<p>Overweight and obesity among children and adolescents is increasing. Diseases which earlier occurred exclusively among adults are now also observed among children. There is an urgent need for new treatments that can change this negative trend. The aim of this study was to describe existing treatments for obesity among children in the age of 6-12 and the effect of those treatments. This descriptive literature study is based on 17 research articles published between 2000 and 2007 from different parts in the world. The treatments found in the studies could be categorised as follows: treatment with only physical activity, multidisciplinary treatment, multidisciplinary treatment with family participation, behavioural program with support from parents and alternative medicine treatments. No significant pattern could be observed for the effects of the different treatments. Similar treatments showed different effects, which makes the data difficult to interpret. Good results among the studied treatments were however, often obtained using multidisciplinary programs. Moreover it was shown that support from parents had a positive effect. It is of major importance to adjust the treatment to each individual and to construct the program in such a way that the effect reside also after completion of the treatment.</p>

Overweight and obesity among children and adolescents is increasing. Diseases which earlier occurred exclusively among adults are now also observed among children. There is an urgent need for new treatments that can change this negative trend. The aim of this study was to describe existing treatments for obesity among children in the age of 6-12 and the effect of those treatments. This descriptive literature study is based on 17 research articles published between 2000 and 2007 from different parts in the world. The treatments found in the studies could be categorised as follows: treatment with only physical activity, multidisciplinary treatment, multidisciplinary treatment with family participation, behavioural program with support from parents and alternative medicine treatments. No significant pattern could be observed for the effects of the different treatments. Similar treatments showed different effects, which makes the data difficult to interpret. Good results among the studied treatments were however, often obtained using multidisciplinary programs. Moreover it was shown that support from parents had a positive effect. It is of major importance to adjust the treatment to each individual and to construct the program in such a way that the effect reside also after completion of the treatment.

<p>Abstract</p><p>This work is about children in sorrow. I have chosen to set the focus on the school and the</p><p>teacher’s role in the meeting with mourning children and the difference between boys and</p><p>girls reactions when mourning.</p><p>The awareness and the great importance for a teachers knowledge to meet a child in mourning,</p><p>is something I myself has experienced when a child in nursery school lost one parent</p><p>through accident.</p><p>The result of the study reflects on four teachers and two headmasters experience of children in</p><p>sorrow and literature in the subject. It is important that the school and the teachers are aware</p><p>of the importance about the knowledge in the subject to be able to meet a mourning child in</p><p>need.</p><p>Keywords: Children, reactions when mourning, sorrow, the teacher’s role</p>

Abstract This work is about children in sorrow. I have chosen to set the focus on the school and the teacher’s role in the meeting with mourning children and the difference between boys and girls reactions when mourning. The awareness and the great importance for a teachers knowledge to meet a child in mourning, is something I myself has experienced when a child in nursery school lost one parent through accident. The result of the study reflects on four teachers and two headmasters experience of children in sorrow and literature in the subject. It is important that the school and the teachers are aware of the importance about the knowledge in the subject to be able to meet a mourning child in need. Keywords: Children, reactions when mourning, sorrow, the teacher’s role

Syftet med studien var att granska hur smärta och smärtbehandling hos barn under 12 år med lårbensbrott dokumenterades enligt Socialstyrelsens föreskrifter i omvårdnadsjournalen på akutmottagningen på Mora lasarett. En retrospektiv journalstudie genomfördes på journaler tillhörande de barn med lårbensbrott som vårdats på akutmottagningen under en femårsperiod. Studien omfattade totalt 38 journaler. För att granska dokumentationens kvantitet och kvalitet användes en modifierad granskningsmall och granskningsnyckel CAT-CH-ING. Utifrån dessa kunde dokumentationen poängsättas och frekvensen av dokumentationen rörande smärta och smärtbehandling beräknas. Resultatet visade att omvårdnadsdokumentationen var bristfällig både vad gällde kvantitet och kvalitet. 13 av 38 journaler saknade helt anteckningar rörande smärta eller smärtbehandling. 16 journaler innehöll dokumentation av anamnes och eller status rörande smärta. Smärtbehandling fanns dokumenterad i 22 journaler, men bara en journal innehöll utvärdering av smärtbehandling. Slutsatsen var att 13 journaler av 38 helt saknade dokumentation rörande smärta eller smärtbehandling, trots att barnen hade en komplicerad fraktur. Övriga 25 journaler utom en hade bristfällig dokumentation enligt Socialstyrelsens föreskrifter.

Resumo UCHÔA-FIGUEIREDO, L. R. O impacto da doença na vida cotidiana dos cuidadores de crianças com epilepsia de dificil controle. 2009. 260f. Tese (Doutorado) Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, São Paulo, 2009. A notícia de que o filho tem uma doença crônica remete os pais a uma crise em relação às expectativas decorrentes do desejo do filho idealizado. A família sofre pela incerteza da evolução da doença e suas possíveis consequências. A mãe, comumente, torna-se a cuidadora principal, ajudando a suprir necessidades, apresentando uma vida ocupacional deficitária, pois despende tempo, energia física e emocional, sofrendo perdas, sobrecarga de atividades e comprometendo a sua qualidade de vida. O objetivo desta pesquisa foi conhecer as mudanças que ocorrem na vida cotidiana do cuidador primário de pacientes, com diagnóstico de Epilepsia de Difícil Controle Infantil associado à encefalopatia crônica não evolutiva, avaliar a qualidade de vida e a sobrecarga em função da situação de adoecimento e verificar a relação desta sobrecarga emocional com a percepção dos cuidadores, sobre sua qualidade de vida. Avaliaram-se 50 cuidadores de crianças entre 7 e 12 anos, de ambos os sexos, com diagnóstico confirmado há cinco anos, e que estavam nesta função há pelo menos dois anos. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa Envolvendo Seres Humanos do HCFMRP e foi realizada no Serviço de Epilepsia Infantil do mesmo hospital. Foram utilizados: prontuários médicos das crianças, entrevista semi-estruturada enfocando o adoecimento, o cuidar e a vida cotidiana, os questionários de sobrecarga, Caregiver Burden Scale e de Qualidade de Vida, WHOQOL-bref. Os dados obtidos na entrevista foram analisados segundo o Sistema Quantitativo Interpretativo. Os dados do WHOQOL-bref e da Caregiver Burden Scale foram submetidos à análise estatística, de acordo com as normas do instrumento. Posteriormente, através da técnica dos quadrantes e da análise de coeficiente não paramétrica de Spearman, os dados foram correlacionados, no sentido de verificar possíveis relações entre aspectos da vida cotidiana, sobrecarga e percepção, por parte dos cuidadores, de sua qualidade de vida. Os resultados possibilitaram conhecer que houve mudança, diminuição do convívio social, alteração na vida profissional e estresse na vida do cuidador em decorrência do ato de cuidar. Em relação à qualidade de vida, pôde-se constatar que o domínio meio ambiente apresentou maior satisfação, enquanto que o menor índice ficou com as relações sociais, indicando assim a importância da rede de apoio social para o cuidador. A variável tempo de cuidado indicou que, quanto maior este for, maior a satisfação com relação ao bem-estar psicológico, meio ambiente e relações sociais. Identificaram-se dois tipos de sobrecarga, a velada e a declarada. Conclui-se que o impacto do adoecimento da criança interfere diretamente na vida cotidiana e nas relações dos cuidadores, assim como na qualidade de vida, porém, percebe-se que recursos estruturais e emocionais contribuem para minimizar os efeitos negativos sobre os cuidadores. Neste sentido ressalta-se a importância da equipe multidisciplinar oferecendo amparo informativo, técnico, troca de experiência e suporte aos cuidadores. / UCHÔA-FIGUEIREDO, L. R. Disease impact on the daily lives of caretakers of children with Difficult to Control Epilepsy. 2009. 260p. Thesis (PhD) Faculty of Philosophy, Science and Humanities of Ribeirao Preto, University of Sao Paulo, São Paulo, 2009. Acknowledging that a child has a chronic disease throws parents into a crisis related to expectations of a desired idealized descendant. The family is uncertain about disease evolution and possible consequences. However, it is the mother, who as a rule, becomes the main caretaker, helping to supply all necessities but showing a occupational life full of short-comings caused by spent time and physical and emotional energy. Her quality of life is further compromised by the suffered losses and work burden. This study aimed to investigate changes in the daily life of primary caretakers of patients diagnosed with Difficult to Control Child Epilepsy associated to non-evolutive chronic encephalopathy , and to evaluate effects of the overload as a function of disease onset on the quality of life. Perception by caretakers of disturbances in their own quality of life by the emotional burden was also verified. The fifty caretakers evaluated were taking care, for at least two years, of children 7 to 12 years old, from both sexes and with a confirmed diagnosis of five years. The study was approved by the Ethics Committee on Research with Human Beings of the University Hospital, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo (HCFMRP) and was conducted at the Child Epilepsy Service of the same Hospital. Data were obtained through the children medical records, half-structured interviews addressing onset of the disease and daily care, and completion of the overload questionnaires ,Caregiver Burden Scale and Quality of Life, WHOQOL-bref. Data from interviews were analyzed by the Interpretation Quantitative System and the ones from WHOQOL-bref and Caregiver Burden Scale submitted to statistical analysis according to the rules of the instruments. Using the quadrant technique and analysis of the non-parametric Spearman coefficient, the data were further correlated to verify the existence of a relationship between aspects of burdened daily life and perception of their quality of life by caretakers. Results showed that the act of care did produce changes in the life of the caretaker, characterized by decreased socializing , disturbed professional life and stress . Considering quality of life, environmental factors were more satisfying than the ones of social relations, emphasizing the importance of social support in the life of a caretaker. As to the variable related to care duration, the longer it lasted the higher satisfaction in psychological well being, environment and social interchange were achieved . Two types of burdens were identified, one concealed and one declared. It is concluded that onset of disease in children does directly interfere in the daily life and relationships of caretakers, thus in their quality of life. However, by showing the contribution of structural and emotional resources to minimize the negative effects on caretakers, the importance of supportive information, techniques and exchange of experiences provided by a multi-professional team is also emphasized.

Resumo UCHÔA-FIGUEIREDO, L. R. O impacto da doença na vida cotidiana dos cuidadores de crianças com epilepsia de dificil controle. 2009. 260f. Tese (Doutorado) Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, São Paulo, 2009. A notícia de que o filho tem uma doença crônica remete os pais a uma crise em relação às expectativas decorrentes do desejo do filho idealizado. A família sofre pela incerteza da evolução da doença e suas possíveis consequências. A mãe, comumente, torna-se a cuidadora principal, ajudando a suprir necessidades, apresentando uma vida ocupacional deficitária, pois despende tempo, energia física e emocional, sofrendo perdas, sobrecarga de atividades e comprometendo a sua qualidade de vida. O objetivo desta pesquisa foi conhecer as mudanças que ocorrem na vida cotidiana do cuidador primário de pacientes, com diagnóstico de Epilepsia de Difícil Controle Infantil associado à encefalopatia crônica não evolutiva, avaliar a qualidade de vida e a sobrecarga em função da situação de adoecimento e verificar a relação desta sobrecarga emocional com a percepção dos cuidadores, sobre sua qualidade de vida. Avaliaram-se 50 cuidadores de crianças entre 7 e 12 anos, de ambos os sexos, com diagnóstico confirmado há cinco anos, e que estavam nesta função há pelo menos dois anos. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa Envolvendo Seres Humanos do HCFMRP e foi realizada no Serviço de Epilepsia Infantil do mesmo hospital. Foram utilizados: prontuários médicos das crianças, entrevista semi-estruturada enfocando o adoecimento, o cuidar e a vida cotidiana, os questionários de sobrecarga, Caregiver Burden Scale e de Qualidade de Vida, WHOQOL-bref. Os dados obtidos na entrevista foram analisados segundo o Sistema Quantitativo Interpretativo. Os dados do WHOQOL-bref e da Caregiver Burden Scale foram submetidos à análise estatística, de acordo com as normas do instrumento. Posteriormente, através da técnica dos quadrantes e da análise de coeficiente não paramétrica de Spearman, os dados foram correlacionados, no sentido de verificar possíveis relações entre aspectos da vida cotidiana, sobrecarga e percepção, por parte dos cuidadores, de sua qualidade de vida. Os resultados possibilitaram conhecer que houve mudança, diminuição do convívio social, alteração na vida profissional e estresse na vida do cuidador em decorrência do ato de cuidar. Em relação à qualidade de vida, pôde-se constatar que o domínio meio ambiente apresentou maior satisfação, enquanto que o menor índice ficou com as relações sociais, indicando assim a importância da rede de apoio social para o cuidador. A variável tempo de cuidado indicou que, quanto maior este for, maior a satisfação com relação ao bem-estar psicológico, meio ambiente e relações sociais. Identificaram-se dois tipos de sobrecarga, a velada e a declarada. Conclui-se que o impacto do adoecimento da criança interfere diretamente na vida cotidiana e nas relações dos cuidadores, assim como na qualidade de vida, porém, percebe-se que recursos estruturais e emocionais contribuem para minimizar os efeitos negativos sobre os cuidadores. Neste sentido ressalta-se a importância da equipe multidisciplinar oferecendo amparo informativo, técnico, troca de experiência e suporte aos cuidadores. / UCHÔA-FIGUEIREDO, L. R. Disease impact on the daily lives of caretakers of children with Difficult to Control Epilepsy. 2009. 260p. Thesis (PhD) Faculty of Philosophy, Science and Humanities of Ribeirao Preto, University of Sao Paulo, São Paulo, 2009. Acknowledging that a child has a chronic disease throws parents into a crisis related to expectations of a desired idealized descendant. The family is uncertain about disease evolution and possible consequences. However, it is the mother, who as a rule, becomes the main caretaker, helping to supply all necessities but showing a occupational life full of short-comings caused by spent time and physical and emotional energy. Her quality of life is further compromised by the suffered losses and work burden. This study aimed to investigate changes in the daily life of primary caretakers of patients diagnosed with Difficult to Control Child Epilepsy associated to non-evolutive chronic encephalopathy , and to evaluate effects of the overload as a function of disease onset on the quality of life. Perception by caretakers of disturbances in their own quality of life by the emotional burden was also verified. The fifty caretakers evaluated were taking care, for at least two years, of children 7 to 12 years old, from both sexes and with a confirmed diagnosis of five years. The study was approved by the Ethics Committee on Research with Human Beings of the University Hospital, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo (HCFMRP) and was conducted at the Child Epilepsy Service of the same Hospital. Data were obtained through the children medical records, half-structured interviews addressing onset of the disease and daily care, and completion of the overload questionnaires ,Caregiver Burden Scale and Quality of Life, WHOQOL-bref. Data from interviews were analyzed by the Interpretation Quantitative System and the ones from WHOQOL-bref and Caregiver Burden Scale submitted to statistical analysis according to the rules of the instruments. Using the quadrant technique and analysis of the non-parametric Spearman coefficient, the data were further correlated to verify the existence of a relationship between aspects of burdened daily life and perception of their quality of life by caretakers. Results showed that the act of care did produce changes in the life of the caretaker, characterized by decreased socializing , disturbed professional life and stress . Considering quality of life, environmental factors were more satisfying than the ones of social relations, emphasizing the importance of social support in the life of a caretaker. As to the variable related to care duration, the longer it lasted the higher satisfaction in psychological well being, environment and social interchange were achieved . Two types of burdens were identified, one concealed and one declared. It is concluded that onset of disease in children does directly interfere in the daily life and relationships of caretakers, thus in their quality of life. However, by showing the contribution of structural and emotional resources to minimize the negative effects on caretakers, the importance of supportive information, techniques and exchange of experiences provided by a multi-professional team is also emphasized.

Studiens syfte är att belysa och undersöka hur förskolepersonal upplever att barns mående och beteende påverkas när de växer upp under missförhållanden i hemmet. Vi vill undersöka på vilket sätt personalen på förskolan uppmärksammar barnets mående och beteende. Studiens frågeställningar fokuserar på hur förskolepersonalen uppmärksammar barnets mående. De teorier som används i studien är Bronfenbrenners utvecklingsekologiska teori samt Anknytningsteorin som utvecklades av John Bowlby och Broberg som förklarar vilka anknytningsmönster barn utvecklar. Resultatet av studien har påvisat att barn som växer upp under missförhållanden i hemmet uttrycker särskilda beteenden och måenden på förskolan. För att besvara syftet och frågeställningen gjordes sex semistrukturerade intervjuer med sex informanter som arbetar på förskola i Malmö och två andra närliggande kommuner.  Det resultatet som belyses är att personal på förskolan uppmärksammar olika signaler hos barnet som kan vara tecken på att barnet far illa i hemmet samt hur barnet utvecklas. Förskollärare kan bidra till att ett barn får stöd och hjälp utifrån att personalen uppmärksammar barnets beteende och kan göra en orosanmälan som kan leda till att barnet får stöd och hjälp. Resultatet belyser även att personal på förskolan upplever att det är svårt när en ska göra en orosanmälan på grund av att det är svårt att avgöra om barnet far illa och vilka konsekvenser det får om de väljer att genomföra en orosanmälan eller inte. / The purpose of this study is to highlight and investigate how preschool staff experience how children's attitude and behavior are affected when they grow up under abusive conditions at home. We want to investigate how the teachers at the preschool pay attention to the child's attitude and behavior. The study's questions focus on how the preschool staff pay attention to the child's well-being. The theories used in the study are Bronfenbrenner's developmental ecology theory and the attachment theory developed by John Bowlby and Broberg which explains which attachment patterns children develop. The results of the study have shown that children who grow up under abusive conditions at home are shown through certain behaviors and attitudes at the preschool. To answer the purpose and the question, six semi-structured interviews were conducted with six informants who work at preschools in Malmö, Svedala and Trelleborg. The result that is highlighted is that staff at the preschool pay attention to various signals in the child that may be signs that the child live under abusive conditions at home and are at risk för adverse growth. Preschool teachers can contribute to a child receiving support and help based on the staff paying attention to the child's behavior. They can make a report of concern that can result in the child receiving support and help. The results also highlight that staff at the preschool experience that it is difficult to know when to make a report of concern because it is difficult to determine if the child is in danger.