| 1. |
- Allard, Christina, et al.
(författare)
-
Rasbiologiskt språkbruk i statens rättsprocess mot sameby
- 2015
-
Ingår i: Dagens Nyheter. - 1101-2447.
-
Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Statens hantering av forskningsresultat i rättsprocessen med Girjas sameby utgör ett hot mot Sverige som rättsstat och kunskapsnation. Åratal av svensk och internationell forskning underkänns och man använder ett språkbruk som skulle kunna vara hämtat från rasbiologins tid. Nu måste staten ta sitt ansvar och börja agera som en demokratisk rättsstat, skriver 59 forskare.
|
|
| 2. |
- Arvidsson, Alf, et al.
(författare)
-
För Sverige i tiden?
- 2009
-
Ingår i: Kulturella perspektiv - Svensk etnologisk tidskrift. - Umeå. - 1102-7908. ; 18:2, s. 2-8
-
Tidskriftsartikel (refereegranskat)
|
|
| 3. |
- Berg, Marie, 1955, et al.
(författare)
-
A midwifery model of intrapartum care - development and implementation
- 2014
-
Ingår i: Leadership, learning and research in nursing and midwifery. Sigma Theta Tau International Honor Society, 2nd European regional conference. 16-18 June 2014 Gothenburg, Sweden..
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)
|
|
| 4. |
- Cornell, Per, 1962, et al.
(författare)
-
A Scandinavian Town and Its Hinterland: The Case of Nya Lödöse
- 2018
-
Ingår i: International Journal of Historical Archaeology. - : Springer Science and Business Media LLC. - 1092-7697 .- 1573-7748. ; 22:2, s. 186-202
-
Tidskriftsartikel (refereegranskat)abstract
- Discussing Nordic towns in medieval and Early Modern eras must always start by noting that this is, at least up to the seventeenth century, a kind of periphery. In this article, we summarize aspects of the sixteenth-century town of Nya Lödöse and its hinterland, drawing on both archaeological and historical knowledge. The hinterland experienced an economic development in the sixteenth century, and increased volumes of exports of wood, iron, and animal products passed the town. Several actor-collectives operated on Nya Lödöse and they played an important part in a military and economic sense. But most of the people of Nya Lödöse lived in poor and sad conditions, not least when compared to the utopia genre of the times. The skeletal material from the churchyard at Nya Lödöse shows the wide distribution of a number of diseases, and a high degree of violence among men. Poverty and misery characterized the location.
|
|
| 5. |
- Faijerson, Jonas, 1977, et al.
(författare)
-
Reactive astrogliosis induces astrocytic differentiation of adult neural stem/progenitor cells in vitro.
- 2006
-
Ingår i: Journal of neuroscience research. - : Wiley. - 0360-4012 .- 1097-4547. ; 84:7, s. 1415-24
-
Tidskriftsartikel (refereegranskat)abstract
- Neural stem cells reside in defined areas of the adult mammalian brain, including the dentate gyrus of the hippocampus. Rat neural stem/progenitor cells (NSPCs) isolated from this region retain their multipotency in vitro and in vivo after grafting into the adult brain. Recent studies have shown that endogenous or grafted NSPCs are activated after an injury and migrate toward lesioned areas. In these areas, reactive astrocytes are present and secrete numerous molecules and growth factors; however, it is not currently known whether reactive astrocytes can influence the lineage selection of NSPCs. We investigated whether reactive astrocytes could affect the differentiation, proliferation, and survival of adult NSPCs by modelling astrogliosis in vitro, using mechanical lesion of primary astrocytes. Initially, it was found that conditioned medium from lesioned astrocytes induced astrocytic differentiation of NSPCs without affecting neuronal or oligodendrocytic differentiation. In addition, NSPCs in coculture with lesioned astrocytes also displayed increased astrocytic differentiation and some of these NSPC-derived astrocytes participated in glial scar formation in vitro. When proliferation and survival of NSPCs were analyzed, no differential effects were observed between lesioned and nonlesioned astrocytes. To investigate the molecular mechanisms of the astrocyte-inducing activity, the expression of two potent inducers of astroglial differentiation, ciliary neurotrophic factor and leukemia inhibitory factor, was analyzed by Western blot and shown to be up-regulated in conditioned medium from lesioned astrocytes. These results demonstrate that lesioned astrocytes can induce astroglial differentiation of NSPCs and provide a mechanism for astroglial differentiation of these cells following brain injury.
|
|
| 6. |
|
|
| 7. |
- Goldkuhl, Lisa, 1983, et al.
(författare)
-
Effekten av att föda barn i ett speciellt utformat födslorum: En randomiserad kontrollerad studie
- 2023
-
Ingår i: Konferensbidrag Reproduktiv Hälsa, Karlstad.
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Bakgrund: Den upplevda miljön har betydelse för födselns fysiologiska processer hos kvinnor. Då majoriteten barn föds på sjukhus är det därav betydelsefullt att utforma sjukhusmiljön utifrån aspekter som främjar trygghet och förtrogenhet. Syfte: Att utvärdera om ett speciellt utformat rum ger bättre utfall i samband med födsel, i jämförelse med standardrum. Metod: En randomiserad kontrollerad studie genomfördes under åren 2019–2020 vid ett sjukhus i västra Sverige. Förstföderskor med en singelgraviditet i fullgången tid lottades till att vårdas antingen i ett rum speciellt utformat för att stödja födselns fysiologiska processer (testrummet) eller i ett standardrum. Hypotesen var att det primära kompositutfallet skulle uppfyllas hos fler kvinnor i testrummet, det vill säga: vaginal spontan födsel, ingen användning av oxytocindropp, positiv förlossningsupplevelse, samt blödning <1000ml. För att kunna påvisa en skillnad på 8% mellan de randomiserade grupperna i det primära utfallet, krävdes 1274 studiedeltagare. Bland sekundära utfall fanns andra perinatala utfall samt självskattad förlossningsupplevelse upp till ett år efter födsel. Resultat: Studien avslutades i förtid på grund av Covid-19-pandemin, vilket gjorde att 406 kvinnor randomiserades totalt. Därav uppnåddes inte tillräcklig styrka för att kunna påvisa en statistiskt signifikant skillnad mellan grupperna avseende det primära utfallet. I testrummet uppfylldes det primära utfallet hos 42% av kvinnorna jämfört med 35% i standardrummet (odds ratio: 1.35, 95% CI 0.90–2.01). Kvinnor i testrummet använde epiduralanalgesi i lägre utsträckning. De rapporterade även mer positiva förlossningsupplevelser 3 och 12 månader efter födsel i jämförelse med kvinnor i standardrummen. Konklusion: Denna för tidigt avslutade studie kunde inte verifiera om testrummet förbättrar det primära utfallet. Däremot använde kvinnor i det testrummet i lägre grad farmakologisk smärtlindring och skattade bättre förlossningsupplevelse över tid. Finansiering: Vetenskapsrådet (2018–02406), Institutionen för Vårdvetenskap och Hälsa, Göteborgs Universitet.
|
|
| 8. |
|
|
| 9. |
- Lundgren, Ingela, 1957, et al.
(författare)
-
Clinician-centred interventions to increase vaginal birth after caesarean section (VBAC): a systematic review
- 2015
-
Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 15:16
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe number of caesarean sections (CS) is increasing globally, and repeat CS after a previous CS is a significant contributor to the overall CS rate. Vaginal birth after caesarean (VBAC) can be seen as a real and viable option for most women with previous CS. To achieve success, however, women need the support of their clinicians (obstetricians and midwives). The aim of this study was to evaluate clinician-centred interventions designed to increase the rate of VBAC.MethodsThe bibliographic databases of The Cochrane Library, PubMed, PsychINFO and CINAHL were searched for randomised controlled trials, including cluster randomised trials that evaluated the effectiveness of any intervention targeted directly at clinicians aimed at increasing VBAC rates. Included studies were appraised independently by two reviewers. Data were extracted independently by three reviewers. The quality of the included studies was assessed using the quality assessment tool, `Effective Public Health Practice Project¿. The primary outcome measure was VBAC rates.Results238 citations were screened, 255 were excluded by title and abstract. 11 full-text papers were reviewed; eight were excluded, resulting in three included papers. One study evaluated the effectiveness of antepartum x-ray pelvimetry (XRP) in 306 women with one previous CS. One study evaluated the effects of external peer review on CS birth in 45 hospitals, and the third evaluated opinion leader education and audit and feedback in 16 hospitals. The use of external peer review, audit and feedback had no significant effect on VBAC rates. An educational strategy delivered by an opinion leader significantly increased VBAC rates. The use of XRP significantly increased CS rates.ConclusionsThis systematic review indicates that few studies have evaluated the effects of clinician-centred interventions on VBAC rates, and interventions are of varying types which limited the ability to meta-analyse data. A further limitation is that the included studies were performed during the late 1980s-1990s. An opinion leader educational strategy confers benefit for increasing VBAC rates. This strategy should be further studied in different maternity care settings and with professionals other than physicians only.
|
|
| 10. |
- Lundgren, Ingela, 1957, et al.
(författare)
-
Clinicians views of factors of importance for improving the rate of vaginal births after caesarean section (VBAC) - A study from countries with high and low VBAC-rates
- 2014
-
Ingår i: Optimising Childbirth Across Europe, 9-10 April 2014. Brussels, Belgium..
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: This study is a part of the ongoing 4-year OptiBIRTH project, which is funded by EU and involving eight European countries. The key aim of the project is to promote increased VBAC rates across Europe. Repeat caesarean section (CS) following previous CS is one of the most significant factors contributing to increased CS rates in the EU. Even though VBAC is the recommended option associated with better outcomes for both mothers and babies, vaginal birth rates after CS vary widely through healthcare settings and countries across Europe. It is important to obtain a deeper knowledge about clinician’s views on VBAC in different countries to understand important factors for improving VBAC rates. The findings of this study will assist in the development of educational interventions targeted towards both clinicians and women, and tested in an upcoming randomised trial in three European countries with low VBAC rates. Aim of the study: The aim with this study was to investigate clinicians’ views on important factors for improving the rate of VBAC in women. Research methodology: Individual interviews, telephone interviews and focus groups interviews with clinician’s (doctors and midwives as well as GPs in different maternity care settings and in rural and urban regions) have been conducted in six countries during 2012-2013; Finland, the Netherlands, Sweden (high VBAC rate), Ireland, Italy, Germany (low VBAC rate). In total about 115 clinicians were interviewed. They answered five questions about VBAC and participation in decision-making. The interviews were analysed using content analysis. Ethical approval: Approval was obtained from study sites in each country. Study findings and conclusions: Findings from this ongoing study will be presented at the congress under the domains: important factors for VBAC, barriers for VBAC, views on decision-making, and support for VBAC.
|
|
| 11. |
- Lundgren, Ingela, 1957, et al.
(författare)
-
Clinicians’ views of factors of importance for improving the rate of VBAC (vaginal birth after caesarean section): a qualitative study from countries with high VBAC rates
- 2015
-
Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 15:196
-
Tidskriftsartikel (refereegranskat)abstract
- Background The most common reason for caesarean section (CS) is repeat CS following previous CS. Vaginal birth after caesarean section (VBAC) rates vary widely in different healthcare settings and countries. Obtaining deeper knowledge of clinicians’ views on VBAC can help in understanding the factors of importance for increasing VBAC rates. Interview studies with clinicians and women in three countries with high VBAC rates (Finland, Sweden and the Netherlands) and three countries with low VBAC rates (Ireland, Italy and Germany) are part of ‘OptiBIRTH’, an ongoing research project. The study reported here is based on interviews in high VBAC countries. The aim of the study was to investigate the views of clinicians working in countries with high VBAC rates on factors of importance for improving VBAC rates. Methods Individual (face-to-face or telephone) interviews and focus group interviews with clinicians (in different maternity care settings) in three countries with high VBAC rates were conducted during 2012–2013. In total, 44 clinicians participated: 26 midwives and 18 obstetricians. Five central questions about VBAC were used and interviews were analysed using content analysis. The analysis was performed in each country in the native language and then translated into English. All data were then analysed together and final categories were validated in each country. Results The findings are presented in four main categories with subcategories. First, a common approach is needed, including: feeling confident with VBAC, considering VBAC as the first alternative, communicating well, working in a team, working in accordance with a model and making agreements with the woman. Second, obstetricians need to make the final decision on the mode of delivery while involving women in counselling towards VBAC. Third, a woman who has a previous CS has a similar need for support as other labouring women, but with some extra precautions and additional recommendations for her care. Finally, clinicians should help strengthen women’s trust in VBAC, including building their trust in giving birth vaginally, recognising that giving birth naturally is an empowering experience for women, alleviating fear and offering extra visits to discuss the previous CS, and joining with the woman in a dialogue while leaving the decision about the mode of birth open. Conclusions This study shows that, according to midwives and obstetricians from countries with high VBAC rates, the important factors for improving the VBAC rate are related to the structure of the maternity care system in the country, to the cooperation between midwives and obstetricians, and to the care offered during pregnancy and birth. More research on clinicians’ perspectives is needed from countries with low, as well as high, VBAC rates
|
|
| 12. |
- Lundgren, Ingela, 1957, et al.
(författare)
-
Evaluation of a midwifery model of woman-centred care during childbirth
- 2016
-
Ingår i: NJF (Nordiskt Jordemoderförbund) Congress. Programme and abstracts. Gothenburg, May 12-14, 2016. - 9789163742699
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Based on a synthesis of 12 qualitative studies on women’s and midwives’ experiences of childbearing, a model of woman-centred care has been developed. The model has three central intertwined themes: a reciprocal relationship, a birthing atmosphere, and grounded knowledge; and two overall themes: the cultural context and the balancing act. Aim: To evaluate the use and effects of the model of woman-centred care provided by midwives during childbirth. Methods: A mixed methods, before-after controlled study is currently underway at two units for normal deliveries at Sahlgrenska University Hospital, Sweden, and an ethnographic actions research study is ongoing at the labour ward of Landspitali, University Hospital in Iceland. The intervention in Sweden comprises a one-day (8 hours) education about the model together with regularly scheduled reflection groups for midwives. The effects are studied by evaluating delivery outcomes, mothers’ childbirth experiences and midwives’ work-related experiences. The primary outcomes are augmentation with oxytocin and mothers’ childbirth experiences assessed with the Childbirth Experience Questionnaire (CEQ 2.0). The secondary outcomes are midwives’ experiences, assessed by means of questionnaires, including stress, burn-out, work satisfaction, and sense of coherence before and one year after the intervention. The qualitative part will study if the model is considered applicable by midwives, obstetricians, assistant nurses and managers at delivery wards, and to the content of midwifery care. An ethnographic field study with midwives and a focus-group study with assistant nurses, obstetricians, midwives and managers have been conducted before start and will be performed after the intervention. The ethnographic action research study in Iceland is focusing on midwives’ experiences and the development of guidelines for implementing the model in practice. Results: Preliminary findings from the study will be presented at the conference. Conclusion: A midwifery model of woman-centred care based on previous research is now evaluated in clinical practice.
|
|
| 13. |
- Lundgren, Ingela, 1957, et al.
(författare)
-
Implementation of a midwifery model of woman-centered care in practice: Impact on oxytocin use and childbirth experiences
- 2022
-
Ingår i: European Journal of Midwifery. - : E.U. European Publishing. - 2585-2906. ; 6:16
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction: Theoretical models for midwifery have been developed in different countries, but few have been evaluated. This study evaluated the implementation of a midwifery model of woman-centered care (MiMo) in practice. Methods: A mixed method study based on an implementation of MiMo was carried out in a labor ward at a university hospital in Sweden, with another labor ward as a reference. The qualitative core component was a secondary analysis of focus groups with midwives after the implementation. The supplemental quantitative components were oxytocin use for augmentation of labor and women’s childbirth experiences before and after the implementation. Results: The midwives viewed MiMo as a useful tool for comprehending the birthing woman holistically, and for identifying what might disturb the birth process. Hindering factors were a lack of organizational stability and time, and midwives’ unwillingness to understand the model. Oxytocin use decreased significantly only in the implementation ward (p=0.002) and a significant difference was found between wards in the post-implementation period (p=0.004). However, logistic regression analyses showed that the interaction between ward and time period, controlling for age, epidural use, and birth outcome, was not significant (p=0.304), indicating that the decrease was not significantly related to the implementation. Childbirth experience did not differ before and after the implementation. Conclusions: By using MiMo in practice, midwives have a tool for comprehending the woman holistically and identifying disturbing factors during the birth. However, more research is needed for further implementation that should focus on the potential as well as hindering factors.
|
|
| 14. |
- Lundgren, Ingela, 1957, et al.
(författare)
-
Vaginal birth after a previous CS –what is the best option and how decide?
- 2016
-
Ingår i: NJF Congress, May 12-14, 2016, Göteborg, Sverige.. - 9789163742699
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: The most common reason for caesarean section (CS) is repeat CS following previous CS. Vaginal birth after caesarean section (VBAC) rates vary widely in different healthcare settings and countries. Obtaining knowledge about the differences across Europe, and women´s and clinicians’ views on VBAC can help in understanding the factors of importance for increasing VBAC rates. Aim: The aim is to discuss the best birthing option for women with a previous CS and the decision-making process between VBAC or CS, based on a summary of research and findings from OptiBIRTH, an ongoing study. Methods: OptiBIRTH is a cluster randomised trial, funded by the European Commission, aiming to increase VBAC rates across Europe through enhanced woman-centred maternity care. An intervention is being tested in Italy, Germany and Ireland based on two systematic reviews and interviews with 71 women and 115 clinicians (midwives and obstetricians) in these countries as well as in countries with high VBAC rates (Finland, Sweden and the Netherlands). Five central questions about VBAC were used and interviews were analysed using content analysis. The analysis was performed in each country in the native language and then translated into English. All data were then analysed together and final categories were validated in each country. Results: The European perspective related to best option and decision-making, derived from systematic reviews of interventions for clinicians and interventions for women, will be presented and led by Cecily Begley. Women´s views and clinicans´views of best option and how to decide will be presented and led by Christina Nilsson (women) and Ingela Lundgren (clinicians). Findings showed that both women and clinicians wished to have more knowledge about the benefits and drawbacks of VBAC and repeat CS. Conclusion: The evidence-based intervention now includes education of women and information-giving to clinicians, and then bringing both groups together to discuss future birthing plans.
|
|
| 15. |
- Lyckestam, Ida, et al.
(författare)
-
Women’s lived experience of vaginal birth after caesarean section (VBAC): a qualitative study from a country with high VBAC rates
- 2016
-
Ingår i: Nordisk Jordemor Kongress Midwives for all. 12-14 maj 2016, Göteborg, Sverige..
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Vaginal Birth After Caesarean section (VBAC) is a relevant question for women having a previous Cesarean Section (CS). Even if VBAC is the recommended choice for most women VBAC rates differs in an international perspective. There is a great deal of research on VBAC but only a few qualitative studies on women’s experiences. These studies are limited to a few countries, notably in countries with low VBAC rates. Studies from countries with high VBAC rates such as Sweden are few. Objective: The aim of this study was to describe the lived experience of VBAC in women living in a region in Sweden; a country with high VBAC rate. Methods: In-depth interviews were conducted with nine women in western part of Sweden one year after their VBAC experience. The data analysis was performed in accordance to a phenomenological reflective lifeworld approach. Results: Results will be presented at the conference. Conclusion: Few qualitative studies on women’s experience of VBAC are published especially in countries with high VBAC rates. Therefore it is important to gain knowledge regarding the women’s experiences in one of these countries. This knowledge can contribute to increase the understanding of women’s experiences, and be used to optimise the care in countries with high as well as low VBAC rates.
|
|
| 16. |
- Manderstedt, Eric, et al.
(författare)
-
Detection of mosaics in hemophilia A by deep Ion Torrent sequencing and droplet digital PCR
- 2020
-
Ingår i: Research and practice in thrombosis and haemostasis. - : Wiley. - 2475-0379. ; 4:7, s. 1121-1130
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The occurrence of mosaicism in hemophilia A (HA) has been investigated in several studies using different detection methods. Objectives: To characterize and compare the ability of AmpliSeq/Ion Torrent sequencing and droplet digital polymerase chain reaction (ddPCR) for mosaic detection in HA. Methods: Ion Torrent sequencing and ddPCR were used to analyze 20 healthy males and 16 mothers of sporadic HA patients. Results: An error-rate map over all coding positions and all positions reported as mutated in the F8-specific mutation database was produced. The sequencing produced a mean read depth of >1500X where >97% of positions were covered by >100 reads. Higher error frequencies were observed in positions with A or T as reference allele and in positions surrounded on both sides with C or G. Seventeen of 9319 positions had a mean substitution error frequency >1%. The ability to identify low-level mosaicism was determined primarily by read depth and error rate of each specific position. Limit of detection (LOD) was <1% for 97% of positions with substitutions and 90% of indel positions. The positions with LOD >1% require repeated testing and mononucleotide repeats with more than four repeat units need an alternative analysis strategy. Mosaicism was detected in 1 of 16 mothers and confirmed using ddPCR. Conclusions: Deep sequencing using an AmpliSeq/Ion Torrent strategy allows for simultaneous identification of disease-causing mutations in patients and mosaicism in mothers. ddPCR has high sensitivity but is hampered by the need for mutationspecific design.
|
|
| 17. |
|
|
| 18. |
- Nilsson, Christina, 1959, et al.
(författare)
-
An effort to make all the pieces come together: Women’s long-term perspectives on their experiences of intense fear of childbirth
- 2012
-
Ingår i: International Journal of Childbirth. - 2156-5287 .- 2156-5295. ; 2:4, s. 255-68
-
Tidskriftsartikel (refereegranskat)abstract
- Women's experiences of childbirth can be both empowering and traumatic, and negative experiences might lead to fear of forthcoming births. Our aim with this phenomenological study was to describe the meaning of fear of childbirth and of birth drawing on women's long-term perspectives. Six women who had sought help for intense fear of childbirth because of a negative birth experience during their second or third pregnancy 7-11 years ago were interviewed. The essential structure of the phenomenon is "an effort to make all the pieces come together" with the constituents: Every childbirth is a narrative that lingers on, fear of childbirth is connected to the period of childbearing, and the experiences of childbirth are central life experiences. Our findings suggest that fear of childbirth and childbirth experiences have been linked together and integrated as important life experiences. It seems like the meaning of the childbirth experiences can be expressed by women in several nuances and tones, indicating the complexity of the experience. The fear of childbirth has lost its importance and is connected to the previous difficult childbirth experience. It is important to understand women's fear of childbirth and birth experiences with respect to individual needs.
|
|
| 19. |
- Nilsson, Christina, 1959, et al.
(författare)
-
Definitions, measurements and prevalence of fear of childbirth: a systematic review
- 2018
-
Ingår i: Bmc Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 18
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Fear of Childbirth (FOC) is a common problem affecting women's health and wellbeing, and a common reason for requesting caesarean section. The aims of this review were to summarise published research on prevalence of FOC in childbearing women and how it is defined and measured during pregnancy and postpartum, and to search for useful measures of FOC, for research as well as for clinical settings. Methods: Five bibliographic databases in March 2015 were searched for published research on FOC, using a protocol agreed a priori. The quality of selected studies was assessed independently by pairs of authors. Prevalence data, definitions and methods of measurement were extracted independently from each included study by pairs of authors. Finally, some of the country rates were combined and compared. Results: In total, 12,188 citations were identified and screened by title and abstract; 11,698 were excluded and full-text of 490 assessed for analysis. Of these, 466 were excluded leaving 24 papers included in the review, presenting prevalence of FOC from nine countries in Europe, Australia, Canada and the United States. Various definitions and measurements of FOC were used. The most frequently-used scale was the W-DEQ with various cut-off points describing moderate, severe/intense and extreme/phobic fear. Different 3-, 4-, and 5/6 point scales and visual analogue scales were also used. Country rates (as measured by seven studies using W-DEQ with >= 85 cut-off point) varied from 6.3 to 14.8%, a significant difference (chi-square = 104.44, d.f. = 6, rho < 0.0001). Conclusions: Rates of severe FOC, measured in the same way, varied in different countries. Reasons why FOC might differ are unknown, and further research is necessary. Future studies on FOC should use the W-DEQ tool with a cut-off point of >= 85, or a more thoroughly tested version of the FOBS scale, or a three-point scale measurement of FOC using a single question as 'Are you afraid about the birth?' In this way, valid comparisons in research can be made. Moreover, validation of a clinical tool that is more focussed on FOC alone, and easier than the longer W-DEQ, for women to fill in and clinicians to administer, is required.
|
|
| 20. |
- Nilsson, Christina, 1959
(författare)
-
Fear of childbirth - Women's previous experiences in the delivery room
- 2013
-
Ingår i: 17 th International congress of the International Society of Psychosomatic Obstetrics and Gynaecology (ISPOG), 22-24 May 2013, Berlin, Germany.. ; 2013
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Despite the large production of research about fear of childbirth (FOC) there are only a few studies that describe women’s experiences of the phenomenon, especially in relation to their previous childbirth experiences. This paper is a summary of my thesis about fear of childbirth with focus on women´s experiences of giving birth. The overall aim was to describe experiences of, and the association between, FOC and birth experiences of women with FOC. Materials and methods: The thesis is partly based on three qualitative studies, using descriptive phenomenology describing experiences of FOC (8 women), of previous birth (9) as well as experiences in a longer perspective (6) in women with FOC. In the fourth study differences between women who reported FOC and those who did not, were calculated using risk ratios and multivariate logistic regression analysis in a sample of 763 women. Results: FOC was described as “to lose oneself as a woman into loneliness”. Previous birth experience was described as “a sense of not being present in the delivery room and an incomplete childbirth experience”. FOC was associated with previous negative birth experiences and emergency caesarean sections. From a long-term perspective, FOC and birth experience was described as “an effort to make all the pieces come together”. Conclusion: This thesis generates evidence on the importance of previous birth experience for women with FOC, from both qualitative and quantitative perspectives. These perspectives illustrate the complexity where women´s experiences in the delivery room are central and important for subsequent FOC. To understand FOC in multiparous women it is important to listen to their birth narratives. To avoid creating fear of childbirth, it is important that maternity care services focus on women’s birth experiences and critically evaluate care in relation to childbirth.
|
|
| 21. |
- Nilsson, Christina, 1959-
(författare)
-
Förlossningsrädsla : med fokus på kvinnors upplevelser av att föda barn
- 2012
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim: The overall aim of this study is to describe experiences of, and the association between, fear of childbirth and birth experiences of women with fear ofchildbirth.Methods: In studies I, II, and IV, a reflective lifeworld approach based on phenomenological philosophy was used to describe women’s experiences of fear of childbirth (I), previous birth experiences (II), and fear of childbirth and of birth experience in a long-term perspective (IV). In study III, differences between women who reported fear of childbirth and those who did not were calculated using risk ratios with a 95 % confidence interval and multivariate logistic regression analysis. Data were collected from interviews with eight (I) and nine (II) pregnant women with intense fear of childbirth, and with six women who had sought care for intense fear of childbirth 7 to 11 years prior to the interview (IV), and via questionnaire from a sample of 763 women during pregnancy and again one year following birth (III).Findings: Fear of childbirth was described as “to lose oneself as a woman into loneliness” (I). Previous birth experience was described as “a sense of not being present in the delivery room and an incomplete childbirth experience” (II). Fear of childbirth was associated with a previous negative birth experience and a previous emergency caesarean section (III). From a long-term perspective, fear of childbirth and birth experience was described as “an effort to make all the pieces come together” (IV).Conclusions: This thesis generates evidence on the importance of previous birth experience for women with fear of childbirth, from both qualitative and quantitative perspectives. These perspectives illustrate the complexity where women´s experiences in the delivery room are central. To avoid creating fear of childbirth, it is important that maternity care services focus on women’s birth experiences and critically evaluate care in relation to childbirth.
|
|
| 22. |
|
|
| 23. |
- Nilsson, Christina, 1959
(författare)
-
The delivery room: Is it a safe place? A hermeneutic analysis of women's negative birth experiences
- 2014
-
Ingår i: Sexual & Reproductive HealthCare. - : Elsevier BV. - 1877-5756 .- 1877-5764. ; 5:4, s. 199-204
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Women’s negative experiences in the delivery room can have significance for later fear of childbirth. Therefore, it is important to critically evaluate the care during childbirth. The aim was to gain a deeper understanding of women’s negative experiences in the delivery room. Methods: This study is based on original data from three qualitative studies on Swedish women’s experiences of fear of childbirth. Data were collected from interviews with 21 women; 15 pregnant women (6 + 9) with intense fear of childbirth, and six women who had experienced intense fear of childbirth 7–11 years prior to the interview. The analysis had a hermeneutic approach, with focus on the women’s descriptions of their previous negative birth experiences. Findings: The interpretation showed that in the delivery room the women were objects of surveillance, and they endured suffering related to the care during childbirth. This involves experiences of midwives as uncaring, feelings of being suppressed, unprotected and lacking safety, of feeling disconnected and of the body as incompetent in giving birth. The birth environments are understood as power structures, containing views of women’s birthing bodies as machines, and delivery rooms as surveillance environments, involving interventions such as foetal heart monitoring, induction and augmentation of labour. Conclusions: The delivery room was, for these women, a place creating fear of childbirth. To avoid negative birth experiences and future fear, women must be offered not only medical, but also emotional and existential safety in the delivery room.
|
|
| 24. |
- Nilsson, Christina, 1959, et al.
(författare)
-
Vaginal Birth After Caesarean: Views of women from countries with low VBAC rates
- 2017
-
Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192 .- 1878-1799. ; 30:6, s. 481-490
-
Tidskriftsartikel (refereegranskat)abstract
- Problem and background: Vaginal birth after caesarean section is a safe option for the majority of women. Seeking women´s views can be of help in understanding factors of importance for achieving vaginal birth in countries where the vaginal birth rates after caesarean is low. Aim: To investigate women’s views on important factors to improve the rate of vaginal birth after caesarean in countries where vaginal birth rates after caesarean rates are low. Methods: A qualitative study using content analysis. Data were gathered through focus groups and individual interviews with 51 women, in their native languages, in Germany, Ireland and Italy. The women were asked five questions about vaginal birth after caesarean. Data were translated to English, analysed together and finally validated in each country. Findings: Important factors for the women were that all involved in caring for them were of the same opinion about vaginal birth after caesarean section, thet they experience shared decision-making with clinicians supportive of vaginal birth, receive correct information, are sufficently prepared for a vaginal birth, and experience a culture that supports vaginal birth after caesarean section. Discussion and conclusion: Women’s decision-making about vaginal birth after caesarean in these countries involves a complex, multidimensional interplay of medical, psychological, social, cultural, personal and practical considerations. Further research is needed to explore if the information deficit women report negatively affects their ability to make informed choices, and to understand what matters most to women when making decisions about vaginal birth after caesarean as a mode of birth.
|
|
| 25. |
- Nilsson, Christina, 1959, et al.
(författare)
-
Vaginal Birth After Cesarean—Views of Women From Countries With High VBAC Rates
- 2017
-
Ingår i: Qualitative Health Research. - : SAGE Publications. - 1049-7323 .- 1552-7557. ; 27:3, s. 325-340
-
Tidskriftsartikel (refereegranskat)abstract
- Despite the consequences for women’s health, a repeat cesarean section birth (CS) after a previous CS is common in Western countries. Vaginal Birth After Cesarean (VBAC) is recommended for most women, yet VBAC rates are decreasing and vary across maternity organizations and countries. We investigated women’s views on factors of importance for improving the rate of VBAC in countries where VBAC rates are high. We interviewed 22 women who had experienced VBAC in Finland, the Netherlands, and Sweden. We used content analysis, which revealed five categories: receiving information from supportive clinicians, receiving professional support from a calm and confident midwife/ obstetrician during childbirth, knowing the advantages of VBAC, letting go of the previous childbirth in preparation for the new birth, and viewing VBAC as the first alternative for all involved when no complications are present. These findings reflect not only women’s needs, but also sociocultural factors influencing their views on VBAC.
|
|
| 26. |
- Nilsson, Christina, 1959, et al.
(författare)
-
Women-centred interventions to increase vaginal birth after caesarean section (VBAC): A systematic review
- 2015
-
Ingår i: Midwifery. - : Elsevier BV. - 0266-6138 .- 1532-3099. ; 31:7, s. 657-663
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: to evaluate the effectiveness of women centred interventions during pregnancy and birth to increase rates of vaginal birth after caesarean. Design: we searched bibliographic databases for randomised trials or cluster randomised trials on women centred interventions during pregnancy and birth designed to increase VBAC rates in women with at least one previous caesarean section. Comparator groups included standard or usual care or an alternative treatment aimed at increasing VBAC rates. The methodological quality of included studies was assessed independently by two authors using the Effective Public Health Practice Project quality assessment tool. Outcome data were extracted independently from each included study by two review authors. Findings: in total, 821 citations were identified and screened by title and abstract; 806 were excluded and full text of 15 assessed. Of these, 12 were excluded leaving three papers included in the review. Two studies evaluated the effectiveness of decision aids for mode of birth and one evaluated the effectiveness of an antenatal education programme. The findings demonstrate that neither the use of decision aids nor information/education of women have a significant effect on VBAC rates. Nevertheless, decision-aids significantly decrease women's decisional conflict about mode of birth, and information programmes significantly increase their knowledge about the risks and benefits of possible modes of birth. Key conclusions: few studies evaluated women-centred interventions designed to improve VBAC rates, and all interventions were applied in pregnancy only, none during the birth. There is an urgent need to develop and evaluate the effectiveness of all types of women-centred interventions during pregnancy and birth, designed to improve VBAC rates. Implications for practice: decision-aids and information programmes during pregnancy should be provided for women as, even though they do not affect the rate of VBAC, they decrease women's decisional conflict and increase their knowledge about possible modes of birth. (C) 2015 Elsevier Ltd. All rights reserved.
|
|
| 27. |
|
|
| 28. |
|
|
| 29. |
- Sjögreen, Lotta, 1954, et al.
(författare)
-
Speech production, intelligibility and oromotor function in seven individuals with Möbius sequence
- 2015
-
Ingår i: International Journal of Speech-Language Pathology. - : Informa UK Limited. - 1754-9507 .- 1754-9515. ; 17:6, s. 537-544
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: Möbius sequence is a rare disease characterized by congenital facial and abducent nerve palsy. Other cranial nerves may be affected. Cleft palate, intellectual disability and neuropsychiatric disorders are associated with the diagnosis. The aim was to explore speech production, intelligibility and oromotor function in a group of individuals with Möbius sequence. Method: Three children (5–11 years) and four adults (26–54 years) were recruited to the study via the Swedish Möbius syndrome association. In addition to cranial nerve dysfunction, two had a hearing impairment, one Asperger syndrome and one a cleft palate. Perceptual assessments included an evaluation of intelligibility in single words and spontaneous speech, the percentage of phonemes correct (PPC) and screening of orofacial functions (NOT-S). Objective measurements were used for the evaluation of nasality, lip force and tongue force. Result: Three individuals had severely impaired intelligibility, two slightly impaired and two had fully intelligible speech. The PPC varied between 59.3–100%. Five individuals had bilateral facial palsy, two unilateral facial palsy and six tongue impairment. One had a slightly increased nasalance score. Compensatory strategies were being effectively used. Conclusion: This case series contributes more in-depth knowledge of speech production, intelligibility and oromotor function in this rare condition.
|
|
| 30. |
- Stanne, Tara M, 1979, et al.
(författare)
-
Low Circulating Acute Brain-Derived Neurotrophic Factor Levels Are Associated With Poor Long-Term Functional Outcome After Ischemic Stroke.
- 2016
-
Ingår i: Stroke; a journal of cerebral circulation. - 1524-4628 .- 0039-2499. ; 47:7, s. 1943-1945
-
Tidskriftsartikel (refereegranskat)abstract
- Brain-derived neurotrophic factor (BDNF) plays important roles in brain plasticity and repair, and it influences stroke outcomes in animal models. Circulating BDNF concentrations are lowered in patients with traumatic brain injury, and low BDNF predicts poor recovery after this injury. We sought to investigate whether circulating concentrations of BDNF are altered in the acute phase of ischemic stroke and whether they are associated with short- or long-term functional outcome.
|
|
| 31. |
- Åberg, Daniel, 1973, et al.
(författare)
-
Serum IGF-I levels correlate to improvement of functional outcome after ischemic stroke.
- 2011
-
Ingår i: The Journal of clinical endocrinology and metabolism. - : The Endocrine Society. - 1945-7197 .- 0021-972X. ; 96:7
-
Tidskriftsartikel (refereegranskat)abstract
- GH has positive cognitive effects when given to GH-IGF-I-deficient patients. GH and IGF-I exert both neuroprotective and regenerative effects on experimental stroke. We investigated whether the endogenous serum IGF-I (s-IGF-I) levels correlated with recovery of functional independence in patients who had suffered an ischemic stroke.
|
|
| 32. |
- Åberg, N David, 1970, et al.
(författare)
-
Altered levels of circulating insulin-like growth factor I (IGF-I) following ischemic stroke are associated with outcome - a prospective observational study
- 2018
-
Ingår i: BMC Neurology. - : Springer Science and Business Media LLC. - 1471-2377. ; 18:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Insulin-like growth factor I (IGF-I) has neuroprotective effects in experimental ischemic stroke (IS). However, in patients who have suffered IS, various associations between the levels of serum IGF-I (s-IGF-I) and clinical outcome have been reported, probably reflecting differences in sampling time-points and follow-up periods. Since changes in the levels of post-stroke s-IGF-I have not been extensively explored, we investigated whether decreases in the levels of s-IGF-I between the acute time-point (median, 4 days) and 3 months (Delta IGF-I, further transformed into Delta IGF-I-quintiles, Delta IGF-I-q) are associated with IS severity and outcome. Methods: In the Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS) conducted in Gothenburg, Sweden, patients with IS who had s-IGF-I measurements available were included (N = 354; 65% males; mean age, 55 years). Baseline stroke severity was evaluated using the National Institutes of Health Stroke Scale (NIHSS) and converted into NIHSS-quintiles (NIHSS-q). Outcomes were assessed using the modified Rankin Scale (mRS) at 3 months and 2 years. Results: In general, the levels of s-IGF-I decreased (positive Delta IGF-I), except for those patients with the most severe NIHSS-q. After correction for sex and age, the 3rd Delta IGF-I-q showed the strongest association to mRS 0-2 [Odds Ratio (OR) 5.11, 95% confidence interval (CI) 2.18-11.9], and after 2 years, the 5th Delta IGF-I-q (OR 3.63, 95% CI 1.40-9.38) showed the strongest association to mRS 0-2. The associations remained significant after multivariate correction for diabetes, smoking, hypertension, and hyperlipidemia after 3 months, but were not significant (p = 0.057) after 2 years. The 3-month associations withstood additional correction for baseline stroke severity (p = 0.035), whereas the 2-year associations were further attenuated (p = 031). Conclusions: Changes in the levels of s-IGF-I are associated primarily with temporally near 3-month outcomes, while associations with long-term 2-year outcomes are weakened and attenuated by other factors. The significance of the change in post-stroke s-IGF-I is compatible with a positive role for IGF-I in IS recovery. However, the exact mechanisms are unknown and probably reflects combinations of multiple peripheral and central actions.
|
|
| 33. |
- Åberg, N David, 1970, et al.
(författare)
-
Association Between Levels of Serum Insulin-like Growth Factor I and Functional Recovery, Mortality, and Recurrent Stroke at a 7-year Follow-up.
- 2020
-
Ingår i: Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association. - : Georg Thieme Verlag KG. - 1439-3646. ; 128:5, s. 303-310
-
Tidskriftsartikel (refereegranskat)abstract
- The association of serum insulin-like growth factor I (s-IGF-I) with favorable outcome after ischemic stroke (IS) beyond 2 years is unknown. We investigated whether the levels of s-IGF-I 3 months post-stroke were associated with functional recovery up to 7 years after IS, considering also mortality and recurrent strokes.Patients (N=324; 65% males; mean age, 55 years) with s-IGF-I levels assessed 3 months after the index IS were included from the Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS). The modified Rankin Scale (mRS) was used to evaluate outcomes at 3 months, 2 and 7 years after IS, and recovery was defined as an improvement, no change, or deterioration in the shifts of mRS score. Baseline stroke severity was determined using the National Institutes of Health Stroke Scale (NIHSS).The mRS score distributions were better in the above-median s-IGF-I group (>146.7ng/ml). The s-IGF-I level was not associated with recurrent stroke (N=79) or death (N=44), although it correlated with recovery (r=0.12, P=0.035). In the regression analysis, s-IGF-I associated with recovery between 3 months and 7 years (but not between 2 and 7 years). The associations did not withstand adjustment for age and sex. For comparison, the corresponding associations between 3 months and 2 years withstood all adjustments.The association for s-IGF-I with long-term post-stroke recovery persists after 7 years, which is also reflected in the mRS score distributions at all time-points. The effects are however modest, and not driven by mortality or recurrent stroke.
|
|
| 34. |
- Åberg, N David, 1970, et al.
(författare)
-
Genetic variation at the IGF1 locus shows association with post-stroke outcome and to circulating IGF1.
- 2013
-
Ingår i: European journal of endocrinology / European Federation of Endocrine Societies. - 1479-683X. ; 169:6, s. 759-65
-
Tidskriftsartikel (refereegranskat)abstract
- In humans, serum IGF1 (s-IGF1) is associated with outcome after ischemic stroke (IS). Therefore variation at the IGF1 locus could also associate with both IS and s-IGF1. We investigated whether genetic variation at the IGF1 locus is associated with i) s-IGF1, ii) IS occurrence, iii) IS severity, and iv) post-stroke outcome.
|
|
| 35. |
- Åberg, N David, 1970, et al.
(författare)
-
Relationship between Levels of Pre-Stroke Physical Activity and Post-Stroke Serum Insulin-Like Growth Factor I
- 2020
-
Ingår i: Biomedicines. - : MDPI AG. - 2227-9059. ; 8:3
-
Tidskriftsartikel (refereegranskat)abstract
- Physical activity (PA) and insulin-like growth factor I (IGF-I) have beneficial effects for patients who have suffered an ischemic stroke (stroke). However, the relationship between the levels of PA and IGF-I after stroke has not been explored in detail. We investigated the pre-stroke PA level in relation to the post-stroke serum IGF-I (s-IGF-I) level, at baseline and at 3 months after the index stroke, and calculated the change that occurred between these two time-points (Delta IGF-I). Patients (N = 380; 63.4% males; mean age, 54.7 years) with data on 1-year leisure-time pre-stroke PA and post-stroke s-IGF-I levels were included from the Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS). Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS). Pre-stroke, leisure-time PA was self-reported as PA1-4, with PA1 representing sedentary and PA2-4 indicating progressively higher PA levels. Associations between s-IGF-I and PA were evaluated by multiple linear regressions with PA1 as the reference and adjustments being made for sex, age, history of previous stroke or myocardial infarctions, cardiovascular risk factors, and stroke severity. PA correlated with baseline s-IGF-I and Delta IGF-I, but not with the 3-month s-IGF-I. In the linear regressions, there were corresponding associations that remained as a tendency (baseline s-IGF-I, p = 0.06) or as a significant effect (Delta IGF-I, p = 0.03) after all the adjustments. Specifically, for each unit of PA, Delta IGF-I increased by 9.7 (95% CI 1,1-18.4) ng/mL after full adjustment. This supports the notion that pre-stroke PA is independently related to Delta IGF-I.
|
|
