Ändra sökning
Avgränsa sökresultatet
2345678 201 - 250 av 6000
RefereraExporteraLänk till träfflistan
Permanent länk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Träffar per sida
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sortering
  • Standard (Relevans)
  • Författare A-Ö
  • Författare Ö-A
  • Titel A-Ö
  • Titel Ö-A
  • Publikationstyp A-Ö
  • Publikationstyp Ö-A
  • Äldst först
  • Nyast först
  • Skapad (Äldst först)
  • Skapad (Nyast först)
  • Senast uppdaterad (Äldst först)
  • Senast uppdaterad (Nyast först)
  • Disputationsdatum (tidigaste först)
  • Disputationsdatum (senaste först)
  • Standard (Relevans)
  • Författare A-Ö
  • Författare Ö-A
  • Titel A-Ö
  • Titel Ö-A
  • Publikationstyp A-Ö
  • Publikationstyp Ö-A
  • Äldst först
  • Nyast först
  • Skapad (Äldst först)
  • Skapad (Nyast först)
  • Senast uppdaterad (Äldst först)
  • Senast uppdaterad (Nyast först)
  • Disputationsdatum (tidigaste först)
  • Disputationsdatum (senaste först)
Markera
Maxantalet träffar du kan exportera från sökgränssnittet är 250. Vid större uttag använd dig av utsökningar.
  • 201.
    Andersen, Randi Dovland
    et al.
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Nursing, Stockholm, Sweden;Telemark Hosp, Dept Child & Adolescent Hlth Serv, POB 2900 Kjorbekk, N-3710 Skien, Norway.
    Munsters, Josanne M. A.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Perinatal, neonatal och barnkardiologisk forskning.
    Vederhus, Bente Johanne
    Haukeland Hosp, Dept Pediat, Bergen, Norway.
    Gradin, Maria
    Orebro Univ, Fac Med & Hlth, Dept Paediat, Orebro, Sweden.
    Pain assessment practices in Swedish and Norwegian neonatal care units2018Ingår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, nr 3, s. 1074-1082Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    The use of measurement scales to assess pain in neonates is considered a prerequisite for effective management of pain, but these scales are still underutilised in clinical practice.

    Aim

    The aim of this study was to describe and compare pain assessment practices including the use of pain measurement scales in Norwegian and Swedish neonatal care units.

    Methods

    A unit survey investigating practices regarding pain assessment and the use of pain measurement scales was sent to all neonatal units in Sweden and Norway (n = 55). All Norwegian and 92% of Swedish units responded.

    Results

    A majority of the participating units (86.5%) assessed pain. Swedish units assessed and documented pain and used pain measurement scales more frequently than Norwegian units. The most frequently used scales were different versions of Astrid Lindgren's Pain Scale (ALPS) in Sweden and Echelle Douleur Inconfort Noveau-Ne (EDIN), ALPS and Premature Infant Pain Profile (PIPP) in Norway. Norwegian head nurses had more confidence in their pain assessment method and found the use of pain measurement scales more important than their Swedish colleagues.

    Conclusion

    The persisting difference between Swedish and Norwegian units in pain assessment and the use of pain measurement scales are not easily explained. However, the reported increased availability and reported use of pain measurement scales in neonatal care units in both countries may be seen as a contribution towards better awareness and recognition of pain, better pain management and potentially less suffering for vulnerable neonates.

  • 202. Anderson, Beverley H.
    et al.
    Kasher, Paul R.
    Mayer, Josephine
    Szynkiewicz, Marcin
    Jenkinson, Emma M.
    Bhaskar, Sanjeev S.
    Urquhart, Jill E.
    Daly, Sarah B.
    Dickerson, Jonathan E.
    O'Sullivan, James
    Leibundgut, Elisabeth Oppliger
    Muter, Joanne
    Abdel-Salem, Ghada M. H.
    Babul-Hirji, Riyana
    Baxter, Peter
    Berger, Andrea
    Bonafe, Luisa
    Brunstom-Hernandez, Janice E.
    Buckard, Johannes A.
    Chitayat, David
    Chong, Wui K.
    Cordelli, Duccio M.
    Ferreira, Patrick
    Fluss, Joel
    Forrest, Ewan H.
    Franzoni, Emilio
    Garone, Caterina
    Hammans, Simon R.
    Houge, Gunnar
    Hughes, Imelda
    Jacquemont, Sebastien
    Jeannet, Pierre-Yves
    Jefferson, Rosalind J.
    Kumar, Ram
    Kutschke, Georg
    Lundberg, Staffan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Lourenco, Charles M.
    Mehta, Ramesh
    Naidu, Sakkubai
    Nischal, Ken K.
    Nunes, Luis
    Ounap, Katrin
    Philippart, Michel
    Prabhakar, Prab
    Risen, Sarah R.
    Schiffmann, Raphael
    Soh, Calvin
    Stephenson, John B. P.
    Stewart, Helen
    Stone, Jon
    Tolmie, John L.
    van der Knaap, Marjo S.
    Vieira, Jose P.
    Vilain, Catheline N.
    Wakeling, Emma L.
    Wermenbol, Vanessa
    Whitney, Andrea
    Lovell, Simon C.
    Meyer, Stefan
    Livingston, John H.
    Baerlocher, Gabriela M.
    Black, Graeme C. M.
    Rice, Gillian I.
    Crow, Yanick J.
    Mutations in CTC1, encoding conserved telomere maintenance component 1, cause Coats plus2012Ingår i: Nature Genetics, ISSN 1061-4036, E-ISSN 1546-1718, Vol. 44, nr 3, s. 338-342Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Coats plus is a highly pleiotropic disorder particularly affecting the eye, brain, bone and gastrointestinal tract. Here, we show that Coats plus results from mutations in CTC1, encoding conserved telomere maintenance component 1, a member of the mammalian homolog of the yeast heterotrimeric CST telomeric capping complex. Consistent with the observation of shortened telomeres in an Arabidopsis CTC1 mutant and the phenotypic overlap of Coats plus with the telomeric maintenance disorders comprising dyskeratosis congenita, we observed shortened telomeres in three individuals with Coats plus and an increase in spontaneous gamma H2AX-positive cells in cell lines derived from two affected individuals. CTC1 is also a subunit of the alpha-accessory factor (AAF) complex, stimulating the activity of DNA polymerase-alpha primase, the only enzyme known to initiate DNA replication in eukaryotic cells. Thus, CTC1 may have a function in DNA metabolism that is necessary for but not specific to telomeric integrity.

  • 203.
    Andersson, Anna Karin
    et al.
    Malardalen Univ, Sch Hlth Care & Welf, Box 883, SE-72123 Vasteras, Sweden..
    Martin, Lene
    Malardalen Univ, Sch Hlth Care & Welf, Box 883, SE-72123 Vasteras, Sweden..
    Strand Brodd, Katarina
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Almqvist, Lena
    Malardalen Univ, Sch Hlth Care & Welf, Box 883, SE-72123 Vasteras, Sweden..
    Patterns of everyday functioning in preschool children born preterm and at term2017Ingår i: Research in Developmental Disabilities, ISSN 0891-4222, E-ISSN 1873-3379, Vol. 67, s. 82-93Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background/Aim: Children born preterm are at risk of neonatal complications but the long-term consequences for everyday functioning is not well known. The study aimed to identify patterns of everyday functioning in preschool children born preterm and at term in relation to perinatal data, neonatal risk factors, behaviour, and socioeconomic status. Registry data and data from parent rated questionnaires were collected for 331 children.

    Method: A person-oriented approach with a cluster analysis was used.

    Results: A seven cluster solution explained 65.91% of the variance. Most children (n = 232) showed patterns of strong everyday functioning. A minority of the children (n = 99), showed diverse patterns of weak everyday functioning. Perinatal characteristics, neonatal risk factors and socio-economics did not predict cluster group membership. Children born preterm were represented in all clusters.

    Conclusion, implications: Most preschool children are perceived by their parents with strong everyday functioning despite being born preterm. However small groups of children are, for various reasons, perceived with weak functioning, but preterm birth is not the sole contributor to patterns of weak everyday functioning. More critical for all children's everyday functioning is probably the interaction between individual factors, behavioural factors and contextual factors. To gain a broader understanding of children's everyday functioning. Child Health Services need to systematically consider aspects of body function, activity and in addition participation and environmental aspects.

  • 204.
    Andersson, Camilla
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Radiologi.
    Röing, Marta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Hälso- och sjukvårdsforskning.
    Ehrsson, Ylva Tiblom
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Johansson, Birgitta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Experimentell och klinisk onkologi. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Klinisk psykologi i hälso- och sjukvård.
    It's a question of endurance: patients with head and neck cancer experiences of 18F-FDG PET/CT in a fixation mask2017Ingår i: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 29, s. 85-90, artikel-id S1462-3889(17)30082-0Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: This study aimed to explore how patients with head and neck cancer experienced undergoing an (18)F-fluoro-deoxy-glucose positrons emissions tomography/computed tomography ((18)F-FDG PET/CT) examination in a fixation mask.

    METHOD: Interviews were conducted with nine patients with known or suspected head and neck cancer who were scheduled for the examination for the first time. The phenomenological method according to van Manen and his four lifeworld existentials; lived space, lived body, lived time, and lived relation was used to analyse the interviews.

    RESULTS: The thoughts and feelings of the patients during the PET/CT examination varied, some found it very difficult, while others did not. However, for all the patients, it was an experience that required some form of coping to maintain composure for example distraction.

    CONCLUSIONS: PET/CT examnation in a fixation mask may be strenuous for some patients. Patients need more detailed information, including suggestions for coping behaviours, prior to the examination, as well as higher level of support during and after the examination. The results of this study may be used to improve patient care and optimize the procedure of PET/CT examination in a fixation mask.

  • 205.
    Andersson, Daniel
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Evaluation of Correlation between mRNA and Protein Expression of Tripeptidyl-Peptidase II: Possible Future Use as a Biomarker for Cancer?2013Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [en]

    Cancer remains one of the most common causes for death in the world today. Researchers are continuously trying to improve old, and develop new, methods in order to strife this global problem. Much research is being made trying to find new specific biomarkers that can be used to detect and diagnose cancer in an early stage.

    One candidate protein for possible future use as a biomarker is tripeptidyl-peptidase II (TPPII) which has previously been shown to be up-regulated in Burkitt´s lymphoma. This paper focuses on the expression of TPPII on an mRNA-level to see if there is any difference between expression in human leucocytes from patients with a leukemia diagnosis and a healthy volunteer, in order to evaluate if the expression of TPPII have any future use as a biomarker.

    Patient samples were analyzed using real time qPCR, to study the expression of mRNA, and Western blot, in order to correlate the mRNA findings with protein expression. Three different cell lines with different characteristics regarding expression and function of TPPII were also used to validate the methods used and for comparison with the patient samples analyzed.

    A difference in expression of mRNA were seen between the different patient samples, both individually and between larger groups of samples with the same diagnosis, indicating a large individual variation, thus making future use in a clinical setting difficult. However, seeing as only a few samples were analyzed in this study, more research must be done in order to draw any final conclusions.

  • 206.
    Andersson, Ellinor
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Barnmorskors stödjande roll i samband med barnafödande: Nyutbildade barnmorskors uppfattningar2013Självständigt arbete på avancerad nivå (magisterexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 207. Andersson, Ewa
    et al.
    Christensson, Kyllike
    Hildingsson, Ingegerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Mothers' satisfaction with group antenatal care versus individual antenatal care: A clinical trial2013Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 4, nr 3, s. 113-120Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The aim of this study was to compare women's satisfaction with group based antenatal care and standard care. Design: A randomised control trial where midwives were randomized to perform either GBAC or standard care. Women were invited to evaluate the two models of care. Data was collected by two questionnaires, in early pregnancy and six months after birth. Crude and adjusted odds ratios with a 95% confidence interval were calculated by model of care. Settings: Twelve antenatal clinics in Sweden between September 2008 and December 2010. Participants: Women in various part of Sweden (n = 700). Findings: In total, 8:16 variables in GBAC versus 9:16 in standard care were reported as deficient. Women in GBAC reported significantly less deficiencies with information about labour/birth OR 0.16 (0.10-0.27), breastfeeding OR 0.58 (0.37-0.90) and time following birth OR 0.61 (0.40-0.94). Engagement from the midwives OR 0.44 (0.25-0.78) and being taken seriously OR 0.55 (0.31-0.98) were also found to be less deficient. Women in GBAC reported the highest level of deficiency with information about pregnancy OR 3.45 (2.03-5.85) but reported less deficiency with time to plan the birth OR 0.61 (0.39-0.96). In addition, women in GBAC more satisfied with care in supporting contact with other parents OR 3.86 (2.30-6.46) and felt more support to initiate breastfeeding OR 1.75 (1.02-2.88). Conclusions: Women in both models of care considered the care as deficient in more than half of all areas. Variables that differed between the two models favoured group based antenatal care.

  • 208.
    Andersson, Ewa
    et al.
    Division for Reproductive Health, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
    Hildingsson, Ingegerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa. Department of Health Science, Mid Sweden University, Sundsvall, Sweden.
    Mother's postnatal stress: an investigation of links to various factors during pregnancy and post-partum2016Ingår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 30, nr 4, s. 782-789Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Higher levels of parental stress have long-term effects on children's health and could lead to dysfunction in the parent-child interaction. Different background factors can be predictors of high parental stress.

    AIM: The aim of this study was to examine parental stress among Swedish women and identify different factors linked to women's parental stress.

    METHOD: About 702 women were recruited to a clinical study and followed up six months after birth. Data were collected by two questionnaires, and 279 women completed the Swedish Parental Stress Questionnaire (SPSQ).

    FINDINGS: Less than very good mental health and depressive symptoms after birth were strongly associated with parental stress, and the strongest association was found between post-partum depressive symptoms and high levels of stress in the subscale Incompetence. Multiparity was associated with high stress in two subscales, and lower level of education was a protective factor for stress in nearly all subscales.

    CONCLUSIONS: Depressive symptoms and perceived poor mental health post-partum are the most important factors related to high parental stress. The results point to the importance of identifying and supporting mothers with depressive symptoms, since these women have both mental illness and increased stress.

  • 209.
    Andersson Grönlund, Marita
    et al.
    Institute of Neuroscience and Physiology/Ophthalmology, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Landgren, Magnus
    Strömland, Kerstin
    Institute of Neuroscience and Physiology/Ophthalmology, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Aring, Eva
    Institute of Neuroscience and Physiology/Ophthalmology, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Svensson, Leif
    Tuvemo, Torsten
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Hellström, Ann
    Relationships between ophthalmological and neuropaediatric findings in children adopted from Eastern Europe2010Ingår i: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 88, nr 2, s. 227-234Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: This study aimed to evaluate and relate visual function, ocular dimensions and neuropaediatric findings in adoptees from Eastern Europe. Methods: We studied 72 of 99 children, born during 1990-95 and adopted from Eastern Europe to western Sweden during 1993-97. The children (mean age 7.5 years, range 4.8-10.5 years; 41 boys, 31 girls) were examined after a mean period of 5 years post-adoption by a multidisciplinary team. Correlations between ophthalmological findings and neuropaediatric data were analysed. Results: Bivariate and regression analyses indicate a significant positive correlation between visual acuity (VA) and perceptual organization (p < 0.001), as well as between strabismus and verbal comprehension (p < 0.02). Fetal alcohol syndrome (FAS) was correlated with low VA (p < 0.02), subnormal stereovision (p < 0.009) and small optic discs (p < 0.02). Small head circumference was related to low VA (p < 0.015) and small optic discs (p < 0.03). Furthermore, small optic discs were related to low birthweight (p < 0.005) and preterm birth (p < 0.01). Large optic cups were correlated with poorer perceptual organization (p < 0.02). Conclusions: In this group of adoptees from Eastern Europe, ophthalmological findings were correlated to neuropaediatric findings, especially those arising from prenatal adverse events resulting in growth deficiency and central nervous system damage. Therefore, it is important and valuable with an ophthalmological examination in children adopted from Eastern Europe.

  • 210.
    Andersson, Helén
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Farmaceutiska fakulteten, Institutionen för farmaceutisk biovetenskap.
    Helmestam, Malin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Zebrowska, Anna
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Farmaceutiska fakulteten, Institutionen för farmaceutisk biovetenskap.
    Olovsson, Matts
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Brittebo, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Farmaceutiska fakulteten, Institutionen för farmaceutisk biovetenskap.
    Tamoxifen-Induced Adduct Formation and Cell Stress in Human Endometrial Glands2010Ingår i: Drug Metabolism And Disposition, ISSN 0090-9556, E-ISSN 1521-009X, Vol. 38, nr 1, s. 200-207Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The beneficial effects of tamoxifen in the prevention and treatment of breast cancer are compromised by an increased risk of endometrial polyps, hyperplasia, and cancer. Tamoxifen is metabolized to an array of metabolites with estrogenic effects but also to reactive intermediates that may form protein and DNA adducts. The aim of this study was to investigate cellular [(3)H]tamoxifen adduct formation by light microscopic autoradiography and cell stress by immunohistochemical analysis of glucose-regulating protein 78 (GRP78), nuclear factor kappaB (NF-kappaB), and caspase 3 in human endometrial explants after short-term incubation with tamoxifen. The cellular expression of tamoxifen-metabolizing enzymes in human endometrial biopsy samples was also determined by immunohistochemistry. The results showed selective [(3)H]tamoxifen adduct formation in glandular and surface epithelia after incubation with a nontoxic concentration of [(3)H]tamoxifen (6 nM). There was also a selective expression of the endoplasmic reticulum stress chaperone GRP78 and activated caspase 3 at these sites after incubation with cytotoxic concentrations of tamoxifen (10-100 microM). The cell stress was preferentially observed in samples from women in the proliferative menstrual phase. No treatment-related expression of NF-kappaB was observed. Constitutive expression of the tamoxifen-metabolizing enzymes CYP1B1, CYP2A6, CYP2B6, CYP2C8/9/19, CYP2D6, and SULT2A1 in glandular and surface epithelia was shown, but there was a large interindividual variation. The colocalization of [(3)H]tamoxifen adducts, expression of GRP78, caspase 3, and tamoxifen-metabolizing enzymes in human glandular and surface epithelia suggest a local bioactivation of tamoxifen at these sites and that epithelial cells are early target sites for tamoxifen-induced cell stress.

  • 211. Andersson, K
    et al.
    Odlind, V
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Milsom, I
    Registrera alla fall av spiralperforation1996Ingår i: Läkartidningen, Vol. 93, s. 2567-Artikel i tidskrift (Övrigt vetenskapligt)
  • 212. Andersson, K
    et al.
    Ryde-Blomqvist, E
    Lindell, K
    Odlind, V
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Milsom, I
    Perforation with intrauterine devices. Report from a Swedish survey1998Ingår i: Contraception, Vol. 57, s. 251-Artikel i tidskrift (Refereegranskat)
  • 213.
    Andersson, Katarina
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Eklund, Emma
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Utvärdering av Barnmorskeprogrammet vid Uppsala universitet 2007–20172018Självständigt arbete på avancerad nivå (magisterexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Bakgrund Tidigare forskning visar att nyutexaminerade barnmorskor önskar mer verksamhetsförlagd utbildning (VFU) och fler praktiska övningstillfällen under utbildningen. Eftersom det råder brist på barnmorskor i Sverige idag är det av stor betydelse att utvärdera barnmorskeprogrammets innehåll och skapa bra förutsättningar för nyutexaminerade barnmorskor. Syfte Syftet med denna studie var att undersöka hur tidigare studenter vid barnmorskeprogrammet vid Uppsala universitet, mellan åren 2007–2017, utvärderar sin utbildning samt deras efterföljande tid som barnmorska. Metod Tvärsnittsstudie med deskriptiv statistik. Insamlad data genomfördes och analyserades som webenkät via programmet SurveyMonkey. Resultat Totalt 94 barnmorskor (44%) besvarade enkäten. Majoriteten av deltagarna ville ha mer VFU och praktiska övningar i form av suturering, akuta situationer som kan uppstå relaterade till en förlossning och handgrepp vid förlossning. Majoriteten av deltagarna upplevde också någon form av stress i att uppnå 50 förlossningar under VFU. Näst intill hälften av deltagarna önskade att barnmorskeprogrammet förlängdes. Flertalet av deltagarna tyckte inte att de fick tillräcklig introduktion på sin arbetsplats när de började arbeta som barnmorska. Slutsats Tidigare studenter vid barnmorskeprogrammet vid Uppsala universitet önskade att programmet innehöll mer VFU och praktiska övningar. De upplevde också att de inte fick tillräcklig introduktion på sin arbetsplats när de började arbeta som barnmorska. 

  • 214. Andersson, Liselott
    et al.
    Sundström-Poromaa, Inger
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Wulff, Marianne
    Åström, Monica
    Bixo, Marie
    Depression and anxiety during pregnancy and six months postpartum: a follow-up study2006Ingår i: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 85, nr 8, s. 937-944Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims. To investigate the relationship between antenatal and postpartum depression and anxiety and to explore associated maternal characteristics. Methods. From a population-based sample of 1,555 women attending two obstetric clinics in Sweden, all women with an antenatal psychiatric diagnosis (n = 220) and a random selection of healthy women (n = 500) were contacted for a second assessment three to six months postpartum. The Primary Care Evaluation of Mental Disorders was used for evaluation on both occasions. Results. Fewer cases of depressive and/or anxiety disorders were prevalent postpartum compared with the second trimester screening. Depression and/or anxiety were prevalent in 16.5% of postpartal women versus 29.2% of pregnant women. There was a significant shift from a majority of subthreshold diagnoses during pregnancy to full Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) diagnoses during the postpartum period. A history of previous psychiatric disorder, living single, and obesity were significantly associated with a new-onset postpartum psychiatric disorder. The absence of a previous psychiatric disorder was significantly associated with a postpartum recovery of depression or anxiety. Conclusions. Depression and anxiety appear to be less common postpartum than during pregnancy.

  • 215. Andersson, Liselott
    et al.
    Sundström-Poromaa, Inger
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Wulff, Marianne
    Åström, Monica
    Bixo, Marie
    Implications of antenatal depression and anxiety for obstetric outcome.2004Ingår i: Obstet Gynecol, ISSN 0029-7844, Vol. 104, nr 3, s. 467-76Artikel i tidskrift (Refereegranskat)
  • 216. Andersson, Liselott
    et al.
    Sundström-Poromaa, Inger
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Wulff, Marianne
    Åström, Monica
    Bixo, Marie
    Neonatal outcome following maternal antenatal depression and anxiety: a population-based study.2004Ingår i: Am J Epidemiol, ISSN 0002-9262, Vol. 159, nr 9, s. 872-81Artikel i tidskrift (Övrigt vetenskapligt)
  • 217.
    Andersson, Maria Eva
    et al.
    Department of Infectious Diseases, University of Gothenburg , Gothenburg , Sweden.
    Elfving, Kristina
    Department of Infectious Diseases, University of Gothenburg , Gothenburg , Sweden.; Univ Gothenburg, Dept Pediat, Gothenburg, Sweden..
    Shakely, Deler
    Department of Medicine, Kungälv Hospital, Sweden.; Karolinska Institutet, Malaria Res, Dept Microbiol Tumor & Cell Biol, Stockholm, Sweden..
    Nilsson, Staffan
    Chalmers University of Technology, Gothenburg, Sweden.
    Msellem, Mwinyi
    Zanzibar Malaria Elimination Programme, Ministry of Health, Tanzania.
    Trollfors, Birger
    Department of Pediatrics, University of Gothenburg, Gothenburg, Sweden.
    Mårtensson, Andreas
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Björkman, Anders
    Malaria Research, Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm.
    Lindh, Magnus
    Department of Infectious Diseases, University of Gothenburg , Gothenburg , Sweden.
    Rapid Clearance and Frequent Reinfection With Enteric Pathogens Among Children With Acute Diarrhea in Zanzibar.2017Ingår i: Clinical Infectious Diseases, ISSN 1058-4838, E-ISSN 1537-6591, Vol. 65, nr 8, s. 1371-1377Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Acute infectious gastroenteritis is an important cause of illness and death among children in low-income countries. In addition to rotavirus vaccination, actions to improve nutrition status, sanitation, and water quality are important to reduce enteric infections, which are frequent also among asymptomatic children. The aim of this study was to investigate if the high prevalence of these infections reflects that they often are not cleared properly by the immune response or rather is due to frequent pathogen exposure.

    Methods: Rectal swabs were collected at time of acute diarrhea and 14 days later from 127 children, aged 2-59 months and living in rural Zanzibar, and were analyzed by real-time polymerase chain reaction targeting multiple pathogens.

    Results: At baseline, detection rates >20% were found for each of enterotoxigenic Escherichia coli, Shigella, Campylobacter, Cryptosporidium, norovirus GII, and adenovirus. At follow-up, a large proportion of the infections had become cleared (34-100%), or the pathogen load reduced, and this was observed also for agents that were presumably unrelated to diarrhea. Still, the detection frequencies at follow-up were for most agents as high as at baseline, because new infections had been acquired. Neither clearance nor reinfection was associated with moderate malnutrition, which was present in 21% of the children.

    Conclusions: Children residing in poor socioeconomic conditions, as in Zanzibar, are heavily exposed to enteric pathogens, but capable of rapidly clearing causative and coinfecting pathogens.

  • 218.
    Andersson, Maria
    et al.
    Univ Gothenburg, Dept Infect Dis, Guldhedsgatan 10B, S-41346 Gothenburg, Sweden.
    Kabayiza, Jean-Claude
    Univ Rwanda, Dept Pediat, Kigali, Rwanda.
    Elfving, Kristina
    Univ Gothenburg, Dept Infect Dis, Guldhedsgatan 10B, S-41346 Gothenburg, Sweden.
    Nilsson, Staffan
    Chalmers Univ Technol, Gothenburg, Sweden.
    Msellem, Mwinyi I.
    Minist Hlth, Zanzibar Malaria Eliminat Programme ZAMEP, Zanzibar, Tanzania.
    Mårtensson, Andreas
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Bjorkman, Anders
    Karolinska Inst, Dept Microbiol Tumor & Cell Biol, Malaria Res, Stockholm, Sweden.
    Bergstrom, Tomas
    Univ Gothenburg, Dept Infect Dis, Guldhedsgatan 10B, S-41346 Gothenburg, Sweden.
    Lindh, Magnus
    Univ Gothenburg, Dept Infect Dis, Guldhedsgatan 10B, S-41346 Gothenburg, Sweden.
    Coinfection with Enteric Pathogens in East African Children with Acute Gastroenteritis-Associations and Interpretations2018Ingår i: American Journal of Tropical Medicine and Hygiene, ISSN 0002-9637, E-ISSN 1476-1645, Vol. 98, nr 6, s. 1566-1570Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Enteric coinfections among children in low-income countries are very common, but it is not well known if specific pathogen combinations are associated or have clinical importance. In this analysis, feces samples from children in Rwanda and Zanzibar less than 5 years of age, with (N = 994) or without (N = 324) acute diarrhea, were analyzed by realtime polymerase chain reaction targeting a wide range of pathogens. Associations were investigated by comparing codetection and mono-detection frequencies for all pairwise pathogen combinations. More than one pathogen was detected in 840 samples (65%). A negative association (coinfections being less common than expected from probability) was observed for rotavirus in combination with Shigella, Campylobacter, or norovirus genogroup II, but only in patients, which is statistically expected for agents that independently cause diarrhea. A positive correlation was observed, in both patients and controls, between Ct (threshold cycle) values for certain virulence factor genes in enteropathogenic Escherichia coli (EPEC) (eae and bfpA) and toxin genes in enterotoxigenic E. coli (eltB and estA), allowing estimation of how often these genes were present in the same bacteria. A significant positive association in patients only was observed for Shigella andEPEC-eae, suggesting that this coinfection might interact in a manner that enhances symptoms. Although interaction between pathogens that affect symptoms is rare, this work emphasizes the importance and difference in interpretation of coinfections depending on whether they are positively or negatively associated.

  • 219.
    Andersson, Ola
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH), Internationell barnhälsa och nutrition.
    Between the sheets - or how to keep babies warm2018Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 107, nr 8, s. 1300-1301Artikel i tidskrift (Övrigt vetenskapligt)
  • 220.
    Andersson, Ola
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Effects of Delayed versus Early Cord Clamping on Healthy Term Infants2013Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    The aim of this thesis was to study maternal and infant effects of delayed cord clamping (≥180 seconds, DCC) compared to early (≤10 seconds, ECC) in a randomised controlled trial. Practice and guidelines regarding when to clamp the cord vary globally, and different meta-analyses have shown contradictory conclusions on benefits and disadvantages of DCC and ECC.

    The study population consisted of 382 term infants born after normal pregnancies and randomised to DCC or ECC after birth. The primary objective was iron stores and iron deficiency at 4 months of age, but the thesis was designed to investigate a wide range of suggested effects associated with cord clamping.

    Paper I showed that DCC was associated with improved iron stores at 4 months (45% higher ferritin) and that the incidence of iron deficiency was reduced from 5.7% to 0.6%. Neonatal anaemia at 2-3 days was less frequent in the DCC group, 1.2% vs. 6.3%. There were no differences between the groups in respiratory symptoms, polycythaemia, or hyperbilirubinaemia.

    In paper II we demonstrated that DCC versus ECC was not associated with higher risk for maternal post partum haemorrhage and rendered a comparable ratio of valid umbilical artery blood gas samples.

    In paper III, the Ages and Stages Questionnaire was used to assess neurodevelopment at 4 months. The total scores did not differ, but the DCC group had a higher score in the problem-solving domain and a lower score in the personal-social domain. Immunoglobulin G level was 0.7 g/L higher in the DCC group at 2–3 days, but did not differ at 4 months. Symptoms of infection up to 4 months were comparable between groups.

    Finally, in paper IV, iron stores and neurodevelopment were similar between groups at 12 months. Gender specific outcome on neurodevelopment at 12 months was discovered, implying positive effects from DCC on boys and negative on girls.

    We conclude that delaying umbilical cord clamping for 180 seconds is safe and associated with a significantly reduced risk for iron deficiency at 4 months, which may have neurodevelopmental effects at a later age.

  • 221.
    Andersson, Ola
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    The transition to extra-uterine life by extremely preterm infants: handle with care2016Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 105, nr 4, s. 337-338Artikel i tidskrift (Övrigt vetenskapligt)
  • 222.
    Andersson, Ola
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Domellof, Magnus
    Andersson, Dan
    Hellström-Westas, Lena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Effect of Delayed vs Early Umbilical Cord Clamping on Iron Status and Neurodevelopment at Age 12 Months A Randomized Clinical Trial2014Ingår i: JAMA PEDIATR, ISSN 2168-6203, Vol. 168, nr 6, s. 547-554Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    IMPORTANCE Prevention of iron deficiency in infancy may promote neurodevelopment. Delayed cord clamping (DCC) can prevent iron deficiency during the first 6 months of life. However, no data are available on long-term effects on infant outcomes in relation to time for umbilical cord clamping. OBJECTIVE To investigate effects of DCC, as compared with early cord clamping (ECC), on infant iron status and neurodevelopment at age 12 months in a European setting. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial of 382 full-term infants born after a low-risk pregnancy at a Swedish county hospital. Follow-up at 12 months included evaluation of iron status (ferritin level, transferrin saturation, transferrin receptor level, reticulocyte hemoglobin level, and mean cell volume) and parental assessment of neurodevelopment by the Ages and Stages Questionnaire, second edition (ASQ). INTERVENTIONS Infants were randomized to DCC (>= 180 seconds after delivery) or ECC (<= 10 seconds after delivery). MAIN OUTCOMES AND MEASURES The main outcome was iron status at age 12 months; the secondary outcome was ASQ score. RESULTS In total, 347 of 382 infants (90.8%) were assessed. The DCC and ECC groups did not differ in iron status (mean ferritin level, 35.4 vs 33.6 ng/mL, respectively; P =.40) or neurodevelopment (mean ASQ total score, 229.6 vs 233.1, respectively; P =.42) at age 12 months. Predictors of ferritin levels were infant sex and ferritin in umbilical cord blood. Predictors of ASQ score were infant sex and breastfeeding within 1 hour after birth. For both outcomes, being a boy was associated with lower results. Interaction analysis showed that DCC was associated with an ASQ score 5 points higher among boys (mean [SD] score, 229 [43] for DCC vs 224 [39] for ECC) but 12 points lower among girls (mean [SD] score, 230 [39] for DCC vs 242 [36] for ECC), out of a maximum of 300 points (P =.04 for the interaction term). CONCLUSIONS AND RELEVANCE Delayed cord clamping did not affect iron status or neurodevelopment at age 12 months in a selected population of healthy term-born infants. However, it may not be possible to demonstrate minor effects on neurodevelopment with the size of the study population and the chosen method for assessment. The current data indicate that sex may influence the effects on infant development after DCC in different directions. The magnitude and biological reason for this finding remain to be investigated.

  • 223.
    Andersson, Ola
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Domellöf, Magnus
    Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden.
    Andersson, Dan
    Department of Pediatrics, Hospital of Halland, Halmstad, Sweden.
    Hellström-Westas, Lena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    A randomized trial of delayed versus early cord clamping: iron status and neurodevelopment at 12 months of ageManuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    Objectives: To investigate effects of delayed umbilical cord clamping, as compared to early, on iron status and infant development at 12 months of age.

    Study design: Term infants (n = 382) were randomly assigned to delayed (≥180 sec) or early (≤10 sec) umbilical cord clamping. Follow up at 12 months of age included evaluation of iron status (ferritin, transferrin saturation, transferrin receptor, reticulocyte hemoglobin equivalent and mean cell volume) and parental assessment of neurodevelopment by the Ages and Stages Questionnaire.

    Results: At 12 months 347 infants were assessed. The two randomization groups did not differ in iron status or in neurodevelopment; 13 had iron deficiency and only one infant had iron deficiency anemia. Predictors of ferritin levels were infant sex and ferritin in umbilical cord blood. Predictors of ASQ were infant sex and breastfeeding within one hour after birth. For both outcomes, being a boy was associated with lower results. Interaction analysis showed that delayed cord clamping was associated with a 5 points higher ASQ score among boys, but a 12 points lower score in girls, out of a maximum of 300 points.

    Conclusions: Delayed cord clamping increases neonatal hemoglobin levels and improves iron status at four months of age, but does not affect ferritin levels or neurodevelopment assessed by ASQ in a selected population of healthy term born infants. However, minor effects on neurodevelopment may not be possible to demonstrate with the size of the study population and the chosen method for assessment. The current data indicate that effects of delayed cord clamping may differ according to infant sex and that boys may benefit more from delayed cord clamping than girls.

  • 224.
    Andersson, Ola
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Domellöf, Magnus
    Andersson, Dan
    Hellström-Westas, Lena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Effects of delayed cord clamping on neurodevelopment and infection at four months of age: a randomised trial2013Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 102, nr 5, s. 525-531Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM:

    To investigate the effect that delayed and early umbilical cord clamping have on neurodevelopment, immunoglobulin G (IgG) and symptoms of infection during the first 4 months of life.

    METHODS:

    Full-term infants (n = 382) were randomised to delayed (≥180 sec) or early cord clamping (≤10 sec). The Ages and Stages Questionnaire (ASQ) was used to assess neurodevelopment at 4 months. Immunoglobulin G was measured at birth, 2-3 days and 4 months. Parents recorded any symptoms indicating infection during the first 4 months of life.

    RESULTS:

    The total scores from the ASQ did not differ between groups. However, the delayed cord clamping (DCC) group had a higher mean (SD) score in the problem-solving domain [55.3 (7.2) vs. 53.5 (8.2), p = 0.03] at 4 months and a lower mean (SD) score in the personal-social domain [49.5 (9.3) vs. 51.8 (8.1), p = 0.01]. The IgG level was higher in the DCC group at 2-3 days (11.7 vs. 11.0 g/L, p = 0.004), but did not differ between the groups at 4 months. Symptoms of infection were comparable between the groups.

    CONCLUSION:

    Delayed cord clamping did not affect overall neurodevelopment or symptoms of infection up to 4 months of age, but may have an impact on specific neurodevelopmental domains.

  • 225.
    Andersson, Ola
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Hellström-Westas, Lena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Andersson, Dan
    Clausen, Jesper
    Domellöf, Magnus
    Effects of delayed compared with early umbilical cord clamping on maternal postpartum hemorrhage and cord blood gas sampling: a randomized trial2013Ingår i: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 92, nr 5, s. 567-574Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective

    To investigate the effect of delayed cord clamping (DCC) compared with early cord clamping (ECC) on maternal postpartum hemorrhage (PPH) and umbilical cord blood gas sampling.

    Design

    Secondary analysis of a parallel-group, single-center, randomized controlled trial.

    Setting

    Swedish county hospital.

    Population

    382 term deliveries after a low-risk pregnancy.

    Methods

    Deliveries were randomized to DCC (≥180 seconds, n = 193) or ECC (≤10 seconds, n = 189). Maternal blood loss was estimated by the midwife. Samples for blood gas analysis were taken from one umbilical artery and the umbilical vein, from the pulsating unclamped cord in the DCC group and from the double-clamped cord in the ECC group. Samples were classified as valid when the arterial-venous difference was -0.02 or less for pH and 0.5 kPa or more for pCO2.

    Main outcome measures

    PPH and proportion of valid blood gas samples.

    Results

    The differences between the DCC and ECC groups with regard to PPH (1.2%, p = 0.8) and severe PPH (-2.7%, p = 0.3) were small and non-significant. The proportion of valid blood gas samples was similar between the DCC (67%, n = 130) and ECC (74%, n = 139) groups, with 6% (95% confidence interval: -4%-16%, p = 0.2) fewer valid samples after DCC.

    Conclusions

    Delayed cord clamping, compared with early, did not have a significant effect on maternal postpartum hemorrhage or on the proportion of valid blood gas samples. We conclude that delayed cord clamping is a feasible method from an obstetric perspective.

  • 226.
    Andersson, Ola
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Hellström-Westas, Lena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Andersson, Dan
    Domellöf, Magnus
    Effect of delayed versus early umbilical cord clamping on neonatal outcomes and iron status at 4 months: a randomised controlled trial2011Ingår i: BMJ. British Medical Journal, E-ISSN 1756-1833, Vol. 343, s. d7157-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To investigate the effects of delayed umbilical cord clamping, compared with early clamping, on infant iron status at 4 months of age in a European setting.

    Design: Randomised controlled trial.

    Setting: Swedish county hospital.

    Participants: 400 full term infants born after a low risk pregnancy.

    Intervention: Infants were randomised to delayed umbilical cord clamping (>= 180 seconds after delivery) or early clamping (<= 10 seconds after delivery).

    Main outcome measures: Haemoglobin and iron status at 4 months of age with the power estimate based on serum ferritin levels. Secondary outcomes included neonatal anaemia, early respiratory symptoms, polycythaemia, and need for phototherapy.

    Results: At 4 months of age, infants showed no significant differences in haemoglobin concentration between the groups, but infants subjected to delayed cord clamping had 45% (95% confidence interval 23% to 71%) higher mean ferritin concentration (117 mu g/L v 81 mu g/L, P<0.001) and a lower prevalence of iron deficiency (1 (0.6%) v 10 (5.7%), P=0.01, relative risk reduction 0.90; number needed to treat=20 (17 to 67)). As for secondary outcomes, the delayed cord clamping group had lower prevalence of neonatal anaemia at 2 days of age (2 (1.2%) v 10 (6.3%), P=0.02, relative risk reduction 0.80, number needed to treat 20 (15 to 111)). There were no significant differences between groups in postnatal respiratory symptoms, polycythaemia, or hyperbilirubinaemia requiring phototherapy.

    Conclusions: Delayed cord clamping, compared with early clamping, resulted in improved iron status and reduced prevalence of iron deficiency at 4 months of age, and reduced prevalence of neonatal anaemia, without demonstrable adverse effects. As iron deficiency in infants even without anaemia has been associated with impaired development, delayed cord clamping seems to benefit full term infants even in regions with a relatively low prevalence of iron deficiency anaemia.

  • 227.
    Andersson, Ola
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH). Department of Research and Development, Region Halland, Sweden.
    Hellström-Westas, Lena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Domellöf, Magnus
    Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden.
    Elective caesarean: does delay in cord clamping for 30 s ensure sufficient iron stores at 4 months of age? A historical cohort control study2016Ingår i: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 6, nr 11, artikel-id e012995Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To compare iron stores in infants born after elective caesarean section (CS) and a 30 s delay of umbilical cord clamping with those born vaginally after early (≤10 s) or delayed (≥180 s) cord clamping.

    DESIGN: Prospective observational study with historical control.

    SETTING: Swedish county hospital.

    POPULATION: 64 infants born after elective CS were compared with a historical control of 166 early clamped and 168 delayed clamped after vaginal birth.

    METHODS: Blood and iron status were measured in blood samples collected at birth, 48-96 hours after birth, 4 and 12 months of age.

    PRIMARY AND SECONDARY OUTCOME MEASURES: Ferritin at 4 months of age was the primary outcome, second outcome measures were other indicators of iron status, and haemoglobin, at 4 and 12 months of age, as well as respiratory distress at 1 and 6 hours after birth.

    RESULTS: At 4 months infants born by elective CS had better iron status than those born vaginally subjected to early cord clamping, shown by higher adjusted mean difference of ferritin concentration (39 µg/L (95% CI 10 to 60)) and mean cell volume (1.8 fL (95% CI 0.6 to 3.0)); and lower levels of transferrin receptors (-0.39 mg/L (95% CI -0.69 to -0.08)). No differences were seen between infants born after elective CS and delayed clamped vaginally born infants at 4 months. No differences were found between groups at 12 months of age.

    CONCLUSIONS: Waiting to clamp the umbilical cord for 30 s after elective CS results in higher iron stores at 4 months of age compared with early cord clamping after vaginal birth, and seems to ensure iron status comparable with those achieved after 180 s delayed cord clamping after vaginal birth.

  • 228.
    Andersson, Ola
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Lindquist, Barbro
    Hosp Halland, Habilitat Ctr, Halmstad, Sweden..
    Lindgren, Magnus
    Lund Univ, Dept Psychol, Lund, Sweden..
    Stjernqvist, Karin
    Lund Univ, Dept Psychol, Lund, Sweden..
    Domellof, Magnus
    Umea Univ, Dept Clin Sci, Pediat Unit, Umea, Sweden..
    Hellström-Westas, Lena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Effect of Delayed Cord Clamping on Neurodevelopment at 4 Years of Age A Randomized Clinical Trial2015Ingår i: JAMA pediatrics, ISSN 2168-6203, E-ISSN 2168-6211, Vol. 169, nr 7, s. 631-638Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    IMPORTANCE Prevention of iron deficiency in infancy may promote neurodevelopment. Delayuci umbilical cord clamping (CC) prevents iron deficiency at 4 to 6 months of age, but long-term effects after 12 months of age have not been reported. OBJECTIVE To investigate the effects of delayed CC compared with early CC on neurodevelopment at 4 years of age. DESIGN, SETTING, AND PARTICIPANTS Follow-up of a randomized clinical trial conducted from April 16, 2008, through May 21, 2010, at a Swedish county hospital. Children who were included in the original study (n = 382) as full-term infants born after a low-risk pregnancy were invited to return for follow-up at 4 years of age. Wechsler Preschool and Primary Scale of Intelligence (WPPSI-111) and Movement Assessment Battery for Children (Movement ABC) scores (collected between April 18, 2012, and July 5, 2013) were assessed by a blinded psychologist. Between April 11, 2012, and August 13, 2013, parents recorded their child's development using the Ages and Stages Questionnaire, Third Edition (ASQ) and behavior using the Strengths and Difficulties Questionnaire. All data were analyzed by intention to treat. INTERVENTIONS Randomization to delayed CC (>= 180 seconds after delivery) or early CC (<= 10 seconds after delivery). MAIN OUTCOMES AND MEASURES The main outcome was full-scale IQ as assessed by the were development as assessed by the scales from the WPPSI-III and Movement ABC, development as recorded using the ASQ, and behavior using the Strengths and Difficulties Questionnaire. RESULTS We assessed 263 children (68.8%). No differences were found in WPPSI-III scores between groups. Delayed CC improved the adjusted mean differences (AMDs) in the ASQ personal-social (AMD, 2.8; 95% Cl, 0.8-4.7) and fine-motor (AMD, 2.1; 95% Cl, 0.2-4.0) domains and the Strengths and Difficulties Questionnaire prosocial subscale (AMD, 0.5; 95% Cl, >0.0-0.9). Fewer children in the delayed-CC group had results below the cutoff in the ASQ fine-motor domain (11.0% vs 3.7%; P =.02) and the Movement ABC bicycle-trail task (12.9% vs 3.8%; P =.02). Boys who received delayed CC had significantly higher AMDs in the WPPSI-III processing-speed quotient (AMD, 4.2; 95% Cl, 0.8-7.6; P =.02), Movement ABC bicycle-trail task (AMD, 0.8; 95% Cl, 0.1-1.5; P =.03), and fine-motor (AMD, 4.7; 95% Cl, 1.0-8.4; P =.01) and personal-social (AMD, 4.9; 95% Cl, 1.6-8.3; P =.004) domains of the ASQ. CONCLUSIONS AND RELEVANCE Delayed CC compared with early CC improved scores in the fine-motor at 4 years of age, especially in boys, indicating that optimizing the time to CC may affect neurodevelopment in a low-risk population of children born in a high-income country.

  • 229. Andersson, Sonia
    et al.
    Mints, Miriam
    Gyllensten, Ulf
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Genomik.
    Lindell, Monica
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi.
    Gustavsson, Inger
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Genomik.
    Lambe, Mats
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi.
    Wilander, Erik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Uneven distribution of human papillomavirus 16111 cervical carcinoma in situ and squamous cell carcinoma in older females: A retrospective database study2014Ingår i: Oncology Letters, ISSN 1792-1074, E-ISSN 1792-1082, Vol. 8, nr 4, s. 1528-1532Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Human papillomavirus (HPV) 16 is the dominant cofactor in cervical cancer development. The present report investigated the age-specific prevalence of HPV16 in cervical carcinoma in situ (CIS) in females attending organised cervical cancer screening. A retrospective observational study was performed based on individual data from two databases. A total of 162 females aged between 20 and 65 years from Uppsala County, Sweden with CIS and an HPV test conducted between 2010 and 2011, preceding or concomitant to CIS diagnosis, were included. Females with cervical squamous cell carcinoma (SCC; n=35) were used for comparison. In total, 96% (n=156) of females with CIS were positive for high-risk HPV; HPV16 was the most prevalent (44.5%), followed by HPV33/52/58 (19.5%), HPV31 (13.1%) and HPV18145 (9.5%). HPV16 was most frequently detected in females with CIS aged between 20 and 29 years (73.6%) and least frequently detected in those aged between 50 and 65 years (33.3%), with a statistically significant age-specific difference (P=0.001). Among the HPV16-positive females, multiple infections were most frequent in the younger age groups. The prevalence of HPV16 in females with CIS decreased with age, whereas a high prevalence of HPV16 remained in females with SCC. These results may indicate that HPV16 has increased oncogenic potential in older females.

  • 230. Andersson, Sonia
    et al.
    Mints, Miriam
    Wilander, Erik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Results of cytology and high-risk human papillomavirus testing in females with cervical adenocarcinoma in situ2013Ingår i: Oncology Letters, ISSN 1792-1074, E-ISSN 1792-1082, Vol. 6, nr 1, s. 215-219Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The incidence rates of cervical adenocarcinoma have been increasing over the last two decades, contrary to those of squamous cell carcinoma. This trend is particularly evident among females aged <40 years and has occurred despite extensive cytology-based screening programs. The aim of the present retrospective database study was to investigate adenocarcinoma in situ (AIS) with respect to previous cytological results, high-risk (HR) human papillomavirus (HPV) infections and histological results from AIS-adjacent squamous mucosa. Databases were used to identify 32 female patients with AIS treated for various conditions between 2009 and 2012 at the Department of Gynecology, Uppsala University Hospital (Uppsala, Sweden) and previous cytological, HPV and histological results. Of the individuals in the study, 64.3% had a previously recorded cytological result showing squamous cell abnormalities; five had glandular cell abnormalities (18%) and two had AIS (7.1%). Among the patients with available HPV results, 95% were HR-HPV-positive; HPV18/45 predominated (77%), followed by HPV16 (27%). The patients with multiple HPV infections were aged <= 32 years, while patients aged >= 38 years were only infected with HPV18/45. All but three patients had cervical intraepithelial neoplasia (CIN) in the AIS-adjacent squamous mucosa, 79% of which was CIN2 or worse. The present retrospective database study suggests that AIS is detected at screening mainly due to simultaneous squamous precursor lesions and that HPV18/45 infection is an increasing co-factor for AIS in older patients. HPV analyses of glandular precursor lesions aid in the identification of female individuals at risk of progression to invasive disease, and thus have a favorable effect on adenocarcinoma prevention, together with vaccination.

  • 231.
    Andersson, Tommy
    et al.
    Institutionen för socialt arbete, Umeå universitet.
    Heimer, Gun
    Uppsala universitet, Nationellt centrum för kvinnofrid (NCK).
    Lucas, Steven
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Våld och hälsa: En befolkningsundersökning om kvinnors och mäns våldsutsatthet samt kopplingen till hälsa2014Rapport (Övrigt vetenskapligt)
  • 232.
    Andersson, Vidar
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Evaluation of CellaVision DM1200 Vet and its ability to differentiate feline leukocytes compared to manual differential count and Advia 21202016Självständigt arbete på grundnivå (yrkesexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [en]

    Leukocyte differential count in peripheral blood smear has, ever since the method was developed more than 100 years ago, been one of the most frequently used diagnostics tool in the routine hematology laboratory. The manual differential count of leukocytes using a microscope is still the standard method in most small and medium sized laboratories. Even though the method does not require any expensive instruments it comes at a high cost due to it being labor intensive and time consuming. In recent years the rapid technical advancements has led to the development of automatic or semi-automatic methods in which the leukocytes are differentiated. In this study a method comparison was made between manual leukocyte differential counts, CellaVision DM1200 Vet and Advia 2120 when analyzing 106 fresh, feline blood samples. The general agreement between results was good, especially for the most common leukocytes, such as neutrophils and lymphocytes. Results for eosinophils and monocytes had moderate agreement. The confidence intervals were generally wider when CellaVision DM1200 Vet was compared with Advia 2120, than when CellaVision DM1200 Vet was compared to the manual differential count. Despite the fact that Advia 2120 and CellaVision DM1200 Vet are both faster and often show comparable results to the manual differential count, the light microscopy will remain the gold standard for difficult samples, where there is suspicion of inflammation (band neutrophils), intracellular microorganisms, reactive lymphocytes or if the sample contains a high degree of smudge cells or artifacts. 

  • 233.
    Andorf, Sandra
    et al.
    Stanford Univ, Stanford, CA 94305 USA..
    Borres, Magnus P
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa. Thermo Fisher Sci, Uppsala, Sweden..
    Block, Whitney
    Stanford Univ, Stanford, CA 94305 USA..
    Lidholm, Jonas
    Thermo Fisher Sci, Uppsala, Sweden..
    Jones, Joseph E.
    Thermo Fisher Sci, Portage, MI USA..
    Galli, Stephen J.
    Stanford Univ, Stanford, CA 94305 USA..
    Chinthrajah, R. Sharon
    Stanford Univ, Stanford, CA 94305 USA..
    Nadeau, Kari C.
    Stanford Univ, Stanford, CA 94305 USA..
    Characterization of multifood allergic children based on clinical and serological data2017Ingår i: Journal of Allergy and Clinical Immunology, ISSN 0091-6749, E-ISSN 1097-6825, Vol. 139, nr 2, s. AB140-AB140Artikel i tidskrift (Övrigt vetenskapligt)
  • 234.
    Andorf, Sandra
    et al.
    Stanford Univ, Dept Med, Div Pulm & Crit Care Med, Stanford, CA 94305 USA.;Stanford Univ, Sean N Parker Ctr Allergy & Asthma Res, Stanford, CA 94305 USA..
    Borres, Magnus P.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa. Thermo Fisher Sci, Immunodiagnost, Uppsala, Sweden..
    Block, Whitney
    Stanford Univ, Dept Med, Div Pulm & Crit Care Med, Stanford, CA 94305 USA.;Stanford Univ, Sean N Parker Ctr Allergy & Asthma Res, Stanford, CA 94305 USA..
    Tupa, Dana
    Stanford Univ, Dept Med, Div Pulm & Crit Care Med, Stanford, CA 94305 USA.;Stanford Univ, Sean N Parker Ctr Allergy & Asthma Res, Stanford, CA 94305 USA..
    Bollyky, Jennifer B.
    Stanford Univ, Dept Med, Div Gen Med, Stanford, CA 94305 USA..
    Sampath, Vanitha
    Stanford Univ, Dept Med, Div Pulm & Crit Care Med, Stanford, CA 94305 USA.;Stanford Univ, Sean N Parker Ctr Allergy & Asthma Res, Stanford, CA 94305 USA..
    Elizur, Arnon
    Stanford Univ, Dept Med, Div Pulm & Crit Care Med, Stanford, CA 94305 USA.;Stanford Univ, Sean N Parker Ctr Allergy & Asthma Res, Stanford, CA 94305 USA..
    Lidholm, Jonas
    Thermo Fisher Sci, Immunodiagnost, Uppsala, Sweden..
    Jones, Joseph E.
    Thermo Fisher Sci, Immunodiagnost, Kalamazoo, MI USA..
    Galli, Stephen J.
    Stanford Univ, Sean N Parker Ctr Allergy & Asthma Res, Stanford, CA 94305 USA.;Stanford Univ, Sch Med, Dept Pathol, Stanford, CA 94305 USA.;Stanford Univ, Sch Med, Dept Microbiol & Immunol, Stanford, CA 94305 USA..
    Chinthrajah, Rebecca S.
    Stanford Univ, Dept Med, Div Pulm & Crit Care Med, Stanford, CA 94305 USA.;Stanford Univ, Sean N Parker Ctr Allergy & Asthma Res, Stanford, CA 94305 USA..
    Nadeau, Kari C.
    Stanford Univ, Dept Med, Div Pulm & Crit Care Med, Stanford, CA 94305 USA.;Stanford Univ, Sean N Parker Ctr Allergy & Asthma Res, Stanford, CA 94305 USA..
    Association of Clinical Reactivity with Sensitization to Allergen Components in Multifood-Allergic Children2017Ingår i: Journal of Allergy and Clinical Immunology: In Practice, ISSN 2213-2198, E-ISSN 2213-2201, Vol. 5, nr 5, s. 1325-1334.e4Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Thirty percent of children with food allergies have multiple simultaneous allergies; however, the features of these multiple allergies are not well characterized serologically or clinically. OBJECTIVE: We comprehensively evaluated 60 multifood-allergic patients by measuring serum IgE to key allergen components, evaluating clinical histories and medication use, performing skin tests, and conducting double-blind, placebo-controlled food challenges (DBPCFCs). METHODS: Sixty participants with multiple food allergies were characterized by clinical history, DBPCFCs, total IgE, specific IgE, and component-resolved diagnostics (IgE and IgG4) data. The food allergens tested were almond, egg, milk, sesame, peanut, pecan, walnut, hazelnut, cashew, pistachio, soy, and wheat. RESULTS: Our data demonstrate that of the reactions observed during a graded DBPCFC, gastrointestinal reactions occurred more often in boys than in girls, as well as in individuals with high levels of IgE to 2S albumins from cashew, walnut, and hazelnut. Certain food allergies often occurred concomitantly in individuals (ie, cashew/pistachio and walnut/pecan/hazelnut). IgE testing to components further corroborated serological relationships between and among these clustered food allergies. CONCLUSIONS: Associations of certain food allergies were shown by DBPCFC outcomes as well as by correlations in IgE reactivity to structurally related food allergen components. Each of these criteria independently demonstrated a significant association between allergies to cashew and pistachio, as well as among allergies to walnut, pecan, and hazelnut. (C) 2017 American Academy of Allergy, Asthma & Immunology

  • 235. Andreasson, C
    et al.
    Stenson, K
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Björck, A
    Heimer, G
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Den svenska hälso- och sjukvårdens arbete inom kompetensområdet våld mot kvinnor: Nationell kartläggning2006Rapport (Övrigt vetenskapligt)
  • 236. Andreen, Lotta
    et al.
    Sundström Poromaa, Inger
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Bixo, Marie
    Nyberg, Sigrid
    Bäckström, Torbjörn
    Allopregnanolone concentration and mood--a bimodal association in postmenopausal women treated with oral progesterone.2006Ingår i: Psychopharmacology (Berl), ISSN 0033-3158, Vol. 187, nr 2, s. 209-21Artikel i tidskrift (Refereegranskat)
  • 237.
    Andresen, E.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Rollins, N. C.
    Sturm, A. W.
    Conana, N.
    Greiner, T.
    Bacterial contamination and over-dilution of commercial infant formula prepared by HIV-Infected mothers in a Prevention of Mother-to-Child Transmission (PMTCT) programme, South Africa2007Ingår i: Journal of Tropical Pediatrics, ISSN 0142-6338, E-ISSN 1465-3664, Vol. 53, nr 6, s. 409-414Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    To examine the safety of formula feeds used by mothers participating in a Prevention of Mother-to-Child Transmission (PMTCT) programme, contents of 94 feeding bottles collected at a PMTCT-clinic were analysed. An additional 17 samples were taken from already prepared feeds during home visits, as well as 21 samples from bottles prepared under observation. Living conditions and educational levels were overall good and mothers had been counselled on safe formula preparation. Samples were analysed for faecal bacteria, using Escherichia coli and Enterococcus sp. as indicators. Protein concentration was used as an indicator of concentration of the formula. Out of 94, 63 (67) of samples obtained at the clinic and 13/16 (81) of available home samples were contaminated with faecal bacteria, compared to 8/21 (38) of those prepared under observation. Out of 94, 58 (62) of the clinic samples containing E. coli and 23/94 (24) of those containing Enterococcus sp. were contaminated with more than the US government recommended limit of 10 CFU/ml. Out of 94, 26 (28) of samples obtained at the clinic, 8/17 (47) of home samples and 3/21 (14) of those prepared under observation were over-diluted, compared to standards. Many mothers did not follow recommended practices in preparing and feeding the bottles.

  • 238.
    Andrén, Caroline
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Induction of HPV-16 Late Gene Expression Through Use of Small Molecule Drugs2016Självständigt arbete på grundnivå (yrkesexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [en]

    Cervical cancer is the second most common cancer in women worldwide. The principal cause of cervical cancer is infection with human papillomavirus (HPV). HPV-16 is a high-risk virus and it is responsible for a high portion of all HPV-caused cancers. The HPV-16 genome consists of early and late genes. The virus initially infects basal cells of the cervix epithelium and in these cells early genes are expressed, whilst late genes, L1 and L2, are only expressed in the upper cell layers of the epithelium. Proteins encoded by the late genes are highly immunogenic, thus it is speculated that expression of the late genes earlier in the virus life cycle could lead to clearance of the virus due to interference of the immune system.

        The aim of this study was to treat reporter cell lines with three different small molecule drugs to see if they had the ability to induce HPV-16 late gene expression. The reporter cell lines used in this study had been previously created by transfecting HeLa-cells with plasmids representing the HPV-16 genome. In these plasmids, L1 is replaced with a CAT reporter gene that encodes the CAT protein, which can be easily quantified using a sandwich ELISA.

        Upon treating the reporter cell lines with TPA, a significant induction of late gene expression was detected. Furthermore, treatment with valproic acid showed some induction of late gene expression. In conclusion, TPA and valproic acid was deemed to have potential to act as a candidate drugs for treatment of HPV infections. 

  • 239.
    Aneblom , G
    et al.
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Larsson , M
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Odlind, V
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Tyden, T
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Oönskade graviditeter trots kunskaper om akut-p-piller2002Ingår i: Vårdfacket, Vol. 6, s. 57Övrigt (Övrigt vetenskapligt)
  • 240.
    Aneblom, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    The Emergency Contraceptive Pill – a Second Chance: Knowledge, Attitudes and Experiences Among Users and Providers2003Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    The overall aim of this thesis was to study knowledge, attitudes and experience of emergency contraceptive pills among women and providers.

    Both quantitative and qualitative methods were used. Focus-group interviews were conducted with teenage-girls (I) and with women who had purchased ECP without prescription (IV). Self-administered waiting-room questionnaires were administered to women presenting for induced abortion in three large hospitals (II, III), and after the deregulation of ECP, a postal questionnaire was sent to pharmacy staff and nurse-midwives in three counties in mid-Sweden (V).

    Overall, women showed high basic awareness of ECP although specific knowledge such as the level of effectiveness, time-frames and how the method works was lacking. Approval of the method was high and most women were positive to use the method if they needed. Contradictory views as to whether ECP undermines contraceptive behavior were expressed. As many as 43% of women requesting induced abortion had a history of one or more previous abortions. Among the abortion applicants, one out of five, 22%, had previously used ECP and 3% had used it to prevent the current pregnancy. Media and friends were the two most common sources of information on ECP. Half of the women, 52%, were positive to having ECP prescription-free. Those women who had purchased ECP in a pharmacy without prescription, appreciated this possibility, and the major benefits expressed were time saving aspects. No severe side-effects were reported. The women's experiences of interaction with pharmacy staff were both positive and negative. The importance of up-to-date information about ECP and the OTC-availability from the health care providers was emphasized. Both pharmacy staff and nurse-midwives had positive attitudes towards ECP and the OTC availability. Of pharmacy staff, 38% reported that they referred women to nurse-midwives/gynecologists for further counseling and follow-ups. The need for increased communication and collaboration between pharmacies and local family planning clinics was reported by both study groups with suggestions of regular meetings for information and discussions.

    The results suggest that ECP is still underused and that more factual information is needed before the method is becoming a known, accepted and integrated back-up method to the existing family planning repertoire. Longitudinal research to assess the long-term effects of ECP is needed.

  • 241.
    Aneblom, Gunilla
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Larsson, Margareta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Tydén, Tanja
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Focus group interviews of Swedish teenage girls about the emergency contraceptive pill1999Ingår i: Scandinavian Journal of Sexology, ISSN 1398-2966, Vol. 2, nr 4, s. 175-184Artikel i tidskrift (Refereegranskat)
  • 242.
    Aneblom, Gunilla
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Larsson, Margareta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    von Essen, Louise
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap.
    Tydén, Tanja
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Women's voices about emergency contraceptive pills "over-the-counter": a Swedish perspective2002Ingår i: Contraception, ISSN 0010-7824, E-ISSN 1879-0518, Vol. 66, nr 5, s. 339-343Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study aimed to describe women’s experiences with the emergency contraceptive pill (ECP) as a prescription-free over-the-counter (OTC) product. Women (median age 24) who had bought ECP as an OTC product were interviewed in focus groups. Data were analyzed by content analysis. All participants appreciated the OTC availability. Timesaving aspects were seen as important benefits and pharmacies were seen as the right place to sell ECP. The media was the main source of information about OTC, probably due to the debates of the introduction of ECP as an OTC product in Sweden. All women discussed the mechanism of action. The women’s experiences of interacting with the pharmacists were both positive and negative. Inconsistencies in routines with regard to providing ECP and different attitudes toward use of ECP among the pharmacists, were identified. The women expected up-to-date information about ECP and the OTC availability from gynecologists and other health professionals.

  • 243.
    Aneblom, Gunilla
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Stålsby Lundborg, Cecilia
    Carlsten, Anders
    Eurenius, Karin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Tydén, Tanja
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Emergency contraceptive pills over-the-counter: practices and attitudes of pharmacy and nurse-midwife providers2004Ingår i: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 55, nr 1, s. 129-135Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Deregulation of emergency contraceptive pills (ECP) has led to pharmacy staff becoming a new provider group of ECP, together with nurse-midwives, who are already experienced in prescribing contraceptives. This postal questionnaire survey aimed to assess practices and attitudes towards ECP and the over-the-counter (OTC)-availability among pharmacy staff (n=237) and nurse-midwives (n=163). The overall response rate was 89%. Both study groups were positive to ECP and the OTC-availability and the vast majority agreed that sexually active women should be aware of ECP and that routine information about ECP should be included in contraceptive counseling. Verbal information on all aspects of ECP to clients was reported more often by nurse-midwives than by pharmacy staff. Both groups supported collaboration between providers. Our findings suggest that further collaboration between pharmacies and family planning clinics should be encouraged to ensure a competent and client-friendly provision of ECP.

  • 244.
    Angeby, Karin
    et al.
    Cent Hosp Karlstad, Womens Dept, Karlstad, Sweden.;Karlstad Univ, Dept Hlth Sci, Fac Hlth Sci & Technol, SE-61588 Karlstad, Sweden..
    Wilde-Larsson, Bodil
    Karlstad Univ, Dept Hlth Sci, Fac Hlth Sci & Technol, SE-61588 Karlstad, Sweden.;Hedmark Univ Coll, Fac Publ Hlth, Dept Nursing & Mental Hlth, Elverum, Norway..
    Hildingsson, Ingegerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi. Mid Sweden Univ, Sundsvall, Sweden. Karoliniska Inst, Stockholm, Sweden..
    Sandin-Bojo, Ann-Kristin
    Karlstad Univ, Dept Hlth Sci, Fac Hlth Sci & Technol, SE-61588 Karlstad, Sweden.;Univ Boras, Sch Hlth Sci, Boras, Sweden..
    Primiparous women's preferences for care during a prolonged latent phase of labour2015Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 6, nr 3, s. 145-150Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To investigate primiparous women's preferences for care during a prolonged latent phase of labour. Methods: A qualitative study based on focus groups and individual interviews and analysed with inductive content analysis. Results: Sixteen primiparous women with a prolonged latent phase of labour >18 hours were interviewed in five focus groups (n = 11) or individually (n = 5). One main category emerged "Beyond normality - a need of individual adapted guidance in order to understand and manage an extended latent phase of labour" which covers the women's preferences during the prolonged latent phase. Five categories were generated from the data: "A welcoming manner and not being rejected", "Individually adapted care", "Important information which prepares for reality and coping", "Participation and need for feedback" and "Staying nearby the labour ward or being admitted for midwifery support". Women with a prolonged latent phase of labour sought to use their own resources, but their needs for professional support increased as time passed. A welcoming attitude from an available midwife during the latent phase created a feeling of security, and personally adapted care was perceived positively. Conclusions: Women with a prolonged latent phase of labour preferred woman-centred care. Midwives play an important role in supporting these women. Women's need for midwifery-support increases as the time spent in latent phase increases.

  • 245. Angeles Martinez-Maestre, Maria
    et al.
    Gambadauro, Pietro
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Gonzalez-Cejudo, Carmen
    Torrejon, Rafael
    Total Laparoscopic Hysterectomy With and Without Robotic Assistance: A Prospective Controlled Study2014Ingår i: Surgical Innovation, ISSN 1553-3506, E-ISSN 1553-3514, Vol. 21, nr 3, s. 250-255Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background. Hysterectomies are very common, and most of them are still performed abdominally. The minimally invasive alternatives are perceived as difficult by gynecologists. Robotic assistance is thought to facilitate laparoscopic surgery. The aim of this study was to compare the surgical outcomes of robotic-assisted and conventional total laparoscopic hysterectomy. Methods. Patients, candidate to hysterectomy for benign indications, were allocated to either robotic or conventional laparoscopy in a quasi-randomized fashion. Patients were operated following a standardized surgical protocol. Main outcome measures were total surgical time, conversions to laparotomy, blood loss, hospital stay, and complications. Results. Fifty-one patients underwent robotic hysterectomy (mean age = 46.59 years) and 54 conventional laparoscopy (mean age = 50.02 years). The groups were homogeneous in body mass index and uterine weight. Robotic-assisted hysterectomies were significantly shorter (154.63 +/- 36.57 vs 185.65 +/- 42.98 minutes in the control group; P =.0001). Patients in the robotic group also had a significantly smaller reduction in hemoglobin (9.69% +/- 8.88% vs 15.29% +/- 8.39% in controls; P =.0012) and hematocrit (10.56% +/- 8.3% vs 14.89% +/- 8.11%; P =.008). No intraoperative conversions to laparotomy were required. Complication rate was low and similar in both groups. All patients were fully recovered at 1-month follow-up outpatient visit. Conclusions. Significantly lower operative times and blood loss indicate that robotic assistance can facilitate surgery already during the learning curve period. Nevertheless, proficiency can be reached in conventional laparoscopy through training, and the cost-effectiveness of robotic hysterectomy for benign conditions is yet to be confirmed.

  • 246.
    Angelhoff, Charlotte
    et al.
    Linkoping Univ, Div Nursing Sci, Dept Social & Welf Studies, Norrkoping, Sweden;Linkoping Univ, Dept Clin & Expt Med, Linkoping, Sweden;Linkoping Univ, Dept Paediat, Linkoping, Sweden.
    Blomqvist, Ylva Thernström
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Perinatal, neonatal och barnkardiologisk forskning.
    Helmer, Charlotte Sahlen
    Linkoping Univ, Div Nursing Sci, Dept Social & Welf Studies, Norrkoping, Sweden;Linkoping Univ, Dept Clin & Expt Med, Linkoping, Sweden;Linkoping Univ, Dept Paediat, Linkoping, Sweden.
    Olsson, Emma
    Orebro Univ, Dept Pediat, Orebro, Sweden;Orebro Univ, Ctr Hlth Care Sci, Orebro, Sweden.
    Shorey, Shefaly
    Natl Univ Singapore, Natl Univ Hlth Syst, Yong Loo Lin Sch Med, Alice Lee Ctr Nursing Studies, Singapore, Singapore.
    Frostell, Anneli
    Linkoping Univ, Div Psychol, Dept Behav Sci & Learning, Linkoping, Sweden.
    Mörelius, Evalotte
    Linkoping Univ, Div Nursing Sci, Dept Social & Welf Studies, Norrkoping, Sweden;Linkoping Univ, Dept Clin & Expt Med, Linkoping, Sweden.
    Effect of skin-to-skin contact on parents' sleep quality, mood, parent-infant interaction and cortisol concentrations in neonatal care units: study protocol of a randomised controlled trial2018Ingår i: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 8, nr 7, artikel-id e021606Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Separation after preterm birth is a major stressor for infants and parents. Skin-to-skin contact (SSC) is a method of care suitable to use in the neonatal intensive care unit (NICU) to minimise separation between parents and infants. Less separation leads to increased possibilities for parent-infant interaction, provided that the parents' sleep quality is satisfactory. We aimed to evaluate the effect of continuous SSC on sleep quality and mood in parents of preterm infants born <33 weeks of gestation as well as the quality of parent-infant interaction and salivary cortisol concentrations at the time of discharge.

    Methods and analysis: A randomised intervention study with two arms-intervention versus standard care. Data will be collected from 50 families. Eligible families will be randomly allocated to intervention or standard care when transferred from the intensive care room to the family-room in the NICU. The intervention consists of continuous SSC for four consecutive days and nights in the family-room. Data will be collected every day during the intervention and again at the time of discharge from the hospital. Outcome measures comprise activity tracker (Actigraph); validated self-rated questionnaires concerning sleep, mood and bonding; observed scorings of parental sensitivity and emotional availability and salivary cortisol. Data will be analysed with pairwise, repeated measures, Mann Whitney U-test will be used to compare groups and analysis of variance will be used to adjust for different hospitals and parents' gender.

    Ethics and dissemination: The study is approved by the Regional Research Ethics Board at an appropriate university (2016/89-31). The results will be published in scientific journals. We will also use conferences and social media to disseminate our findings.

  • 247.
    Angsten, Gertrud
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Barnkirurgi.
    Danielson, Johan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Barnkirurgi.
    Kassa, Ann-Marie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Barnkirurgi.
    Lilja, Helene Engstrand
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Barnkirurgi.
    Outcome of laparoscopic versus open gastrostomy in children2015Ingår i: Pediatric surgery international (Print), ISSN 0179-0358, E-ISSN 1437-9813, Vol. 31, nr 11, s. 1067-1072Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Laparoscopic gastrostomy (LAPG) has gained popularity in children. The aim of this study was to compare the outcome of LAPG versus open gastrostomy (OG) in children with focus on complications, operative times and postoperative length of stay. Retrospective study of children who had gastrostomies inserted at our tertiary Pediatric Surgery Center from 2000 until 2013. The indications for a gastrostomy were an anticipated need for enteral support for at least 6 months. Totally 243 children were included in the study, 83 with LAPG and 160 with OG. We found a significant difference in postoperative length of stay, 3 days in the LAPG group versus 4 days in the OG group but no difference in a sub-group analysis from 2010 to 2013 when both techniques were used. There was no difference in median operative time or complications rates. Granuloma was the dominating complication in both groups. These two feeding-access techniques are comparable regarding complications, operative times and postoperative length of stay. The choice of surgical method should be individualized based on the patient's characteristics and the experience of the surgeon. The favorable results with LAPG in adults are not necessarily transferable to children since there are physiological and anatomical differences.

  • 248.
    Angsten, Gertrud
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Barnkirurgi.
    Finkel, Yigael
    Lucas, Steven
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Kassa, Ann-Marie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Barnkirurgi.
    Paulsson, Mattias
    Engstrand Lilja, Helene
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Barnkirurgi.
    Improved outcome in neonatal short bowel syndrome using parenteral fish oil in combination With ω-6/9 Lipid Emulsions2012Ingår i: JPEN - Journal of Parenteral and Enteral Nutrition, ISSN 0148-6071, E-ISSN 1941-2444, Vol. 36, nr 5, s. 587-595Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background:

    Newborn infants with short bowel syndrome (SBS) represent a high risk group of developing intestinal failure-associated liver disease (IFALD) which may be fatal. However, infants have a great capacity for intestinal growth and adaptation if IFALD can be prevented or reversed. A major contributing factor to IFALD may be the soybean oil-based intravenous lipid emulsions used since the introduction of parenteral nutrition (PN) 40 years ago.

    Methods:

    This retrospective study compares the outcome in 20 neonates with SBS treated with parenteral fish oil (Omegaven) in combination with omega-6/9 lipid emulsions (ClinOleic) with the outcome in a historical cohort of 18 patients with SBS who received a soybean oil-based intravenous lipid emulsion (Intralipid).

    Results:

    Median gestational age was 26 weeks in the treatment group and 35.5 weeks in the historical group. All patients were started on PN containing Intralipid that was switched to ClinOleic/Omegaven in the treatment group at a median age of 39 gestational weeks. In the treatment group, direct bilirubin levels were reversed in all 14 survivors with cholestasis (direct bilirubin >50 umol/). Median time to reversal was 2.9 months. Only 2 patients died of liver failure (10%).  In the historical cohort, 6 patients (33%) died of liver failure and only 2 patients showed normalization of bilirubin levels.

    Conclusions:

    Parenteral fish oil in combination with omega-6/9 lipid emulsions was associated with improved outcome in premature neonates with SBS. When used instead of traditional soybean-based emulsions, this mixed lipid emulsion may facilitate intestinal adaptation by increasing the IFALD-free period.

  • 249.
    Angsten, Gertrud
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Barnkirurgisk forskning.
    Gustafson, Elisabet
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Barnkirurgisk forskning.
    Dahl, Niklas
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Medicinsk genetik och genomik.
    Christofferson, Rolf H.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Barnkirurgisk forskning.
    Resolution of infantile intestinal pseudo-obstruction in a boy2017Ingår i: Journal of Osteoporosis and Physical Activity, ISSN 2052-3211, E-ISSN 2213-5766, Vol. 24, s. 28-34Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    A term boy with spontaneous passage of meconium exhibited episodes of abdominal distension and diarrhea. Due to failure to thrive and suspicion of Hischsprung's disease he was referred to our university hospital at five months of age. Rectal biopsies were normal. Laparotomy revealed dilation of the small bowel and colon without any mechanical obstruction. Full thickness bowel biopsies were taken and a loop ileostomy was constructed. Histopathology revealed fibrosing myopathy, Cajal cell hypertrophy, and neuronal degeneration in both the large and small bowel. The small bowel showed mastocytosis without inflammation. A central venous catheter was placed for vascular access, replaced three times and later switched to a subcutaneous venous port. Catheters were locked after use with vancomycin-heparin and later taurolidine. The individually tailored home parenteral nutrition contained unsaturated fatty acid lipids to reduce cholestasis. Initial insufficient growth was improved after correction of partial parenteral nutrition based on a metabolic balance study. The ileostomy was revised once and finally taken down at 11 years of age following one year without parenteral support. At follow-up at 13 years of age he has episodes of moderate abdominal pain and has entered puberty and reports a high quality of life. (C) 2017 The Authors. Published by Elsevier Inc.

  • 250.
    Angsten, Gertrud
    et al.
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Valind, S
    Takalo, R
    Neu, H
    Meurling, Staffan
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Inhibition of carnitine-acyl transferase I by oxfenicine studied in vivo with (11 C)-labeled fatty acids2005Ingår i: Nuclear Medicine and Biology, nr 32, s. 495-503Artikel i tidskrift (Refereegranskat)
2345678 201 - 250 av 6000
RefereraExporteraLänk till träfflistan
Permanent länk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf