| 1. |
- Söderström, Lisa, 1982-, et al.
(författare)
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Associations between dietary advice on modified fibre and lactose intakes and nutrient intakes in men with prostate cancer undergoing radiotherapy
- 2022
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Ingår i: Upsala Journal of Medical Sciences. - : Upsala Medical Society. - 0300-9734 .- 2000-1967. ; 127:1
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: A variety of non-evidence-based dietary advice on modified fibre and lactose intakes are provided to patients undergoing pelvic radiotherapy to counteract treatment-related bowel symptoms. More knowledge on the nutritional consequences of such advice is needed. This study aimed to explore how advice on modified fibre and lactose intakes during pelvic radiotherapy was associated with nutrient intakes amongst patients with prostate cancer.Methods: A total of 77 Swedish men who underwent radiotherapy (50/2 Gy + boost 20–30 Gy) in 2009–2014 due to prostate cancer were given dietary advice at radiotherapy onset (baseline) and at 4 and 8 weeks after radiotherapy onset, to modify their fibre and lactose intakes. At baseline, the participants completed a food frequency questionnaire (FFQ) and a 24-h dietary recall. At 4 and 8 weeks, the participants completed the FFQ and a 4-day estimated food record.Fibre and lactose intakes were measured by intake scores calculated from the FFQs. Multiple linear regression models were used to analyse associations between intake scores and fibre- and lactose-related nutrients.Results: In adjusted analyses, there were few significant associations between dietary advice on modified fibre and lactose intakes and observed intakes of fibre- and lactose-related nutrients. A more modified lactose intake was thus associated with a lower intake of calcium (P = 0.041), whilst a more modified fibre intake was associated with a higher value for the change in intake of vitamin C (P = 0.016).Conclusions: Dietary advice on modified fibre and lactose intake was in most cases not significantly associated with altered nutrient intakes, rather the energy and nutrient intakes were mostly stable during the pelvic radiotherapy. More research is needed on the nutritional consequences of dietary advice on modified fibre and lactose intakes to reach consensus on if they should continue to be provided in the clinic.
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| 2. |
- Bolger, Ann F, 1957-, et al.
(författare)
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Transit of blood flow through thehuman left ventricle mapped by cardiovascular magnetic resonance
- 2007
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Ingår i: Journal of Cardiovascular Magnetic Resonance. - : Informa UK Limited. - 1097-6647 .- 1532-429X. ; 9:5, s. 741-747
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:The transit of blood through the beating heart is a basic aspect of cardiovascular physiology which remains incompletely studied. Quantification of the components of multidirectional flow in the normal left ventricle (LV) is lacking, making it difficult to put the changes observed with LV dysfunction and cardiac surgery into context.METHODS:Three dimensional, three directional, time resolved magnetic resonance phase-contrast velocity mapping was performed at 1.5 Tesla in 17 normal subjects, 6 female, aged 44+/-14 years (mean+/-SD). We visualized and measured the relative volumes of LV flow components and the diastolic changes in inflowing kinetic energy (KE). Of total diastolic inflow volume, 44+/-11% followed a direct, albeit curved route to systolic ejection (videos 1 and 2), in contrast to 11% in a subject with mildly dilated cardiomyopathy (DCM), who was included for preliminary comparison (video 3). In normals, 16+/-8% of the KE of inflow was conserved to the end of diastole, compared with 5% in the DCM patient. Blood following the direct route lost or transferred less of its KE during diastole than blood that was retained until the next beat (1.6+/-1.0 millijoules vs 8.2+/-1.9 millijoules, p<0.05); whereas, in the DCM patient, the reduction in KE of retained inflow was 18-fold greater than that of the blood tracing the direct route.CONCLUSION:Multidimensional flow mapping can measure the paths, compartmentalization and kinetic energy changes of blood flowing into the LV, demonstrating differences of KE loss between compartments, and potentially between the flows in normal and dilated left ventricles.
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| 3. |
- Calais, Fredrik, 1971-, et al.
(författare)
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Incremental prognostic value of coronary and systemic atherosclerosis after myocardial infarction
- 2018
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Ingår i: International Journal of Cardiology. - : Elsevier. - 0167-5273 .- 1874-1754. ; 261, s. 6-11
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Tidskriftsartikel (refereegranskat)abstract
- Background: The role of systemic atherosclerosis in myocardial infarction (MI) patients is not fully understood. We investigated the incremental prognostic value of coronary and systemic atherosclerosis after acute MI by estimating extra-cardiac artery disease (ECAD) and extent of coronary atherosclerosis.Methods and results: The study included 544 prospective MI patients undergoing coronary angiography. For all patients, the longitudinal coronary atherosclerotic extent, expressed as Sullivan extent score (SES) was calculated. In addition, the patients underwent non-invasive screening for ECAD in the carotid, aortic, renal and lower limb. SES was found to be associated with ECAD independent of baseline clinical parameters [adjusted odds ratio (OR) 1.04 95% confidence interval (CI) 1.02-1.06, P < 0.001]. Extensive systemic atherosclerosis, defined as the combination of extensive coronary disease (SES >= 17) and ECAD, was associated with higher risk for all-cause mortality compared to limited systemic atherosclerosis (SES < 17 and no ECAD) (hazard ratio [HR] 2.9 95% CI 1.9-4.5, P < 0.001, adjusted for Global Registry of Acute Coronary Events risk score parameters 1.8, 95% CI 1.1-3.0, P = 0.019). The risk for the composite endpoint of cardiovascular death or hospitalization was significantly higher in patients with extensive systemic atherosclerosis compared to patients with limited systemic atherosclerosis (HR 3.1, 95% CI 2.1-4.7, P < 0.001, adjusted HR 1.9, 95% CI 1.2-3.1, P < 0.004).Conclusions: Visual estimation of the longitudinal coronary atherosclerotic extent at the time of MI predicts ECAD. Coexistence of extensive coronary disease and ECAD defines a group with particularly poor prognosis after MI.
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| 4. |
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| 5. |
- Fattahi, Nina, et al.
(författare)
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Risk factors in 50-year-old men predicting development of abdominal aortic aneurysm
- 2020
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Ingår i: Journal of Vascular Surgery. - : Elsevier BV. - 0741-5214 .- 1097-6809. ; 72:4, s. 1337-1346
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Tidskriftsartikel (refereegranskat)abstract
- Background: Abdominal aortic aneurysm (AAA) is a potentially lethal condition associated with several well-known risk factors including age, smoking, and male sex. The aim of this study was to identify risk factors predicting future development of AAA, which could influence future prevention strategies.Methods: This study collected the data sets of the Westmannia Cardiovascular Risk Factors Study (WICTORY) from 1990 to 1999 and combined them with cases of individuals who have undergone ultrasound examination of the infrarenal aortic diameter as part of the Vastmanland County's ongoing AAA screening program that commenced in 2007 or for other purposes. The study analyzed 5817 men aged 50 years at the time they participated in WICTORY and who underwent an ultrasound examination of the infrarenal aorta on average 15 years later.Results: The prevalence of AAA in our study was 2.6%. Age, smoking status, angina pectoris treatment, prior myocardial infarction, blood pressure treatment, body mass index, waist circumference, systolic blood pressure, heart rate, and total cholesterol level were found to be associated with the development of AAA later in life in the univariate analysis. In the multivariate analysis, current smokers at age 50 years had 11 times higher risk for later development of AAA (hazard ratio [HR], 11.178; confidence interval [CI], 6.277-19.908; P < .001). Former smokers did not suffer a similar risk of AAA development. Elevated total cholesterol concentration at baseline was associated with later AAA development (HR, 1.275; CI, 1.119-1.451; P < .001), as were increasing age (HR, 1.702; CI, 1.153-2.512; P = .007) and waist circumference (HR, 1.019; CI, 1.002-1.037; P = .031).Conclusions: Both the well-known and the somewhat less established possible predictors for future development of AAA identified in this study can support improvement of strategic preventive measures toward specific risk groups and thereby possibly reduce the risk for development of AAA later in life or at least increase the possibility of an early diagnosis in patients with intact AAA.
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| 6. |
- Gerhardsson, Emma, et al.
(författare)
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Mothers' Adaptation to a Late Preterm Infant When Breastfeeding
- 2020
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Ingår i: Journal of Perinatal & Neonatal Nursing. - : Wolters Kluwer. - 0893-2190 .- 1550-5073. ; 34:1, s. 88-95
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to psychometrically test the Adaptation to the Late Preterm Infant when Breastfeeding Scale (ALPIBS) and also to test how a mother's self-efficacy predicts adaptation to a late preterm infant when breastfeeding. This study had a longitudinal and prospective design, and data collection was consecutive. Mothers (n = 105) with infants born between and weeks were recruited from a neonatal intensive care unit or a maternity unit. The ALPIBS was developed using exploratory factor analysis, and the association between breastfeeding self-efficacy and ALPIBS score was examined using linear regression analysis. The Breastfeeding Self-Efficacy Scale-Short Form instrument was used to measure self-efficacy in breastfeeding. A higher degree of self-efficacy was significantly associated with a higher degree of adaptation to the late preterm infant's breastfeeding behavior (P < .001). We identified 4 separate underlying factors measured by 11 items in the ALPIBS: (A) breastfeeding is a stressful event; (B) the infant should breastfeed as often as he or she wants; (C) a mother has to breastfeed to be a good mother; and (D) it is important to ensure control over the infant's feeding behavior. There is a link between self-efficacy and ALPIBS score, and self-efficacy is a modifiable factor that influences breastfeeding.
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| 7. |
- Hellsmark, Hans, 1974, et al.
(författare)
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Teknologiska innovationssystem inom energiområdet: En praktisk vägledning till identifiering av systemsvagheter som motiverar särskilda politiska åtaganden
- 2014
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Syftet med denna rapport är att illustrera hur ett praktiskt inriktat ramverk, tekno- logiska innovationssystem (TIS), kan användas av analytiker och beslutsfattare vid departement och myndigheter för att analysera strategiskt viktiga teknikområden ?????????????????????????????????????????????????????????????????????????????I rapporten analyseras fem TIS centrerade kring havsbaserad vindkraft, marin energi, ????????????????????????????????????????????????????????????????????????????????????? systemsvagheter som bromsar områdets vidare utveckling, vilka som kan åtgärdas av systemets aktörer och vilka som motiverar särskilda politiska åtaganden. Rapporten utgör därmed ett underlag för att formulera åtgärder för att åstadkomma ökad innova- tion, teknikspridning och industrialisering inom ovan nämnda teknikområden.Studien har även möjliggjort en jämförande analys av likheter och skillnader ???????????????????????????????????????????????????????????????????????????????? ?????????????????????????????????????????????????????????????????????????????????????? mellan områdena – de är starka respektive svaga av olika orsaker. Detta visar att ???????????????????????????????????????????????????????????????????????Samtidigt har områdena gemensamma drag. Systemets aktörer, där även politiska ???????????????????????????????????????????????????????????????????????????????????? ?????????????????????????????????????????????????????????????????????????????- skapsnätverk. Men de har varit sämre på att skapa tidiga nischmarknader som ger utrymme för fortsatt lärande och kostnadsreduktion. Sådana nischer kan ibland skapas av marknadens aktörer, men ofta krävs politiska styrmedel. De behövs för att investeringar i kunskapsutveckling ska kunna nyttiggöras och för att en bred industriell utveckling inom nya områden skall göras möjlig i Sverige.Vidare presenteras lärdomar kring vad en aktiv teknikpolitik innebär. Två huvud- ??????????????????????????????????????????????????????????????????????????????- hällsbygget och därför bör vara ett politikområde bland många samt att den skarpa ??????????????????????????????????????????????????????????????????????????????- ?????????????????????????????????????????????????????????????????????????????????? ?????????????????????????????????????????????????????????????????????????????????? olika faser av innovationssystemets utveckling.För att lyckas med en aktiv teknikpolitik behövs en hög grad av koordinering ??????????????????????????????????????????????????????????????????????? teknikområden så att ”rätt” typ av åtgärder kan sättas in vid ”rätt” tidpunkt av ”rätt” aktör. TIS-ramverket lyfts här fram som en metod för att skapa ett sådant underlag. Slutligen presenteras en metod för projektbedömningar som syftar till att stötta handläggare i utvärderingar av projekt inom nya teknikområden.Rapporten i sin helhet riktar sig särskilt till beslutsfattare och handläggare vid myndigheter, departement och politiker, men även andra organisationer och indi- vider med intresse av att högt ställda klimatmål ska kunna nås samtidigt som en positiv näringslivsutveckling möjliggörs.
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| 8. |
- Karlsson Rosenblad, Andreas, Fil. dr, 1973-, et al.
(författare)
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A psychometric evaluation of the Functional assessment of cancer therapy-kidney symptom index (FKSI-19) among renal cell carcinoma patients suggesting an alternative two-factor structure
- 2021
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Ingår i: Quality of Life Research. - : Springer. - 0962-9343 .- 1573-2649. ; 30:9, s. 2663-2670
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To psychometrically evaluate the hypothesized four-factor structure of the 19-item Functional Assessment of Cancer Therapy-Kidney Symptom Index (FKSI-19) health-related quality of life (HRQoL) instrument in a sample of surgically treated renal cell carcinoma (RCC) patients and examine if an alternative factor structure with good psychometric properties may be derived from the available items.METHODS: The model fit of the hypothesized four-factor structure was examined using confirmatory factor analysis on cohort data from 1731 individuals included in the National Swedish Kidney Cancer Register who had undergone surgery for RCC during the three years 2016-2018 and answered the FKSI-19 instrument within 6-12 months after surgery. Exploratory factor analysis was applied to the same dataset to derive a possible alternative factor solution.RESULTS: -value or the Comparative Fit Index, although the Standardized Root Mean Square Residual and Root Mean Square Error of Approximation measures indicated good and acceptable model fits, respectively. An alternative 14-item trimmed FKSI version (FKSI-14) with a two-factor structure derived from the available FKSI-19 items was found to measure the same aspects of HRQoL as the full FKSI-19 instrument.CONCLUSION: The present study is the first to use psychometric methods for examining the factor structure of the FKSI-19 instrument. The hypothesized four-factor structure of FKSI-19 provided a barely acceptable model fit. The two-factor FKSI-14 structure may be used as an alternative or complement to the four-factor structure when interpreting the FKSI-19 instrument.
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| 9. |
- Klarare, Anna, et al.
(författare)
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Translation, Cross-Cultural Adaptation, and Psychometric Analysis of the Attitudes Towards Homelessness Inventory for Use in Sweden
- 2021
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Ingår i: Worldviews on Evidence-Based Nursing. - : Wiley. - 1545-102X .- 1741-6787. ; 18:1, s. 42-49
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Homelessness is an increasing problem worldwide, and the origins of homelessness in high-income countries are multifaceted. Due to stigma and discrimination, persons in homelessness delay seeking health care, resulting in avoidable illness and death. The Attitudes Towards Homelessness Inventory (ATHI) was developed to cover multiple dimensions of attitudes toward persons in homelessness and to detect changes in multiple segments of populations. It has, however, not previously been translated to Swedish.AIMS: The aim of the present study was to translate, cross-culturally adapt, and psychometrically test the ATHI for use in a Swedish healthcare context.METHODS: The project used a traditional forward- and back-translation process in six stages: (1) two simultaneous translations by bilingual experts; (2) expert review committee synthesis; (3) blind back-translation; (4) expert review committee deliberations; (5) pre-testing with cognitive interviews including registered nurses (n = 5), nursing students (n = 5), and women in homelessness (n = 5); and (6) psychometric evaluations. The final ATHI questionnaire was answered by 228 registered nurses and nursing students in the year 2019.RESULTS: The translation process was systematically conducted and entailed discussions regarding semantic, idiomatic, experiential, and conceptual equivalence. Confirmatory factor analysis was used to examine if the collected data fitted the hypothesized four-factor structure of the ATHI. Overall, it was found that the model had an acceptable fit and that the Swedish version of ATHI may be used in a Swedish healthcare context.LINKING EVIDENCE TO ACTION: The ATHI has been shown to be a psychometrically acceptable research instrument for use in a Swedish healthcare context. The systematic and rigorous process applied in this study, including experts with diverse competencies in translation proceedings and testing, improved the reliability and validity of the final Swedish version of the ATHI. The instrument may be used to investigate attitudes toward women in homelessness among nursing students and RNs in Sweden.
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| 10. |
- Sundström, Johan, Professor, 1971-, et al.
(författare)
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Rationale for a Swedish cohort consortium
- 2019
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Ingår i: Upsala Journal of Medical Sciences. - : Taylor & Francis Group. - 0300-9734 .- 2000-1967. ; 124:1, s. 21-28
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Tidskriftsartikel (refereegranskat)abstract
- We herein outline the rationale for a Swedish cohort consortium, aiming to facilitate greater use of Swedish cohorts for world-class research. Coordination of all Swedish prospective population-based cohorts in a common infrastructure would enable more precise research findings and facilitate research on rare exposures and outcomes, leading to better utilization of study participants' data, better return of funders' investments, and higher benefit to patients and populations. We motivate the proposed infrastructure partly by lessons learned from a pilot study encompassing data from 21 cohorts. We envisage a standing Swedish cohort consortium that would drive development of epidemiological research methods and strengthen the Swedish as well as international epidemiological competence, community, and competitiveness.
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| 11. |
- Söderström, Lisa, 1982-, et al.
(författare)
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Dietary advice and oral nutritional supplements do not increase survival in older malnourished adults : a multicentre randomised controlled trial
- 2020
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Ingår i: Upsala Journal of Medical Sciences. - : Uppsala Medical Society. - 0300-9734 .- 2000-1967. ; 125:3, s. 240-249
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Forskningsöversikt (refereegranskat)abstract
- Objectives: The study aimed to investigate the effect on survival after 6 months of treatment involving individual dietary advice and oral nutritional supplements in older malnourished adults after discharge from hospital. Methods: This multicentre randomised controlled trial included 671 patients aged 65 years who were malnourished or at risk of malnutrition when admitted to hospital between 2010 and 2014, and followed up after 8.2 years (median 4.1 years). Patients were randomised to receive dietary advice or oral nutritional supplements, separate or in combination, or routine care. The intervention started at discharge from the hospital and continued for 6 months, with survival being the main outcome measure. Results: During the follow-up period 398 (59.3%) participants died. At follow-up, the survival rates were 36.9% for dietary advice, 42.4% for oral nutritional supplements, 40.2% for dietary advice combined with oral nutritional supplements, and 43.3% for the control group (log-rank test p = 0.762). After stratifying the participants according to nutritional status, survival still did not differ significantly between the treatment arms (log-rank test p = 0.480 and p = 0.298 for the 506 participants at risk of malnutrition and the 165 malnourished participants, respectively). Conclusions: Oral nutritional supplements with or without dietary advice, or dietary advice alone, do not improve the survival of malnourished older adults. These results do not support the routine use of supplements in older malnourished adults, provided that survival is the aim of the treatment.
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| 12. |
- Andersson, Fredrik, 1974-, et al.
(författare)
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Female top management in family firms and non-family firms : Evidence from total population data
- 2018
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Ingår i: International Journal of Entrepreneurship and Small Business. - : InderScience Publishers. - 1476-1297 .- 1741-8054. ; 35:3, s. 303-326
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Tidskriftsartikel (refereegranskat)abstract
- We exploit information on ownership, management and kinship to study the representation of women in top management teams in Swedish family and non-family firms among domiciled limited liability firms over the years 2004 to 2010. The share of female top managers is analysed across listed and non-listed firms as well as across industries. We then estimate the likelihood that a woman is elected into the top management team in family and non-family firms using a probit regression model where we control for firm- A nd individual-level characteristics, including the gender distribution of the firm and kinship relations to existing board members and firm owners. We find that non-listed family firms are more likely to appoint female top managers, whereas we find no differences among listed firms. Moreover, we find that the gender composition and kinship structures of firms influence the appointment of female top managers.
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| 13. |
- Andersson, Fredrik, 1974-, et al.
(författare)
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The Characteristics and Performance of Family Firms : Exploiting information on ownership, governance and kinship using total population data
- 2017
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Rapport (refereegranskat)abstract
- Family firms are often considered characteristically different from non-family firms, and the economic implications of these differences have generated significant academic debate. However, our understanding of family firms suffers from an inability to identify them in total population data, as this requires information on owners, their kinship and involvement in firm governance, which is rarely available. We present a method for identifying domiciled family firms using register data that offers greater accuracy than previous methods. We then apply it to data from Statistics Sweden concerning firm ownership, governance and kinship over the years 2004-2010. Next, we use Swedish data to estimate these firms’ economic contribution to total employment and gross domestic product (GDP) and compare them to private domiciled non-family firms in terms of their characteristics and economic performance. We find that the family firm is the prevalent organizational form, contributing to over one-third of all employment and GDP. Family firms are common across industries and sizes, ranging from the smallest producers to the largest multinational firms. However, their characteristics differ across sizes and legal forms, thereby indicating that the seemingly contradictory findings among previous studies on family firms may be due to unobserved heterogeneity. We furthermore find that they are smaller than private non-family firms in employment and sales and carry higher solidity, although they are more profitable. These differences diminish with firm size, however. We conclude that the term ‘family firm’ contains great diversity and call for increased attention to their heterogeneity.
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| 14. |
- Andersson, Fredrik, 1974-, et al.
(författare)
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The Characteristics of Family Firms : Exploiting Information on Ownership, Kinship and Governance Using Total Population Data
- 2018
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Ingår i: Small Business Economics. - : Kluwer Academic/Plenum Publishers. - 0921-898X .- 1573-0913. ; 51:3, s. 539-556
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Tidskriftsartikel (refereegranskat)abstract
- Family firms are often considered characteristically different from non-family firms. However, our understanding of family firms suffers from an inability to identify them in total population data; information is rarely available regarding owners, their kinship, and their involvement in firm governance. We present a method for identifying domiciled family firms using register data; this method offers greater accuracy than previous methods. We apply this method to Swedish data concerning firm ownership, governance, and kinship from 2004 to 2010. We find that the family firm is a significant organizational form, contributing over one third of all employment and gross domestic product (GDP). Family firms are common in most industries and range in size. Furthermore, we find that, compared to private non-family firms, family firms have fewer total assets, employment, and sales and carry higher solidity, although family firms are more profitable. These differences diminish with firm size. We conclude that the term “family firm” includes a large variety of firms, and we call for increased attention to their heterogeneity.
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| 15. |
- Blennow, Jörgen, 1966, et al.
(författare)
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Sequential Comparative Study of Dielectric Response and Analyses of Oil and Paper from a Power Transformer Undergoing Repair
- 2005
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Ingår i: In Proc. 14th International Symposium on High Voltage Engineering.
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Konferensbidrag (refereegranskat)abstract
- Methods, based on characterisation of dielectric response, for assessing moisture content in pressboard and paper are gaining ground. However, there is a need for calibrating obtained results with results from other techniques. This communication presents results from a study of a 50/10 kV - 40 MVA power transformer, which was sent to a workshop for repair, thus allowing for collecting samples of the solid insulation. Dielectric spectroscopy measurements in frequency domain were conducted at several occasions before and after the repair. Moisture estimation based on dielectric response measurements as well as on titration of oil samples yielded similar results to those obtained by direct titration of paper samples, as long as appropriate temperature values were used in all the analyses mentioned. The temperature value during measurements should be used for the analysis of the dielectric response, while in-service temperature of oil should be used for the evaluation based on Karl Fisher titration.
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| 16. |
- Blixt, Ingrid, 1968-, et al.
(författare)
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Breastfeeding training improved healthcare professional's self-efficacy to provide evidence-based breastfeeding support : A pre-post intervention study
- 2023
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Ingår i: Midwifery. - : Elsevier. - 0266-6138 .- 1532-3099. ; 125
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To describe healthcare professional's (HCP's) perceived self-efficacy in their ability to provide breastfeeding support before and after a breastfeeding training program.DESIGN: Pre-post intervention study.SETTING: Antenatal care and child healthcare (CHC) centres in Sweden during 2020.PARTICIPANTS: An intervention group consisting of 39 HCPs (midwives 51.3%, child healthcare nurses 46.2%) completing a questionnaire at baseline and after intervention, and a control group of 34 HCPs (midwives 61.8%, child healthcare nurses 38.2%) completing a questionnaire at baseline.INTERVENTION: A breastfeeding training program in line with the Ten Steps to Successful Breastfeeding and WHO recommendations about breastfeeding.MEASUREMENTS AND FINDINGS: The 11-item Breastfeeding Support Confidence Scale (BSCS) measures HCP's self-efficacy regarding providing breastfeeding support in line with Ten Steps to Successful Breastfeeding and WHO recommendations. The intervention group experienced a significantly increased self-efficacy from pre-intervention to post-intervention for 8 of the 11 BSCS items, with the overall BSCS index score increasing from 36.87 to 39.56 points (p = 0.001). The index score in the intervention group at follow-up was significantly higher than the corresponding score in the control group at baseline (p = 0.025). The intervention group had significantly higher scores at follow-up than the control group at baseline on the questions: "I'm sure that I can help mothers continue to breastfeed even if the infant doesn't follow the growth curve" (p = 0.026) and "I'm sure that I can help mothers continue to breastfeed when the breastfeeding is painful" (p = 0.048).KEY CONCLUSIONS: The breastfeeding training program improved HCP' self-efficacy to provide evidence-based support to breastfeeding mothers.IMPLICATIONS FOR PRACTICE: This training program is well suited to implement in clinical practice and follows the Ten Steps to Successful Breastfeeding.TRIAL REGISTRATION: ACTRN12623000648628.
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| 17. |
- Gaber, Sophie, et al.
(författare)
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The relationship between attitudes to homelessness and perceptions of caring behaviours : a cross-sectional study among women experiencing homelessness, nurses and nursing students
- 2022
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Ingår i: BMC Women's Health. - : Springer Nature. - 1472-6874. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Women experiencing homelessness have complex and multifaceted healthcare needs and yet they are an underserved population across healthcare services. Nurses are trained to perform an integral role in the provision of equitable healthcare and their attitudes towards homelessness may therefore influence the care that women experiencing homelessness receive. This study aimed to examine correlations between attitudes towards homelessness and caring behaviours, and to test if these correlations differed between the groups of women experiencing homelessness, registered nurses, and nursing students. Methods A cross-sectional design using convenience sampling was used to recruit women experiencing homelessness (n = 37), registered nurses (n = 90), and nursing students (n = 138) in Stockholm, Sweden between August 2019 and December 2020. The participants answered two questionnaires: the Attitudes Toward Homelessness Inventory and the Caring Behaviours Inventory-24. Correlations between ordinal variables were calculated using Spearman's rank correlation rho. Tests of equality between two independent correlations were performed using a Z-test applied to Fisher's z-transformed correlations. An advisory board of women with lived experience of homelessness supported the interpretation of the results. Results Weak, negative correlations were identified between the Attitudes Toward Homelessness Inventory and Caring Behaviours Inventory-24. The Attitudes Toward Homelessness Inventory mean total scores (SD) were 4.1 (0.6), 4.2 (0.6), 4.1 (0.5) points for the women experiencing homelessness, registered nurse, and nursing student groups, respectively, with the corresponding scores for the Caring Behaviours Inventory-24 being 4.1 (1.1), 5.2 (0.5), 4.8 (0.7) points, respectively. Conclusions To promote equitable health for women experiencing homelessness, healthcare providers and nurse educators should consider the role of stigmatising attitudes in relation to caring behaviours.
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| 18. |
- Gaber, Sophie, et al.
(författare)
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The relationship between attitudes to homelessness and perceptions of caring behaviours : a cross-sectional study among women experiencing homelessness, nurses and nursing students
- 2022
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Ingår i: BMC Women's Health. - : BioMed Central (BMC). - 1472-6874. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Women experiencing homelessness have complex and multifaceted healthcare needs and yet they are an underserved population across healthcare services. Nurses are trained to perform an integral role in the provision of equitable healthcare and their attitudes towards homelessness may therefore influence the care that women experiencing homelessness receive. This study aimed to examine correlations between attitudes towards homelessness and caring behaviours, and to test if these correlations differed between the groups of women experiencing homelessness, registered nurses, and nursing students.Methods: A cross-sectional design using convenience sampling was used to recruit women experiencing homelessness (n = 37), registered nurses (n = 90), and nursing students (n = 138) in Stockholm, Sweden between August 2019 and December 2020. The participants answered two questionnaires: the Attitudes Toward Homelessness Inventory and the Caring Behaviours Inventory-24. Correlations between ordinal variables were calculated using Spearman’s rank correlation ρ. Tests of equality between two independent correlations were performed using a Z-test applied to Fisher’s z-transformed correlations. An advisory board of women with lived experience of homelessness supported the interpretation of the results.Results: Weak, negative correlations were identified between the Attitudes Toward Homelessness Inventory and Caring Behaviours Inventory-24. The Attitudes Toward Homelessness Inventory mean total scores (SD) were 4.1 (0.6), 4.2 (0.6), 4.1 (0.5) points for the women experiencing homelessness, registered nurse, and nursing student groups, respectively, with the corresponding scores for the Caring Behaviours Inventory-24 being 4.1 (1.1), 5.2 (0.5), 4.8 (0.7) points, respectively.Conclusions: To promote equitable health for women experiencing homelessness, healthcare providers and nurse educators should consider the role of stigmatising attitudes in relation to caring behaviours. © 2022, The Author(s).
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| 19. |
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| 20. |
- Graff, Pål, 1973-, et al.
(författare)
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Evaluating Measuring Techniques for Occupational Exposure during Additive Manufacturing of Metals : A Pilot Study
- 2017
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Ingår i: Journal of Industrial Ecology. - : John Wiley & Sons. - 1088-1980 .- 1530-9290. ; 21:Suppl. 1, s. S120-S129
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Tidskriftsartikel (refereegranskat)abstract
- Additive manufacturing that creates three-dimensional objects by adding layer uponlayer of material is a new technique that has proven to be an excellent tool for themanufacturing of complex structures for a variety of industrial sectors. Today, knowl-edge regarding particle emissions and potential exposure-related health hazards forthe operators is limited. The current study has focused on particle numbers, masses,sizes, and identities present in the air during additive manufacturing of metals. Mea-surements were performed during manufacturing with metal powder consisting es-sentially of chromium, nickel, and cobalt. Instruments used were Nanotracer (10 to300 nanometers [nm]), Lighthouse (300 nm to 10 micrometers), and traditional filter-basedparticle mass estimation followed by inductively coupled plasma mass spectrometry. Resultsshowed that there is a risk of particle exposure at certain operations and that particle sizestended to be smaller in recycled metal powder compared to new. In summary, nanosizedparticles were present in the additive manufacturing environment and the operators wereexposed specifically while handling the metal powder. For the workers’ safety, improvedpowder handling systems and measurement techniques for nanosized particles will possiblyhave to be developed and then translated into work environment regulations. Until then,relevant protective equipment and regular metal analyses of urine is recommended.
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| 21. |
- Granstam, Elisabet, 1963-, et al.
(författare)
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Long‐term follow‐up of antivascular endothelial growth factor treatment for diabetic macular oedema : a four‐year real‐world study
- 2020
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Ingår i: Acta Ophthalmologica. - : Wiley. - 1755-375X .- 1755-3768. ; 98:4, s. 360-367
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Tidskriftsartikel (refereegranskat)abstract
- PurposeTo evaluate visual acuity (VA) and central retinal thickness (CRT) on optical coherence tomography during a 4‐year period in patients treated for sight‐threatening diabetic macular oedema (DMO) at two Swedish county hospitals. Additionally, to compare health‐related quality of life and subjective visual functioning before and after 4 years of treatment.MethodsFifty‐eight patients with DMO were evaluated after 4 years of antivascular endothelial growth factor (VEGF) treatment. VA, CRT and clinical data were retrospectively reviewed. Health‐related quality of life and subjective visual functioning were evaluated with Short Form Health Survey (SF‐36) and National Eye Institute Vision Functioning Questionnaire 25 (VFQ‐25). Comparisons between independent groups were performed using Pearson's χ2 test, Fisher's exact test or Mann–Whitney U test. Spearman's ρ was used for correlation analyses. Wilcoxon signed‐rank test was used for comparison between dependent groups. Logistic regression analysis was applied for analysis of VA and CRT over 4 years.ResultsFollow‐up data were obtained from 37 of 58 (63.8%) patients. Baseline characteristics were similar, regardless of follow‐up. VA improvement at 1 year (mean + 4.4, SD 7.5; ETDRS letter score) was maintained over 3 years, then declined. CRT was reduced throughout the study. In the first treatment year, eyes received 5.1 (1.4) anti‐VEGF injections, followed by approximately two injections yearly. Additional treatment included laser and dexamethasone implants. SF‐36 showed no change at 4 years, compared with baseline. VFQ‐25 demonstrated improvement in near vision activities (p = 0.036).ConclusionSignificant long‐term improvement in visual function was present in patients with anti‐VEGF‐treated DMO.
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| 22. |
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| 23. |
- Karlsson, Andreas, 1973-
(författare)
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A comparison of blood pressure indices as predictors of all-cause mortality among middle-aged men and women during 701,707 person-years of follow-up
- 2018
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Ingår i: Journal of Human Hypertension. - : NATURE PUBLISHING GROUP. - 0950-9240 .- 1476-5527. ; 32:10, s. 660-667
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Tidskriftsartikel (refereegranskat)abstract
- High systolic blood pressure (SBP) is often used as a measure of hypertension in epidemiological studies. Alternative blood pressure (BP) indices include diastolic blood pressure (DBP), pulse pressure (PP), mid-blood pressure (MBP) and mean arterial pressure (MAP). The present study compares the predictive ability for all-cause mortality (ACM) of these indices and the novel BP index mean proportional arterial pressure (MPAP), defined as the weighted mean of SBP and DBP where the weights are proportional to SBP's and DBP's contributions to the sum of SBP and DBP. Using a Swedish cohort of 32,238 middle-aged men and women, not being on antihypertensive treatment, examined in 1989-2000 and followed-up until March 9, 2017, the predictive abilities for ACM of SBP, DBP, PP, MBP, MAP and MPAP were compared using a likelihood-based R 2 -type measure for adjusted and unadjusted Cox regression models. Of the included participants (mean age 45.4 years, 48.2% men), 2936 (9.1%) died during a mean follow-up time of 21.8 years, equalling 701,707 person-years at risk. Higher BP were for all indices significantly associated with increased ACM. For all models, those including MPAP had the highest predictive ability, followed in turn by models including MBP, SBP, MAP, DBP and PP, respectively. The difference was significant for SBP, DBP and PP in unadjusted models and for PP in fully adjusted models. In conclusion, MPAP and MBP are the best predictors of ACM. Until the clinical usefulness of these indices has been evaluated, they may primarily be useful for epidemiological studies.
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| 24. |
- Karlsson, Andreas, 1973-
(författare)
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Estimation and Inference for Quantile Regression of Longitudinal Data : With Applications in Biostatistics
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis consists of four papers dealing with estimation and inference for quantile regression of longitudinal data, with an emphasis on nonlinear models.The first paper extends the idea of quantile regression estimation from the case of cross-sectional data with independent errors to the case of linear or nonlinear longitudinal data with dependent errors, using a weighted estimator. The performance of different weights is evaluated, and a comparison is also made with the corresponding mean regression estimator using the same weights.The second paper examines the use of bootstrapping for bias correction and calculations of confidence intervals for parameters of the quantile regression estimator when longitudinal data are used. Different weights, bootstrap methods, and confidence interval methods are used.The third paper is devoted to evaluating bootstrap methods for constructing hypothesis tests for parameters of the quantile regression estimator using longitudinal data. The focus is on testing the equality between two groups of one or all of the parameters in a regression model for some quantile using single or joint restrictions. The tests are evaluated regarding both their significance level and their power.The fourth paper analyzes seven longitudinal data sets from different parts of the biostatistics area by quantile regression methods in order to demonstrate how new insights can emerge on the properties of longitudinal data from using quantile regression methods. The quantile regression estimates are also compared and contrasted with the least squares mean regression estimates for the same data set. In addition to looking at the estimates, confidence intervals and hypothesis testing procedures are examined.
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| 25. |
- Karlsson Rosenblad, Andreas, 1973-
(författare)
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Accuracy of automatic forecasting methods for univariate time series data : A case study predicting the results of the 2018 Swedish general election using decades-long data series
- 2021
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Ingår i: Communications in Statistics: Case Studies, Data Analysis and Applications. - : Informa UK Limited. - 2373-7484. ; 7:3, s. 475-493
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Tidskriftsartikel (refereegranskat)abstract
- This study compared the accuracy of automatic time series forecasting methods in predicting the results of the 2018 Swedish general election using data from the Party Preference Survey opinion poll collected during the years 1984–2018. The general exponential smoothing state space (ETS) model performed best, outperforming even the exit poll collected at the time of the election, while the complex seasonal autoregressive integrated moving average (ARIMA) model was beaten by the simple exponential smoothing method. Holt’s linear trend method performed worse than even the naïve method. The results of this study show the usefulness of easily applied automatic forecasting methods.
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| 26. |
- Karlsson Rosenblad, Andreas, Fil. dr, docent, 1973-, et al.
(författare)
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Health literacy and its association with mental and spiritual well-being among women experiencing homelessness
- 2024
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Ingår i: Health Promotion International. - : Oxford University Press. - 0957-4824 .- 1460-2245. ; 39:2
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Tidskriftsartikel (refereegranskat)abstract
- Low health literacy (HL) has been linked to low self-rated health, reduced efficacy of behaviour change, and challenges in preventing, treating, or managing health conditions. People experiencing homelessness are at risk of poor HL; however, few studies have investigated HL in relation to mental and spiritual well-being among people experiencing homelessness in general, or women experiencing homelessness specifically. This cross-sectional study of 46 women experiencing homelessness in Stockholm, Sweden, recruited during the period October 2019–December 2020, aimed to examine how HL was associated with mental and spiritual well-being among women experiencing homelessness. Participants answered questions about socio-demographic characteristics (age, length of homelessness, education) and digital technology (mobile phone/the Internet) use, in addition to Swedish language versions of three questionnaires administered through structured, face-to-face interviews: the Communicative and Critical Health Literacy Scale, the General Health Questionnaire 12 and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being. Data were analysed using linear regression, which revealed statistically significant associations between HL and mental well-being (p = .009), and between HL and spiritual well-being (p = .022). However, neither socio-demographic characteristics nor digital technology use were significantly associated with HL. In conclusion, promoting HL may improve mental and spiritual well-being in this vulnerable population. An advisory board of women with lived experiences of homelessness (n = 5) supported the interpretation of the findings and emphasised the need to consider HL in relation to basic needs such as ‘housing first’. Moreover, health information and services should be accessible to people with different degrees of HL.
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| 27. |
- Karlsson Rosenblad, Andreas, Fil. dr, docent, 1973-, et al.
(författare)
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Health literacy and its association with mental and spiritual well-being among women experiencing homelessness
- 2024
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Ingår i: Health Promotion International. - : Oxford University Press. - 0957-4824 .- 1460-2245. ; 39:2
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Tidskriftsartikel (refereegranskat)abstract
- Low health literacy (HL) has been linked to low self-rated health, reduced efficacy of behaviour change, and challenges in preventing, treating, or managing health conditions. People experiencing homelessness are at risk of poor HL; however, few studies have investigated HL in relation to mental and spiritual well-being among people experiencing homelessness in general, or women experiencing homelessness specifically. This cross-sectional study of 46 women experiencing homelessness in Stockholm, Sweden, recruited during the period October 2019–December 2020, aimed to examine how HL was associated with mental and spiritual well-being among women experiencing homelessness. Participants answered questions about socio-demographic characteristics (age, length of homelessness, education) and digital technology (mobile phone/the Internet) use, in addition to Swedish language versions of three questionnaires administered through structured, face-to-face interviews: the Communicative and Critical Health Literacy Scale, the General Health Questionnaire 12 and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being. Data were analysed using linear regression, which revealed statistically significant associations between HL and mental well-being (p = .009), and between HL and spiritual well-being (p = .022). However, neither socio-demographic characteristics nor digital technology use were significantly associated with HL. In conclusion, promoting HL may improve mental and spiritual well-being in this vulnerable population. An advisory board of women with lived experiences of homelessness (n = 5) supported the interpretation of the findings and emphasised the need to consider HL in relation to basic needs such as ‘housing first’. Moreover, health information and services should be accessible to people with different degrees of HL.
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| 28. |
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| 29. |
- Karlsson Rosenblad, Andreas, 1973-, et al.
(författare)
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Self-efficacy in breastfeeding predicts how mothers perceive their preterm infant's state-regulation
- 2022
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Ingår i: International Breastfeeding Journal. - : BioMed Central (BMC). - 1746-4358. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundMothers of preterm infants often perceive the infant as having problems with crying, sleeping and feeding, sometimes summarised as ‘state-regulation’. Breastfeeding rates are lower among preterm infants, and the mother’s self-efficacy in breastfeeding is central to understanding which mothers are going to breastfeed their infants. We have previously shown that mothers with higher self-efficacy have an easier time adapting to the infant and in this study we hypothesised that the degree of self-efficacy also is associated with how difficult the mother believes it is to take care of the infant. The aim of this study was to investigate whether the late preterm infant’s mother’s self-efficacy in breastfeeding was associated with how the mother experienced her infant’s state-regulation at three months of corrected age.MethodsThe study had a prospective and longitudinal design with a consecutive data collection through questionnaires. Inclusion criteria were mothers (n = 105) with a singleton infant born between 34 + 0 and 36 + 6 weeks of gestation. At term age, the mothers completed the Breastfeeding Self-efficacy Scale-Short Form and at the three months corrected age follow-up, mothers completed the Infant state-regulation index: questions related to whether the infant had difficulties with colic, persistent crying, comforting, falling asleep, sleep problems, breastfeeding, eating or poor weight gain.ResultsThe analyses showed that being an older mother, perceiving breastfeeding support, and having a higher breastfeeding self-efficacy were all significantly associated with identifying the infant as having better state-regulation.ConclusionsThere was an association between mothers’ self-efficacy in breastfeeding and her perceptions of how good state-regulation the infant had. This is an important finding, as self-efficacy is a manageable factor that could positively affect how the mother perceives taking care of her infant. Clinical implication: Improved self-efficacy is known to be an important factor in increased breastfeeding prevalence and healthcare professionals should also target mother’s self-efficacy in breastfeeding to improve mother-infant relationship.
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| 30. |
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| 31. |
- Kotol, David, et al.
(författare)
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Longitudinal Plasma Protein Profiling Using Targeted Proteomics and Recombinant Protein Standards
- 2020
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Ingår i: Journal of Proteome Research. - : American Chemical Society (ACS). - 1535-3893 .- 1535-3907. ; 19:12, s. 4815-4825
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Tidskriftsartikel (refereegranskat)abstract
- Spike-in of standards of known concentrations used in proteomics-based workflows is an attractive approach for both accurate and precise multiplexed protein quantification. Here, a quantitative method based on targeted proteomics analysis of plasma proteins using isotope-labeled recombinant standards originating from the Human Protein Atlas project has been established. The standards were individually quantified prior to being employed in the final multiplex assay. The assays are mainly directed toward actively secreted proteins produced in the liver, but may also originate from other parts of the human body. This study included 21 proteins classified by the FDA as either drug targets or approved clinical protein biomarkers. We describe the use of this multiplex assay for profiling a well-defined human cohort with sample collection spanning over a one-year period. Samples were collected at four different time points, which allowed for a longitudinal analysis to assess the variable plasma proteome within individuals. Two assays toward APOA1 and APOB had available clinical data, and the two assays were benchmarked against each other. The clinical assay is based on antibodies and shows high correlation between the two orthogonal methods, suggesting that targeted proteomics with highly parallel, multiplex analysis is an attractive alternative to antibody-based protein assays.
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| 32. |
- Sabel, Nina, 1973, et al.
(författare)
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XRMA analysis and X-ray diffraction analysis of dental enamel from human permanent teeth exposed to hydrogen peroxide of varying pH
- 2019
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Ingår i: Journal of Clinical and Experimental Dentistry. - : Medicina Oral, S.L.. - 1989-5488. ; 11:6, s. e512-e520
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Tidskriftsartikel (refereegranskat)abstract
- Background : This in vitro investigation shows how 3.3% H2O2, at different pH-values affects the enamel. Material and Methods : A number of fifteen human premolars were used. The enamel of the coronal half in six of the teeth, were exposed by H2O2. Nine teeth were prepared to enamel powder. The enamel was exposed to 3.3% H2O2, at six different pH-values (pH range 4.5 - 7.0). Analyses of the topography of enamel performed by scanning electron microscope (SEM) and the chemical composition of enamel by X-ray microanalysis (XRMA). X-ray powder diffraction (XRD) analysed the crystallinity in enamel powder. Results : The exposure to H2O2 at pH < 5.5 resulted in a rougher topography of the enamel, according to the SEM studies. The XRMA analysis revealed a increase in the ratio of Ca:C. Exposure to H2O2 at pH > 5.5 resulted in a decrease of O in the exposed enamel, and changes in C:P, Ca:C, Ca:P and Ca:O were observed. The H2O22 did not affect the unit cell parameters, but the signal-to-noise level was increased for slightly acidic or neutral solutions. The unit cell parameters decreased in the acidic solutions. Conclusions : The exposure to H2O2 at varying pH values affect the enamel with two different mechanisms. One effect is the oxidation of the organic or bioorganic matter in the hydroxyapatite matrix, due to the use of 3.3% H2O2. The other effect is due to the current pH of the H2O2, since the structure of the hydroxyapatite starts to erode when the pH < 5.5.
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| 33. |
- Tallheden, Tommi, 1972, et al.
(författare)
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Gene expression during redifferentiation of human articular chondrocytes.
- 2004
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Ingår i: Osteoarthritis and cartilage / OARS, Osteoarthritis Research Society. - : Elsevier BV. - 1063-4584. ; 12:7, s. 525-35
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of the present study was to investigate gene expression during the in vitro redifferentiation process of human articular chondrocytes isolated from clinical samples from patient undergoing an autologous chondrocyte transplantation therapy (ACT). METHOD: Monolayer (ML) expanded human articular chondrocytes from four donors were cultured in a 3D pellet model and the redifferentiation was investigated by biochemistry, histology, immunohistochemistry and microarray analysis. RESULTS: The culture expanded chondrocytes redifferentiated in the pellet model as seen by an increase in collagen type II immunoreactivity between day 7 and 14. The gene expression from ML to pellet at day 7 included an increase in cartilage matrix proteins like collagen type XI, tenascin C, dermatopontin, COMP and fibronectin. The late phase consisted of a strong downregulation of extracellular signal-regulated protein kinase (ERK-1) and an upregulation of p38 kinase and SOX-9, suggesting that the late phase mimicked parts of the signaling processes involved in the early chondrogenesis in limb bud cells. Other genes, which indicated a transition from proliferation to tissue formation, were the downregulated cell cycle genes GSPT1 and the upregulated growth-arrest-specific protein (gas). The maturation of the pellets included no signs of hypertrophy or apoptosis as seen by downregulation of collagen type X, Matrix Gla protein and increased expression of caspase 3. CONCLUSION: Our data show that human articular chondrocytes taken from surplus cells of patient undergoing ACT treatment and expanded in ML, redifferentiate and form cartilage like matrix in vitro and that this dynamic process involves genes known to be expressed in early chondrogenesis.
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| 34. |
- Uhlén, Mathias, et al.
(författare)
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The human secretome
- 2019
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Ingår i: Science Signaling. - : American Association for the Advancement of Science (AAAS). - 1945-0877 .- 1937-9145. ; 12:609
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Tidskriftsartikel (refereegranskat)abstract
- The proteins secreted by human cells (collectively referred to as the secretome) are important not only for the basic understanding of human biology but also for the identification of potential targets for future diagnostics and therapies. Here, we present a comprehensive analysis of proteins predicted to be secreted in human cells, which provides information about their final localization in the human body, including the proteins actively secreted to peripheral blood. The analysis suggests that a large number of the proteins of the secretome are not secreted out of the cell, but instead are retained intracellularly, whereas another large group of proteins were identified that are predicted to be retained locally at the tissue of expression and not secreted into the blood. Proteins detected in the human blood by mass spectrometry-based proteomics and antibody-based immuno-assays are also presented with estimates of their concentrations in the blood. The results are presented in an updated version 19 of the Human Protein Atlas in which each gene encoding a secretome protein is annotated to provide an open-access knowledge resource of the human secretome, including body-wide expression data, spatial localization data down to the single-cell and subcellular levels, and data about the presence of proteins that are detectable in the blood.
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| 35. |
- Woksepp, Hanna, et al.
(författare)
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Simultaneous Measurement of 11 Antibiotics for use in the Intensive Care Unit by Ultra Performance Liquid Chromatography-Tandem Mass Spectrometry
- 2022
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Ingår i: Therapeutic Drug Monitoring. - Philadelphia, PA, United States : Lippincott Williams & Wilkins. - 0163-4356 .- 1536-3694. ; 44:2, s. 308-318
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Recent studies indicate that a high proportion of patients in the intensive care unit (ICU) fail to attain adequate antibiotic levels. Thus, there is a need to monitor the antibiotic concentration to ensure effective treatment. Herein, the authors aimed to develop an ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) method for the simultaneous quantification of antimicrobials to assess individualized therapeutic drug monitoring (TDM).METHODS: A UHPLC-MS/MS method with 11 antibiotics (ciprofloxacin, moxifloxacin, benzylpenicillin, levofloxacin, linezolid, rifampicin, meropenem, cloxacillin, cefotaxime, clindamycin, and piperacillin) was developed. Chromatographic separation was performed using a Kinetex biphenyl reversed-phase column, with gradient elution using 0.1% formic acid (FA) and methanol with 0.1% FA. Sample preparation was performed using methanol protein precipitation. The total run time was 5 min.RESULTS: For all analytes, the inter-assay inaccuracies for calibrators were ≤5%. The inter-day inaccuracies for the quality controls (QCs) were ≤5% for all analytes. The inter-assay precision for calibration standards ranged between 1.42% and 6.11%. The inter-assay imprecision for QCs of all antibiotics and concentrations ranged between 3.60% and 16.1%. Inter-assay inaccuracy and imprecision for the QCs and calibration standards were ≤15% for all drugs, except benzylpenicillin.CONCLUSION: A rapid UHPLC-MS/MS method was developed for the simultaneous quantification of 11 different antibiotics. Minimal sample preparation was required to ensure a rapid turnaround time. The method was applied to clinical samples collected from four ICUs.
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