A Longitudinal Study of Maternal Postnatal Bonding and Psychosocial Factors that Contribute to Social-Emotional Development.

In this longitudinal study, we examined how maternal bonding and psycho-social factors are associated with social-emotional problems in two-year-old children. Our data came from a birth cohort from which data were collected at four timepoints: prenatally during the third trimester, and postnatally at 3, 8 and 24 months. The participants were 1,667 mothers, of which 943 (56.6%) returned the questionnaire at each timepoint of the longitudinal study. The Children's social-emotional problems were examined using the Brief Infant-Toddler Social and Emotional Assessment. According to linear regression analysis, maternal bonding difficulties at three and eight months, maternal expectations of the unborn baby during pregnancy, and maternal relationships within and outside the family were related to social-emotional problems in children of two years of age. The results highlight the importance of screening mothers who already prenatally have bonding problems or mothers who have bonding problems postnatally to provide effective and targeted intervention support.

The significance of supportive and undermining elements in the maternal representations of an unborn baby.

OBJECTIVE: The maternal representations of an unborn baby begin to develop during pregnancy. However, the factors that moderate them are not well identified. The objective of this study was to jointly explore supportive and undermining factors in the maternal representations of an unborn baby and motherhood. METHODS: Cross-sectional data comprising 1646 women studied during the third trimester of pregnancy. Maternal expectations were measured using a 12-item self-report questionnaire, Mother's Representations about an Unborn Baby. Depression, anxiety, family atmosphere and adult attachment were measured using standardised questionnaires. Statistical analysis is based on multivariate linear regression analysis. RESULTS: The most powerful predictors of a mother's prenatal expectations were the mother's educational status, age, closeness in adult relationships, higher levels of depressive symptoms and family atmosphere. In accordance with our hypothesis, depression was related to the mother's more negative expectations on their relationship with the unborn baby and on regularity in the baby's sleeping and eating patterns. A positive family atmosphere and the mother's ability for closeness and dependence (i.e. confidence) in adult relationships were related to more positive expectations of the mother-unborn baby relationship. On the other hand, stress, anxiety and adverse life events were not related to the mother's expectations of her unborn baby. CONCLUSIONS: The results may be helpful in identifying families who need early professional support and call for studies where the prenatal phase is explored as a proactive phase for the development of the child-parent relationship.

Physical activity, cardiorespiratory fitness, and metabolic outcomes in monozygotic twin pairs discordant for body mass index.

This study aims to investigate (i) how monozygotic (MZ) twin pairs who are discordant for body mass index (BMI) differ for objectively and subjectively measured physical activity (PA) and cardiorespiratory fitness (VO2 max) and (ii) associations of PA and VO2 max with adiposity and measures of metabolic health, in individual twins and independent of genetic and shared environmental effects within twin pairs. We examined 27 BMI-discordant and 14 BMI-concordant MZ twin pairs. Fat and fat-free mass (ffm) were measured by dual-energy X-ray absorptiometry and VO2 max by spiroergometry. PA was measured objectively by accelerometers using ActiGraph GT1M for daytime activity and Actiwatch AW7 for 24 h/d. Self-reported PA was obtained through the Baecke and IPAQ long-form questionnaires. Objectively measured moderate-to-vigorous PA (MVPA, min/d), steps/d, and VO2 max/kg were significantly lower, by 30%, 21%, and 14%, respectively, in the heavier compared with the leaner co-twins of the BMI-discordant twin pairs. There were no significant differences in self-reported PA or VO2 max/ffm. As expected, PA and VO2 max/ffm were similar in the BMI-concordant co-twins. Furthermore, the 24-h recording of activity suggested that the heavier co-twins had more restless sleep during the night, whereas the leaner co-twins were more active during the day. Within all twin pairs, higher MVPA and steps per day were associated with lower fat percentage and improved metabolic health measures. Objectively, but not subjectively measured PA is associated with lower fat percentage and better metabolic health, independent of genetic and shared environmental factors.

Do parental co-viewing and discussions mitigate TV-induced fears in young children?

BACKGROUND: While excessive television viewing has been associated with negative outcomes in children's welfare, parental co-viewing has been suggested as an effective way to prevent these negative effects. The objective of the present study is to specify some social contexts of co-viewing and to assess whether co-viewing modifies the effects of media on children's TV-related fears. METHODS: The study is based on a representative random sample of 331 children aged 5-6 years. It is based on parental reports of children's TV-related fears and family television viewing practices. RESULTS: Parental co-viewing and discussion of television programmes with the child were found to be associated with higher rates of children's TV-related fears, high television exposure in general and watching adults' television programmes. The association between TV-related fears and co-viewing remained significant even after controlling for gender, maternal education, family income and the quantity and quality of television viewing. Co-viewing and TV-related discussions increased the risk for TV-related fears nearly fourfold (adjusted odds ratio 3.92, 95% confidence interval 1.37-11.17 and adjusted odds ratio 3.31, 95% confidence interval 1.33-8.20, respectively). CONCLUSIONS: The findings suggest that co-viewing and discussing television programmes are more common in families where television exposure is high. Because both co-viewing and discussing television programmes were associated with higher fear scores regardless of the quantity and quality of television exposure, the research shows that in everyday life co-viewing may not be done in such a way that it leads to a reduction of children's fears. More studies are needed to explore the co-viewing practices of families in more detail.

Current incidence and management of children with traumatic head injuries: the Stockholm experience.

PURPOSE: A traumatic head injury is one of the most common causes of morbidity and mortality among children, however few population-based studies in this area have been reported. Therefore, the aim of this study was to evaluate the incidence and management of traumatic head injuries in children at a level-one trauma centre in Stockholm, Sweden. PARTICIPANTS: All children (n = 3168) who visited the emergency department with a history of head injury during 1 year were included. METHOD: The required information was collected retrospectively and the children's medical records were reviewed. RESULTS: The overall incidences of head injury were 865 per 100 000 children with the highest incidence (2379/10(5) children) occurring among children younger than 18 months of age. Twelve per cent (n = 396) were admitted to a hospital ward and CT scans were performed in 13% (n = 412) of all children. During this year, 0.3% required a neurosurgical intervention and only 1% of all children had documentation of a planned follow-up appointment. CONCLUSION: The findings indicate that clinical documentation as a part of the early management in children with a head injury is inconsistent and suffers from lack of valid criteria. Implementation of clinical guidelines during emergency care would help improve subsequent hospital care, as well as the planning of health care services for these children.

Poor sleep and psychiatric symptoms at school: an epidemiological study.

The objective of this study was to evaluate associations between sleep problems and psychiatric symptoms at school. A random sample consisting of 5813 eight- to nine-year-old children was selected from ordinary schools. Both parents' and children's reports of sleep problems were taken into account. The psychiatric symptoms were addressed according to the teachers' reports (the Rutter Scale B). Children with severe sleep problems were more likely to have a psychiatric disturbance according to the Rutter B Scale (OR 2.45, 95% CI 1.85-3.25). Logistic regression models showed that severe sleep problems were highly associated with emotional problems (OR 2.74, 95% CI 1.84-4.13), school attendance problems (OR 2.53, 95% OR 1.45-4.41), behavioural problems (OR 2.44, 95% CI 1.59-3.75) and hyperactivity (OR 2.02, 95% CI 1.30-3.13). Over 95% of severe sleep problems were reported only by the children themselves. In conclusion, children with severe sleep problems have substantially more teacher-reported psychiatric symptoms than those with no or mild sleep complaints. In diagnosing sleep disorders, it is important to include children as informants because relevant information may be overlooked when only parents are questioned.

Associations of age and gender with activity and sleep.

Associations between age/gender and activity/sleep (measured by actigraphs) in 66 healthy children aged 5-12 y were studied. With increasing age, daytime motor activity and total sleep time decreased and activity pattern changed. No gender differences were found. It was concluded that in this age group there is an age-dependent change in the amount and pattern of motor activity and sleep due to developmental and/or environmental factors.

Sleep and psychiatric symptoms in school-age children.

OBJECTIVE: To assess associations between the quantity and quality of children's sleep and parent- and teacher-reported psychiatric symptoms. METHOD: Forty-nine physically healthy 7- to 12-year-old children from normal classes participated. They were monitored for 72 consecutive hours with belt-worn activity monitors (actigraphs) to obtain objective data on their daytime and nighttime activity and sleep. In addition, Child Behavior Checklists and Teacher's Report Forms were filled out by the parents and teachers, respectively. RESULTS: Quantity of sleep was significantly associated with total symptom score on the Teacher's Report Form. The highest associations were found between low true sleep time and teacher-reported externalizing symptoms such as aggressive and delinquent behavior and attention and social problems. Sleep parameters were not associated with parent-reported psychiatric symptoms, except for the association found between delayed sleep latency and aggressive, delinquent behavior. CONCLUSIONS: The objectively measured amount of school-age children's sleep was associated with teacher-reported psychiatric symptoms. Parents may be unaware of their child's sleep deficiencies as the behavioral problems may be more evident at school than at home. Sensitive and objective measurements are needed to rule out the possibility of inadequate sleep underlying behavioral problems.

Sleep problems of school-aged children: a complementary view.

The aim of this population-based multicentre study was to evaluate the prevalence rates of sleep problems among 8-9-y-old children. The sample consisted of 5813 Finnish children, making up 10% of the age cohort. Both parents and children provided information. Disturbed sleep was reported by 21.7% of parents. Most of the problems were mild; only 0.3% were serious. Dyssomnias were frequent: 11.1% had difficulties with sleep onset, 7.1% with night waking and 2.3% with waking too early. Multiple sleep problems were present in 9.1% of the children. 17.8% of children reported disturbed sleep, 12.7% had problems many nights and 5.1% every night. In 32.0% of cases, either the parent or the child reported disturbed sleep; 7.4% of these reports came from both the parent and the child, 14.1% from the parent only and 10.3% from the child only. The correspondence between informants was poor (kappa = 0.224). Sleeping problems were associated with somatic and psychiatric problems. It is concluded that by restricting questioning to parents only, one-third of all potential cases of sleep problems may go unnoticed. In order to increase the sensitivity of screening children's sleep problems, both parents and children should provide information in epidemiological settings as well as in clinical work.