Cecilia Boldemann

Outdoor environmental assessment of attention promoting settings for preschool children.

The restorative potential of green outdoor environments for children in preschool settings was investigated by measuring the attention of children playing in settings with different environmental features. Eleven preschools with outdoor environments typical for the Stockholm area were assessed using the outdoor play environment categories (OPEC) and the fraction of visible sky from play structures (sky view factor), and 198 children, aged 4.5-6.5 years, were rated by the staff for inattentive, hyperactive and impulsive behaviors with the ECADDES tool. Children playing in large and integrated outdoor areas containing large areas of trees, shrubbery and a hilly terrain showed less often behaviors of inattention (p<.05). The choice of tool for assessment of attention is discussed in relation to outdoor stay and play characteristics in Swedish preschool settings. The results indicate that the restorative potential of green outdoor environments applies also to preschool children and that environmental assessment tools as OPEC can be useful when to locate and develop health-promoting land adjacent to preschools.

Trends during a half century in relative squamous cell carcinoma distribution by body site in the Swedish population: Support for accumulated sun exposure as the main risk factor

There is a strong relationship between squamous cell carcinoma (SCC) and exposure to ultraviolet radiation in terms of accumulated exposure. In this study, data from the Swedish Cancer Registry are surveyed to discern a reflection of behavioral and societal changes in relative distribution of SCC by body site. Data for the time period 1960–2004, including a total of 66 221 cases (56 669 people) were analyzed by body site for age and gender cohorts. The age‐standardized (European population) incidence per 100 000 of SCC in the year 2004 was 30.4 in males and 15.4 in females. In the year 1960, the corresponding incidences were 7.7 and 3.8; that is, SCC has become four times more frequent in Sweden for both sexes during this period. The standardized incidence of SCC increased on all body sites except eyelids (men and women) and ears (women). Head tumors dominated among patients aged 70 years or more and diagnosed 1960–1964. Among patients less than 70 years old at diagnosis in 2000–2004, tumors of the trunk and limbs dominated. A relative increase of tumors of the scalp and neck was observed in all age groups (men), and of tumors of the trunk and upper limbs in all age groups and both sexes except among patients aged more than 90 years of age. In contrast, a relative decrease of tumors on the face (including the ears) was seen in all age groups. The relative increase of SCC of the trunk and upper limbs is a plausible reflection of intentional tanning.

Comparison of pedometer and accelerometer measures of physical activity during preschool time on 3- to 5-year-old children

Aims:  To compare pedometer steps with accelerometer counts and to analyse minutes of engagement in light, moderate and vigorous physical activity in 3‐ to 5‐year‐old children during preschool time.

The quality of the outdoor environment influences childrens health- a cross sectional study of preschools

To test how the quality of the outdoor environment of child day care centres (DCCs) influences childrens health.

Objectively measured physical activity level a during a physical education class: A pilot study with Swedish youth

UNLABELLED The aim of this study is to advance our knowledge of the contribution of a typical physical education (PE) class to childrens daily physical activity. METHODS The pilot project is a part of a survey study comprising 11 fourth grader classes (250 pupils). One class of 19 pupils (9 girls) participated in the pilot study. Daily step counts were measured by Yamax pedometers during four consecutive weekdays. During PE class, the participants wore a second pedometer and an Actigraph GT1M accelerometer. RESULTS The total average step count during PE class was 2512, average 74 steps/min. The counts for the whole day were 16668, and 19 steps/min respectively. The total share of moderate-vigorous physical activity (MVPA) of the PE class was 50.4% (52.5% and 48.3% for boys and girls respectively). There was an inverse correlation between daily mean step count and contribution of PE class step to daily mean step (r = -0.64, p = .003). CONCLUSION The contribution of PE class to MVPA was in high in both boys and girls. Considering the suggested independent role of physical fitness for cardiovascular health in children, the PE class must be seen as an important health factor, especially for otherwise inactive children.

Physical activity decreased by a quarter in the 11- to 12-year-old Swedish boys between 2000 and 2013 but was stable in girls: a smartphone effect?

This study explored physical activity, body mass index (BMI) and overweight and obesity from 2000 to 2013 using a convenience sample of second‐ and fifth‐grade Swedish schoolchildren aged 8–9 years and 11–12 years, respectively.

Suberythemal Sun Exposures at Swedish Schools Depend on Sky Views of the Outdoor Environments - Possible Implications for Pupils' Health.

More scheduled outdoor stay is increasingly advocated for school children. This study measured 2nd, 5th and 8th graders’ erythemal UV‐exposure in September, March and May at four Swedish schools. We related those exposures, as fractions of total available ambient radiation, to the schools outdoor environments differing in amount of shade, vegetation, and peripheral city‐scape quantified as percentage of free sky view calculated from fish‐eye photographs. Exposures correlated with the sky views (with exceptions in May) and were suberythemal. The exposures were also below the threshold limit of the International Commission on Non‐Ionizing Radiation Protection (ICNIRP) for hazard evaluation of UVR but were potentially enough for adequate vitamin D formation according to a cited model calculation – as illustrated in the results and discussed. The school environments, typical in southern and middle Sweden, offer enough shade to protect children from overexposure during seasons with potentially harmful solar UV radiation. Pupils’ outdoor stay may be extended during September and March. In May extended outdoor stay of the youngest pupils requires a more UVR‐protective environment.

Levels of Physical Activity during Physical Education lessons in Sweden

The aim of this study was to measure the percentage of sedentary light and moderate‐to‐vigorous physical activity (%MVPA) provided by physical education (PE) lessons for Swedish second, fifth and eighth grade students, aged eight, 11 and 14.

Upgrading Preschool Environment in a Swedish Municipality Evaluation of an Implementation Process

Redesigning outdoor preschool environment may favorably affect multiple factors relevant to health and reach many children. Cross-sectional studies in various landscapes at different latitudes have explored the characteristics of preschool outdoor environment considering the play potential triggering combined physical activity and sun-protective behavior due to space, vegetation, and topography. Criteria were pinpointed to upgrade preschool outdoor environment for multiple health outcomes to be applied in local government in charge of public preschools. Purposeful land use policies and administrative management of outdoor land use may serve to monitor the quality of preschool outdoor environments (upgrading and planning). This study evaluates the process of implementing routines for upgrading outdoor preschool environments in a medium-sized municipality, Sweden, 2008-2011, using qualitative and quantitative analysis. Recorded written material (logs and protocols) related to the project was processed using thematic analysis. Quantitative data (m2 flat/multileveled, overgrown/naked surface, and fraction of free visible sky) were analyzed to assess the impact of implementation (surface, topography, greenery integrated in play). The preschool outdoor environments were upgraded accordingly. The quality of implementation was assessed using the theory of policy streams approach. Though long-term impact remains to be confirmed the process seems to have changed work routines in the interior management for purposeful upgrading of preschool outdoor environments. The aptitude and applicability of inexpensive methods for assessing, selecting, and upgrading preschool land at various latitudes, climates, and outdoor play policies (including gender aspects and staff policies) should be further discussed, as well as the compilation of data for monitoring and evaluation.

Translation of children’s cycling into steps: the share of cycling in 10-year-olds’ physical activity

Abstract Background: Active travel has a potential to increase children’s physical activity (PA). Pedometers offer a valid option to measure PA, but do not capture cycling activity. Children’s self-reported cycling distances can be analyzed by the Geografic Information System (GIS). Aim: To combine pedometry and GIS mapping to identify the relative amount of cycling in children’s PA. Study group: Of all children in 4th grade (n=187) in Staffanstorp Sweden, 144 had valid pedometer data. Fifty-six children were non-cyclists while 88 children (32 boys, 47 girls, 9 gender unknown) reported at least one cycle journey. Methods: Cycle trips were entered into GIS and calculated to total cycling distance. Average length of the single distances cycled per day was 676 m (SD=534 m). A previously reported cycling speed (13.5 km/h) was used to calculate time spent cycling. Consequently distance=676 m, speed=13.5 km/h=13,500 m/3600 s=3.75 m/s and time=676m/3.75m/s=180.26 s=3 min. Expenditure of 4 and 5 metabolic equivalents (METs) has in children been reported equivalent to 122 and 127 steps/min, respectively. We estimated 4.7 METs (13.5 km/h) as 126 steps for every min of cycling (127–122=5×0.7=125.5). Results: The daily mean cycle distance was 676 m, on average 379 additional steps/day for cycling children (min. 21, max. 1385, SD=299) with no gender difference. Additional “steps” obtained by cycling corresponded to on average 3% of their PA. Conclusion: The relative contribution of cycling in 10-year-old children’s PA level is quite small and stable between children across different levels of activity levels, regardless of gender.