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  • 1. A Molarius, A
    et al.
    Granström, F
    Feldman, Inna
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Kalander Blomqvist, M
    Pettersson, H
    Ello, S
    Can financial insecurity and condescending treatment explain the higher prevalence of poor self-rated health in women than in men? A population-based cross-sectional study in Sweden2012Konferansepaper (Annet vitenskapelig)
  • 2.
    Aalto, Heidi
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Föräldrars upplevelser av omvårdnaden av sitt sent underburna barn på BB: En intervjustudie2014Independent thesis Advanced level (degree of Master (One Year)), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund: Sent underburna barn vårdas ofta på BB-avdelning för fullgångna barn. De har högre frekvens av återinläggningar på sjukhus än fullgångna barn. De flesta studier kring underburna barns vistelse på sjukhus är inte gjorda specifikt på sent underburna barn. Syfte: Syftet är att utforska föräldrars upplevelser av omvårdnaden av sent underburna barn på en BB-avdelning i Sverige. I analysen användes det teoretiska begreppet empowerment. Metod: Studien är deskriptiv med en kvalitativ ansats. Telefonintervjuer användes som datainsamlingsmetod. Fem mammor och två pappor deltog i studien. Intervjuerna analyserades med innehållsanalys. Resultat/Slutsats: Föräldrarna upplevde att personalen antingen förmedlade empowerment eller inte. Omvårdnadsåtgärder kring barnet som gjorde föräldrarna mer delaktiga upplevdes mer positivt och omvårdnadsåtgärder som orsakade en separation mellan föräldrar och barn upplevdes mer negativt. Föräldrarna hade svårt att ifrågasätta personal, även om de upplevde att något kring omvårdnadsåtgärden kändes fel. Omvårdnadsåtgärder, utfördes inte alltid i enlighet med vetenskap och beprövad erfarenhet. Personalen kan utbildas mer i att främja empowerment i föräldrarollen och därmed även öka föräldradelaktigheten i barnets omvårdnad och möjligheten att se varje familjs unika behov. Mer forskning behövs om hur detta ska ske.

  • 3. Aaltonen, Pertti
    et al.
    Amory, John K
    Anderson, Richard A
    Behre, Hermann M
    Bialy, Gabriel
    Blithe, Diana
    Bone, Wilhelm
    Bremner, William J
    Colvard, Doug
    Cooper, Trevor G
    Elliesen, Jörg
    Gabelnick, Henry L
    Gu, Yi-Qun
    Handelsman, David J
    Johansson, Elof A B
    Kersemaekers, Wendy
    Liu, Peter
    MacKay, Trent
    Matlin, Stephen
    Mbizvo, Michael
    McLachlan, Robert I
    Meriggiola, Maria Cristina
    Mletzko, Stephan
    Mommers, Ellen
    Muermans, Hilde
    Nieschlag, Eberhard
    Odlind, Viveca
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Page, Stephanie T
    Radlmaier, Albert
    Sitruk-Ware, Regine
    Swerdloff, Ronald
    Wang, Christina
    Wu, Frederick
    Zitzmann, Michael
    10th Summit Meeting consensus: recommendations for regulatory approval for hormonal male contraception.2007Inngår i: J of Andrology, vol. 28, No 3 May/June, 2007, s. 362-363Konferansepaper (Annet vitenskapelig)
  • 4.
    Aarnio, Pauliina
    et al.
    Univ Tampere, Fac Social Sci Global Hlth & Dev, Kalevantie 4, FI-33014 Tampere, Finland;Univ Tampere, Med Sch, Dept Int Hlth, Tampere, Finland.
    Kulmala, Teija
    Univ Tampere, Med Sch, Child Hlth Res Unit, Tampere, Finland;Univ Tampere, Med Sch, Dept Int Hlth, Tampere, Finland.
    Olsson, Pia
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Obstetrisk och reproduktiv hälsoforskning.
    Husband's role in handling pregnancy complications in Mangochi District, Malawi: A call for increased focus on community level male involvement2018Inngår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 16, s. 61-66Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: The objective of the current study is to provide information about husbands' role in decision-making and healthcare seeking in cases of pregnancy complications in Mangochi district, Malawi with an analysis of qualitative interviews using the concepts of "capital" and "field" from Bourdieu's social field theory. Study design: Twelve husbands and wives who had experienced pregnancy complications and six key informants from a semi-rural area of Mangochi district were interviewed individually. Thematic analysis was conducted based on the concepts of capital and field in Bourdieu's social field theory. Results: Husbands have significant economic and symbolic capital in decisions about healthcare seeking during instances of pregnancy complications as a result of their roles as father, head of the household and main income earner. Lack of money is the only acceptable reason for husbands to deny their wives healthcare. Husbands have limited access to knowledge of maternal health, which can compromise their decisions about seeking healthcare. Joint decision-making within families can be bypassed to allow for prompt healthcare seeking in emergencies. Conclusions: Husbands are important decision makers regarding seeking healthcare for pregnancy complications because of their economic and symbolic power and despite their limited access to knowledge of maternal health. Maternal healthcare seeking practices would benefit from wives gaining an empowered role as well as improved knowledge of maternal health among husbands.

  • 5.
    Aarnio, Pauliina
    et al.
    Dept for International Health, Medical School, University of Tampere, Finland.
    Olsson, Pia
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Chimbiri, Agnes
    Kulmala, Teija
    Male involvement in antenatal HIV counseling and testing: exploring men's perceptions in rural Malawi2009Inngår i: AIDS Care, ISSN 0954-0121, E-ISSN 1360-0451, Vol. 21, nr 12, s. 1537-1546Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Antenatal care can act as an excellent tool to improve access to HIV counseling and testing services. This paper investigates an issue that may weaken its potential, namely lack of male involvement. We explored married men's perceptions of HIV in pregnancy and male involvement in antenatal HIV testing and counseling in Southern Malawi through 11 focus group discussions and a cross-sectional survey (n=388). The main findings were that men were largely unaware of available antenatal HIV testing and counseling services, and perceived it overall problematic to attend female-oriented health care. Most men supported provision of antenatal HIV testing. They perceived husbands to participate in the process indirectly through spousal communication, being faithful during pregnancy, and supporting the wife if found HIV-positive. Involvement of husbands was compromised by men's reluctance to learn their HIV status and the threat that HIV poses on marriage. Men stressed the importance of prior spousal agreement of antenatal HIV testing and considered HIV testing without their consent a valid reason for divorce. We suggest that male involvement in antenatal HIV testing requires refocusing of information and health services to include men. To avoid negative social outcomes for women, comprehensive and early involvement of men is essential.

  • 6.
    Aarnio, Riina
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Reproduktionsbiologi.
    Self-sampling for HPV testing in primary cervical screening: Including clinical and health economic aspects2020Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Persistent infection with high-risk human papillomavirus (HPV) is a prerequisite for the development of cervical cancer. HPV testing has higher sensitivity for high-grade cervical intraepithelial neoplasia (CIN2+) than cytology, resulting in more effective screening. As HPV testing also offers an opportunity for self-sampling, it could serve as an even more effective and cost-effective method of cervical screening.

    First, we compared repeated self-sampling for HPV testing with Pap smear cytology in detection of CIN2+ in primary cervical screening for women aged 30–49 years (n=36 390). We found a more than twofold higher detection rate of CIN2+ and a fourfold higher detection rate of CIN2 with self-sampling compared with cytology. However, no difference was seen between the arms in the detection rate of CIN3+. It thus seems that CIN is detected at an earlier stage with self-sampling than with cytology, but the impact of this needs to be further explored.

    Second, as management of HPV-positive women with normal cytology results is a challenge, we wanted to evaluate the proportion of cases of histological CIN2+ in these women. In this prospective study we performed LEEP and found that 15% (6/40) of the women had undetected CIN2+. These findings can be used in counseling women about the risk of cervical cancer and helping clinicians in decisions on management.

    Third, we performed a cost-effectiveness analysis on the same study population as in Study I. Self-sampling for HPV testing resulted in a higher participation rate and more detected cases of CIN2+ at a lower cost and was regarded as more cost-effective than Pap smear cytology in cervical screening. These results can guide policy-makers when planning future screening programs.

    Fourth, we compared self-sampling with sampling by medical professionals for HPV testing in detection of CIN2+, using a combination of an FTA card as storage medium and a PCR-based HPV test (hpVIR) in women aged 30–60 years (n=11 951). No difference in the detection rates of histological CIN2+ was found between the arms.

    Taken together, self-sampling resulted in a higher participation rate than sampling by medical professionals in cervical screening and that triage with repeated self-sampling resulted in high compliance and detection rate of CIN2+. As repeated self-sampling for HPV testing was also cost-effective, it could serve as an attractive alternative in the development of future cervical screening programs. More research is needed on how to refine the management of HPV-positive women by self-sampling only.

    Delarbeid
    1. Randomised study shows that repeated self-sampling and HPV test has more than two-fold higher detection rate of women with CIN2+ histology than Pap smear cytology
    Åpne denne publikasjonen i ny fane eller vindu >>Randomised study shows that repeated self-sampling and HPV test has more than two-fold higher detection rate of women with CIN2+ histology than Pap smear cytology
    Vise andre…
    2018 (engelsk)Inngår i: British Journal of Cancer, ISSN 0007-0920, E-ISSN 1532-1827, Vol. 118, nr 6, s. 896-904Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Background:

    This randomised study compared the detection rate of cervical intraepithelial neoplasia-positive (CIN2+) based on histology in women performing repeated self-sampling of vaginal fluid (VF) for human papillomavirus (HPV) test with a control group following the ordinary screening by Pap smear cytology.

    Methods:

    36390 women aged 30–49 years scheduled for invitation to organised screening were randomised in two groups, one to perform self-sampling of VF for HPV test (n=17 997, HPV arm) and the other group to perform screening by PAP smear cytology (n=18 393, control arm). HPV positive women in the HPV arm repeated the self-sampling and the HPV test on average 4.4 months later and those with two consecutive positive HPV tests were referred to colposcopy. Outcome was CIN2+ based on histology during 18-month follow-up.

    Results:

    Participation rate was 47% in the HPV arm and 39% in the control arm. The HPV prevalence in the first self-sampling was 6.9%, and 71% of these women were HPV positive in their second test. For the per-protocol approach, cumulative prevalence of histological CIN2+ in the HPV arm was 20.2 per 1000 women screened as compared to 10.8 in the control arm. The cumulative prevalence of CIN2+ diagnosed per 1000 years screened was 160.8 in the HPV arm as compared with 25.4 in the control arm.

    Conclusions:

    Repeated self-sampling of VF and HPV test had more than a two-fold higher discovery rate of CIN2+ per 1000 women screened as compared with PAP smear cytology.

    HSV kategori
    Identifikatorer
    urn:nbn:se:uu:diva-367087 (URN)10.1038/bjc.2017.485 (DOI)000427945800030 ()29438367 (PubMedID)
    Forskningsfinansiär
    Swedish Foundation for Strategic Research Swedish Cancer SocietySwedish Society for Medical Research (SSMF)
    Tilgjengelig fra: 2018-11-28 Laget: 2018-11-28 Sist oppdatert: 2020-03-18bibliografisk kontrollert
    2. Diagnostic excision of the cervix in women over 40 years with human papilloma virus persistency and normal cytology
    Åpne denne publikasjonen i ny fane eller vindu >>Diagnostic excision of the cervix in women over 40 years with human papilloma virus persistency and normal cytology
    Vise andre…
    2019 (engelsk)Inngår i: European journal of obstetrics & gynecology and reproductive biology: X, ISSN 2590-1613, Vol. 3, artikkel-id 100042Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Objective: Persistent infection with human papillomavirus (HPV) is recognized as the main risk factor of cervical cancer. Investigation via cytology and colposcopy have lower sensitivity than HPV testing in the diagnosis of high-grade cervical intraepithelial neoplasia (CIN2+). Despite normal cytology and colposcopy findings women with persistent HPV infection have an increased risk of CIN2+. The aim of the study was to evaluate the proportion of histologically confirmed CIN2+ in women with persistent HPV infection and normal Pap smears.

    Study design: From April 2013 until March 2016 we prospectively recruited 91 women over 40 years with persistent HPV infection without any abnormalities in cytology. Of these, 40 women attended a gynecological examination including an HPV test, Pap smear, endocervical cytology, colposcopy with biopsies and diagnostic loop electrosurgical excision procedure (LEEP). Biopsy and LEEP samples were subjected to histological examination.

    Results: CIN2+ was verified by histological examination of the LEEP sample in 6/40 (15%) of the women. All the cytological samples were normal and none of the biopsies confirmed CIN2+. Only 19/40 women still had a persistent HPV infection at the study visit. None of the 21/40 women who had cleared their HPV infection at the study visit had CIN2+ in histology of the LEEP sample.

    Conclusions: A persistent HPV infection needs to be monitored despite normal Pap smears, since 6/40 (15%) women older than 40 years, was revealed to have an undiagnosed CIN2+ when LEEP was performed. Counseling women regarding the risk of cervical cancer and the expected effect of an eventual LEEP can help them to make an optimal informed choice.

    Emneord
    Cervical intraepithelial neoplasia, Colposcopy, Human papillomavirus, Loop electrical excision procedure, Transformation zone
    HSV kategori
    Identifikatorer
    urn:nbn:se:uu:diva-400770 (URN)10.1016/j.eurox.2019.100042 (DOI)31404426 (PubMedID)
    Tilgjengelig fra: 2020-01-02 Laget: 2020-01-02 Sist oppdatert: 2020-03-18bibliografisk kontrollert
    3. Cost-effectiveness analysis of repeated self-sampling for HPV testing in primary cervical screening: a randomized study
    Åpne denne publikasjonen i ny fane eller vindu >>Cost-effectiveness analysis of repeated self-sampling for HPV testing in primary cervical screening: a randomized study
    Vise andre…
    (engelsk)Manuskript (preprint) (Annet vitenskapelig)
    Abstract [en]

    Background

    Human papillomavirus (HPV) testing is recommended in primary cervical screening to improve cancer prevention. An advantage of HPV testing is that it can be performed on self-samples, which could increase population coverage and result in a more efficient strategy to identify women at risk of developing cervical cancer. Our objective was to assess whether repeated self-sampling for HPV testing is cost-effective in comparison with Pap smear cytology for detection of cervical intraepithelial neoplasia grade 2 or more (CIN2+) in increasing participation rate in primary cervical screening.

    Methods

    A cost-effectiveness analysis (CEA) was performed on data from a previously published randomized clinical study including 36 390 women aged 30–49 years. Participants were randomized either to perform repeated self-sampling of vaginal fluid for HPV testing (n = 17 997, HPV self-sampling arm) or to midwife-collected Pap smears for cytological analysis (n = 18 393, Pap smear arm).

    Results

    Self-sampling for HPV testing led to 1633 more screened women and 107 more histologically diagnosed CIN2+ at a lower cost vs. midwife-collected Pap smears (€ 228 642 vs. € 781 139). 

    Conclusions

    This study projected that repeated self-sampling for HPV testing increased participation and detection of CIN2+ at a lower cost than midwife-collected Pap smears in primary cervical screening. Offering women a home-based self-sampling may therefore be a more cost-effective alternative than clinic-based screening.

     

    Emneord
    Self-sampling, HPV testing, primary cervical screening, cost-effectiveness, CIN2+, precancerous lesion, cervical cancer
    HSV kategori
    Forskningsprogram
    Obstetrik och gynekologi
    Identifikatorer
    urn:nbn:se:uu:diva-405549 (URN)
    Tilgjengelig fra: 2020-02-28 Laget: 2020-02-28 Sist oppdatert: 2020-03-12bibliografisk kontrollert
    4. Comparison of vaginal self-sampling and cervical sampling by medical professionals for the detection of HPV and CIN2+: a randomized study
    Åpne denne publikasjonen i ny fane eller vindu >>Comparison of vaginal self-sampling and cervical sampling by medical professionals for the detection of HPV and CIN2+: a randomized study
    Vise andre…
    (engelsk)Manuskript (preprint) (Annet vitenskapelig)
    Abstract [en]

    Primary screening with human papillomavirus (HPV) test is more effective in reducing cervical cancer incidence than cytology and it also offers the opportunity to self-sample. We conducted a randomized study to compare vaginal self-sampling with cervical sampling by medical professionals for HPV testing concerning prevalence of HPV and detection of cervical intraepithelial neoplasia (CIN) of grade 2 or worse (CIN2+)  or grade 3 or worse (CIN3+) in primary screening. In total, 11 951 women aged 30–60 years were randomized into two groups, 5961 for self-sampling (SS arm) and 5990 for sampling by medical professionals (SMP arm). Sampling was performed with a Rovers®Viba-brush in the SS arm and a cytobrush in the SMP arm. All samples were applied to an indicating FTA elute card and analyzed for HPV using a clinically validated real-time PCR test (hpVIR). All HPV-positive women performed repeated sampling about six months later using the same procedure as used initially. All HPV-positive women in the second sampling were referred to colposcopy. HPV prevalence in the first test did not differ between the SS arm (6.8%, 167/2466) and the SMP arm (7.8%, 118/1519) (p=0.255). The prevalence of CIN2+ per 1000 screened women was 17 (43/2466 × 1000) (95%CI 13–24) in the SS arm and 21 (32/1519 × 1000) (95%CI 15–30) in the SMP arm. For CIN3+, the prevalence per 1000 screened women was 14 (35/2466 × 1000) (95%CI 10–20) in the SS arm and 15 (23/1519 × 1000) (95%CI 10–23) in the SMP arm.  In conclusion, self-sampling and sampling by medical professionals showed the same prevalence of HPV and detection rate of CIN2+ and CIN3+ in histology.

    Novelty and Impact

    Offering self-sampling in primary cervical screening results in similar rates of HPV prevalence and detection of CIN2+ and CIN3+ compared with sampling by medical professionals when using an FTA card as storage medium and PCR-based HPV test (hpVIR). Considering health-economic aspects, resources should be directed towards self-sampling as a first choice for primary cervical screening, with careful follow-up of this strategy.

    Emneord
    Self-sampling, HPV test, Primary cervical screening
    HSV kategori
    Forskningsprogram
    Obstetrik och gynekologi
    Identifikatorer
    urn:nbn:se:uu:diva-405547 (URN)
    Tilgjengelig fra: 2020-02-28 Laget: 2020-02-28 Sist oppdatert: 2020-03-12bibliografisk kontrollert
  • 7.
    Aarnio, Riina
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Reproduktionsbiologi.
    Isacson, Isabella
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Sanner, Karin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Reproduktionsbiologi.
    Gustavsson, Inger M.
    Uppsala universitet, Science for Life Laboratory, SciLifeLab. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Medicinsk genetik och genomik.
    Gyllensten, Ulf B.
    Uppsala universitet, Science for Life Laboratory, SciLifeLab. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Medicinsk genetik och genomik.
    Olovsson, Matts
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Reproduktionsbiologi.
    Comparison of vaginal self-sampling and cervical sampling by medical professionals for the detection of HPV and CIN2+: a randomized studyManuskript (preprint) (Annet vitenskapelig)
    Abstract [en]

    Primary screening with human papillomavirus (HPV) test is more effective in reducing cervical cancer incidence than cytology and it also offers the opportunity to self-sample. We conducted a randomized study to compare vaginal self-sampling with cervical sampling by medical professionals for HPV testing concerning prevalence of HPV and detection of cervical intraepithelial neoplasia (CIN) of grade 2 or worse (CIN2+)  or grade 3 or worse (CIN3+) in primary screening. In total, 11 951 women aged 30–60 years were randomized into two groups, 5961 for self-sampling (SS arm) and 5990 for sampling by medical professionals (SMP arm). Sampling was performed with a Rovers®Viba-brush in the SS arm and a cytobrush in the SMP arm. All samples were applied to an indicating FTA elute card and analyzed for HPV using a clinically validated real-time PCR test (hpVIR). All HPV-positive women performed repeated sampling about six months later using the same procedure as used initially. All HPV-positive women in the second sampling were referred to colposcopy. HPV prevalence in the first test did not differ between the SS arm (6.8%, 167/2466) and the SMP arm (7.8%, 118/1519) (p=0.255). The prevalence of CIN2+ per 1000 screened women was 17 (43/2466 × 1000) (95%CI 13–24) in the SS arm and 21 (32/1519 × 1000) (95%CI 15–30) in the SMP arm. For CIN3+, the prevalence per 1000 screened women was 14 (35/2466 × 1000) (95%CI 10–20) in the SS arm and 15 (23/1519 × 1000) (95%CI 10–23) in the SMP arm.  In conclusion, self-sampling and sampling by medical professionals showed the same prevalence of HPV and detection rate of CIN2+ and CIN3+ in histology.

    Novelty and Impact

    Offering self-sampling in primary cervical screening results in similar rates of HPV prevalence and detection of CIN2+ and CIN3+ compared with sampling by medical professionals when using an FTA card as storage medium and PCR-based HPV test (hpVIR). Considering health-economic aspects, resources should be directed towards self-sampling as a first choice for primary cervical screening, with careful follow-up of this strategy.

  • 8.
    Aarnio, Riina
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Reproduktionsbiologi.
    Wikström, Ingrid
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Reproduktionsbiologi.
    Gustavsson, Inger M.
    Uppsala universitet, Science for Life Laboratory, SciLifeLab. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Medicinsk genetik och genomik.
    Gyllensten, Ulf B.
    Uppsala universitet, Science for Life Laboratory, SciLifeLab. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Medicinsk genetik och genomik.
    Olovsson, Matts
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Reproduktionsbiologi.
    Diagnostic excision of the cervix in women over 40 years with human papilloma virus persistency and normal cytology2019Inngår i: European journal of obstetrics & gynecology and reproductive biology: X, ISSN 2590-1613, Vol. 3, artikkel-id 100042Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: Persistent infection with human papillomavirus (HPV) is recognized as the main risk factor of cervical cancer. Investigation via cytology and colposcopy have lower sensitivity than HPV testing in the diagnosis of high-grade cervical intraepithelial neoplasia (CIN2+). Despite normal cytology and colposcopy findings women with persistent HPV infection have an increased risk of CIN2+. The aim of the study was to evaluate the proportion of histologically confirmed CIN2+ in women with persistent HPV infection and normal Pap smears.

    Study design: From April 2013 until March 2016 we prospectively recruited 91 women over 40 years with persistent HPV infection without any abnormalities in cytology. Of these, 40 women attended a gynecological examination including an HPV test, Pap smear, endocervical cytology, colposcopy with biopsies and diagnostic loop electrosurgical excision procedure (LEEP). Biopsy and LEEP samples were subjected to histological examination.

    Results: CIN2+ was verified by histological examination of the LEEP sample in 6/40 (15%) of the women. All the cytological samples were normal and none of the biopsies confirmed CIN2+. Only 19/40 women still had a persistent HPV infection at the study visit. None of the 21/40 women who had cleared their HPV infection at the study visit had CIN2+ in histology of the LEEP sample.

    Conclusions: A persistent HPV infection needs to be monitored despite normal Pap smears, since 6/40 (15%) women older than 40 years, was revealed to have an undiagnosed CIN2+ when LEEP was performed. Counseling women regarding the risk of cervical cancer and the expected effect of an eventual LEEP can help them to make an optimal informed choice.

  • 9.
    Aarnio, Riina
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Reproduktionsbiologi.
    Östensson, Ellinor
    Karolinska Institutet.
    Olovsson, Matts
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Reproduktionsbiologi.
    Gustavsson, Inger M.
    Uppsala universitet, Science for Life Laboratory, SciLifeLab. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Medicinsk genetik och genomik.
    Gyllensten, Ulf B.
    Uppsala universitet, Science for Life Laboratory, SciLifeLab. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Medicinsk genetik och genomik.
    Cost-effectiveness analysis of repeated self-sampling for HPV testing in primary cervical screening: a randomized studyManuskript (preprint) (Annet vitenskapelig)
    Abstract [en]

    Background

    Human papillomavirus (HPV) testing is recommended in primary cervical screening to improve cancer prevention. An advantage of HPV testing is that it can be performed on self-samples, which could increase population coverage and result in a more efficient strategy to identify women at risk of developing cervical cancer. Our objective was to assess whether repeated self-sampling for HPV testing is cost-effective in comparison with Pap smear cytology for detection of cervical intraepithelial neoplasia grade 2 or more (CIN2+) in increasing participation rate in primary cervical screening.

    Methods

    A cost-effectiveness analysis (CEA) was performed on data from a previously published randomized clinical study including 36 390 women aged 30–49 years. Participants were randomized either to perform repeated self-sampling of vaginal fluid for HPV testing (n = 17 997, HPV self-sampling arm) or to midwife-collected Pap smears for cytological analysis (n = 18 393, Pap smear arm).

    Results

    Self-sampling for HPV testing led to 1633 more screened women and 107 more histologically diagnosed CIN2+ at a lower cost vs. midwife-collected Pap smears (€ 228 642 vs. € 781 139). 

    Conclusions

    This study projected that repeated self-sampling for HPV testing increased participation and detection of CIN2+ at a lower cost than midwife-collected Pap smears in primary cervical screening. Offering women a home-based self-sampling may therefore be a more cost-effective alternative than clinic-based screening.

     

  • 10.
    Aarts, Clara
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Exclusive breastfeeding-Does it make a difference?: A longitudinal, prospective study of daily feeding practices, health and growth in a sample of Swedish infants2001Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    The concept of exclusive breastfeeding in relation to daily feeding practices and to health and growth of infants in an affluent society was examined. In a descriptive longitudinal prospective study 506 mother-infant pairs were followed from birth through the greater part of the first year. Feeding was recorded daily, and health and growth were recorded fortnightly.

    Large individual variations were seen in breastfeeding patterns. A wide discrepancy between the exclusive breastfeeding rates obtained from "current status" data and data "since birth" was found.

    Using a strict definition of exclusive breastfeeding from birth and taking into account the reasons for giving complementary feeding, the study showed that many exclusively breastfed infants had infections early in life, the incidence of which increased with age, despite continuation of exclusive breastfeeding. However, truly exclusively breastfed infants seem less likely to suffer infections than infants who receive formula in addition to breast milk. Increasing formula use was associated with an increasing likelihood of suffering respiratory illnesses. The growth of exclusively breastfed infants was similar to that of infants who were not exclusively breastfed.

    The health of newborn infants during the first year of life was associated with factors other than feeding practices alone. Some of these factors may be prenatal, since increasing birth weight was associated with an increasing likelihood of having respiratory symptoms, even in exclusively breastfed infants. However, exclusive breastfeeding was shown to be beneficial for the health of the infant even in an affluent society.

  • 11.
    Aarts, Clara
    et al.
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Hornell, Agneta
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Kylberg, Elisabeth
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Hofvander, Yngve
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Gebre-Medhin, Mehari
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Breastfeeding patterns in relation to thumb sucking and pacifier use1999Inngår i: Pediatrics, Vol. 104, s. 50-Artikkel i tidsskrift (Fagfellevurdert)
  • 12.
    Aarts, Clara
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Kylberg, Elisabeth
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Hofvander, Yngve
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Gebre-Medhin, Meharigm
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Growth under privileged conditions of healthy Swedish infants exclusively breastfed from birth to 4-6 months:  a longitudinal prospective study based on daily records of feeding2003Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 92, nr 2, s. 145-151Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim:

    In most studies the methodology used to study growth in relation to breastfeeding patterns cannot ensure that exclusive breastfeeding has in fact occurred since birth. The aim of this study was to investigate the growth of healthy infants in Sweden in whom exclusive breastfeeding for the first 4–6 mo was ascertained through daily feeding records and to compare the results with the World Health Organization (WHO) “12-month breastfed pooled data set” and the Euro-Growth references for exclusively breastfed infants, as well as with the National Center for Health Statistics (NCHS)/WHO reference.

    Methods:

    147 exclusively breastfed infants and 325 non-exclusively breastfed Swedish infants, with a birthweight of ≥3 kg, were included. The mothers had previous breastfed at least one infant for at least 4 mo. Weight was recorded fortnightly and length monthly.

    Results:

    Infants exclusively breastfed since birth showed similar growth in weight and height to that of the non-exclusively breastfed infants. During the first 6 mo of life the growth of exclusively breastfed infants was also similar to that of the infants regularly receiving formula at 12–16 wk of age, mostly in addition to breast milk. The monthly growth increments were fairly similar to those of the “WHO pooled breastfed data set” and the Euro-Growth references for exclusively breastfed infants.

    Conclusion:

    In an affluent society truly exclusively breastfed infants seem to have the same growth during the first half year of life as non-exclusively breastfed infants with a high breastfeeding rate.

  • 13.
    Aarts, Clara
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Kylberg, Elisabeth
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Hornell, A
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Hofvander, Yngve
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Gebre-Medhin, Mehari
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Greiner, Ted
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    How exclusive is exclusive breastfeeding? A comparison of data since birth with current status data:  2000Inngår i: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 29, nr 6, s. 1041-1046Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND:

    There is no accepted and widely used indicator for exclusive breastfeeding since birth. Indeed, the difference between 'current status' data on exclusive breastfeeding and data on 'exclusive breastfeeding since birth' is rarely recognized. We used data from a longitudinal study to examine this issue.

    METHODS:

    A descriptive longitudinal, prospective study design was used in which 506 mother-infant pairs were included. The mothers completed daily recordings on infant feeding during the first nine months after birth. A research assistant conducted fortnightly home visits with structured interviews. The resulting data on breastfeeding patterns are presented in two different ways: analysis of 'current status' data based on a single 24-hour recording of infant feeding at 2, 4 and 6 months of age, and analysis of data 'since birth', i.e. data on infant feeding for every day, starting from birth until the ages of 2, 4 and 6 months.

    RESULTS:

    A wide discrepancy between the results obtained from the two analyses was found. The difference in the exclusive breastfeeding rate was over 40 percentage points at both 2 and 4 months of age (92% versus 51% at 2 months and 73% versus 30% at 4 months) and 9 percentage points at 6 months (11% versus 1.8%).

    CONCLUSIONS:

    Current status indicators based on a 24-hour period may be inadequate and even misleading for many purposes. We propose that in many studies an indicator called 'exclusive breastfeeding since birth' could be added.

  • 14.
    Abacan, MaryAnn
    et al.
    Univ Philippines Manila, Inst Human Genet, NIH, Manila, Philippines.
    Alsubaie, Lamia
    KASCH, King Abdulaziz Med City, Riyadh, Saudi Arabia.
    Barlow-Stewart, Kristine
    Univ Sydney, Fac Med & Hlth, Northern Clin Sch, Sydney, NSW, Australia.
    Caanen, Beppy
    Maastricht Univ, Dept Clin Genet, Med Ctr, Maastricht, Netherlands.
    Cordier, Christophe
    SYNLAB Genet, Dept Genet, Lausanne, Switzerland.
    Courtney, Eliza
    Natl Canc Ctr, Div Med Oncol, Canc Genet Serv, Singapore, Singapore.
    Davoine, Emeline
    Lausanne Univ Hosp CHUV, Lausanne, Switzerland.
    Edwards, Janice
    Univ South Carolina, Genet Counseling Program, Transnat Alliance Genet Counseling, Columbia, SC USA.
    Elackatt, Niby J.
    Cloudnine Hosp, Org Rare Dis India, Bangalore, Karnataka, India.
    Gardiner, Kate
    LifeLabs Genet, Toronto, ON, Canada.
    Guan, Yue
    Emory Univ, Rollins Sch Publ Hlth, Atlanta, GA USA.
    Huang, Lian-Hua
    China Med Univ, Sch Nursing, Taichung, Taiwan;Natl Taiwan Univ, Coll Med, Sch Nursing, Taipei, Taiwan.
    Ingvoldstad, Charlotta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa. Karolinska Univ Hosp, Ctr Fetal Med & Clin Genet, Stockholm, Sweden;Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden.
    Kejriwal, Sahil
    Univ Washington, Inst Publ Hlth Genet, Seattle, WA USA.
    Kim, Hyon J.
    Ajou Univ, Med Sch, Suwon, South Korea;Konyang Univ, Grad Sch, Suwon, South Korea.
    Lambert, Deborah
    Natl Rare Dis Off, Dublin, Ireland.
    Lantigua-Cruz, Paulina Araceli
    Univ Med Sci Havana, Havana, Cuba.
    Lee, Juliana M. H.
    Natl Univ Malaysia, Kuala Lumpur, Malaysia.
    Lodahl, Marianne
    Copenhagen Univ Hosp, Rigshosp, Dept Clin Genet, Copenhagen, Denmark.
    Lunde, Ashild
    Univ Bergen, Dept Global Publ Hlth & Primary Care, Bergen, Norway.
    Macaulay, Shelley
    Univ Witwatersrand, Fac Hlth Sci, Div Human Genet, Johannesburg, South Africa;Natl Hlth Lab Serv, Johannesburg, South Africa.
    Macciocca, Ivan
    Victorian Clin Genet Serv, Melbourne, Vic, Australia.
    Margarit, Sonia
    Clin Alemana Univ Desarrollo, Fac Med, Ctr Genet & Genom, Santiago, Chile.
    Middleton, Anna
    Soc & Eth Res Connecting Sci, Wellcome Genome Campus, Cambridge, England;Univ Cambridge, Fac Educ, Cambridge, England.
    Moldovan, Ramona
    Babes Bolyai Univ, Dept Psychol, Cluj Napoca, Romania.
    Ngeow, Joanne
    Natl Canc Ctr, Div Med Oncol, Canc Genet Serv, Singapore, Singapore.
    Obregon-Tito, Alexandra J.
    Univ Arkansas Med Sci, Little Rock, AR 72205 USA.
    Ormond, Kelly E.
    Stanford Univ, Sch Med, Dept Genet, Stanford, CA USA;Stanford Univ, Sch Med, Stanford Ctr Biomed Eth, Stanford, CA USA;Stanford Univ, Sch Med, 300 Pasteur Dr,MC 5208, Stanford, CA USA.
    Paneque, Milena
    Univ Porto, CGPP Ctr Predict & Prevent Genet, I3S, Porto, Portugal;Univ Porto, IBMC Inst Mol & Cell Biol, Porto, Portugal.
    Powell, Karen
    Cone Hlth Canc Ctr, Greensboro, NC USA.
    Sanghavi, Kunal
    Jackson Lab Genom Med, Farmington, CT USA.
    Scotcher, Diana
    Manchester Univ Hosp NHS Fdn Trust, St Marys Hosp, Manchester Ctr Genom Med, Manchester, Lancs, England.
    Scott, Jenna
    Univ British Columbia, Vancouver, BC, Canada.
    Juhe, Clara Serra
    Univ Pompeu Fabra, Dept Ciencies Expt & Salut, Inst Hosp Mar Invest Med, Ctr Invest Biomed Red Enfermedades Raras, Barcelona, Spain.
    Shkedi-Rafid, Shiri
    Hadassah Hebrew Univ, Med Ctr, Jerusalem, Israel.
    Wessels, Tina-Marie
    Univ Cape Town, Div Human Genet, Cape Town, South Africa.
    Yoon, Sook-Yee
    Natl Univ Malaysia, Kuala Lumpur, Malaysia;Canc Res, Subang Jaya, Malaysia;Univ Malaya, Med Ctr, Kuala Lumpur, Malaysia.
    Wicklund, Catherine
    Northwestern Univ, Feinberg Sch Med, Chicago, IL 60611 USA.
    The Global State of the Genetic Counseling Profession2019Inngår i: European Journal of Human Genetics, ISSN 1018-4813, E-ISSN 1476-5438, Vol. 27, nr 2, s. 183-197Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    The profession of genetic counseling (also called genetic counselling in many countries) began nearly 50 years ago in the United States, and has grown internationally in the past 30 years. While there have been many papers describing the profession of genetic counseling in individual countries or regions, data remains incomplete and has been published in diverse journals with limited access. As a result of the 2016 Transnational Alliance of Genetic Counseling (TAGC) conference in Barcelona, Spain, and the 2017 World Congress of Genetic Counselling in the UK, we endeavor to describe as fully as possible the global state of genetic counseling as a profession. We estimate that in 2018 there are nearly 7000 genetic counselors with the profession established or developing in no less than 28 countries.

  • 15.
    Abdelmenan, Semira
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Berhane, Hanna Y.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Jirström, Magnus
    Worku, Alemayehu
    Trenholm, Jill
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Berhane, Yemane
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Ekström, Eva-Charlotte
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Availability, affordability and consumption of family food:-the social stratification in Addis Ababa, the EAT Addis Study in EthiopiaManuskript (preprint) (Annet vitenskapelig)
  • 16.
    Abdul Fatah, Naderah
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Oskarsson, Sofia
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Preventivmedelsanvändning bland kvinnor med utvecklingsstörning – en litteraturöversikt2015Independent thesis Advanced level (degree of Master (One Year)), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Sammanfattning

    Individer med utvecklingsstörning har under en stor del av historien betraktats som mindervärdiga eller som icke-mänskliga varelser och har under lång tid förvägrats grundläggande mänskliga rättigheter. Exempelvis hade man i Sverige fram till 1976 ett juridiskt stöd för att tvångssterilisera personer med utvecklingsstörning. Under senare tid har dock inställningen att personer med utvecklingsstörning ska ha samma möjligheter och levnadsomständigheter som andra personer vuxit fram i stora delar av västvärlden. Detta har bland annat lett till en mer personcentrerad vård där personer med utvecklingsstörning fått mer makt att bestämma över sina egna liv. Mot denna bakgrund är syftet med denna litteraturöversikt att ta fram ett kunskapsunderlag för att designa en lättläst broschyr om preventivmedel anpassad för kvinnor med utvecklingsstörning. Metoden som används är en litteraturöversikt där databaserna PubMed, Google Scholar och PsycINFO har genomsökts. Efter granskning och analys valdes 18 artiklar ut att inkluderas i resultatet. Resultatet visade att kvinnor med utvecklingsstörning har begränsad kunskap om preventivmedel och reproduktion. Valet av preventivmedel påverkades av olika faktorer som begränsad kunskap om preventivmedelsanvändning, brist på lättläst informationsmaterial samt läkarens begränsade kunskap och erfarenhet av att ge preventivmedelsrådgivning till kvinnor med utvecklingsstörning. För att ytterligare förbättra situationen för dessa kvinnor behöver ett flertal förändringar ske. Framförallt behöver kvinnor med utvecklingsstörning få en ökad kunskap om sex, samlevnad och preventivmedel. Dessutom behöver kunskapen om dessa kvinnors särskilda behov stärkas bland förskrivande barnmorskor och läkare.

  • 17.
    Abdulcadir, Jasmine
    et al.
    Outpatient Clinic for Women with FGM/C, Department of Obstetric and Gynecology, Geneva University Hospitals.
    Abdulcadir, Omar
    Referral Centre for Preventing and Curing Female Genital Mutilation, Department of Maternal and Child Health, Careggi University Hospital, Florence, Italy.
    Caillet, Martin
    Outpatient Clinic for Women with FGM/C, Department of Obstetric and Gynecology, Geneva University Hospitals.
    Catania, Lucrezia
    Referral Centre for Preventing and Curing Female Genital Mutilation, Department of Maternal and Child Health, Careggi University Hospital, Florence, Italy.
    Cuzin, Béatrice
    Division of Urology and Transplantation, Edouard Herriot Hospital, Lyon, France.
    Essén, Birgitta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH), Internationell kvinno- och mödrahälsovård och migration.
    Foldès, Pierre
    Institute of Reproductive Health, Saint Germain en Laye, Paris, France.
    Johnsdotter, Sara
    Faculty of Health and Society, Malmö University, Malmö, Sweden.
    Johnson-Agbakwu, Crista
    Refugee Women's Health Clinic, Obstetrics & Gynecology, Maricopa Integrated Health System.
    Nour, Nawal
    Global Ob/Gyn and African Women's Health Center, Ambulatory Obstetrics, Office for Multicultural Careers, Division of Global Obstetrics and Gynecology, Brigham and Women's Hospital.
    Ouedraogo, Charlemagne
    University Hospital Yalgado Ouedraogo of Ouagadougou, Ouagadougou, Burkina Faso.
    Warren, Nicole
    Department of Community Public Health Nursing, John Hopkins School of Nursing, Baltimore, MD, USA.
    Wylomanski, Sophie
    Department of Gynecology and Obstetrics, Nantes University Hospital, Nantes, France.
    Clitoral Surgery After Female Genital Mutilation/Cutting2017Inngår i: Aesthetic surgery journal, ISSN 1090-820X, E-ISSN 1527-330X, Vol. 37, nr 9, s. NP113-NP115Artikkel i tidsskrift (Annet vitenskapelig)
  • 18.
    Abdulcadir, Jasmine
    et al.
    Department of Obstetrics and Gynecology, University Hospitals of Geneva, Switzerland.
    Ahmadu, Fuambai Sia
    Catania, Lucrezia
    Essén, Birgitta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Gruenbaum, Ellen
    Johnsdotter, Sara
    Johnson, Michelle C.
    Johnson-Agbakwu, Crista
    Kratz, Corinne
    Sulkin, Carlos Londoño
    McKinley, Michelle
    Njambi, Wairimu
    Rogers, Juliet
    Shell-Duncan, Bettina
    Shweder, Richard A.
    Human Development, University of Chicago, Illinois.
    Seven things to know about female genital surgeries in Africa2012Inngår i: The Hastings center report, ISSN 0093-0334, E-ISSN 1552-146X, Vol. 42, nr 6, s. 19-27Artikkel i tidsskrift (Fagfellevurdert)
  • 19.
    Abeid, Muzdalifat
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa. Muhimbili University of Health and Allied Sciences, Tanzania.
    Improving Health-seeking Behavior and Care among Sexual Violence Survivors in Rural Tanzania2015Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    The aim of this thesis was to assess the effects of providing community education and training to healthcare workers to improve community response, healthcare and support for rape survivors in the Kilombero district of Tanzania. The overall design of the project was to begin with an exploratory study (Paper I) to establish the community’s perceptions towards sexual violence and their perceived recommendations to address this issue. Using a structured questionnaire, the community’s knowledge and attitudes towards sexual violence were determined along with their associations with demographic factors (Paper II). Papers III and IV assessed the effect of healthcare workers’ training and a community information package, respectively, using a controlled quasi-experimental design. The findings highlighted the social norms and variety of barriers that impacted negatively on the survivors’ care-seeking from support services and health outcomes. Increasing age and higher education were associated with better knowledge and less accepting attitudes towards sexual violence. Training on the management of sexual violence was effective in improving healthcare workers’ knowledge and practice but not attitude. Knowledge on sexual violence among the communities in the intervention and comparison areas increased significantly over the study period; from 57.3% to 80.6% in the intervention area and from 55.5% to 71.9% in the comparison area. In the intervention area, women had significantly less knowledge than men at baseline (53% Vs 64%, p<.001).There was a reduction, though not significantly, in acceptance attitudes from 28.1% to 21.8% in favor of women. In conclusion, the current intervention provides evidence that healthcare workers’ training and community education is effective in improving knowledge but not attitudes towards sexual violence. The findings have potential implications for interventions aimed at preventing and responding to violence. The broader societal norms that hinder rape disclosure need to be re-addressed.

    Delarbeid
    1. Community perceptions of rape and child sexual abuse: a qualitative study in rural Tanzania
    Åpne denne publikasjonen i ny fane eller vindu >>Community perceptions of rape and child sexual abuse: a qualitative study in rural Tanzania
    Vise andre…
    2014 (engelsk)Inngår i: BMC International Health and Human Rights, ISSN 1472-698X, E-ISSN 1472-698X, Vol. 14, s. 23-Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Background: Rape of women and children is recognized as a health and human rights issue in Tanzania and internationally. Exploration of the prevailing perceptions in rural areas is needed in order to expand the understanding of sexual violence in the diversity of Tanzania's contexts. The aim of this study therefore was to explore and understand perceptions of rape of women and children at the community level in a rural district in Tanzania with the added objective of exploring those perceptions that may contribute to perpetuating and/or hindering the disclosure of rape incidences. Methods: A qualitative design was employed using focus group discussions with male and female community members including religious leaders, professionals, and other community members. The discussions centered on causes of rape, survivors of rape, help-seeking and reporting, and gathered suggestions on measures for improvement. Six focus group discussions (four of single gender and two of mixed gender) were conducted. The focus group discussions were recorded, transcribed verbatim, and analyzed using manifest qualitative content analysis. Results: The participants perceived rape of women and children to be a frequent and hidden phenomenon. A number of factors were singled out as contributing to rape, such as erosion of social norms, globalization, poverty, vulnerability of children, alcohol/drug abuse and poor parental care. Participants perceived the need for educating the community to raise their knowledge of sexual violence and its consequences, and their roles as preventive agents. Conclusions: In this rural context, social norms reinforce sexual violence against women and children, and hinder them from seeking help from support services. Addressing the identified challenges may promote help-seeking behavior and improve care of survivors of sexual violence, while changes in social and cultural norms are needed for the prevention of sexual violence.

    Emneord
    Child sexual abuse, Community perceptions, Focus group discussions, Rape, Rural, Sexual violence, Tanzania
    HSV kategori
    Identifikatorer
    urn:nbn:se:uu:diva-232600 (URN)10.1186/1472-698X-14-23 (DOI)000340801600001 ()
    Tilgjengelig fra: 2014-09-23 Laget: 2014-09-22 Sist oppdatert: 2018-01-11bibliografisk kontrollert
    2. Knowledge and attitude towards rape and child sexual abuse - a community-based cross-sectional study in Rural Tanzania
    Åpne denne publikasjonen i ny fane eller vindu >>Knowledge and attitude towards rape and child sexual abuse - a community-based cross-sectional study in Rural Tanzania
    Vise andre…
    2015 (engelsk)Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 15, nr 1, artikkel-id 428Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    BACKGROUND: Violence against women and children is globally recognized as a social and human rights concern. In Tanzania, sexual violence towards women and children is a public health problem. The aim of this study was to determine community knowledge of and attitudes towards rape and child sexual abuse, and assess associations between knowledge and attitudes and socio-demographic characteristics.

    METHODS: A cross-sectional study was undertaken between May and June 2012. The study was conducted in the Kilombero and Ulanga rural districts in the Morogoro Region of Tanzania. Men and women aged 18-49 years were eligible for the study. Through a three-stage cluster sampling strategy, a household survey was conducted using a structured questionnaire. The questionnaire included socio-demographic characteristics, attitudes about gender roles and violence, and knowledge on health consequences of rape. Data were analyzed using the Statistical Package for Social Sciences (SPSS) software, version 21. Main outcome measures were knowledge of and attitudes towards sexual violence. Multivariate analyses were used to assess associations between socio-demographic characteristics and knowledge of and attitudes towards sexual violence.

    RESULTS: A total of 1,568 participants were interviewed. The majority (58.4%) of participants were women. Most (58.3%) of the women respondents had poor knowledge on sexual violence and 63.8% had accepting attitudes towards sexual violence. Those who were married were significantly more likely to have good knowledge on sexual violence compared to the divorced/separated group (AOR = 1.6 (95% CI: 1.1-2.2)) but less likely to have non-accepting attitudes towards sexual violence compared to the single group (AOR = 1.8 (95%CI: 1.4-2.3)). Sex of respondents, age, marital status and level of education were associated with knowledge and attitudes towards sexual violence.

    CONCLUSIONS: Our study showed that these rural communities have poor knowledge on sexual violence and have accepting attitudes towards sexual violence. Increasing age and higher education were associated with better knowledge and less accepting attitudes towards sexual violence. The findings have potentially important implications for interventions aimed at preventing violence. The results highlight the challenges associated with changing attitudes towards sexual violence, particularly as the highest levels of support for such violence were found among women.

    HSV kategori
    Identifikatorer
    urn:nbn:se:uu:diva-253212 (URN)10.1186/s12889-015-1757-7 (DOI)000353941200001 ()25927715 (PubMedID)
    Tilgjengelig fra: 2015-05-25 Laget: 2015-05-25 Sist oppdatert: 2017-12-04bibliografisk kontrollert
    3. Evaluation of a training program for health care workers to improve the quality of care for rape survivors: a quasi-experimental design study in Morogoro, Tanzania
    Åpne denne publikasjonen i ny fane eller vindu >>Evaluation of a training program for health care workers to improve the quality of care for rape survivors: a quasi-experimental design study in Morogoro, Tanzania
    Vise andre…
    2016 (engelsk)Inngår i: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 9, artikkel-id 31735Artikkel, forskningsoversikt (Fagfellevurdert) Published
    Abstract [en]

    BACKGROUND:

    Sexual violence against women and children in Tanzania and globally is a human rights violation and a developmental challenge.

    OBJECTIVE:

    The aim of this study was to assess the impact of training health professionals on rape management. The specific objectives were to evaluate the changes of knowledge and attitudes toward sexual violence among a selected population of health professionals at primary health care level.

    DESIGN:

    A quasi-experimental design using cross-sectional surveys was conducted to evaluate health care workers' knowledge, attitude, and clinical practice toward sexual violence before and after the training program. The study involved the Kilombero (intervention) and Ulanga (comparison) districts in Morogoro region. A total of 151 health professionals at baseline (2012) and 169 in the final assessment (2014) participated in the survey. Data were collected using the same structured questionnaire. The amount of change in key indicators from baseline to final assessment in the two areas was compared using composite scores in the pre- and post-interventions, and the net intervention effect was calculated by the difference in difference method.

    RESULTS:

    Overall, there was improved knowledge in the intervention district from 55% at baseline to 86% and a decreased knowledge from 58.5 to 36.2% in the comparison area with a net effect of 53.7% and a p-value less than 0.0001. The proportion of participants who exhibited an accepting attitude toward violence declined from 15.3 to 11.2% in the intervention area but increased from 13.2 to 20.0% in the comparison area.

    CONCLUSIONS:

    Training on the management of sexual violence is feasible and the results indicate improvement in healthcare workers' knowledge and practice but not attitudes. Lessons learned from this study for successful replication of such an intervention in similar settings require commitment from those at strategic level within the health service to ensure that adequate resources are made available.

    Emneord
    healthcare worker, training, quasi-experimental, rape, sexual violence, Tanzania
    HSV kategori
    Forskningsprogram
    Obstetrik och gynekologi
    Identifikatorer
    urn:nbn:se:uu:diva-261889 (URN)10.3402/gha.v9.31735 (DOI)000381095700001 ()27435570 (PubMedID)
    Forskningsfinansiär
    Sida - Swedish International Development Cooperation Agency
    Tilgjengelig fra: 2015-09-05 Laget: 2015-09-04 Sist oppdatert: 2017-12-04bibliografisk kontrollert
    4. A community-based intervention for improving health-seeking behavior among sexual violence survivors: A controlled before and after design study in rural Tanzania
    Åpne denne publikasjonen i ny fane eller vindu >>A community-based intervention for improving health-seeking behavior among sexual violence survivors: A controlled before and after design study in rural Tanzania
    Vise andre…
    2015 (engelsk)Inngår i: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 8, artikkel-id 28608Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Background: Despite global recognition that sexual violence is a violation of human rights, evidence still shows it is a pervasive problem across all societies. Promising community intervention studies in the low- and middle-income countries are limited.

    Objective: This study assessed the impact of a community-based intervention, focusing on improving the community’s knowledge and reducing social acceptability of violence against women norms with the goal to prevent and respond to sexual violence.

    Design: The strategies used to create awareness included radio programs, information, education communication materials and advocacy meetings with local leaders. The intervention took place in Morogoro region in Tanzania. The evaluation used a quasi-experimental design including cross-sectional surveys at baseline (2012) and endline (2014) with men and women aged 18-49. Main outcome measures were number of reported rape cases at health facilities and the community’s knowledge and attitudes towards sexual violence.

    Results: The number of reported rape events increased by more than 50% at health facilities during the intervention. Knowledge on sexual violence increased significantly in both areas over the study period (from 57.3% to 80.6% in the intervention area and from 55.5% to 71.9% in the comparison area; p<.001), and the net effect of the intervention between the two areas was statistically significant (6.9, 95% CI 0.2–13.5, p= 0.03). There was significant improvement in most of attitude indicators in the intervention area, but not in the comparison area. However, the intervention had no significant effect in the overall scores of acceptance attitudes in the final assessment when comparing the two areas (-2.4, 95%CI: -8.4 – 3.6, p= 0.42).

    Conclusions: The intervention had an effect on some indicators on knowledge and attitudes towards sexual violence even after a short period of intervention. This finding informs the public health practitioners of the importance of combined strategies in achieving changes.

    Emneord
    sexual violence, evaluation, community intervention, Tanzania
    HSV kategori
    Forskningsprogram
    Obstetrik och gynekologi
    Identifikatorer
    urn:nbn:se:uu:diva-261900 (URN)10.3402/gha.v8.28608 (DOI)000361749600001 ()
    Forskningsfinansiär
    Sida - Swedish International Development Cooperation Agency
    Tilgjengelig fra: 2015-09-05 Laget: 2015-09-05 Sist oppdatert: 2017-12-04bibliografisk kontrollert
  • 20.
    Abeid, Muzdalifat
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH). Department of Obstetrics/Gynecology, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania .
    Muganyizi, Projestine
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH). Department of Obstetrics/Gynecology, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania .
    Massawe, Siriel
    Department of Obstetrics/Gynecology, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania.
    Mpembeni, Rose
    Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania.
    Darj, Elisabeth
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Axemo, Pia
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH). Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway .
    Knowledge and attitude towards rape and child sexual abuse - a community-based cross-sectional study in Rural Tanzania2015Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 15, nr 1, artikkel-id 428Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Violence against women and children is globally recognized as a social and human rights concern. In Tanzania, sexual violence towards women and children is a public health problem. The aim of this study was to determine community knowledge of and attitudes towards rape and child sexual abuse, and assess associations between knowledge and attitudes and socio-demographic characteristics.

    METHODS: A cross-sectional study was undertaken between May and June 2012. The study was conducted in the Kilombero and Ulanga rural districts in the Morogoro Region of Tanzania. Men and women aged 18-49 years were eligible for the study. Through a three-stage cluster sampling strategy, a household survey was conducted using a structured questionnaire. The questionnaire included socio-demographic characteristics, attitudes about gender roles and violence, and knowledge on health consequences of rape. Data were analyzed using the Statistical Package for Social Sciences (SPSS) software, version 21. Main outcome measures were knowledge of and attitudes towards sexual violence. Multivariate analyses were used to assess associations between socio-demographic characteristics and knowledge of and attitudes towards sexual violence.

    RESULTS: A total of 1,568 participants were interviewed. The majority (58.4%) of participants were women. Most (58.3%) of the women respondents had poor knowledge on sexual violence and 63.8% had accepting attitudes towards sexual violence. Those who were married were significantly more likely to have good knowledge on sexual violence compared to the divorced/separated group (AOR = 1.6 (95% CI: 1.1-2.2)) but less likely to have non-accepting attitudes towards sexual violence compared to the single group (AOR = 1.8 (95%CI: 1.4-2.3)). Sex of respondents, age, marital status and level of education were associated with knowledge and attitudes towards sexual violence.

    CONCLUSIONS: Our study showed that these rural communities have poor knowledge on sexual violence and have accepting attitudes towards sexual violence. Increasing age and higher education were associated with better knowledge and less accepting attitudes towards sexual violence. The findings have potentially important implications for interventions aimed at preventing violence. The results highlight the challenges associated with changing attitudes towards sexual violence, particularly as the highest levels of support for such violence were found among women.

  • 21.
    Abeid, Muzdalifat
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH). Muhimbili University of Health and Allied Sciences, Tanzania.
    Muganyizi, Projestine
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH). Muhimbili University of Health and Allied Sciences, Tanzania.
    Mpembeni, Rose
    Muhimbili University of Health and Allied Sciences, Tanzania.
    Darj, Elisabeth
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH). Norwegian University of Science and Technology, Trondheim, Norway.
    Axemo, Pia
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    A community-based intervention for improving health-seeking behavior among sexual violence survivors: A controlled before and after design study in rural Tanzania2015Inngår i: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 8, artikkel-id 28608Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Despite global recognition that sexual violence is a violation of human rights, evidence still shows it is a pervasive problem across all societies. Promising community intervention studies in the low- and middle-income countries are limited.

    Objective: This study assessed the impact of a community-based intervention, focusing on improving the community’s knowledge and reducing social acceptability of violence against women norms with the goal to prevent and respond to sexual violence.

    Design: The strategies used to create awareness included radio programs, information, education communication materials and advocacy meetings with local leaders. The intervention took place in Morogoro region in Tanzania. The evaluation used a quasi-experimental design including cross-sectional surveys at baseline (2012) and endline (2014) with men and women aged 18-49. Main outcome measures were number of reported rape cases at health facilities and the community’s knowledge and attitudes towards sexual violence.

    Results: The number of reported rape events increased by more than 50% at health facilities during the intervention. Knowledge on sexual violence increased significantly in both areas over the study period (from 57.3% to 80.6% in the intervention area and from 55.5% to 71.9% in the comparison area; p<.001), and the net effect of the intervention between the two areas was statistically significant (6.9, 95% CI 0.2–13.5, p= 0.03). There was significant improvement in most of attitude indicators in the intervention area, but not in the comparison area. However, the intervention had no significant effect in the overall scores of acceptance attitudes in the final assessment when comparing the two areas (-2.4, 95%CI: -8.4 – 3.6, p= 0.42).

    Conclusions: The intervention had an effect on some indicators on knowledge and attitudes towards sexual violence even after a short period of intervention. This finding informs the public health practitioners of the importance of combined strategies in achieving changes.

  • 22.
    Abeid, Muzdalifat
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH). MUHAS, Dept Obstet Gynecol, Dar Es Salaam, Tanzania.
    Muganyizi, Projestine
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH). MUHAS, Dept Obstet Gynecol, Dar Es Salaam, Tanzania.
    Mpembeni, Rose
    MUHAS, Dept Epidemiol & Biostat, Dar Es Salaam, Tanzania.
    Darj, Elisabeth
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH). Norwegian Univ Sci & Technol, Dept Publ Hlth & Gen Practice, Trondheim, Norway.
    Axemo, Pia
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Evaluation of a training program for health care workers to improve the quality of care for rape survivors: a quasi-experimental design study in Morogoro, Tanzania2016Inngår i: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 9, artikkel-id 31735Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    BACKGROUND:

    Sexual violence against women and children in Tanzania and globally is a human rights violation and a developmental challenge.

    OBJECTIVE:

    The aim of this study was to assess the impact of training health professionals on rape management. The specific objectives were to evaluate the changes of knowledge and attitudes toward sexual violence among a selected population of health professionals at primary health care level.

    DESIGN:

    A quasi-experimental design using cross-sectional surveys was conducted to evaluate health care workers' knowledge, attitude, and clinical practice toward sexual violence before and after the training program. The study involved the Kilombero (intervention) and Ulanga (comparison) districts in Morogoro region. A total of 151 health professionals at baseline (2012) and 169 in the final assessment (2014) participated in the survey. Data were collected using the same structured questionnaire. The amount of change in key indicators from baseline to final assessment in the two areas was compared using composite scores in the pre- and post-interventions, and the net intervention effect was calculated by the difference in difference method.

    RESULTS:

    Overall, there was improved knowledge in the intervention district from 55% at baseline to 86% and a decreased knowledge from 58.5 to 36.2% in the comparison area with a net effect of 53.7% and a p-value less than 0.0001. The proportion of participants who exhibited an accepting attitude toward violence declined from 15.3 to 11.2% in the intervention area but increased from 13.2 to 20.0% in the comparison area.

    CONCLUSIONS:

    Training on the management of sexual violence is feasible and the results indicate improvement in healthcare workers' knowledge and practice but not attitudes. Lessons learned from this study for successful replication of such an intervention in similar settings require commitment from those at strategic level within the health service to ensure that adequate resources are made available.

  • 23.
    Abeid, Muzdalifat
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Muganyizi, Projestine
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Olsson, Pia
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Darj, Elisabeth
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Axemo, Pia
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Community perceptions of rape and child sexual abuse: a qualitative study in rural Tanzania2014Inngår i: BMC International Health and Human Rights, ISSN 1472-698X, E-ISSN 1472-698X, Vol. 14, s. 23-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Rape of women and children is recognized as a health and human rights issue in Tanzania and internationally. Exploration of the prevailing perceptions in rural areas is needed in order to expand the understanding of sexual violence in the diversity of Tanzania's contexts. The aim of this study therefore was to explore and understand perceptions of rape of women and children at the community level in a rural district in Tanzania with the added objective of exploring those perceptions that may contribute to perpetuating and/or hindering the disclosure of rape incidences. Methods: A qualitative design was employed using focus group discussions with male and female community members including religious leaders, professionals, and other community members. The discussions centered on causes of rape, survivors of rape, help-seeking and reporting, and gathered suggestions on measures for improvement. Six focus group discussions (four of single gender and two of mixed gender) were conducted. The focus group discussions were recorded, transcribed verbatim, and analyzed using manifest qualitative content analysis. Results: The participants perceived rape of women and children to be a frequent and hidden phenomenon. A number of factors were singled out as contributing to rape, such as erosion of social norms, globalization, poverty, vulnerability of children, alcohol/drug abuse and poor parental care. Participants perceived the need for educating the community to raise their knowledge of sexual violence and its consequences, and their roles as preventive agents. Conclusions: In this rural context, social norms reinforce sexual violence against women and children, and hinder them from seeking help from support services. Addressing the identified challenges may promote help-seeking behavior and improve care of survivors of sexual violence, while changes in social and cultural norms are needed for the prevention of sexual violence.

  • 24.
    Abrahamsson, Jonas
    et al.
    Queen Silvia Children’s Hospital, Gothenburg.
    Forestier, Erik
    Heldrup, Jesper
    Jahnukainen, Kirsi
    Jónsson, Olafur G.
    Lausen, Birgitte
    Palle, Josefine
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Zeller, Bernward
    Hasle, Henrik
    Aarhus University Hospital Skejby, Aarhus.
    Response-Guided Induction Therapy in Pediatric Acute Myeloid Leukemia With Excellent Remission Rate2011Inngår i: Journal of Clinical Oncology, ISSN 0732-183X, E-ISSN 1527-7755, Vol. 29, nr 3, s. 310-315Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose

    To evaluate the early treatment response in children with acute myeloid leukemia (AML) using a response-guided induction strategy that includes idarubicin in the first course.

    Patients and Methods

    All Nordic children with AML younger than 15 years (n = 151) were treated on the Nordic Society for Pediatric Hematology and Oncology (NOPHO) AML 2004 protocol. After the first course of idarubicin, cytarabine, etoposide, and 6-thioguanin, patients with good response were allowed hematologic recovery before the second course, whereas patients with a poor (>= 15% blasts) or intermediate (5% to 14.9% blasts) were recommended to proceed immediately with therapy. Patients not in remission after the second course received fludarabine, cytarabine, and granulocyte colony-stimulating factor. Poor responders received allogeneic stem-cell transplantation (SCT) as consolidation.

    Results

    Seventy-four percent of patients had good response, 17% had intermediate response, and 7% had poor response after the first course. The overall remission frequency was 97.4%, with 92% in remission after the second course. The rate of induction death was 1.3%. Patients with an intermediate response had a lower event-free survival of 35% compared with good (61%) and poor responders (82%).

    Conclusion

    The NOPHO-AML 2004 induction strategy gives an excellent remission rate with low toxic mortality in an unselected population. Outcome is worse in patients with intermediate response but may be improved by intensifying consolidation in this group using SCT.

  • 25.
    Abrahamsson, Niclas
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Ahlund, Lovisa
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Ahrin, Elsa
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Alfonsson, Sven
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Klinisk psykologi i hälso- och sjukvård.
    Video-based CBT-E improves eating patterns in obese patients with eating disorder: A single case multiple baseline study2018Inngår i: Journal of Behavior Therapy and Experimental Psychiatry, ISSN 0005-7916, E-ISSN 1873-7943, Vol. 61, s. 104-112Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND AND OBJECTIVES:

    Cognitive Behavioral Therapy (CBT) is effective for treating eating disorders but it may be difficult to reach patients living far from urban centers. Mobile video-based psychotherapy may potentially improve service reach but has not yet been evaluated. The purpose of this study was to investigate the effects of mobile video-based CBT for eating disorder and to explore the feasibility to use this technology in clinical care.

    METHODS:

    A controlled single case multiple baseline design was used which allowed for statistical analyses with randomization tests and non-overlap of all pairs (NAP). Five patients in the first stage of eating disorder treatment were included and the main outcome variable was daily meal frequency. Secondary outcome variables included eating disorder symptoms, psychological distress and treatment satisfaction.

    RESULTS:

    The treatment resulted in a significant (p < .01) increase in daily meal frequency with medium to large effect sizes (combined NAP = .89). Four participants reported reliable improvements in eating disorder symptoms and three reported improvements in mood. The participants reported high satisfaction with the treatment and with the mobile video-application despite some technical problems.

    LIMITATIONS:

    Self-reported data on eating behavior is prone to be biased and the results of single case studies may have limited generalizability.

    CONCLUSION:

    CBT can be delivered effectively via a mobile video application and, despite some technological issues, can be well received by patients. All participants in this study had previous low access to mental health services and reported high satisfaction with the treatment format.

  • 26. Abrams, P
    et al.
    Cardozo, L
    Fall, M
    Griffiths, D
    Rosier, P
    Ulmsten, U
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Van Kerrebroeck, P
    Victor, A
    Wein, A
    The standardisation of terminology in lower urinary tract function: reportfrom the standardisation sub-committee of the International ContinenceSociety.2003Inngår i: Urology, Vol. 61, s. 37-Artikkel i tidsskrift (Fagfellevurdert)
  • 27. Abrams, P
    et al.
    Cardozo, L
    Fall, M
    Griffiths, D
    Rosier, P
    Ulmsten, U
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    van Kerrebroeck, P
    Victor, A
    Wein, A
    The standardisation of terminology of lower urinary tract function: Report from the standardistation sub-committee of the International Continence Society.2002Inngår i: Neurourology and Urodynamics, Vol. 21, s. 167-Artikkel i tidsskrift (Fagfellevurdert)
  • 28.
    Abuelgasim, Khalda
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
     “Who do I turn to?” The experiences of Sudanese women and Eritrean refugee women when trying to access healthcare services in Sudan after being subject to gender-based violence2018Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
    Abstract [en]

    Aim: To explore the experiences of Sudanese women and Eritrean refugee women in Sudan when seeking healthcare after being subject to gender-based violence.

    Background: In Sudan there is a general assumption that anyone who is subject violence, including gender-based violence, must first go to the police department to file a report and be given “Form Eight”, a legal document, which they must present to the healthcare provider before they receive any care. Without this form healthcare providers are, supposedly, by law not allowed to treat the person. This complicates an already vague system of services for women subject to gender-based violence.

    Methods: A qualitative study using semi-structured interviews of eight Sudanese women and seven Eritrean refugee women. Data was analyzed through a framework analysis (a form of thematic analysis).

    Results: Women had to bring Form Eight before they received any help, this led to a delay in the time to receive care. There was a general lack of cooperation by police officers. Some women feared the consequences of help seeking, apparent amongst those subject to domestic violence and the Eritrean refugee women. Generally, the healthcare provided to these women was inadequate.

    Conclusion: This study concludes the experiences of all the women in this study when seeking healthcare after being subject to gender-based violence were far from international standards. A lot needs to be done in order for women to know the clear answer to the question posed in the title of this study; “Who do I turn to?”.

  • 29.
    Abujrais, Sandy
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk kemi.
    Olovsson, Matts
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Reproduktionsbiologi.
    Ahnoff, Martin
    Department of Marine Sciences, University of Gothenburg, Carl Skottbergs gata 22B, SE-41319 Gothenburg, Sweden..
    Rasmusson, Annica
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk farmakogenomik och osteoporos.
    Larsson, Anders
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk kemi.
    Åkerfeldt, Torbjörn
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk kemi.
    Kultima, Kim
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk kemi.
    A sensitive method detecting trace levels of levonorgestrel using LC-HRMS.2019Inngår i: Contraception, ISSN 0010-7824, E-ISSN 1879-0518, Vol. 100, nr 3, s. 247-249Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To develop a high resolution mass spectrometry (HRMS) method to quantify levonorgestrel (LNG) in serum.

    STUDY DESIGN: Levonorgestrel was extracted using solid phase extraction and measured using liquid chromatography (LC) HRMS.

    RESULTS: Low limit of quantification (LLOQ) was 25pg/mL and low limit of detection (LLOD) was 12.5pg/mL. Precision and accuracy bias were<10%. LNG in serum samples from Mirena® users ranged between 37 to 219pg/mL (n=12). In eight out of 22 patients with suspected intrauterine device (IUD) expulsion LNG was detected (26 to 1272pg/mL).

    CONCLUSION: A sensitive, fast and simple LC-HRMS method was developed to detect trace levels of LNG.

  • 30.
    Adams, Emma A.
    et al.
    Norwegian Univ Sci & Technol, NTNU, Dept Publ Hlth & Nursing, NO-7491 Trondheim, Norway;Ontario Shores Ctr Mental Hlth Sci, Strateg Initiat, Whitby, ON, Canada.
    Darj, Elisabeth
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH). Norwegian Univ Sci & Technol, NTNU, Dept Publ Hlth & Nursing, NO-7491 Trondheim, Norway;St Olavs Univ Hosp, Dept Obstet & Gynecol, Trondheim, Norway.
    Wijewardene, Kumudu
    Univ Sri Jayewardenepura, Fac Med Sci, Dept Community Med Hlth, Nugegoda, Sri Lanka.
    Infanti, Jennifer J.
    Norwegian Univ Sci & Technol, NTNU, Dept Publ Hlth & Nursing, NO-7491 Trondheim, Norway.
    Perceptions on the sexual harassment of female nurses in a state hospital in Sri Lanka: a qualitative study2019Inngår i: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 12, nr 1, artikkel-id 1560587Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background:

    Sexual harassment occurs within the nursing profession globally, challenging the health and safety of nurses and the quality and efficiency of health systems. In Sri Lanka, no studies have explored this issue in the health sector; however, female employees face sexual harassment in other workplace settings.

    Objective:

    To explore female nurses' perceptions of workplace sexual harassment in a large state hospital in Sri Lanka.

    Methods:

    This is a qualitative study conducted in an urban, mainly Buddhist and Singhalese context. We invited all female senior and ward nurses working in the hospital to participate in the study. We conducted individual in-depth interviews with four senior nurses and focus group discussions with 29 nurses in three groups.

    Results:

    The nurses described a variety of perceived forms of sexual harassment in the hospital. They discussed patient-perpetrated incidents as the most threatening and the clearest to identify compared with incidents involving doctors and other co-workers. There was significant ambiguity regarding sexual consent and coercion in relationships between female nurses and male doctors, which were described as holding potential for exploitation or harassment. The nurses reported that typical reactions to sexual harassment were passive. Alternatively, they described encountering inaction or victim blaming when they attempted to formally report incidents. They perceived that workplace sexual harassment has contributed to negative societal attitudes about the nursing profession and discussed various informal strategies, such as working in teams, to protect themselves from sexual harassment in the hospital.

    Conclusions:

    Sexual harassment was a perceived workplace concern for nurses in this hospital. To develop effective local prevention and intervention responses, further research is required to determine the magnitude of the problem and explore differences in responses to and consequences of sexual harassment based on perpetrator type and intent, and personal vulnerabilities of the victims, among other factors.

  • 31.
    Adel, Rabie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Challenges facing Pro-life and Pro-choice organisations within Warsaw, Poland2015Independent thesis Advanced level (degree of Master (Two Years)), 180 hpOppgave
  • 32.
    Adelholt, Denise
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    The Effects of Cell Culture Medium and Supplements on the Differentiation of Boundary Cap Neural Crest Stem Cells2016Independent thesis Basic level (professional degree), 10 poäng / 15 hpOppgave
    Abstract [en]

    Boundary cap neural crest stem cells (bNCSCs) are multipotent cells that form a barrier between CNS and PNS, playing an important role in ingrowth of neurites into the spinal cord during development. Because of the stemness and multipotency of bNCSCs, they self-renew and can be used directly for transplantation or as a source of matured neural cells. It is important that cells used for cell therapy differentiate and develop into the mature cells that the recipient needs. To ensure this, cells are guided towards specific cell fates, and one way of doing this is with medium supplements. The purpose of this study was to analyze the effects of three different media with supplements on the differentiation of bNCSCs. Two cell lineages of bNCSCs expressing green- and red fluorescent protein were treated with different media for differentiation. The effects of the media supplements neurotrophic glial cell line-derived neurotrophic factor (GDNF), cilinary neurotrophic factor (CTNF) and fetal bovine serum (FBS) were compared, with one medium containing no additional factors. It was found that when GDNF and CTNF are supplemented in the differentiation media, bNCSCs are guided towards astrocytes. Interestingly, the medium containing no additional factors gave rise to an even amount of neurons and astrocytes. FBS had an inhibitory effect on overall differentiation of bNCSCs, giving rise to the smallest amount of neurons and astrocytes. The bNCSCs are promising for cell therapy, as their differentiation can be guided with the use of medium supplements.

  • 33. Adeniran, Abosede
    et al.
    Likaka, Andrew
    Knutsson, Anneka
    Costello, Anthony
    Daelmans, Bernadette
    Maliqi, Blerta
    Burssa, Daniel
    Freer, Joseph
    Askew, Ian
    Bowen, Lisa
    Kak, Lily
    McDougall, Lori
    Zaka, Nabila
    Tunçalp, Özge
    Tenhoope-Bender, Petra
    Syed, Shamsuzzoha Babar
    Swartling Peterson, Stefan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH), Internationell barnhälsa och nutrition.
    Luchesi, Thiago
    Zeck, Willibald
    Were, Wilson
    Barker, Pierre
    Naimy, Zainab
    Leadership, action, learning and accountability to deliver quality care for women, newborns and children.2018Inngår i: Bulletin of the World Health Organization, ISSN 0042-9686, E-ISSN 1564-0604, Vol. 96, nr 3, s. 222-224Artikkel i tidsskrift (Fagfellevurdert)
  • 34.
    Adolphson, Katja
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Axemo, Pia
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Högberg, Ulf
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Midwives' experiences of working conditions, perceptions of professional role and attitudes towards mothers in Mozambique2016Inngår i: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 40, s. 95-101Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: low- and middle-income countries still have a long way to go to reach the fifth Millennium Development Goal of reducing maternal mortality. Mozambique has accomplished a reduction of maternal mortality since the 1990s, but still has among the highest in the world. A key strategy in reducing maternal mortality is to invest in midwifery. AIM: the objective was to explore midwives' perspectives of their working conditions, their professional role, and perceptions of attitudes towards mothers in a low-resource setting. SETTING: midwives in urban, suburban, village and remote areas; working in central, general and rural hospitals as well as health centres and health posts were interviewed in Maputo City, Maputo Province and Gaza Province in Mozambique. METHOD: the study had a qualitative research design. Nine semi-structured interviews and one follow-up interview were conducted and analysed with qualitative content analysis. RESULTS: two main themes were found; commitment/devotion and lack of resources. All informants described empathic care-giving, with deep engagement with the mothers and highly valued working in teams. Lack of resources prevented the midwives from providing care and created frustration and feelings of insufficiency. CONCLUSIONS: the midwives perceptions were that they tried to provide empathic, responsive care on their own within a weak health system which created many difficulties. The great potential the midwives possess of providing quality care must be valued and nurtured for their competency to be used more effectively.

  • 35. af Sandeberg, Margareta
    et al.
    Wettergren, Lena
    Bjork, Olle
    Arvidson, Johan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Johansson, Eva
    Does school attendance during initial cancer treatment in childhood increase the risk of infection?2013Inngår i: Pediatric Blood & Cancer, ISSN 1545-5009, E-ISSN 1545-5017, Vol. 60, nr 8, s. 1307-1312Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background The present study aimed to investigate the relationship between school attendance and infection requiring antimicrobial treatment in children undergoing treatment for cancer. Procedure A national cohort of children aged 7-16 years undergoing cancer treatment was assessed during two observation periods of 19 days each, 1 month (n=89) and 2.5 months (n=89) poststart of treatment. Children free from infection at start of each observation period were included. Multivariable logistic regression analyses were performed including factors potentially associated with start of antimicrobial treatment. Results Twenty-seven (30%) children started antimicrobial treatment during the first observation period. Factors associated with an increased risk of starting antimicrobial treatment were diagnosed with sarcoma (OR=24.37, P=0.002) or non-Hodgkin lymphoma (OR=17.57, P=0.025), having neutropenia (OR=5.92, P=0.020) and age less than 13 years (OR=8.54, P=0.014). During the second observation period, when 20 (22%) children started antimicrobial treatment, the probability of starting treatment was increased in children with neutropenia (OR=4.25, P=0.007). There was no statistically significant association between starting treatment for infection and school attendance. Conclusions In this study, children attending school while undergoing cancer treatment did not run a higher risk of starting antimicrobial treatment than children absent from school. However, there is a need for further studies evaluating risk of infections in children with ongoing cancer treatment. 

  • 36. Af Sandeberg, Margareta
    et al.
    Wettergren, Lena
    Bjork, Olle
    Arvidson, Johan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Johansson, Eva
    Is school attendance during initial childhood cancer treatment associated with infection?2012Inngår i: Pediatric Blood & Cancer, ISSN 1545-5009, E-ISSN 1545-5017, Vol. 59, nr 6, s. 1112-1112Artikkel i tidsskrift (Annet vitenskapelig)
  • 37. Aghajanova, L.
    et al.
    Altmae, S.
    Stavreus-Evers, Anneli
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Giudice, L. C.
    Stanniocalcin-1 in Human Endometrium2015Inngår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 103, nr 2, s. E6-E7Artikkel i tidsskrift (Annet vitenskapelig)
  • 38.
    Aghajanova, Lusine
    et al.
    Univ Calif San Francisco, Dept Obstet Gynecol & Reprod Sci, 550 16th St,7th Floor,Box 0132, San Francisco, CA 94158 USA..
    Altmae, Signe
    Competence Ctr Hlth Technol, Tartu, Estonia.;Univ Granada, Sch Med, Dept Pediat, Granada, Spain..
    Kasvandik, Sergo
    Competence Ctr Hlth Technol, Tartu, Estonia.;Univ Tartu, Inst Technol, Prote Core Facil, Tartu, Estonia.;Univ Tartu, Womens Clin, Tartu, Estonia..
    Salumets, Andres
    Competence Ctr Hlth Technol, Tartu, Estonia.;Univ Tartu, Womens Clin, Tartu, Estonia..
    Stavreus-Evers, Anneli
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Giudice, Linda C.
    Univ Calif San Francisco, Dept Obstet Gynecol & Reprod Sci, 550 16th St,7th Floor,Box 0132, San Francisco, CA 94158 USA..
    Stanniocalcin-1 expression in normal human endometrium and dysregulation in endometriosis2016Inngår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 106, nr 3, s. 681-691Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To determine expression of stanniocalcin-1 (STC1) in human endometrium with and without endometriosis and its regulation by steroid hormones. Design: Laboratory study. Setting: University. Patient(s): Nineteen women with endometriosis and 33 control women. Intervention(s): Endometrial biopsy and fluid sampling. Main Outcome Measure(s): Analysis of early secretory (ESE) and midsecretory (MSE) endometrial secretomes from fertile women with the use of nano-liquid chromatography-dual mass spectrometry;real-time quantitative polymerase chain reaction, and immunohistochemistry for STC1 and its receptor calcium-sensing receptor (CASR) mRNA and proteins in endometrium with and without endometriosis; evaluation of STC1 and CASR mRNA expression in endometrial stromal fibroblasts (eSF) from women with and without endometriosis decidualized with the use of E2P or 8-bromo-cyclic adenosine monophosphate (cAMP). Result(s): STC1 protein was strongly up-regulated in MSE versus ESE in endometrial fluid of fertile women. STC1 mRNA significantly increased in MSE from women with, but not from those without, endometriosis, compared with proliferative endometrium or ESE, with no significant difference throughout the menstrual cycle between groups. STC1 mRNA in eSF from control women increased >230-fold on decidualization with the use of cAMP versus 45-fold from women with endometriosis, which was not seen on decidualization with E-2/P. CASR mRNA did not exhibit significant differences in any condition and was not expressed in isolated eSF. STC1 protein immunoexpression in eSF was significantly lower in women with endometriosis compared with control women. Conclusion(s): STC1 protein is significantly up-regulated in MSE endometrial fluid and is dysregulated in eutopic endometrial tissue from women with endometriosis. It is likely regulated by cAMP and may be involved in the pathogenesis of decidualization defects.

  • 39. Aghajanova, Lusine
    et al.
    Altmäe, Signe
    Bjuresten, Kerstin
    Hovatta, Outi
    Landgren, Britt-Marie
    Stavreus-Evers, Anneli
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Disturbances in the LIF pathway in the endometrium among women with unexplained infertility2009Inngår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 91, nr 6, s. 2602-2610Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To study the expression of leukemia inhibitory factor (LIF), its receptors LIFR and gp130, and its inhibitor SOCS1 in endometria from fertile women and infertile women with unexplained infertility. Signaling through the LIF pathway is involved in maintenance of a receptive state of human endometrium. Impaired endometrial receptivity may be a cause of female infertility. DESIGN: Prospective clinical study. SETTING: Hospital-based IVF unit and university-affiliated reproductive research laboratories. PATIENT(S): Twenty-six healthy fertile women and 14 women with unexplained infertility. INTERVENTION(S): Endometrial biopsy. MAIN OUTCOME MEASURE(S): Pinopode formation, expression of LIF, LIFR, gp130, and SOCS1 protein and mRNA in endometrial biopsies. RESULT(S): The expression of LIFR in the endometrium was negatively correlated to the expression of SOCS1 and positively correlated to the formation of pinopodes. In control fertile women, simultaneous intense apical staining of LIFR and gp130 together with faint SOCS1 staining was observed in epithelial cells, whereas the opposite was seen in most women with unexplained infertility. CONCLUSION(S): Unexplained infertility in some women might be explained by disturbances in the LIF pathway in midsecretory-phase endometrium.

  • 40. Aghajanova, Lusine
    et al.
    Bjuresten, Kerstin
    Altmäe, Signe
    Landgren, Britt-Marie
    Stavreus-Evers, Anneli
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    HB-EGF but not amphiregulin or their receptors HER1 and HER4 is altered in endometrium of women with unexplained infertility2008Inngår i: Reproductive Sciences, ISSN 1933-7191, Vol. 15, nr 5, s. 484-92Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Heparin-binding, epidermal growth factor-like growth factor (HB-EGF) and its receptors (HER I and HER4) play a role in the human implantation process. Amphiregulin is a member of the EGF family but with unknown function in human fertility. It has been suggested that some women with unexplained infertility have defective endometrial development. The aim of this study is to determine the presence of amphiregulin and the receptors HER1 and HER4 in normal human endometrium throughout the menstrual cycle. In addition) the present study aims to compare endometrium from women with unexplained infertility with endometrium from women with male factor infertility and healthy fertile controls. Immunohistochemistry and real-time polymerase chain reaction were used to determine the expression of HB-EGF, HER 1, HER4, and amphiregulin. The stromal staining of HER I and the epithelial staining of HER4 were most intense in the mid- and late-secretory-phase endometrium. Amphiregulin did not vary during the menstrual cycle. In the mid-secretory phase, the protein expression of HB-EGF was lower in endometrium from women with unexplained infertility versus normal endometrium and endometrium from women with malefactor infertility. HB-EGF and HER4 mRNA expression in mid-secretory endometrium of women with unexplained and malefactor infertility were increased compared with normal controls. Impaired endometrial expression of certain members of the EGF family may contribute to infertility in some women with unexplained infertility.

  • 41.
    Aghajanova, Lusine
    et al.
    Dept of Clinical Science, Intervention and Technology, Div of Obstetrics and Gynaecology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
    Lindeberg, Maria
    Dept of Clinical Science, Intervention and Technology, Div of Obstetrics and Gynaecology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
    Carlsson, Inger Britt
    Dept of Clinical Science, Intervention and Technology, Div of Obstetrics and Gynaecology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
    Stavreus-Evers, Anneli
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Zhang, Pu
    Dept of Clinical Science, Intervention and Technology, Div of Obstetrics and Gynaecology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
    Scott, Jennifer E.
    Dept of Clinical Science, Intervention and Technology, Div of Obstetrics and Gynaecology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
    Hovatta, Outi
    Dept of Clinical Science, Intervention and Technology, Div of Obstetrics and Gynaecology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
    Skjöldebrand-Sparre, Lottie
    Division of Obstetrics and Gynaecology, Dept of Clinical Sciences, karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.
    Receptors for thyroid-stimulating hormone and thyroid hormones in human ovarian tissue2009Inngår i: Reproductive Biomedicine Online, ISSN 1472-6483, E-ISSN 1472-6491, Vol. 18, nr 3, s. 337-347Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Dysfunction in thyroid regulation can cause menstrual and ovulatory disturbances, the mechanism of which is not clear. The distribution and activity of the thyroid-stimulating hormone (TSHR), and the thyroid hormone receptors (TR) alpha1, alpha2 and beta1 in human ovarian tissue and in granulosa cells was studied using immunohistochemistry, reverse-transcriptase polymerase chain reaction (RT-PCR), quantitative PCR and immunoassays. Strong immunostaining of TSHR, TRalpha1 and TRbeta1 was observed in ovarian surface epithelium and in oocytes of primordial, primary and secondary follicles, with minimal staining in granulosa cells of secondary follicles. Granulosa cells of antral follicles expressed TSHR, TRalpha1 and TRbeta1 proteins. Messenger RNA for all receptors was present in ovarian tissue. Mature human granulosa cells expressed transcripts for 5' deiodinases types 2 and 3, but not type 1, indicating the possibility of conversion of peripheral thyroid hormone thyroxin (T(4)). Granulosa cells stimulated with TSH showed a significant increase in cAMP concentrations after 2 h of culture (P = 0.047), indicating activation through TSHR. Stimulation with T(4) resulted in increased extracellular signal-regulated kinase 1 and 2 activation after 10, 30, 60 min and 24 h. These data demonstrate that TSH and thyroid hormone receptors may participate in the regulation of ovarian function.

  • 42. Aghajanova, Lusine
    et al.
    Mahadevan, S
    Altmäe, Signe
    Stavreus-Evers, Anneli
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Regan, L
    Sebire, N
    Dixon, P
    Fisher, R A
    Van den Veyver, I B
    No evidence for mutations in NLRP7, NLRP2 or KHDC3L in women with unexplained recurrent pregnancy loss or infertility2015Inngår i: Human Reproduction, ISSN 0268-1161, E-ISSN 1460-2350, Vol. 30, nr 1, s. 232-238Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    STUDY QUESTION: Are mutations in NLRP2/7 (NACHT, LRR and PYD domains-containing protein 2/7) or KHDC3L (KH Domain Containing 3 Like) associated with recurrent pregnancy loss (RPL) or infertility?

    SUMMARY ANSWER: We found no evidence for mutations in NLRP2/7 or KHDC3L in unexplained RPL or infertility.

    WHAT IS KNOWN ALREADY: Mutations in NLRP7 and KHDC3L are known to cause biparental hydatidiform moles (BiHMs), a rare form of pregnancy loss. NLRP2, while not associated with the BiHM pathology, is known to cause recurrent Beckwith Weidemann Syndrome (BWS).

    STUDY DESIGN, SIZE, AND DURATION: Ninety-four patients with well characterized, unexplained infertility were recruited over a 9-year period from three IVF clinics in Sweden. Blood samples from 24 patients with 3 or more consecutive miscarriages of unknown etiology were provided by the Recurrent Miscarriage Clinic at St Mary's Hospital, London, UK.

    PARTICIPANTS/MATERIALS, SETTING, METHODS: Patients were recruited into both cohorts following extensive clinical studies. Genomic DNA was isolated from peripheral blood and subject to Sanger sequencing of NLRP2, NLRP7 and KHDC3L. Sequence electropherograms were analyzed by Sequencher v5.0 software and variants compared with those observed in the 1000 Genomes, single nucleotide polymorphism database (dbSNP) and HapMap databases. Functional effects of non-synonymous variants were predicted using Polyphen-2 and sorting intolerant from tolerant (SIFT).

    MAIN RESULTS AND THE ROLE OF CHANCE: No disease-causing mutations were identified in NLRP2, NLRP7 and KHDC3L in our cohorts of unexplained infertility and RPL.

    LIMITATIONS, REASONS FOR CAUTION: Due to the limited patient size, it is difficult to conclude if the low frequency single nucleotide polymorphisms observed in the present study are causative of the phenotype. The design of the present study therefore is only capable of detecting highly penetrant mutations.

    WIDER IMPLICATIONS OF THE FINDINGS: The present study supports the hypothesis that mutations in NLRP7 and KHDC3L are specific for the BiHM phenotype and do not play a role in other adverse reproductive outcomes. Furthermore, to date, mutations in NLRP2 have only been associated with the imprinting disorder BWS in offspring and there is no evidence for a role in molar pregnancies, RPL or unexplained infertility.

    STUDY FUNDING/COMPETING INTERESTS: This study was funded by the following sources: Estonian Ministry of Education and Research (Grant SF0180044s09), Enterprise Estonia (Grant EU30020); Mentored Resident research project (Department of Obstetrics and Gynecology, Baylor College of Medicine); Imperial NIHR Biomedical Research Centre; Grant Number C06RR029965 from the National Center for Research Resources (NCCR; NIH). No competing interests declared.

  • 43.
    Aghajanova, Lusine
    et al.
    Dept of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, USA.
    Rumman, Amani
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Altmäe, Signe
    Wånggren, Kjell
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Stavreus-Evers, Anneli
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Diminished endometrial expression of ghrelin and ghrelin receptor contributes to infertility2010Inngår i: Reproductive sciences (Thousand Oaks, Calif.), ISSN 1933-7205, Vol. 17, nr 9, s. 823-832Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The objectives were to investigate the presence, distribution and sex steroid hormone regulation of ghrelin and its receptor, growth hormone secretagogue receptor (GHSR), in human endometrium in relation to endometrial receptivity and fertility. Endometrial biopsies were obtained from women with unexplained infertility and healthy fertile volunteers. Ishikawa cells were used to mimic the action of ghrelin in endometrium. Immunostaining of GHSR was strong in luminal epithelium and stroma during mid-secretory phase. Ghrelin and GHSR expression is less intense in mid-secretory endometrium of infertile women compared to fertile controls. Treatment with estrogen and/or progesterone or their antagonists did not significantly change the relative expression of GHSR in Ishikawa and stromal cells. Ghrelin was present in and secreted from human blastocysts, which suggest that the communication between human blastocyst and endometrium might involve ghrelin. Low levels of GHSR in endometrium from women with unexplained infertility may in part explain the infertility.

  • 44.
    Aghajanova, Lusine
    et al.
    Dept of Clinical Science, Karolinska Institutet, Stockholm, Sweden.
    Stavreus-Evers, Anneli
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Lindeberg, Maria
    Dept of Clinical Science, Karolinska Institutet, Stockholm, Sweden.
    Landgren, Britt-Marie
    Dept of Clinical Science, Karolinska Institutet, Stockholm, Sweden.
    Skjöldebrand Sparre, Lottie
    Hovatta, Outi
    Dept of Clinical Science, Karolinska Institutet, Stockholm, Sweden.
    Thyroid-stimulating hormone receptor and thyroid hormone receptors are involved in human endometrial physiology2011Inngår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 95, nr 1, s. 230-237Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To study the expression, distribution, and function of thyroid-stimulating hormone receptor (TSHR) and thyroid hormone receptors (TR) alpha1, alpha2, and beta1 in human endometrium. DESIGN: Experimental clinical study. SETTING: University hospital. PATIENT(S): 31 fertile women. INTERVENTION(S): Endometrial biopsy samples obtained throughout the menstrual cycle. MAIN OUTCOME MEASURE(S): Real-time reverse transcriptase polymerase chain reaction, immunohistochemistry and Western blot to study the expression of TSHR, TRalpha1, TRalpha2, and TRbeta1 messenger RNA (mRNA) and proteins in human endometrium. RESULT(S): We found TSHR, TRalpha1, TRalpha2 and TRbeta1 mRNA and proteins expressed in human endometrium. Immunostaining for TSHR in the luminal epithelium and TRalpha1 and beta1 in the glandular and luminal epithelium increased statistically significantly on luteinizing hormone (LH) days 6 to 9, coinciding with appearance of pinopodes. Endometrial stromal and Ishikawa cells expressed mRNA for TSHR, TR, and iodothyronine deiodinases 1-3. After 48 hours, TSH significantly increased leukemia inhibitory factor (LIF) and LIF receptor (LIFR) messenger RNA (mRNA) in endometrial stromal cells, but decreased their expression in Ishikawa cells. Glucose transporter 1 mRNA was up-regulated by TSH in Ishikawa cells. We found that TSH statistically significantly increased secretion of free triiodothyronine (T(3)) and total thyroxin (T(4)) by Ishikawa cells compared with nonstimulated cells. CONCLUSION(S): Thyroid hormones are directly involved in endometrial physiology.

  • 45.
    Aghyad, Dakakni
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Verification of hypochromic erythrocytes on Sysmex XN 20002020Student paper other, 10 poäng / 15 hpOppgave
    Abstract [en]

    Anemia is a serious blood disease that more than two billion suffer from worldwide. Half of that number consist of iron deficiency anemia, which is insufficiency of iron supply to the bone marrow due to empty iron store or hampered iron utilization due to inflammation. Therefore, requires rapid diagnosis.

        Analysis parameter for hypochromic erythrocytes (HYPO-He) is a highly applicable parameter for detection of iron deficiency using Sysmex XN 2000. It measures erythrocytes with low hemoglobin concentration. The aim of this study was to verify whether the research parameter HYPO-He should be included as a diagnostic analysis for anemia at the Hudiksvall Clinical Chemistry Laboratory in the Gävleborg Region, Sweden.

        The study material consisted of 34 samples, whole blood with EDTA. Two samples for in-series-imprecision and two for sustainability control. The two control materials (low and normal) and samples with properly filled tubes were analyzed with Sysmex XN in the reticulocyte channel using the optical method, by flow cytometry with laser.

        The results of duplicate sample on Sysmex XN showed that linear regression value R2 was 1.0 and coefficient of variation CV was 0.83 %. During this project, similar results were obtained that other projects had done with different instruments and methods. According to the results, HYPO-He is reliable and useful for improved iron deficiency diagnostics. Additional studies on HYPO-He stability is recommended.

  • 46. Agnafors, S.
    et al.
    Sydsjö, G.
    Comasco, Erika
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Neuropsykofarmakologi. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Bladh, M.
    Oreland, Lars
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Neuropsykofarmakologi.
    Svedin, C.
    Behaviour problems in children-a longitudinal study of genetic and environmental factors2015Inngår i: European Child and Adolescent Psychiatry, ISSN 1018-8827, E-ISSN 1435-165X, Vol. 24, s. S35-S35Artikkel i tidsskrift (Annet vitenskapelig)
  • 47.
    Agnarsson, I
    et al.
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Mpello, A
    Gunnlaugsson, G
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Hofvander, Y
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Greiner, T
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Infant feeding practices during the first six months of life in a rural area in Tanzania2001Inngår i: East Afr. Med. J., Vol. 78, s. 9-Artikkel i tidsskrift (Fagfellevurdert)
  • 48. Agostino, R
    et al.
    Antsaklis, A
    Breart, G
    Carrapato, M R G
    Chabernaud, J-L
    Debauche, C
    Di Renzi, GC
    Kollee, L A A
    Macagno, F
    Novak-Antolic, Z
    Papiernik, E
    Sedin, G
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Truffert, P
    van Reempts, P
    Recommendations from the European Association of Perinatal Medicine 1. New decision rules: regionalization in perinatal care and indications for perinatal transfer1999Inngår i: Prenatal and Neonatal Medicine, Vol. 4 suppl 1, s. 104-Artikkel i tidsskrift (Fagfellevurdert)
  • 49. Agostino, R
    et al.
    Breart, G
    Cabero, I
    Roura, L
    Carrapato, M R G
    Chabernaud, J-L
    Debauche, C
    Di Renzo, GC
    Fenton, A C
    Gadzinowski, J
    Kollee, L A A
    Macagno, F
    Milligan, D W A
    Moessinger, A
    Novak-Antolic, Z
    Papiernik, E
    Peitersen, B
    Reiter, H-L
    Sedin, G
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Truffert, P
    van Reempts, P
    Velebil, P
    Zeitlin, J
    Recommendtions for the European Association of Perinatal Medicine 3. Evaluation tools for perinatal transfer policies1999Inngår i: Prenatal and Neonatal Medicine, Vol. 4 suppl 1, s. 112-Artikkel i tidsskrift (Fagfellevurdert)
  • 50. Agostino, R
    et al.
    Fenton, AC
    Kollee, L A A
    Chabernaud, J-L
    Carrapato, M R G
    Peitersen, B
    Sedin, G
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Derganc, M
    Organization of neonatal transport in Europe1999Inngår i: Prenatal and Neonatal Medicine, Vol. 4 suppl 1, s. 20-Artikkel i tidsskrift (Fagfellevurdert)
1234567 1 - 50 of 6239
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