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- Ferry, Sven A., et al.
(author)
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High diagnostic accuracy of nitrite test paired with Urine sediment can reduce unnecessary antibiotic therapy
- 2015
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In: Open Microbiology Journal. - : Bentham Science Publishers Ltd.. - 1874-2858. ; 9, s. 150-159
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Journal article (peer-reviewed)abstract
- Background: Urinary tract infections (UTIs) are common bacterial infections dominated by lower UTI in women (LUTIW). Symptoms only are insufficient for diagnosis and accordingly, near patient diagnostic tests confidently confirming significant bacteriuria are desirable. The nitrite test (NIT) has low sensitivity, while bacterial and leukocyte counts disjunctively paired in urine sediment microscopy (SED) have high sensitivity. Similar symptomatic cure rates are found post antibiotic vs. placebo therapy in patients with negative cultures. Consequently, prescription on symptoms only implies unnecessary antibiotic therapy. Aims: to evaluate the diagnostic outcomes of NIT, SED and NIT disjunctively paired with SED (NIT+SED) vs. urine culture, with special focus on bladder incubation time (BIT), and to assess if NIT+SED can reduce unnecessary antibiotic therapy. Methods: A diagnostic, primary care, multicentre study including 1070 women with symptoms suggestive of lower UTI. Results: Significant bacteriuria was found in 77%. The BIT highly influenced the diagnostic outcomes and the optimal duration was ≥4h with sensitivity of 66, 90 and 95% for NIT, SED and NIT+SED, respectively. SED performed only in NIT negative specimens could reduce unnecessary antibiotics by 10% vs. prescription on symptoms only. The number needed to test with SED to reduce one unnecessary antibiotic course was five patients at BIT ≥4h and six patients at ≤3h or overall. Conclusion: The BIT highly influences the diagnostic outcomes with the highest accuracy of NIT+SED. Diagnosis of LUTIW with NIT+SED can reduce unnecessary antibiotic therapy and subsequently decrease antimicrobial resistance. Trial registration: The Swedish Medical Product Agency 1995 03 01:151:01783/94. © 2015, Ferry et al.; Licensee Bentham Open.
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| 2. |
- Monsen, Tor J., et al.
(author)
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Mecillinam resistance and outcome of pivmecillinam treatment in uncomplicated lower urinary tract infection in women
- 2014
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In: Apmis. - Hoboken : Wiley. - 0903-4641 .- 1600-0463. ; 122:4, s. 317-323
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Journal article (peer-reviewed)abstract
- Pivmecillinam (PIV) is a first-line antimicrobial for treatment of lower urinary tract infection in women (LUTIW). Mecillinam, the active substance of PIV, is bactericidal mainly against gram-negative uropathogens, whereas gram-positive species are considered intrinsically resistant. However, successful treatment of LUTIW caused by Staphylococcus saprophyticus has been reported, but more rarely for other gram-positive species. The aim of this study was to compare clinical and bacteriological outcome of PIV vs placebo treatment among uropathogens with special focus on mecillinam-resistant isolates. We analysed data from a prospective, multicentre, placebo-controlled, primary health care, therapy study performed in Sweden in 1995-1998 that included 1143 women with symptoms suggestive of LUTIW. Urine cultures were collected and symptoms registered at inclusion and at follow-up visits. Overall, the efficacy of PIV was superior to that of placebo. Clinical and bacteriological outcomes of PIV treatment were similar for S. saprophyticus, Escherichia coli as for most other uropathogens irrespective of their susceptibility to mecillinam. However, the occurrence of enterococci increased nearly fivefold shortly post PIV treatment, although with mild symptoms and a high spontaneous eradication. As susceptibility to mecillinam in vitro did not predict bacteriological and clinical outcome of PIV treatment, we suggest that the present breakpoints for mecillinam should be revised.
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| 6. |
- Eliasson, Inger, et al.
(author)
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Manlig idrottsprofilering i grundskolan
- 2012
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In: Svensk Idrottsforskning. - Stockholm : Centrum för idrottsforskning (CIF). - 1103-4629. ; 21:1, s. 33-37
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Journal article (other academic/artistic)abstract
- Den svenska modellen innebär traditionellt att skolan ansvarar för undervisning i idrottsämnet och föreningarna för idrotten på fritiden. Men i dag går tusentals elever på idrottsgymnasium och var fjärde högstadieskola erbjuder träning på skoltid.
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| 7. |
- Eliasson, Inger, 1966-, et al.
(author)
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Manlig idrottsprofilering i grundskolan
- 2012
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In: Svensk Idrottsforskning. - Stockholm : Centrum för idrottsforskning (CIF). - 1103-4629. ; 21:1, s. 33-37
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Journal article (other academic/artistic)
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| 9. |
- Fahlén, Josef, et al.
(author)
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Governing by numbers : the homogenization and standardization of sport club activities through policy implementation systems
- 2016
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In: Book of Abstract EASS 2016. - Copenhagen : University of Copenhagen, Department of Nutrition, Exercise and Sport 2016. - 9788791771644 ; , s. 55-55
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Conference paper (peer-reviewed)abstract
- This abstract reports on a study of the implementation of a digitalized reporting system for local authority financial support to voluntary and membership-based sport club activities. It focuses on consequences of the implementation for sport clubs’ organisation, leadership and activities by drawing on data from qualitative and semi-structured interviews with 43 sport club representatives representing 20 sport clubs in four Swedish municipalities. Respondents and clubs were strategically sampled based on characteristics recognized in the literature as influential in sport policy implementation (e.g. May, Harris & Collins, 2013). The background of this interest is the focus in existing literature on policy content in general and specifically on the implementation of policies with the content of aiming at widening the social role for sport (e.g. Coalter, 2007). While valuable in our understanding of the implementation of social policies in sport, such studies have limited power in furthering our understanding of sport policy implementation per se. So by building on the argument put forward by Stenling and Fahlén (2014) that sport clubs’ propensity to act as policy implementers are contingent on an alignment between what a sport club is actually doing and what any given policy asks of it, this particular study aimed at examining the implementation of a policy tool seemingly devoid of policy content in order to be able to zoom in more on the consequences of the actual implementation process. Results show how the implementation process itself contributes to homogenizing sport clubs’ activities (cf. Sjöblom & Fahlén, 2010) and to standardizing what sport ‘is’ and ‘is not’ (cf. Fahlén, 2015). By extension, it contributes to limiting access for participants and volunteers in direct contravention of local as well as national sport policy goals. These findings are discussed in the light of recent debates on measures for increased sport participation.
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| 10. |
- Fahlén, Josef, et al.
(author)
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Resursfördelning och jämställdhet
- 2018
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In: Resurser, representation och "riktig" idrott. - Stockholm : Centrum för idrottsforskning. - 9789198405026 ; , s. 96-119
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Book chapter (other academic/artistic)
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