ABSTRACT
The main ethical imperative of all paediatric actions is the demand to do everything "in the best interests of children". Relevant guidelines can be derived from the UN Declaration on the Rights of Children, whereupon every child has the fundamental right to life and dignity, and is entitled to optimal medical care. Paediatric care in general includes the responsibility to achieve the highest level of knowledge, consideration of the child-specific somatic, mental and social development, empathic and trustworthy communication with the child and parents, observance of the recommendations of the Charter of the Rights of Children in Hospital, and cooperation with experts in related professions. Good communication is based on respect for the dignity of the child as a person and on the use of child-specific language, recognizing the rights of the child to be involved in consent or assent. Good clinical practice dictates and demands high standards of practice in therapeutics, research and medical interventions involving children. Decision making in extreme situations with regard to continuation, withholding or withdrawing life supporting measures is amongst the most complex and ethically difficult tasks of a doctor. Ethical issues with regard to neglect, maltreatment, abuse and addictions involving children need scrupulous consideration. Paediatricians have a prime responsibility to promote and protect the well being of children.
Subject(s)
Ethics, Medical , Pediatrics , Physician's Role , Adolescent , Child , Child Abuse , Child Advocacy , Communication , Decision Making , Drug Prescriptions , Human Rights , Humans , Informed Consent , Substance-Related DisordersSubject(s)
Child Health Services , Child Welfare , Patient Advocacy , Refugees , Child , Confidentiality , Ethics, Medical , Humans , SwedenSubject(s)
Breast Feeding , Female , Health Knowledge, Attitudes, Practice , Humans , Infant , Infant, Newborn , Mother-Child Relations , Sweden , Time FactorsSubject(s)
Malaria/diagnosis , Adoption , Animals , Child, Preschool , Chloroquine/therapeutic use , Emigration and Immigration , Female , Humans , Infant , Malaria/drug therapy , Malaria/ethnology , Male , Plasmodium falciparum/pathogenicity , Primaquine/therapeutic use , Pyrimethamine/therapeutic use , Sweden , Thailand/ethnology , Tropical ClimateABSTRACT
Dental caries and the utilization of the Public Dental Service in Sweden were investigated in 84 Turkish immigrant children born in Sweden, 69 Turkish children born in Turkey and 85 Swedish age- and sex-matched controls. Dental fear was also studied. The mean age of the children was 8.3 years. Turkish immigrant children had more caries both in the primary and in the permanent teeth than Swedish children. Children born in Turkey had more caries in the primary dentition than those born in Sweden. Turkish children came more often for emergency visits than Swedish children and expressed dental fear more frequently. Turkish immigrant children therefore constitute a high risk group for caries and need supervision early after immigration.
Subject(s)
Dental Caries/epidemiology , Adolescent , Child , Dental Health Services/statistics & numerical data , Dental Health Surveys , Emigration and Immigration , Humans , School Dentistry , Sweden , Turkey/ethnologySubject(s)
Child Abuse/legislation & jurisprudence , Child Advocacy , Child Care , Child , Child, Preschool , Humans , Infant , SwedenSubject(s)
Bottle Feeding , Infant Nutritional Physiological Phenomena , Breast Feeding , Female , Growth , Humans , Infant, NewbornABSTRACT
Height, weight and body proportions were studied in 155 Turkish school children born in Sweden, living in a defined area in Stockholm. They were compared with Swedish children matched for sex, age and physical environment, and with a smaller number of Turkish children born in Turkey or in countries other than Turkey and Sweden. Parents' socio-economic levels were extremely low on a Swedish comparison. Growth was correlated to socio-economic background. The study was cross-sectional and longitudinal, combining growth data for key ages from health documents with contemporary data. Turkish schoolchildren under 10 years of age, born in Sweden, were significantly shorter than Swedish children, the difference beginning in the pre-school years. Turkish children born in Turkey were short on arrival in Sweden but soon caught up with the Turkish children born in Sweden. Genetic factors only could not explain the difference in height-for-age between Turkish children born in Sweden and Swedish children. With a longer period of stay in Sweden an increase in height-for-age would be expected.
Subject(s)
Growth , Adolescent , Body Height , Body Weight , Child , Child, Preschool , Epidemiologic Methods , Female , Humans , Infant , Infant, Newborn , Male , Socioeconomic Factors , Sweden , Turkey/ethnologyABSTRACT
Turkish preschool children in Stockholm, Sweden, 59 born 1979, 32 born 1976 and 43 siblings of preschool age have been studied as to nutritional status including anthropometric parameters, dental caries, haemoglobin level and bacteriological and parasitological findings in faeces and as to deaths of siblings in Turkey and Sweden. Growth was very close to that of the Swedish standard. Two of three children with slightly subnormal growth had had recent direct or indirect contact with the home country. There were no signs of nutritional deficiency but dental caries was common. There was little anaemia. One case of shigellosis was found. Mortality of infancy was significantly reduced after immigration. The group had made a successful nutritional adaptation in Sweden considering their origin in regions of Turkey with a high prevalence of growth failure. Health care in this group should aim at prevention of diarrhoeal disease on visits to Turkey as well as of dental caries.
Subject(s)
Anthropometry , Infant Mortality , Nutritional Status , Body Weight , Child, Preschool , Dental Caries , Hemoglobins/analysis , Humans , Infant , Sex Factors , Sweden , Turkey/ethnologyABSTRACT
Fifty-nine Turkish infants in metropolitan Stockholm and two adjacent communities have been studied regarding food consumption pattern. The infants were breastfed for a shorter period than expected in Turkey and shorter than in Swedish children. Illiterate mothers breastfed longer than those who had received some kind of education. Formula feeding was extensively used. Supplementary semisolid feeding was introduced, mainly at 4-6 months of age, much earlier than in Turkey but rather later than in Swedish families. Some problems were noted with the bottle feeding, most importantly with regard to hygienic practices, dangerous especially on summer visits to Turkey. Unsatisfactory handling of bottle feeding was linked to the mother's educational level. Further interest in nutrition education for this and other immigrant groups is important.
