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  • 101.
    Janson, Staffan
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Sundelin, C
    Starrin, Bengt
    Karlstad University, Faculty of Social and Life Sciences, Department of Social Studies.
    Fattiga barns hälsa i det rika Europa2001In: Läkartidningen, 2001, 24, 98, 2914-2918Article in journal (Refereed)
  • 102.
    Janson, Staffan
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Svensson, Birgitta
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Funktionsnedsättning och utsatthet2012In: Barn med funktionsnedsättning, Lund: Studentlitteratur AB, 2012, 1, p. 75-84Chapter in book (Other academic)
  • 103.
    Janson, Staffan
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Svensson, Birgitta
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Långberg, Bodil
    Stiftelsen Allmänna Barnhuset .
    Sweden: A 30-Year Ban on Physical Punishment of Children2011In: Global Pathways to Abolishing Physical Punishment: Realizing Children's Rights / [ed] J. E. Durrant, A. B. Smith, New York: Routledge, 2011, 1, p. 241-255Chapter in book (Refereed)
  • 104.
    Janson, Staffan
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Wolfe, Ingrid
    Cass, Hilary
    Thompson, Matthew J
    Craft, Alan
    Peile, Ed
    Wiegersma, Pieter A
    Chambers, T L
    McKee, Martin
    How can we improve child health services?2011In: BMJ. British Medical Journal, E-ISSN 1756-1833, Vol. 342, p. 901-904Article in journal (Refereed)
    Abstract [en]

    Western European health systems are not keeping pace with changes in child health needs. Non-communicable diseases are increasingly common causes of childhood illness and death. Countries are responding to changing needs by adapting child health services in different ways and useful insights can be gained through comparison, especially because some have better outcomes, or have made more progress, than others. Although overall child health has improved throughout Europe, wide inequities remain. Health services and social and cultural determinants contribute to differences in health outcomes. Improvement of child health and reduction of suffering are achievable goals. Development of systems more responsive to evolving child health needs is likely to necessitate reconfiguring of health services as part of a whole-systems approach to improvement of health. Chronic care services and first-contact care systems are important aspects. The Swedish and Dutch experiences of development of integrated systems emphasise the importance of supportive policies backed by adequate funding. France, the UK, Italy, and Germany offer further insights into chronic care services in different health systems. First-contact care models and the outcomes they deliver are highly variable. Comparisons between systems are challenging. Important issues emerging include the organisation of first-contact models, professional training, arrangements for provision of out-of-hours services, and task-sharing between doctors and nurses. Flexible first-contact models in which child health professionals work closely together could offer a way to balance the need to provide expertise with ready access. Strategies to improve child health and health services in Europe necessitate a whole-systems approach in three interdependent systems—practice (chronic care models, first-contact care, competency standards for child health professionals), plans (child health indicator sets, reliable systems for capture and analysis of data, scale-up of child health research, anticipation of future child health needs), and policy (translation of high-level goals into actionable policies, open and transparent accountability structures, political commitment to delivery of improvements in child health and equity throughout Europe).

  • 105.
    Jansson, Staffan
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences. Örebro University.
    Malmberg, F.
    Örebro University.
    Barn som far illa: Alla barn måste skyddas från kränkningar2014In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 111, no 47, article id 2090Article in journal (Refereed)
    Abstract [en]

    Sweden was the first country in the world to introduce a corporal punishment ban in 1979. Corporal punishment was looked upon as a normal part of upbringing in the 1960s, but today more than 90 % of all Swedish parents regard this as a deviant behavior. While the diagnostic tools for establishing of intentional injuries are continuously refined, neglect of children has been more difficult to define and describe. In later years, however, it has been obvious that neglect for many children is chronic and with long-term effects that are just as devastating as corporal punishment and sexual abuse. All over the world a more ecological view on family violence is developing, also taking into account countries’ social, cultural and political conditions.

  • 106.
    Jernbro, Carolina
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Janson, Staffan
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Bornehag, Carl-Gustaf
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Barns liv och hälsa i Värmland 20142015Report (Other (popular science, discussion, etc.))
  • 107.
    Jernbro, Carolina
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Eriksson, Ulla-Britt
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Young adult's personal views on childabuse2010In: Nordic Journal of Social Research, ISSN 1892-2783, Vol. 1, p. 1-16Article in journal (Refereed)
  • 108.
    Jernbro, Carolina
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Otterman, Gabriel
    Uppsala universitet.
    Tindberg, Ylva
    Uppsala universitet.
    Lucas, Steven
    Uppsala universitet.
    Janson, Staffan
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Disclosure of maltreatment and perceived adult support among Swedish adolescents2017In: Child Abuse Review, ISSN 0952-9136, E-ISSN 1099-0852, Vol. 26, no 6, p. 451-464Article in journal (Refereed)
  • 109.
    Jernbro, Carolina
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Svensson, Birgitta
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Tindberg, Y
    Uppsala universitet.
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Multiple psychosomatic symptoms can indicate child physical abuse: results from a study of Swedish schoolchildren2012In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 101, no 3, p. 324-9Article in journal (Refereed)
    Abstract [en]

    AIM:

    To examine whether children with self-reported experiences of either physical abuse alone or combined with intimate partner violence report more psychosomatic symptoms than other children and to explore whether these possible associations are enhanced by school-related factors, chronic condition and demographic factors.

    METHODS:

    A national cross-sectional study of 2771 pupils in grades 4, 6 and 9 from 44 schools in Sweden was carried out in 2006 (91% response rate). Data were analysed with univariate tests (chi-square), multiple logistic regression analyses and stratified logistic regression analyses, expressed as crude odds ratio (OR) and adjusted odds ratio (AOR) with 95% confidence intervals.

    RESULTS:

    There was a strong association between reported physical abuse and multiple (three or more) psychosomatic symptoms among schoolchildren (AOR 2.12). Chronic condition was the only determinant that had an obvious enhancing effect on the association between physical abuse and psychosomatic symptoms in childhood.

    CONCLUSION:

    This study shows that multiple psychosomatic symptoms are associated with child physical abuse. Health professionals therefore need to pay special attention to schoolchildren who complain about the co-occurrence of psychosomatic symptoms and pattern of symptoms, which could not be easily explained by other causes.

  • 110.
    Jernbro, Carolina
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Tindberg, Ylva
    Uppsala universitet.
    Lucas, Steven
    Uppsala universitet.
    Janson, Staffan
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Quality of life among Swedish school children who experienced multitype child maltreatment2015In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 104, no 3, p. 320-325Article in journal (Refereed)
    Abstract [en]

    AIM:The aim of this study was to examine the overlap between child maltreatment types and their association with quality of life among school children.

    METHODS:A national cross-sectional study of 3202 grade nine Swedish pupils of 15 years of age was carried out in 2011 with an 84% response rate. Data were analysed using Pearson chi-square and multiple linear regression analyses.

    RESULTS:Of the total sample, 650 children (20%) reported at least one type of maltreatment. There was a large degree of overlap between maltreatment types. In particular, neglect and witnessing intimate partner violence overlapped with most other types of maltreatment. There was a significant relationship between the degree of abuse and multitype maltreatment. Results showed a linear relationship between the number of types of maltreatment and quality of life (p < 0.001), indicating a dose-response relationship.

    CONCLUSION:The results emphasise the negative impact of child maltreatment on children's lives and highlight the importance of taking the broad spectrum of child maltreatment into account in both research and practice. A more comprehensive assessment of the width of maltreatment among professionals may help to identify the most seriously maltreated children and lead to an improved ability to target intervention and prevention at these children.

  • 111. Kalander Blomqvist, M.
    et al.
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Värmlänningarnas liv och hälsa 20042005Book (Refereed)
  • 112. Kalander Blomqvist, M.
    et al.
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Äldre i Värmland2007Book (Refereed)
  • 113.
    Kalander Blomqvist, Marina
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Janson, StaffanKarlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.Starrin, BengtKarlstad University, Faculty of Social and Life Sciences, Department of Social Studies.
    Värmlänningarnas liv & hälsa 20082009Collection (editor) (Other academic)
  • 114. Kalander-Blomquist, Marina
    et al.
    Nyberg, CeciliaJanson, StaffanKarlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Värmlänningars liv och hälsa 20122014Collection (editor) (Other (popular science, discussion, etc.))
  • 115.
    Koivula, Tanja
    et al.
    The Foundation for Disabled Children and Youth, Finland.
    Ellonen, Noora
    University of Tampere, Finland.
    Janson, Staffan
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Jernbro, Carolina
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Huhtala, Heini
    University of Tampere, Finland.
    Paavilainen, Eija
    University of Tampere, Finland; South Ostrobothnia Hospital District, Finland.
    Psychological and physical violence towards children with disabilities in Finland and Sweden2018In: Journal of Child Health Care, ISSN 1367-4935, E-ISSN 1741-2889, p. 1-15Article in journal (Refereed)
    Abstract [en]

    This article describes psychological aggression and physical violence by Swedish and Finnish mothers (N = 3420) towards their 0- to 12-year-old children with disabilities (N = 286) by comparing such behaviour with the mothers of children without disabilities (N = 3134). The survey data are based on representative samples from Finland and Sweden of mothers’ reports of their behaviour towards their child in conflict situations. Mothers of children with disabilities reported more psychological aggression towards their child than did mothers of children without disabilities. Mothers used psychological aggression, especially towards children with neurological/psychological disabilities. However, the only significant difference regarding physical violence was repetitive use of mild physical violence. Overall, the analysis suggests that children with neurological/psychological disabilities are more exposed to both psychological and physical violence than children without disabilities or children with somatic/developmental disabilities.

  • 116.
    Lahne, K
    et al.
    Uppsala university.
    Otterman, Gabriel
    Uppsala University.
    Janson, Staffan
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Alltför få oklara dödsfall bland barn utreds i Sverige2013In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 110, no 46Article in journal (Refereed)
  • 117.
    Larsson, Malin
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Hägerhed-Engman, Linda
    SP Technical Research Institute of Sweden, Borås, Sweden.
    Kolarik, Barbara
    Danish Building Research Institute (SBI), Department of Construction and Health, Horsholm, Denmark.
    James, P
    Harvard School of Public Health, Boston, MA, USA.
    Lundin, F
    County Council of Värmland, Karlstad, Sweden.
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Sundell, Jan
    1) Technical University of Denmark, International Centre for Indoor Environment and Energy, Denmark 2) University of Texas at Tyler, Texas, USA.
    Bornehag, Carl-Gustaf
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    PVC - as flooring material - and its association with incident asthma in a Swedish child cohort study2010In: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 20, no 6, p. 494-501Article in journal (Refereed)
  • 118.
    Larsson, Malin
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Hägerhed-Engman, Linda
    SP Technical Research Institute of Sweden, Borås, Sweden.
    Moniruzzaman, Syed
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Sundell, Jan
    1) Technical University of Denmark, International Centre for Indoor Environment and Energy, Denmark 2) University of Texas at Tyler, Texas, USA.
    Bornehag, Carl-Gustaf
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Can we trust cross-sectional studies when studying the risk of moisture related problems indoor for asthma in children?2011In: International Journal of Environmental Health Research, ISSN 0960-3123, E-ISSN 1369-1619, Vol. 21, no 4, p. 237-247Article in journal (Refereed)
  • 119.
    Larsson, Malin
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Hägerhed-Engman, Linda
    SP Technical Research Institute of Sweden, Borås, Sweden.
    Sigsgaard, Torben
    Institute of Public Health, Aarhus University, Department of Environmental and Occupational Medicine, Denmark.
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Sundell, Jan
    1) Technical University of Denmark, International Centre for Indoor Environment and Energy, Denmark 2) University of Texas at Tyler, Texas, USA.
    Bornehag, Carl-Gustaf
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Incidence rates of asthma, rhinitis and eczema symptoms and influential factors in young children in Sweden2008In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 97, no 9, p. 1210-1215Article in journal (Refereed)
    Abstract [en]

    Aim: To estimate the incidence rates for asthma, rhinitis and eczema symptoms and to investigate the importance of different influential factors for the incidence of these symptoms. Methods: The Dampness in Building and Health study commenced in the year 2000 in Värmland, Sweden with a parental questionnaire based on an ISAAC protocol to all children in the age of 1–6 years. Five years later a follow-up questionnaire was sent to the children that were 1–3 years at baseline. In total, 4779 children (response rate = 73%) participated in both surveys and constitute the study population in this cohort study. Results: The 5-year incidence of doctor-diagnosed asthma was 4.9% (95% CI 4.3–5.3), rhinitis was 5.7% (5.0–6.4) and eczema was 13.4% (12.3–14.5). However, incidence rates strongly depend on the health status of the baseline population. Risk factors for incident asthma were male gender and short period of breast-feeding. Allergic symptoms in parents were also a strong risk factor for incident asthma, as well as for rhinitis and eczema. Conclusion: When comparing incident rates of asthma between different studies it is important to realize that different definitions of the healthy baseline population will give rise to different incident rates.

  • 120.
    Larsson, Malin
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Bornehag, Carl-Gustaf
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Associations Between Different Background Factors and Parental-Reported Autism Spectrum Disorder (ASD) in Children 6-8 Years of Age2009Conference paper (Refereed)
  • 121.
    Larsson, Malin
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Weiss, Bernard
    Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA.
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Sundell, Jan
    1) Technical University of Denmark, International Centre for Indoor Environment and Energy, Denmark 2) University of Texas at Tyler, Texas, USA.
    Bornehag, Carl-Gustaf
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Associations between indoor environmental factors and parental-reported autistic spectrum disorders in children 6-9 years of age2009In: Neurotoxicology, ISSN 0161-813X, E-ISSN 1872-9711, no 30, p. 822-831Article in journal (Refereed)
  • 122.
    Lucas, Steven
    et al.
    Uppsala Univ, Dept Womens & Childrens Hlth, S-75185 Uppsala, Sweden..
    Jernbro, Carolina
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Tindberg, Ylva
    Uppsala Univ, Dept Womens & Childrens Hlth, S-75185 Uppsala, Sweden..
    Janson, Staffan
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences. Uppsala Univ, Dept Womens & Childrens Hlth, S-75185 Uppsala, Sweden..
    Bully, bullied and abused. Associations between violence at home and bullying in childhood2016In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 44, no 1, p. 27-35Article in journal (Refereed)
    Abstract [en]

    Aims: The aim was to examine experiences of bullying among Swedish adolescents and whether victims and perpetrators were also exposed to violence in the home, with particular focus on how abuse severity affected the risk of exposure to bullying. Methods: A nationally representative sample of pupils aged 14-15 responded to a questionnaire exploring exposure to corporal punishment and other types of violence. Results were analysed using Pearson's chi-square and multiple logistic regression, adjusting for factors regarding the child, the parents and the families' socioeconomic status. Results: Among the 3197 respondents, a significant proportion reported at least one incident of either bullying victimisation (girls 36%, boys 26%) or bullying perpetration (girls 24%, boys 36%). Physical and emotional violence in the home, including witnessed intimate partner violence, were significantly associated with both bullying victimisation and bullying perpetration. Odds ratios for exposure to bullying rose with increasing frequency and severity of abuse. Adjusted odds ratios ranged from 1.6 for any event of abuse vs. single episodes of bullying to 20.3 for multiple types of abuse vs. many episodes of bullying. The child's gender and the presence of a chronic health condition were consistently associated with nearly all levels of abuse and bullying. Conclusions: Bullying experiences are common among youth and are clearly associated with abuse. Frequent bullying, whether as victim or perpetrator, warrants particular vigilance, as it appears to be an indicator of severe violence in the home.

  • 123. Lundberg, K.
    et al.
    Eriksson, Ulla-Britt
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Norén, I.
    Elfstrand, T.
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Arbetslösa sjukskrivna. Fyra studier om arbetslöshet och långtidssjukskrivning2002Report (Other academic)
  • 124. McKee, M.
    et al.
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Counting the cost of violence in the Middle East2005In: European Journal of Public Health, Vol. Vol 15:2Article in journal (Refereed)
  • 125. Molarius, A
    et al.
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Self-rated health, chronic diseases and symptoms among middle aged and elderly men and women2002In: Journal of Clinical Epidemiology 2002;55. 364-370Article in journal (Refereed)
  • 126.
    Nilson, Finn
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Bodin, Maja
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Andersson, Ragnar
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Sammanfattning och rekommendationer2011Report (Other academic)
  • 127.
    Olsson, Ann
    et al.
    Primary Care Research Unit, County Council of Värmland, Karlstad.
    Fahlén, I.
    Department of Research and Public Health, County Council of Värmland, Torsby.
    Janson, Staffan
    Primary Care Research Unit, County Council of Värmland, Karlstad.
    Health behaviours, risk-taking and conceptual changes among schoolchildren aged 7 to 19 years in semi-rural Sweden2008In: Child Care Health and Development, ISSN 0305-1862, E-ISSN 1365-2214, Vol. 34, no 3, p. 302-309Article in journal (Refereed)
    Abstract [en]

    Background This study covers a broad age group (7–19 years) and includes a wide range of themes. The aim is to describe how various behaviours, complaints and conceptual changes come into play and to discuss the factors that might support or hamper the happiness and well-being of growing children and adolescents. We also discuss the implications of our findings for future prevention programmes. Methods This cross-sectional study included all schoolchildren in a semi-rural district in Sweden (2181 pupils). A structured classroom questionnaire was used but the children were also given the opportunity to describe in their own words what was important for their happiness and well-being. Results Mean response rate was 85%. Most changes in behaviour occurred between 11 and 14 years of age. Girls had a more rapid process of change than boys. Both girls and boys experienced stress in their relations with peers, parents and teachers. Gender differences in emotional support were prominent. Regardless of age and sex, all schoolchildren asked for a richer choice of leisure time activities, a place where they could meet with friends and caring teachers, parents and adults in the surrounding community. Conclusions Adolescence was perceived as a risky and problematic period not only by adults but also by the adolescents themselves. However, the perceived risks and the worries differed. While the adults mainly worried about the early onset of smoking and drug use, the schoolchildren worried about their social situation and their personal relationships. After decades of preventive programmes in Swedish schools, only modest results are seen. To be effective, future preventive programmes probably have to focus more on the conceptual world of the growing child.

  • 128.
    Olsson, Ann
    et al.
    Primärvårdens FoU-enhet.
    Hasselgren, Mikael
    Hagquist, Curt
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health.
    Janson, Staffan
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    The association between medical conditions and gender, well-being, psychosomatic complaints as well as school adaptability2013In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 102, no 5, p. 550-555Article in journal (Refereed)
    Abstract [en]

    Aim:

    The aim was to assess the association between medical conditions and gender,

    well-being, psychosomatic complaints and school adaptability. The second aim was

    to determine whether self-reported medical conditions should be included in class-room

    questionnaires that deal with well-being and risk behaviour.

    Methods:

    A cross-sectional class-room questionnaire was given to all 15- to 16-year-olds

    within a Swedish county. The questionnaire included background factors, subjective health,

    well-being, psychosomatic complaints, self image, drug use and also several themes

    from the school context. In addition, there were 13 medical conditions/problems to tick

    (yes or no) and an open alternative for other problems/medical conditions.

    Results:

    3108 questionnaires (response rate 84%) were analysed. The majority of the girls

    and the boys reported no medical conditions; however, 49% of the girls and 39% of the

    boys reported at least one medical condition. The medical conditions were associated with

    gender, well-being, psychosomatic complaints and school adaptability. The association was

    stronger for girls than for boys.

    Conclusion:

    Medical conditions among these teenagers were associated with gender, wellbeing,

    psychosomatic complaints and school adaptability, particularly for girls. Our results

    suggest that medical conditions could preferably be included in regular classroom

    questionnaires.

  • 129.
    Perhamre, S
    et al.
    Varmland Cty Council, Ctr Sports Med Varmland, Karlstad, Sweden..
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences. Varmland Cty Council, Dept Paediat, Karlstad, Sweden.
    Norlin, R
    Univ Orebro, Univ Hosp, Dept Orthopaed, Orebro, Sweden.
    Klässbo, M
    Univ Orebro, Univ Hosp, Dept Orthopaed, Orebro, Sweden.
    Sever's injury: treatment with insoles provides effective pain relief2010In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 21, no 6, p. 819-823Article in journal (Refereed)
    Abstract [en]

    Sever's injury (apophysitis calcanei) is considered to be the dominant cause of heel pain among children between 8 and 15 years. The traditional advice is to reduce and modify the level of physical activity. Recommended treatment in general is the same as for adults with Achilles tendon pain. The purpose of the study was to find out if insoles, of two different types, were effective in relieving heel pain in a group of boys (n = 38) attending a Sports Medicine Clinic for heel pain diagnosed as Sever's injury. The type of insole was randomized, and self-assessed pain during physical activity in the treatment phase with insoles was compared with pain in the corresponding pre- and post-treatment phases without insoles. There were no other treatments added and the recommendations were to stay on the same activity level. All patients maintained their high level of physical activity throughout the study period. Significant pain reduction during physical activity when using insoles was found. Application of two different types of insoles without any immobilization, other treatment, or modification of sport activities results in significant pain relief in boys with Sever's injury.

  • 130.
    Rantakeisu, Ulla
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies.
    Olsson, Eva
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies.
    Hagquist, Curt
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health.
    Janson, Staffan
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies.
    Berger, Sune
    Starrin, Bengt
    Karlstad University, Faculty of Social and Life Sciences, Department of Social Studies.
    Trött på den ekonomiska krisen?2009In: Värmlands Folkblad, Vol. 20, no oktoberArticle in journal (Other (popular science, discussion, etc.))
  • 131.
    Schyllander, Jan
    et al.
    Swedish Civil Contingencies Agency.
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Nyberg, Cecilia
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Eriksson, Ulla-Britt
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Ekman Stark, Diana
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences. Högskolan Väst.
    Case analysis of all children's drowning deaths occuring in Sweden 1998-20072013In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 41, no 2, p. 174-179Article in journal (Refereed)
    Abstract [en]

    Aims: The goal of this research project was to explore circumstances surrounding each drowning death occurring to children and adolescents ages 0–17 in Sweden during the years 1998–2007. Methods: Records from the National Board of Forensic Medicine (NBFM) and other sources were analysed. We collected information on children’spersonal characteristics (sex, age, ethnic background, weight, height, physical condition, and pre-existing health conditions) and the circumstances of deaths (time and place of occurrence, type of drowning, resuscitation efforts and medical care given, for example). We also collected information on prevention factors: the physical environment, adult supervision, whether or not the child could swim, and if the child was using a personal flotation device at the time of death. Results: Our analysis showed that 109 children had drowned in Sweden during the study period – of this group, 96 had died from unintentional causes. Children from immigrant backgrounds, particularly with families coming from the Middle East and Iran, were inordinately represented in the group of victims who had died from unintentional drowning deaths. Other risk factors included: coming from a single parent-headed family, alcohol use by older victims and a lack of ability to swim. Conclusions: Prevention efforts to prevent drowning in the future should focus on preventing alcohol use by young bathers; better fencing around swimming sites; improved coverage of swimming lessons to all children in Sweden, especially children from immigrant families; more education on drowning risks for single parents; and better awareness by adults on the need for constant supervision of children and adolescents in and near water.

  • 132. Starrin, B.
    et al.
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Secure Employment and Insecure Employment: Differences in self-reported health2006In: Unemployment and HealthArticle in journal (Refereed)
  • 133.
    Starrin, Bengt
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Social Studies.
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Typer av arbete, arbetslöshet och psykosocial ohälsa2005In: Arbetsmarknad & Arbetsliv, 11, 1, 33-43, 2005, Vol. 2005:11Article in journal (Refereed)
  • 134.
    Starrin, Bengt
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Social Studies.
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Unemployment, Secure Employment and Insecure Employment - Differences in Self Reported Ill Health2006In: Kieselbach, T., Winefield, A H., Boyd, C & Anderson, S (red) Unemployment and Health. International and Interdisicplinary Perspectives. Australian Academic Press, 2006, 2006Chapter in book (Refereed)
  • 135.
    Starrin, Bengt
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Social Studies.
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Molarius, A
    Värmlands kommunpolitiker Stora variationer i förtroendet2001In: Nya Wermlandstidningen, 2001, 15 augustiArticle in journal (Other (popular science, discussion, etc.))
  • 136.
    Starrin, Bengt
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Social Studies.
    Rantakeisu, Ulla
    Karlstad University, Faculty of Social and Life Sciences, Department of Social Studies.
    Kalander-Blomqvist, Marina
    Jansson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    I krisens spår: Levnadsvillkor och hälsa i spåren av den finansiella krisen2011Report (Other academic)
  • 137.
    Strukcinskiene, B
    et al.
    Faculty of Health Sciences, Klaipeda University, Lithuania.
    Andersson, Ragnar
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Suicide mortality trends in young people aged 15 to 19 years in Lithuania2011In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 100, no 11, p. 476-480Article in journal (Refereed)
    Abstract [en]

    AIM:

    This paper considers the suicide mortality trends from 1990-2009 in young people aged 15 to 19 years in Lithuania.

    METHODS:

    Suicide and injury mortality data, plus mortality data from all causes, were used to compare the trend lines.

    RESULTS:

    Suicide mortality rate in young people aged 15-19 years and in all population showed a rising trend from 1990, and then a decreasing trend from 2002 year. This trend was significant exclusively in boys. When comparing suicide deaths as a percentage of injury deaths and of all deaths in the age group 15-19 years, rising trends for boys were evident, whilst in girls, there was no evidence of change.

  • 138. Strukcinskiene, B
    et al.
    Marinkenas, A
    Towner, E
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Andersson, Ragnar
    Road traffic injury mortality in children and young people in transitional Lithuania - a longitudinal analysis2008Article in journal (Refereed)
  • 139. Strukcinskiene, B
    et al.
    Marinkenas, A
    Towner, E
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Andersson, Ragnar
    Road traffic injury mortality in children and young people in transitional Lithuania - a longitudinal analysis2008Other (Other (popular science, discussion, etc.))
  • 140. Strukcinskiene, B
    et al.
    Marinkenas, A
    Towner, E
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Andersson, Ragnar
    Road traffic injury mortality in children and young people in transitional Lithuania a longitudinal analysis from 1971 to 20052008In: Acta Paediatrica 2008; 97, pp.358-361Article in journal (Refereed)
  • 141. Strukcinskiene, B
    et al.
    Marinkenas, A
    Towner, E
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Andersson, Ragnar
    Road traffic injury mortality in children and young people in transitional Lithuania - a longitudinal analysis from 1971 to 20052007In: Accepted by Acta Paediatrica 2007Article in journal (Refereed)
  • 142.
    Svensson, Birgitta
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Andershed, Henrik
    Univ Orebro, Sch Law Psychol & Social Work, SE-70182 Orebro, Sweden..
    Janson, Staffan
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    A Survey of Swedish Teachers' Concerns for Preschool Children at Risk of Maltreatment2015In: Early Childhood Education Journal, ISSN 1082-3301, E-ISSN 1573-1707, Vol. 43, no 6, p. 495-503Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate a problem that is related to pre-school teachers' prolonged and temporary concerns for children's home situations and the extent to which these children were in need of special support in pre-school and/or were reported to the CPA. Data were obtained from a Swedish prospective study (the SOFIA-study) including 2,017 pre-school children. In this specific study, data from pre-school teacher and parent questionnaires were analyzed (baseline 2010, follow up 2011). Four groups were compared: no concern (85 %), newly arisen concern (6 %), previous concern (5 %), and prolonged concern (4 %). When pre-school teachers expressed prolonged concerns for the children's home situations they not only expressed lasting multiple concerns for children's health and development but also reported long-term problems in the contact between staff and parents. There was an obvious association between concern for the home situation and assessed need of special support in pre-school (37 % in the prolonged concern group). Reports to the child protection agency were made in a minority of the cases. In conclusion, pre-school teachers' concern for children at risk of maltreatment can be understood from a broad perspective on children's health and development. This study highlights the importance of early assessment of the child's home situation, to ensure that proper support is given.

  • 143.
    Svensson, Birgitta
    et al.
    Karlstad University, Faculty of Social and Life Sciences.
    Bornehag, Carl-Gustav
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Jansson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Chronic conditions in children increase the risk for physical abuse – but vary with socio-economic circumstances2011In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 100, p. 407-412Article in journal (Refereed)
    Abstract [en]

    Aim: To explore whether children (age 10, 12 and 15 years) with self-reported chronic conditions are at higher risk of physical abuse and⁄or exposure to intimate-partner violence than other children, while considering the importance of demographic factors.

    Methods: A national cross-sectional study of 2771 pupils in grades 4, 6 and 9 from 44 schools in Sweden (91% response rate). Conflict Tactic Scales were used to measure physical abuse and separate questions measured exposure to intimate-partner violence. A list of 13 diagnoses was used to estimate chronic conditions.

    Results: Children with chronic conditions had an increased risk for physical abuse (CPA) only (OR 1.67) as well as in combination with exposure to intimate-partner violence (IPV) (OR 2.54), but not to IPV only, compared to children without chronic conditions. Furthermore, when chronic conditions were combined with country of birth other than Sweden and living in low-income areas, the risk for CPA increased even more, indicating interactive effects.

    Conclusions: A wide range of chronic health conditions in children increased the risk for physical abuse. This indicates that certain factors unite this group of children, irrespective of the type of disability or degree of severity, but where a combination with socio-economic circumstances is of importance.

  • 144.
    Svensson, Birgitta
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Eriksson, Ulla-Britt
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Janson, Staffan
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Exploring risk for abuse of children with chronic conditions or disabilities: parent’s perceptions of stressors and the role of professionals2013In: Child Care Health and Development, ISSN 0305-1862, E-ISSN 1365-2214, Vol. 39, no 6, p. 887-893Article in journal (Refereed)
    Abstract [en]

    Background: Children with chronic conditions or disabilities are at an increased risk for abuse. High-levels of parental stress have been identified as possible trigger for abuse, where a combination of several factors are of importance, such as lack of social support and limited resources in the neighborhood. Suggestions for preventive measures have merely focused on parenting strategies and targeted intervention programs. So far, little attention has been paid to how the risk for abuse might relate to parent’s perceptions of stressors and the role of professionals. The purpose of the current study was therefore to explore risk factors for abuse with focus on both parent-child and parent-professional relationships.

    Method:Semi-structured in-depth interviews with 15 parents of children with chronic conditions or disabilities were collected and analysed according to qualitative content analysis.

    Findings:Three major themes were found that could be seen as risk factors for child abuse: 1) Emotional demands in precarious situations between parent and child. 2) Gradual shift in responsibility from professionals to parents concerning access to and coordination of service and support. 3) Emotionally closed environment between professionals and parents and taboo on talking about abuse. The gradual shift in responsibility had emotional implications, which could reinforce parental stress and thereby also indirect increase the risk of child abuse. The gradual shift in responsibility also seemed to generate an emotionally closed environment and reinforce the taboo on talking about abuse, which in turn hindered preventive measures. 2

    Conclusions:In the light of parent’s perceptions of stressors and the role of professionals the findings indicate that abuse against children with chronic conditions or disability is not only a family matter, but also depending on qualities in service, professional support and social norms. The result pinpoints three challenges for preventive measures, all with emotional implications; parental strategies, organisational efforts and cultural awareness.

  • 145.
    Svensson, Birgitta
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Psykosomatiska symtom hos barn som upplevt våld i hemmet2009In: Barnläkaren, ISSN 1651-0534, Vol. 6, p. 14-16Article in journal (Other academic)
  • 146.
    Svensson, Birgitta
    et al.
    Karlstad University, Faculty of Social and Life Sciences.
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences.
    Suspected Child Maltreatment: Preschool Staff in a Conflict of Loyalty2008In: Early Childhood Education Journal, ISSN 1082-3301, E-ISSN 1573-1707, Vol. 36, no 1, p. 25-31Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate the actions of Swedish preschool staff when suspecting the maltreatment of children in their domestic environment, and the staff’s further experiences and relations to the family members.

    Methods A questionnaire in 2005 to the staff of 189 child groups in community preschools, including 3,100 children.

    Results: A report to Child Protective Agency (CPA) was submitted in 30% of the cases where maltreatment was suspected. The staff’s decisions as well as their working situation, and how they estimated the parents’ benefits from CPA support were deeply affected by their different relations to the families. The staff had their best contact with the children and their most insecure and vulnerable contact with the fathers.

    Conclusions: In situations with suspected child maltreatment the staff face conflicts of loyalty, mostly based on insecure relations, which could become an impediment to supporting and educating the children.

  • 147.
    Timpka, Toomas
    et al.
    Linkoping Univ, Athlet Res Ctr, SE-58183 Linkoping, Sweden.;Linkoping Univ, Dept Med & Hlth Sci, SE-58183 Linkoping, Sweden.;Cty Council Ostergotland, Ctr Healthcare Dev, Unit Hlth Anal, Linkoping, Sweden..
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Jacobsson, Jenny
    Linkoping Univ, Athlet Res Ctr, SE-58183 Linkoping, Sweden.;Linkoping Univ, Dept Med & Hlth Sci, SE-58183 Linkoping, Sweden..
    Ekberg, Joakim
    Linkoping Univ, Athlet Res Ctr, SE-58183 Linkoping, Sweden.;Linkoping Univ, Dept Med & Hlth Sci, SE-58183 Linkoping, Sweden.;Cty Council Ostergotland, Ctr Healthcare Dev, Unit Hlth Anal, Linkoping, Sweden..
    Dahlstrom, Orjan
    Linkoping Univ, Athlet Res Ctr, SE-58183 Linkoping, Sweden.;Linkoping Univ, Dept Behav Sci & Learning, SE-58183 Linkoping, Sweden..
    Kowalski, Jan
    Karolinska Inst, Pediat Unit, Dept Clini Sci Intervent & Technol, Stockholm, Sweden..
    Bargoria, Victor
    Linkoping Univ, Athlet Res Ctr, SE-58183 Linkoping, Sweden.;Linkoping Univ, Dept Med & Hlth Sci, SE-58183 Linkoping, Sweden.;Moi Univ, Dept Orthopaed & Rehabil, Eldoret, Kenya..
    Mountjoy, Margo
    McMaster Univ, Dept Family Med, Kitchener, ON, Canada..
    Svedin, Carl G.
    Linkoping Univ, Athlet Res Ctr, SE-58183 Linkoping, Sweden.;Linkoping Univ, Dept Med & Hlth Sci, SE-58183 Linkoping, Sweden..
    Protocol Design for Large-Scale Cross-Sectional Studies of Sexual Abuse and Associated Factors in Individual Sports: Feasibility Study in Swedish Athletics2015In: Journal of Sports Science and Medicine (JSSM), ISSN 1303-2968, Vol. 14, no 1, p. 179-187Article in journal (Refereed)
    Abstract [en]

    To ensure health and well-being for their athletes, sports organizations must offer preventive measures against sexual abuse. The aim of this study was to design and evaluate feasibility of a research protocol for cross-sectional epidemiological studies of sexual abuse in athletics. Examination of the requirements on the study of sexual abuse in athletics was followed by iterated drafting of protocol specifications and formative evaluations. The feasibility of the resulting protocol was evaluated in a national-level study among elite athletics athletes (n = 507) in Sweden. The definition of sexual abuse, the ethical soundness of the protocol, reference populations and study of co-morbidity, and the means for athlete-level data collection were identified as particularly complex issues in the requirements analyses. The web-based survey defined by the protocol facilitates anonymous athlete self-reporting of data on exposure to sexual abuse. 198 athletes (39%) fully completed the feasibility survey. 89% (n = 177) reported that they agreed with that the questions in the survey were important, and 95% (n = 189) reported that they answered truthfully to all questions. Similarly, 91% (n = 180) reported that they did not agree with that the questions were unpleasant for them. However, 16% (n = 32) reported that they did not find the survey to be of personal value, and 12% (n = 23) reported that the survey had caused them to think about issues that they did not want to think about. Responding that participation was not personally gratifying was associated with training more hours (p = 0.01). There is a scarcity of research on the prevention of sexual abuse in individual sports. The present protocol should be regarded as a means to overcome this shortcoming in athletics. When implementing the protocol, it is necessary to encourage athlete compliance and to adapt the web-based survey to the particular infrastructural conditions in the sports setting at hand.

  • 148.
    Wolfe, Ingrid
    et al.
    European Centre on Health of Societies in Transition, London School of Hygiene & Tropical Medicine, London, UK.
    Thompson, Matthew
    European Observatory on Health Systems and Policies, London School of Hygiene & Tropical Medicine, London, UK.
    Gill, Peter
    Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
    Tamburlini, Giorgio
    Centro per la Salute del Bambino, Trieste, Italy.
    Blair, Mitch
    Division of Paediatrics, Imperial College, London, UK.
    van den Bruel, Ann
    Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
    Ehrich, Jochen
    Medizinische Hochschule, Hannover, Hanover, Germany.
    Pettoello-Mantovani, Massimo
    School of Medicine, University of Foggia, Foggia, Italy.
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Karanikolos, Marina
    European Centre on Health of Societies in Transition, London School of Hygiene & Tropical Medicine, London, UK.
    McKee, Martin
    European Centre on Health of Societies in Transition, London School of Hygiene & Tropical Medicine, London, UK.
    Health services for children in western Europe2013In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 381, no 9873, p. 1224-1234Article in journal (Refereed)
    Abstract [en]

    Western European health systems are not keeping pace with changes in child health needs. Non-communicable diseases are increasingly common causes of childhood illness and death. Countries are responding to changing needs by adapting child health services in different ways and useful insights can be gained through comparison, especially because some have better outcomes, or have made more progress, than others. Although overall child health has improved throughout Europe, wide inequities remain. Health services and social and cultural determinants contribute to differences in health outcomes. Improvement of child health and reduction of suffering are achievable goals. Development of systems more responsive to evolving child health needs is likely to necessitate reconfiguring of health services as part of a whole-systems approach to improvement of health. Chronic care services and first-contact care systems are important aspects. The Swedish and Dutch experiences of development of integrated systems emphasise the importance of supportive policies backed by adequate funding. France, the UK, Italy, and Germany offer further insights into chronic care services in different health systems. First-contact care models and the outcomes they deliver are highly variable. Comparisons between systems are challenging. Important issues emerging include the organisation of first-contact models, professional training, arrangements for provision of out-of-hours services, and task-sharing between doctors and nurses. Flexible first-contact models in which child health professionals work closely together could offer a way to balance the need to provide expertise with ready access. Strategies to improve child health and health services in Europe necessitate a whole-systems approach in three interdependent systems—practice (chronic care models, first-contact care, competency standards for child health professionals), plans (child health indicator sets, reliable systems for capture and analysis of data, scale-up of child health research, anticipation of future child health needs), and policy (translation of high-level goals into actionable policies, open and transparent accountability structures, political commitment to delivery of improvements in child health and equity throughout Europe).

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