"Smoking in Children's Environment Test": a qualitative study of experiences of a new instrument applied in preventive work in child health care

Background Despite knowledge of the adverse health effects of passive smoking, children are still   being exposed. Children's nurses play an important role in tobacco preventive work   through dialogue with parents aimed at identifying how children can be protected from   environmental tobacco smoke (ETS) exposure. The study describes the experiences of   Child Health Care (CHC) nurses when using the validated instrument SiCET (Smoking   in Children's Environment Test) in dialogue with parents. Method In an intervention in CHC centres in south-eastern Sweden nurses were invited to use   the SiCET. Eighteen nurses participated in focus group interviews. Transcripts were   reviewed and their contents were coded into categories by three investigators using   the method described for focus groups interviews. Results The SiCET was used in dialogue with parents in tobacco preventive work and resulted   in focused discussions on smoking and support for behavioural changes among parents.   The instrument had both strengths and limitations. The nurses experienced that the   SiCET facilitated dialogue with parents and gave a comprehensive view of the child's   ETS exposure. This gave nurses the possibility of taking on a supportive role by offering   parents long-term help in protecting their child from ETS exposure and in considering   smoking cessation. Conclusion Our findings indicate that the SiCET supports nurses in their dialogue with parents   on children's ETS exposure at CHC. There is a need for more clinical use and evaluation   of the SiCET to determine its usefulness in clinical practice under varying circumstances.funding agnencies|Swedish National Institute of Public Health||Futurum - The Academy for Healthcare, Jonkoping County Council|

Health-Related Quality of Life in Children and Adolescents with Celiac Disease: From the Perspectives of Children and Parents

Aim. To examine how celiac children and adolescents on gluten-free diet valued their health-related quality of life, and if age and severity of the disease at onset affected the children's self-valuation later in life. We also assessed the parents' valuation of their child's quality of life. Methods. The DISABKIDS Chronic generic measure, short versions for both children and parents, was used on 160 families with celiac disease. A paediatric gastroenterologist classified manifestations of the disease at onset retrospectively. Results. Age or sex did not influence the outcome. Children diagnosed before the age of five scored higher than children diagnosed later. Children diagnosed more than eight years ago scored higher than more recently diagnosed children, and children who had the classical symptoms of the disease at onset scored higher than those who had atypical symptoms or were asymptomatic. The parents valuated their children's quality of life as lower than the children did. Conclusion. Health-related quality of life in treated celiac children and adolescents was influenced by age at diagnosis, disease severity at onset, and years on gluten-free diet. The disagreement between child-parent valuations highlights the importance of letting the children themselves be heard about their perceived quality of life

Should the PBL tutor be present? A cross-sectional study of group effectiveness in synchronous and asynchronous settings

Background: The tutorial group and its dynamics are a cornerstone of problem-based learning (PBL). The tutor\u27s support varies according to the setting, and it is pertinent to explore group effectiveness in relation to different settings, for example online or campus-based. The PBL groups\u27 effectiveness can partly be assessed in terms of cognitive and motivational aspects, using a self-report tool to measure PBL group effectiveness, the Tutorial Group Effectiveness Instrument (TGEI). This study\u27s aim was to explore tutor participation in variations of online and campus-based tutorial groups in relation to group effectiveness. A secondary aim was to validate a tool for assessing tutorial group effectiveness in a Swedish context. Methods: A cross-sectional study was conducted with advanced-level nursing students studying to become specialised nurses or midwives at a Swedish university. The TGEI was used to measure motivational and cognitive aspects in addition to overall group effectiveness. The instrument\u27s items were translated into Swedish and refined with an expert group and students. The responses were calculated descriptively and compared between groups using the Mann-Whitney U and Kruskal-Wallis tests. A psychometric evaluation was performed using the Mokken scale analysis. The subscale scores were compared between three different tutor settings: the tutor present face-to-face in the room, the tutor present online and the consultant tutor not present in the room and giving support asynchronously. Results: All the invited students (n = 221) participated in the study. There were no differences in motivational or cognitive aspects between students with or without prior PBL experience, nor between men and women. Higher scores were identified on cognitive aspects (22.6, 24.6 and 21.3; p \u3c 0.001), motivational aspects (26.3, 27 and 24.5; p = 002) and group effectiveness (4.1, 4.3, 3.8, p = 0.02) for the two synchronously tutored groups compared to the asynchronously tutored group. The TGEI subscales showed adequate homogeneity. Conclusions: The tutor\u27s presence is productive for PBL group effectiveness. However, the tutor need not be in the actual room but can provide support in online settings as long as the tutoring is synchronous. © 2020 The Author(s)

Perceptions of Malawian Nurses about Nursing Interventions for Malnourished Children and Their Parents

In developing countries, malnutrition among children is a major public-health issue. The aim of the study was to describe perceptions of Malawian nurses about nursing interventions for malnourished children and their parents. A qualitative method was used. Data were collected and analyzed according to the phenomenographic research approach. Twelve interviews were performed with 12 nurses at a rural hospital in northern Malawi, Southeast Africa. Through the analysis, two major concepts, comprising four categories of description, emerged: managing malnutrition today and promotion of a favourable nutritional status. The categories of description involved identification and treatment of malnutrition, education during treatment, education during prevention, and assurance of food security. The participating nurses perceived education to be the most important intervention, incorporated in all areas of prevention and treatment of malnutrition. Identification and treatment of malnutrition, education during treatment, education to prevent malnutrition, and assurance of food security were regarded as the most important areas of intervention

Two tales of cardiovascular risks – middle-aged women living in Sweden and Scotland – a cross-sectional comparative study.

OBJECTIVES: To compare cardiovascular risk factors as well as rates of cardiovascular diseases in middle-aged women from urban areas in Scotland and Sweden. DESIGN: Comparative cross-sectional study. SETTING: Data from the general population in urban areas of Scotland and the general population in two major Swedish cities in southeast Sweden, south of Stockholm. PARTICIPANTS: Comparable data of middle-aged women (40-65 years) from the Scottish Health Survey (n=6250) and the Swedish QWIN study (n=741) were merged together into a new dataset (n=6991 participants). MAIN OUTCOME MEASURE: We compared middle-aged women in urban areas in Sweden and Scotland regarding risk factors for cardiovascular disease (CVD), CVD diagnosis, anthropometrics, psychological distress and lifestyle. RESULTS: In almost all measurements, there were significant differences between the countries, favouring the Swedish women. Scottish women demonstrated a higher frequency of alcohol consumption, smoking, obesity, low vegetable consumption, a sedentary lifestyle and also more psychological distress. For doctor-diagnosed coronary heart disease, there were also significant differences, with a higher prevalence among the Scottish women. CONCLUSIONS: This is one of the first studies that clearly shows that Scottish middle-aged women are particularly affected by a worse profile of CVD risks. The profound differences in CVD risk and outcome frequency in the two populations are likely to have arisen from differences in the two groups of women's social, cultural, political and economic environments.Funding agencies: Swedish Heart and Lung Association [E136-15/E106/13]; Clinic ALF funds, Region Ostergotland, Sweden [LiO-446241]; Research and PhD studies Committee (FUN), Linkoping University, Sweden [LiU-2014-020251]</p

Könsfördelning i två läromedel i ämnet Svenska för årskurs 9.

Ett genusperspektiv bidrar till att justera ”modellbyggen” av världen där kvinnan gjorts till det andra könet. Skolans läroplaner visar på att jämställdhet är en del av dagens värdegrund. Därför har jag undersökt två läroböcker, Uppdrag Svenska 3 från 1990, samt Studio Svenska 4 från 2005, båda för årskurs 9 för att se hur de representerar och presenterar män och kvinnor. Båda läroböckerna är skrivna av kvinnliga författare. Min tes var att männen skulle dominera den äldre boken och att representationen av kvinnor skulle ha ökat till den nyare boken. Mina huvudsakliga frågeställningar var hur många män respektive kvinnor förekommer i de två böckerna, hur många män respektive kvinnor förekommer på bilder i de båda böckerna samt om det faktum att läroböckerna är skrivna av kvinnor skulle ha något genomslag i valet av författare och bildmaterial. För att svara på detta räknade jag förekomsten av män och kvinnor i ord och bild, och för att synliggöra resultaten använde jag mig av diagram där jag fann det belysande. Jag valde också att göra vissa kvalitativa bedömningar om beskrivning samt representationen av könen. För att möjliggöra detta behövdes en redogörelse av några begrepp som jag behövde använda mig av, kön, genus samt kanon. Kön kan anses vara ett vardagligt samt biologiskt laddat ord, mer statiskt än det mer dynamiska ordet genus som förklarar konstruktionen av kön som en pågående process. Kanon kan betyda fastställd norm och inom den litterära västerländska kanon som Harold Bloom försvarar finns det bara 15 % kvinnor. I min närläsning av US3 samt SS4 kom jag fram till att den äldre boken hade en lägre andel kvinnliga författare än den senare. Sättet man skrev om kvinnor hade också förändrats men huruvida detta beror på att de är skrivna av kvinnor går inte att fastslå eftersom jag då skulle behövt jämföra med en lärobok skriven av män. Däremot verkar en medvetenhet om genusordningen ha gjort sig gällande. Slutsatsen jag drog var att min tes stämde. Männen dominerade den äldre boken och fler kvinnor fanns representerade i den nyare. Kvinnobilden hade förändrats till det bättre men gick inte att betraktas som jämställd

Passive Smoking in Children : The Importance of Parents’ Smoking and Use of Protective Measures

Passive smoking has been recognised as a health hazard, and chidren are especially vulnerable. The general aim of this thesis was to describe and analyse the importance of parents’ smoking and smoking behaviour for children’s tobacco smoke exposure. The studies were conducted in the South-East part of Sweden and pre-school children and their parents constituted the study samples. Five studies are described in six papers. Smoking prevalence among parents (14%) and commonly used measures of protection were surveyed. An instrument designed to measure children’s tobacco smoke exposure in the home was developed and validated. It was used on 687 families with a smoking parent and a child 2½-3 years old, included in a prospective cohort study on environmental variables of importance for immun-mediated diseases ABIS (All Babies in South-East Sweden). Almost 60% of the parents stated that they always smoked outdoors with the door closed, 14% mixed this with smoking near the kitchen fan, 12% near an open door, 7% mixed all these behaviours and 8 % smoked indoors without precautions. The smoking behaviours were related to the children’s creatinine adjusted urine cotinine. All groups had significantly higher values than had children from non-smoking homes, controls. Outdoor smoking with the door closed seemed to be the best, though not a total, measure for tobacco smoke protection in the home. Most parents were aware of the importance of protecting children from tobacco smoke exposure but all were not convinced of the increased risk for disease for exposed children. The majority of parents were not satisfied with the smoking prevention in health-care and 50% did not think that their smoking was of any concern to the child health care nurse. Further research is warranted to describe if the difference in exposure score related to smoking behaviours is related to different prevalence of disease. Efforts are needed to convince those who still smoke indoors that tobacco smoke exposure influence children’s health and that consequent outdoor smoking with the door closed seemed to give the best protection.Article I: copyright (2003), with permission from Oxford University Press. On the day of the public defence the status of article III was: Submitted and the status of article VI was: Revised and resubmitted and the original title was: Attitudes to children’s tobacco smoke exposure among smoking and non-smoking parents and their opinions on how the issue is handled in health care.</p

Perceptions of Malawian Nurses about Nursing Interventions for Malnourished Children and Their Parents

In developing countries, malnutrition among children is a major public-health issue. The aim of the study was to describe perceptions of Malawian nurses about nursing interventions for malnourished children and their parents. A qualitative method was used. Data were collected and analyzed according to the phenomenographic research approach. Twelve interviews were performed with 12 nurses at a rural hospital in northern Malawi, Southeast Africa. Through the analysis, two major concepts, comprising four categories of description, emerged: managing malnutrition today and promotion of a favourable nutritional status. The categories of description involved identification and treatment of malnutrition, education during treatment, education during prevention, and assurance of food security. The participating nurses perceived education to be the most important intervention, incorporated in all areas of prevention and treatment of malnutrition. Identification and treatment of malnutrition, education during treatment, education to prevent malnutrition, and assurance of food security were regarded as the most important areas of intervention