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- Silén, A, et al.
(författare)
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Evaluation of the UBC test in the urine of healthy individuals, patients with benign disorders and urinary bladder cancer.
- 2000
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Ingår i: Oncology reports. - : Spandidos Publications. - 1021-335X .- 1791-2431. ; 7:6, s. 1269-74
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Tidskriftsartikel (refereegranskat)abstract
- Using the UBC test, the specificity, sensitivity and prognostic information were evaluated in patients with recently diagnosed transitional cell carcinoma (TCC) and in a control group consisting of apparently healthy individuals and individuals with benign disorders. Frozen urine samples from the 485 individuals in the control group and 100 newly diagnosed TCC patients were analyzed with the UBC test, specific for epitopes on cytokeratin fragments released from the urothelial cells. All the samples were analyzed and corrected for creatinine. No significant concentration difference was found between males and females (p=0.65) and there was no age dependent relation. The median concentration for the entire control group was estimated at 3.7 microg/g and the 95th percentile was calculated at 53.0 microg/g. The apparently healthy individuals in the control group had a median value of 3.4 microg/g with a 95th percentile of 24.3 microg/g. An increased frequency of elevated UBC concentrations was found in some benign disorders e.g., anemia, thyroid disorders, diabetes mellitus, hyperlipemia, urosepsis and cystitis. Patients with superficial tumors exhibited a 66% sensitivity (at 95% specificity), and the UBC concentrations did not differ statistically (p=0.16) from those patients with muscle invasive lesions with a 52% sensitivity. When the UBC concentrations were related to histopathological grade, a significant concentration difference (p<0.004) was found between low grade tumors (sensitivity 41%) and high grade tumors (sensitivity 72%). Survival analysis showed that patient with muscle invasive tumors, high-grade tumors and high UBC concentrations have a significantly reduced survival (five-year survival was estimated to 30%, 35% and 30% respectively) compared to patients with superficial tumors, low-grade tumors or low UBC concentrations (five-year survival, 60%, 85% and 75% respectively). The UBC test showed good accuracy and repeatability. Clinically the test could assist in tumor grading and the detection of recurrent disease, which in turn could assist in treatment selection for the individual patient and possibly improve prognosis.
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- Wiklund, H., et al.
(författare)
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Innovation and TQM in Swedish higher education development : possibilities and pitfalls
- 2003
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Ingår i: The TQM Magazine. - : Emerald Group Publishing Limited. - 1754-2731 .- 0954-478X. ; 15:2, s. 99-107
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Tidskriftsartikel (refereegranskat)abstract
- Emphasis on quality improvement has been one of the most characteristic features of higher education policy in Nordic and other European countries during the 1990s. In Sweden, the universities’ work with quality management has been evaluated for several years. In January 2001, the National Agency of Higher Education in Sweden introduced a new comprehensive system for quality assessment. The Swedish assessment system stresses that the assessment should have as a corner‐stone the specific prerequisites for each university and subject, e.g. business administration and their development strategy. The comprehensive quality assessments of Swedish higher education institutions are discussed together with stimulating innovation and continuous improvement of higher education.
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- Wiklund, Ingela, et al.
(författare)
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A comparative study in Stockholm, Sweden of labour outcome and women's perceptions of being referred in labour
- 2002
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Ingår i: Midwifery. - : Churchill Livingstone. - 0266-6138 .- 1532-3099. ; 18:3, s. 193-199
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Tidskriftsartikel (refereegranskat)abstract
- Objective: to study the outcome of labour and women's perceptions of being referred after onset of labour. Design: a comparative study carried out between October 1998 and April 1999. Setting: prospective parents in Stockholm, Sweden are offered a choice of which of the five hospitals in which they want to give birth. In reality, there is a lack of maternity beds in Stockholm to implement this policy and therefore nearly 10% of labouring women are being referred during labour. Participants: the study population was selected from one of the five hospitals. Included in the study were 266 labouring women, with a 37-42 weeks uncomplicated pregnancy, fetus presenting by the vertex and spontaneous onset of labour. During pregnancy, all the women had chosen the same labour ward where they planned to deliver. However, at the onset of labour half of the women, case group I (n = 133) were referred to another maternity unit due to lack of space in the labour ward. For every referred woman a control woman matched for age, parity and date of delivery was selected, with the same inclusion criteria, except being referred, control group II (n = 133). Methods: a questionnaire with closed and open questions was posted to the women after birth and used to collect quantitative and qualitative data on the outcome of labour and the women's perceptions of referral during labour. Findings: routines such as epidural analgesia (EDA) (p < 0.002), episiotomies (p < 0.015) and morphine/pethidine during labour (p < 0.023) were more common in the referred group. The women in the referred group considered to a higher extent that referral during labour had affected their emotional state (p < 0.001). Women in both groups had been worried during pregnancy by the thought of having to be referred when labour had started and the referral had caused practical problems, stress and a feeling of not being welcome in the referral labour ward. Key conclusion and implications for practice: referral during established normal labour may affect labour outcome, and the possibility that they may be referred worries women during pregnancy. Maternity policies and practices should be organised so that caring goals, such as continuity of care and women's' participation in birth planning, can be met. © 2002 Elsevier Science Ltd. All rights reserved.
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