Åkerstedt, Torbjörn
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    Lindblad, Frank
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    Playing a violent television game affects heart rate variability2009Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 98, nr 1, s. 166-172Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To investigate how playing a violent/nonviolent television game during the evening affects sympathetic and parasympathetic reactions during and after playing as well as sleep quality during the night after playing.

    Subjects and Methods: In total, 19 boys, 12–15 years of age, played television games on two occasions in their homes and participated once without gaming. Heart rate, heart rate variability (HRV) and physical activity were measured during gaming/participating and the night to follow using a portable combined heart rate and movement sensor. A sleep diary and questionnaires about gaming experiences and session-specific experiences were filled in.

    Criteria for Selection of Games: Violent game involves/rewards direct physical violence (no handguns) against another person, and nonviolent game involves/rewards no violence; same game design ('third-person game'); conducted in the same manner; no differences concerning motor activity; similar sound and light effects; no sexual content, violence against women or racial overtones.

    Results: During violent (vs. nonviolent) gaming, there was significantly higher activity of the very low frequency component of the HRV and total power. During the night after playing, very low frequency, low frequency and high frequency components were significantly higher during the violent (vs. nonviolent) condition, just as total power. There were no significant differences between the three conditions (violent/nonviolent/no gaming) with respect to an index reflecting subjectively perceived sleep difficulties. Nor was there any difference between violent and nonviolent condition for any single sleep item.

    Conclusion: Violent gaming induces different autonomic responses in boys compared to nonviolent gaming – during playing and during the following night – suggesting different emotional responses. Subjectively perceived sleep quality is not influenced after a single gaming experience. Future studies should address the development of the autonomic balance after gaming over longer time than a night, physiological adaptation to frequent gaming and potential gender differences.

  • 29.
    Ivarsson, Malena
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen. Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    Anderson, Martin
    Karolinska Institutet.
    Åkerstedt, Torbjörn
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    Lindblad, Frank
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    Playing a violent television game does not affect saliva cortisol2009Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 98, nr 6, s. 1052-1053Artikkel i tidsskrift (Fagfellevurdert)
  • 30. Julihn, Annika
    et al.
    Cunha Soares, Fernanda
    Hjern, Anders
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap, Centrum för forskning om ojämlikhet i hälsa (CHESS). Karolinska Institutet, Sweden.
    Dahllöf, Göran
    Development level of the country of parental origin on dental caries in children of immigrant parents in Sweden2021Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 110, nr 8, s. 2405-2414Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: To study the association of parental country of origin—expressed as low-, medium- and high-Human Development Index (HDI) countries—with caries experience in children of immigrant families in Stockholm.

    Methods: This registry-based cohort study included all children born in 2000–2003 who resided in Stockholm County, Sweden, at age 3 years (n = 83,147) with follow-up at 7 years of age. A logistic regression was performed for the multivariate analysis with adjustments for socio-demographic factors.

    Results: After adjustments, logistic regression analyses revealed that, compared with Swedish children of the same age, the risk of caries was highest when the immigrant parents originated in a medium (OR 4.22 (95% CI 3.99:4.47)) or low (OR 2.80 (95% CI 2.56:3.06)) income country background at age 7 years, but was increased also for high-income country background, OR 1.77 (95% CI 1.52–2.05). Furthermore, the risk of presenting with caries experience at age 7 years increased for all children in the 1st (lowest) household income quintile in the host country Sweden.

    Conclusion: This study shows that the developmental level of the parental country of birth as well as the family socioeconomic position in Sweden influence the risk for caries development in their children.

  • 31. Kark, M.
    et al.
    Hjern, Anders
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS). Karolinska Institutet, Sweden.
    Rasmussen, F.
    Poor school performance is associated with a larger gain in body mass index during puberty2013Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 103, nr 2, s. 207-213Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: Social inequalities in type 2 diabetes and coronary heart disease may be established in formative school years. We investigated whether school performance is associated with adiposity and increase in body mass index (BMI) between 10 and 15 years of age.

    Methods: A community sample of 2633 school children had height and weight measured in school at the ages of 10 and 15. Percentages of body fat and waist circumference were measured at the age of 15. Mean grades in several school subjects at the age of 15 (ninth school year) were divided into quartiles. A linear regression analysis with BMI as the main outcome took into account parental education and ethnicity, obtained from registers, and children’s living habits, collected by questionnaires.

    Results: In adjusted models, longitudinal changes in BMI between the ages of 10 and 15 were larger in the lowest quartiles of school grades compared with the highest: for girls, they were b=0.45 (p=0.007) and for boys they wereb=0.45 (p= 0.016). Crosssectional regression analyses, with percentage of body fat and waist circumference as outcomes, showed similar results.

    Conclusion: Our results suggest that school performance is one pathway to social inequalities in obesity in school children.

  • 32. Kling, Stefan
    et al.
    Vinnerljung, Bo
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Hjern, Anders
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS). Karolinska Institutet, Sweden.
    Somatic assessments of 120 Swedish children taken into care reveal large unmet health and dental care needs2016Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 105, nr 4, s. 416-420Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AimFor decades, non-Nordic countries have consistently reported high rates of somatic health problems among children placed in care by the authorities. This study examined the unmet health and dental care needs of Swedish children in foster and residential care. MethodsThe health of 120 consecutive children aged 0-17 years, who had recently been placed in foster or residential care in one Swedish region, was assessed by an experienced paediatrician using patient records, their medical history and a physical examination. ResultsFollowing the assessments, 51% of the subjects received at least one referral to a specialist or to primary care, either for a previously undetected medical condition or for a follow-up of a previously detected condition noted in their patient records. The study showed that 40% of the girls and 33% of boys were overweight and completed vaccination rates were only 86% for children up to the age of six and 68% for 7- to 17-year-olds. Half of the 7- to 17-year-olds had untreated dental decay. ConclusionOur study revealed a large unmet need for health and dental care interventions among children placed in foster care and residential care and a systematic strategy is required to address those needs.

  • 33. Köhler, M.
    et al.
    Emmelin, M.
    Hjern, Anders
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS). Karolinska Institutet, Sweden.
    Rosvall, M.
    Children in family foster care have greater health risks and less involvement in Child Health Services2015Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 104, nr 5, s. 508-513Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim

    This study investigated the impact of being in family foster care on selected health determinants and participation in Child Health Services (CHS).

    Methods

    Two groups of 100 children, born between 1992 and 2008, were studied using data from Swedish Child Health Services for the preschool period up to the age of six. The first group had been in family foster care, and the controls, matched for age, sex and geographic location, had not. Descriptive statistics were used to describe differences in health determinants and participation in Child Health Services between the two groups.

    Results

    The foster care group had higher health risks, with lower rates of breastfeeding and higher levels of parental smoking. They were less likely to have received immunisations and attended key nurse or physician visits and speech and vision screening. Missing data for the phenylketonuria test were more common in children in family foster care.

    Conclusion

    Children in family foster care were exposed to more health risks than the control children and had lower participation in the universal child health programme during the preschool period. These results call for secure access to high‐quality preventive health care for this particularly vulnerable group of children.

  • 34. Lind, Johannes
    et al.
    Schollin Ask, Lina
    Juarez, Sol
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Hjern, Anders
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS). Sachs’ Children and Youth Hospital, South General Hospital, Sweden; Karolinska Institutet, Sweden.
    Hospital care for viral gastroenteritis in socio-economic and geographical context in Sweden 2006-20132018Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 107, nr 11, s. 2011-2018Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIM: We investigated socio-economic and geographical determinants of hospital care for viral gastroenteritis in young children.

    METHOD: This is a register-based study in a national birth cohort of 752 078 children 0-5 years of age in Sweden during 2006-2012. Hazard ratios (HR) of time to first admission and first episode of outpatient emergency department (ED) care with a diagnosis of viral gastroenteritis were estimated with Cox regression.

    RESULTS: The adjusted HRs for hospital admission with a diagnosis of viral gastroenteritis were increased when the mother was below 25 years at the birth of the child, 1.30 (95% CI: 1.24-1.35), had a short (<=9 years) education, 1.18 (95% CI: 1.12-1.23), a psychiatric disorder, 1.34 (95% CI: 1.30-1.39), and/or when parents were born outside Europe, 1.23 (95% CI: 1.18-1.29). In contrast, the disposable income of the family was only marginally associated with such hospital admissions. The pattern of HRs for outpatient ED hospital care was similar. Hospital care incidences for viral gastroenteritis differed considerably between Swedish counties.

    CONCLUSION: Parental indicators associated with a lower level of health literacy increase the risk for hospital care due to gastroenteritis in young children. Information about oral rehydration should be provided in ways that are accessible to these parents.

  • 35. Lindgren, C
    et al.
    Lindblad, Frank
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    The enigma of the welfare state: excellent child health prerequisites--poor subjective health2010Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 99, nr 6, s. 803-7Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The rate of subjective health complaints among Swedish children is increasing by age and over time, and more so than among children in other Scandinavian countries. In contrast, the somatic health and prerequisites for wellbeing are excellent. This paradoxical situation, The Enigma of the Welfare State, is the focus of this viewpoint. We argue that one important background factor may be late adverse effects of the welfare society itself and some of its inherent values. We have identified several possible pathways. We have given them names of diseases--on the society level--like health obsession, stress panic, welfare apathy and hyper-individualism. Together with other factors such as a dysfunctional school and an unsatisfactory labour market for youth, these diseases are involved in an interplay that is constantly inducing anxiety and low self-esteem. CONCLUSION: The gradually deteriorating self-reported health among Swedish youth may, to some degree, be explained as a late adverse effect of the welfare society itself and its inherent values.

  • 36. Lindström, K.
    et al.
    Lindblad, F.
    Hjern, Anders
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Preterm birth and ADHD in school children : a Swedish national cohort study2010Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 99, nr Suppl46, s. 66-Artikkel i tidsskrift (Fagfellevurdert)
  • 37.
    Lundequist, Aiko
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen. Karolinska Institutet, Sweden.
    Bohm, Birgitta
    Lagercrantz, Hugo
    Forssberg, Hans
    Smedler, Ann-Charlotte
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen.
    Cognitive outcome varies in adolescents born preterm, depending on gestational age, intrauterine growth and neonatal complications2015Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 104, nr 3, s. 292-299Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: The aim of this study was to investigate long-term cognitive outcome in a cohort of 18-year-olds born preterm and previously assessed at the age of 5.5.

    Methods: We tested 134 adolescents born preterm with a very low birthweight of <1500g and 94 term-born controls with a comprehensive cognitive battery at 18years of age. The cohort was subdivided into 73 extremely preterm, 42 very preterm and 19 moderately preterm infants with gestational ages of 23-27, 28-31 and 32-36weeks, respectively. The moderately preterm group was dominated by adolescents born small for gestational age.

    Results:Very preterm adolescents performed on a par with term-born controls. In contrast, extremely preterm adolescents displayed inferior results on all cognitive tests, more so if they had suffered neonatal complications. Moderately preterm adolescents scored lower than very preterm and full-term born adolescents, particularly on complex cognitive tasks.

    Conclusion: Adolescents born at 28weeks of gestation or later, with appropriate birthweight and no perinatal complications, functioned like term-born peers at 18years of age. Extremely preterm birth per se posed a risk for long-term cognitive deficits, particularly executive deficits. Adolescents born moderately preterm but small for gestational age were at risk of general cognitive deficits.

  • 38. Mensah, Tita
    et al.
    Hjern, Anders
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap, Centrum för forskning om ojämlikhet i hälsa (CHESS). Karolinska Institutet, Sweden.
    Håkanson, Kickan
    Johansson, Pia
    Jonsson, Ann Kristine
    Mattsson, Titti
    Tranæus, Sofia
    Vinnerljung, Bo
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Östlund, Pernilla
    Klingberg, Gunilla
    Organisational models of health services for children and adolescents in out-of-home care: Health technology assessment2020Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 109, nr 2, s. 250-257Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Aim: Decades of research confirm that children and adolescents in out‐of‐home care (foster family, residential care) have much greater health care needs than their peers. A systematic literature review was conducted to evaluate organisational health care models for this vulnerable group.Methods: A systematic literature search was undertaken of the following data‐bases: Academic Search Elite, CENTRAL, Cochrane Database of Systematic Reviews, Cinahl, DARE, ERIC, HTA, PsycInfo, Psychology and Behavioural Sciences Collection, PubMed, SocIndex. Randomised and non‐randomised controlled trials were to be included. Two pairs of reviewers independently assessed abstracts of the identified published papers. Abstracts meeting the inclusion criteria were ordered in full text. Each article was reviewed independently, by pairs of reviewers. A joint assessment was made based on the inclusion criteria and relevance. Cases of disagreement were resolved by consensus discussion.Results: No study with low or medium risk of bias was identified.Conclusion: In the absence of studies of acceptable quality, it is not possible to assess the impact of organisational models intended to ensure adequate health and dental care for children and adolescents in out‐of‐home care. Therefore, well‐designed follow‐up studies should be conducted following the implementation of such models.

  • 39. Nilsson, Gill
    et al.
    Westerlund, Joakim
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Kognitiv psykologi. Sahlgrenska University Hospital, Sweden; University of Gothenburg, Sweden.
    Fernell, Elisabeth
    Billstedt, Eva
    Miniscalco, Carmela
    Arvidsson, Thomas
    Olsson, Ingrid
    Gillberg, Christopher
    Neurodevelopmental problems should be considered in children with febrile seizures2019Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, nr 8, s. 1507-1514Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: Clinical developmental phenotyping of four- to five-year-old children with febrile seizures (FSs).

    Methods: Children with FS (n = 157, corresponding to 3.7% of the targeted general population of four-five-year-olds) had been identified at child healthcare centres in Gothenburg. Parents of 73 children (41 boys, 32 girls) accepted participation in the present study. The assessments included a neuropaediatric assessment, Movement ABC, Wechsler Preschool and Primary Scale of Intelligence-III and parent questionnaires (Five-to-Fifteen (FTF) and Strengths and Difficulties Questionnaire (SDQ)). Hospital records were reviewed, when applicable.

    Results: One-third of the children had at least one DSM-5 neurodevelopmental disorder diagnosis or marked developmental problems within areas of attention, activity regulation, behaviour, speech and language, general cognition or motor functioning. No differences were found between children with single vs recurrent or simple vs complex FS.

    Conclusion: Febrile seizure are relatively often associated with Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations (ESSENCEs). We found no indications that ESSENCE might be caused by FS per se. However, the results suggest that child healthcare professionals should consider the possibility of ESSENCE in children with a history of FS.

  • 40. Norberg, Hanna
    et al.
    Stålnacke, Jannica
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen.
    Heijtz, Rochellys Diaz
    Smedler, Ann-Charlotte
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen.
    Nyman, Margareta
    Forssberg, Hans
    Norman, Mikael
    Antenatal corticosteroids for preterm birth: dose-dependent reduction in birthweight, length and head circumference2011Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 100, nr 3, s. 364-369Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: This study was undertaken to evaluate the effects of repeated courses of antenatal corticosteroids (ACS) on foetal growth. Methods: We studied 94 infants exposed to 2-9 courses of ACS. Mean gestational age (GA) at first exposure was 29 and at birth 34 weeks. Exposure data were retrieved from case record files. Information on potential confounders was collected from the Swedish Medical Birth Registry. Standard deviation scores (SDS) for birthweight (BW), birthlength (BL) and head circumference (HC) were calculated and considered as outcomes. Results: GA at start of ACS did not affect outcome. BW-SDS, BL-SDS and HC-SDS were -0.21, -0.19 and +0.25 in infants exposed to two courses, compared to -1.01, -1.04 and -0.23 in infants exposed to >= 4 courses of ACS (p = 0.04-0.07). In multiple regression analyses, >= 4 courses were associated with lower BW-SDS, BL-SDS and HC-SDS (p = 0.007-0.04) compared to SDS after 2-3 courses. The effects from >= 4 courses on BW and BL were comparable to reduction in birth size seen in twins and on HC to that observed after maternal smoking. Conclusions: Multiple courses of ACS are associated with a dose-dependent decline in foetal growth, which may affect later development and health.

  • 41. Olsson, Martina Barnevik
    et al.
    Carlsson, Lotta Höglund
    Westerlund, Joakim
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen.
    Gillberg, Christopher
    Fernell, Elisabeth
    Autism before diagnosis: crying, feeding and sleeping problems in the first two years of life2013Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 102, nr 6, s. 635-639Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim To chart early registered regulatory problems (RP) in a representative group of young children with and without autism spectrum disorder (ASD). Methods The target group comprised 208 preschool children with ASD, whose records from the Child Health Centres (CHC) were reviewed regarding numbers of consultations for excessive crying, feeding and sleeping problems. The records from an age- and gender-matched comparison group were obtained from the same CHCs as those of the index children Results Significant differences between the ASD and comparison groups were found for each domain studied and when domains were collapsed. Two or more consultations had occurred in 44% of the children in the ASD group and in 16% of the comparison group (p<0.001). No correlations were found with regard to gender, later severity of autism, cognitive level or degree of hyperactivity. Conclusion Regulatory problems (RP) were much more common in children who later received a diagnosis of ASD. Children with many RP in infancy require attention from CHC and paediatric services and need to be followed with regard to development and family support.

  • 42. Osman, Fatumo
    et al.
    Flacking, Renée
    Klingberg Allvin, Marie
    Schön, Ulla-Karin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Qualitative study showed that a culturally tailored parenting programme improved the confidence and skills of Somali immigrants2019Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, nr 8, s. 1482-1490Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: Parenting programmes tailored to immigrant parents have been reported to improve the mental health of the children and parents, as well as parents' sense of competence in parenting. However, research on parents' experiences of programmes tailored to their needs is scarce. This qualitative study aimed to describe Somali parents' experiences of how a culturally sensitive programme affected their parenting.

    Methods: The study was conducted in a middle-sized city in Sweden in 2015. Data were collected through semi-structured interviews with 50 participants two months after they took part in a parenting support programme. Inductive and deductive qualitative content analyses were used.

    Results: A light has been shed was a metaphor that emerged from the analysis and that captured the knowledge the parents gained from the parenting system in Sweden. Parents gained confidence in their parenting role and became emotionally aware of their child's social and emotional needs and how to respond to them. Holding the sessions in the participant's native language was important for the parents' participation and acceptance of the programme.

    Conclusion: Parenting programmes should be tailored to the specific needs of the participants and cultural sensitivity should be factored into programmes to attract immigrant parents.

  • 43. Otterman, Gabriel
    et al.
    Lainpelto, Katrin
    Stockholms universitet, Juridiska fakulteten, Juridiska institutionen. Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    Lindblad, Frank
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet. Uppsala University, Sweden.
    Factors influencing the prosecution of child physical abuse cases in a Swedish metropolitan area2013Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 102, nr 12, s. 1199-1203Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIM: To examine whether case characteristics of alleged child physical abuse, such as severity, influence criminal investigation procedures and judicial outcomes.

    METHOD: We identified all police-reported cases of nonfatal child physical abuse during 2006 in a Swedish metropolitan area (n = 158). Case characteristics were abstracted from police records.

    RESULTS: Over half (56%) of the victims were boys, and the median age group was 9-12 years. The severity of the alleged violence was low in 8% of cases, moderate in 51% and high in 41%. Suspects were interviewed in 53% of cases, with fathers more likely to be interviewed than mothers. Children were forensically interviewed in 52% of cases, with 9% physically examined by a clinician and 2.5% by a forensic specialist. Seven per cent of the cases were prosecuted and 1.3% resulted in summary punishment. We found no association between severity of alleged abuse and whether the suspect was interviewed, the child was forensically interviewed or physically examined or whether the perpetrator was prosecuted.

    CONCLUSIONS: Despite the high severity of alleged violence, physical examination rates were low, suggesting a need for criminal investigative procedures on child physical abuse to be reviewed in Sweden.

  • 44. Oxelgren, Ulrika Wester
    et al.
    Åberg, Marie
    Myrelid, Åsa
    Annerén, Göran
    Westerlund, Joakim
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Kognitiv psykologi. Gothenburg University, Sweden.
    Gustafsson, Jan
    Fernell, Elisabeth
    Autism needs to be considered in children with Down Syndrome2019Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, nr 11, s. 2019-2026Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: To analyse levels and profiles of autism symptoms in children with Down Syndrome (DS) with and without diagnosed autism spectrum disorder (ASD) and to specifically study the groups with severe Intellectual Disability (ID).

    Methods: From a population‐based cohort of 60 children with DS (age 5–17 years) with 41 participating children, scores obtained from the Autism Diagnostic Observation Schedule (ADOS) Module‐1 algorithm were compared between those with and without diagnosed ASD. Children with DS and ASD were also compared to a cohort of children with idiopathic ASD, presented in the ADOS manual.

    Results: Children with DS and ASD had significantly higher ADOS scores in all domains compared to those without ASD. When the groups with DS, with and without ASD, were restricted to those with severe ID, the difference remained. When the children with DS and ASD and the idiopathic autism group were compared, the ADOS profiles were similar.

    Conclusion: A considerable proportion of children with DS has ASD, but there is also a group of children with DS and severe ID without autism. There is a need to increase awareness of the high prevalence of autism in children with DS to ensure that appropriate measures and care are provided.

  • 45. Reuter, Antonia
    et al.
    Silfverdal, Sven-Arne
    Lindblom, Kristin
    Hjern, Anders
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS). Sachs’ Children and Youth hospital, Sweden; Karolinska Institutet, Sweden.
    A systematic review of prevention and treatment of infant behavioural sleep problems2020Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 109, nr 9, s. 1717-1732Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Aim: The aim of this review was to evaluate the evidence for interventions for behavioural sleep problem in infants.

    Methods: Systematic review based on a search in MEDLINE, Web of Science and PsychINFO in December 2017 for articles published in English during 2007-2017 about preventive and treatment interventions for sleep problems in infants. The review included controlled trials and meta-analyses with at least 20 infants in study groups assessed according to the Grading of Recommendations Assessment, Development and Evaluation criteria.

    Results: Out of 476 original articles assessed for eligibility, 12 studies were included in the synthesis. Interventions with behavioural, educational and massage strategies were evaluated. No intervention was evaluated in more than one trial. Five interventions with behavioural methods for establishing consistent routines or controlled crying showed modest short-term effects, while the evidence for elements of education was inconsistent. Studies of massage were of poor quality. Knowledge gaps were identified regarding interventions in cross-cultural context, involving fathers, in children below six months of age, in high-risk populations and consequences of interventions that include extinction.

    Conclusion: Some support for short-term effects of behavioural treatment strategies was found, but more studies are needed to establish evidence.

  • 46. Rindsjö, Erika
    et al.
    Barber, Matthew
    Theorell, Töres
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    Lindblad, Frank
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    Alm, Johan
    Scheynius, Annika
    Joerink, Maaike
    Increased mRNA expression of glucocorticoid receptor-P in placenta is associated with a decreased risk of allergen sensitisation in the child2015Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 104, nr 6, s. 638-640Artikkel i tidsskrift (Fagfellevurdert)
  • 47. Schollin Ask, Lina
    et al.
    Hjern, Anders
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS). Karolinska Institutet, Sweden; Sachs′ Children and Youth Hospital, Sweden.
    Lindstrand, Ann
    Olen, Ola
    Sjögren, Eva
    Blennow, Margareta
    Örtqvist, Ake
    Receiving early information and trusting Swedish child health centre nurses increased parents' willingness to vaccinate against rotavirus infections2017Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 106, nr 8, s. 1309-1316Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: Rotavirus vaccines are effective against severe infections, but have a modest impact on mortality in high-income countries. Parental knowledge and attitudes towards vaccines are crucial for high vaccination coverage. This study aimed to identify why parents refused to let their infant have the vaccination or were unsure. Methods: This cross-sectional study was based on 1,063 questionnaires completed by the parents of newborn children in 2014. Stepwise logistic regression was used to identify the main predictors. Results: Most (81%) parents intended to vaccinate their child against the rotavirus, while 19% were unwilling or uncertain. Parents with less education and children up to five weeks of age were more likely to be unwilling or uncertain about vaccinating their child. Factors associated with a refusal or uncertainty about vaccinating were not having enough information about the vaccine, no intention of accepting other vaccines, paying little heed to the child health nurses' recommendations, thinking that the rotavirus was not a serious illness and not believing that the vaccine provided protection against serious forms of gastroenteritis. Conclusion: Early information, extra information for parents with less education and close positive relationships between parents and child health nurses were important factors in high rotavirus vaccination rates.

  • 48. Swartz, Jackie
    et al.
    Alm, Johan
    Theorell, Töres
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    Lindblad, Frank
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet. Uppsala University.
    Parental Sense of Coherence in the first 2 years of life is not related to parental and child diurnal cortisol rhythm or proxies of anthroposophic lifestyle2013Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 102, nr 9, s. 920-924Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: Sense of Coherence (SOC) is hypothesized to have direct physiological consequences on endocrine and immunological processes. In this study, we compare parental SOC scores from pregnancy in groups of infants and parents representing different lifestyles (anthroposophic, partly anthroposophic and nonanthroposophic). We also analyse whether these could predict cortisol levels of the parents and their infants at 6-24 months postpartum. Methods: Parental SOC-13 was collected during the third trimester of pregnancy from a birth cohort of families with different lifestyles. Salivary samples were collected from the whole family when the child was 6 months (n = 210), 12 (n = 178) and 24 months of age (n = 149), and cortisol levels were analysed with radioimmunoassay technique. Results: Sense of Coherence scores did not differ between the three lifestyle groups, and there were no correlations between SOC scores and salivary cortisol concentrations in separate analyses of mothers, fathers and children at any sampling age or at any sampling time during the day (morning, afternoon, bedtime). Conclusion: Sense of Coherence scores did not vary in parents with different lifestyles and were not associated with salivary cortisol levels in parents or in children.

  • 49. Swartz, Jackie
    et al.
    Stenius, Fredrik
    Alm, Johan
    Theorell, Töres
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    Lindblad, Frank
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet. Uppsala University, Sweden.
    Lifestyle and salivary cortisol at the age of 12 and 24 months2012Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 101, nr 9, s. 979-984Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: To analyse salivary cortisol levels in 12- and 24-month-olds from families with an anthroposophic lifestyle and comparisons (partly anthroposophic and non-anthroposophic). Methods: Salivary samples were collected at child ages of 12 (n = 178) and 24 (n = 149) months. Cortisol was analysed with radioimmunoassay technique. Results: Evening cortisol levels in children from anthroposophic families were lower than in comparisons at 12 months of age (geometric means: anthroposophic 1.7, partly anthroposophic 1.9, non-anthroposophic 3.6 nmol/L; p = 0.024) and at 24 months of age (1.1, 1.8 and 2.9 nmol/L, respectively; p = 0.002). At 24 months of age, similar differences were noted also for the afternoon levels (2.3, 3.3 and 3.9 nmol/L, respectively; p = 0.043). At age 12 months, the differences in the evening cortisol were statistically explained by a meat-free diet and at age 24 months by the anthroposophic lifestyle as such. The circadian variations were parallel in the three groups at age 12 and 24 months. No cortisol differences were observed between parents representing different lifestyles. Conclusions: An anthroposophic lifestyle is associated with low cortisol levels in the evening at age 12 and 24 months, at age 24 months also in the afternoon.

  • 50. Söderström, Ulf
    et al.
    Aman, Jan
    Hjern, Anders
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Being born in Sweden increases the risk for type 1 diabetes: a study of migration of children to Sweden as a natural experiment.2012Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 101, nr 1, s. 73-77Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim:  To investigate whether the age of first exposure to a high-incidence country like Sweden determines the risk of T1DM in children with an origin in a low incidence region of the world. Methods:  Register study in a Swedish study population in the age 6-25 years in three categories of residents with an origin in low incidence regions of T1DM (Eastern Europe, East Asia, South Asia and Latin America); 24 252 international adoptees; 47 986 immigrants and 40 971 Swedish-born with two foreign-born parents and a comparison group of 1 770 092 children with Swedish-born parents. Retrieval of a prescription of insulin during 2006 was used as an indicator of T1DM and analysed with logistic regression. Results:  The odds ratios (OR) for T1DM were lower than the Swedish majority population for residents with an origin in the four low incidence regions. Being Swedish-born implied a higher risk for T1DM in the four low incidence study groups compared with the internationally adopted with an OR of 1.68 (CI 1.03-2.73). Conclusions:  Being born in Sweden increases the risk for T1DM in children with an origin in low incidence countries. This may imply that exposures in utero or very early infancy are important risk factors for T1DM.

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