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Skantze C, Almqvist-Tangen G, Nyholm M, Karlsson S. Parents' Experiences of Communication With School Nurses About Their Child's Weight Development in Sweden. J Sch Nurs 2023:10598405231221050. [PMID: 38130128 DOI: 10.1177/10598405231221050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
This study aimed to describe parents' experiences of communication with school nurses concerning the growth data and weight development of their children aged 8 and 10 years old in Sweden. Eighteen interviews with parents were conducted and analyzed through qualitative content analysis. The result showed a need for improved dialogue where the parents viewed the health visit's purpose as unclear and lacked feedback. The parents desired access to their child's growth data and described the need for an improved channel for receiving information. The parents moreover experienced the lack of a child-centered perspective, described the child's context as not in focus, and desired collaboration around their child. This study shows the need for the development of evidence-based methods for communicating growth data and weight development between School Health Service (SHS) and parents, as well as the need for a reformed SHS perspective towards parents and children.
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Affiliation(s)
- Caroline Skantze
- School of Health and Welfare, Halmstad University, Halmstad, Halland, Sweden
| | - Gerd Almqvist-Tangen
- Department of Paediatrics, University of Gothenburg, Gothenburg, Västra Götaland, Sweden
| | - Maria Nyholm
- School of Health and Welfare, Halmstad University, Halmstad, Halland, Sweden
| | - Staffan Karlsson
- School of Health and Welfare, Halmstad University, Halmstad, Halland, Sweden
- Faculty of Health Science, Kristianstad University, Kristianstad, Sweden
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Berggren S, Almquist-Tangen G, Wolfbrandt O, Roswall J. Effects of the COVID-19 pandemic on the physical activity and screen time habits of children aged 11-13 years in Sweden. Front Public Health 2023; 11:1241938. [PMID: 37637825 PMCID: PMC10447604 DOI: 10.3389/fpubh.2023.1241938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 07/24/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction Physical activity (PA), exercise, sedentary behavior and screen time are lifestyle factors that have been shown to significantly impact child health in different ways. These lifestyle factors were affected to different degrees by global restrictions during the COVID-19 pandemic. We investigated PA and screen time in a cohort of Swedish children in both 2019 and 2021, before and during the pandemic. Method Adolescents born in 2008 in Halland, Sweden, and included in a previous longitudinal birth cohort study were invited to take part in follow-up questionnaires about PA, screen time and COVID-19. A total of 1041 children aged 11 (in 2019) and 13 years (in 2021) replied and 777 of them answered on both occasions. Results Most children (42.1%) reported that their leisure time PA was unchanged from 2019 to 2021. Compared to unchanged PA 33.9% exercised more often (p = 0.011) and 23.9% exercised less (p < 0.001), both differences statistically significant. Roughly, 43.2% of boys and 34.9% of girls in 2021 exercised so that they became breathless or broke a sweat at least 4 times a week not counting physical education in school, corresponding figures for 2019 were 38.2% for boys and 35.2% for girls. The majority of children were able to continue attending leisure time sports clubs during the pandemic, but participation decreased from 88.3% to 76.3% from 11 to 13 years of age. Most reported that sports club routines changed during the pandemic, but only 40.9% reported fewer practice opportunities. Attending a sports club gave greater protection against loss of PA during the pandemic than not belonging to one (41.0% vs. 23.2%, p < 0.001). The majority (71.1%) of children spent more time on screens in 2021 than 2019, with a mean increase of 9.4 h (95% CI 8.6 to 10.2 h) from 20.7 to 30.1 hours per week (p < 0.001) during the study. Conclusions Swedish children largely maintained their levels of PA during the pandemic at 13 years of age and these were possibly safeguarded by the comparably mild pandemic restrictions in Sweden in 2021. However, they did increase their screen time between 11 and 13 years of age.
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Affiliation(s)
- Sara Berggren
- Department of Pediatrics, Sahlgrenska Academy, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
- Halland Health Center Hyltebruk, Hyltebruk, Sweden
| | - Gerd Almquist-Tangen
- Department of Pediatrics, Sahlgrenska Academy, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
- Child Health Care Unit, Halmstad, Sweden
| | - Olivia Wolfbrandt
- Department of Pediatrics, Halland Hospital Halmstad, Halmstad, Sweden
| | - Josefine Roswall
- Department of Pediatrics, Sahlgrenska Academy, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
- Department of Pediatrics, Halland Hospital Halmstad, Halmstad, Sweden
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Berggren S, Andersson O, Hellström‐Westas L, Dahlgren J, Roswall J. Serum osteocalcin levels at 4 months of age were associated with neurodevelopment at 4 years of age in term-born children. Acta Paediatr 2022; 111:338-345. [PMID: 34647329 DOI: 10.1111/apa.16151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 11/30/2022]
Abstract
AIM The hormone osteocalcin influenced neurodevelopment and cognition in mice models; this human study explored potential associations between total serum levels in human infants and neurodevelopment at 4 years of age. METHODS The data were based on two Swedish birth cohorts from 2008 to 2009. We followed 158 healthy full-term vaginal births (51% girls) by measuring serum osteocalcin in cord blood and at 4, 12 and 36 months. The values were compared with neurodevelopment tests at 4 years of age. RESULTS There was an association between osteocalcin at 4 months and later full-scale intelligence quotient (IQ; r2 0.031, p < 0.05). Children with osteocalcin levels in the highest quartile scored 5.6 (95% confidence interval [1.3, 9.9]) points higher than those in the lowest quartile, with mean scores of 118.8 ± 8.8 and 113.2 ± 9.2 (p < 0.05). They also scored higher on gross motor skills (p < 0.05) and showed greater ability during the drawing trail test (p < 0.005). Cord levels of osteocalcin were negatively associated with processing speed and fine motor development at 4 years, but levels at 12 and 36 months were not associated with later neurodevelopment. CONCLUSION Osteocalcin levels in infancy appeared to be associated with later IQ and motor development, but more research is needed.
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Affiliation(s)
- Sara Berggren
- Department of Paediatrics Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Department of Paediatrics Halland Hospital Halmstad Halmstad Sweden
- Health Center Hyltebruk Health Center Halland Halmstad Sweden
| | - Ola Andersson
- Department of Clinical Sciences Lund Pediatrics/Neonatology Lund University Lund Sweden
| | | | - Jovanna Dahlgren
- Department of Paediatrics Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - Josefine Roswall
- Department of Paediatrics Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Department of Paediatrics Halland Hospital Halmstad Halmstad Sweden
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Wang J, Zhu D, Cheng X, Liuzhou Y, Zhu B, Montgomery S, Cao Y. Maternal perception of child weight and concern about child overweight mediates the relationship between child weight and feeding practices. Public Health Nutr 2022; 25:1-10. [PMID: 35000661 PMCID: PMC9991628 DOI: 10.1017/s1368980022000040] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To examine the mediating effects of maternal perception of child weight (weight perception) and concern about overweight (weight concern) on the paths between child weight and maternal feeding practices. SETTING Pudong District, Shanghai, China. PARTICIPANTS A convenience sample of 1164 mothers who were primary caregivers of preschool children. RESULTS Sixty per cent of the mothers perceived their overweight/obese children as normal weight or even underweight. The disagreement between actual child weight and maternal weight perception was statistically significant (Kappa = 0·212, P < 0·001). Structural equation modelling indicated that weight perception fully mediated the relationship between child BMI Z-scores and pressure to eat. Weight concern fully mediated the relationships between child BMI Z-scores and the other three feeding practices. The serial mediating effects of weight perception and concern were statistically significant for the paths between child BMI Z-score and monitoring (β = 0·035, P < 0·001), restriction (β = 0·022, P < 0·001), and food as a reward (β = -0·017, P < 0·05). CONCLUSION Child weight may influence maternal feeding practices through weight perception and concern. Thus, interventions are needed to increase the accuracy of weight perception, which may influence several maternal feeding practices and thereby contribute to child health.
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Affiliation(s)
- Jian Wang
- Shanghai Jiao Tong University School of Nursing, 200025Shanghai, People's Republic of China
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Daqiao Zhu
- Shanghai Jiao Tong University School of Nursing, 200025Shanghai, People's Republic of China
| | - Xuwen Cheng
- Department of Children's Disease Prevention, Jinyang Community Health Service Center, Shanghai, People's Republic of China
| | - Yicong Liuzhou
- Department of Nursing, Shanghai Children's Medical Center, Shanghai, People's Republic of China
| | - Bingqian Zhu
- Shanghai Jiao Tong University School of Nursing, 200025Shanghai, People's Republic of China
| | - Scott Montgomery
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
- Clinical Epidemiology Division, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Yang Cao
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
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Burton ZA, Lewis R, Bennett T, McLernon DJ, Engelhardt T, Brooks PB, Edwards MR. Prevalence of PErioperAtive CHildhood obesitY in children undergoing general anaesthesia in the UK: a prospective, multicentre, observational cohort study. Br J Anaesth 2021; 127:953-961. [PMID: 34627621 DOI: 10.1016/j.bja.2021.07.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 07/13/2021] [Accepted: 07/30/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Childhood obesity has become a serious global healthcare challenge. No UK data currently define its anaesthetic and perioperative implications. We aimed to determine obesity prevalence amongst UK children undergoing general anaesthesia and the incidence of predefined adverse perioperative events, and to compare perioperative obesity rates with National Child Measurement Programme (NCMP) data. METHODS During a site-selected consecutive 7-day study period, all children (2-16 yr) undergoing general anaesthesia were included. Anonymised hospital, surgical, and procedural details; demographic data; and adverse perioperative events were collected prospectively by Paediatric Anaesthesia Trainee Research Network (PATRN) collaborators. RESULTS For this study, 102 UK hospitals participated and 4232 cases were included in the final analysis; 76% of hospitals did not routinely calculate BMI. In addition, 3030 (71.6%; 95% confidence interval [CI]: 70.2-73.0%) children of healthy weight were compared with 537 (12.7%; 11.7-13.7%) children who were overweight and 478 (11.3%; 10.3-12.2%) children with obesity. Children with obesity (n=71; 14.9%) more commonly underwent (adeno)tonsillectomy than children of healthy weight (n=282; 9.3%; P<0.001; odds ratio [OR] 2.15; 95% CI: 1.58-2.92). Fewer children with obesity (n=365; 77% vs n=2552; 85%) were anaesthetised by consultant anaesthetists (OR 0.62; 95% CI: 0.48-0.79). Mask ventilation was difficult for 3.7% of children with obesity vs 0.6% of children of healthy weight (difference 3.0%; 95% CI: 1.3-4.7%; P<0.001). Comparison with NCMP data demonstrated an over-representation of obesity amongst the paediatric surgical population. CONCLUSIONS This large multicentre cohort study suggests a concerning prevalence of children with obesity presenting for anaesthesia. These results should be used to inform optimal provision of care for this population and support perioperative healthcare initiatives to address the burden of childhood obesity. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03994419.
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Affiliation(s)
- Zoë A Burton
- Department of Anaesthesia, Sheffield Children's Hospital NHS Foundation Trust, Sheffield, UK.
| | - Rosie Lewis
- Department of Anaesthesia, Portsmouth Hospitals University NHS Trust, Portsmouth, UK
| | - Tom Bennett
- Department of Anaesthesia, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - David J McLernon
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | | | - Thomas Engelhardt
- McGill University Health Center, Montreal Children's Hospital, Montreal, QC, Canada
| | - Peter B Brooks
- Department of Anaesthesia, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Mark R Edwards
- Department of Anaesthesia, University Hospital Southampton NHS Foundation Trust, Southampton, UK
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Blanchet R, Kengneson CC, Bodnaruc AM, Gunter A, Giroux I. Factors Influencing Parents' and Children's Misperception of Children's Weight Status: a Systematic Review of Current Research. Curr Obes Rep 2019; 8:373-412. [PMID: 31701349 DOI: 10.1007/s13679-019-00361-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE OF REVIEW Misperception of children's weight status is prevalent among parents and children themselves and may impact parents' and children's health behaviors. This study was conducted in order to provide a descriptive systematic review of research on factors influencing parents' and children's misperceptions of children's weight status published in the past 5 years. RECENT FINDINGS Factors studied most often in relation to parents' and children's misperception included children's weight status, gender, and age, as well as parents' weight status, parental education levels and socioeconomic status, and ethnicity. Most determinants that were found to have a significant influence on misperception in parents also did in children. The literature on misperception of children's weight status is extensive. Most determinants assessed in included studies were known determinants of childhood obesity. Further research should be directed toward better understanding the impact of weight status perception (whether it is accurate or not) on health behaviors and weight gain over time.
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Affiliation(s)
- Rosanne Blanchet
- Department of Agricultural, Food & Nutritional Sciences, Faculty of Agricultural, Life & Environmental Sciences, University of Alberta, Edmonton, Canada
| | - Cris-Carelle Kengneson
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Alexandra M Bodnaruc
- School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Ashley Gunter
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Isabelle Giroux
- School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada.
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Barman M, Murray F, Bernardi AI, Broberg K, Bölte S, Hesselmar B, Jacobsson B, Jonsson K, Kippler M, Rabe H, Ross AB, Sjöberg F, Strömberg N, Vahter M, Wold AE, Sandberg AS, Sandin A. Nutritional impact on Immunological maturation during Childhood in relation to the Environment (NICE): a prospective birth cohort in northern Sweden. BMJ Open 2018; 8:e022013. [PMID: 30344169 PMCID: PMC6196815 DOI: 10.1136/bmjopen-2018-022013] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Prenatal and neonatal environmental factors, such as nutrition, microbes and toxicants, may affect health throughout life. Many diseases, such as allergy and impaired child development, may be programmed already in utero or during early infancy. Birth cohorts are important tools to study associations between early life exposure and disease risk. Here, we describe the study protocol of the prospective birth cohort, 'Nutritional impact on Immunological maturation during Childhood in relation to the Environment' (NICE). The primary aim of the NICE cohort is to clarify the effect of key environmental exposures-diet, microbes and environmental toxicants-during pregnancy and early childhood, on the maturation of the infant's immune system, including initiation of sensitisation and allergy as well as some secondary outcomes: infant growth, obesity, neurological development and oral health. METHODS AND ANALYSIS The NICE cohort will recruit about 650 families during mid-pregnancy. The principal inclusion criterion will be planned birth at the Sunderby Hospital in the north of Sweden, during 2015-2018. Questionnaires data and biological samples will be collected at 10 time-points, from pregnancy until the children reach 4 years of age. Samples will be collected primarily from mothers and children, and from fathers. Biological samples include blood, urine, placenta, breast milk, meconium, faeces, saliva and hair. Information regarding allergic heredity, diet, socioeconomic status, lifestyle including smoking, siblings, pet ownership, etc will be collected using questionnaires. Sensitisation to common allergens will be assessed by skin prick testing and allergic disease will be diagnosed by a paediatrician at 1 and 4 years of age. At 4 years of age, the children will also be examined regarding growth, neurobehavioural and neurophysiological status and oral health. ETHICS AND DISSEMINATION The NICE cohort has been approved by the Regional Ethical Review Board in Umeå, Sweden (2013/18-31M). Results will be disseminated through peer-reviewed journals and communicated on scientific conferences.
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Affiliation(s)
- Malin Barman
- Food and Nutrition Science, Department of Biology and Biological Engineering, Chalmers University of Technology, Göteborg, Sweden
- Department of Obstetrics and Gynaecology, University of Gothenburg, the Sahlgrenska Academy, Institute of Clinical Sciences, Göteborg, Sweden
| | - Fiona Murray
- Sunderby Research Unit, Region Norrbotten, Luleå, Sweden
| | - Angelina I Bernardi
- Department of Infectious Diseases, University of Gothenburg, Institute of Biomedicine, the Sahlgrenska Academy, Göteborg, Sweden
| | - Karin Broberg
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women’s and Children’s Health, Karolinska Institutet & Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Bill Hesselmar
- Department of Paediatrics, University of Gothenburg, Institute of Clinical Sciences, Göteborg, Sweden
| | - Bo Jacobsson
- Department of Obstetrics and Gynaecology, University of Gothenburg, the Sahlgrenska Academy, Institute of Clinical Sciences, Göteborg, Sweden
| | - Karin Jonsson
- Food and Nutrition Science, Department of Biology and Biological Engineering, Chalmers University of Technology, Göteborg, Sweden
| | - Maria Kippler
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Hardis Rabe
- Department of Infectious Diseases, University of Gothenburg, Institute of Biomedicine, the Sahlgrenska Academy, Göteborg, Sweden
| | - Alastair B Ross
- Food and Nutrition Science, Department of Biology and Biological Engineering, Chalmers University of Technology, Göteborg, Sweden
| | - Fei Sjöberg
- Department of Infectious Diseases, University of Gothenburg, Institute of Biomedicine, the Sahlgrenska Academy, Göteborg, Sweden
| | | | - Marie Vahter
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Agnes E Wold
- Department of Infectious Diseases, University of Gothenburg, Institute of Biomedicine, the Sahlgrenska Academy, Göteborg, Sweden
| | - Ann-Sofie Sandberg
- Food and Nutrition Science, Department of Biology and Biological Engineering, Chalmers University of Technology, Göteborg, Sweden
| | - Anna Sandin
- Sunderby Research Unit, Region Norrbotten, Luleå, Sweden
- Department of Clinical Sciences, Unit of Pediatrics, Umeå University, Umeå, Sweden
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Mårild S. Tackling parents' misperceptions about their children's weight issues needs careful handling. Acta Paediatr 2018; 107:919-920. [PMID: 29573282 DOI: 10.1111/apa.14273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Staffan Mårild
- Department of Pediatrics; Institute of Clinical Sciences; Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
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