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It is well known that CO2 reacts with primary and secondary amines in aqueous solutions and forms carbamates. This reaction can have consequences when studying the self‐assembly of amines. In this article, we discuss the practical challenges when working with an alkyl Y‐shaped amine (Y12‐amine) and demonstrate how the formation of carbamate species influences the physicochemistry of the amine‐based surfactant. A drift in dynamic surface tension was observed for Y12‐amine at pH above pKa due to the reaction with the naturally occurring CO2 from the atmosphere. The drift in dynamic surface tension was more pronounced at pH above pKa, than at and below pKa. Furthermore, the drift in dynamic surface tension of Y12‐amine at pH 12 also affected the surfactant's critical micelle concentration (CMC). CMC of Y12‐amine determined by the pendant drop at the air/water interface was almost five times higher than at the N2/water interface. The latter result was in agreement with the one determined by monitoring the change in chemical shift of 1H NMR in a N2 atmosphere. Moreover, it was also shown that the adsorption of the amine at different interfaces influences carbamate formation. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study was to compare the results of a 2013 nationwide survey of 1001 women representative of the Swedish female population with the results of a similar survey carried out in 2017, after new guidelines for contraceptive use were published in 2014.Methods: Women between 16 and 49 years of age took part in a telephone survey; questions covered demographics, contraceptive use, knowledge of and attitudes towards contraception, importance of monthly bleeding, and experience of unintended pregnancy. We compared the responses collected in 2013 with those collected in 2017.Results: Of all women in 2017, 717/1008 (71.1%) were currently using contraception; 291/1008 (28.9%) women were not. Long-acting reversible contraception (LARC) was used by 311/1008 (30.9%) women, which was a significant increase from 2013 (243/1001, 24.3%; p = .001). The unmet need for contraception in Sweden in 2017 was estimated to be 15.2%. A total of 783 (77.7%) women had never experienced an unintended pregnancy. A significantly higher proportion of unintended pregnancies reported in 2017 were terminated compared with 2013.Conclusion: Sweden has a large unmet need for contraception. In 2017, LARC use had increased compared with 2013. A large proportion of women had experienced an unintended pregnancy. Increasing overall contraceptive use is important to reduce the rates of unintended and unwanted pregnancies. [ABSTRACT FROM AUTHOR]

Graphical abstract Abstract Fatty alkyldiamine readily reacts with CO 2 in aqueous solution at pH 12 to reversibly form surface active carbamate species. The carbamate can be reverted to the amine by exposure to N 2 and heat. In this work, a carbamate-based surfactant (Y12-carbamate) has been used to disperse and stabilize hydrophobic nanoparticles. This state could be regarded as the "on" state of a series of cycle. The nanoparticles were then flocculated when the carbamate groups were cleaved by exposure to N 2 and heating, corresponding to the "off" state. In a subsequent cycle, the nanoparticles were re-dispersed by exposure to CO 2 , while the pH remained at 12. This cycle of re-dispersion and flocculation could be repeated two times without impairing the particle size. However, further cycles increased the particle size, indicating that all particles could not be completely re-dispersed. In addition, we also investigated the effect of pH on the colloidal stability with sodium Y12-carbamate, by measuring particle size and electrophoretic mobility. The results showed that pH strongly influenced the stability of the nanoparticles. Sodium Y12-carbamate stabilized the particles with a negative electrophoretic mobility at pH well above pKa whereas at pH close to pKa of Y12-amine (pKa = 9.0), the particles quickly flocculated, as a result of an ion-pair formation between Y12-ammonium and Y12-carbamate. [ABSTRACT FROM AUTHOR]

Carbon dioxide is commonly used as pH regulator in switchable surfactant systems and in the formation of alkyl ammonium-alkyl carbamate ion-pair. Its use to form a meta-stable anionic surfactant has been less explored and can impart a cleavable character to the amphiphile. The reaction between CO 2 and an alkylamine, N,N-di(propylamino)dodecylamine (Y12-amine), under alkaline pH conditions, produced a stable anionic carbamate-based surfactant (Y12-carbamate). By heating and exposure to N 2 , anionic Y12-carbamate could slowly be reverted into Y12-amine. The surface activity of Y12-amine and Y12-carbamate was investigated by surface tension measurements. To study the behavior of Y12-amine at the gas-water interface during CO 2 exposure, we used the pendant drop technique with a sealed chamber where the gas composition could be controlled. The Y12-carbamate had a higher CMC than Y12-amine at pH 12, and was also less surface active. The ion pair Y12-ammonium – Y12-carbamate, obtained at neutral pH, exhibited the lowest CMC and the highest surface activity. The interfacial formation of anionic Y12-carbamate induced an increase in surface tension. When CO 2 was exchanged to N 2 , the migration from the bulk to the interface of Y12-amine induced a decrease in surface tension. The rate was dependent on the concentration of Y12-amine. [ABSTRACT FROM AUTHOR]

For children living with long-term illness, school age is a risk period with regard to psychosocial ill health and poor compliance with treatment. There is a need for methods to promote health, well-being, and self-esteem. This study describes a new concept for supporting children, person-centred web-based learning and support, which has been tested in 12 preschool children and incorporates learning about feelings, relationships, and the right to integrity. SKYPE was used for conversations between the child and the web teacher. Methods. The programme was developed and tested in two steps. The conversations were tape-recorded and analysed using phenomenography. The questions addressed concerned the quality of the intervention process: accessibility of intervention, learning content and support, and identification of measurable items and patterns. Findings. The children found it interesting to communicate with their web teacher using SKYPE. The story about Max and Sara served as a good basis for discussion, and development was found in the learning process. The children were able to talk about relations and feelings and developed an understanding for use in new situations in their daily lives. Items and patterns that are useful for research and documentation were identified, for example, well-being, resources, needs, and wishes. [ABSTRACT FROM AUTHOR]

Background: Male-factor infertility underlies approximately 30% of infertility in couples seeking treatment; of which 10% is due to azoospermia. The development of assisted reproductive technology (ART), enabling the use of epididymal or testicular sperm for fertilization of the partner's oocytes, has made biological fatherhood possible for men with obstructive azoospermia. There is limited knowledge of men's experience of their own infertility. The aim of this study was to describe men's experiences of obstructive azoospermia infertility. Methods: Eight men with obstructive azoospermia, who had terminated Swedish public health system ART treatment two years previously without subsequent childbirth, were interviewed using a descriptive phenomenological method. Results: The essence of the phenomenon is expressed with a metaphor: climbing a mountain step by step with the aim of reaching the top, i.e. having a child and thus a family with a child. Four constituents are included (1) inadequacy followed by a feeling of redress (2) marginalisation, (3) chivalry (4) extension of life and starting a family as driving forces. Conclusions: Knowledge of men's experiences of their own infertility is important as a supporting measure to increase the quality of care of infertile couples. By adopting this facet of gender perspective in fertility treatment guidelines, care can hopefully be optimized. [ABSTRACT FROM AUTHOR]

Children′s experiences of attitudes and rules for going to the toilet in school Introduction: School children often base their toilet habits on behavioural and social reasons. Bladder emptying problems, urinary tract infections and constipation are common health problems which are also associated with irregular toilet habits. School rules for going to the toilet have been shown to create difficulties for school children with bladder dysfunction. Aim of this study was to describe children’s experiences of school rules for going to the toilet and their significance for the children. Methods: Individual open-ended questions with 19 schoolchildren aged 9–16 in elementary schools. Results: To manage the children’s toilet needs, teachers used rules designed for maintaining order in the classroom. The children saw their toilets needs as a private matter and experienced it complicated to go to the toilet during recess as time was short and the risk for violation of their integrity was at its highest. The most frustrating when to comply with rules during lessons was to be forced to, in front of all their classmates, make public the need to go to the toilet: i.e the most private was exposed to the disclosure. Conclusion: The rules for going to the toilet came from the teachers’ need for maintaining order in the classroom and were not adapted to the children’s physical and developmental needs. To violate the integrity of children can affect their willingness to go to the school toilet which in turn affects their wellbeing during school time. [ABSTRACT FROM AUTHOR]

Objective. Growth surveillance of children in school health services is a routine in Sweden. We describe the effect at follow-up of an overt identification of obesity in school children. Methods. Follow-up data were collected in two populations of ten-year-old children with obesity. Children in the study group belonged to a cohort born in 1990. Here the presence of obesity had been identified at the routine growth screening, and intervention activities against obesity had been actively offered. Controls belonged to a cohort born in 1989. Results. Of the 176 children with obesity, 91 were in the study group (41 girls) and 85 (44 girls) in the control group. No differences were found between the groups in age, gender or body mass index at baseline. At follow-up, after one to two years, children in the study group had a modest but significantly more pronounced decrease in the relative body mass index, compared with controls. The mean difference between the populations in body mass index standard deviation score (z-score) after adjustment for baseline body mass index and follow-up time was -0.14 (95% confidence interval: -0.25 to -0.02; P=0.027). Socioeconomic status, gender, follow-up time and group were independent predictors for change in body mass index z-score. Conclusions. To identify children with obesity in a routine school health survey may be a crucial initial step in the management of childhood obesity. [ABSTRACT FROM AUTHOR]

Background and aims: The importance of fathers’ participation for development of the child and the well-being of the family is recognized from earlier research. In Sweden, legislation allows fathers to share the parental leave equally with the mother even so fathers only use a small of their paid leave. The aim of the study was to explore experiences of the first year as a father. Method: A phenomenological life world approach was used. Ethical approval was obtained. Ten men, recruited by a purposive sample, were interviewed 12–14 months after the delivery of their first child. The data collection was performed during June and August 2004 in the south-west area of Sweden. Findings: The essence of the experiences of the first year as father was to place the baby in the centre without giving up one’s own person. The child provided warmth and happiness in the family and men experienced a deeper relationship to their partner. The contact between father and child was facilitated by engagement and time spent alone with the child. The major constituents identified from the findings were ‘To be overwhelmed’, ‘To master the new situation’ and ‘To get a new completeness in life’. Discussion and conclusion: To master fatherhood maintenance of integrity and possibility to develop an independent relationship with the child is important. Fathers are invited to participate in postnatal childbirth education but the activities address women’s needs and it is doubtful if the fathers benefit from participation. Though fathers entered the delivery room some decades ago, as a support to the woman, health personnel of today must be aware of fathers’ own needs and the impact gender aspects have on their professional support. [ABSTRACT FROM AUTHOR]

ABSTRACT: Irregular bladder and bowel habits can contribute to urinary and bowel problems. Schoolchildren undergoing treatment for these problems often do not follow the recommendation of regular toilet visits at school, claiming negative perceptions of school toilets. This study examined 6- to 16-year-old schoolchildren's perceptions of school toilets and whether the perceptions affect bladder and bowel habits at school. Some 385 Swedish schoolchildren aged 6 to 16 years were surveyed using a semistructured questionnaire. Children aged 13 to 16 years had the most negative perceptions. Twenty-five percent (overall 16%) of older children reported never using the school toilet to urinate, and 80% (overall 63%) never used it to defecate. Perceptions of sight and smell and emotional constraints hindered children from using the school toilets. Children generally based their perceptions of school toilets on physical appearance, offensive smell, and feelings of insecurity. Children's perceptions affected their toilet habits and would rather endure physical discomfort than the psychological and social discomfort of using the school toilet. Children already suffering from urinary tract or intestinal problems face particular difficulties without regular toilet visits during the day. [ABSTRACT FROM AUTHOR]

To study the biological variation in the content of some persistent organic pollutants, viz hexachlorobenzene (HCB), α- and γ-hexachlorocyclohexane (α- and γ-HCH), and 1,1,1-trichloro-2,2-bis-(4-chlorophenyl)-ethane (DDT) were analysed in needles from Scots pine trees growing at an isolated peninsula south of Stockholm, Sweden. The concentration variations of each compound was evaluated by a nested analysis of variance (ANOVA) with sampling site specific compass direction, individual tree, and sampling height as factors. Two pair-wise post hoc tests were used to test significant results from the ANOVA. The hexachlorocyclohexanes showed no significant differences between sampling site, trees or sampling height. DDT concentration was significantly lower at the sampling site with the densest vegetation compared to at least three of the other sampling sites. HCB was significantly lower at the lowest sampling height (0.5 m). [Copyright &y& Elsevier]

Objective: Bedwetting is the most common form of incontinence in children. Research in recent years suggests that there can be many different factors responsible for the problem of bed wetting, one of which is bladder dysfunction. The aim of this pilot study was to identify infrequent voiding (“hold pattern”) and to investigate whether increasing the number of micturitions during the day can improve the nocturnal enuresis in children with several failed treatment attempts. Material and Methods: Twenty-two children with severe bedwetting were treated. Twelve of them had had no other treatment than increasing the number of regular micturitions during the day, while 10 patients had had enuresis alarm or desmopressin added. Results: The number of wet nights after 1 month of treatment decreased in all children and the improvement continued in most of the children during the follow-up period. Conclusions: This study suggests that bladder training by increasing the number of micturitions during the day can be valuable in the treatment of nocturnal enuresis. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to provide knowledge about communication using SKYPE with young children with chronic illness; advantages and barriers are investigated related to education and data issues collection. A qualitative exploratory research method was applied to interviews and notes via SKYPE between children and their web teachers. The data were analysed using phenomenography. The findings are based on five children aged between three and six years and presented in two main categories and seven subcategories. The advantages were: being able to be at home; well-known being and convenience for the child and the family; being to watch and observe each other; being supported by the family; the family were able to contribute to the development of the intervention; and attend ones possible regardless of geographical distance. Barriers were that the images could drop out of range of the computer camera and the SKYPE Internet connection works intermittently with audio or picture. [ABSTRACT FROM PUBLISHER]

Abstract: Nanoparticles of controlled size, well defined shape, pure phase and of clean surfaces are ideal model systems to investigate surface/interfacial reactions. In this study we have explored the possibility of synthesizing TiO2 nanoparticles in the size range of 7–20nm under well controlled experimental conditions. A simple method based on the hydrolysis of TiCl4 was used to obtain particles having surfaces free from organics. Stable dispersions of TiO2 nanoparticles of various sizes were obtained by optimizing the reaction/dialysis time and temperature. The synthesized TiO2 particles were found to be predominantly of anatase phase and narrow particle size distributions were obtained. The TiO2 particles were characterized with respect to their phase, size and shape by X-ray diffraction (XRD) and transmission electron microscopy (TEM), respectively. Particle size distribution in a colloidal dispersion was obtained by the electrospray scanning mobility particle sizer (ES-SMPS) method and compared with an average particle size determined from dynamic light scattering (DLS). The average particle sizes obtained by the DLS and ES-SMPS methods were in good agreement, while a primary particle size of ∼4nm was found in X-ray diffraction irrespective of the particle size in solution. Early stages of the nucleation process were monitored by the ES-SMPS method. These results show that small particles of 4–5nm are initially formed and it is highly likely that large particles are formed due to aggregation of primary particles. [Copyright &y& Elsevier]

When a child is diagnosed with cancer, the whole family, including siblings, lives in fear of how the cancer will affect the sick child and how it will influence other family members. The aim of this article is to describe the experiences expressed by the siblings in a support group environment when their families have or have had a child diagnosed with cancer. Fifteen siblings 8 to 19 years of age with a brother or sister who was receiving treatment for or had died from cancer were interviewed after participating in therapeutic support groups. These interviews were conducted two weeks after the last group interaction and were analyzed using qualitative content analysis. Regardless of gender and age, the siblings felt a sense of belonging and comfort by being in a group, which they appreciated. They were able to share their experiences and help each other with advice and encouragement. They all drew strength from each other. A therapeutic support group for siblings of children with cancer is beneficial. Follow-up interviews with the siblings indicated they found the groups helpful in coping with their situation. [ABSTRACT FROM AUTHOR]

Background and aims: Childhood overweight is presented as a complex problem to solve. To elaborate efforts required in striving for normal weight in overweight children healthy signs of life from the child’s point of view should be identified and promoted. The aim of the present study is to describe everyday experiences of life, body and well-being in children with overweight. Method: A qualitative descriptive design based on lifeworld perspective was used in 16 open-ended interviews with overweight children aged 10–12 years. Child overweight was defined by body mass index (kg/m2) for each age. Drawings and body pictograms were used to supplement the interviews. Text was analysed using qualitative content analysis. Findings: The primary finding was the respondents’ search for a sense of community in daily life. The respondents yearned to be part of a community but spent a lot of time alone. Parents and other family members were an important source of community but were not present enough in the respondents’ daily life. The respondents had a sound body image, were concerned about their bodies and were aware of a healthy lifestyle. Nevertheless, they did not manage to implement this awareness in practice. Unhealthy sleeping, eating and exercise habits along with a sense of victimization were revealed in the interviews. Well-being meant self-esteem, trust and satisfaction and was preserved and improved through exciting relationships and activities. Feeling well was equal to feeling capable, feeling happy and feeling a sense of community. Discussion and conclusions: Findings emphasize the problem of loneliness in the children studied. Their healthy signs of life were not promoted in an acceptable way. They spent too much time alone doing sedentary activities with easy access to junk food. Findings indicate they should be provided with company at all meals and during activities on a daily basis. [ABSTRACT FROM AUTHOR]

Background and aim: When a newborn baby needs care in a neonatal intensive care unit (NICU), the parents are welcome to stay with their child whenever they wish. The aim of the present study was to investigate the time per day parents are present together with their child at the NICU and to identify factors that facilitated and obstructed their presence. Methods: In a descriptive study 67 parents of 42 children from two NICUs registered all time they spent at the NICU and then took part in a structured interview. Findings: Parental presence at NICUs varied depending on types of accommodation offered. Those who stayed in parent rooms at the units showed a significantly higher presence with their children than parents who stayed at family hotel, at home or on a maternity ward. Factors that motivated parental presence were primarily the willingness to take parental responsibility, the child’s condition requiring it, and the want to have control. Good treatment by the staff, a family-friendly environment and high quality care were main facilitating factors for parents to be present at the NICU. Obstructing factors were primarily ill health by parents, a non-family-friendly environment, care of the home and of children at home. Conclusions: The result shows that there is a need to develop a family-friendly environment that provides optimal conditions for parents to be with their child in a NICU and to consider the parent’s own reason for being or not being present. [ABSTRACT FROM AUTHOR]

Title. Children’s experiences of visiting a seriously ill/injured relative on an adult intensive care unit Aim. This paper is a report of a study of children’s experiences of visiting a seriously ill/injured relative in an intensive care unit. Background. Little attention has been paid to children’s experiences and needs when visiting a relative being cared for at a high technological adult intensive care unit. Instead, the focus has been on adult’s experiences and needs. Method. In 2004, 28 children (14 girls, 14 boys) aged 4–17 years who had visited an adult relative were interviewed 3 months after the visit. A hermeneutic approach was used when interpreting and analysing the text. Findings. Four themes were generated from the data: It meant waiting, It was strange, It was white and It was good. Waiting was experienced as difficult, increasing the feeling of uncertainty, exclusion and separation, which in turn led to tension and concern. ‘It was strange’ was perceived as unfamiliar but also with interest and curiosity. The experience of the intensive care unit was that it was white. Everything in the patient’s room was experienced as white and gloomy. It lacked joy. ‘It was good’ was stated about the outcome of the visit because through this they were given the opportunity to meet and see the relative by themselves. This evoked feelings of relief and joy. The visit did not seem to frighten the child; instead it generated feelings of release and relief. Conclusion. Children’s experiences of visiting an adult intensive care unit seem to support theories that emphasize the involvement and participation of children in family matters. [ABSTRACT FROM AUTHOR]

In a neonatal intensive care unit (NICU), the care is carried out not only by health care professionals but also by parents. The aim was to describe from a lifeworld hermeneutics approach, health care professionals' experience of parents' presence and participation in the care of their child in the NICU. Twenty health care professionals in two NICUs were interviewed. The interpretations of four themes indicate that the care personnel in NICU were ambivalent towards the presence of parents and set limits including dictating conditions for parental participation. In the encounter with the parents, they balanced between closeness and distance and had difficulty in meeting worried parents. There was little ability to deal with parents in crisis in the correct manner and sometimes an avoiding attitude was present. The care environment obstructed the personnel's endeavours to involve the parents in the care of their child. The result shows there is a need to train personnel in the art of dealing with parents in crisis. This should include developing the care environment to allow parents to be present and take part in the care of their child but also give personnel the prerequisites to make this possible. [ABSTRACT FROM AUTHOR]

persson e., gustavsson b., hellström a-l., lappas g.&hultén l. (2005) Journal of Advanced Nursing49(1), 51–58Ostomy patients’ perceptions of quality of careThis paper reports a study whose aim was to assess the quality of care in ostomy patients seen from a patient perspective.A stoma operation causes profound changes in a patient's life because of resulting physical damage, disfigurement, loss of bodily function, and change in personal hygiene. Such changes are a cause of major concern for patients and raise important issue for the quality of care.The study group comprised patients who had undergone a colostomy for rectal cancer or an ileostomy for ulcerative colitis, all attending a stoma outpatient clinic. Quality of care was assessed using the identity-oriented dimension of the validated questionnaire‘Quality of Care from the Patient's Perspective’. Forty-two ileostomy and 49 colostomy patients completed the questionnaire.While the vast majority of patients in both groups thought that most topics in the questionnaire were important, most rated many aspects of their quality of care as unsatisfactory. One-third of the colostomy patients and one-half of the ileostomy patients were dissatisfied with the information they received about the results of medical examinations and laboratory tests, and an even higher proportion was dissatisfied with their opportunities to participate in the decision-making process or to discuss sexual matters. Stoma-related complications, which occurred in 71% of the ileostomy patients and in 43% of the colostomy patients, had no impact on these results.Information and counselling for patients having ostomies, both on the part of specialist nurses and colorectal surgeons, appeared to deficient, suggesting that standards for quality of care require continuous evaluation and revision. [ABSTRACT FROM AUTHOR]

Background: An association between bladder-bowel dysfunction (BBD) and urinary tract infection (UTI) is well-known. However, a question less explored is whether children with UTI early in life also have increased prevalence of BBD after they are toilet-trained. In this study, consecutively selected children with pyelonephritis during their first year of life were assessed for BBD at pre-school age. Methods: Ninety-two children (51 boys) hospitalized due to pyelonephritis during their first year of life were assessed for BBD at median age 5.4 years. A validated BBD questionnaire, along with urine flow and residual volume measurements, was used for diagnosing BBD. During follow-up, the group was well-characterized regarding renal status, vesicoureteral reflux (VUR), and recurrent UTI. Results: BBD was diagnosed in 35/92 (38%), of which the majority was sub-diagnosed with dysfunctional voiding (DV). There was a strong association between BBD and recurrent UTI during follow-up (p < 0.0001), but only a slight association with VUR status at presentation. Nevertheless, in the group with both BBD and VUR, recurrent UTI was four times higher (12/13, 92%) than in children who had neither VUR nor BBD (23%), (p = 0.0008). BBD was also associated with kidney damage (p = 0.017). Conclusion: In children with pyelonephritis during the first year of life, 38% had BBD at pre-school age, regardless of whether they had VUR or not. The study shows an important association between BBD and recurrent UTI, so an assessment of BBD is therefore recommended for pre-school children with UTI, especially when they have history of pyelonephritis during infancy. [ABSTRACT FROM AUTHOR]

Background: Autologous stem-cell transplantation (ASCT) is a common treatment for lymphoma but it has some mortality. Methods: All 433 lymphoma patients who underwent ASCT for lymphoma at Karolinska Huddinge 1994–2016 were investigated, including CD34+ cell amounts, medications, infectious and other complications, intensive care, longitudinal laboratory values, and secondary myeloid neoplasia. Results: The 100-day non-relapse and overall mortalities were 5.6% and 7.2%. Stem-cell harvests < 5 million CD34+ cells/kg correlated with inferior 100-day and long-term survival. Prior to conditioning (93% BEAM), elevated (both 3–9 and ≥ 10 mg/L) C-reactive protein (CRP) and creatinine, and low albumin (but not higher age) predicted inferior higher 100-day survival. Intravenous antibiotics were given to 97% (22% positive blood cultures) and parenteral nutrition to 89%. After 1 year, 86% had normalized hemoglobin. The 5-year risk for secondary myeloid neoplasia was 4.1%, associated with smaller harvests. Conclusions: Before starting conditioning, patients should have preferably harvested ≥ 5 million CD34+ cells/kg and normal CRP, albumin, and creatinine. It appears safe to transplant patients ≥ 66 years. [ABSTRACT FROM AUTHOR]

Introduction: To investigate if potty training from infancy can affect bladder dysfunction in boys with posterior urethral valves (PUV). Subjects and Methods: The voiding pattern and emptying ability were followed using the 4-hour voiding observation method in 17 Vietnamese boys with PUV aged 3 months to 4 years who had been potty-trained from infancy. This group was compared with a group of healthy Vietnamese boys. Results: In the boys with PUV, the bladder volume increased according to age, and interrupted voiding was rare. However, when comparing boys with PUV with healthy boys, a significant difference was noted with more frequent voidings and lower voided volumes in the age group 0 - 1 year (P < 0.001). Despite the minimum amount of residual urine, average 8 ml or less in the boys with PUV, the age groups 1 - 2 and 2 - 4 years had significantly higher residual volumes compared with those of the healthy boys (P < 0.001). Conclusion: The findings from the 4-hour voiding observation showed few signs of dysfunctional bladder in the Vietnamese boys with PUV, including residual urine, even if there were signs of dysfunction compared with the healthy Vietnamese boys. Potty training from infancy could favor early bladder rehabilitation in boys with PUV. [ABSTRACT FROM AUTHOR]

Background Departing from the widespread use of the internet in modern society and the emerging use of web applications in healthcare this project captures persons' needs and expectations in order to develop highly usable web recourses. The purpose of this paper is to outline a multi-case research project focused on the development and evaluation of person-centred web-based support for people with long-term illness. To support the underlying idea to move beyond the illness, we approach the development of web support from the perspective of the emergent area of person-centred care. The project aims to contribute to the ongoing development of web-based supports in health care and to the emerging field of person-centred care. Methods/design The research design uses a meta-analytical approach through its focus on synthesizing experiences from four Swedish regional and national cases of design and use of web-based support in long-term illness. The cases include children (bladder dysfunction and urogenital malformation), young adults (living close to persons with mental illness), and two different cases of adults (women with breast cancer and childbearing women with type 1 diabetes). All of the cases are ongoing, though in different stages of design, implementation, and analysis. This, we argue, will lead to a synthesis of results on a meta-level not yet described. Discussion To allow valid comparisons between the four cases we explore and problematize them in relation to four main aspects: 1) The use of people's experiences and needs; 2) The role of use of theories in the design of person-centred web-based supports; 3) The evaluation of the effects of health outcomes for the informants involved and 4) The development of a generic person-centred model for learning and social support for people with long-term illness and their significant others. Person-centred web-based support is a new area and few studies focus on how web-based interventions can contribute to the development of person-centred care. In summary, the main intention of the project outlined here is to contribute with both a synthesis of results on meta-level from four cases and a substantial contribution to the field personcentred care. [ABSTRACT FROM AUTHOR]

Background: A father's experience of the birth of his first child is important not only for his birth-giving partner but also for the father himself, his relationship with the mother and the newborn. No validated questionnaire assessing first-time fathers' experiences during childbirth is currently available. Hence, the aim of this study was to develop and validate an instrument to assess first-time fathers' experiences of childbirth.Method: Domains and items were initially derived from interviews with first-time fathers, and supplemented by a literature search and a focus group interview with midwives. The comprehensibility, comprehension and relevance of the items were evaluated by four paternity research experts and a preliminary questionnaire was pilot tested in eight first-time fathers. A revised questionnaire was completed by 200 first-time fathers (response rate = 81%) Exploratory factor analysis using principal component analysis with varimax rotation was performed and multitrait scaling analysis was used to test scaling assumptions. External validity was assessed by means of known-groups analysis.Results: Factor analysis yielded four factors comprising 22 items and accounting 48% of the variance. The domains found were Worry, Information, Emotional support and Acceptance. Multitrait analysis confirmed the convergent and discriminant validity of the domains; however, Cronbach's alpha did not meet conventional reliability standards in two domains. The questionnaire was sensitive to differences between groups of fathers hypothesized to differ on important socio demographic or clinical variables.Conclusions: The questionnaire adequately measures important dimensions of first-time fathers' childbirth experience and may be used to assess aspects of fathers' experiences during childbirth. To obtain the FTFQ and permission for its use, please contact the corresponding author. [ABSTRACT FROM AUTHOR]

Objective. This study compares quality of life among couples who had adopted a child 4-5.5 years previously with couples whose conception was spontaneous, as well as with couples who had successful or unsuccessful in vitro fertilization (IVF) treatment. Design. Cross-sectional study. Setting. Tertiary level university hospital. Sample. From the following groups, 979 responses were obtained: adoption; successful IVF; unsuccessful IVF-living with children; unsuccessful IVF-living without children; and childbirth after spontaneous conception (controls). Methods. Quality of life was studied with the Psychological General Well Being (PGWB) and Sense of Coherence (SOC) instruments. Demographic, socio-economic and health data were obtained with additional questionnaires. Multiple variance analysis was applied. Main outcome measures. The PGWB and SOC scores. Results. After adjustment for seven confounders, the adoption group had higher PGWB scores than the unsuccessful IVF-living without children and the controls and higher SOC scores than all other groups. The unsuccessful IVF-living without children had lower PGWB and SOC scores than all other groups. The PGWB and SOC scores among controls did not differ from those with successful IVF or unsuccessful IVF-living with children. Conclusions. Adjusted PGWB and SOC scores revealed a high quality of life in the adoption group. However, the group unsuccessful IVF-living without children had low quality of life scores. Quality of life appears to be independent of the outcome of IVF treatment as long as there are children in the family. [ABSTRACT FROM AUTHOR]

Background: Management of the third stage of labor, the period following the birth of the infant until delivery of the placenta, is crucial. Active management using synthetic oxytocin has been advocated to decrease blood loss. It has been suggested, but not studied, that oxytocin may increase afterpains. The aim of this study was to compare women's experience of pain intensity when the third stage of labor was managed actively and expectantly and their experience of afterpains. Methods: A single-blind, randomized, controlled trial was performed at two delivery units in Sweden in a population of healthy women with normal, singleton pregnancies, gestational age of 34 to 43 weeks, cephalic presentation, and expected vaginal delivery. Women ( n = 1,802) were randomly allocated to either active management or expectant management of the third stage of labor. Afterpains were assessed by Visual Analog Scale (VAS) and the Pain-o-Meter (POM-WDS) 2 hours after delivery of the placenta and the day after childbirth. Results: At 2 hours after childbirth, women in the actively managed group had lower VAS pain scores than expectantly managed women ( p = 0.014). Afterpains were scored as more intense the day after, compared with 2 hours after, childbirth in both groups. Multiparas scored more intense afterpains, compared with primiparas, irrespective of management ( p < 0.001). Conclusions: Active management of the third stage of labor does not provoke more intense afterpains than expectant management. (BIRTH 38:4 December 2011) [ABSTRACT FROM AUTHOR]

Objective. To describe and compare quality of life in men and women who had in vitro fertilization (IVF) within the Swedish public health system 4–5.5 years previously, either unsuccessfully and were subsequently living without children, or successfully, having children aged 4–5.5 years. These groups were compared to a control group of men and women with children born at the same time as in the successful group. Design. Cross-sectional study. Setting. Reproductive Unit, Sahlgrenska University Hospital, Gothenburg, Sweden. Sample. Twenty-six men and 37 women in the unsuccessful group, 135 men and 154 women in the successful group and 93 men and 118 women in the control group. Methods. Questionnaire study. The respective gender differences were studied in the control and study groups. Main outcome measures. Psychological general well-being (PGWB), sense of coherence (SOC), experience of infertility, demographic-socio-economic, and health characteristics. Results. Men in the unsuccessful IVF group scored lower in total PGWB and SOC indices than the successful group men. They reported more depression, lower PGWB and lower SOC than the control group men. Women in the unsuccessful IVF group reported more anxiety, depression, and lower SOC than the successful group women and more depression and lower SOC indices than control group women. Men and women in the unsuccessful IVF group did not differ in any of the parameters. Men in the successful IVF group had higher PGWB, less signs of depression and more self-confidence than women in that group. C onclusion. Quality of life in men seems more negatively affected by involuntary infertility than reported in earlier studies. [ABSTRACT FROM AUTHOR]

Objective. To describe quality of life in men and women who had terminated in vitro fertilization (IVF) within the public health system 4-5.5 years previously, and for whom treatment did not result in childbirth. Design. Cross-sectional study. Setting. Reproductive Unit, Sahlgrenska University Hospital, Gothenburg, Sweden. Sample. Four hundred pairs were invited to participate, 71% accepted and 68% completed questionnaires. Methods. Questionnaire study. Study subgroups were compared with a control group with children and with each other. Main outcome measure. Psychological General Well-Being (PGWB), Sense of Coherence (SOC), experience of infertility, demographic-socio-economic and health characteristics were measured. Results. Surprisingly, 76.7% had or lived together with children; 39.6% had biological children, 34.8% had adopted and 3.7% were parents to both biological and adopted children. No differences were found between the study and the control groups, except in SOC which scored lower in the study group. The study group with children had a higher PGWB index than the 23.3% without children and the controls. SOC scored higher in the subgroup with than those without children. Infertility was still a central issue in the subgroup without children. Conclusion. Despite having undergone unsuccessful IVF within the public health system, more than 75% lived with children 4-5.5 years later. This subgroup had a better quality of life, compared to those without children. Additional IVF treatment may result in increased quality of life. [ABSTRACT FROM AUTHOR]

Present-day society has produced changes in family living patterns and conditions and this has resulted in new stressors and health problems. Most children and adolescents with chronic diseases and disabilities, who were previously cared for at hospitals and institutions for long periods, are now integrated in society and they are expected to live a normal life in the conditions that currently prevail. The number of young people with long-term illnesses/disability has increased worldwide during the last decades. There is lack of studies relating to the way young people regard their daily lives and factors that are important for their well-being. The aim of this study was to describe the meaning of feeling good in daily life in adolescents living with a long-term illness or disability. Eight boys and seven girls, aged between 12 and 19 years, with different conditions of long-term illness or disability, participated in the study. Tape-recorded interviews were conducted between the years 2003–2004 and the data were analysed using content analysis. The results revealed that the adolescents with long-term illness generally experienced well-being like everybody else. Three themes were found to be important in order to feel good: ‘a feeling of acceptance of illness/disability as a natural part of life’, ‘a feeling of support’ and ‘a feeling of personal growth’. This study concludes that adolescents with long-tem illness or disabilities experience well-being when they are allowed to prepare for living a normal life integrated in society. [ABSTRACT FROM AUTHOR]

OBJECTIVE To determine the congruence between self-reported and objective data on incontinence, voided volume (VV) and voiding frequency (VF), in a prospective study of treatment of functional urinary incontinence (UI) due to urge syndrome or dysfunctional voiding in children. PATIENTS AND METHODS In all, 202 children, enrolled in the European Bladder Dysfunction Study (EBDS), provided self-reported data on UI, VV and VF, before and after treatment, with validated questionnaires and 72-h voiding diaries. Objective data were obtained with uroflowmetry and a 12-h pad test, also before and after treatment. Questionnaires and diaries were checked and scored by a urotherapist, at scheduled office visits that were combined with uroflowmetry. RESULTS At entry, parents under-reported UI on the questionnaires in 45% of cases, compared with the urotherapist’s scores, and the 12-h pad test sensitivity for UI was only 64% (95% confidence interval 55–73%). The voiding diaries had inconsistent entries on UI and on VV. VF was overestimated in the questionnaires and underestimated in the diaries, compared with the urotherapist’s scores. A VF of >7/day decreased significantly after EBDS treatment, but with no correlation with treatment outcome. The mean VV increased significantly after treatment for UI, also with no correlation with treatment outcome. CONCLUSIONS Voiding diaries and questionnaires are useful tools for charting individual treatment and for screening, but they are ill-suited to documenting outcome variables in urge syndrome or dysfunctional voiding, because of over- and under-reporting. VV and VF lack specificity as outcome variables in children with urge syndrome or dysfunctional voiding. The 12-h pad test is not sensitive enough to complement self-reported symptoms of UI in children with urge syndrome or dysfunctional voiding. Clinical studies on UI rely on complaints and self-reported symptoms, but in children the reporting should be supervised by a trained urotherapist, to provide the necessary checks and balances. [ABSTRACT FROM AUTHOR]

Background: From birth the child has an ability to respond to the environment, which influences the interaction between mother and child. If this attachment is interrupted, the child's emotional development is negatively influenced. When the child needs care in a neonatal intensive care unit (NICU) it is difficult to establish contacts between mother and child. Separation from the child is found to be the most difficult aspect for mothers when their newborn child is hospitalized in a NICU. Aim: The aim of this study was to describe mothers’ experiences when their full-term newborn child was cared for in a NICU during the postpartum maternity care period. Method: A phenomenological hermeneutic interview study was performed. Ten mothers were interviewed once, 6 months to 6 years after the experience. Results: The essence of the experience is understood as an alternation between two opposite concepts, exclusion and participation, with emphasis on exclusion. A feeling of exclusion dominates when the new mother feels a lack of interaction and a sense of not belonging to either the maternity care unit or the NICU. This has a negative effect on her maternal feelings. On the contrary, when a feeling of participation dominates, a continuous dialogue exists and the mother is cared for as a unique person with unique needs. This supports her maternal feelings in a positive direction. The implication of the result for nurses is that it is important to decrease mothers’ experience of exclusion and to increase their feeling of participation when their child is cared for in a NICU. A return visit to the responsible nurse to go through the treatment and experiences should be offered to all parents whose child has been cared for in a NICU. [ABSTRACT FROM AUTHOR]

Background: Departing from the widespread use of the internet in modern society and the emerging use of web applications in healthcare this project captures persons' needs and expectations in order to develop highly usable web recourses. The purpose of this paper is to outline a multi-case research project focused on the development and evaluation of person-centred web-based support for people with long-term illness. To support the underlying idea to move beyond the illness, we approach the development of web support from the perspective of the emergent area of person-centred care. The project aims to contribute to the ongoing development of web-based supports in health care and to the emerging field of person-centred care.Methods/design: The research design uses a meta-analytical approach through its focus on synthesizing experiences from four Swedish regional and national cases of design and use of web-based support in long-term illness. The cases include children (bladder dysfunction and urogenital malformation), young adults (living close to persons with mental illness), and two different cases of adults (women with breast cancer and childbearing women with type 1 diabetes). All of the cases are ongoing, though in different stages of design, implementation, and analysis. This, we argue, will lead to a synthesis of results on a meta-level not yet described.Discussion: To allow valid comparisons between the four cases we explore and problematize them in relation to four main aspects: 1) The use of people's experiences and needs; 2) The role of use of theories in the design of person-centred web-based supports; 3) The evaluation of the effects of health outcomes for the informants involved and 4) The development of a generic person-centred model for learning and social support for people with long-term illness and their significant others. Person-centred web-based support is a new area and few studies focus on how web-based interventions can contribute to the development of person-centred care. In summary, the main intention of the project outlined here is to contribute with both a synthesis of results on meta-level from four cases and a substantial contribution to the field person-centred care. [ABSTRACT FROM AUTHOR]