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Sundelin, Claes
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Publications (10 of 29) Show all publications
Kristjánsdóttir, J., Sundelin, C. & Naessén, T. (2018). Health-related quality of life in young women starting hormonal contraception: a pilot study. European journal of contraception & reproductive health care, 23(3), 171-178
Open this publication in new window or tab >>Health-related quality of life in young women starting hormonal contraception: a pilot study
2018 (English)In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 23, no 3, p. 171-178Article in journal (Refereed) Published
Abstract [en]

Objectives: Our purpose was to study whether there is a difference in self-rated health-related quality of life (HRQOL) and changes in HRQOL perception after 3 months of hormonal contraceptive use in adolescents. Seasonal variations in symptoms of depression were also studied. Methods: A test group (T1) (n=193) and a selected control group (n=238) of women aged 14-20 years who were visiting a young person's clinic completed the 36-item short-form health survey (SF-36) and answered additional questions on menstrual history and pattern, need for menstrual pain relief medication, and other regular medication. The test group was reassessed after 3 months of hormonal contraception (T2). Seasonal variations in reported SF-36 scores were studied for the whole group. Results: The selected control group and test group at T1 were similar with regard to age at menarche and menstrual pattern. The duration of bleeding and use of painkillers were significantly reduced and the impact on everyday life was significantly improved after 3 months of hormonal contraception (p=.000, two-tailed). No changes in HRQOL or symptoms of possible depression were found after 3 months of hormonal contraception. The highest prevalence odds ratio for possible depression (SF-36 mental health scale score <= 48), adjusted for group, season and age, for spring vs winter, was 2.15 (95% confidence interval 0.95, 4.85). Conclusions: After 3 months of hormonal contraception both the number of days of menstrual bleeding and the use of medication to relieve menstrual pain were reduced, but there were no significant changes in self-rated HRQOL perception. Seasonal effects on HRQOL were reported.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD, 2018
Keywords
Adolescence, contraception, depression, mental health, quality of life, SF-36
National Category
Public Health, Global Health, Social Medicine and Epidemiology Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-358345 (URN)10.1080/13625187.2018.1455179 (DOI)000434668100001 ()29671353 (PubMedID)
Available from: 2018-08-27 Created: 2018-08-27 Last updated: 2018-08-27Bibliographically approved
Bröms, K., Norbäck, D., Eriksson, M., Sundelin, C. & Svärdsudd, K. (2013). Prevalence and co-occurrence of parentally reported possible asthma and allergic manifestations in pre-school children. BMC Public Health, 13, 764
Open this publication in new window or tab >>Prevalence and co-occurrence of parentally reported possible asthma and allergic manifestations in pre-school children
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2013 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 13, p. 764-Article in journal (Refereed) Published
Abstract [en]

Background: The aim of this study was to make an in-depth analysis of the prevalence and co-occurrence in pre-school children of possible asthma and atopic manifestations. Methods: In Sweden 74%-84% of preschool children, depending on age, attend municipality organised day-care centres. Parents of 5,886 children 1-6 years of age, sampled from day-care centres in 62 municipalities all over Sweden, responded to a postal questionnaire regarding symptoms indicating prevalent possible asthma, allergic rhinitis, eczema, and food, furred pet and pollen allergy and other data in their children. Possible asthma was defined as any of the four criteria wheezing four times or more during the last year, physician diagnosis and current wheezing, ever had asthma and current wheezing, and current use of inhalation steroids, all based on questionnaire responses. Results: The overall prevalence of possible asthma was 8.9%, of eczema 21.7%, of rhinitis 8.1%, and of food allergy 6.6%. There was a highly significant co-occurrence between possible asthma and all atopic manifestations, 35.7% having any of the manifestations. Presence of pet allergy was the manifestation showing the closest co-occurrence with presence of possible asthma, presence of pollen allergy with presence of rhinitis, and presence of food allergy with presence of eczema. Assessed from plots of age-specific prevalence of possible asthma, rhinitis, eczema and food allergy, the prevalence of all manifestations increased from one to three years of age and then decreased, except for rhinitis where the prevalence increased until six years of age, indicating no specific ordered sequence. Conclusions: Parentally reported possible asthma, eczema and food allergy had a curvilinear prevalence course across age with a maximum at age 3, while rhinitis prevalence increased consistently with age. Co-occurrence between possible asthma and atopic manifestations was common, and some combinations were more common than others, but there was no evidence of a specific ordered onset sequence.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-208084 (URN)10.1186/1471-2458-13-764 (DOI)000323753900001 ()
Available from: 2013-09-23 Created: 2013-09-23 Last updated: 2017-12-06Bibliographically approved
Holmberg, K., Sundelin, C. & Hjern, A. (2013). Screening for attention-deficit/hyperactivity disorder (ADHD): can high-risk children be identified in first grade?. Child Care Health and Development, 39(2), 268-276
Open this publication in new window or tab >>Screening for attention-deficit/hyperactivity disorder (ADHD): can high-risk children be identified in first grade?
2013 (English)In: Child Care Health and Development, ISSN 0305-1862, E-ISSN 1365-2214, Vol. 39, no 2, p. 268-276Article in journal (Refereed) Published
Abstract [en]

Aim 

Recent studies have demonstrated the beneficial long-term effects of an indicated parent support programme for acting out behaviour in pre-school children with attention-deficit/hyperactivity disorder (ADHD) traits. In this study we wanted to assess different thresholds for screening with the Conners scale for hyperactive-inattentive behaviours in first grade for ADHD in grade four.

Method

The study population consisted of 422 first graders (6- to 7-year-olds) in one municipality in Stockholm County who were screened with Conners 10-item scale and followed up by ADHD assessment in grade four. Sensitivity, specificity, likelihood ratios, and positive predictive value (PPV) of the screening by parents and teachers in first grade for being diagnosed with ADHD in fourth grade were calculated.

Results 

The prevalence of pervasive and situational ADHD was 5.7% and 5.9% respectively. A score ≥10 on the Conners scale in first grade in teachers' reports identified 63% [95% confidence interval (CI): 43-79] of children diagnosed with pervasive ADHD in grade four (P < 0.001) with a PPV of 29% and a positive likelihood ratio (LR+) of 6.72. Parental reports of a score ≥10 yielded a lower sensitivity (29%; 95% CI: 15-49), PPV of 20% and LR+ of 4.24 for pervasive ADHD. The best predictor was a combination of parent and teacher scores ≥10 with a PPV of 50% and LR+ of 16.63. Associations with situational ADHD were weak with LR+ of 1.81 and 2.49, respectively, for teachers' and parental scores ≥10.

Conclusions

This study indicates a strong association between a teacher's report of a score ≥10 on the Conners scale in first grade and pervasive ADHD in grade four, while parental reports were less predictive.

Keywords
ADHD, behavioural screening, Conners 10-item scale, CD, disruptive behaviour, parent and teacher ratings, school children. Wilson and Jungner criteria
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-101030 (URN)10.1111/j.1365-2214.2012.01382.x (DOI)000314127800015 ()22515618 (PubMedID)
Available from: 2009-04-16 Created: 2009-04-16 Last updated: 2017-12-13Bibliographically approved
Kristjansdottir, J., Olsson, G. I., Sundelin, C. & Naessén, T. (2013). Self-reported health in adolescent girls varies according to the season and its relation to medication and hormonal contraception: A descriptive study. European journal of contraception & reproductive health care, 18(5), 343-354
Open this publication in new window or tab >>Self-reported health in adolescent girls varies according to the season and its relation to medication and hormonal contraception: A descriptive study
2013 (English)In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 18, no 5, p. 343-354Article in journal (Refereed) Published
Abstract [en]

Objectives To study seasonal variations in self-rated health and depressive symptoms in adolescent girls and possible differences in reported health with regard to use of medications. Method The SF-36 questionnaire was completed by 1250 girls with a mean age of 17 years, who visited a health centre in the course of one year. From January to July inclusive, depressive symptoms in 453 of the participants were also assessed using MADRS-S. Age and regular medication data were recorded. Results Significantly better mental health and less depressive symptoms were reported during the summer, than in winter months. Seasonality was more related to the SF-36 mental, than physical health subscales. Respondents treated with hormonal contraceptives (HCs) only and those not taking any medication scored better on several SF-36 subscales, than girls on antidepressives and other medications. Respondents taking HCs tended to report better physical health and less depressive symptoms on MADRS-S than those taking no medication. Conclusions Adolescent girls showed seasonal variations in self-reported health and depressive symptoms, with more symptoms during winter months. HC users tended to report better physical health and less depressive symptoms than those on no medication. The high prevalence of suspected depression during the winter months deserves attention.

Keywords
Adolescence, Depression, Mental health, Contraception, Quality of life
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-209461 (URN)10.3109/13625187.2013.821107 (DOI)000324618100004 ()
Available from: 2013-10-24 Created: 2013-10-21 Last updated: 2017-12-06Bibliographically approved
Bröms, K., Norbäck, D., Sundelin, C., Eriksson, M. & Svärdsudd, K. (2012). A nationwide study of asthma incidence rate and its determinants in Swedish pre-school children. European Journal of Epidemiology, 27(9), 695-703
Open this publication in new window or tab >>A nationwide study of asthma incidence rate and its determinants in Swedish pre-school children
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2012 (English)In: European Journal of Epidemiology, ISSN 0393-2990, E-ISSN 1573-7284, Vol. 27, no 9, p. 695-703Article in journal (Refereed) Published
Abstract [en]

While many studies on asthma prevalence have been published, the number of studies on asthma incidence in pre-school children is limited. In this project, a nationwide sample of pre-school children was followed with the aim of estimating cumulative 5-year asthma incidence and its determinants. Parents of 5,886 children 1-6 years of age, sampled from day-care centres in 62 municipalities all over Sweden, responded in 2002 to a baseline postal questionnaire with questions regarding symptoms indicating possible asthma or atopic conditions, and a number of other variables. In 2007, parents of 4,255 children responded to an almost identical follow-up questionnaire. Of these, the 3,715 children who were free from asthma at baseline constitute the study population for this report. A large number of potential baseline determinants for cumulative 5-year asthma incidence were identified. Of these, food allergy, rhinitis, incomplete asthma diagnosis criteria (wheezing last 12 months, and ever had asthma but no current symptoms), parental rhinitis, parental asthma, age, and eczema, in ranking order of importance, remained significant in multivariate logistic regression analysis. The asthma incidence rate was highly dependent on presence or absence of these variables, the average annual rate ranging from 2/1,000/year in 6-year-olds with no determinants to154/1,000/year in 1-year-olds with all determinants, corresponding to 11/1,000/year based on the whole study population.

National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
urn:nbn:se:uu:diva-185282 (URN)10.1007/s10654-012-9725-3 (DOI)000310589700004 ()22911025 (PubMedID)
Available from: 2012-11-21 Created: 2012-11-21 Last updated: 2017-12-07Bibliographically approved
Magnusson, M., Lagerberg, D. & Sundelin, C. (2012). Organizational differences in early child health care: mothers' and nurses' experiences of the services. Scandinavian Journal of Caring Sciences, 26(1), 161-168
Open this publication in new window or tab >>Organizational differences in early child health care: mothers' and nurses' experiences of the services
2012 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 26, no 1, p. 161-168Article in journal (Refereed) Published
Abstract [en]

Aim: 

The aim of this study was to evaluate parents' and nurses' perceptions of the child health services (CHS) in relation to whether the nurse worked exclusively with children (focused-child health centre, CHC) vs. with people of all ages (mixed-CHC).

Method: 

Information about parents' perceptions about the CHS was acquired by a questionnaire intended for the mothers of 18-month-old children. One thousand thirty-nine answered in the baseline 2002-2003 and 996 in the follow-up 2004-2005. The nurses answered a special questionnaire aimed to obtain knowledge about their satisfaction with their work. Eighteen CHCs were chosen from the county of Uppsala and eighteen from other Swedish counties. The CHCs were chosen from areas with poor psycho-social status. The data were collected by questionnaires to mothers and nurses, and the analysis used the chi-square test, t-test and logistic regression. The study was approved by the Research Ethics Committees of the universities involved.

Results:

Mothers were more satisfied, and the nurses found their work tasks easier, at CHCs where the child health nurse worked exclusively with children, compared with mothers and nurses belonging to CHCs where the nurses provided care to people of all ages.

Conclusion: 

The findings indicated that nurses working exclusively with children, being able to concentrate their time and knowledge on a specialized field, develop a more solid child health competence. There are strong reasons to consider introducing 'exclusive' CHCs in psycho-socially vulnerable areas, which would probably make the services more effective. However, intensified education may modify the drawbacks of mixed-CHCs.

Keywords
attitudes, child nursing, health services research, health visiting, organizational development
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-162987 (URN)10.1111/j.1471-6712.2011.00910.x (DOI)000300567200020 ()21883341 (PubMedID)
Available from: 2011-12-06 Created: 2011-12-06 Last updated: 2017-12-08Bibliographically approved
Wallby, T., Lagerberg, D., Magnusson, M. & Sundelin, C. (2011). Basta: Validitet i ett regionalt barnhälsovårdsregister. Uppsala: Barnhälsovårdens länsavdelning
Open this publication in new window or tab >>Basta: Validitet i ett regionalt barnhälsovårdsregister
2011 (Swedish)Report (Other academic)
Abstract [en]

Aim:

To validate a local Child Health Care Quality database (Basta) in the county of Uppsala, Sweden in terms of completeness and agreement with the Child Health Care record (CHCR).

Material and methods:

The target population for the study consisted of 2-year old children born during 2005 to 2008 and registered as residents in the county of Uppsala Sweden (n= 15 769), each child enrolled at one specific Child Health Centre (CHC, n= 41) in the county. The study population was determined by means of a two step cluster selection design. In step one 11 CHC: s was randomly selected. In step 2 five percent of the children at each of the 11 randomized CHC was randomly selected, the selection procedure ending up in a study population comprising 198 children. The CHCR for all 198 children was retrieved and information regarding visits at the CHC, home visits, participation in parenting group, parental smoking habits, breastfeeding and vaccination status was entered into the study database together with the corresponding data from the Basta database. The data on each pair of connected variables was compared and the results regarding the number of visits at CHC, the number of home visits, any home visit, a minimum number of 6 visits at CHC,  a minimum number of 11 visits at CHC and participation in parenting group at any time were expressed as the percentage of correspondence. For results regarding if the child had received each dose of the recommended vaccines, breastfeeding status at given time points and paternal smoking at given time points the sensitivity, specificity and positive and negative predictive value between the CHCR and the corresponding Basta data was calculated.

Results:

The sensitivity value for given doses of vaccines against diphtheria, tetanus, whooping cough, polio myelitis and hemophilus influenza was > 95 % and for breastfeeding at 1 week, 2, 4 and 6 months of child age 94-95 %. The sensitivity value for maternal smoking was 100 % and for paternal smoking>90 %. For any home visit, participation in parenting group at any time, a minimum number of 6 visits at CHC and a minimum number of 11 visits at CHC the calculated sensitivity value were between 88 to 96 %. The sensitivity value for the exact match of number of visits at CHC was low. Increasing the tolerance to +/- 3 visits the sensitivity value was 88 %.

Conclusions:

The results showed a satisfactory level of completeness in the Basta database and sufficient agreement with data in the CHCR. The data in Basta could be considered valid enough to be used for both the guarantee of quality and research purposes. However, some concerns could be made about using data on breastfeeding at 10 and 12 months and smoking status at 9 months where the attrition was higher and the exact number of visits at CHC where the exact match was low.

Place, publisher, year, edition, pages
Uppsala: Barnhälsovårdens länsavdelning, 2011
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Pediatrics
Identifiers
urn:nbn:se:uu:diva-170034 (URN)
Available from: 2012-03-08 Created: 2012-03-07 Last updated: 2012-03-08Bibliographically approved
Lagerberg, D., Magnusson, M. & Sundelin, C. (2011). Child health and maternal stress: does neighbourhood status matter?. International Journal of Adolescent Medicine and Health, 23(1), 19-25
Open this publication in new window or tab >>Child health and maternal stress: does neighbourhood status matter?
2011 (English)In: International Journal of Adolescent Medicine and Health, ISSN 0334-0139, E-ISSN 2191-0278, Vol. 23, no 1, p. 19-25Article in journal (Refereed) Published
Abstract [en]

The purpose of this cross-sectional questionnaire study was to explore neighbourhood-level differences in health behaviour, maternal stress and sense of coherence, birth weight, child health and behaviour, and children's television watching habits. In total, 2006 pairs of Swedish mothers and children, aged approximately 20 months, from the general population participated in the study. A total of 1923 lived in neighbourhoods of average socioeconomic status in six counties, and 83 in a high-status neighbourhood in one of the counties. Data were collected in 2002-2003 and 2004-2005 through the Child Health Services. Socio-demographic confounders were adjusted for in multiple logistic regressions (maternal age, country of birth, education, marital status and parity). Compared with their counterparts in average neighbourhoods, mothers in the high-status neighbourhood were less frequently smokers and had been breastfeeding their children more. They felt less stress from social isolation and had a higher sense of coherence. All these differences except lower social isolation were non-significant after adjusting for socio-demographic characteristics. Privileged mothers felt more restricted by their parenting tasks (unadjusted comparison), and more privileged children were frequent television watchers. Child birth weight, health and behaviour were no better in the privileged than in average neighbourhoods. This paper adds to previous knowledge by showing that status-based geographic differences in important parenting and health parameters can be non-significant in an equitable society such as Sweden, where all families with young children have access to free high-quality health services. Individual characteristics could provide better explanations than neighbourhood status.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-162984 (URN)10.1515/ijamh.2011.004 (DOI)21721359 (PubMedID)
Available from: 2011-12-06 Created: 2011-12-06 Last updated: 2017-12-08Bibliographically approved
Kristjánsdóttir, J., Olsson, G. I., Sundelin, C. & Naessen, T. (2011). Could SF-36 be used as a screening instrument for depression in a Swedish youth population?. Scandinavian Journal of Caring Sciences, 25(2), 262-268
Open this publication in new window or tab >>Could SF-36 be used as a screening instrument for depression in a Swedish youth population?
2011 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, no 2, p. 262-268Article in journal (Refereed) Published
Abstract [en]

 Objective: Depression among youth is a condition associated with serious long-term morbidity and suicide. The aim of this study was to investigate whether a HRQoL instrument, the short form 36 version 1.0 (SF-36), could be used to screen for depression in a clinical Youth Centre (YC). A second purpose was to describe self-reported health and depression. Setting: A clinical YC at a University hospital. Design: A sample of 660 youths, 14-20 years old was assessed with SF-36 and Montgomery Asberg Depression Rating Scale, self-screening version (MADRS-S). Answers to all the questions in both instruments were given by 79% (519/660; 453 women and 66 men). Mean age in the sample was 17.5 +/- 1.6 years. Results: Strong correlations were found between all the SF-36 subscales and the depression ratio scale MADRS-S. Receiver operating characteristic (ROC) curve analysis confirmed that the SF-36 subscales mental health (MH) and vitality (VT) could correctly predict depression on the individual level with Area Under the ROC Curve values 0.87 and 0.84 in ROC curves. Individuals scoring 48 or lower on MH and 40 or lower on VT should be followed up with a clinical interview concerning possible depressive disorder. Mild to moderate depression was common (35.5%), especially among women (37.5%). Men scored higher than women on all SF-36 subscales except for physical functioning. Conclusions: The SF-36 can be used to screen for suspect depression in a youth population followed by interview. This gives an opportunity to detect and treat emerging depressive symptoms early.

Keywords
adolescence, depression, health services research, mental health, quality of life, screening
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-140118 (URN)10.1111/j.1471-6712.2010.00821.x (DOI)000290589300008 ()20731793 (PubMedID)
Available from: 2011-01-04 Created: 2011-01-04 Last updated: 2017-12-11Bibliographically approved
Lagerberg, D., Magnusson, M. & Sundelin, C. (2011). Drawing the line in the Edinburgh Postnatal Depression Scale (EPDS): a vital decision. International Journal of Adolescent Medicine and Health, 23(1), 27-32
Open this publication in new window or tab >>Drawing the line in the Edinburgh Postnatal Depression Scale (EPDS): a vital decision
2011 (English)In: International Journal of Adolescent Medicine and Health, ISSN 0334-0139, E-ISSN 2191-0278, Vol. 23, no 1, p. 27-32Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

The Edinburgh Postnatal Depression Scale (EPDS) is widely used in early child health care. This study examined the appropriateness of the recommended EPDS cut-off score 11/12.

METHODS:

Two main analyses were performed: 1. Associations between EPDS scores and maternal health behaviour, stress, life events, perceived mother-child interaction quality and child behaviour. 2. Screening parameters of the EPDS, i.e., sensitivity, specificity and positive predictive value. EPDS scores were available for 438 mothers and maternal questionnaires for 361 mothers.

RESULTS:

Already in the EPDS score intervals 6-8 and 9-11, there were notable adversities, according to maternal questionnaires, in stress, perceived quality of mother-child interaction, perceived child difficultness and child problem behaviours. Using maternal questionnaire reports about sadness/distress postpartum as standard, the recommended EPDS cut-off score 11/12 resulted in a very low sensitivity (24%). The cutoff score 6/7 yielded a sensitivity of 61%, a specificity of 82% and a positive predictive value of 61%.

CONCLUSIONS:

In terms of both clinical relevance and screening qualities, an EPDS cut-off score lower than 11/12 seems recommendable.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-162985 (URN)10.1515/ijamh.2011.005 (DOI)21721360 (PubMedID)
Available from: 2011-12-06 Created: 2011-12-06 Last updated: 2017-12-08Bibliographically approved
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