Infusion pumps are used in all departments of a hospital, in the emergency care unit as well as in pediatrics. The pumps administer intravenous medications for the purpose of helping patients to manage pain and are unfortunately not spared from emerging errors. Due to the complexity of the process involved in infusion pumps, errors regarding delay in administration are encountered. Especially vulnerable to errors are pediatric patients, due to the high risk of over- or under-dosing. This study aims to investigate the effects on administration delay by analysing the medical supply and system utilized for the infusion pumps. This is accomplished through implementation of Compartmental Modeling in Pharmacokinetics in combination with a self developed mathematical model for estimating the administration delay. Simulations were performed for analysing how various sizes of medical supply effected delay time. The result from the computed mathematical model indicates that increased volumes on utilized equipment will increase delay time. The combined use of a decreased flow rate and smaller equipment sizes will have the greatest affects on the delay in administration. The result obtained from the computed compartmental model can be useful for medical staff to be able to estimate the delay in administration. However, further validation is required before the utilization of the model can be applied in hospitals. / Infusionspumpar används på alla avdelningar på ett sjukhus, inom akutvården samt inom pediatrik. Pumparna administrerar olika mediciner i syfte att hjälpa patienten att hantera smärta och är tyvärr inte förskonade från att fel kan förekomma. På grund av komplexiteten i processen, involverad i infusionspumpar, uppstår fel gällande förseningar i administrering av medicin. Speciellt sårbara för dessa typer av förseninigar är pediatriska patienter, på grund av den förhöjda risker gällande över- eller underdosering. Denna studie syftar till att undersöka effekterna gällande administreringsfördröjning genom att analysera det medicinska utrustningen och systemet som används för infusionspumparna. Detta uppnås genom implementering av kompartmentmodellering i farmakokinetik i kombination med en egenutvecklad matematisk modell för att uppskatta administreringsfördröjningen. Simuleringar utfördes för att analysera effekterna av olika storlekar på medicinsk utrustning i förhållande till fördröjningen av administreringe. Resultatet från den beräknade matematiska modellen indikerar att ökade volymer gällande den medicinska utrustningen kommer att öka fördröjningstiden. Den kombinerade användningen av en minskad flödeshastighet och mindre utrustningsstorlekar kommer att ha störst inverkan på förseningen i administreringen. Resultatet som erhålls från den beräknade kompartmentmodellen kan vara användbar för sjukvårdspersonal för att kunna uppskatta förseningen i administrationen. Ytterligare validering krävs dock innan användningen av modellen kan tillämpas på sjukhus.

Till akutmottagningen söker patienter i alla åldrar. Akutsjuksköterskan ska ha kunskap om och kunna omhänderta alla patienter som kommer till akutmottagningen. Pediatriska patienter har särskilda behov, deras fysiologi skiljer sig gentemot vuxna och de utgör därför en specifik patientgrupp. De kommunicerar och uttrycker sig inte heller som vuxna och kan redan i tidig ålder ge uttryck för smärta på sina egna sätt. Patientens aktiva deltagande varierar och patienten kan behöva olika former av stöd beroende på var i vårdprocessen de befinner sig. Det finns många faktorer som påverkar ett omhändertagande, både positivt och negativt. Syftet med studien var att belysa främjande och hindrande faktorer vid omhändertagande av barn på somatisk akutmottagning och utformades efter PEO (Population, Exposure, Outcome). Som metod användes en strukturerad litteraturöversikt med systematisk sökmetod. Resultatet av sökningarna i PubMed och Cinahl gav 15 artiklar med mixad ansats som analyserades med integrerad analysmetod. Det framkom sex huvudkategorier. Kommunikation och information med föräldrar som tar upp vikten av en öppen kommunikationsmiljö, informationsöverföring, sjuksköterskors centrala roll för kommunikation och att använda olika informationskällor för att underlätta kommunikationen. Under rubriken “kommunikation med barnet” framkom delaktighet i samtal om vårdprocessen, åldersanpassad kommunikation och information samt kommunikation om smärtupplevelser. Distraktion, smärtlindring, visad omtanke samt vårdmiljö var andra faktorer som visade sig påverka omhändertagandet av barn på somatisk akutmottagning. Slutsatsen från studien indikerar att omhändertagande av barn på somatisk akutmottagning kräver fokus på barnets delaktighet, familjecentrerad vård och kommunikation. Främjande faktorer kring omhändertagande är aktiv kommunikation, åldersanpassad och tillfredsställande information, distraktioner, snabb smärtlindring, anpassade vårdmiljöer samt visad omtanke. Hindrande faktorer är osäkerhet från närstående, lång väntan på smärtlindring och kommunikationssvårigheter. För ett effektivt och tillfredsställande omhändertagande av pediatriska patienter behöver hänsyn tas till de här främjande och hindrande faktorerna. / Patients of all ages come to the emergency department. The emergency specialist nurse must have knowledge of and be able to care for all patients who come to the emergency department. Pediatric patients have special needs, their physiology differs from that of adults and they therefore constitute a specific patient group. They do not communicate and express themselves like adults but can already at an early age express pain in their own ways. The patient's active participation varies and the patient may need different forms of support. There are many factors that affect emergency care, both positive and negative. The purpose of the study was to elucidate promoting and hindering factors in the care of children in somatic emergency departments and was designed according to PEO (population, exposure, outcome). The method used was a structured literature study with a systematic search. The result of the search in Pubmed and Cinahl yielded 15 articles with a mixed approach that were analyzed using an integrated analysis method. Six main categories emerged. Communication and information with parents that address the importance of an open communication environment, information transfer, nurse´s central role in communication and using different sources to facilitate communication. Under the heading "communication with the child", participation in conversations about the care process, age-appropriate communication and information and communication about pain experiences emerged. Distraction, pain relief, caring and care environment were other factors that were found to affect the care of children in somatic emergency departments. The conclusion from the study indicates that caring for acutely ill children requires a focus on the child's participation, family-centered nursing and communication. Promoting factors regarding emergency care are age-appropriate information, distractions, rapid pain relief, adapted care environments and shown consideration. Impeding factors are uncertainty from relatives, long waits for pain relief and communication difficulties. For good emergency care of pediatric patients these promoting and hindering factors need to be taken into account.

Bakgrund: Barnsjuksköterskor har en högre pediatrisk kompetensnivå än allmänsjuksköterskor. Teoretisk kunskap i kombination med erfarenhet skapar kompetens och utöver kompetensutveckling bidrar specialistutbildning till förbättring av vården, personlig tillfredställelse, löneutveckling och möjligheter till befordran. Trots detta ökar integreringen av allmänsjuksköterskor inom hälso- och sjukvården för barn och ungdomar till följd av den rådande bristen på barnsjuksköterskor. Syfte: Syftet med studien är att belysa barnsjuksköterskans professionella erfarenheter av att arbeta med barn och ungdomar i hälso- och sjukvården efter genomförd specialistsjuksköterskeutbildning. Metod: Studien var av kvalitativ design där data samlades in genom semistrukturerade intervjuer med åtta barnsjuksköterskor som tagit specialistsjuksköterskeexamen mellan år 2020-2024. Data analyserades med kvalitativ innehållsanalys. Resultat: Analysen resulterade i fyra kategorier: Specialistkompetens ger ökad trygghet, Specialistkompetens ger ökad respekt, Specialistkompetens medger nya arbetsmarknadsmöjligheter och Specialistkompetens fördjupas med erfarenhet. Konklusion: Specialistutbildning innebär en kompetensutveckling för barnsjuksköterskor och en förbättrad kvalitet av arbetet med barn och ungdomar. För att motivera fler allmänsjuksköterskor att specialisera sig krävs en tydlig skillnad i arbetet före och efter specialisering. Det är även avgörande att utbildningen betalas av arbetsgivaren för att specialisering ska vara gynnsam för allmänsjuksköterskor. / Background: Pediatric nurses have a higher level of pediatric competence than general nurses. Theoretical knowledge combined with experience creates competence, and in addition to competence development, specialist training contributes to the improvement of care, personal satisfaction, salary progression, and promotion opportunities. Nevertheless, the integration of general nurses in pediatrics is increasing due to the current shortage of pediatric nurses. Purpose: The purpose of the study is to shed light on the pediatric nurse's professional experiences of working with children and adolescents in health and medical care after completed specialist nurse training. Method: The study was of a qualitative design where data was collected through semi-structured interviews with eight pediatric nurses who graduated specialist nursing degrees between the years of 2020-2024. Data were analysed using qualitative content analysis. Results: The analysis resulted in four categories: Specialist competence gives increased security, Specialist competence gives increased respect, Specialist competence allows new labor market opportunities and Specialist competence deepens with experience. Conclusion: Specialist training means competence development for pediatric nurses and an improved quality of work with children and adolescents. In order to motivate more general nurses to specialize, a clear difference in the work before and after specialization is required. It is also crucial that the training is paid for by the employer in order for specialization to be beneficial for general nurses.

United Nations has lately stated ambitious health targets for 2030 in the Sustainable Development Goal agenda, following the already achieved progress between 1990 and 2015 when the number of children dying before the age of five was reduced by more than half. However, the mortality reduction in the first month of life after birth has not kept the same pace. Furthermore, a large number of stillbirths have previously not been accounted for. The aim of this thesis was to evaluate the impact of clinical training in neonatal resuscitation, and to identify strategies for an effective implementation at a maternal health facility in Nepal. Focus group discussions were used to explore the perceptions of teamwork among staff working closest to the infant at the facility. A prospective cohort study with nested referents was applied to determine effect on birth outcomes after an intervention with Helping Babies Breathe, a simplified protocol for neonatal resuscitation. Sustainability of the acquired skills after training was addressed by employing a quality improvement cycle. Video recordings of health workers performance were collected to analyse adherence to protocol. Midwives described the need for universal protocols in neonatal resuscitation and management involvement in clinical audit and feedback. There was a reduction of intrapartum stillbirth (aOR 0.46, 95% CI 0.32–0.66) and neonatal mortality within 24 hours of life (aOR 0.51, 95% CI 0.31–0.83) after the intervention. Ventilation of infants increased (OR 2.56, 95% CI 1.67–3.93) and potentially harmful suctioning was reduced (OR 0.13, 95% CI 0.09–0.17). Neonatal death from intrapartum-related complications was reduced and preterm infants survived additional days in the neonatal period after the intervention. Low birth weight was not found to be a predictor of deferred resuscitation in the studied context. This study confirmed the robustness of Helping Babies Breathe as an educational tool for training in neonatal resuscitation. Accompanied with a quality improvement cycle it reduced intrapartum stillbirth and mortality on the day of delivery in a low-income facility setting. Improved postnatal care is needed to maintain the gains in survival through the neonatal period. Increased management involvement in audit and quality of care could improve clinical performance among health workers.

<p>The overall aims of this research were to develop methods of identifying adolescents with unhealthy and/or risk-taking behavior with special reference to sexuality, and to evaluate support measures for young people in need of such interventions. A further aim was to assess strategies for preventing unhealthy and/or risk-taking behavior. Data were obtained by questionnaires (studies I, III, IV and V) and interviews (study II).</p><p>The results showed that young men involved in unintended pregnancies would benefit from active participation in the decision making regarding continuation or termination of the pregnancy, and from support at Outpatient Clinics for Adolescents in Sweden, including information together with the partner (I).</p><p>It was also concluded that consideration should be paid to questions and problems, e.g. feelings, apprehensions, moral issues and psychosocial factors, that require individual support from personnel with knowledge and resources to help young men in this difficult situation (II).</p><p>Among the most important findings regarding young men who had been involved in an unplanned pregnancy were that in this group a high percentage had previously considered suicide and that anabolic steroids were frequently used, compared with young men without experience of pregnancy (III).</p><p>The finding that unprotected intercourse occurred in a fairly high frequency among 13- to 18-year-olds, despite massive education and easy access to contraceptives, gives reason for further considerations regarding appropriate ways of providing information to young people (IV).</p><p>Girls and boys in vocational programs in Swedish high schools exhibit more risk-taking behaviors than those in theoretical programs and these two groups differ in clustering and accumulation of these behaviors. This means that preventive interventional strategies need to be elaborated with regard to these differences, with the aim of improving health maintenance among adolescents (V).</p><p>Child-and-youth centers with a developmental and research capacity need to be established with the broad purpose of drawing up health prevention programs for children and young people.</p>

The overall aims of this research were to develop methods of identifying adolescents with unhealthy and/or risk-taking behavior with special reference to sexuality, and to evaluate support measures for young people in need of such interventions. A further aim was to assess strategies for preventing unhealthy and/or risk-taking behavior. Data were obtained by questionnaires (studies I, III, IV and V) and interviews (study II). The results showed that young men involved in unintended pregnancies would benefit from active participation in the decision making regarding continuation or termination of the pregnancy, and from support at Outpatient Clinics for Adolescents in Sweden, including information together with the partner (I). It was also concluded that consideration should be paid to questions and problems, e.g. feelings, apprehensions, moral issues and psychosocial factors, that require individual support from personnel with knowledge and resources to help young men in this difficult situation (II). Among the most important findings regarding young men who had been involved in an unplanned pregnancy were that in this group a high percentage had previously considered suicide and that anabolic steroids were frequently used, compared with young men without experience of pregnancy (III). The finding that unprotected intercourse occurred in a fairly high frequency among 13- to 18-year-olds, despite massive education and easy access to contraceptives, gives reason for further considerations regarding appropriate ways of providing information to young people (IV). Girls and boys in vocational programs in Swedish high schools exhibit more risk-taking behaviors than those in theoretical programs and these two groups differ in clustering and accumulation of these behaviors. This means that preventive interventional strategies need to be elaborated with regard to these differences, with the aim of improving health maintenance among adolescents (V). Child-and-youth centers with a developmental and research capacity need to be established with the broad purpose of drawing up health prevention programs for children and young people.

Bakgrund: Förekomsten av övervikt och fetma bland barn ökar i stora delar av världen. Brist på fysisk aktivitet är en av orsakerna bakom övervikt och fetma. För barn med fetma kan små mängder fysisk aktivitet ha stora positiva hälsoeffekter. Det finns ett behov av att utveckla nya effektiva strategier för att öka mängden fysisk aktivitet bland barn med övervikt eller fetma. Mobil hälsa (m-hälsa) används som ett paraplybegrepp för hälsotjänster förmedlade genom mobila enheter och definieras som ”medicinsk eller offentlig hälsoutövning som stöds av mobila enheter så som mobiltelefoner, anordningar för patientövervakning, personliga digitala assistenter och andra trådlösa enheter”. En potentiell strategi för att påverka mängden fysisk aktivitet bland barn med övervikt eller fetma är m-hälsa genom användning av mobiltelefon. Syfte: Att kartlägga och beskriva vilka interventioner med m-hälsokomponent genom användning av mobiltelefon som utvärderat fysisk aktivitet eller Body Mass Index (BMI) bland barn med övervikt eller fetma. Metod: En systematisk litteraturstudie där studier som beskrev interventioner med mhälsokomponenter för målgruppen barn 0-18 år med övervikt eller fetma inkluderades. Sökning genomfördes i tre vetenskapliga databaser. Resultat: Sökningarna resulterade i 649 studier av vilka 16 mötte uppsatta inklusionskriterier. M-hälsokomponenten innefattade i de flesta studier användning av sms och i några studier användning av app. Funktionen med m-hälsokomponenten studerades och delades in i självregistrering, kommunikation, uppmuntran, utbildning och påminnelse. De inkluderade studierna rapporterade olika former av BMI där två studier visade på signifikanta skillnader mellan interventions-och kontrollgrupp med störst minskning för interventionsgruppen. Få studier rapporterade objektivt mätt tid i fysisk aktivitet på måttlig till hög intensitet. Slutsats: Den vanligast förekommande interventionen med m-hälsokomponent genom användning av mobiltelefon bland barn med övervikt eller fetma var sms. För att kunna förstå och jämföra på vilket sätt m-hälsa kan användas skulle ett ramverk för beskrivning av dessa interventioner underlätta. / Background: The presence of overweight and obesity among children is increasing in large parts of the world. Lack of physical activity is one of the causes of overweight and obesity. For children with obesity, small amounts of physical activity may have major positive health effects. There is a need to develop new effective strategies to increase the amount of physical activity among children with overweight or obesity. Mobile health (mHealth) is used as an umbrella term for health services transmitted by mobile devices and is defined as "medical or public health practice supported by mobile devices such as mobile phones, patient monitoring devices, personal digital assistants and other wireless devices." A potential strategy for influencing the amount of physical activity in children with overweight or obesity is mHealth through the use of mobile phones. Objective: To examine and describe what interventions with mHealth component through the use of mobile phones that evaluated physical activity or Body Mass Index (BMI) in children with overweight or obesity. Methods: A systematic literature study in which studies describing interventions with mHealth components for the target group of children 0-18 years of overweight or obesity were included. Search was conducted in three scientific databases. Results: The searches resulted in 649 studies, of which 16 met set inclusion criteria. In most studies, the mHealth component included the use of text messaging and in some studies the use of app. The function of the mHealth component was studied and divided into self-registration, communication, encouragement, education and reminder. The included studies reported different forms of BMI where two studies showed significant differences between the intervention and control group with the greatest reduction for the intervention group. Few studies reported objectively measured time in physical activity of moderate to high intensity. Conclusion: The most common intervention with mHealth component through the use of mobile phones among children with overweight or obesity was text messaging. In order to understand and compare how mHealth can be used, a framework for the description of these interventions would facilitate.

Infusion pumps administer medications like morphine to pediatric patients in order to manage pain. Drug delivery delays can be the result of flow rate variabilities in the infusion pump system. Due to the risk of over-or underdosing, this could have a high impact on the pediatric population. This study’s aim is to investigate the effect of drug dilution and dosing delays by investigating which factors affect the morphine concentration in the patient. Implementation of a previously developed population pharmacokinetic model was performed in MATLAB. Then combining it with a self-developed model of the infusion pump system, a model which included the infusion pump and the system between the pump and the patient. Simulations were performed to investigate the contributing factors. The results show that dosing delays decrease with an increasing patient’s age. There are larger morphine concentration variations with lower syringe flow rates. A decrease in dosage and a smaller syringe volume result in a shorter time of reaching a steady state concentration. Using the wrong syringe which is not compatible with the machine will lead to an increasing morphine concentration in the patient that does not reach a steady state. A limitation of the study was that no clinical data was used for the simulations. These results are useful for clinicians when making decisions regarding intravenous administration of morphine, potentially leading to fewer medication errors. / Infusionspumpar administrerar läkemedel som morfin till pediatriska patienter för smärtlindring. Fördröjning av läkemedelstillförsel kan vara resultatet av flödeshastighetsvariationer i infusionspumpsystemet. På grund av risken för över- eller underdosering kan detta ha en stor inverkan på den pediatriska populationen. Denna studies syfte är att undersöka effekten av läkemedels- utspädning och -fördröjning genom att undersöka vilka faktorer som påverkar koncentrationen av morfin i patienten. Implementering av en tidigare utvecklad populationsfarmakokinetisk modell gjordes i MATLAB . För att sedan kombinera den med en egenutvecklad modell av infusionspumpsystemet, en modell som inkluderade infusionspumpen och systemet mellan pumpen och patienten. Simuleringar utfördes för att undersöka de bidragande faktorerna. Resultaten visar att doseringsfördröjningar minskar med patientens stigande ålder. Det finns större koncentrationsvariationer med lägre sprutflödeshastig- heter. En minskning av dosen och en mindre sprutvolym resulterar i en kortare tid för att uppnå en steady state-koncentration. Användning av fel spruta som inte är kompatibel med maskinen kommer att leda till en ökad morfinkon- centration hos patienten som inte når ett stabilt tillstånd. En begränsning med studien var att inga klinisk data användes för simuleringarna. Dessa resultat är användbara för läkare när de fattar beslut om intravenös administrering av morfin, vilket potentiellt kan leda till färre medicineringsfel.

Atopic dermatitis (AD) and other atopic diseases are strongly related to skinbarrier dysfunction, a biomeasure which has limited and unsatisfactory assessmenttechniques. Machine learning (ML) powered electrical impedance spectroscopy(EIS) has been shown to differentiate defective barrier function in mice and adults. Techniques such as principal component analysis (PCA) andsupport vector classifiers (SVC) can be used as ML tools to evaluate EIS measurements. EIS measurements taken on unaffected skin of children aged between 4 monthsand 3 years were collected and analysed using the children’s AD status. Measurements were grouped into one of four groups based on this AD status; No AD (No AD was developed up until 2 years of age), Pre AD (measurements takenbefore the onset of AD), AD remission (measurements taken after the onset ofAD) and AD flare (measurements taken during active AD). A SVC model was trained on the raw EIS measurement data to distinguish measurements from twoof the binarized AD status groups; AD flare and No AD. An additional SVC model was trained on the No AD group, distinguishing measurements based onbinarized age groups: measurements taken at 4 months against measurements taken at 3 years of age. The AD model tested on AD flare against No AD within the test set yielded AUC of 0.92, with a sensitivity and specificity of 89.29% and 88.89% respectively. When testing on all groups of the test set, Pre AD and AD remission groups had group means between the AD flare and No AD groups. No data bias against age was detected in the model. The results of the age model showed that age could be chronologically identified by the age model. The AD model was able to differentiate active AD children from children never experiencing AD symptoms on visually unaffected skin and in turn detecting skin barrier dysfunction. Separate studies would need to be conducted to test the predictive power and external validity of the model. Age is a significant factor to consider when designing ML models using EIS data in children, with proper balance in the training set a data bias within the model can be avoided. EIS is a versatile technique due to its data rich nature. Machine learning powered electrical impedance spectroscopy measurements are able to detect skin barrier dysfunction. Age is a significant factor when measuring EIS on children, but can be managed. / Atopisk dermatit (AD) och andra atopiska sjudomar är starkt kopplade tillhudbarrärdefekter, en hudegenskap där diagnosverktygen är begränsade och otillräckliga. Maskininlärning (ML) i kombination med elektrisk impedansspektroskopi (EIS) har visats att kunna differentiera defekta hudbarrärer i möss och hos vuxna människor. Tekniker såsom principalkomponentanalys (PCA) och stödvektormaskiner (SVM) kan användas som ML verktyg för att utvärdera EIS-mätningar. Statistiska analysverktyg såsom reciever operator characteristics (ROC) tillsammans med arean under kurvan (AUC) och andra precisionsmått kan användas för att utvärdera ML modeller. EIS-mätningar utförda på opåverkad hud hos barn mellan 4 månader och 3 års ålder samlades och analyserades med hjälp av barnens atopiska status. Samtliga mätningarna grupperades i en av totalt fyra grupper baserade på deras atopiska status; Ingen AD (Ingen AD hade utvecklats upp till 2 års ålder), Pre AD (mätningarna togs innan sjukdomsförloppet), AD remission (mätningarna togs efter sjukdomsförloppet) och AD aktiv (mätningarn togs under sjukdomsförloppet). En SVM modell tränades på EIS-rådata för att särskilja mellan två av grupperna binärt; AD aktiv och ingen AD. En ytterliggare SVM modell tränades på endast ingen AD-gruppen för att särskilja mellan mätningarna tagna vid åldrarna 4 månader och 3 år, omgjorta till binära grupper.  AD modellen testades med en jämförelse mellan AD aktiv-gruppen och ingen AD-gruppen med test data och resulterade i en AUC på 0.92, med en respektive sensitivitet och specificitet på 89.29\% samt 88.89\%. Modellen testades även på de ytterliggare grupperna i test datan, Pre AD och AD remission som båda hade gruppmedelvärden som låg mellan AD aktiv-gruppens och ingen AD-gruppens. Inga systematiska fel med avseende på barnens ålder hittades i AD-modellen. Resultaten från ålders-modellen visade på att modellen kunde rangordna mätningarna baserat på ålder. AD-modellen kunde differentiera barn med aktiv AD mot barn som aldrig hade uppvisat atopiska symptom på opåverkad hud, vilket innebär en differentiering av hudbarrärdefekter. Separata studier är nödvändiga för att testa prediktiv prestanda hos modellen samt dess externa validitet. Ålder är en signifikant faktor när ML modeller med EIS-data ska designas, men med tillräcklig balans i träningsdatan kan systematiska fel förhindras. EIS är en versatil teknik med avseense på dess datakomplexitet. EIS tillsammans med maskininlärning kan särskilja defekta hudbarriärer hos barn. Ålder är en signifikant faktor när EIS mäts på barn, men kan hanteras.

Background. The current understanding on caries and enamel developmental defects prevalence and frequency, caries risk, health-related quality life (HRQoL) and stress response in young children with cleft lip and/or palate (CL/P) are sparse. In this thesis these aspects were investigated in 5- and 10- year-old children with CL/P in comparison to non-cleft children in the same ages. Design. The studies in this thesis have a cross-sectional case-control design. Participants. The study group consisted of 139 children with CL/P (80 children aged 5 years and 59 aged 10 years) and 313 non-cleft controls (144 children aged 5 years and 169 aged 10 years). Method. Caries was scored according to International Caries Detection and Assessment System (ICDAS II) and developmental enamel defects were measured as presence and frequency of hypoplasia and hypomineralization. Oral hygiene was assessed using Quigley-Hein plaque index. Stimulated saliva samples were analyzed for mutans streptococci, lactobacilli, buffering capacity and secretion rates. Information regarding children’s oral hygiene routines, dietary habits and fluoride exposure were collected with questionnaires. Caries risk was evaluated with algorithm-based software, Cariogram while HRQoL was perceived with KIDSCREEN-52. Stress response was analyzed with cortisol concentration in saliva at three different time points using a commercial competitive radioimmunoassay. Results. Caries prevalence (36% versus 18%) and caries frequency (1.2 dmfs versus 0.9 dmfs) was significantly higher in 5-year-old children with CL/P in comparison to non-cleft controls. In 10-yearolds no significant difference was found between children with CL/P and non-cleft controls in caries prevalence (47% versus 38%) or in caries frequency (0.7 DMFS versus 0.5 DMFS). Children with CL/P had significantly higher prevalence of enamel defects, higher counts of salivary lactobacilli and less good oral hygiene. The odds of being categorized with high caries risk were elevated in children with CL/P. Children with CL/P had similar HRQoL and salivary cortisol concentrations as non-cleft controls. However, 10-year-old boys with CL/P had significantly higher cortisol concentrations in the evening than non-cleft boys. Conclusions. Preschool children with CL/P seem to have more caries in the primary dentition than non-cleft controls. Children with CL/P had increased odds of being categorized as high caries risk individuals compared to controls. Some of the contributing factors seem to be higher prevalence of enamel defects, impaired oral hygiene and elevated salivary lactobacilli. Furthermore, as measured with the help of cortisol concentrations in saliva, children with CL/P were not more stressed than noncleft controls and their HRQoL was comparable to a European norm population. It appears that regular comprehensive preventive oral care in children with CL/P is effective in preventing caries development in permanent teeth. However, children with CL/P are at risk of caries development and preventive oral care should be implemented and started earlier than today.