Physical Activity, Blood Glucose and C-Peptide in Healthy School-Children, a Longitudinal Study

Aim To further elucidate the relationship between physical activity and several risk factors for development of diabetes (glucose, C-peptide and obesity) over time. Methods A prospective longitudinal study where physical activity was measured on 199 children from Kalmar and Linköping at age 8, and the same 107 children from Linköping again at age 12. Anthropometric data was collected and blood was analyzed for C-peptide and f-glucose. The children in the study were representative for the general Swedish child population, and on an average lean. Results High physical activity was related to lower C-peptide at age 8 and 12. This correlation was especially pronounced in boys, who also were more physically active than girls at both time points. The association seen at 8 years of age was similar at age 12 in most children. Children with higher BMI Z-Score had a higher fasting C-peptide (age 12) but linear regression showed that children with more steps per day were less likely to have a higher fasting C-peptide irrespective of BMI. Longitudinal follow-up showed that a decrease in physical activity increased insulin resistance and β-cell load. Conclusions Already in young children, physical activity improves insulin sensitivity and decreases the need of C-peptide over time. This seems to become even more pronounced with increasing age when children are followed longitudinally. Low physical activity increases the load on insulin producing β-cells, might increase the risk for both type 1- and 2 diabetes.

Den nyanserade bilden av barnet : -En studie av samtalsmallar inför utvecklingssamtal på förskolan

Målet med studien är att förstå hur och vad som beskrivs och bedöms genom de samtalsmallar som används inför utvecklingssamtal på förskolan. Det är en kvalitativ studie baserad på innehållsanalys av insamlade dokument. Innehållsanalysen utfördes genom kodscheman som tas upp av Bergström och Boréus (2008). I analysarbetet har vi inspirerats av diskursanalysen. Studien är baserad på åtta samtalsmallar inför utvecklingssamtal från olika förskolor i en kommun i Mellansverige. Studien visar att samtalsmallarna innehöll flera olika sätt att beskriva och bedöma barn. Genom vårt analysarbete fann vi framför allt fem tydliga teman som utgör vårt resultat; Det lärande barnet, där barnet genom samtalsmallarna beskrivs och bedöms inom olika områden och ses som lärande eller under utveckling. Barnet som person, baserat på punkterna i samtalsmallarna som utgörs av bedömning och beskrivning av barnets personliga attribut. Det bristande barnet, med grund i samtalsmallarnas fokus på barnets tillkortakommanden och brister. Barnet i verksamhetens kontext, utifrån punkter i samtalsmallarna där verksamheten beskrivs och bedöms och Det positivt framställda barnet, grundat i till exempel uppmaningar i samtalsmallarna om att hålla samtalen i positiv anda. Tillika visar studien att flera olika barnsyner ligger till grund för hur barn ska beskrivas och bedömas i samtalsmallarna, samt att det råder motsägelser och bristande direktiv i förskolans styrdokument för utvecklingssamtalens syfte och innehåll.

Agenda för samverkan eller verksamhetens agenda? Om professionellas erfarenheter av samverkan enligt samordnad individuell plan (SIP)

Agenda for collaboration or an agency agenda? Professionals’ experiences of colla­boration according to a coordinated individual plan (CIP) An increasing number of children and adolescents develop complex needs that require simultaneous action by different professionals. Several reports state that efforts for these children and adolescents have become increasingly specialized and fragmented. Since 2010, there are statutory requirements for collaboration according to a coordinated individual plan (SIP) between health care and social services. Pre-school and school can after regional agreement be involved in the co-ordination as equal partner. Collaboration in line with CIP is expected to offset the fragmentation for benefit of the service users’ ability to monitor and comprehend interventions. The aim was to investigate professionals’ experiences of CIP. The study consists of qualitative analysis of 12 focus group interviews with a total of 71 staff with different professions in health care, education and social services about their experiences of CIP. The results indicate that the participants act according to their core mission: nurturing, teaching and investigation. Two main categories with four sub-categories each appeared in the analysis. The main category, hindering factors, contains the categories: different mandates and requirements, requirements for presence initiative, questioning and censure, and timelines and prioritization. The main category of facilitating factors contains the categories: similar interpretation of common agreement, mutual respect and shared learning, common terminology and documentation, and willingness to collaborate. The analysis indicate that CIP was perceived as alternating between, on the one hand, a pro-active and service-focused tool, and on the other hand, a competing and compelling professional instrument.