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  • 6201.
    Peterson, Christer G. B.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk kemi.
    Sangfelt, Per
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Wagner, M.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Hansson, Tony
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Lettesjö, H.
    Carlson, Marie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Fecal levels of leukocyte markers reflect disease activity in patients with ulcerative colitis2007Inngår i: Scandinavian Journal of Clinical and Laboratory Investigation, ISSN 0036-5513, E-ISSN 1502-7686, Vol. 67, nr 8, s. 810-820Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE:

    A prominent feature of inflammatory bowel disease (IBD) is the presence of inflammatory cells in the gut mucosa, and which contribute to the ongoing inflammatory process. The aim of the study was to evaluate fecal neutrophil, eosinophil, mast cell and macrophage markers in the assessment of disease activity in patients with ulcerative colitis (UC).

    METHODS:

    Twenty-eight patients with active UC; 4 with proctitis, 16 with left-side colitis and 8 with total colitis, were included in the study. Patient history, endoscopy and histopathology were examined and fecal and serum samples were evaluated at inclusion and after 4 and 8 weeks of treatment. Fecal samples were analysed for myeloperoxidase (MPO), eosinophil protein X (EPX), mast cell tryptase, IL-1beta and TNF-alpha using immunoassays. Blood samples were analysed for MPO, EPX, C-reactive protein, orosomucoid and leucocyte counts.

    RESULTS:

    Fecal MPO and IL-1beta levels were elevated in all patients at inclusion despite different disease extensions. Striking reductions in fecal levels of MPO, EPX, tryptase and IL-1beta were observed after 4 weeks of treatment in 20/28 patients with complete remission after 8 weeks. No further reductions were seen in 20/27 patients at 8 weeks. Endoscopic score correlated to IL-1beta at all visits (p<0.01), to MPO at visits 2 and 3 (p<0.05, p<0.001), EPX at visit 2 (p<0.05) and tryptase at visit 3 (p<0.01). Levels of fecal markers also related to histological indices of the disease.

    CONCLUSIONS:

    Measurements of fecal MPO, EPX and IL-1beta could be objective complements to endoscopical and histopathological evaluations in the daily care of patients with UC.

  • 6202.
    Peterson, Christer
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Hansson, Tony
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Skott, Anna
    Bengtsson, Ulf
    Ahlstedt, Staffan
    Magnusson, Jenny
    Detection of Local Mast-Cell Activity in Patients With Food Hypersensitivity2007Inngår i: Journal of investigational allergology & clinical immunology, ISSN 1018-9068, E-ISSN 1698-0808, Vol. 17, nr 5, s. 314-320Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Mast cells play a central role in many inflammatory diseases and assessment of their activation may be of use to provide objective confirmation of the outcome of food challenge in the diagnosis of food hypersensitivity. However, to date, assessment of mastcell activation using serum markers has been unsuccessful. Objective: The aim of this study was to explore whether locally released tryptase could be detected in stool samples from patients with food hypersensitivity. Methods: Nine patients (median age, 55 years; range, 26 - 68 years) with food hypersensitivity confirmed by double-blind placebo-controlled food challenge were included in the study. Tryptase concentration was assessed in stool samples collected before and after an open food challenge at home and symptoms were recorded throughout the study. Tryptase concentration was also assessed in stool samples from 16 apparently healthy individuals (median age, 44 years; range, 27 - 72 years). Results: Measurement of fecal tryptase levels in 16 healthy control subjects revealed an upper limit of the normal range (mean + 2 SD of log transformed data) of 10 ng/g. Fecal tryptase levels exceeded 10 ng/g in 7 out of 9 patients in one or more samples obtained during the study. The tryptase levels varied between patients in response to the food challenge and the individual mean levels of tryptase correlated with the corresponding levels of the inflammatory marker eosinophil protein X (ρ = 0.7500, P = .02). Conclusion: Measurement of tryptase levels in stool samples is feasible using the method described here. Our results revealed elevated concentrations of fecal tryptase in patients with food hypersensitivity. However, several factors, including food exposure, may account for the increase in fecal tryptase and further studies are necessary to elucidate the role of mast cells in food hypersensitivity.

  • 6203.
    Peterson, S
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Controlling iodine deficiency disorders-studies for program management in Sub-Saharan Africa. ( Doctoral Thesis), Acta Universitatis Upsaliensis, Comprehensive Summaries of Uppsala Disseratations from the Faculty of Medicine2000Annet (Annet vitenskapelig)
  • 6204.
    Peterson, S
    et al.
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Assey, V
    Forsberg, B
    Greiner, T
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Kavishe, F
    Mduma, B
    Rosling, H
    Sanga, A
    Gebre-Medhin, M
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Coverage and cost of iodized oil capsule distribution in Tanzania1999Inngår i: Health Policy and Planning, Vol. 14, s. 390-Artikkel i tidsskrift (Fagfellevurdert)
  • 6205.
    Peterson, S
    et al.
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Legue, FT
    Tylleskar, T
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Kpizingui, E
    Rosling, H
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Improved cassava processing can help reduce iodine deficiency disorders in the Central African Republic1995Inngår i: Nutrition Research, Vol. 15, s. 803-Artikkel i tidsskrift (Fagfellevurdert)
  • 6206.
    Peterson, S
    et al.
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Nsungwa-Sabiiti, J
    Magumba, G
    Were, W
    Nambooze, J
    Nsabagasani, X
    Mukasa, G
    Where referral is difficult or impossible: an in-depth study on the size of the problem, its context and coping mechanisms. Kampala: MOH, Child Health Divisition, IMCI; WHO, Kampala2000Annet (Annet vitenskapelig)
  • 6207.
    Peterson, S
    et al.
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Rosling, H
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Tylleskar, T
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Gebre-Medhin, M
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Taube, A
    Endemic goitre in Guinea1995Inngår i: Lancet, Vol. 345, s. 513Annet (Annet vitenskapelig)
  • 6208.
    Peterson, Stefan
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Controlling iodine deficiency disorders: Studies for program management in sub-Saharan Africa2000Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Studies were performed to improve iodine deficiency control programs. Goitre rates and cassava processing practices were compared in three Central African Republic (CAR) populations. Short-cuts in cassava processing were associated with elevated urinary thiocyanate and increased goitre rates, suggesting a goitrogenic effect in one population. While improved cassava processing may be beneficial, the priority is to correct the iodine deficiency.

    The use of the urinary iodine/tiocyanate ratio as indicator of goitrogenic effects was explored using data from Tanzania and CAR. As the ratio can be calculated in four mathematically different ways and has physiological shortcomings, its use is discouraged.

    Biannual iodised oil capsule (IOC) distribution in a Tanzanian population of 7 million during nine years was studied. Mean distribution coverage was 64%, mean delay of subsequent distribution 1.25 years, and only 43% of targeted person-time was covered. The cost of capsules constituted more than 90% of total program costs. It is cost-effective to invest more funds in communication, support of peripheral staff and supervision.

    In a highland Tanzanian village, salt iodine content was highly variable compared to national standards. While school-children had adequate urinary iodine, women at delivery and newborns showed signs of in adequate iodine status. Salt iodine concentrations should be monitored during production and distribution down to household level, and iodine status assessed in all vulnerable groups before adjusting recommended salt iodization levels at production.

    WHO's 1994 change in palpation goitre definition considerably lowered specificity and increased measured goitre rates by 25% in Tanzanian school-children compared to the previous system. Ultrasound estimation of thyroid volume under rugged field conditions requires considerable human and material resources yet had a precision only slightly better than palpation. In resource poor settings appropriately trained palpators using the 1960 WHO definition of goitre remain optimal for estimating thyroid size until precision and cost of ultrasound has improved.

    Monitoring of process indicators needs to be an ongoing priority activity, separate from periodic evaluations of impact.

    Fulltekst (pdf)
    FULLTEXT01
  • 6209.
    Peterson, Stefan
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    FN's tomma diplomati hotar de mänskliga rättigheterna1995Inngår i: FinanstidningenArtikkel i tidsskrift (Annet vitenskapelig)
  • 6210.
    Peterson, Stefan
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Sanga, A.
    Eklöf, Hampus
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för onkologi, radiologi och klinisk immunologi.
    Bunga, B.
    Taube, A.
    Gebre-Medhin, Mehari
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Rosling, H.
    Classification of thyroid size by palpation and ultrasonography in field surveys2000Inngår i: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 355, nr 9198, s. 106-110Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Goitre surveys are used to assess the degree of iodine deficiency in a population. The change of goitre classification made by WHO in 1994 implied that a smaller thyroid size should be regarded as goitre. Furthermore, the acceptable goitre prevalence was lowered from 10% to 5%, and ultrasonography was recommended as a more precise method for diagnosis of goitre. We studied the effects of the change of palpation system, and compared the precision of the old and new systems with that of ultrasonographic examination. METHODS: We studied 225 schoolchildren (aged 7-14 years) in a highland village in Tanzania. The size of the thyroid was assessed in duplicate by ultrasonography and by WHO's 1960 and 1994 palpation systems. The latter were done by three examiners. Variations within and between examination methods and examiners were assessed, and measurement errors by ultrasonography were assessed from duplicate examinations. The sensitivity and specificity of the two palpation systems were calculated, with diagnosis by ultrasonography as the gold standard. Apparent palpation prevalences were calculated at a "true" 5% prevalence. FINDINGS: The lowered criterion for goitre resulted in an extra 20-33% of children being diagnosed as having goitre by palpation. The variation between repeat examinations was only slightly smaller by ultrasonography (kappa=0.63) than by experienced examiners (kappa=0.57-0.58). The variation between thyroid volume estimation by ultrasonography and the true volume was about 50% due to both measurement error and variation in the shape of thyroid lobes. The new goitre criterion decreased specificity from 76% to 29%, whereas sensitivity rose from 56% to 80%. In contrast, a suggested sharpening of the old criterion increased specificity to 90%. INTERPRETATION: A return to the old (1960) palpation criterion for goitre: "lobes larger than the terminal phalanxes of thumbs" and to an accepted palpation goitre prevalence of 10% can allow affordable monitoring of thyroid size through palpation in field surveys.

  • 6211.
    Petridou, E.
    et al.
    National and Kapodistrian University of Athens Medical School, Dept. of Hygiene- Epidemiology and Medical Statistics, Athens, Greece; 2Karolinska Institute, Clinical Epidemiology Unit- Department of Medicine, Stockholm, Sweden.
    Georgakis, M.
    National and Kapodistrian University of Athens Medical School, Dept. of Hygiene- Epidemiology and Medical Statistics, Athens, Greece.
    Erdmann, F.
    International Agency for Research on Cancer, Section of Environment and Radiation, Lyon, France; Danish Cancer Society Research Center, Childhood Cancer Survivorship Research Group- Unit of Survivorship, Copenhagen, Denmark.
    Ezzat, S.
    National Liver Institute- Menoufia University, Department of Epidemiology and Preventive Medicine- NLI-SSI Collaborative Research Center, Caire, Egypt.
    Mora, A.M.
    Universidad Nacional Heredia, Central American Institute for Studies on Toxic Substances IRET, Heredia, Costa Rica.
    Dessypris, N.
    National and Kapodistrian University of Athens Medical School, Dept. of Hygiene- Epidemiology and Medical Statistics, Athens, Greece.
    Schüz, J.
    International Agency for Research on Cancer, Section of Environment and Radiation, Lyon, France.
    Infante-Rivard, C.
    McGill University, Department of Epidemiology- Biostatistics and Occupational Health Faculty of Medicine, Montreal- Québec, Canada.
    Skalkidou, Alkistis
    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.
    C.S.G. CLIC Studies Group, -
    CLIC Studies Group, Athens, Greece.
    PO-124 Childhood Leukemia International Consortium (CLIC) Studies Report Diffrential Associations of Advanced Parental Age with Childhood Acute Lymphoblastic Leukemia2018Inngår i: Pediatric Blood & Cancer, ISSN 1545-5009, E-ISSN 1545-5017, Vol. 65, nr 52, s. S150-S151Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [en]

    Background/Objectives:Advanced parental age has beenassociated with adverse health effects in the offspring includ-ing childhood (0-14 years) acute lymphoblastic leukemia(ALL), as reported in our meta-analysis of published stud-ies. Primary data from 16 studies participating in theChildhood Leukemia International Consortium provide aunique methodological opportunity to further explore thisassociation.Design/Methods:Data from 11 case-control (CC) studies(7919 cases; 12942 interviewed controls) and five nested case-control (NCC) studies (8801 cases; 29690 controls recordlinked via population-based registries) with enrollment peri-ods ranging from 1968 to 2015 were used. Adjusted oddsratios (OR) were derived from each study using five-yearpaternal and maternal age increments and introduded in twometa-analyses by CC or NCC study design.Results:Advancement of paternal age was associated withstatistically significant higher risk for ALL in the off-spring (ORCC:1.05; ORNCC:1.04) and advanced mater-nal age only in the NCC (ORNCC:1.05). By contrast, theresults were heterogeneous in CC studies (ORCC:0.99, 95%CI:0.91-1.07, heterogeneityI2=58%,p=0.002). The positive association between parental age and risk of ALL was moreevident in the age group among 1-5 years and remainedunchanged after mutual adjustment for the collinear effect ofthe paternal and maternal age variables. We further performedanalyses of the relatively small numbers of discordant pater-nal and maternal age pairs to explore the collinear effect ofparental age but the results were not fully enlightening.Conclusions:The results of this larger ever dataset of primarydata allowing for separate analysis by study design and bettercontrol of selection bias in CC studies strengthen the evidencethat advanced parental age is associated with increased child-hood ALL risk. The observational study design and ollinear-ity of maternal with paternal age complicate causal interpre-tation. Employing datasets with cytogenetic information mayfurther elucidate involvement of each parental component andclarify underlying mechanisms.  

  • 6212. Petridou, E
    et al.
    Salvanos, H
    Skalkidou, A
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Dessypris, N
    Moustaki, M
    Trichopoulos, D
    Are there common triggers of preterm deliveries?2001Inngår i: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 108, nr 6, s. 598-604Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To assess the effect(s) of transient events which are perceived as stressful on the inseption of preterm delivery.

    DESIGN: A case-control study, with immature infants as cases and borderline term babies as controls.

    SETTING: A teaching maternity hospital in Athens.

    POPULATION: All infants born at less than 37 weeks of gestation, during a twelve-month period.

    METHODS: Information was collected about maternal socio-demographic and lifestyle characteristics, clinical variables and stressful events occurring within two weeks prior to delivery.

    MAIN OUTCOME MEASURES: Factors affecting the risk of preterm delivery.

    RESULTS: Extreme prematurity (<33 weeks) is more common among younger (<25 years of age) and older (>29 years of age) women and is positively associated with parity, body mass index and smoking, whereas it is inversely associated with educational level, regular physical exercise and serious nausea/vomiting. After controlling for these factors, however, only coitus during the last weeks of pregnancy had a significant triggering effect on prematurity (P = 0.004, odds ratio 3.21, 95% CI 1.45 to 7.09 for very immature babies, and P = 0.04, OR = 2.20, 95% CI 1.03 to 4.70 for immature babies). On the contrary, several events perceived as stressful, such as illness of relatives or friends, husband's departure, loss of employment, were unrelated to the onset of premature labour.

    CONCLUSIONS: Coitus during the last few weeks of pregnancy appears to increase the risk of preterm delivery, while a possible detrimental effect of physical exertion seems more limited. Stressful events should not receive undue attention as possible causes of preterm delivery.

  • 6213. Petridou, E
    et al.
    Skalkidou, A
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Dessypris, N
    Kedikoglou, S
    Mantzoros, C
    Chroussos, G
    Trichopoulos, D
    Growth velocity during the first postnatal week of life is not related to adiponectin or leptin.2004Inngår i: Paediatric and Perinatal Epidemiology, ISSN 0269-5022, E-ISSN 1365-3016, Vol. 18, nr 5, s. 395-Artikkel i tidsskrift (Fagfellevurdert)
  • 6214. Petridou, E T
    et al.
    Sergentanis, T N
    Perlepe, C
    Papathoma, P
    Tsilimidos, G
    Kontogeorgi, E
    Kourti, M
    Baka, M
    Moschovi, M
    Polychronopoulou, S
    Sidi, V
    Hatzipantelis, E
    Stiakaki, E
    Iliadou, A N
    La Vecchia, C
    Skalkidou, Alkistis
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Adami, Ho
    Socioeconomic disparities in survival from childhood leukemia in the United States and globally: a meta-analysis2015Inngår i: Annals of Oncology, ISSN 0923-7534, E-ISSN 1569-8041, Vol. 26, nr 3, s. 589-597Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Despite advancements in the treatment of childhood leukemia, socioeconomic status (SES) may potentially affect disease prognosis. This study aims to evaluate whether SES is associated with survival from childhood leukemia.

    METHODS: The US National Cancer Institute Surveillance, Epidemiology and End Results Program (SEER) 1973-2010 data were analyzed; thereafter, results were meta-analyzed along with those from survival (cohort) studies examining the association between SES indices and survival from childhood leukemia (end-of-search date: 31 March 2014). Random-effects models were used to calculate pooled effect estimates (relative risks, RRs); meta-regression was also used.

    RESULTS: We included 29 studies yielding 28 804 acute lymphoblastic leukemia (ALL), 3208 acute myeloblastic leukemia (AML) and 27 650 'any' leukemia (denoting joint reporting of all subtypes) cases. According to individual-level composite SES indices, children from low SES suffered from nearly twofold higher death rates from ALL (pooled RR: 1.83, 95% confidence interval 1.00-3.34, based on four study arms); likewise, death RRs derived from an array of lower area-level SES indices ranged between 1.17 and 1.33 (based on 11 study arms). Importantly, the survival gap between higher and lower SES seemed wider in the United States, with considerably (by 20%-82%) increased RRs for death from ALL in lower SES. Regarding AML, poorer survival was evident only when area-level SES indices were used. Lastly, remoteness indices were not associated with survival from childhood leukemia.

    CONCLUSION: Children with lower SES suffering childhood leukemia do not seem to equally enjoy the impressive recent survival gains. Special health policy strategies and increased awareness of health providers might minimize the effects of socioeconomic disparities.

  • 6215.
    Petridou, Eleni
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Mantzoros, Christos S
    Belechri, Maria
    Skalkidou, Alkistis
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Dessypris, Nick
    Papathoma, Eugenia
    Salvanos, Heraklis
    Lee, Jennifer H
    Kedikoglou, Simeon
    Chrousos, George
    Trichopoulos, Dimitrios
    Neonatal leptin levels are strongly associated with female gender, birth length, IGF-I levels and formula feeding.2005Inngår i: Clinical Endocrinology, ISSN 0300-0664, E-ISSN 1365-2265, Vol. 62, nr 3, s. 366-71Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To investigate predictors of circulating leptin in healthy full-term newborns and to explore the relationship with anthropometric variables, serum levels of adiponectin and the major components of the IGF system at birth. To explore whether leptin levels are regulated by breastfeeding vs. formula feeding.

    DESIGN: Observational cross-sectional study.

    PATIENTS: Three hundred and nineteen healthy full-term newborns delivered during 1999 in Athens, Greece.

    MEASUREMENTS: Anthropometric measurements, formula feeding information and blood samples were obtained. Leptin and adiponectin determinations were performed using a radioimmunoassay (RIA).

    RESULTS: Multivariate regression analyses showed that leptin levels were positively associated with female gender, newborn length, ponderal index and IGF-I levels, but not with adiponectin levels. Newborns who were fed exclusively with milk formulas had more than twice the leptin levels of those who were exclusively breastfed.

    CONCLUSIONS: Leptin levels are positively related to female gender and anthropometric characteristics of neonates but, contrary to studies in adults, are not correlated with adiponectin levels. We also found evidence that formula feeding imparts a considerable increase in leptin levels in newborns.

  • 6216. Petridou, Eleni
    et al.
    Papadopoulos, Fotios C
    Frangakis, Constantine E
    Skalkidou, Alkistis
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Trichopoulos, Dimitrios
    A role of sunshine in the triggering of suicide.2002Inngår i: Epidemiology, ISSN 1044-3983, E-ISSN 1531-5487, Vol. 13, nr 1, s. 106-9Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Several reports indicate that suicide follows a seasonal pattern with a dominant peak during the month of maximum daylight. The purpose of this study was to evaluate the hypothesis that sunshine exposure may trigger suicidal behavior. We found a remarkably consistent pattern of seasonality with peak incidence around June in the northern hemisphere and December in the southern hemisphere. Moreover, there was a positive association between the seasonal amplitude of suicide (measured by relative risk) and total sunshine in the corresponding country. These findings indicate that sunshine may have a triggering effect on suicide, and suggests further research in the field of sunshine-regulated hormones, particularly melatonin.

  • 6217.
    Petridou, Eleni T.
    et al.
    Dept. of Hygiene and Epidemilogy and Pathology, University of Athens Medical School.
    Mitsiades, Nicholas
    Dept. of Hygiene and Epidemilogy and Pathology, University of Athens Medical School.
    Gialamas, Spyros
    Angelopoulos, Miltiadis
    Skalkidou, Alkistis
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Dessypris, Nick
    Hsi, Alex
    Lazaris, Nikolaos
    Polyzos, Aristidis
    Syrigos, Constantinos
    Brennan, Aoife M.
    Tseleni-Balafouta, Sofia
    Mantzoros, Christos S.
    Division of Endocrinology, Diabetes and Metabolism, Beth Israel Deaconess Medical Center, Boston, USA.
    Circulating adiponectin levels and expression of adiponectin receptors in relation to lung cancer: two case-control studies2007Inngår i: Oncology, ISSN 0030-2414, E-ISSN 1423-0232, Vol. 73, nr 3-4, s. 261-269Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Decreased circulating levels of adiponectin, an adipocyte-secreted hormone and endogenous insulin sensitizer, have been associated with several obesity-related malignancies. Thiazolidinedione administration, which increases adiponectin levels, decreases risk for lung cancer. Whether circulating adiponectin levels are associated with lung cancer and/or whether adiponectin receptors are expressed in lung cancer remains unknown. METHODS: We conducted a case-control study of 85 patients with incidental, histologically confirmed lung cancer and 170 healthy controls matched by gender and age. In a separate study, archival lung specimens from 134 cancerous and 8 noncancerous tissues were examined for relative expression of adiponectin receptors AdipoR1 and AdipoR2 using immunohistochemistry. RESULTS: Tobacco smoking, heavy alcohol intake and education were all associated with lung cancer risk, whereas serum adiponectin levels were not significantly different between cases and controls (multiple logistic regression, odds ratio per SD of adiponectin among controls: 1.13, 95% confidence interval: 0.64-2.02). Adiponectin levels were significantly lower (odds ratio: 0.25, 95% confidence interval: 0.10-0.78) among patients with advanced compared to those with limited disease stage. Expression of adiponectin receptors was apparent only in the cancerous lung tissue (64.2% AdipoR1 and 61.9% AdipoR2 in cancerous vs. 0% among noncancerous tissue). Specifically, AdipoR1 was expressed in all disease types, but no difference was noted with disease stage, whereas AdipoR2 was mainly expressed in the non-small cell carcinomas and more prominently in the advanced disease stage (80%). CONCLUSIONS: Circulating adiponectin levels are not different in cases of this malignancy - which seems to be unrelated to obesity and insulin resistance - compared to their healthy controls, though hormonal levels were significantly lower in advanced versus limited lung cancer. Both adiponectin receptors were expressed in cancerous lung tissue, but not in normal control tissue and there was a differential expression by disease stage. These findings should be further explored, especially in the context of the recently reported protective effect of thiazolidinediones in diabetic patients with lung cancer.

  • 6218. Petridou, Eleni Th.
    et al.
    Dikalioti, Stavroula K.
    Skalkidou, Alkistis
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Andrie, Elisabeth
    Dessypris, Nick
    Trichopoulos, Dimitrios
    Sun exposure, birth weight, and childhood lymphomas: A case control study in Greece2007Inngår i: Cancer Causes and Control, ISSN 0957-5243, E-ISSN 1573-7225, Vol. 18, nr 9, s. 1031-1037Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives  To explore whether the inverse association of sun exposure with non Hodgkin lymphoma among adults is also evident among the childhood population and test the specificity of the relation by contrasting the findings to those for Hodgkin lymphoma. Methods  A total of 87 cases of childhood (0–14 years) with non Hodgkin lymphoma and 71 with Hodgkin lymphoma, diagnosed in Greece through the national network of childhood Hematology-Oncology Units, during a 7-year period, along with 164 age- and gender-matched control children were enrolled in the study. The guardians of all eligible children were interviewed in person on the basis of a structured questionnaire covering socio-demographic, anthropometric, and perinatal characteristics. Average time of sunbathing per year at a seaside resort was used as a proxy variable of exposure to sun controlling for use of sun protection measures. Results  The estimated incidence of 10.2 cases per 1,000,000 children-years {95% Confidence Intervals (CI), 8.4–12.1} for NHL during the study period in Greece is around the average figure in countries of the European Union. There was an inverse association of sun exposure with Non Hodgkin lymphoma, namely, for an increment of 15 days of sunbathing at seaside resorts children had almost 40% lower risk (Odds Ratio: 0.60, 95% CI: 0.43–0.83), whereas no such association was evident for Hodgkin lymphoma. The risk for non Hodgkin lymphoma has been found to be statistically and significantly higher in birth weight (Odds ratio: 1.42 and 95% CI, 1.04–1.92, for every 500 g increment), whereas there was no substantial indication that maternal education or maternal smoking during the child’s life were important risk factors for the disease. Conclusions  This is the first study to provide epidemiological evidence that increased sun exposure of children may also be associated with a decreased risk of developing childhood non Hodgkin, but not Hodgkin lymphoma.

     

  • 6219.
    Petridou, Eleni Th.
    et al.
    Karolinska Inst, Dept Med, Clin Epidemiol Unit, Stockholm, Sweden;Univ Athens, Med Sch, Dept Hyg Epidemiol & Med Stat, 75 Mikras Asias Str, Athens 11527, Greece.
    Georgakis, Marios K.
    Univ Athens, Med Sch, Dept Hyg Epidemiol & Med Stat, 75 Mikras Asias Str, Athens 11527, Greece.
    Erdmann, Friederike
    Danish Canc Soc Res Ctr, Childhood Canc Survivorship Res Grp, Unit Survivorship, Copenhagen, Denmark;Int Agcy Res Canc, Sect Environm & Radiat, Lyon, France.
    Ma, Xiaomei
    Yale Sch Med, Yale Comprehens Canc Ctr, Yale Sch Publ Hlth Canc Prevent & Control, Dept Chron Dis Epidemiol, New Haven, CT USA.
    Heck, Julia E.
    Univ Calif Los Angeles, Sch Publ Hlth, Dept Epidemiol, Los Angeles, CA 90024 USA.
    Auvinen, Anssi
    Univ Tampere, Fac Social Sci, Tampere, Finland.
    Mueller, Beth A.
    Univ Washington, Sch Publ Hlth, Dept Epidemiol, Seattle, WA 98195 USA;Fred Hutchinson Canc Res Ctr, Publ Hlth Sci Div, Seattle, WA USA.
    Spector, Logan G.
    Univ Minnesota, Dept Pediat, Div Epidemiol & Clin Res, Minneapolis, MN 55455 USA.
    Roman, Eve
    Univ York, Dept Hlth Sci, Epidemiol & Canc Stat Grp, York, N Yorkshire, England.
    Metayer, Catherine
    Univ Calif Berkeley, Sch Publ Hlth, Berkeley, CA 94720 USA.
    Magnani, Corrado
    Univ Piemonte Orientale, SCDU Epidemiol Tumori, Dipartimento Med Traslazi, Novara, Italy.
    Pombo-de-Oliveira, Maria S.
    Inst Nacl Canc, Pediat Hematol Oncol Program, Rio De Janeiro, Brazil.
    Ezzat, Sameera
    Menoufia Univ, Natl Liver Inst, NLI SSI Collaborat Res Ctr, Dept Epidemiol & Prevent Med, Cairo, Egypt.
    Scheurer, Michael E.
    Baylor Coll Med, Texas Childrens Canc Ctr, Dept Pediat, Houston, TX 77030 USA.
    Maria Mora, Ana
    Univ Nacl, Cent Amer Inst Studies Toxic Subst IRET, Heredia, Costa Rica.
    Dockerty, John D.
    Univ Otago, Dunedin Sch Med, Dept Preventat & Social Med, Dunedin, New Zealand.
    Hansen, Johnni
    Danish Canc Soc, Res Ctr, Copenhagen, Denmark.
    Kang, Alice Y.
    Univ Calif Berkeley, Sch Publ Hlth, Berkeley, CA 94720 USA.
    Wang, Rong
    Yale Sch Med, Yale Comprehens Canc Ctr, Yale Sch Publ Hlth Canc Prevent & Control, Dept Chron Dis Epidemiol, New Haven, CT USA.
    Doody, David R.
    Fred Hutchinson Canc Res Ctr, Publ Hlth Sci Div, Seattle, WA USA.
    Kane, Eleanor
    Univ York, Dept Hlth Sci, Epidemiol & Canc Stat Grp, York, N Yorkshire, England.
    Rashed, Waffa M.
    Childrens Canc Hosp Egypt, Res Dept, Cairo, Egypt;Armed Forces Coll Med, Biomed Res Dept, Cairo, Egypt.
    Dessypris, Nick
    Univ Athens, Med Sch, Dept Hyg Epidemiol & Med Stat, 75 Mikras Asias Str, Athens 11527, Greece.
    Schuz, Joachim
    Int Agcy Res Canc, Sect Environm & Radiat, Lyon, France.
    Infante-Rivard, Claire
    McGill Univ, Fac Med, Dept Epidemiol Biostat & Occupat Hlth, Montreal, PQ, Canada.
    Skalkidou, Alkistis
    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.
    Advanced parental age as risk factor for childhood acute lymphoblastic leukemia: results from studies of the Childhood Leukemia International Consortium2018Inngår i: European Journal of Epidemiology, ISSN 0393-2990, E-ISSN 1573-7284, Vol. 33, nr 10, s. 965-976Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Advanced parental age has been associated with adverse health effects in the offspring including childhood (0-14 years) acute lymphoblastic leukemia (ALL), as reported in our meta-analysis of published studies. We aimed to further explore the association using primary data from 16 studies participating in the Childhood Leukemia International Consortium. Data were contributed by 11 case-control (CC) studies (7919 cases and 12,942 controls recruited via interviews) and five nested case-control (NCC) studies (8801 cases and 29,690 controls identified through record linkage of population-based health registries) with variable enrollment periods (1968-2015). Five-year paternal and maternal age increments were introduced in two meta-analyses by study design using adjusted odds ratios (OR) derived from each study. Increased paternal age was associated with greater ALL risk in the offspring (ORCC 1.05, 95% CI 1.00-1.11; ORNCC 1.04, 95% CI 1.01-1.07). A similar positive association with advanced maternal age was observed only in the NCC results (ORCC 0.99, 95% CI 0.91-1.07, heterogeneity I (2) = 58%, p = 0.002; ORNCC 1.05, 95% CI 1.01-1.08). The positive association between parental age and risk of ALL was most marked among children aged 1-5 years and remained unchanged following mutual adjustment for the collinear effect of the paternal and maternal age variables; analyses of the relatively small numbers of discordant paternal-maternal age pairs were not fully enlightening. Our results strengthen the evidence that advanced parental age is associated with increased childhood ALL risk; collinearity of maternal with paternal age complicates causal interpretation. Employing datasets with cytogenetic information may further elucidate involvement of each parental component and clarify underlying mechanisms.

  • 6220.
    Petridou, Eleni Th.
    et al.
    Department of Hygiene, Epidemiology and Medical Statistics, Athens University Medical School, Greece.
    Sergentanis, Theodoros N.
    Panagopoulou, Paraskevi
    Moschovi, Maria
    Polychronopoulou, Sophia
    Baka, Margarita
    Pourtsidis, Apostolos
    Athanassiadou, Fani
    Kalmanti, Maria
    Sidi, Vasiliki
    Dessypris, Nick
    Frangakis, Constantine
    Matsoukis, Ioannis L.
    Stefanadis, Christodoulos
    Skalkidou, Alkistis
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Stephansson, Olof
    Adami, Hans-Olov
    Kieler, Helle
    Center for Pharmacoepidemiology, Karolinska Institutet T2, Karolinska University Hospital, Stockholm, Sweden.
    In vitro fertilization and risk of childhood leukemia in Greece and Sweden2012Inngår i: Pediatric Blood & Cancer, ISSN 1545-5009, E-ISSN 1545-5017, Vol. 58, nr 6, s. 930-936Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background Cancer risk in children born after in vitro fertilization (IVF) remains largely unknown. We aimed to investigate risk of leukemia and lymphoma following IVF using two nationwide datasets. Methods. The hospital-based case-control study in Greece derived from the National Registry for Childhood Hematological Malignancies (1996-2008, 814 leukemia and 277 lymphoma incident cases with their 1: 1 matched controls). The Swedish casecontrol study was nested in the Swedish Medical Birth Register (MBR) (1995-2007, 520 leukemia and 71 lymphoma cases with their 5,200 and 710 matched controls) with ascertainment of incident cancer cases in the National Cancer Register. Study-specific and combined odds ratios (OR) were estimated using conditional logistic regression, with adjustment for possible risk factors. Results. Nationwide studies pointed to similar size excess risk of leukemia following IVF, but to a null association between IVF and lymphoma. The proportion of leukemia cases conceived through IVF was 3% in Greece and 2.7% in Sweden; prevalence of IVF in matched controls was 1.8% and 1.6%, respectively. In combined multivariable analyses, the increased risk of leukemia was confined to age below 3.8 years (OR 2.21; 95% confidence interval, CI: 1.27-3.85) and to acute lymphoblastic leukemia (ALL) (OR 1.77; 95% CI: 1.062.95) with no sufficient evidence of excess risk for other leukemias (OR 1.34; 95% CI: 0.38-4.69). Following IVF, OR for ALL was 2.58 (95% CI: 1.37-4.84) before age 3.8 and 4.29 (95% CI: 1.4912.37) before age 2 years. Conclusions. IVF seems to be associated with increased risk of early onset ALL in the offspring. 

  • 6221.
    Petridou, Eleni Th
    et al.
    Department of Hygiene, Epidemiology and Medical Statistics, Athens University Medical School, National and Kapodistrian University of Athens, Greece.
    Sergentanis, Theodoros N
    Department of Hygiene, Epidemiology and Medical Statistics, Athens University Medical School, National and Kapodistrian University of Athens, Greece.
    Skalkidou, Alkistis
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Antonopoulos, Constantine N
    Department of Hygiene, Epidemiology and Medical Statistics, Athens University Medical School, National and Kapodistrian University of Athens, Greece.
    Dessypris, Nick
    Department of Hygiene, Epidemiology and Medical Statistics, Athens University Medical School, National and Kapodistrian University of Athens, Greece.
    Svensson, Tobias
    Unit of Clinical Epidemiology, Department of Medicine, Centre for Pharmacoepidemiology, Karolinska Institutet, Solna, Sweden.
    Stephansson, Olof
    Department of Women’s and Children’s Health, Division of Obstetrics and Gynecology, Karolinska Institutet, Solna, Sweden.
    Kieler, Helle
    Unit of Clinical Epidemiology, Department of Medicine, Centre for Pharmacoepidemiology, Karolinska Institutet, Solna, Sweden.
    Smedby, Karin E
    Unit of Clinical Epidemiology, Department of Medicine, Centre for Pharmacoepidemiology, Karolinska Institutet, Solna, Sweden.
    Maternal and birth anthropometric characteristics in relation to the risk of childhood lymphomas: a Swedish nationwide cohort study2015Inngår i: European Journal of Cancer Prevention, ISSN 0959-8278, E-ISSN 1473-5709, Vol. 24, nr 6, s. 535-541Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This Swedish nationwide cohort study aims to examine the role of maternal characteristics (maternal age, education, smoking, BMI, diabetes, and preeclampsia) and multiple intrauterine growth measures on the risk of childhood lymphomas. A total of 3 444 136 singleton live births registered in the Swedish Medical Birth Register were analyzed, among whom there were 515 incident non-Hodgkin lymphoma (NHL) cases and 169 Hodgkin lymphoma (HL) cases aged 0-14 years at diagnosis (1973-2007) identified through linkage with the Swedish Cancer Register. Proportional hazards models were used to estimate the hazard ratio (HR) and 95% confidence intervals (95% CI) of NHL and HL. Male sex (HR=2.00, 95% CI: 1.66-2.41), older maternal age (HR=1.03, 95% CI: 1.00-1.06, per 1-year increase), and large for gestational age compared with appropriate for gestational age (AGA) birth weight (HR=1.83, 95% CI: 1.20-2.79) were correlated with the risk of NHL; of note, in subanalysis by sex, the latter association was confined to girls (HR=3.37, 95% CI: 1.90-5.97, Pinteraction by sex=0.008). The risk of childhood HL overall was more evident among boys (HR=2.03, 95% CI: 1.46-2.81), whereas indices of accelerated fetal growth were not convincingly associated with the risk of HL. Apart from the established association with sex, the findings point to accelerated intrauterine growth as a risk factor for childhood NHL that may differ by sex. Given the rarity of this condition at birth, however, further studies with more elaborate indices are needed to conclude on its association with rare diseases such as HL.

  • 6222.
    Petros, P
    et al.
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Ulmsten, U
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    An anatomical classification-a new paradigm for management of female lower urinary tract dysfunction1998Inngår i: Eur J Obstetrics and Gynecology and Repro. Biol., Vol. 80, s. 87-Artikkel i tidsskrift (Fagfellevurdert)
  • 6223.
    Petros, P
    et al.
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Ulmsten, U
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Is detrusor instability a prematurely activated (but otherwise normal) micturition reflex?1997Inngår i: The Lancet, Vol. 349, s. 505Annet (Annet vitenskapelig)
  • 6224. Petros, P
    et al.
    Ulmsten, U
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Role of the pelvic floor in bladder neck opening and closure II: Vagina1997Inngår i: Int Urogynecol J, Vol. 8, s. 69-Artikkel i tidsskrift (Fagfellevurdert)
  • 6225. Petros, P
    et al.
    Ulmsten, U
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Urethral pressure increase on effort originates from within the urethra, and continence from musculovaginal closure.1995Inngår i: Neurourology & Urodynamics, Vol. 14, s. 337-Artikkel i tidsskrift (Fagfellevurdert)
  • 6226.
    Pettersson, Julia
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Wikström, Caroline
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Upplevelsen av kontinuitet med samma barnmorska under graviditet och förlossning: En intervjustudie2016Independent thesis Advanced level (degree of Master (One Year)), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Barnmorskemottagningen Hjärtat i Uppsala erbjuder kontinuitetsbaserad mödrahälsovård där kvinnor kan föda med hjälp av en barnmorska de känner igen från Hjärtat. Resultat från studier om kvinnors upplevelse av kontinuitetsbaserad förlossningsvård går i sär. Några visar att det inverkar positivt på förlossningsupplevelsen medan andra visar att det inte spelar någon roll. Syfte: Syftet är att undersöka kvinnors upplevelser av att i förlossningsarbetet vårdas av en barnmorska de känner igen från mödravården, och om denna kontinuitet påverkar deras upplevelse av trygghet under förlossningen. Metod: Studien hade en kvalitativ, deskriptiv design och nio kvinnor intervjuades. Deltagarna hade antingen blivit vårdade under förlossningen av sin “egen” barnmorska från barnmorskemottagningen Hjärtat eller av en de kände igen därifrån. Intervjumaterialet analyserades med hjälp av kvalitativ innehållsanalys. Resultat: Resultatet visade att kvinnorna var positivt inställda till den kontinuitetsbaserade vård de fått. För de som födde sitt första barn var det viktigt att ha en barnmorska de kände igen för trygghetens skull. För omföderskor var det mer en positiv faktor som inte påverkade tryggheten på samma sätt. Slutsats: Kontinuitetsbaserad vårdform skapar trygghet för kvinnan genom att hon har en relation till sin barnmorska. Tryggheten i relationen kommer genom att barnmorskan känner till kvinnans historia sedan tidigare, eller bara av att se ett bekant ansikte i förlossningssalen. Att under förlossningen bli vårdad av en barnmorska man känner eller känner igen, upplevs som positivt, även om vissa kan tycka att situationen kan bli för intim.

  • 6227.
    Pettersson, Malin Lindell
    et al.
    Linköping Univ, Dept Obstet & Gynecol, SE-58185 Linköping, Sweden.;Linköping Univ, Dept Biomed & Clin Sci, SE-58185 Linköping, Sweden..
    Bladh, Marie
    Linköping Univ, Dept Obstet & Gynecol, SE-58185 Linköping, Sweden.;Linköping Univ, Dept Biomed & Clin Sci, SE-58185 Linköping, Sweden..
    Nedstrand, Elizabeth
    Linköping Univ, Dept Obstet & Gynecol, SE-58185 Linköping, Sweden.;Linköping Univ, Dept Biomed & Clin Sci, SE-58185 Linköping, Sweden..
    Skoog Svanberg, Agneta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Reproduktiv hälsa.
    Lampic, Claudia
    Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden.;Umeå Univ, Dept Psychol, Umeå, Sweden..
    Sydsjo, Gunilla
    Linköping Univ, Dept Obstet & Gynecol, SE-58185 Linköping, Sweden.;Linköping Univ, Dept Biomed & Clin Sci, SE-58185 Linköping, Sweden..
    Maternal advanced age, single parenthood, and ART increase the risk of child morbidity up to five years of age2022Inngår i: BMC Pediatrics, ISSN 1471-2431, E-ISSN 1471-2431, Vol. 22, nr 1, artikkel-id 39Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background Advanced maternal age, single status and use of assisted reproductive technology (ART) are increasing in mothers in high-income countries, and all are known risk factors for negative obstetric outcomes. Less is known about their long-term consequences for childhood morbidity. Thus, the aim of this study was to investigate morbidity up to five years of age, in the children of older, single, and/or ART-treated mothers. Methods A cross-sectional using Swedish registers was performed comprising 23 772 children. The prevalence of diagnosis and the number of hospital visits for specialist care, were compared and analyzed in relation to maternal age at childbirth, maternal civil status, and mode of conception. The odds ratio for specialized care within each ICD-chapter were estimated using single and multiple logistic regression. Results Children born to single mothers and children conceived using ART had significantly more outpatient visits for specialist care and significantly more diagnoses compared to children with married/cohabiting mothers, and spontaneously conceived children. Children born to mothers of advanced maternal age (>= 40) had fewer in- and outpatient visits. However, they were significantly more often diagnosed within ICD-chapters XVI, XVII i.e., they experienced more morbidity in the neonatal period. Conclusion The results indicate that children born to single mothers and children of ART-treated mothers have a higher morbidity and consume more specialist care than children of married/cohabiting and spontaneously pregnant mothers. We conclude that the use of ART, maternal single status and advanced maternal age are risk factors of importance to consider in pediatric care and when counseling women who are considering ART treatment.

    Fulltekst (pdf)
    FULLTEXT01
  • 6228.
    Pettersson, Malin Lindell
    et al.
    Linköping Univ, Dept Obstet & Gynecol, Dept Clin & Expt Med, Linköping, Sweden..
    Nedstrand, Elizabeth
    Linköping Univ, Dept Obstet & Gynecol, Dept Clin & Expt Med, Linköping, Sweden..
    Bladh, Marie
    Linköping Univ, Dept Obstet & Gynecol, Dept Clin & Expt Med, Linköping, Sweden..
    Skoog Svanberg, Agneta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Reproduktiv hälsa.
    Lampic, Claudia
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom. Karolinska Inst, Dept Womens & Childrens Hlth, SE-17177 Stockholm, Sweden.
    Sydsjo, Gunilla
    Linköping Univ, Dept Obstet & Gynecol, Dept Clin & Expt Med, Linköping, Sweden..
    Mothers who have given birth at an advanced age: health status before and after childbirth2020Inngår i: Scientific Reports, E-ISSN 2045-2322, Vol. 10, nr 1, artikkel-id 9739Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Women postpone childbirth to an age when morbidity is higher and fertility has decreased and yet the knowledge of mothers' morbidity related to age remains scarce. Swedish national register data from the Medical Birth Register and National Patient Register was used to investigate the incidence of diseases listed in the International Classification of Diseases, version 10 (ICD-10) in women who gave birth 2007-8. The index group consisted of women 40 years of age or older (n=8 203) were compared to a control group of women, younger than 40 years (n=15 569) at childbirth. The period studied was five years before childbirth to five years after. The main outcome measures were incidence of disease diagnosed in specialized hospital care. Demographical data and use of assisted reproduction (ART) were adjusted for. The results showed that older women were more likely to be single; less frequently used tobacco; were educated on a higher level; had a higher BMI and more often had used ART to become pregnant. The older women showed a higher morbidity rate. In the diagnostic groups: Neoplasms, Blood and immune system, Eye and adnexa, Ear and mastoid, Circulatory, Digestive, Skin and subcutaneous tissue, Musculoskeletal and connective tissue, and Genitourinary. The results add to the body of knowledge of a number of specific risks faced by older mothers and may be used to identify preventive actions concerning fertility and morbidity both before and after childbirth.

    Fulltekst (pdf)
    FULLTEXT01
  • 6229.
    Pettersson, Malin Lindell
    et al.
    Linköping Univ, Dept Obstet & Gynecol, SE-58185 Linköping, Sweden.;Linköping Univ, Dept Biomed & Clin Sci, SE-58185 Linköping, Sweden..
    Sydsjo, Gunilla
    Linköping Univ, Dept Obstet & Gynecol, SE-58185 Linköping, Sweden.;Linköping Univ, Dept Biomed & Clin Sci, SE-58185 Linköping, Sweden..
    Lampic, Claudia
    Umeå Univ, Dept Psychol, S-90187 Umeå, Sweden..
    Skoog Svanberg, Agneta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Elenis, Evangelia
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Reproduktiv hälsa.
    Perceived social support in solo women seeking treatment with donor gametes and in women in heterosexual couples seeking IVF-treatment with own gametes2023Inngår i: Scientific Reports, E-ISSN 2045-2322, Vol. 13, artikkel-id evael941Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Solo motherhood is a family constellation that is becoming increasingly common in high income countries. The demographic characteristics of solo women entering treatment with donated sperm or embryo have been shown to be different from that of cohabiting women. The general importance of perceived social support is frequently amplified when health and quality of life are concerned, and positively affects mental health status, experienced stress, perceived self-efficacy during the transition to parenthood and during parenthood itself. The objective of the present study was to compare demographic characteristics, social network and perceived social support among solo women and cohabiting women awaiting fertility treatment. This objective was explored with a study-specific demographic and background questionnaire as well as through questions on access to practical support and the Multidimensional Scale of Perceived Social Support (MSPSS) assessing different sources of support. This study is a part of a longitudinal prospective multicenter study of solo women who awaited donation treatment in six Swedish public and private fertility clinics and a comparison group of women who were cohabiting/married to male partner and awaited in vitro fertilization (IVF) treatment with the couple's own gametes. A total of 670 women were invited and 463 accepted participation (69% response rate); 207 solo women (study group) and 256 cohabiting women (comparison group). The results show significant differences in age, education, and employment between the groups. Solo women were on average 3.6 years older, had a higher level of education, a higher-income profession, and were more frequently working full time. Solo women perceived an equally high degree of social support from their families, significantly higher levels of support from friends and significantly lower support from a significant other compared to cohabiting women. Solo women expected their mother to be the most supportive person in future parenthood, while cohabiting women most often stated their cohabiting partner to fill that role. The study adds to the body of knowledge of solo women as a sociodemographic distinct group going at motherhood alone, stating a high degree of currently perceived and expected social support. The previously studied negative impact that lack of a co-parent might have, may be attenuated by the expected and perceived social support from family and friends.

    Fulltekst (pdf)
    FULLTEXT01
  • 6230. Pettersson, R
    et al.
    Rasmussen, F
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Daily intake of copper from drinking water among young children in Sweden1999Inngår i: Environmental Health Perspectives, Vol. 107, s. 441-Artikkel i tidsskrift (Fagfellevurdert)
  • 6231.
    Pettersson, Ulrika
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    BB vård i hemmet efter hemgång direkt från förlossningsenhet2013Independent thesis Advanced level (degree of Master (One Year)), 10 poäng / 15 hpOppgave
    Fulltekst (pdf)
    Tidig hemgång bb
  • 6232.
    Pettersson, Ulrika
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Comparison between two different activity diaries for children and an activity meter.2019Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [en]

    Background:

    The level of activity in an individual can be the difference between health and illness. Physical inactivity can cause diseases such as osteoporosis and type-2 diabetes. It has been reported that children live an increasingly inactive life, with less than the recommended a total of 60 minutes daily for children and adolescents of 6-17 years of age. Objective: The objective was to compare two activity diaries and how the results correspond to measurements by an activity meter. Material and methods: This study included 12 children who each carried an activity meter for four days to measure Total Energy Expenditure. In parallel, they filled in two different activity diaries. In the diaries two different calculation methods were used, with a Physical Activity Ratio value or a Metabolic Equivalent of Task value which then was inserted into equations to calculate Total Energy Expenditure. Anthropometric measurements were obtained by use of a stadiometer, a caliper and a bioimpedance scale. Results: The results from the Physical Activity Ratio diary indicated a better match with the results from the activity meter. Conclusions: Between the two diaries significant difference in how the activities were estimated were found, where an overestimation could be seen in the diary that used the Metabolic Equivalent of Task. Differences could also be seen between the activity meter and both diaries, also here the difference were bigger with the Metabolic Equivalent of Task diary. The Physical Activity Ratio diary was better matched with the activity meter.

    Fulltekst (pdf)
    fulltext
  • 6233.
    Pettman, Danelle
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Hälsovetenskap och e-hälsa.
    O'Mahen, Heather
    Mood Disorders Centre, Department of Psychology, University of Exeter, Exeter, UK.
    Blomberg, Oscar
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Hälsovetenskap och e-hälsa.
    Mårtensson, Erika
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Historisk-filosofiska fakulteten, Centrum för genusvetenskap. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Hälsovetenskap och e-hälsa.
    Carpentsier, Beatrice
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Jämlik hälsa och arbetsliv.
    Skoog Svanberg, Agneta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Reproduktiv hälsa.
    von Essen, Louise
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap. Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Hälsovetenskap och e-hälsa.
    Woodford, Joanne
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Hälsovetenskap och e-hälsa.
    Baby&Me: Development and adaptation of a supported internet-administered integrated behavioural activation intervention for postpartum depression and parenting: A participatory action approach2020Inngår i: 6th International Congress of Clinical Psychology and Health with Children and Adolescents: Book Of Abstracts, Ediciones Pirámide (Grupo Anaya, S. A.) , 2020, s. 84-84Konferansepaper (Annet vitenskapelig)
    Abstract [en]

    Postpartum depression (PPD) can interfere witha mother’s ability to engage in sensitive caregiving,however a recent systematic review and meta-analysisby our group (Pettman et al., 2020) revealed the majority of existing PPD interventions focus on the mothersmood alone, without additional support with parenting.Further, in a recent randomised controlled feasibilitytrial telephone supported internet-administered behavioural activation (BA) intervention for PPD demonstrated feasibility and acceptability with a large effectsize for depression at post-treatment (-0.87, 95% CI0.42-1.32), maintained at 6 months (O’Mahen et al.,2014). Attrition rates were low, with 10% attrition inthe BA group at post-treatment and 14% at 6-monthfollow-up. However, only small effect sizes were foundfor self-reported perception of relationship with infant(parental bonding). The purpose of this research is todevelop an accessible internet-based intervention thatintegrates BA treatment for PPD with parenting skillsand to adapt it to a Swedish population. Adopting theMedical Research Council (United Kingdom) phase I(development) framework, this qualitative study willuse a participatory action research (PAR) approach.Using PAR will place Swedish mothers with lived experience of PPD at the centre of the intervention development process. Through a series of iterative workshops,meetings and online feedback, a Mother ResearcherPartner Panel of mothers with lived experience ofPPD and Health Care Professional Advisory Group willassist the research team in iteratively developing theintegrated PPD and parenting intervention. Resultswill report mothers’ intervention design and deliverypreferences, including technical elements, visual andaudio elements, and amount and format of professional support. Results will also describe adaptations toimprove the cultural appropriateness, relevance, andacceptability of the intervention to Swedish mothers.  

  • 6234.
    Pettman, Danelle
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Hälsovetenskap och e-hälsa.
    O'Mahen, Heather
    Mood Disorders Centre, Department of Psychology, University of Exeter, Exeter, UK.
    Blomberg, Oscar
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Hälsovetenskap och e-hälsa.
    Mårtensson, Erika
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Hälsovetenskap och e-hälsa.
    Skoog Svanberg, Agneta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Reproduktiv hälsa.
    von Essen, Louise
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Hälsovetenskap och e-hälsa.
    Woodford, Joanne
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Hälsovetenskap och e-hälsa.
    Development of an integrated behavioural activation and parenting internet-administered intervention for postpartum depression parenting sensitivity: Protocol for a participatory action research study2020Konferansepaper (Annet vitenskapelig)
  • 6235.
    Pettman, Danelle
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Hälsovetenskap och e-hälsa.
    O'Mahen, Heather
    Mood Disorders Centre, Department of Psychology, University of Exeter, Exeter, UK.
    Blomberg, Oscar
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Hälsovetenskap och e-hälsa.
    Skoog Svanberg, Agneta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Reproduktiv hälsa.
    von Essen, Louise
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap. Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Hälsovetenskap och e-hälsa.
    Woodford, Joanne
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Hälsovetenskap och e-hälsa.
    Effectiveness and acceptability of cognitive behavioural therapy based interventions for maternal peripartum depression: A systematic review, meta-analysis and thematic synthesis2020Konferansepaper (Fagfellevurdert)
  • 6236.
    Pettman, Danelle
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Hälsovetenskap och e-hälsa.
    O'Mahen, Heather
    Mood Disorders Centre, Department of Psychology, University of Exeter, Exeter, UK.
    Blomberg, Oscar
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Hälsovetenskap och e-hälsa.
    Skoog Svanberg, Agneta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Reproduktiv hälsa.
    von Essen, Louise
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap. Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Hälsovetenskap och e-hälsa.
    Woodford, Joanne
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Hälsovetenskap och e-hälsa.
    Effectiveness of cognitive behavioural therapy-based interventions for maternal perinatal depression: A systematic review and meta-analysis2022Inngår i: BABCP 50th Annual Conference: Imperial College London 21 – 23 July 2022, 2022Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Background: Perinatal depression is prevalent condition which impact negatively upon mothers, infants, families and widersociety. The evidence based suggests that cognitive behavioral therapy (CBT) based interventions are effective for perinataldepression, however the effect upon important secondary outcomes, and a number of potential clinical andmethodological moderators has yet to be examined.Methods: A systematic review and meta-analysis was conducted to explore the effectiveness of CBT-based interventionsfor perinatal depression on symptoms of depression, anxiety, stress, parenting, perceived social support, and perceivedparental competence. Clinical and methodological moderators potentially associated with effectiveness were explored. Asystematic search was performed for randomized controlled trials (RCTs) of CBT-based interventions for perinataldepression. Searches were performed up until November 2021.Results: The systematic review included 31 studies (5,291 participants) and the meta-analysis included 26 studies (4,658participants). The overall effect size was medium (hedges g = -0.53 [95% CI -0.65 to -0.40]); with high heterogeneity.Significant effects were found for anxiety, individual stress, and perceived social support, however few studies includedthese secondary outcomes. In the subgroup analysis; type of control, type of cognitive behavioral therapy, and type ofhealth professional were significant moderators of the main effect (symptoms of depression). Some concerns of risk of biaswere present in many studies and one study had a high risk of bias.27Conclusions: CBT-based interventions for perinatal depression appear effective, however results should be cautiouslyinterpreted given high levels of heterogeneity and risk of bias presented in many studies. The moderating effect of the typeprofessional delivering interventions warrants further study. Additionally, the results indicate a need to improveconsistency of reporting across trials with the development of a minimum core data set and to design and conduct trialswith longer-term follow-up periods.PROSPERO registration: CRD42020152254.

  • 6237.
    Pettman, Danelle
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Hälsovetenskap och e-hälsa.
    O’Mahen, Heather
    Mood Disorders Centre, Department of Psychology, University of Exeter, Exeter, UK.
    Blomberg, Oscar
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Hälsovetenskap och e-hälsa.
    Skoog Svanberg, Agneta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Reproduktiv hälsa.
    von Essen, Louise
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Hälsovetenskap och e-hälsa.
    Woodford, Joanne
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Hälsovetenskap och e-hälsa.
    Effectiveness of cognitive behavioural therapy-based interventions for maternal perinatal depression: a systematic review and meta-analysis2023Inngår i: BMC Psychiatry, E-ISSN 1471-244X, Vol. 23, nr 1, artikkel-id 208Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

    Depression during the perinatal period (during pregnancy and the year after childbirth) is common and associated with a range of negative effects for mothers, infants, family members, and wider society. Although existing evidence suggests cognitive behavioral therapy (CBT) based interventions are effective for perinatal depression, less is known about the effect of CBT-based interventions on important secondary outcomes, and a number of potential clinical and methodological moderators have not been examined.

    Methods

    A systematic review and meta-analysis primarily examined the effectiveness of CBT-based interventions for perinatal depression on symptoms of depression. Secondary aims examined the effectiveness of CBT-based interventions for perinatal depression on symptoms of anxiety, stress, parenting, perceived social support, and perceived parental competence; and explored clinical and methodological moderators potentially associated with effectiveness. A systematic search of electronic databases and other sources was performed up to November 2021. We included randomized controlled trials comparing CBT-based interventions for perinatal depression with control conditions allowing for the isolation of the effects of CBT.

    Results

    In total, 31 studies (5291 participants) were included in the systematic review and 26 studies (4658 participants) were included in the meta-analysis. The overall effect size was medium (hedges g = − 0.53 [95% CI − 0.65 to − 0.40]); with high heterogeneity. Significant effects were also found for anxiety, individual stress, and perceived social support, however few studies examined secondary outcomes. Subgroup analysis identified type of control, type of CBT, and type of health professional as significant moderators of the main effect (symptoms of depression). Some concerns of risk of bias were present in the majority of studies and one study had a high risk of bias.

    Conclusions

    CBT-based interventions for depression during the perinatal period appear effective, however results should be interpreted with caution given high levels of heterogeneity and low quality of included studies. There is a need to further investigate possibly important clinical moderators of effect, including the type of health professional delivering interventions. Further, results indicate a need to establish a minimum core data set to improve the consistency of secondary outcome collection across trials and to design and conduct trials with longer-term follow-up periods.

    Fulltekst (pdf)
    fulltext
  • 6238.
    Pettman, Danelle
    et al.
    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.
    O'Mahen, Heather
    Mood Disorders Centre, School of Psychology, University of Exeter, Exeter, UK.
    Skoog Svanberg, Agneta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Reproduktiv hälsa.
    von Essen, Louise
    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.
    Axfors, Cathrine
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Ekselius: Psykiatri.
    Blomberg, Oscar
    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.
    Woodford, Joanne
    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.
    Effectiveness and acceptability of cognitive behavioural therapy based interventions for maternal peripartum depression: A systematic review, meta-analysis and thematic synthesis protocol2019Inngår i: BMJ Open, E-ISSN 2044-6055, Vol. 9, nr 12, artikkel-id e032659Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    INTRODUCTION:

    Peripartum depression is a common mental health difficulty associated with a range of negative impacts for the mother, infant and wider family. This review will examine the effectiveness of cognitive-behavioural therapy (CBT) based interventions for peripartum depression. Secondary aims are to explore the effect of CBT-based interventions targeted at peripartum depression on novel secondary outcomes and moderators potentially associated with effectiveness. To date, there has been little examination of effect on important secondary outcomes (eg, anxiety, stress and parenting), nor clinical and methodological moderators. Further, this review aims to explore the acceptability of CBT-based interventions for women with peripartum depression and examine important adaptations for this population.

    METHODS AND ANALYSIS:

    Electronic databases (e.g., MEDLINE; ISI Web of Science; CINAHL; CENTRAL; Prospero; EMBASE; ASSIA; PsychINFO; SCOPUS; And Swemed+) will be systematically searched. Database searches will be supplemented by expert contact, reference and citation checking, and grey literature. Primary outcomes of interest will be validated measures of symptoms of depression. A proposed meta-analysis will examine: (1) the overall effectiveness of psychological interventions in improving symptoms of depression (both self-reported and diagnosed major depression) in the peripartum period; (2) the impact of interventions on secondary outcomes (eg, anxiety, stress and parenting); (3) clinical and methodological moderators associated with effectiveness. A thematic synthesis will be conducted on qualitative data exploring the acceptability of CBT-based intervention for postpartum depression including participants' experience and perspectives of the interventions, satisfaction, barriers and facilitators to intervention use, intervention relevance to mothers' situations and suggestions for improvements to tailor interventions to the peripartum client group.

    ETHICS AND DISSEMINATION:

    Formal ethical approval is not required by the National Ethical Review Board in Sweden as primary data will not be collected. The results will be disseminated through a peer-reviewed publication and inform the development of a new psychological intervention for peripartum depression. This study including protocol development will run from March 2019 to March 2020.

    Fulltekst (pdf)
    fulltext
  • 6239. Petzold, Max
    et al.
    Sonesson, Christian
    Bergman, Eva
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Kieler, Heller
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Surveillance in longitudinal models: Detection of intrauterine growth restriction2004Inngår i: Biometrics, nr 60, s. 1025-1033Artikkel i tidsskrift (Fagfellevurdert)
  • 6240.
    Peute, Linda W.
    et al.
    Centre for Human Factor Engineering of Health Information technology - Amsterdam UMC, University of Amsterdam, department of Medical Informatics, Amsterdam, The Netherlands.
    Lichtner, Valentina
    Centre for Medication Safety and Service Quality, UCL School of Pharmacy, UK.
    Baysari, Melissa T.
    The University of Sydney, Faculty of Medicine and Health, Sydney, Australia.
    Hägglund, Maria
    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. Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
    Homco, Juell
    Department of Medical Informatics, University of Oklahoma - Tulsa School of Community Medicine, USA.
    Jansen-Kosterink, Stephanie
    Roessingh Research and Development, eHealth group, Enschede, The Netherlands.
    Jauregui, Ignacio
    Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina.
    Kaipio, Johanna
    Department of Computer Science, Aalto University, Finland.
    Kuziemsky, Craig E.
    MacEwan University, Edmonton, AB, Canada.
    Lehnbom, Elin Christina
    Department of Pharmacy, Faculty of Health Sciences, UiT The Arctic University of Norway, Norway; Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Sweden.
    Leite, Francisca
    Hospital da Luz Learning Health, Portugal.
    Lesselroth, Blake
    Department of Medical Informatics, University of Oklahoma - Tulsa School of Community Medicine, USA.
    Luna, Daniel
    Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina.
    Otero, Carlos
    Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina.
    Pedersen, Rune
    Norwegian Centre for E-health Research, University Hospital of North Norway HF, Norway; Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Norway.
    Pelayo, Sylvia
    Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, INSERM-CIC-IT 1403/Evalab, Lille, France.
    Santos, Raquel
    Hospital da Luz Learning Health, Portugal.
    Silva, Nuno-André
    Hospital da Luz Learning Health, Portugal.
    Tyllinen, Mari
    Department of Computer Science, Aalto University, Finland.
    Van Velsen, Lex
    Roessingh Research and Development, eHealth group, Enschede, The Netherlands.
    Zheng, Wu Yi
    The University of Sydney, Faculty of Medicine and Health, Sydney, Australia.
    Jaspers, Monique
    Centre for Human Factor Engineering of Health Information technology - Amsterdam UMC, University of Amsterdam, department of Medical Informatics, Amsterdam, The Netherlands.
    Marcilly, Romaric
    Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, INSERM-CIC-IT 1403/Evalab, Lille, France.
    Challenges and Best Practices in Ethical Review of Human and Organizational Factors Studies in Health Technology: a Synthesis of Testimonies2020Inngår i: IMIA Yearbook of Medical Informatics, ISSN 0943-4747, Vol. 29, nr 1, s. 58-70Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: Human and Organizational Factors (HOF) studies in health technology involve human beings and thus require Institutional Review Board (IRB) approval. Yet HOF studies have specific constraints and methods that may not fit standard regulations and IRB practices. Gaining IRB approval may pose difficulties for HOF researchers. This paper aims to provide a first overview of HOF study challenges to get IRB review by exploring differences and best practices across different countries.

    Methods: HOF researchers were contacted by email to provide a testimony about their experience with IRB review and approval. Testimonies were thematically analyzed and synthesized to identify and discuss shared themes.

    Results: Researchers from seven European countries, Argentina, Canada, Australia, and the United States answered the call. Four themes emerged that indicate shared challenges in legislation, IRB inefficiencies and inconsistencies, general regulation and costs, and lack of HOF study knowledge by IRB members. We propose a model for IRB review of HOF studies based on best practices.

    Conclusion: International criteria are needed that define low and high-risk HOF studies, to allow identification of studies that can undergo an expedited (or exempted) process from those that need full IRB review. Enhancing IRB processes in such a way would be beneficial to the conduct of HOF studies. Greater knowledge and promotion of HOF methods and evidence-based HOF study designs may support the evolving discipline. Based on these insights, training and guidance to IRB members may be developed to support them in ensuring that appropriate ethical issues for HOF studies are considered.

    Fulltekst (pdf)
    fulltext
  • 6241.
    Peven, Kimberly
    et al.
    London Sch Hyg & Trop Med, Maternal Adolescent Reprod & Child Hlth MARCH Ctr, Keppel St, London WC1E 7HT, England.;Kings Coll London, Florence Nightingale Fac Nursing Midwifery & Pall, London, England..
    Day, Louise T.
    London Sch Hyg & Trop Med, Maternal Adolescent Reprod & Child Hlth MARCH Ctr, Keppel St, London WC1E 7HT, England..
    Ruysen, Harriet
    London Sch Hyg & Trop Med, Maternal Adolescent Reprod & Child Hlth MARCH Ctr, Keppel St, London WC1E 7HT, England..
    Tahsina, Tazeen
    Int Ctr Diarrhoeal Dis Res Bangladesh Iccdr B, Maternal & Child Hlth Div, Dhaka, Bangladesh..
    KC, Ashish
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH), Internationell barnhälsa och nutrition. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH), Global hälsa - implementering och hållbarhet.
    Shabani, Josephine
    Ifakara Hlth Inst, Dept Hlth Syst Impact Evaluat & Policy, Dar Es Salaam, Tanzania..
    Kong, Stefanie
    London Sch Hyg & Trop Med, Maternal Adolescent Reprod & Child Hlth MARCH Ctr, Keppel St, London WC1E 7HT, England..
    Ameen, Shafiqul
    Int Ctr Diarrhoeal Dis Res Bangladesh Iccdr B, Maternal & Child Hlth Div, Dhaka, Bangladesh..
    Basnet, Omkar
    Golden Community, Res Div, Lalitpur, Nepal..
    Haider, Rajib
    Int Ctr Diarrhoeal Dis Res Bangladesh Iccdr B, Maternal & Child Hlth Div, Dhaka, Bangladesh..
    Rahman, Qazi Sadeq-ur
    Int Ctr Diarrhoeal Dis Res Bangladesh Iccdr B, Maternal & Child Hlth Div, Dhaka, Bangladesh..
    Blencowe, Hannah
    London Sch Hyg & Trop Med, Maternal Adolescent Reprod & Child Hlth MARCH Ctr, Keppel St, London WC1E 7HT, England..
    Lawn, Joy E.
    London Sch Hyg & Trop Med, Maternal Adolescent Reprod & Child Hlth MARCH Ctr, Keppel St, London WC1E 7HT, England..
    Stillbirths including intrapartum timing: EN-BIRTH multi-country validation study2021Inngår i: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 21, nr SUPPL, artikkel-id 226Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BackgroundAn estimated >2 million babies stillborn around the world each year lack visibility. Low- and middle-income countries carry 84% of the burden yet have the least data. Most births are now in facilities, hence routine register-recording presents an opportunity to improve counting of stillbirths, but research is limited, particularly regarding accuracy. This paper evaluates register-recorded measurement of hospital stillbirths, classification accuracy, and barriers and enablers to routine recording.MethodsThe EN-BIRTH mixed-methods, observational study took place in five hospitals in Bangladesh, Nepal and Tanzania (2017-2018). Clinical observers collected time-stamped data on perinatal care and birth outcomes as gold standard. To assess accuracy of routine register-recorded stillbirth rates, we compared birth outcomes recorded in labour ward registers to observation data. We calculated absolute rate differences and individual-level validation metrics (sensitivity, specificity, percent agreement). We assessed misclassification of stillbirths with neonatal deaths. To examine stillbirth appearance (fresh/macerated) as a proxy for timing of death, we compared appearance to observed timing of intrauterine death based on heart rate at admission.Results23,072 births were observed including 550 stillbirths. Register-recorded completeness of birth outcomes was >90%. The observed study stillbirth rate ranged from 3.8 (95%CI=2.0,7.0) to 50.3 (95%CI=43.6,58.0)/1000 total births and was under-estimated in routine registers by 1.1 to 7.3 /1000 total births (register: observed ratio 0.9-0.7). Specificity of register-recorded birth outcomes was >99% and sensitivity varied between hospitals, ranging from 77.7-86.1%. Percent agreement between observer-assessed birth outcome and register-recorded birth outcome was very high across all hospitals and all modes of birth (>98%). Fresh or macerated stillbirth appearance was a poor proxy for timing of stillbirth. While there were similar numbers of stillbirths misclassified as neonatal deaths (17/430) and neonatal deaths misclassified as stillbirths (21/36), neonatal deaths were proportionately more likely to be misclassified as stillbirths (58.3% vs 4.0%). Enablers to more accurate register-recording of birth outcome included supervision and data use.ConclusionsOur results show these routine registers accurately recorded stillbirths. Fresh/macerated appearance was a poor proxy for intrapartum stillbirths, hence more focus on measuring fetal heart rate is crucial to classification and importantly reduction in these preventable deaths.

    Fulltekst (pdf)
    FULLTEXT01
  • 6242.
    Peyda Moore, Simon
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa).
    The effect of maternal education on breastfeeding initiation behavior of Ugandan mothers: Secondary analysis of DHS 2016 data using the COM-B model2019Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
    Abstract [en]

    Background: The World Health Organization recommends early breastfeeding initiation, within the first hour of life. Ugandan mothers with no formal schooling appear superior in fulfilling this recommendation compared to mothers with primary, secondary, or higher education.

    Aim: This secondary analysis of Ugandan Demographic and Health Survey data from 2016 aimed to statistically analyze the association between maternal education and early breastfeeding initiation, to find socio-economic and health care determinants that promote the behavior.

    Methods: Ugandan mothers (n=9,209, 15 to 49 years) were included in statistical analysis. Chi-squared testing and logistic regression were used to assess associations between maternal education (exposure) and fulfillment of early breastfeeding initiation less than 1 hour after birth (outcome).

    Results: Out of the eligible mothers in a weighted sample, 68% (n=6,281) fulfilled early breastfeeding initiation and 32% (n=2,928) did not meet the criteria. Maternal primary education significantly predicted the outcome of early breastfeeding initiation (p ≤ 0.05, AOR: 0.80, with 95% CI 0.67-0.95) in a negative direction, compared to uneducated mothers. This result was adjusted for maternal residence, education, occupation, and parity, along with the husband/partner's education. Moreover, educational attainment beyond the primary level indicated a non-significant association to the criteria fulfillment when compared to uneducated mothers.

    Conclusions: Ugandan maternal education does not seem to significantly promote early BFI behavior. Primary level education only indicated a significantly negative association compared to uneducated Ugandan mothers. Traditional lifestyle factors (lower level education, and corresponding level of occupation, and larger families) appeared to be associated with the desired behavior.

    Fulltekst (pdf)
    fulltext
  • 6243.
    Peyrl, Andreas
    et al.
    Med Univ Vienna, Dept Pediat & Adolescent Med, Vienna, Austria.;Med Univ Vienna, Comprehens Ctr Pediat, Vienna, Austria.;Med Univ Vienna, Dept Pediat & Adolescent Med, Wahringer Gurtel 18-20, A-1090 Vienna, Austria..
    Chocholous, Monika
    Med Univ Vienna, Dept Pediat & Adolescent Med, Vienna, Austria.;Med Univ Vienna, Comprehens Ctr Pediat, Vienna, Austria..
    Sabel, Magnus
    Sahlgrens Univ Hosp, Queen Silvia Childrens Hosp, Childhood Canc Ctr, Gothenburg, Sweden.;Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Gothenburg, Sweden..
    Lassaletta, Alvaro
    Hosp Infantil Univ Nino Jesus, Dept Pediat Neurooncol, Madrid, Spain..
    Sterba, Jaroslav
    Univ Hosp Brno, Pediat Oncol Dept, Brno, Czech Republic..
    Leblond, Pierre
    Oscar Lambret Comprehens Canc Ctr, Pediat Oncol Unit, Lille, France.;Inst Hematol & Doncol Pediat, Ctr Leon Berard, Lyon, France..
    Nysom, Karsten
    Rigshospitalet, Dept Paediat & Adolescent Med, Copenhagen, Denmark..
    Torsvik, Ingrid
    Haukeland Hosp, Dept Paediat & Adolescent Med, Bergen, Norway..
    Chi, Susan N.
    Dana Farber Canc Inst, Dept Pediat Neurooncol, Boston, MA USA..
    Perwein, Thomas
    Med Univ Graz, Dept Pediat & Adolescent Med, Div Pediat Hemato Oncol, Graz, Austria..
    Jones, Neil
    Salzburger Univ klinikum, Kinderonkol, Salzburg, Austria..
    Holm, Stefan
    Karolinska Univ Hosp, Dept Pediat Hematol & Oncol, Stockholm, Sweden..
    Nyman, Per
    Linkoping Univ Hosp, Dept Paediat, Linkoping, Sweden..
    Moerse, Helena
    Skane Univ Hosp, Pediat Canc Ctr, Lund, Sweden..
    Öberg, Anders
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Barnonkologisk forskning - särskilt fokus på komplikationer. Uppsala Univ, Dept Pediat, Uppsala, Sweden..
    Weiler-Wichtl, Liesa
    Med Univ Vienna, Dept Pediat & Adolescent Med, Vienna, Austria.;Med Univ Vienna, Comprehens Ctr Pediat, Vienna, Austria..
    Leiss, Ulrike
    Med Univ Vienna, Dept Pediat & Adolescent Med, Vienna, Austria.;Med Univ Vienna, Comprehens Ctr Pediat, Vienna, Austria..
    Haberler, Christine
    Med Univ Vienna, Dept Neurol, Vienna, Austria..
    Schmook, Maresa T.
    Med Univ Vienna, Dept Biomed Imaging & Image Guided Therapy, Div Neuroradiol & Musculoskeletal Radiol, Vienna, Austria..
    Mayr, Lisa
    Med Univ Vienna, Dept Pediat & Adolescent Med, Vienna, Austria.;Med Univ Vienna, Comprehens Ctr Pediat, Vienna, Austria..
    Dieckmann, Karin
    Med Univ Vienna, Dept Radiooncol, Vienna, Austria..
    Kool, Marcel
    Hopp Childrens Canc Ctr KiTZ, Heidelberg, Germany.;German Canc Consortium DKTK, Div Pediat Neurooncol, German Canc Res Ctr DKFZ, Heidelberg, Germany.;Princess MaximaCtr Pediat Oncol, Utrecht, Netherlands..
    Gojo, Johannes
    Med Univ Vienna, Dept Pediat & Adolescent Med, Vienna, Austria.;Med Univ Vienna, Comprehens Ctr Pediat, Vienna, Austria..
    Azizi, Amedeo A.
    Med Univ Vienna, Dept Pediat & Adolescent Med, Vienna, Austria.;Med Univ Vienna, Comprehens Ctr Pediat, Vienna, Austria..
    Andre, Nicolas
    Assistance Publ Hop Marseille, Dept Pediat Oncol, Marseille, France.;Aix Marseille Univ, Canc Res Ctr Marseille, Marseille, France..
    Kieran, Mark
    Dana Farber Canc Inst, Dept Pediat Neurooncol, Boston, MA USA..
    Slavc, Irene
    Med Univ Vienna, Dept Pediat & Adolescent Med, Vienna, Austria.;Med Univ Vienna, Comprehens Ctr Pediat, Vienna, Austria..
    Sustained Survival Benefit in Recurrent Medulloblastoma by a Metronomic Antiangiogenic Regimen A Nonrandomized Controlled Trial2023Inngår i: JAMA Oncology, ISSN 2374-2437, E-ISSN 2374-2445, Vol. 9, nr 12, s. 1688-1695Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Importance Medulloblastoma recurrence in patients who have previously received irradiation has a dismal prognosis and lacks a standard salvage regimen.Objective To evaluate the response rate of pediatric patients with medulloblastoma recurrence using an antiangiogenic metronomic combinatorial approach (Medulloblastoma European Multitarget Metronomic Anti-Angiogenic Trial [MEMMAT]).Design, Setting, and Participants This phase 2, investigator-initiated, multicenter nonrandomized controlled trial assessed 40 patients with relapsed or refractory medulloblastoma without a ventriculoperitoneal shunt who were younger than 20 years at original diagnosis. Patients were enrolled between April 1, 2014, and March 31, 2021.Interventions Treatment consisted of daily oral thalidomide, fenofibrate, celecoxib, and alternating 21-day cycles of low-dose (metronomic) oral etoposide and cyclophosphamide, supplemented by intravenous bevacizumab and intraventricular therapy consisting of alternating etoposide and cytarabine.Main Outcomes and Measures The primary end point was response after 6 months of antiangiogenic metronomic therapy. Secondary end points included progression-free survival (PFS), overall survival (OS), and quality of life. Adverse events were monitored to assess safety.Results Of the 40 patients (median [range] age at treatment start, 10 [4-17] years; 25 [62.5%] male) prospectively enrolled, 23 (57.5%) achieved disease control after 6 months of treatment, with a response detected in 18 patients (45.0%). Median OS was 25.5 months (range, 10.9-40.0 months), and median PFS was 8.5 months (range, 1.7-15.4 months). Mean (SD) PFS at both 3 and 5 years was 24.6% (7.9%), while mean (SD) OS at 3 and 5 years was 43.6% (8.5%) and 22.6% (8.8%), respectively. No significant differences in PFS or OS were evident based on molecular subgroup analysis or the number of prior recurrences. In patients demonstrating a response, mean (SD) overall 5-year PFS was 49.7% (14.3%), and for patients who remained progression free for the first 12 months of treatment, mean (SD) 5-year PFS was 66.7% (16.1%). Treatment was generally well tolerated. Grade 3 to 4 treatment-related adverse events included myelosuppression, infections, seizures, and headaches. One heavily pretreated patient with a third recurrence died of secondary acute myeloid leukemia.Conclusions and Relevance This feasible and well-tolerated MEMMAT combination regimen demonstrated promising activity in patients with previously irradiated recurrent medulloblastoma. Given these results, this predominantly oral, well-tolerated, and outpatient treatment warrants further evaluation.

  • 6244. Peña, R.
    et al.
    Pérez, Wilton
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Meléndez, M.
    Källestål, Carina
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Persson, Lars Åke
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    The Nicaraguan health and demographic surveillance site, HDSS-León: A platform for public health research2008Inngår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 36, nr 3, s. 318-325Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: To describe the Health and Demographic Surveillance System (HDSS) in Leon, Nicaragua and to present results from the 2002-2003 baseline. Design and methods: A 22% sample of the total population in Leon, both urban and rural, was selected in 1993. This sample was updated in 2002 and will be followed up on a biannual basis with regard to births, deaths, in-migration, and out-migration. A group of 18 female fieldworkers perform 10 household interviews per day, 20 days per month. They use a map that is produced by a Geographical Information System. It shows all the households, and is the main means of the interviewers finding the households. An extensive data quality control system is used. Results: In total, 54,647 persons lived in the area of the surveillance system, and they resided in 10,994 households. The mean age was 26 years;, the sex ratio was 0.93. The infant and neonatal mortality rates were 25.4 and 20.5 per 1,000 live births, respectively. In total, 2,034 people out-migrated from the study area and 3,377 in-migrated. Of the households, 53% were classified as non-poor, 41% as poor, and 6% as extremely poor. Six per cent of the population did not have a toilet or a latrine, and only 16% in the rural area had indoor running water. The surveillance system revealed that 10% were illiterate. Conclusions: The HDSS in Leon has shown that it can serve as a platform for further intervention studies as well as for research training.

  • 6245. Pfaffmann Zambruni, Jerome
    et al.
    Rasanathan, Kumanan
    Hipgrave, David
    Miller, Nathan P
    Momanyi, Maureen
    Pearson, Luwei
    Rio, Dolores
    Romedenne, Magali
    Singh, Sagri
    Young, Mark
    Peterson, Stefan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Community health systems: allowing community health workers to emerge from the shadows2017Inngår i: The Lancet Global Health, E-ISSN 2214-109X, Vol. 5, nr 9, s. e866-e867, artikkel-id S2214-109X(17)30268-1Artikkel i tidsskrift (Fagfellevurdert)
  • 6246.
    Pfeifer, Susan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Barnonkologi: Maligna tumörer barnonkologins fokus på asco 20112011Inngår i: Novartis Onkologi, , s. 5s. 10-15Artikkel, forskningsoversikt (Annet vitenskapelig)
  • 6247.
    Pfeifer, Susan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Många nya rön om maligna tumörer hos barn2011Inngår i: Onkologi i Sverige, ISSN 1653-1582, nr 4, s. 6s. 74-80Artikkel, forskningsoversikt (Annet vitenskapelig)
  • 6248.
    Pfeifer, Susan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Nya trender inom barnonkologin2010Inngår i: Onkologi i Sverige, ISSN 1653-1582, Vol. 4, s. 4s. 68-72Artikkel i tidsskrift (Annet vitenskapelig)
  • 6249.
    Pfeifer, Susan
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Nister, Monica
    de Stahl, Teresita Diaz
    Basmaci, Elisa
    Swedish Biobank for Childhood Tumors2014Inngår i: Neuro-Oncology, ISSN 1522-8517, E-ISSN 1523-5866, Vol. 16, s. 141-141Artikkel i tidsskrift (Annet vitenskapelig)
  • 6250.
    Pfeifer, Susan
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Nistér, Monica
    Department of Oncology-Pathology, Karolinska Institutet, Sweden.
    Diaz de Ståhl, Teresita
    Department of Oncology-Pathology, Karolinska Institutet, Sweden.
    Basmaci, Elisa
    Department of Oncology-Pathology, Karolinska Institutet, Sweden.
    The Swedish Pediatric Tumor Biobank2014Inngår i: 16th International Symposium on Pediatric Neuro-Oncology in conjunction with the 8th St. Jude-VIVA Forum, 28 June - 2 July, 2014., 2014Konferansepaper (Fagfellevurdert)
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