Childcare use and overweight in Finland: cross-sectional and retrospective associations among 3- and 5-year-old children.

BACKGROUND: Different types of non-parental childcare have been found to associate with childhood overweight in several, but not all studies. Studies on the matter are mainly North American. OBJECTIVES: The objective of our study was to examine associations between childcare use and overweight in Finland. METHODS: The cross-sectional and partly retrospective data consists of 1683 3- and 5-year-old children participating in the Child Health Monitoring Development project (LATE-project) conducted in 2007-2009 in Finland. Children were measured at health check-ups and information on child's age when entering childcare, the number of childcare places the child has had, current type of childcare (parental, informal, [group] family childcare, childcare centre) and the current amount of childcare (hours) were gathered. Parents' body mass indices, family educational level, family structure, maternal smoking during pregnancy and child's birth weight were treated as covariates. RESULTS: Beginning childcare before age 1 (adjusted model: odds ratio [OR] 2.53, 95% confidence interval [CI] 1.41-4.52) and, for girls only, number of childcare places (adjusted model: OR 1.33, 95% CI 1.11-1.60), were associated with an increased risk of overweight. The current type of childcare or the time currently spent in childcare was not associated with overweight. CONCLUSION: Beginning childcare before age 1, which is quite rare in Finland, and having attended several childcare places were associated with overweight even when adjusting for family socioeconomic status and other family background variables. The significance of these findings needs to be further studied.

Health behaviors, waist circumference and waist-to-height ratio in children.

BACKGROUND: Waist circumference (WC) and waist-to-height ratio (WHtR) begin to gain attention as measures of adiposity and as important cardiometabolic disease risk factors also among children. Still, little research has been done on behavioral determinants of WC and WHtR in children. The purpose of this study was to examine associations between health behaviors, WC and WHtR in children. METHODS: The study was a cross-sectional study conducted in Swedish-speaking schools in Helsinki region in 2006. In all, 1146 children were recruited, from which 55 % took part in the study. A total of 604 9-11-year-old children (312 girls, 292 boys) were measured by research staff and completed a study questionnaire on their health behaviors, including breakfast intake, TV viewing, sleep duration and physical activity, and a 16-item food frequency questionnaire. Covariance analysis was used as the statistical analysis method. RESULTS: When controlling for other health behaviors, for example, irregular breakfast (B-coefficient 2.49 CI, 0.64-4.34; P<0.01), TV viewing (B-coefficient 0.89 CI, 0.17-1.61; P<0.05), a TV in child's room (B-coefficient 2.30 CI, 0.73-3.86; P<0.01) and physical inactivity during school breaks (B-coefficient 0.78 CI, 0.19-1.37; P<0.01) were associated with larger WC. Results were similar with WHtR. CONCLUSIONS: Many health behaviors were related to children's WC and WHtR. Determinants were associated to both WC and WHtR similarly.

Helicobacter pylori in alcohol induced acute pancreatitis.

BACKGROUND AND AIMS: The objective of this study was to measure the association of Helicobacter pylori infection with alcoholic acute pancreatitis. MATERIAL AND METHODS: This study comprised of 50 patients with their first alcoholic pancreatitis and 50 alcoholic controls with no history of pancreatitis but similar alcohol use recruited from an alcohol rehabilitation center. Helicobacter infection was measured using Enzygnost EIA IgG-test. Complications and length of hospital stay were also recorded in patients with alcoholic pancreatitis. RESULTS: The seroprevalence of Helicobacter pylori was 10/50 (20%) in the pancreatitis group and 15/50 (30%) in the control group (p = NS). The median length of hospital stay of pancreatitis patients was 7 days, 11 days for those tested positive (range 6-25) and 6 days for those tested negative (range 3-47) for Helicobacter pylori, p = 0.013. As determined with the Atlanta criteria, seropositive patients tended to have more often severe pancreatitis, 4/10 (40%) vs. 6/40 (15%), OR 3.78 (95% CI 0.815-17.52), p = 0.097. CONCLUSIONS: This study suggests that Helicobacter pylori infection is not associated clinically significantly with the development of alcoholic pancreatitis. However, Helicobacter pylori infection may be associated with longer hospital stay due to more severe disease, which needs to be studied in a larger series of patients.

Anxiety and directed attention in women awaiting breast cancer surgery.

PURPOSE/OBJECTIVES: To investigate the relationship between anxiety and directed attention (the ability to focus and concentrate) in women awaiting breast cancer surgery and the potential influence of age and extent of anticipated surgery (breast conservation versus mastectomy) on attentional functioning and anxiety. DESIGN: Descriptive, cross-sectional. SAMPLE AND SETTING: Convenience sample of 45 women newly diagnosed with localized breast cancer at a Midwestern university medical center. METHODS: Subjects were assessed approximately 11 days before surgery using objective measures of attention: Digit Span, the Symbol Digit Modalities Test, the Necker Cube Pattern Control Test, the Attentional Function Index (a subjective measure of effectiveness of attentional functioning), and the Tension-Anxiety subscale of the Profile of Mood States. MAIN RESEARCH VARIABLES: Capacity to direct attention, perceived attentional functioning, anxiety level, age, and extent of anticipated breast surgery. FINDINGS: Level of anxiety was related inversely (r = -0.63, p < 0.01) to perceptions of attentional functioning but not to performance on any objective measures of attention in the pretreatment period. No differences in anxiety level existed in regard to age or extent of anticipated surgery. However, older women (> or = 55 years) showed overall significantly lowered (p < 0.001) performance on the attentional measures than younger women. CONCLUSIONS: Preoperative anxiety is a clinically significant issue in women newly diagnosed with breast cancer regardless of age and extent of anticipated surgery. Higher anxiety requires use of attentional resources and initially may act to reduce perceptions of effectiveness in attentional functioning. Older women who have high anxiety combined with both subjective and objective decline in attentional functioning may be at particularly high risk for attentional fatigue. IMPLICATIONS FOR NURSING PRACTICE: Women newly diagnosed with breast cancer may experience not only increased anxiety and associated perceptions of decreased attentional functioning but also a subsequent depletion of attentional reserves as a result of the onset of attentional fatigue. Nurses can assess anxiety in women during the preoperative period and assist them in coping with the psychological and cognitive demands associated with this highly stressful period.