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| 2. |
- Hildingsson, Ingegerd, et al.
(författare)
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Childbirth thoughts in mid-pregnancy: Prevalence and associated factors in prospective parents.
- 2010
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Ingår i: Sexual and Reproductive HealthCare. - : Elsevier. - 0195-9255 .- 1877-5756. ; 1:2, s. 45-53
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Tidskriftsartikel (refereegranskat)abstract
- Background: Parents' thoughts about childbirth during pregnancy are important for the adjustment process but little is known about factors associated with such thoughts. Objectives: To describe and study background characteristics, feelings and support in relation to thoughts about childbirth in mid-pregnancy, in women and their partners and to analyze which factors are most important for having thoughts and feelings about childbirth. Method: A cross-sectional study of 1212 women and 1105 men recruited shortly after the routine ultra sound examination in pregnancy weeks 17-19. Data was collected by a questionnaire in mid-pregnancy. Data were analyzed using relative risks with 95% confidence interval and logistic regression. Results: A high proportion of women (75%) and men (67%) reported having thoughts about childbirth. In women childbirth related fear Odds Ratio (OR) 2.7; [95% CI 1.62-4.37], high level of education (OR 1.8, [95% CI 1.32-2.34] and major emotional changes OR 1.5, [95% CI 1.0-2.1] were the most important factors associated with having thoughts about childbirth. In men, high level of education OR 1.1 [95% CI 1.41-2.52], getting the opportunity to ask question at prenatal visits OR 1.6 [95% CI 1.17-2.07], and expecting the first baby OR 1.6 [1.17-2.07] contributed most to the model. Discussion: This study shows that the majority of prospective parents think about the birth of their baby in mid-pregnancy. Some factors are common for both parents, but women's thoughts are more based on emotional and physical changes and fears while men's are more based on the social situation such as expecting the first baby and organizational issues in prenatal care, and instrumental issues such as finances. Further studies are needed about the content of the parents' thoughts.
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| 3. |
- Hildingsson, Ingegerd, et al.
(författare)
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Still behind the glass wall? Swedish fathers’ experiences with postnatal care
- 2009
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Ingår i: Journal of Obstetric, Gynecologic and Neonatal Nursing. - : Elsevier BV. - 0884-2175 .- 1552-6909. ; 38:3, s. 280-289
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Tidskriftsartikel (refereegranskat)abstract
- To describe new fathers' satisfaction with postnatal care after the introduction of a more family-centered model and to study factors related to fathers' overall satisfaction with postnatal care. Two cohorts of fathers who had a live-born baby during a 15 weeks period in 2004 and 2006. A Swedish hospital. Postnatal care options were traditional postnatal ward, early discharge, cocare at neonatal ward, and from 2006 a family suite on a hotel ward. Two hundred and eighty-four fathers whose babies were born in 2004 and 356 fathers whose babies were born in 2006. Data were collected using a questionnaire and descriptive statistical odds ratios with 95% confidence interval and logistic regression analyses were used. Six hundred and forty (64%) fathers completed the questionnaire. There was no improvement between the 2 years in satisfaction with the content of postnatal care, although fathers who stayed in the family suite on the hotel ward were more satisfied with the postnatal care over all. The following factors were most significant for predicting dissatisfaction with postnatal care: no support from staff, not being treated nicely, dissatisfaction with the environment, lack of medical check-ups for the mother, and visiting hours. A true family perspective should be applied in postnatal care and the new parents viewed as a family unit, not as medical cases only. Staff working in postnatal wards should be given the opportunity to involve fathers in postnatal care.
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| 4. |
- Karlström, Annika, et al.
(författare)
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Postoperative pain after cesarean birth affects breastfeeding and infant care
- 2007
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Ingår i: Journal of Obstetric, Gynecologic and Neonatal Nursing. - : Elsevier BV. - 0884-2175 .- 1552-6909. ; 36:5, s. 430-440
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study women's experience of postoperative pain and pain relief after cesarean birth and factors associated with pain assessment and the birth experience. DESIGN: Descriptive patient survey. Data were collected through a questionnaire. The outcome variables were assessments of pain using a Visual Analog Scale and women's birth experience measured on a seven-point Likert scale. SETTING: Central Swedish county hospital, maternity unit. PATIENTS/PARTICIPANTS: The sample consisted of 60 women undergoing cesarean birth. RESULTS: Women reported high levels of experienced pain during the first 24 hours. Seventy-eight percent of the women scored greater than or equal to 4 on the Visual Analog Scale, which can be seen as inadequately treated pain. There was no difference between elective and emergency cesarean births in the levels of pain. In spite of high levels of pain, women were pleased with the pain relief. The risk of a negative birth experience was 80% higher for women undergoing an emergency cesarean birth compared with elective cesarean birth. Postoperative pain negatively affected breastfeeding and infant care. CONCLUSIONS: There is a need for individual and adequate pain treatment for women undergoing cesarean birth, as high levels of pain interfere with early infant care and breastfeeding.
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| 5. |
- Karlström, Annika, et al.
(författare)
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Swedish caregivers’ attitudes towards caesarean section on maternal request
- 2009
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192 .- 1878-1799. ; 22:2, s. 57-63
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Tidskriftsartikel (refereegranskat)abstract
- Background Caesarean section (CS) is not an option that women in Sweden can chose themselves, although the rise in CS rate has been attributed to women. This study describes obstetricians’ and midwives’ attitudes towards CS on maternal request. Methods A qualitative descriptive study, with content analysis of 5 focus group discussions where 16 midwives and 9 obstetricians participated. Results The overarching theme was identified as “Caesarean section on maternal request—a balance between resistance and respect”. On the one hand, CS was viewed as a risky project; on the other hand, request for a CS was understood and respected when women had had a previous traumatic birth experience. Still, a CS was not really seen as a solution for childbirth related fear. Five categories were related to the theme. Overall, our findings indicate that caregivers blamed the women for the increase, they considered the management of CS on maternal request difficult, and they suggested preventive methods to reduce CS and means to strengthen their professional roles. Key conclusions and implication for practice Both midwives and obstetricians considered the management of CS on maternal request difficult, and the result showed that they balanced between resistance and respect. The result also showed that the participants stressed the importance of professionals advocating natural birth with evidence-based knowledge and methods to prevent maternal requests. Ongoing discussions among health professionals on attitudes and practice would strengthen their professional roles and lead to a decrease in CS rates in Sweden. Background: Caesarean section (CS) is not an option that women in Sweden can chose themselves,although the rise in CS rate has been attributed to women. This study describesobstetricians’ and midwives’ attitudes towards CS on maternal request. Methods: A qualitative descriptive study, with content analysis of 5 focus group discussions where16 midwives and 9 obstetricians participated. Results: The overarching theme was identified as ‘‘Caesarean section on maternal request–—abalance between resistance and respect’’. On the one hand, CS was viewed as a risky project; on theother hand, request for a CS was understood and respected when women had had a previoustraumatic birth experience. Still, a CS was not really seen as a solution for childbirth related fear.Five categorieswere related to the theme.Overall, our findings indicate that caregivers blamed thewomen for the increase, they considered the management of CS on maternal request difficult, andthey suggested preventive methods to reduce CS and means to strengthen their professional roles. Key conclusions and implication for practice: Both midwives and obstetricians considered the
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| 6. |
- Karlström, Annika, et al.
(författare)
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Women's postoperative experiences before and after the introduction of spinal opioids in anaesthesia for caesareansection
- 2010
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 19:9-10, s. 1326-1334
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Tidskriftsartikel (refereegranskat)abstract
- Aim.The aim was to evaluate a new anaesthetic routine and to study the effect of spinal opioids for caesarean section on postoperative pain, expectations of pain, satisfaction with pain treatment, breastfeeding, infant care and length of hospital stay.Background.Inadequate postoperative pain relief is a problem among hospitalised patients. Women undergoing caesarean section have been shown to experience high levels of pain during the first days after operation. Women are expected to breastfeed and care for their newborn while recovering from major abdominal surgery and sufficient pain relief are of importance.Design.Comparative patient survey.Methods.Data were collected through a questionnaire distributed to two independent samples of women undergoing elective and emergency caesarean section before and after the introduction of an additive of opioids in obstetric spinal anaesthesia. Chi-square tests were performed, and risk ratios were used for bivariate analysis. Logistic regression modelling was used for multivariate analysis.Results.The group of women undergoing caesarean section with opioids added to the spinal anaesthesia reported significantly lower levels of experienced pain. High pain levels irrespective of mode of caesarean section affected breastfeeding and infant care. Length of hospital stay for caesarean women was shortened and the consumption of analgesics was reduced.Conclusions.Women receiving an additive of opioids in spinal anaesthesia experienced lower levels of pain. Low pain levels facilitate breastfeeding and infant care and are of relevance for financial considerations.Relevance to clinical practice.The results of this study indicate that spinal opioids for women undergoing caesarean section have a positive effect on the postoperative pain experience. Women undergoing caesarean section and have high pain levels are in special need of attention and care because of a higher risk of a decreased ability to breastfeed and to take care of their newborn.
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| 7. |
- Popov, Oleg, 1959-, et al.
(författare)
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Secondary and university students’ understandings of physical and technical phenomena : informing pedagogy and practice
- 2000
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Ingår i: Learning and teaching science and mathematics in secondary and higher education. - Joensuu : University of Joensuu, Department of applied education. - 9517088957 ; , s. 43-50
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Konferensbidrag (refereegranskat)abstract
- This paper presents some findings from the piloting phase of our research on students’ thinking about physical processes imbedded in a number of technical and natural phenomena. We mean by “thinking physics” how students use language of physics, i.e. appropriate terminology, concepts and modelling tools.
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| 8. |
- Skovbjerg, Susann, 1973, et al.
(författare)
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High cytokine levels in perforated acute otitis media exudates containing live bacteria
- 2010
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Ingår i: Clinical microbiology and infection. - : Elsevier BV. - 1469-0691 .- 1198-743X. ; 16:9, s. 1382-1388
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Tidskriftsartikel (refereegranskat)abstract
- Acute otitis media (AOM) is an inflammatory response to microbes in the middle ear, sometimes associated with rupture of the tympanic membrane. Human leukocytes produce different patterns of inflammatory mediators in vitro when stimulated with Gram-positive and Gram-negative bacteria, respectively. Here, we investigated the cytokine and prostaglandin E(2) (PGE(2)) responses in middle ear fluids (MEFs) from children with spontaneous perforated AOM and related the levels to the presence of pathogens detected by culture (live) or PCR (live or dead). Furthermore, in vivo cytokine pattern was compared with that induced in leukocytes stimulated by dead bacteria in vitro. MEFs with culturable pathogenic bacteria contained more IL-1beta (median 110 vs <7.5 ng/ml), TNF (6.3 vs <2.5 ng/ml), IL-8 (410 vs 38 ng/ml), and IL-10 (0.48 vs <0.30 ng/ml), than culture negative fluids, irrespective of PCR findings. IL-6 and PGE(2) were equally abundant (69-110 ng/ml) in effusions with live, dead or undetectable bacteria. Cytokine levels were unrelated to bacterial species and to the presence or absence of virus. Similar levels of TNF and IL-6 as found in the MEFs were obtained by in vitro stimulation of leukocytes, while 11x more IL-1beta and 3.5x more IL-8 was produced in vivo, and 22x more IL-10 was produced in vitro. A vigorous production of pro-inflammatory cytokines accompany AOM with membrane rupture regardless of causative agent, but the production seems to cease rapidly once the bacteria are killed and fragmented. IL-6 and PGE(2), however, remain after bacterial disintegration and may play a role in the resolution phase.
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| 9. |
- Skovbjerg, Susann, 1973, et al.
(författare)
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High Cytokine Levels in Tonsillitis Secretions Regardless of Presence of Beta-Hemolytic Streptococci
- 2015
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Ingår i: Journal of Interferon and Cytokine Research. - : Mary Ann Liebert Inc. - 1079-9907 .- 1557-7465. ; 35:9, s. 682-689
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Tidskriftsartikel (refereegranskat)abstract
- Acute pharyngotonsillitis denotes tonsillar inflammation caused by bacteria or viruses. Here, we investigated if beta-hemolytic streptococci (beta-HS) tonsillitis would differ in inflammatory mediator response from tonsillitis of other causes. Tonsillar secretions were obtained from 36 acute pharyngotonsillitis patients and 16 controls. Bacteria were cultured quantitatively and 18 different viruses were quantified by real-time polymerase chain reaction. Cytokine and prostaglandin E-2 (PGE(2)) levels were determined by enzyme-linked immunosorbent assays. Almost half of the patients' tonsillar secretions yielded high counts of beta-HS, and most samples contained viruses, irrespective of whether beta-HS were present or not. The Epstein-Barr virus (EBV) was the most common virus (patients 62% and controls 13%). Compared to controls, patients' secretions had higher levels of interleukin (IL)-1 beta, IL-6, IL-8, tumor necrosis factor (TNF), and PGE(2), while few samples contained IL-12, IL-10, or interferon-gamma (IFN-gamma). The presence of beta-HS in tonsillitis secretions could not be distinguished by any of the measured mediators, while the presence of EBV DNA tended to be associated with enhanced levels of IL-1 beta and IL-8. The results suggest a common inflammatory response in acute pharyngotonsillitis, regardless of causative agent. The suggested correlation between intense inflammation and the presence of EBV DNA in tonsillitis secretions may be due to reactivation of the virus and/or the EBV-containing B cells.
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