Seven- to nine-year-old children's own assessment of health-related quality of life is important in preventing overweight and obesity.

The aim was to study how, and to what degree, health-related quality of life (HRQOL), as assessed by children and their mothers, was related to overweight and obesity among children aged seven to nine years. Mother-child pairs of 149 non-overweight, 95 overweight and 16 obese children participated. We assessed HRQOL by the children's self-report and parent proxy report module of the PedsQL™ 4.0 Generic Core Scales. We found that non-overweight children scored HRQOL slightly higher than overweight ones but significantly higher than did obese children. The same pattern was seen for the mothers' proxy HRQOL score and mothers in general scored higher than the children did. The results indicate that mothers in general were not sufficiently aware of how overweight and obesity affect their children's HRQOL. The psychosocial dimension of HRQOL was the most important aspect for the children. Thus, there is a need for information of mothers/parents about the impact of overweight and obesity on children's HRQOL. Such intervention by health professionals may among other interventions help to prevent and reduce overweight and obesity among children and thus help to increase the children's HRQOL throughout their lives.

Action competence obstacles to managing childhood overweight: in-depth interviews with mothers of 7- to 9-year-old children.

This qualitative phenomenological study interviewed seven mothers to overweight children and six mothers to non-overweight children aged 7 to 9 years old about their views and experiences with preventing and managing overweight in their children. The essence was that the mothers felt responsible for their children's habits, including those leading to overweight. They also felt that competent and had the opportunity to take preventive measures against child overweight but they did not always have the energy to do so. Even resourceful mothers required support from nurses and health professionals. Our results contribute to better understanding how to approach, motivate and support mothers to draw on their own competencies to benefit their children's weight and health.

Maternal and child awareness and expectations of child overweight.

OBJECTIVE: We investigated mothers' and children's assessments of body weight and their expectations about perceived body size in relation to overweight of the children. METHODS: We performed a case-control study of 111 cases of overweight children and 149 controls of non-overweight children (mean age 8.1 years) and their mothers. All were examined and interviewed about their assessment of body weight and their perception of a normal, attractive and acceptable body size. RESULTS: Case children were less able than control children to correctly assess their own body weight (p < 0.001), as were mothers of overweight children (MOC) to assess their children's body weight (p < 0.001). The majority of mothers from both groups wished their children to have a normal body size, but 18% of MOC wished their children to have an overweight body size (p < 0.013). The majority of case children, control children and mothers found a normal body size for boys and girls to be the most attractive and socially acceptable, but more MOC found overweight among boys to be the most attractive (p = 0.006). CONCLUSION: Overweight children and their mothers show increased uncertainty in the assessment of overweight and obesity, but the perception of a normal, attractive and socially acceptable body size is not distorted.

Child overweight--mothers' competence to take action.

OBJECTIVE: We investigated mothers' possession and display of action competence to counteract or prevent overweight and eventual obesity in their children. Action competence is defined as a personal resource where the most important aspect is the individual's wish to take action and to believe in its benefit. It unfolds within the room for action as experienced by the individual due to action obstacles and action potentials. METHODS: In a case-control study, mothers of 111 overweight children (MOC) were compared with mothers of 149 non-overweight children (MNC). They underwent a semistructured interview about action competence, lifestyle, and their 7- to 9-year-old children. RESULTS: Compared to MNC, MOC considered it more important to change habits, both for themselves (p = 0.003) and their children (p < 0.001). MOC were more motivated to change habits (p < 0.001), assessed their action competence to be higher (p < 0.001), and felt to a greater extent that they supported their children to achieve an appropriate weight (p < 0.001) compared with MNC. No difference was found between MOC and MNC in the assessment of their own room for action and their children's room for action. CONCLUSION: Self-assessed room for action was not limited for either MOC or MNC, and MOC even assessed their action competence to be greater.

[Autoimmune polyglandular syndrome in a 13-year old girl]. / Autoimmunt polyglandulaert syndrom hos en 13-årig pige.

Autoimmune polyglandular syndrome (APS) is an entity, defined by autoimmunity towards two or more endocrine organs. APS is classified in 3 subgroups (type-1, type-2a, type-2b), according to the organs involved. A case is presented of a 13-year old girl referred to the Department of Paediatrics with hypothyroidism, subsequently diagnosed adrenocortical insufficiency and impending Addison crisis, typical for APS-type 2a. In the paper we discuss the need for more attention to APS in clinical work.

[Paediatrics. Centralisation of treatment]. / Paediatri. Centralisering af behandling.

Today there are 19 paediatric departments in Denmark. Most of the children's departments are placed in obsolete buildings. Centralisation in children's hospital provides a child-oriented environment with staff, who are knowledgeable about the needs of children, have the competence in both basic and highly specialised medical care, there will be greater opportunities to conduct research in children's diseases and be at the cutting-edge of both national and international excellence in the paediatric area of specialisation, accomplishing this ambition through research and medical improvements.

Efficacy of selective antenatal screening for hepatitis B among pregnant women in Denmark: is selective screening still an acceptable strategy in a low-endemicity country?

The prevalence of hepatitis B virus (HBV) carriage in Denmark is unknown, but expected to be low (0.1%). This study aimed to evaluate the efficacy of selective antenatal screening for HBV infection and the epidemiology of HBV and hepatitis C virus (HCV) among pregnant women. 4098 women were included in the study. Blood tests were examined for hepatitis B surface antigen (HBsAg), anti-hepatitis B core antigen (HBc) and anti-HCV. Case records were studied to evaluate whether patients at risk for HBV infection had been tested. Among the 4098 women, 18 10.4%, 95% confidence interval (95% CI) 0.3-0.71 were HBsAg positive. All had a risk factor for HBV infection. Only 13 (72%) were identified as HBsAg positive in the selective screening programme. 115 women (2.8%, 95% CI 2.3-3.4) were anti-HBc positive only. 95 (83%) were at risk for HBV. Only 72 of these (63%) were tested for HBsAg. The screening programme in this area of Denmark did not pick up one-third of pregnant women at risk of HBV.

[Beta-thalassemia major in children and adolescents in Denmark]. / beta-thalassaemia major hos børn og unge i Danmark.

INTRODUCTION: Beta-thalassemia major occurs with increasing frequency among Danish children as a result of immigration. The aim of the study was to estimate the occurrence of beta-thalassemia major in Denmark, analyse the treatment and organ functions, and identify areas for an improved treatment strategy. MATERIAL AND METHODS: During 1998-99 all Danish pediatric departments were contacted for identification of children aged 0-18 years with beta-thalassemia major. Blood transfusions and chelation therapy were registered, and for Eastern Denmark clinical, endocrine, cardiac, and serologic parameters were performed. RESULTS: Twenty-six children had beta-thalassemia major. Out of these, 20 received blood transfusions, and 17 patients were chelated. Eight patients were not chelated owing to previous bone marrow transplantation, treatment with hydroxyurea or ferritin < 2000 micrograms/l and young age. One patient had died. The body height was between 1.5 and -5.4 SDS (median -1.7) and the sitting height was -0.6 to -5.6 SDS (median -2.3). The bone age was delayed 1-5 years (median -2.5) in six out of ten examined patients, and puberty delayed in four out of five. A dilated left ventricle was documented in one out of eight patients examined. All patients were HIV and hepatitis C negative. For 75% of the children, the parents were related. DISCUSSION: Children and adolescents with beta-thalassemia major in Denmark experience major heterogenicity with regard to treatment and late effects. An earlier and more effective iron chelation therapy together with improved patient support may reduce growth disturbances and endocrine and cardiac late effects.