Height, weight and body proportions were studied in 155 Turkish school children born in Sweden, living in a defined area in Stockholm. They were compared with Swedish children matched for sex, age and physical environment, and with a smaller number of Turkish children born in Turkey or in countries other than Turkey and Sweden. Parents' socio-economic levels were extremely low on a Swedish comparison. Growth was correlated to socio-economic background. The study was cross-sectional and longitudinal, combining growth data for key ages from health documents with contemporary data. Turkish schoolchildren under 10 years of age, born in Sweden, were significantly shorter than Swedish children, the difference beginning in the pre-school years. Turkish children born in Turkey were short on arrival in Sweden but soon caught up with the Turkish children born in Sweden. Genetic factors only could not explain the difference in height-for-age between Turkish children born in Sweden and Swedish children. With a longer period of stay in Sweden an increase in height-for-age would be expected.
Dental caries and the utilization of the Public Dental Service in Sweden were investigated in 84 Turkish immigrant children born in Sweden, 69 Turkish children born in Turkey and 85 Swedish age- and sex-matched controls. Dental fear was also studied. The mean age of the children was 8.3 years. Turkish immigrant children had more caries both in the primary and in the permanent teeth than Swedish children. Children born in Turkey had more caries in the primary dentition than those born in Sweden. Turkish children came more often for emergency visits than Swedish children and expressed dental fear more frequently. Turkish immigrant children therefore constitute a high risk group for caries and need supervision early after immigration.
The main ethical imperative of all paediatric actions is the demand to do everything "in the best interests of children". Relevant guidelines can be derived from the UN Declaration on the Rights of Children, whereupon every child has the fundamental right to life and dignity, and is entitled to optimal medical care. Paediatric care in general includes the responsibility to achieve the highest level of knowledge, consideration of the child-specific somatic, mental and social development, empathic and trustworthy communication with the child and parents, observance of the recommendations of the Charter of the Rights of Children in Hospital, and cooperation with experts in related professions. Good communication is based on respect for the dignity of the child as a person and on the use of child-specific language, recognizing the rights of the child to be involved in consent or assent. Good clinical practice dictates and demands high standards of practice in therapeutics, research and medical interventions involving children. Decision making in extreme situations with regard to continuation, withholding or withdrawing life supporting measures is amongst the most complex and ethically difficult tasks of a doctor. Ethical issues with regard to neglect, maltreatment, abuse and addictions involving children need scrupulous consideration. Paediatricians have a prime responsibility to promote and protect the well being of children.
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