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Biomedical subjects

C Sundelin

Publications and source records attributed to C Sundelin.

At least 19 recordsLinked to original sources
PubMed1992

Growing up in Uppsala. The role of public services in identification and treatment of health and adjustment problems. Part I. Definition and classification of dependent variables.

A comprehensive prospective longitudinal study of health, development and social adjustment from the age of four to 18 years has been carried out in Uppsala, Sweden. This report presents the accumulated psychosocial burden up to 18 years of age for all 1715 children born in 1965 and resident in Uppsala from age 10 to 18 years. The psychosocial burden up to 18 years of age was assessed through analysis of records and register information from school health services, authorities for care of the handicapped, the Department of Child Psychiatry, social agencies and legal authorities. The analysis showed that 11.8% of the adolescents had a severe psychosocial burden up to the age of 18 years which could hamper their future life as adults. It was possible to categorize the whole birth cohort into one subgroup without manifest psychosocial problems and five different subgroups with serious problems: the six groups (severe mental or physical handicap, antisocial behaviour, psychiatric problems, social support, multiple problems, "normal") had specific profiles concerning sex distribution, symptoms, social background, utilization of care services and delinquency.

Adolescent↗
PubMed1992

Growing up in Uppsala. Part II. Could adolescents with severe psychosocial problems have been identified by symptoms observed in school at age 10 years?

The study comprised all 1715 children born in 1965 and resident in Uppsala at age 10 and 18 years. Data were collected through teacher interviews and analysis of school health records in grade 3 at the age of 10 years. The psychosocial burden up to the age of 18 years was assessed on the basis of all registered contacts with official institutions outside school (authorities for care of the handicapped, Department of Child Psychiatry, social agencies, legal authorities). Approximately 12% of the adolescents were clearly in a situation of manifest psychosocial risk on the threshold of adult life. These adolescents were assigned to five mutually exclusive problem groups comprising different sex distribution, symptoms and utilization of institutional care. The analysis of the relationship between data from grade 3 and the psychosocial burden up to 18 years of age showed that the information available to the school did not permit reasonably secure predictions of the child's psychosocial situation at the end of adolescence. Observations in school of pre-adolescent children cannot be used as a basis for risk-group strategies aiming at concentrating early treatment measures and resources to a restricted number of children at risk. However, the prognosis is apparently serious for a limited number of 10-year-olds with serious problems in school.

Adaptation, Psychological↗
PubMed1992

Feeding problems in an affluent society. Follow-up at four years of age in children with early refusal to eat.

Twenty-four children, previously investigated at 3-12 months of age for refusal to eat during at least four weeks with no apparent medical cause, were followed up prospectively and reinvestigated at four years of age. Comparisons were made with 38 controls, selected from the same child health care districts. Information was obtained from parental interviews, medical records and assessments by a speech therapist. At four years of age, 17 of the 24 children with early refusal to eat (71%) were reported by the parents to still have feeding problems and 10 (42%) were reported as hyperactive. Compared to the controls, the children with early refusal to eat seemed to have an equally good prognosis with respect to health, growth and development, but were at risk of later problems with their eating patterns and behaviour.

Body Height↗
PubMed1992

Assessment of speech and language skills in children.

A speech and language assessment procedure was developed to study different aspects of speech and language skills in children 6.5 years old who had needed intensive care in the neonatal period. It was required that the procedure could be carried out at one examination session and that it should characterize a broad spectrum of language skills and permit detection of deviations in language development. The assessment comprises three parts. Part A is an evaluation of the child's spontaneous speech during a 10- to 15-minute conversation between the child and the assessor. Eight different variables are assessed, and an overview of the child's conversational behaviour is obtained. Part B is an assessment of speech and language skills. A set procedure is used to assess auditory discrimination, interaction between auditory and speech motor capacity, different comprehension functions, vocabulary and word fluency. Some motor tasks are included to elucidate the relationship between speech and non-linguistic fine motor activity. Part C is an interview with the parents. A control group of 40 children was tested. The assessment protocol is now being applied for follow-up examination of children who have needed neonatal intensive care at Uppsala University Hospital, Sweden.

Child↗
PubMed1991

Child health records as a database for clinical practice, research and community planning.

In considering health information systems, great hope is attached to the use of child health records as a data source for research and community planning. In order to test the completeness of child health records data and their agreement with other sources, information about living conditions, use of medical services and health problems in preschool children were studied in 707 child health centres' records. The results show a considerable number of deficiencies in the system which could, to a certain extent, be remedied by improved instructions to the staff. Health problems in the area of child care also need to be fully defined.

Child Health Services↗
PubMed1990

Services to families with children. A study of community work in Uppsala.

This article describes some of the results of a study of services to families and children in a suburban district, Sweden. Services included in the study were: maternal and child health care, child psychiatry, services for handicapped children, school health care, day care services, community social services and family counselling services. The baseline studies comprised analyses of official goals expressed in legislation and recommendations, interviews with local politicians and administrators, record studies, studies of working time distribution and questionnaires to field professionals and families. The results indicate that services with traditional goals and well-defined tasks (e.g. health supervision) were more satisfied with their goal attainment, less inclined to collaborate with other services, and more occupied with direct client work than services with non-traditional goals and vaguely defined tasks (e.g. strengthening democracy).

Adolescent↗
PubMed1987

Early and late discharge after hospital birth: breastfeeding.

Breastfeeding was studied among women discharged early and late after normal delivery in a hospital. Early discharge was defined as leaving the hospital 24-48 h after delivery in combination with domiciliary visits, and late discharge as the regular hospital postpartum care (mean 6 days). 164 women interested in participating in the early discharge study were randomly allocated in late pregnancy to a group offered early discharge (Experimental group = EG) or a group offered the traditional later discharge (Control group = CG). After medical exclusions and non-medical withdrawals, 50 mother-infant couples remained in EG and 54 in CG. Regular breastfeeding at 6 months after birth was reported by 63% of the multiparae in EG and 41% in CG (p = 0.06). Thirty-three per cent of the primiparae in each group were still breastfeeding at 6 months. 2% of the infants in EG and 72% in CG received supplementary breastmilk at least once during their first week of life. Infants discharged early were breastfed more often on the 2nd (NS), 3rd (p less than 0.05) and 4th day (p less than 0.001) after birth, compared with infants who stayed longer in hospital. There were no statistically significant differences between EG and CG women in their experience of success in breastfeeding according to daily records from the first 14 days after the birth.

Breast Feeding↗
PubMed1987

Early and late discharge after hospital birth. Health of mother and infant in the postpartum period.

Early discharge, defined as hospital leave 24-48 hours after birth, was introduced at Falun Hospital in 1984. 164 women interested in participating in an evaluative study of the program were randomly allocated in late pregnancy to an Experimental group (EG) offered early discharge, and a Control group (CG) offered the regular postpartum care in hospital. After medical and other withdrawals 24 h after the birth, 50 women remained in EG and 54 in CG. Infant morbidity and number of prescribed medicaments during the first 6 months after the birth were lower in EG than in CG, but the difference was not statistically significant. EG mothers made fewer visits to the Child Health Centre nurse than did CG mothers (p less than 0.05). No significant difference in puerperal complications was demonstrated, but the intake of sedatives by EG mothers was smaller than that of CG mothers during the first puerperal week (p less than 0.01).

Analgesics↗
PubMed1986

Long-term follow-up of children breast-fed by mothers using oral contraceptives.

In a long-term follow-up study 48 breast-fed children, whose mothers had used oral contraceptives containing 50 micrograms of ethinylestradiol while lactating, were compared to a matched control group whose mothers had not used any hormonal contraceptives during lactation. In spite of a very large number of data collected from several different sources of information, no effect could be demonstrated of the ingested steroid, neither upon the panorama of diseases nor upon intellectual or psychological behaviour of the infants and children up to 8 years of age. The mothers who used oral contraceptives lactated a significantly shorter period of time than the controls, but no differences were found in weight gain and height increase in the children between cases and controls.

Breast Feeding↗
PubMed1986

Early feeding problems in an affluent society. I. Categories and clinical signs.

The aim of this study was to analyse early feeding problems. Fifty infants, between the ages of 3 and 12 months, were reported by the Child Health Centre (CHC) nurse and the parents to have some form of feeding problem, which had been present for at least one month. Data were collected by a visit to the infant's home, from medical records and by interviewing the CHC nurse. Three main problem categories were distinguished: Refusal to eat (28 infants), colic (9 infants) and vomiting (8 infants). The problems had often begun at an early age and had persisted for a long time (mean age at onset 4.3 months, mean duration 4.5 months). Eight of the infants had significant medical disorders, which in seven of them explained the feeding problems. In 23 infants the weight increase had been poor since the commencement of the problems. The CHC nurses considered most of the problems troublesome, difficult to treat and uncommon.

Body Weight↗
PubMed1986

Early feeding problems in an affluent society. II. Determinants.

The aim of this investigation was to identify different factors of importance for the occurrence of feeding problems during the first year of life. Forty-two infants, 3-12 months old, with feeding problems without any obvious medical explanation were matched to 42 controls with respect to age, sex and Child Health Centre (CHC) affiliation. Information was obtained by interviewing the parents and from medical records. Four factors emerged as being highly significant, namely "feeding problems presented by the parents during their own infancy" (p less than 0.001), "great anxiety experienced by the mother during the pregnancy" (p less than 0.02), "breast-feeding problems experienced by the mother" (p less than 0.001) and "ill-health in the mother" (p less than 0.001). A special study in which the maternal and paternal grandparents were interviewed, corroborated the parents' information on their own early feeding difficulties. This finding could explain a large proportion of the feeding problems that have no obvious medical origin.

Analysis of Variance↗
PubMed1979

Socio-economic status of the family and health problems in the preschool child. Lack of correlation in a Swedish sample.

Recent reports from countries with a highly developed economic status point out the association of well-being of children with socio-economic factors. The aim of the present investigation was to examine the extent to which health problems, i.e. functional impairments, diseases and handicaps, in 4-year-old children are related to socio-economic factors. The analysis was based on data from 7 173 children who had undergone the routine general health screening of 4-year-olds in the county of Uppsala. In the statistical analysis the main emphasis was laid on an explanation of the variance on the individual plane. The results showed that the correlations between health problems and socio-economic factors in general were weak or non-existent. An explanation of the lack of correlation in our sample might be that Sweden had succeeded in largely eliminating the health problems associated with external living conditions of the family. If differences between population groups do exist--and in the light of findings from other investigations it seems highly probable that they do--then these differences are probably to be sought in families' way of functioning, in the internal and external pattern of communication, in the general emotional climate and in the degree of social integration in the society.

Child Development↗