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1.
  • Lahrouchi, Najim, et al. (author)
  • Transethnic Genome-Wide Association Study Provides Insights in the Genetic Architecture and Heritability of Long QT Syndrome
  • 2020
  • In: Circulation. - : Lippincott Williams & Wilkins. - 0009-7322 .- 1524-4539. ; 142:4, s. 324-338
  • Journal article (peer-reviewed)abstract
    • Background: Long QT syndrome (LQTS) is a rare genetic disorder and a major preventable cause of sudden cardiac death in the young. A causal rare genetic variant with large effect size is identified in up to 80% of probands (genotype positive) and cascade family screening shows incomplete penetrance of genetic variants. Furthermore, a proportion of cases meeting diagnostic criteria for LQTS remain genetically elusive despite genetic testing of established genes (genotype negative). These observations raise the possibility that common genetic variants with small effect size contribute to the clinical picture of LQTS. This study aimed to characterize and quantify the contribution of common genetic variation to LQTS disease susceptibility. Methods: We conducted genome-wide association studies followed by transethnic meta-analysis in 1656 unrelated patients with LQTS of European or Japanese ancestry and 9890 controls to identify susceptibility single nucleotide polymorphisms. We estimated the common variant heritability of LQTS and tested the genetic correlation between LQTS susceptibility and other cardiac traits. Furthermore, we tested the aggregate effect of the 68 single nucleotide polymorphisms previously associated with the QT-interval in the general population using a polygenic risk score. Results: Genome-wide association analysis identified 3 loci associated with LQTS at genome-wide statistical significance (P<5x10(-8)) nearNOS1AP,KCNQ1, andKLF12, and 1 missense variant inKCNE1(p.Asp85Asn) at the suggestive threshold (P<10(-6)). Heritability analyses showed that approximate to 15% of variance in overall LQTS susceptibility was attributable to common genetic variation (h2SNP0.148; standard error 0.019). LQTS susceptibility showed a strong genome-wide genetic correlation with the QT-interval in the general population (r(g)=0.40;P=3.2x10(-3)). The polygenic risk score comprising common variants previously associated with the QT-interval in the general population was greater in LQTS cases compared with controls (P<10-13), and it is notable that, among patients with LQTS, this polygenic risk score was greater in patients who were genotype negative compared with those who were genotype positive (P<0.005). Conclusions: This work establishes an important role for common genetic variation in susceptibility to LQTS. We demonstrate overlap between genetic control of the QT-interval in the general population and genetic factors contributing to LQTS susceptibility. Using polygenic risk score analyses aggregating common genetic variants that modulate the QT-interval in the general population, we provide evidence for a polygenic architecture in genotype negative LQTS.
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2.
  • Lundin, Anette (author)
  • Rättfärdigade prioriteringar : en kvalitativ analys av hur personal i äldreomsorgen hanterar motstridiga verksamhetslogiker
  • 2017
  • Doctoral thesis (other academic/artistic)abstract
    • This dissertation aims at contributing to social scientific knowledge about prevailing prioritizations in eldercarepractice by looking at an economic and a caring logic, and how these logics are overlapping, contradictory or comein conflict with each other. A more concrete aim is to understand how the personnel describe their work with orfor balance between the logics and their justifications prioritizations made in the care of older persons. The researchquestion is: How do personnel and care unit manager at a public nursing home understand and handle the twologics that govern care work for facilitating wellbeing of the residents. The aim and research question led to threesub-aims: 1) to analyze the personnel’s experiences of and meaning making about the care work they carry out, 2)to illuminate and problematize the two logics above, and 3)to analyze how the personnel justify their prioritizationsin prevailing context, and how their accountability have an effect on their professional identities.Empirical material was gathered through 13 individual interviews with care personnel and their care unitmanager at a public nursing home in Sweden. These interviews were complemented by a group interview. Thematerial was analyzed by the use of three methods: phenomenology (Paper I and II), reflexive analysis (Paper III),and a positioning analysis (Paper IV). Paper I found that the personnel understands the residents’ well-being asbeing characterized by feeling of being existentially touched. This essence is constituted by feeling freedom ofchoice, pleasure, and closeness to someone or something. In Paper II, the work for facilitating this kind of wellbeingwas characterized by three ambiguities: (i) freedom of choice for the older persons vs. institutionalconstraints, (ii) the residents' need for activation vs. wanting not to be activated, and (iii) the residents' need forroutine vs. the eldercarers' not being able to know what the residents need. Paper III showed that the care unitmanager created a hybrid of the two logics (economy is care and vice versa) and that the personnel oppose thishybrid. The opposition is shaped as the personnel divides their work in care and “those other things”. Thesefindings showed how interaction between the logics expresses itself in practice and that it is the personnel who hasto handle contradictions between the logics in their everyday care work. The positioning analysis in Paper IV hadthree levels. The first level showed how the carers align with their peers and that they find the organizationalframe, within which they have agency, changed due to increased workload. This change led to an order of priorities.The second level showed that the carers relate to three aspects when making accounts: the care itself, the olderpersons, and the media. The third level showed that the carers share a view of administration, cleaning, servingmeals, and filling up supplies, as not being parts of caring.The dissertation’s theoretical framework focused on theories on logics, accountability, and professionalidentity. The conclusion is that both logics are needed in order to facilitate the well-being of the older persons. Therelationships between the two logics are not always clear and if their contradictions are not illuminated, there is arisk for a care practice that does not facilitate the well-being of their residents. An important theoreticalcontribution is that logics of activities should be understood vertically (form political, through management, anddown to the level of practice) instead of horizontally. The practical implications emphasize the importance ofsupporting the personnel’s professional identity on the one hand, and discussing the logics on the other. Byunderstanding differences between definitions on management-level and practice level, a homogeneity can bereached.
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3.
  • Wang, Zhaoming, et al. (author)
  • Imputation and subset-based association analysis across different cancer types identifies multiple independent risk loci in the TERT-CLPTM1L region on chromosome 5p15.33
  • 2014
  • In: Human Molecular Genetics. - : Oxford University Press (OUP). - 0964-6906 .- 1460-2083. ; 23:24, s. 6616-6633
  • Journal article (peer-reviewed)abstract
    • Genome-wide association studies (GWAS) have mapped risk alleles for at least 10 distinct cancers to a small region of 63 000 bp on chromosome 5p15.33. This region harbors the TERT and CLPTM1L genes; the former encodes the catalytic subunit of telomerase reverse transcriptase and the latter may play a role in apoptosis. To investigate further the genetic architecture of common susceptibility alleles in this region, we conducted an agnostic subset-based meta-analysis (association analysis based on subsets) across six distinct cancers in 34 248 cases and 45 036 controls. Based on sequential conditional analysis, we identified as many as six independent risk loci marked by common single-nucleotide polymorphisms: five in the TERT gene (Region 1: rs7726159, P = 2.10 × 10(-39); Region 3: rs2853677, P = 3.30 × 10(-36) and PConditional = 2.36 × 10(-8); Region 4: rs2736098, P = 3.87 × 10(-12) and PConditional = 5.19 × 10(-6), Region 5: rs13172201, P = 0.041 and PConditional = 2.04 × 10(-6); and Region 6: rs10069690, P = 7.49 × 10(-15) and PConditional = 5.35 × 10(-7)) and one in the neighboring CLPTM1L gene (Region 2: rs451360; P = 1.90 × 10(-18) and PConditional = 7.06 × 10(-16)). Between three and five cancers mapped to each independent locus with both risk-enhancing and protective effects. Allele-specific effects on DNA methylation were seen for a subset of risk loci, indicating that methylation and subsequent effects on gene expression may contribute to the biology of risk variants on 5p15.33. Our results provide strong support for extensive pleiotropy across this region of 5p15.33, to an extent not previously observed in other cancer susceptibility loci.
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5.
  • Balk, Lennart, et al. (author)
  • Widespread episodic thiamine deficiency in Northern Hemisphere wildlife
  • 2016
  • In: Scientific Reports. - : Nature Publishing Group. - 2045-2322. ; 6
  • Journal article (peer-reviewed)abstract
    • Many wildlife populations are declining at rates higher than can be explained by known threats to biodiversity. Recently, thiamine (vitamin B-1) deficiency has emerged as a possible contributing cause. Here, thiamine status was systematically investigated in three animal classes: bivalves, ray-finned fishes, and birds. Thiamine diphosphate is required as a cofactor in at least five life-sustaining enzymes that are required for basic cellular metabolism. Analysis of different phosphorylated forms of thiamine, as well as of activities and amount of holoenzyme and apoenzyme forms of thiaminedependent enzymes, revealed episodically occurring thiamine deficiency in all three animal classes. These biochemical effects were also linked to secondary effects on growth, condition, liver size, blood chemistry and composition, histopathology, swimming behaviour and endurance, parasite infestation, and reproduction. It is unlikely that the thiamine deficiency is caused by impaired phosphorylation within the cells. Rather, the results point towards insufficient amounts of thiamine in the food. By investigating a large geographic area, by extending the focus from lethal to sublethal thiamine deficiency, and by linking biochemical alterations to secondary effects, we demonstrate that the problem of thiamine deficiency is considerably more widespread and severe than previously reported.
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6.
  • Bendtsen, Katja Maria, et al. (author)
  • Particle characterization and toxicity in C57BL/6 mice following instillation of five different diesel exhaust particles designed to differ in physicochemical properties
  • 2020
  • In: Particle and Fibre Toxicology. - : Springer Science and Business Media LLC. - 1743-8977. ; 17:1
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: Diesel exhaust is carcinogenic and exposure to diesel particles cause health effects. We investigated the toxicity of diesel exhaust particles designed to have varying physicochemical properties in order to attribute health effects to specific particle characteristics. Particles from three fuel types were compared at 13% engine intake O2 concentration: MK1 ultra low sulfur diesel (DEP13) and the two renewable diesel fuels hydrotreated vegetable oil (HVO13) and rapeseed methyl ester (RME13). Additionally, diesel particles from MK1 ultra low sulfur diesel were generated at 9.7% (DEP9.7) and 17% (DEP17) intake O2 concentration. We evaluated physicochemical properties and histopathological, inflammatory and genotoxic responses on day 1, 28, and 90 after single intratracheal instillation in mice compared to reference diesel particles and carbon black. RESULTS: Moderate variations were seen in physical properties for the five particles: primary particle diameter: 15-22 nm, specific surface area: 152-222 m2/g, and count median mobility diameter: 55-103 nm. Larger differences were found in chemical composition: organic carbon/total carbon ratio (0.12-0.60), polycyclic aromatic hydrocarbon content (1-27 μg/mg) and acid-extractable metal content (0.9-16 μg/mg). Intratracheal exposure to all five particles induced similar toxicological responses, with different potency. Lung particle retention was observed in DEP13 and HVO13 exposed mice on day 28 post-exposure, with less retention for the other fuel types. RME exposure induced limited response whereas the remaining particles induced dose-dependent inflammation and acute phase response on day 1. DEP13 induced acute phase response on day 28 and inflammation on day 90. DNA strand break levels were not increased as compared to vehicle, but were increased in lung and liver compared to blank filter extraction control. Neutrophil influx on day 1 correlated best with estimated deposited surface area, but also with elemental carbon, organic carbon and PAHs. DNA strand break levels in lung on day 28 and in liver on day 90 correlated with acellular particle-induced ROS. CONCLUSIONS: We studied diesel exhaust particles designed to differ in physicochemical properties. Our study highlights specific surface area, elemental carbon content, PAHs and ROS-generating potential as physicochemical predictors of diesel particle toxicity.
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7.
  • Berg, Agneta, et al. (author)
  • Dementia care nurses experiences of systematic clinical group supervision and supervised individually planned nursing care
  • 2000
  • In: Journal of Nursing Management. - 0966-0429 .- 1365-2834. ; 8:6, s. 357-368
  • Journal article (peer-reviewed)abstract
    • AimTo reveal 13 nurses' experiences of systematic clinical group supervision and supervised individually planned nursing care, while working with people suffering from severe dementia.BackgroundClinical supervision is a major issue in nursing, however empirical knowledge of the subject is limited. Nurse's narrations about their experiences may extend the knowledge available and serve as a basis for creating models of support systems for nurses in their care provision.MethodsOpen-ended interviews were performed and the text was analysed through content analysis. A questionnaire was used to evaluate the views of the effects of clinical supervision.FindingsTwo main themes were found. Confirmed uniqueness included two sub-themes: confirming the nurses as a person and as a professional and confirming the patient as a unique human being. Consolidated sense of community included three sub-themes: closer relationship between the nurses, changed organization of nursing care and improved individualizing in routines of nursing care. The questionnaire result showed improvements in co-operation and in providing professional nursing care and personal development.ConclusionInterventions to improve working conditions for the nurses and care quality for the patients may well focus the core process, i.e. feedback and support for the nurse–patient interaction and person-orientated nursing care, taking into account the constellation and conditions of the group.
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8.
  • Berg, Agneta, 1950-, et al. (author)
  • Nurses' creativity, tedium and burnout during 1 year of clinical supervision and implementation of individually planned nursing care : comparisons between a ward for severely demented patients and a similar control ward
  • 1994
  • In: Journal of Advanced Nursing. - 0309-2402 .- 1365-2648. ; 20:4, s. 742-749
  • Journal article (peer-reviewed)abstract
    • The aim of this study was to study creativity and innovative climate, tedium and burnout among the nurses on two wards during 1 year of systematic clinic supervision combined with the implementation of individualized care on an experimental ward (EW) for severely demented patients, as compared with a similar control ward (CW) EW nurses had systematic clinic supervision and each patient had his/her nursing care carefully planned, documented and evaluated The intervention was evaluated by means of the Creative Climate Questionnaire, Burnout Measure and the Maslach Burnout Inventory Creativity and innovative climate improved significantly among the EW nurses (n= 19) in eight out of 10 factors during the year of intervention while there was no change on the control ward (n= 20) Tedium and burnout decreased significantly among the EW nurses while no change was seen in this respect among the CW nurses It seems reasonable to assume that systematic clinical supervision and individualized planned care decreases the negative outcome of stress caused by the psychological burden imposed by nursing care It also increases nurses' creativity, which, in turn, may benefit patient care The findings of this study point to the necessity for a support system that focuses on the work itself, i e the nursing care Individualized planned care and systematic clinical supervision may offer this kind of support.
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9.
  • Berg, Agneta, et al. (author)
  • Nurses' creativity, tedium and burnout during 1 year of clinical supervision and implementation of individually planned nursing care : comparisons between a ward for severely demented patients and a similar control ward
  • 1994
  • In: Journal of Advanced Nursing. - : Wiley-Blackwell Publishing Ltd. - 0309-2402 .- 1365-2648. ; 20:4, s. 742-749
  • Journal article (peer-reviewed)abstract
    • The aim of this study was to study creativity and innovative climate, tedium and burnout among the nurses on two wards during 1 year of systematic clinic supervision combined with the implementation of individualized care on an experimental ward (EW) for severely demented patients, as compared with a similar control ward (CW) EW nurses had systematic clinic supervision and each patient had his/her nursing care carefully planned, documented and evaluated The intervention was evaluated by means of the Creative Climate Questionnaire, Burnout Measure and the Maslach Burnout Inventory Creativity and innovative climate improved significantly among the EW nurses (n= 19) in eight out of 10 factors during the year of intervention while there was no change on the control ward (n= 20) Tedium and burnout decreased significantly among the EW nurses while no change was seen in this respect among the CW nurses It seems reasonable to assume that systematic clinical supervision and individualized planned care decreases the negative outcome of stress caused by the psychological burden imposed by nursing care It also increases nurses' creativity, which, in turn, may benefit patient care The findings of this study point to the necessity for a support system that focuses on the work itself, i e the nursing care Individualized planned care and systematic clinical supervision may offer this kind of support.
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10.
  • Berg, Elisabeth, 1951-, et al. (author)
  • Uppdrag Språklyft med matematik : Högläsningstexter och elevuppdrag med problemlösning
  • 2013. - 1
  • Book (pop. science, debate, etc.)abstract
    • Boken vänder sig till lärare från förskoleklass till årskurs 3.Med utgångspunkt i spännande och inspirerande högläsningstexter får eleverna ta sig an kreativa och roliga matematiska uppdrag att utföra i grupp eller individuellt. Eleverna får arbeta med och lösa problem där de själva eller tillsammans i grupp väljer lämpliga lösningsstrategier. De får förklara hur de har tänkt och jämföra sina olika lösningar.Uppdrag Språklyft med matematik utgår från det centrala innehållet i kursplanen i matematik samt Skolverkets bedömningsstöd Nya Språket lyfter! och ger eleverna tillfällen att ur olika perspektiv öva matematiska och språkliga förmågor.Elevuppdragen som finns i boken är kopieringsunderlag. I anslutning till varje uppdrag finns en handledning till läraren.Boken har två teman, Leksaksfabiken (Fk-3) samt Detektivbyrån (årskurs 2-3).
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11.
  • Berg, Frida, et al. (author)
  • The uncoupling protein 1 gene (UCP1) is disrupted in the pig lineage : A genetic explanation for poor thermoregulation in piglets
  • 2006
  • In: PLoS Genetics. - : Public Library of Science (PLoS). - 1553-7390 .- 1553-7404. ; 2:8, s. 1178-1181
  • Journal article (peer-reviewed)abstract
    • Piglets appear to lack brown adipose tissue, a specific type of fat that is essential for nonshivering thermogenesis in mammals, and they rely on shivering as the main mechanism for thermoregulation. Here we provide a genetic explanation for the poor thermoregulation in pigs as we demonstrate that the gene for uncoupling protein 1 (UCP1) was disrupted in the pig lineage. UCP1 is exclusively expressed in brown adipose tissue and plays a crucial role for thermogenesis by uncoupling oxidative phosphorylation. We used long-range PCR and genome walking to determine the complete genome sequence of pig UCP1. An alignment with human UCP1 revealed that exons 3 to 5 were eliminated by a deletion in the pig sequence. The presence of this deletion was confirmed in all tested domestic pigs, as well as in European wild boars, Bornean bearded pigs, wart hogs, and red river hogs. Three additional disrupting mutations were detected in the remaining exons. Furthermore, the rate of nonsynonymous substitutions was clearly elevated in the pig sequence compared with the corresponding sequences in humans, cattle, and mice, and we used this increased rate to estimate that UCP1 was disrupted about 20 million years ago.
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12.
  • Berg, Jörgen, 1975, et al. (author)
  • Just as Blue - Through with falling
  • 2023
  • In: Spotify, Itunes, Youtube..
  • Artistic work (other academic/artistic)abstract
    • Skivinspelning hösten 2022 i studio Epidemin i Göteborg av bandet Just as Blue. Publicerad januari 2023. Genre: Bluegrass.
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13.
  • Berg, Marie, 1955, et al. (author)
  • Diabetes och graviditet : Den komplicerade graviditeten
  • 2016
  • In: Reproduktiv hälsa - barnmorskans kompetensområde. Helena Lindgren et al. Del 2, 18.6, s. 357-368. - Lund : Studentlitteratur AB. - 9789144090054 ; , s. 357-368
  • Book chapter (peer-reviewed)abstract
    • Reproduktiv, perinatal och sexuell hälsa är ett självständigt huvudområde knutet till livets början och området för mänsklig reproduktion i ett livscykel- och genusperspektiv. Inom huvudområdet studeras och utvecklas kunskap om den normala processen och dess avvikelser i samband med graviditet, förlossning och nyföddhetsperiod samt föräldraskapets utveckling. Vidare studeras och utvecklas kunskap och teorier om kvinnors reproduktiva hälsa, sexualitet och fertilitetskontroll samt barnmorskans främjande, förebyggande, vårdande och behandlande arbete - med och för - kvinnan, barnet och familjen. Reproduktiv hälsa omfattar barnmorskans verksamhet inom reproduktiv, perinatal och sexuell hälsa. Boken är uppbyggd utifrån ICM:s (International Confederation of Midwives) beskrivning av barnmorskans kompetensområden, och den omfattar även ett webbmaterial med bland annat sammanfattningar i form av bildspel, tester och undervisningsfilmer. Boken riktar sig till barnmorskestudenter och yrkes verk samma barnmorskor samt till övriga hälsoprofessioner verksamma inom reproduktiv hälsa. Reproduktiv hälsa är framtagen i dialog med, och granskad av, vårt vetenskapliga råd. Vi rekommenderar att den används som lärobok i barnmorskeutbildningen fortsättningsvis.
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16.
  • Berg, Ulla B., et al. (author)
  • New standardized cystatin C and creatinine GFR equations in children validated with inulin clearance
  • 2015
  • In: Pediatric Nephrology. - : Springer Science and Business Media LLC. - 1432-198X .- 0931-041X. ; 30:8, s. 1317-1326
  • Journal article (peer-reviewed)abstract
    • This study compares glomerular filtration rate (GFR) equations in children based on standardized cystatin C (CYSC) and creatinine (CREA) and their combinations with renal clearance of inulin (C-inulin). A total of 220 children with different renal disorders were referred for C-inulin (median 84 ml/min/1.73 m(2)). Bias, precision (interquartile range, IQR), and accuracy (percentage of estimates +/- 30 % of C-inulin; P30) were evaluated for two cystatin C equations, CAPA(CYSC) and Berg(CYSC), for creatinine equations, Schwartz(CREA) and Gao(CREA), the arithmetic mean of CAPA(CYSC) and Schwartz(CREA) (MEAN(CAPA+Schwartz)), Berg(CYSC) and Schwartz(CREA) (MEAN(BERG+SCHWARTZ)) and the composite equation Chehade(CYSC+CREA). Overall results of CAPA(CYSC), Berg(CYSC), Schwartz(CREA), Gao(CREA), MEAN(CAPA+Schwartz,) MEAN(BERG+SCHWARTZ) and Chehade(CYSC+CREA) were: median bias -7.6/-4.9/-3.7/-2.3/-4.6/-4.0/-10.1 %, IQR 20.0/19.9/21.7/22.4/21.0/20.9/23.3 ml/min/1.73 m(2) and P30 86/86/80/83/89/91/83 %. The cystatin C equations, MEAN(CAPA+Schwartz) and MEAN(BERG+SCHWARTZ) had a more stable performance across subgroups compared with Schwartz(CREA), Gao(CREA) and Chehade(CYSC+CREA). Cystatin C was the preferred filtration marker for GFR estimation in children, while the benefit of combining cystatin C and creatinine deserves further investigations.
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17.
  • Bergman, Åke, et al. (author)
  • Science and policy on endocrine disrupters must not be mixed : a reply to a "common sense" intervention by toxicology journal editors
  • 2013
  • In: Environmental Health. - : BioMed Central (BMC). - 1476-069X. ; 12
  • Journal article (peer-reviewed)abstract
    • The "common sense" intervention by toxicology journal editors regarding proposed European Union endocrine disrupter regulations ignores scientific evidence and well-established principles of chemical risk assessment. In this commentary, endocrine disrupter experts express their concerns about a recently published, and is in our considered opinion inaccurate and factually incorrect, editorial that has appeared in several journals in toxicology. Some of the shortcomings of the editorial are discussed in detail. We call for a better founded scientific debate which may help to overcome a polarisation of views detrimental to reaching a consensus about scientific foundations for endocrine disrupter regulation in the EU.
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18.
  • Björk, Jonas, et al. (author)
  • Validation of standardized creatinine and cystatin C GFR estimating equations in a large multicentre European cohort of children
  • 2019
  • In: Pediatric Nephrology. - : Springer Science and Business Media LLC. - 0931-041X .- 1432-198X.
  • Journal article (peer-reviewed)abstract
    • Background: Most validations of paediatric glomerular filtration rate (GFR) estimating equations using standardized creatinine (CR) and cystatin C (CYS) assays have comprised relatively small cohorts, which makes accuracy across subgroups of GFR, age, body mass index (BMI) and gender uncertain. To overcome this, a large cohort of children referred for GFR determination has been established from several European medical centres. Methods: Three thousand four hundred eight measurements of GFR (mGFR) using plasma clearance of exogenous substances were performed in 2218 children aged 2–17 years. Validated equations included Schwartz-2009CR/2012CR/CYS/CR+CYS, FASCR/CYS/CR+CYS, LMRCR, Schwartz-LyonCR, BergCYS, CAPACYS, CKD-EPICYS, AndersenCR+CYS and arithmetic means of the best single-marker equations in explorative analysis. Five metrics were used to compare the performance of the GFR equations: bias, precision and three accuracy measures including the percentage of GFR estimates (eGFR) within ± 10% (P10) and ± 30% (P30) of mGFR. Results: Three of the cystatin C equations, BergCYS, CAPACYS and CKD-EPICYS, exhibited low bias and generally satisfactory accuracy across all levels of mGFR; CKD-EPICYS had more stable performance across gender than the two other equations. Among creatinine equations, Schwartz-LyonCR had the best performance but was inaccurate at mGFR < 30 mL/min/1.73 m2 and in underweight patients. Arithmetic means of the best creatinine and cystatin C equations above improved bias compared to the existing composite creatinine+cystatin C equations. Conclusions: The present study strongly suggests that cystatin C should be the primary biomarker of choice when estimating GFR in children with decreased GFR. Arithmetic means of well-performing single-marker equations improve accuracy further at most mGFR levels and have practical advantages compared to composite equations.
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19.
  • Carlsson, Ninni, 1962, et al. (author)
  • Forskare i könsrelaterat våld svarar David Eberhard : Okunskap i GP om #MeeToo och sexuella kränkningar
  • 2017
  • In: Göteborgs-Posten, Ledarbloggen, 2017-11-20. - 1103-9345.
  • Journal article (pop. science, debate, etc.)abstract
    • Syftet med denna artikel är att granska och problematisera en gästkrönika i Göteborgs-Posten den 6 november 2017, där psykologen David Eberhard kritiserar #metoo-rörelsen. Med exempel från lagstiftning och aktuell forskning diskuterar artikelförfattarna, sex forskare i könsrelaterat våld vid Institutionen för Socialt arbete, Göteborgs universitet, hur krönikan präglas av okunskap om sexuella kränkningar och tidigare kvinnorörelsers arbete; och hur den uttrycker en könsdiskriminerande och stigmatiserande attityd till dem som nu bryter tystnaden om egna erfarenheter. Artikeln är en replik till Eberhard som publicerades på Göteborgs-Postens ledarblogg den 20 november 2017.
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20.
  • Coppo, Rosanna, et al. (author)
  • Is there long-term value of pathology scoring in immunoglobulin A nephropathy? : A validation study of the Oxford Classification for IgA Nephropathy (VALIGA) update
  • 2020
  • In: Nephrology, Dialysis and Transplantation. - : Oxford University Press (OUP). - 0931-0509 .- 1460-2385. ; 35:6, s. 1002-1009
  • Journal article (peer-reviewed)abstract
    • Background: It is unknown whether renal pathology lesions in immunoglobulin A nephropathy (IgAN) correlate with renal outcomes over decades of follow-up.Methods: In 1130 patients of the original Validation Study of the Oxford Classification for IgA Nephropathy (VALIGA) cohort, we studied the relationship between the MEST score (mesangial hypercellularity, M; endocapillary hypercellularity, E; segmental glomerulosclerosis, S; tubular atrophy/interstitial fibrosis, T), crescents (C) and other histological lesions with both a combined renal endpoint [50% estimated glomerular filtration rate (eGFR) loss or kidney failure] and the rate of eGFR decline over a follow-up period extending to 35 years [median 7 years (interquartile range 4.1-10.8)].Results: In this extended analysis, M1, S1 and T1-T2 lesions as well as the whole MEST score were independently related with the combined endpoint (P < 0.01), and there was no effect modification by age for these associations, suggesting that they may be valid in children and in adults as well. Only T lesions were associated with the rate of eGFR loss in the whole cohort, whereas C showed this association only in patients not treated with immunosuppression. In separate prognostic analyses, the whole set of pathology lesions provided a gain in discrimination power over the clinical variables alone, which was similar at 5 years (+2.0%) and for the whole follow-up (+1.8%). A similar benefit was observed for risk reclassification analyses (+2.7% and +2.4%).Conclusion: Long-term follow-up analyses of the VALIGA cohort showed that the independent relationship between kidney biopsy findings and the risk of progression towards kidney failure in IgAN remains unchanged across all age groups and decades after the renal biopsy.
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21.
  • Coppo, Rosanna, et al. (author)
  • Risk factors for progression in children and young adults with IgA nephropathy : an analysis of 261 cases from the VALIGA European cohort
  • 2017
  • In: Pediatric nephrology (Berlin, West). - : Springer Science and Business Media LLC. - 0931-041X .- 1432-198X. ; 32:1, s. 139-150
  • Journal article (peer-reviewed)abstract
    • There is a need for early identification of children with immunoglobulin A nephropathy (IgAN) at risk of progression of kidney disease. Data on 261 young patients [age < 23 years; mean follow-up of 4.9 (range 2.5-8.1) years] enrolled in VALIGA, a study designed to validate the Oxford Classification of IgAN, were assessed. Renal biopsies were scored for the presence of mesangial hypercellularity (M1), endocapillary hypercellularity (E1), segmental glomerulosclerosis (S1), tubular atrophy/interstitial fibrosis (T1-2) (MEST score) and crescents (C1). Progression was assessed as end stage renal disease and/or a 50 % loss of estimated glomerular filtration rate (eGFR) (combined endpoint) as well as the rate of renal function decline (slope of eGFR). Cox regression and tree classification binary models were used and compared. In this cohort of 261 subjects aged < 23 years, Cox analysis validated the MEST M, S and T scores for predicting survival to the combined endpoint but failed to prove that these scores had predictive value in the sub-group of 174 children aged < 18 years. The regression tree classification indicated that patients with M1 were at risk of developing higher time-averaged proteinuria (p < 0.0001) and the combined endpoint (p < 0.001). An initial proteinuria of ae0.4 g/day/1.73 m(2) and an eGFR of < 90 ml/min/1.73 m(2) were determined to be risk factors in subjects with M0. Children aged < 16 years with M0 and well-preserved eGFR (> 90 ml/min/1.73 m(2)) at presentation had a significantly high probability of proteinuria remission during follow-up and a higher remission rate following treatment with corticosteroid and/or immunosuppressive therapy. This new statistical approach has identified clinical and histological risk factors associated with outcome in children and young adults with IgAN.
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22.
  • Delanaye, Pierre, et al. (author)
  • Performance of creatinine-based equations to estimate glomerular filtration rate in White and Black populations in Europe, Brazil, and Africa
  • 2022
  • In: Nephrology, Dialysis and Transplantation. - : Oxford University Press. - 0931-0509 .- 1460-2385. ; 38:1, s. 106-118
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: A new Chronic Kidney Disease Epidemiology equation without race variable has been recently proposed (CKD-EPIAS). This equation has neither been validated outside USA nor compared to the new European Kidney Function Consortium (EKFC) and Lund-Malmö Revised (LMREV) equations, developed in European cohorts.METHODS: Standardized creatinine and measured glomerular filtration rate (GFR) from the European EKFC cohorts (n = 13 856 including 6031 individuals in the external validation cohort), from France, (n = 4429, including 964 Black Europeans), from Brazil (n = 100), and from Africa (n = 508) were used to test the performances of the equations. A matched analysis between White Europeans and Black Africans or Black Europeans was performed.RESULTS: In White Europeans (n = 9496), both the EKFC and LMREV equations outperformed CKD-EPIAS (bias of -0.6 and -3.2, respectively versus 5.0 mL/min/1.73m², and accuracy within 30% of 86.9 and 87.4, respectively versus 80.9%). In Black Europeans and Black Africans, the best performance was observed with the EKFC equation using a specific Q-value ( = concentration of serum creatinine in healthy males and females). These results were confirmed in matched analyses, which showed that serum creatinine concentrations were different in White Europeans, Black Europeans, and Black Africans for the same measured GFR, age, sex and body mass index. Creatinine differences were more relevant in males.CONCLUSION: In a European and African cohort, the performances of CKD-EPIAS remain suboptimal. The EKFC equation, using usual or dedicated, population-specific Q-values presents the best performance in the whole age range in the European and African populations included in this study.
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23.
  • Delanaye, Pierre, et al. (author)
  • Performance of creatinine-based equations to estimate glomerular filtration rate with a methodology adapted to the context of drug dosage adjustment
  • 2022
  • In: British Journal of Clinical Pharmacology. - : Wiley-Blackwell Publishing Inc.. - 0306-5251 .- 1365-2125. ; 88:5, s. 2118-2127
  • Journal article (peer-reviewed)abstract
    • AIM: The Cockcroft-Gault (CG) creatinine-based equation is still used to estimate glomerular filtration rate (eGFR) for drug dosage adjustment. Incorrect eGFR may lead to hazardous over- or underdosing METHODS: In a cross-sectional analysis, CG was validated against measured GFR (mGFR) in 14,804 participants and compared with the Modification-of-Diet-in-Renal-Diseases (MDRD), Chronic-Kidney-Disease-Epidemiology (CKD-EPI), Lund-Malmö-Revised (LMR), and European-Kidney-Function-Consortium (EKFC) equations. Validation focused on bias, imprecision, and accuracy (percentage of estimates within ±30% of mGFR, P30), overall and stratified for mGFR, age, and body mass index at mGFR <60 mL/min, as well as classification in mGFR stages.RESULTS: The CG equation performed worse than the other equations, overall and in mGFR, age and BMI subgroups in terms of bias (systematic overestimation), imprecision and accuracy except for patients ≥65 years where bias and P30 were similar to MDRD and CKD-EPI, but worse than LMR and EKFC. In subjects with mGFR<60 mL/min and at BMI [18.5-25[kg/m2 , all equations performed similarly and for BMI<18.5kg/m2 CG and LMR had the best results though all equations had poor P30-accuracy. At BMI≥25kg/m2 the bias of the CG increased with increasing BMI (+17.2mL/min at BMI≥40kg/m2 ). The four more recent equations also classified mGFR stages better than CG.CONCLUSIONS: The CG equation showed poor ability to estimate GFR overall and in analyses stratified for GFR, age, and BMI. CG was inferior to correctly classify the patients in the mGFR staging compared to more recent creatinine-based equations.
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24.
  • Ekvall, Ulla, 1946-, et al. (author)
  • Lärobok och kemipraktik
  • 2010. - 1
  • In: Innehållet i fokus. - Stockholm : Stockholms universitets förlag. - 9789176566657 ; , s. 119-144
  • Book chapter (other academic/artistic)
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25.
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26.
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27.
  • Eriksson, Inger, 1952-, et al. (author)
  • Vilket kemiinnehåll görs tillgängligt i finlandssvenska och svenska klassrum? Kemitexter som redskap för naturvetenskapligt lärande
  • 2010
  • In: Resultatdialog 2010. - Stockholm : Vetenskapsrådet. - 9789173071840 ; , s. 51-56
  • Book chapter (other academic/artistic)abstract
    • Svenska och finska (och finlandssvenska) elevers naturvetenskapliga prestationer uppvisar markanta skillnader i internationella mätningar som PISA. Mot bakgrund av att Finland och Sverige har ett till synes likartat skolsystem är det inte helt enkelt att förstå varför de finska och finlandssvenska eleverna presterar så mycket bättre än de svenska. Vad är det som skapar sådana skillnader? Många olika förklaringar har förts fram, tex i relation till lärarutbildning. Men vilket kemilärande möjliggörs i svenska och finlandssvenska undervisningspraktiker? Kemiinnehållet i läromedel från Sverige och Finland är i stort det samma och i finlandssvenska skolor fram till 2007 användes ofta svenska läromedel. I projektet genomfördes 20-40h videobandade klassrumsobservationer relaterade till kemiundervisningen i tre skolor vardera i Svenskfinland (2007-08) och Sverige (2009). Observationerna, kombinerade med intervjuer och dokumentationer, fokuserade periodiska systemet och kemiska bindningar. De första analyserna ger en bild av att det finns skillnader i innehållets behandling och vad som karaktäriserar de konstituerade undervisningspraktikerna i de båda länderna. I finlandssvenska skolor fokuseras t.ex. faktareproduktion (memorering), formelskrivning och detaljerade provfrågor, samma läromedel används i alla skolor. I svenska skolor betonas förståelse av vardagsfenomen, diskussioner och prov som skiljer på G, VG och MVG-frågor där G-frågor utgörs av enkla faktakunskaper. Undervisningen i de finlandssvenska skolorna framstår således som mera lika varandra medan undervisningen i de svenska skolorna uppvisar större variation gällande innehållets behandling och klassrumskommunikation.
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28.
  • Hagström, Åke, et al. (author)
  • Isolates as models to study bacterial ecophysiology and biogeochemistry
  • 2018
  • In: Aquatic Microbial Ecology. - : Inter-Research. - 0948-3055 .- 1616-1564. ; 80:1, s. 15-27
  • Journal article (peer-reviewed)abstract
    • Here, we examine the use of bacterial isolates growing in artificial media or seawater as a means to investigate bacterial activity in the upper ocean. The discovery of a major role of bacteria in the ocean's carbon cycle owes greatly to the development of culture-independent assemblage-level approaches; however, this should not detract from the recognition of model isolates as representing the environmental microbiome. A long-established tool for culturing bacteria, in medicine and general microbiology, has been agar plates. In addition, a great variety of liquid substrates including seawater have been used to successfully identify and cultivate important bacteria such as Pelagibacter ubique. Yet, the discrepancy between microscopic counts and plate counts, the great plate count anomaly, has led to a biased perception of the limited relevance of isolated bacteria. Linking isolates to whole-genome sequencing, phylogenetic analysis and computational modeling will result in culturable model bacteria from different habitats. Our main message is that bacterial ecophysiology, particularly growth rates in seawater, and functionalities inferred through the identity, abundance and expression of specific genes could be mechanistically linked if more work is done to isolate, culture and study bacteria in pure cultures. When we rally behind a strategy aimed at culturing targeted phenotypes, we are not saying that culture independent studies of bacteria in the sea are not informative. We are suggesting that culturebased studies can help integrate the ecological and genomic views.
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29.
  • Hahn Berg, IC, et al. (author)
  • Salivary protein adsorption onto hydroxyapatite and SDS-mediated elution studied by in situ ellipsometry
  • 2001
  • In: Biofouling (Print). - 0892-7014 .- 1029-2454. ; 17, s. 173-187
  • Journal article (peer-reviewed)abstract
    • Whole unstimulated saliva from two donors was investigated both with respect to adsorption characteristics and SDS-induced elutability. Salivary protein adsorption onto hydroxyapatite (HA) discs was studied by means of in situ ellipsometry in the concentration range 0.1-20% saliva. The adsorbed amounts on HA were found to be similar to those on silica, but the rates of adsorption were lower. Protein adsorption was virtually unaffected by the presence of Na+, whereas Ca2+ induced nucleation of calcium phosphate at the surface, the deposition rate being influenced by the pellicle age but not by the presence of saliva in bulk solution. The SDS elutability of adsorbed pellicles was determined on HA as well as on silica surfaces. Desorption from both surfaces was found to occur in the same SDS concentration range, although a residual layer was observed on HA. The slight net positive charge and lower charge density of HA as compared to the strongly negatively charged silica, may, at least partly, account for this observation by causing a reduction in the repulsive force between protein-surfactant complexes and the surface. Interindividual differences, observed in the adsorption as well as elution experiments, are thought to relate to the compositional differences observed by SDS-PAGE
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30.
  • Hellström, Anna-Lena, 1946, et al. (author)
  • Feeling good in daily life: from the point of view of boys with posterior urethral valves
  • 2006
  • In: J Urol. - 0022-5347. ; 176:4 Pt 2, s. 1742-6
  • Journal article (peer-reviewed)abstract
    • PURPOSE: We determined what is important to feel good in daily life when living with a long-term illness that requires daily treatment routines. MATERIALS AND METHODS: Seven boys between 6 and 16 years old who were born with posterior urethral valves narrated their experiences with daily life. They were on clean intermittent catheterization, had impaired renal function and 2 had undergone transplantation. RESULTS: Being involved in decisions about themselves was important, as was having their own doctor and nurse. Friends were important. Clean intermittent catheterization was something that worried them in relation to friends and made them feel uncertain about how they would react to it. The boys accepted the catheterization procedure as something that had to be done but they needed strategies to be able to comply. A single event, such as no available toilet, was enough to interrupt treatment. CONCLUSIONS: In these boys prescribed treatment was a surprisingly small part of their lives. The clean intermittent catheterization routine was sometimes experienced as an obstacle in company with friends. The new challenge might be to achieve compliance with the treatment routine in daily life in a long-term perspective.
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31.
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32.
  • Johansson, Annica E M, et al. (author)
  • Participation in the workforce after a traumatic brain injury : a matter of control
  • 2016
  • In: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 38:5, s. 423-432
  • Journal article (peer-reviewed)abstract
    • PURPOSE: This study sought to explore individual experience in developing a mastery of daily activities and roles after a traumatic brain injury (TBI) with the objective of returning to work.METHOD: Eight 30-60-year-old men, employed at the time of injury, were each interviewed three times over a 6-month period. Ten to 21 months after the injuries, four participants had returned to work at least part time. Grounded theory was adapted for analyses.RESULTS: A single core category emerged: a desire for control: focusing on high-priority issues. Still, 2 years after injury, the participants were uncertain about their abilities with respect to what was expected of them at work. They felt they would do better as time progressed.CONCLUSIONS: The participants' uncertainty about their efficacy cast doubt on their beliefs in improving their skills, balancing daily activities and work. They wondered about the sustainability of their health and efficacy at work. Wanting to control their own improvement, the participants asked for counselling in strategies and techniques to help with their progress. This issue could be taken into account in follow-up rehabilitation programmes. Additionally, the workplace might be the ideal context in which to develop the structures and routines necessary to master life in general. Implications for Rehabilitation Two years after injury, the participants remained uncertain about their abilities with respect to what was expected of them at work. The participants felt they would do better as time progressed. The participants, wanting to control their own improvement, sought counselling to help sort out their priorities and found it could contribute to help with their progress in finding a suitable balance between daily activities and work. A consequence of our main finding, in a multidisciplinary context, is that counselling in structures and routines with respect to work-related tasks should be considered to be an integral part of any rehabilitation programme after TBI.
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33.
  • Lindgren, Britt-Marie, 1961- (author)
  • Self-harm - hovering between hope and despair : experiences and interactions in a health care context.
  • 2011
  • Doctoral thesis (other academic/artistic)abstract
    • Background The definition of self-harm used in this project is repeated, impulsive behaviour causing tissue damage, yet not intended as a suicide attempt. Instead of wishing to die, the person who self-harms wishes to be relieved from anxiety. The thesis comprises four studies and the overall aim was to describe experiences of care among people who self-harm, professional caregivers, and close relatives (parents), and to explore interpretative repertoires that jointly construct the interaction between people who self-harm and their professional caregivers. Methods The participants were nine women who self-harmed (I), six nurses, three of each sex (II), five mothers and one stepfather (III), and six women who self-harmed in two psychiatric inpatient wards and their caregivers (IV). Data were collected through narrative interviews (I, II, III), participant observations (IV), and informal interviews (IV). The interviews lasted between 40 and 50 minutes (I), between 40 and 65 minutes (II), and between 30 and 85 minutes (III). The observations including informal interviews in study IV comprised 150 hours of descriptive observations and 40 hours of focused observations. The data were analysed using qualitative content analysis (I, II), phenomenological hermeneutics (III), and discursive psychology (IV). Results People who self-harmed experienced care as inferior, not satisfying their needs. The findings presented a paradox; on the one hand, the women realised that society considered self-harm an inappropriate way to alleviate mental suffering, and on the other hand, they experienced self-harm as the only way to survive and to foster hope in themselves (I). Caregivers felt powerless and burdened when unable to identify and satisfy the women’s needs. Feelings of fear, frustration, and abandonment created a significant burden for caregivers (II). Parents’ lived experience of the professional care and caregivers of their self-harming adult children could be described as a hostage drama. As in a hostage situation, parents felt held to emotional ransom by deficient care and sometimes hostile caregivers (III). The interpretative repertoires that jointly constructed the interaction between those who self-harmed and their professional caregivers, were for the caregivers a fostering and a supportive repertoire, and for the women who self-harmed a victim and an expert repertoire. The interactions between a fostering caregiver and a woman as expert or as victim, and between a supportive caregiver and a woman as victim, were complicated and promoted feelings of hopelessness among the participants. Interactions between a supportive caregiver and a woman as expert were more satisfying and raised hope among the participants (IV). Synthesis of findings Hope and hopelessness ran together as a thread of meaning throughout the studies. All participants experienced and expressed hope and hopelessness in various ways. The self-harming women hovered between hope and hopelessness, hoping for help and support, but led back to hopelessness by their experiences in care. The women used self-harm as a way to cope and to maintain hope in themselves. The parents initially had confidence in healthcare and hoped for help. However, their experiences of meeting deficient care often made them feel hopeless. Parents paid an emotional ransom when they accepted deficient care for their daughters. The caregivers felt frustrated, angry, and powerless, and their view of self-harm as an endless behaviour led to hopelessness. However, they struggled to see the women’s abilities, not only their difficulties, and described how they had to try to see self-harm in another way. Caregivers who were convinced that it was possible to stop self-harming and leave it behind were able to bring hope to themselves, to parents, and to the women who self-harmed. The present studies suggest that there is a difference between self-harm and suicide attempts or suicide. Other researchers echo these findings. Conclusions Paradoxically, self-harm usually seems to be a life sustaining act, a way of raising hope in oneself. The importance of caregivers who listen and try to understand people who self-harm, as well as their close family members, is evident. By asking open-ended questions and being non-judgemental, listening, and showing a genuine interest in the person’s lived experience; caregivers can inspire hope in people who self-harm.
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34.
  • Lindmark, Ulrika, 1965-, et al. (author)
  • Health-promoting factors in higher education for a sustainable working life : protocol for a multicenter longitudinal study
  • 2020
  • In: BMC Public Health. - London : BioMed Central. - 1471-2458. ; 20:1
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: The World Health Organization has highlighted the importance of health promotion for health service providers in order to ensure sustainable working life for individuals involved in providing health services. Such sustainability begins when students are preparing to manage their own future health and welfare in working life. It has been suggested that universities, employees and trainee health professionals should adopt or follow a salutogenic approach that not only complements the providing of information on known health risks but also favors health promotion strategies. This paper describes the study design and data collection methods in a planned study aiming to explore health-promoting factors for a sustainable working life among students in higher education within healthcare and social work. METHODS: This protocol describes a multicenter longitudinal study involving Swedish students on higher education programs in the healthcare and social work sectors. In 2018, the study invited students on seven education programs at six universities to participate. These programs were for qualification as: biomedical laboratory scientists (n = 121); dental hygienists (n = 87); nurses (n = 1411); occupational therapists (n = 111); physiotherapists (n = 48); radiographers (n = 60); and, social workers (n = 443). In total, 2283 students were invited to participate. Participants completed a baseline, a self-reported questionnaire including six validated instruments measuring health-promoting factors and processes. There are to be five follow-up questionnaires. Three while the students are studying, one a year after graduating, and one three years after graduating. Each questionnaire captures different health-promoting dimensions, namely: health-promoting resources (i.e. sense of coherence); occupational balance; emotional intelligence; health and welfare; social interaction; and work and workplace experiences/perceptions. DISCUSSION: This study focuses on the vastly important aspect of promoting a sustainable working life for healthcare and social work employees. In contrast to previous studies in this area, the present study uses different, validated instruments in health promotion, taking a salutogenic approach. It is hoped that, by stimulating the implementation of new strategies, the study's findings will lead to education programs that prepare students better for a sustainable working life in healthcare and social work.
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35.
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36.
  • Lundin, Anette, et al. (author)
  • Feeling existentially touched - A phenomenological notion of the well-being of elderly living in special housing accommodation from the perspective of care professionals
  • 2013
  • In: International Journal of Qualitative Studies on Health and Well-being. - : CoAction Publishing. - 1748-2623 .- 1748-2631. ; 8
  • Journal article (peer-reviewed)abstract
    • This article presents a phenomenological analysis of interview material, in which 12 care professionals in elderly care reflect on the elderly's well-being within the frame of special housing accommodation. The perspective of the care professionals is of special interest. The findings show that the well-being is characterized as the elderly's feelings of being existentially touched. The well-being is an existential experience of being acknowledged as a human being and is an approach that classifies the elderly's needs as those of having, loving, and being. The meaning of the phenomenon is elucidated by the constituents: (1) to feel the freedom of choice, (2) to feel pleasure, and (3) to feel closeness to someone or something. The findings contribute new understanding of well-being in the elderly care by its existential dimension of the well-being as "just being'' and of doing things in order to experience meaningfulness. Accordingly, the well-being of the elderly as it is seen from the perspective of the care professionals involves both carers' subjectivity and intersubjectivity between the care professional and the elderly. An implication for promoting elderly's well-being is to develop awareness of these existential dimensions.
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37.
  • Lundin, Anette, et al. (author)
  • Witnessing presence : Swedish care professionals' experiences of supporting resident's well-being processes within the frame of residential care homes (RCH)
  • 2016
  • In: Journal of Aging Studies. - : Elsevier. - 0890-4065 .- 1879-193X. ; 37, s. 1-9
  • Journal article (peer-reviewed)abstract
    • The purpose of this article is to analyse the phenomenon of supportive care for older persons' well-being. The phenomenon is seen from the eldercarers' meaning-making through their lifeworld perspective at a residential care home. Based on primary empirical interview material with twelve professionals in the context of Swedish eldercare, a phenomenological analysis was undertaken. The result shows that the phenomenon of supportive care for older persons' well-being creates certain ambiguities in the professionals' meaning-making. In practice, it balances between the older persons' (from hereon called residents) needs and the conditions of the eldercare organization. The ambiguities (the what) is made up by three constituents: (i) freedom of choice for the older persons vs. institutional constraints, (ii) the residents' need for activation vs. wanting not to be activated, and (iii) the residents' need for routine vs. the eldercarers' not being able to know what the residents need. The conclusions drawn are that this ambiguity has consequences for the eldercarers' choice of handling supportive care for older persons' well-being (the how). They have to navigate between the support for authenticity, dwelling and mobility, and their own presence and time. In performing supportive care for older persons' well-being, the eldercarers have to consider aspects concerning the resident's lifeworld, the social setting of the eldercare ward, and the institutional demands of the organization. The practical implications for supporting well-being in the care of older residents are manifested in the importance of 'the little things', and the eldercarer's ability to give receptive attention, which requires presence.
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38.
  • Lundin, Anette, et al. (author)
  • Witnessing presence : Swedish care professionals’ experiences of supporting older people´s well-being processes within the frame of residential home care (RHC)
  • 2016
  • In: Journal of Aging Studies. - : Elsevier BV. - 0890-4065 .- 1879-193X. ; 37, s. 1-9
  • Journal article (other academic/artistic)abstract
    • In this article, we are concerned with analyzing the phenomenon of supportive social care for older people`s well-being from the carers’ meaning making through their life world perspective at a residential care home (RCH). Based on empirical data consisting of interview material with 12 care professionals in the context of Swedish eldercare, a phenomenological analysis was undertaken. The result shows that the phenomenon of supportive social care for well-being is a question of ambiguity in the professionals’ meaning making and in practice it balances between the residents´ needs and the conditions of the care organization. This phenomenon of ambiguity (the what) is made up by three constituents: (i) freedom of choice for the older people vs. institutional constraints, (ii) the residents’ need for activation vs. wanting not to be activated, and (iii) the residents’ need for routine vs. the carers´ not being able to know what the residents need. The conclusions drawn are that this ambiguity has consequences for the carers’ positions for supportive social care for older people´s well-being (the how) in that they have to navigate between the support for authenticity, dwelling and mobility, and carers’ presence and time. In performing a supportive social care for well-being, the carers have to consider aspects concerning the older person’s lifeworld, the social setting of the eldercare ward, and the institutional demands of the organisation. The practical implications for supporting well-being in the social care of older people is manifested in the importance of ‘the little things’, and the carer’s ability to give receptive attention, which requires the presence.  
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39.
  • Mustonen, Ulla, et al. (author)
  • Elämänkulku, mielenterveys ja hyvinvointi. Seurantatutkimus 16-vuotiaista tamperelaisnuorista 22-, 32- ja 42-vuotiaina (TAM-projekti)
  • 2013
  • Reports (other academic/artistic)abstract
    • The development of children and young people and the conditions in which they are brought up lay the foundation for future well-being. People's educational and lifestyle choices in adolescence and early adulthood influence their health and social status far into their adult years. Adulthood and adult well-being are defined by roles at work, in interpersonal relationship, in family, and in other communities as well as by individual needs for change and development. This research report describes the life cycle and well-being from youth to early middle-age of one age group of pupils in Tampere, totalling some 2200 persons. The report summarises key results from a 25-year-long longitudinal study. The survey examines different kinds of risk factors in family backgrounds, adolescence, early adulthood and adult life and their links with mental health and psychosocial well-being. It also studies factors that protect against problems in mental health and well-being in young people's development and in their life cycle. The target group consisted of all Finnish-speaking pupils in the 9th grade of comprehensive school in the city of Tampere in spring 1983 (n = 2269). The research data was collected with a survey questionnaire, which a total of 2194 pupils (96.7%) filled in during one lesson at school. The first follow-up was carried out as a postal questionnaire when the respondents were 22 years old (n = 1656), and the second when the respondents were 32 years old (n =1471). The most recent followup was carried out in 2009 when the respondents were 42 years old (n = 1334). Key topics in all the follow-up surveys have been physical and mental health, health behaviour, social relationships, life situation, and psychosocial resources. The research findings indicate so far that most of the respondents have fared well at the developmental tasks and challenges they have faced in the different stages of their life. It seems, however, that there are risk factors associated with young people's growth and development and the environment in which they grow up, and that these risk factors may have negative effects on well-being in adolescence and far into adulthood. For example, the results indicate that a family's low socio-economic THL – Raportti 17/2013 9 Elämänkulku, mielenterveys ja hyvinvointi status is linked with unhealthy lifestyles in adolescence and a lower level of educational attainment in adulthood. Childhood experience of parents' divorce foretold a higher risk of problems in mental health, interpersonal relationships, and other relationships, as well as a lower socio-economic status in later life. It was also discovered that multiple social deprivation in adolescence is associated with higher mortality in adulthood. Adult depression was linked with depressive symptoms and low self-esteem especially in adolescence. Also, a link was discovered between long-term diseases and mental health. Young people with a long-term disease reported psychosomatic symptoms more often than their peers. In adulthood, a long-term disease was linked with depression among men, but not among women. Men with a long-term disease made more use of emotional means of coping than healthy men, and they had a lower sense of control over their own lives. The most important factors associated with a high level of alcohol consumption were male gender, childhood experience of divorce, depressive symptoms in adolescence, as well as regular binge drinking already at young age. With regard to binge drinking, different kinds of development paths were identified from adolescence to early middle-age. Two kinds of development paths were identified to be associated with various dimensions of social deprivation in early middle-age. These were regular binge drinking from adolescence to early middle among women and men and increasing regular binge drinking during the life-cycle among men. However, no similar link was observed when binge drinking decreased from early adulthood and adulthood. When studying factors that protect against problems of mental health and wellbeing, it was discovered, for example, that good relationship with parents, high selfesteem, and an intimate relationship protected young people against depression in later life. These factors had also an indirect link with the quality of intimate relationships in adult life. In the group of people with a long-term disease, factors protecting against depression included active problem-solving perspective to coping among men and experienced access to social support among women. Changes in individual resources, such as self-esteem, sense of control, and experiencing life as meaningful, were associated with the development of socio-economic inequalities in health in early adulthood. If these resources remained unchanged, also the socio-economic inequalities in health remained unchanged, while an increase in the resources signified a narrowing of the socio-economic inequalities in health. The analysing and reporting of the longitudinal study continue still, and two related dissertations are under way. A number of articles on the study have been published in distinguished scientific journals both in Finland and abroad. The research material has been used in several thesis studies, and the findings have been reported extensively both nationally and internationally. This report includes a list of these THL – Raportti 17/2013 10 Elämänkulku, mielenterveys ja hyvinvointi publications. Those interested in learning more about the research and its themes can study the original publications. The research material forms an internationally valuable follow-up material, and the research results can be utilised especially in social welfare and health care services that aim to promote the mental health and wellbeing of young people and adults. The result can also be used in education services and youth services. The research project and individual researchers have received funding from various sources. We are grateful for all the financial support to our research project. We would like to thank especially the Academy of Finland, the Signe and Ane Gyllenberg Foundation and the Yrjö Jahnsson Foundation for their significant support in enabling the data collection in different stages of the research, as well as the Tampere University School of Health Sciences and the National Public Health Institute/National Institute for Health and Welfare for providing the premises for conducting the research. We extend our warmest thanks to those who took part in this longitudinal study for their long-term interest in the study and for the valuable information they gave about their own lives.
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40.
  • Nilsson, Gunnar, et al. (author)
  • KUL fyller i kunskapsluckor
  • 2018
  • In: Läkartidningen. - : Sveriges läkarförbund. - 0023-7205 .- 1652-7518. ; 115:30-32
  • Journal article (other academic/artistic)
  •  
41.
  • Nyman, Ulf, et al. (author)
  • [GFR estimation in children - age-adjusted creatinine makes the adult Lund-Malmö equation applicable in children and facilitates automatic GFR reporting from the clinical laboratory]
  • 2021
  • In: Läkartidningen. - : Läkartidningen Förlag AB. - 0023-7205 .- 1652-7518. ; 118
  • Journal article (peer-reviewed)abstract
    • Age-adjustment of creatinine, i.e. recalculation of childhood levels of creatinine to corresponding levels at 18 years of age and applied in the adult revised Lund-Malmö GFR equation led to markedly improved accuracy in Swedish children (n=1 718) at measured GFR <75 mL/min/1.73 m2 (n=318) and preserved high accuracy at ≥75 mL/min/1.73 m2 (n=1 400). The adjusted LMR equation performed as well as dedicated paediatric equations based on height. The proposed adjustment strategy has four strengths: (i) the original coefficients of the adult GFR equation can be used, (ii) the same equation can be used across the entire lifespan without artificial changes in estimated GFR when switching from paediatric to adult care, (iii) the lack of height factor makes it easier to automatically report estimated GFR by the laboratories and (iv) age-adjusted creatinine values imply that well-established creatinine reference intervals for adults can also be used for children.
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42.
  • Nyman, Ulf, et al. (author)
  • Så kan formel för vuxna skatta glomerulär filtration hos barn
  • 2021
  • In: Lakartidningen. - 0023-7205. ; 118
  • Journal article (peer-reviewed)abstract
    • Age-adjustment of creatinine, i.e. recalculation of childhood levels of creatinine to corresponding levels at 18 years of age and applied in the adult revised Lund-Malmö GFR equation led to markedly improved accuracy in Swedish children (n=1 718) at measured GFR <75 mL/min/1.73 m2 (n=318) and preserved high accuracy at ≥75 mL/min/1.73 m2 (n=1 400). The adjusted LMR equation performed as well as dedicated paediatric equations based on height. The proposed adjustment strategy has four strengths: (i) the original coefficients of the adult GFR equation can be used, (ii) the same equation can be used across the entire lifespan without artificial changes in estimated GFR when switching from paediatric to adult care, (iii) the lack of height factor makes it easier to automatically report estimated GFR by the laboratories and (iv) age-adjusted creatinine values imply that well-established creatinine reference intervals for adults can also be used for children.
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43.
  •  
44.
  • Paerregaard, Karsten, 1952, et al. (author)
  • Introducción
  • 2005
  • In: EL QUINTO SUYO: Transnacionalidad y formaciones diaspóricas en la migración peruana. - Lima, Peru : Instituto de Estudios Peruanos. - 9972511367 ; , s. 11-34
  • Book chapter (peer-reviewed)
  •  
45.
  • Pottel, Hans, et al. (author)
  • Development and Validation of a Modified Full Age Spectrum Creatinine-Based Equation to Estimate Glomerular Filtration Rate : A Cross-sectional Analysis of Pooled Data
  • 2021
  • In: Annals of Internal Medicine. - : American College of Physicians. - 0003-4819 .- 1539-3704. ; 174:2, s. 183-191
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: The Chronic Kidney Disease in Children Study (CKiD) equation for children and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation for adults are recommended serum creatinine (SCr)-based calculations for estimating glomerular filtration rate (GFR). However, these equations, as well as their combination, have limitations, notably the problem of implausible changes in GFR during the transition from adolescence to adulthood and overestimation of GFR in young adults. The full age spectrum (FAS) equation addresses these issues but overestimates GFR when SCr levels are low.OBJECTIVE: To develop and validate a modified FAS SCr-based equation combining design features of the FAS and CKD-EPI equations.DESIGN: Cross-sectional analysis with separate pooled data sets for development and validation.SETTING:  = 13) with measured GFR available.PATIENTS: 11 251 participants in 7 studies (development and internal validation data sets) and 8378 participants in 6 studies (external validation data set).MEASUREMENTS: Clearance of an exogenous marker (reference method), SCr level, age, sex, and height were used to develop a new equation to estimate GFR.RESULTS: ] in adults) across the FAS (2 to 90 years) and SCr range (40 to 490 µmol/L [0.45 to 5.54 mg/dL]) and with fewer estimation errors exceeding 30% (6.5% [CI, 3.8% to 9.1%] in children and 3.1% [CI, 2.5% to 3.6%] in adults) compared with the CKiD and CKD-EPI equations.LIMITATION: No Black patients were included.CONCLUSION: The new EKFC equation shows improved accuracy and precision compared with commonly used equations for estimating GFR from SCr levels.PRIMARY FUNDING SOURCE: Swedish Research Council (Vetenskapsrådet).
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46.
  • Pottel, Hans, et al. (author)
  • Estimating glomerular filtration rate at the transition from pediatric to adult care
  • 2019
  • In: Kidney International. - : Elsevier BV. - 0085-2538 .- 1523-1755. ; 95:5, s. 1234-1243
  • Journal article (peer-reviewed)abstract
    • The current Kidney Disease Improving Global Outcomes (KDIGO) guidelines recommend the use of the bedside creatinine-based Chronic Kidney Disease in Children (CKiD) equation to estimate glomerular filtration rate (GFR) in children and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation in adults. However, this approach causes implausible changes in estimated GFR (eGFR) at the transition from pediatric to adult care. We investigated the performance of the KDIGO strategy and various creatinine-based eGFR equations in a cross-sectional dataset of 5,764 subjects (age 10-30 years), using directly measured GFR (mGFR) as reference. We also evaluated longitudinal GFR slopes in 136 subjects who transitioned to adult care. Implausible changes in eGFR resulted from the large overestimation (bias=+21 mL/min/1.73m 2 ) and poor precision of the CKD-EPI equation in the 18-20 year age group, compared to CKiD in the 16-18 year age group (bias=-2.7 mL/min/1.73m 2 ), resulting in a mean change of 23 mL/min/1.73m 2 at the transition to adult care. Averaging the CKiD and CKD-EPI estimates in young adults only partially mitigated this issue. The Full Age Spectrum equation (with and without height), the Lund-Malmö Revised equation, and an age-dependent weighted average of CKiD and CKD-EPI resulted in much smaller changes in eGFR at the transition (change of 0.6, -2.1, -0.9 and -1.8 mL/min/1.73m 2 , respectively). The longitudinal analysis revealed a significant difference in average GFR slope between mGFR and the KDIGO strategy (-2.2 vs. +2.9 mL/min/1.73 m 2 /year), which was not observed with the other approaches. These results suggest that the KDIGO recommendation for GFR estimation at the pediatric-adult care transition should be revisited.
  •  
47.
  • Pottel, Hans, et al. (author)
  • Extending the cystatin C based EKFC-equation to children - validation results from Europe.
  • 2023
  • In: Pediatric nephrology (Berlin, West). - 0931-041X .- 1432-198X.
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: A new cystatin C based European Kidney Function Consortium (EKFCCysC) equation was recently developed for adults, using the same mathematical form as the previously published full age spectrum creatinine based EKFC-equation (EKFCCrea). In the present study the cystatin C based EKFC-equation is extended to children, by defining the appropriate cystatin C rescaling factor QCysC.METHODS: Rescaling factor QCysC for cystatin C was defined as: a) 0.83 mg/L, exactly as it was defined for young adults in the adult equation, and b) a more complex QCysC-age relationship based on 4th degree cystatin C-age polynomials after evaluation of data from Uppsala, Stockholm and Canada and aggregated data from Germany. The EKFCCysC equation was then validated in an independent dataset in European children (n = 2,293) with measured GFR, creatinine, cystatin C, age, height and sex available.RESULTS: The EKFCCysC with the simple QCysC-value of 0.83 had a bias of -7.6 [95%CI -8.4;-6.5] mL/min/1.73 m2 and a P30-value of 85.8% [95%CI 84.4;87.3] equal to the EKFCCysC with the more complex 4th degree QCysC-value. The arithmetic mean of the EKFCCrea and EKFCCysC with the simple QCysC of 0.83 had a bias of -4.0 [95%CI -4.5;-3.1] mL/min/1.73 m2 and P30 of 90.4% [95%CI 89.2;91.6] similar to using the more complex 4th degree QCysC-polynomial.CONCLUSION: Using exactly the same QCysC of 0.83 mg/L, the adult EKFCCysC can easily be extended to children, with some bias but acceptable P30-values. The arithmetic mean of EKFCCrea and EKFCCysC results in bias closer to zero and P30 slightly over 90%. A higher resolution version of the Graphical abstract is available as Supplementary information.
  •  
48.
  • Risum, Malene, et al. (author)
  • Introduction of a Comprehensive Diagnostic and Interdisciplinary Management Approach in Haematological Patients with Mucormycosis : A Pre and Post-Intervention Analysis
  • 2020
  • In: JOURNAL OF FUNGI. - : MDPI. - 2309-608X. ; 6:4
  • Journal article (peer-reviewed)abstract
    • Mucormycosis is a life threatening infection in patients with haematological disease. We introduced a Mucorales-PCR and an aggressive, multidisciplinary management approach for mucormycosis during 2016-2017 and evaluated patient outcomes in 13 patients diagnosed and treated in 2012-2019. Management principle: repeated surgical debridement until biopsies from the resection margins were clean as defined by negative Blankophor microscopy, Mucorales-PCR (both reported within 24 h), and cultures. Cultured isolates underwent EUCAST E.Def 9.3.1 susceptibility testing. Antifungal therapy (AFT) (mono/combination) combined with topical AFT (when possible) was given according to the minimal inhibitory concentration (MIC), severity of the infection, and for azoles, specifically, it was guided by therapeutic drug monitoring. The outcome was evaluated by case record review. All patients underwent surgery guided by diagnostic biopsies from tissue and resection margins (195 samples in total). Comparing 2012-2015 and 2016-2019, the median number of patients of surgical debridements was 3 and 2.5 and of diagnostic samples: microscopy/culture/PCR was 3/3/6 and 10.5/10/10.5, respectively. The sensitivity of microscopy (76%) and Mucorales-PCR (70%) were similar and microscopy was superior to that of culture (53%; p = 0.039). Initial systemic AFT was liposomal amphotericin B (n = 12) or posaconazole (n = 1) given as monotherapy (n = 4) or in combination with isavuconazole/posaconazole (n = 3/6) and terbinafine (n = 3). Nine patients received topical amphotericin B. All received isavuconazole or posaconazole consolidation therapy (n = 13). Mucormycosis related six month mortality was 3/5 in 2012-2015 and 0/7 patients in 2016-2019 (one patient was lost for follow-up). Implementation of combination therapy (systemic+topical AFT/combination systemic AFT) and aggressive surgical debridement guided by optimised diagnostic tests may improve the outcome of mucormycosis in haematologic patients.
  •  
49.
  • Selin, Lotta, et al. (author)
  • Dosage of oxytocin for augmentation of labor and women’s childbirth experiences: A randomized controlled trial
  • 2021
  • In: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 100:5, s. 971-978
  • Journal article (peer-reviewed)abstract
    • Introduction: The aim of this study was to compare childbirth experiences and experience of labor pain in primiparous women who had received high- vs low-dose oxytocin for augmentation of delayed labor. Material and methods: A multicenter, parallel, double-blind randomized controlled trial took place in six Swedish labor wards. Inclusion criteria were healthy primiparous women at term with uncomplicated singleton pregnancies, cephalic fetal presentation, spontaneous onset of labor, confirmed delayed labor progress and ruptured membranes. The randomized controlled trial compared high- vs low-dose oxytocin used for augmentation of a delayed labor progress. The Childbirth Experience Questionnaire version 2 (CEQ2) was sent to the women 1month after birth. The CEQ2 consists of 22 items in four domains: Own capacity, Perceived safety, Professional support and Participation. In addition, labor pain was reported with a visual analog scale (VAS) 2hours postpartum and 1month after birth. The main outcome was the childbirth experience measured with the four domains of the CEQ2. The clinical trial number is NCT01587625. Results: The CEQ2 was sent to 1203 women, and a total of 1008 women (83.8%) answered the questionnaire. The four domains of childbirth experience were scored similarly in the high- and low-dose oxytocin groups of women: Own capacity (P=.36), Perceived safety (P=.44), Professional support (P=.84), Participation (P=.49). VAS scores of labor pain were reported as similar in both oxytocin dosage groups. Labor pain was scored higher 1month after birth compared with 2hours postpartum. There was an association between childbirth experiences and mode of birth in both the high- and low-dose oxytocin groups. Conclusions: Different dosage of oxytocin for augmentation of delayed labor did not affect women’s childbirth experiences assessed through CEQ2 1month after birth, or pain assessment 2hours or 1month after birth. © 2020 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG)
  •  
50.
  • Selin, Lotta, et al. (author)
  • High-dose versus low-dose of oxytocin for labour augmentation : a randomised controlled trial
  • 2019
  • In: Women and Birth. - : ELSEVIER. - 1871-5192 .- 1878-1799. ; 32:4, s. 356-363
  • Journal article (peer-reviewed)abstract
    • Problem: Delayed labour progress is common in nulliparous women, often leading to caesarean section despite augmentation of labour with synthetic oxytocin.Background: High-or low-dose oxytocin can be used for augmentation of delayed labour, but evidence for promoting high-dose is weak.Aim: To ascertain the effect on caesarean section rate of high-dose versus low-dose oxytocin for augmentation of delayed labour in nulliparous women.Methods: Multicentre parallel double-blind randomised controlled trial (ClinicalTrials.gov: NCT01587625) in six labour wards in Sweden. Healthy nulliparous women at term with singleton cephalic fetal presentation, spontaneous labour onset, confirmed delay in labour and ruptured membranes (n = 1351) were randomised to labour augmentation with either high-dose (6.6 mU/minute) or low-dose (3.3 mU/minute) oxytocin infusion.Findings: 1295 women were included in intention-to-treat analysis (high-dose n = 647; low-dose n = 648). Caesarean section rates did not differ between groups (12.4% and 12.3%, 95% Confidence Interval -3.7 to 3.8). Women with high-dose oxytocin had: shorter labours (-23.4 min); more uterine tachysystole (43.2% versus 33.5%); similar rates of instrumental vaginal births, with more due to fetal distress (43.8% versus 22.7%) and fewer due to failure to progress (39.6% versus 58.8%). There were no differences in neonatal outcomes.Discussion: Our study could not confirm results of two systematic reviews indicating, with weak evidence, that use of high-dose oxytocin was associated with lower frequency of caesarean section.Conclusion: We found no advantages for routine use of high-dose oxytocin in the management of delay in labour. Low-dose oxytocin regimen is recommended to avoid unnecessary events of tachysystole and fetal distress. 
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