Intrauterine exposure to caffeine and inattention/overactivity in children

AIM

To determine the association between intrauterine exposure to timing and sources of caffeine and inattention/overactivity, suggesting ADHD in the child.

METHOD

This study used prospectively collected data from the large population-based study, The Norwegian Mother and Child Cohort Study (MoBa). Participants were 25 343 mothers and their 18-month-old children. Mothers reported on consumption of a number of caffeine sources at the 17th week and 30th week of gestation, as well as child inattention/overactivity at 18 months. Data were analysed using univariate analyses of covariance (ancova).

RESULTS

Once we controlled for confounders, there was a small effect of caffeine intake at 17th week of gestation on inattention/overactivity combined, and both 17th and 30th week of gestation on overactivity, when investigated separately from inattention. Surprisingly, the caffeine effect was only found for soft drinks, not tea or coffee.

CONCLUSION

Intrauterine exposure to soft drinks rather than coffee, the traditional focus, is associated with maternal reports of overactive behaviour in children aged 18 months.

Parental reported bullying among Nordic children: a population-based study

BACKGROUND

Bullying has been shown to be a serious problem amongst school children, but few studies have been population-based and included pre-school children.

METHODS

The study is part of a cross-sectional comparative study in 1984 and 1996, focusing on children's and their families' health and welfare in the Nordic countries. At each point of time parents of 3000 randomly selected children aged 2-17 years in each of five Nordic countries received a postal questionnaire. Altogether approximately 20,000 questionnaires were completed. The prevalence of bullying, risk factors for bullying and possible effect factors were analysed.

RESULTS

Parents reported bullying of their child in 15.1% of the cases. Bullying varied from 7.2% in Sweden to about 20% in Denmark and Finland. There was a small increase in bullying from 13.7% in 1984 to 16.4% in 1996. Bullying was most frequent in boys (OR: 1.4) and in children 2-6 and 7-12 years old (OR: 2.0 and 2.2 compared with older children). Children of single parents and of parents with low education had increased risks (OR: 1.4 and 1.4). Children with chronic conditions had higher risks for being bullied (OR: 2.3). In 1996 children with psychiatric/nervous problems and hyperactivity had high risks for being bullied (OR: 8.8 and 10.5) and for bullying others (3.9 and 3.5). Being bullied was associated with poor thriving and psychosomatic and psychological problems. No countries had national interventions before 1984, but Sweden had early focused on the problem and implemented a strong national policy before 1996. After 1996 national anti-bullying policies were strengthened in the Nordic countries, most in Sweden and Norway.

CONCLUSION

Bullying is common among Nordic children, including pre-school children. Bullying is a threat to children's health, and augments problems in children with chronic conditions. The low prevalence of bullying in Sweden may be a result from sustained, strong anti-bullying policies. There is still a need for continuing interventions.

[Nasal congestion and earache--upper respiratory tract infections in 4-year-old children]

BACKGROUND

Few population-based studies in Norway have addressed upper respiratory infections in children.

MATERIAL AND METHODS

A questionnaire concerning health, diseases and living condition was administered to parents of all four-year-old children in Vestfold county (n = 1912). Participation rate was 79%.

RESULTS

Close to one out of three of the children suffered from recurrent common cold (four episodes or more) during the last year. One third experienced otitis at least once, and one out of twenty experienced four episodes of otitis or more. Day-care centre attendance was the only significant risk factor for recurrent common cold (odds ratio 1.50; 95% CI 1.18-1.92) or otitis (odds ratio 1.42; 95% CI 1.12-1.77). The odds ratios were essentially unchanged after logistic regression analysis, when mother's education, housing, other children in the family, passive smoking, and history of breastfeeding were included in the analysis. Children with otitis or recurrent common cold consulted a doctor almost ten times as often as other children.

INTERPRETATION

Day-care centre attendance has significant influence on the occurrence of upper respiratory infections in four-year-olds, but less influence than reported for younger children. Other environmental differences seem to be of little importance and do not represent any potential for prophylaxis.

Recurrent pain symptoms in children and parents

Recurrent pain in five different areas (stomach, arms & legs, head, back and neck & shoulders) in a population of 348 school children and their parents has been investigated. The study presented here is restricted to 229 mother-father-child trios. Forty-four percent of the children reported pain in at least one area compared to 60% of the mothers and 51% of the fathers. Headache and pains in arms and legs were most common in boys. The most frequent pain sites for girls were head and back. Overall, girls complained more than boys. No significant associations between complaints in parents and their children were demonstrated, analysed by logistic regression analysis. Furthermore, there was no significant association between the reported pain in the mother and father.

CONCLUSION

Children's pain did not associate with parental pain in this study. The results do not support previous hypotheses that recurrent pain clusters in families.

[Drug prescription to 4-year-old children in the county of Vestfold]

We carried out a study of four-year-old children's general health, diseases and use of medicines over a 12-month period in 1995-96. The study was based on a questionnaire administered in connection with the regular health controls. Questionnaires from 1,912 children were returned, representing 79% of children born during one year in the county. More than half the children had received medicine prescribed by a physician, corresponding to 557 preparations per 1,000 children. Some children had used several types of drugs, with a mean of 1.4 preparations per child. Antibiotics were prescribed to 63% of the children. Compared to what has been found in other studies, the use of prescribed medicine was moderate. More pharmacoepidemiological studies are needed to assess whether the use of medicine in children is at an acceptable level.

[Regional differences in the incidence of femoral neck fractures in Norway]

Studies reporting data from the late seventies indicated there were significant differences in the incidence of hip fracture from county to county in Norway. We used the most recent available data on the occurrence of hip fracture in 1994 and 1995 and analyzed regional variations in the incidence of hip fracture, standardized for age and sex, among people aged 65 years and over. In 1994 and 1995 16,779 hip fractures occurred in Norway among people aged 65 years and over, making an overall annual crude incidence rate of 12.1 per 1,000 population. Incidence rates varied from 8.1 for the county of Finnmark to 14.9 per 1,000 population for Oslo. Standardized rates per 1,000 aged 65 years and over varied from 9.2 in the county of Finnmark to 15.0 in Vestfold. There has been a clear regional pattern in the incidence rate. Oslo and the counties in the south and south-east had the highest incidence rate. Compared with reports from 1978 and 1979, the span of relative differences in the county incidence rates has narrowed. The sources of these differences are not explained.

[Health status survey in a district with many immigrant children]

In Norway, prophylactic child health care is organized through local mother and child clinics, each of which serves a given population. This study summarizes the findings from the routine check-up of four-year-olds in a district with a high proportion of immigrant families. The sample consisted of 70 children, 33 of them from immigrant families. The ordinary check-up was supplemented by information obtained by means of a questionnaire, which was filled in by the public health nurse and the doctor in consultation with the parents. A validated scale, or checklist (BCL), for ordinary behavioural problems among pre-school children was also included. The findings must be interpreted with caution, one reason being the large socio-economic differences between the immigrant and the Norwegian families included in the study. Nevertheless, the difference between the eating habits of the two groups of children was striking, in spite of the emphasis placed on diet at the clinic. Another important finding was the poor knowledge of Norwegian among the immigrant children, which was obviously associated with the poor language skills of the mothers. Therefore, an important element of the preventive health work among immigrant children should be to encourage the mothers to attend courses in Norwegian.

[Academic degrees and changing ceremonies]

The traditions and ceremonies regarding doctoral dissertations in Europe date back to early medieval times, to the school of health at Salerno. The University of Oslo, founded in 1811, inherited the traditions from Denmark. Up to 1845, the dissertations were held in Latin, which was a burden on the candidates. The first four candidates who presented a thesis for a doctorate were all from the Faculty of Medicine. After 1845, the Norwegian language was permitted, but up to the end of the century there were still only few dissertations, and a doctorate degree was not highly valued. The number has since increased, and this degree is more highly esteemed. The ceremonies around the dissertations have also changed. The first promotions included solemn procedures in Latin, but later on the promotion ceremonies disappeared for 91 years. Promotion ceremonies reappeared in 1933, but changes have been observed more recently, probably related to changing cultural opinions and trends. The policy today seems to indicate a trend towards more ceremony, accompanied by festivity.

Development of stomach-ache and headache during middle childhood: co-occurrence and psychosocial risk factors

Development of somatic symptoms and associations with psychosocial risk factors were investigated in a longitudinal study of Norwegian children aged 4-10 years. Complaints of stomach-ache only were associated with emotionally well-adapted children, and mothers with low education and high emotional support. Children complaining of headache only behaved well as preschoolers, showed a tendency towards high achievement motivation at school and their mothers were employed outside the home. Children with the co-occurrence syndrome seemed to constitute a separate entity. They differed from the others as the syndrome was associated with previous behavioural and emotional problems, current emotional disturbances and mothers with less support. Family demographic stability, further child health problems and school factors were not associated with the co-occurrence syndrome.