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  • 1.
    Abbas, Hassan
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine.
    Huzeirovic, Melisa
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine.
    En jämförelse mellan två sjukdomsgrupper med PET/CT som undersökningsmetod: Beräkning av den totala effektiva dosen från PET- och CT-undersökning2019Independent thesis Basic level (degree of Bachelor), 180 HE creditsStudent thesis
    Abstract [en]

    Background: Lung cancer and malignant melanoma are diseases investigated by the dual-modality positron emission tomography/computed tomography (PET/CT). There are radiation risks with the examination that can appear as stochastic effects such as cancer. The aim of this study was to compare the radiation doses between the lung cancer group (suspected or verified) and the malignant melanoma group by calculating the total effective radiation dose and to declare the risk with the PET/CT examination. Material and method: The material contained parameters regarding the examination and the sample contained 20 patients from the two groups. The method was retrospective with a quantitative approach. Results: There was a significant difference (p <0,001) between these two groups, were the lung cancer group received 11,95 milliSievert (mSv) and the malignant melanoma group 6,03 mSv and the percentage risk for lethal cancer increased by 0,06% and 0,03%, respectively. Conclusions: The lung cancer group received twice as much effective dose than the malignant melanoma group. However, the effective dose is so low that the risk increase of the lethal cancer is marginal, and the benefit of the examination outweighs the risks.

    Download full text (pdf)
    FULLTEXT01
  • 2. Antoniou, A. C.
    et al.
    Beesley, J.
    McGuffog, L.
    Sinilnikova, O. M.
    Healey, S.
    Neuhausen, S. L.
    Ding, Y. C.
    Rebbeck, T. R.
    Weitzel, J. N.
    Lynch, H. T.
    Isaacs, C.
    Ganz, P. A.
    Tomlinson, G.
    Olopade, O. I.
    Couch, F. J.
    Wang, X.
    Lindor, N. M.
    Pankratz, V. S.
    Radice, P.
    Manoukian, S.
    Peissel, B.
    Zaffaroni, D.
    Barile, M.
    Viel, A.
    Allavena, A.
    Dall'Olio, V.
    Peterlongo, P.
    Szabo, C. I.
    Zikan, M.
    Claes, K.
    Poppe, B.
    Foretova, L.
    Mai, P. L.
    Greene, M. H.
    Rennert, G.
    Lejbkowicz, F.
    Glendon, G.
    Ozcelik, H.
    Andrulis, I. L.
    Thomassen, M.
    Gerdes, A. -M
    Sunde, L.
    Cruger, D.
    Jensen, U. B.
    Caligo, M.
    Friedman, E.
    Kaufman, B.
    Laitman, Y.
    Milgrom, R.
    Dubrovsky, M.
    Cohen, S.
    Borg, A.
    Jernström, H.
    Lindblom, A.
    Rantala, J.
    Stenmark-Askmalm, M.
    Melin, B.
    Nathanson, K.
    Domchek, S.
    Jakubowska, A.
    Lubinski, J.
    Huzarski, T.
    Osorio, A.
    Lasa, A.
    Durán, M.
    Tejada, M. -I
    Godino, J.
    Benitez, J.
    Hamann, U.
    Kriege, M.
    Hoogerbrugge, N.
    Van Der Luijt, R. B.
    Van Asperen, C. J.
    Devilee, P.
    Meijers-Heijboer, E. J.
    Blok, M. J.
    Aalfs, C. M.
    Hogervorst, F.
    Rookus, M.
    Cook, M.
    Oliver, C.
    Frost, D.
    Conroy, D.
    Evans, D. G.
    Lalloo, F.
    Pichert, G.
    Davidson, R.
    Cole, T.
    Cook, J.
    Paterson, J.
    Hodgson, S.
    Morrison, P. J.
    Porteous, M. E.
    Walker, L.
    Kennedy, M. J.
    Dorkins, H.
    Peock, S.
    Godwin, A. K.
    Stoppa-Lyonnet, D.
    De Pauw, A.
    Mazoyer, S.
    Bonadona, V.
    Lasset, C.
    Dreyfus, H.
    Leroux, D.
    Hardouin, A.
    Berthet, P.
    Faivre, L.
    Loustalot, C.
    Noguchi, T.
    Sobol, H.
    Rouleau, E.
    Nogues, C.
    Frénay, M.
    Vénat-Bouvet, L.
    Hopper, J. L.
    Daly, M. B.
    Terry, M. B.
    John, E. M.
    Buys, S. S.
    Yassin, Y.
    Miron, A.
    Goldgar, D.
    Singer, C. F.
    Dressler, A. C.
    Gschwantler-Kaulich, D.
    Pfeiler, G.
    Hansen, T. V. O.
    Jnson, L.
    Agnarsson, B. A.
    Kirchhoff, T.
    Offit, K.
    Devlin, V.
    Dutra-Clarke, A.
    Piedmonte, M.
    Rodriguez, G. C.
    Wakeley, K.
    Boggess, J. F.
    Basil, J.
    Schwartz, P. E.
    Blank, S. V.
    Toland, A. E.
    Montagna, M.
    Casella, C.
    Imyanitov, E.
    Tihomirova, L.
    Blanco, I.
    Lazaro, C.
    Ramus, S. J.
    Sucheston, L.
    Karlan, B. Y.
    Gross, J.
    Schmutzler, R.
    Wappenschmidt, B.
    Engel, C.
    Meindl, A.
    Lochmann, M.
    Arnold, N.
    Heidemann, S.
    Varon-Mateeva, R.
    Niederacher, D.
    Sutter, C.
    Deissler, H.
    Gadzicki, D.
    Preisler-Adams, S.
    Kast, K.
    Schönbuchner, I.
    Caldes, T.
    De La Hoya, M.
    Aittomäki, K.
    Nevanlinna, H.
    Simard, J.
    Spurdle, A. B.
    Holland, H.
    Chen, X.
    Platte, R.
    Chenevix-Trench, G.
    Easton, D. F.
    Common breast cancer susceptibility alleles and the risk of breast cancer for BRCA1 and BRCA2 mutation carriers: Implications for risk prediction2010In: Cancer Research, ISSN 0008-5472, E-ISSN 1538-7445, Vol. 70, no 23, p. 9742-9754Article in journal (Refereed)
    Abstract [en]

    The known breast cancer susceptibility polymorphisms in FGFR2, TNRC9/TOX3, MAP3K1, LSP1, and 2q35 confer increased risks of breast cancer for BRCA1 or BRCA2 mutation carriers. We evaluated the associations of 3 additional single nucleotide polymorphisms (SNPs), rs4973768 in SLC4A7/NEK10, rs6504950 in STXBP4/COX11, and rs10941679 at 5p12, and reanalyzed the previous associations using additional carriers in a sample of 12,525 BRCA1 and 7,409 BRCA2 carriers. Additionally, we investigated potential interactions between SNPs and assessed the implications for risk prediction. The minor alleles of rs4973768 and rs10941679 were associated with increased breast cancer risk for BRCA2 carriers (per-allele HR = 1.10, 95% CI: 1.03-1.18, P = 0.006 and HR = 1.09, 95% CI: 1.01-1.19, P = 0.03, respectively). Neither SNP was associated with breast cancer risk for BRCA1 carriers, and rs6504950 was not associated with breast cancer for either BRCA1 or BRCA2 carriers. Of the 9 polymorphisms investigated, 7 were associated with breast cancer for BRCA2 carriers (FGFR2, TOX3, MAP3K1, LSP1, 2q35, SLC4A7, 5p12, P = 7 × 10-11 - 0.03), but only TOX3 and 2q35 were associated with the risk for BRCA1 carriers (P = 0.0049, 0.03, respectively). All risk-associated polymorphisms appear to interact multiplicatively on breast cancer risk for mutation carriers. Based on the joint genotype distribution of the 7 risk-associated SNPs in BRCA2 mutation carriers, the 5% of BRCA2 carriers at highest risk (i.e., between 95th and 100th percentiles) were predicted to have a probability between 80% and 96% of developing breast cancer by age 80, compared with 42% to 50% for the 5% of carriers at lowest risk. Our findings indicated that these risk differences might be sufficient to influence the clinical management of mutation carriers.

  • 3. Antoniou, A. C.
    et al.
    Sinilnikova, O. M.
    McGuffog, L.
    Healey, S.
    Nevanlinna, H.
    Heikkinen, T.
    Simard, J.
    Spurdle, A. B.
    Beesley, J.
    Chen, X.
    Neuhausen, S. L.
    Ding, Y. C.
    Couch, F. J.
    Wang, X.
    Fredericksen, Z.
    Peterlongo, P.
    Peissel, B.
    Bonanni, B.
    Viel, A.
    Bernard, L.
    Radice, P.
    Szabo, C. I.
    Foretova, L.
    Zikan, M.
    Claes, K.
    Greene, M. H.
    Mai, P. L.
    Rennert, G.
    Lejbkowicz, F.
    Andrulis, I. L.
    Ozcelik, H.
    Glendon, G.
    Gerdes, A. -M
    Thomassen, M.
    Sunde, L.
    Caligo, M. A.
    Laitman, Y.
    Kontorovich, T.
    Cohen, S.
    Kaufman, B.
    Dagan, E.
    Baruch, R. G.
    Friedman, E.
    Harbst, K.
    Barbany-Bustinza, G.
    Rantala, J.
    Ehrencrona, H.
    Karlsson, P.
    Domchek, S. M.
    Nathanson, K. L.
    Osorio, A.
    Blanco, I.
    Lasa, A.
    Benítez, J.
    Hamann, U.
    Hogervorst, F. B. L.
    Rookus, M. A.
    Collee, J. M.
    Devilee, P.
    Ligtenberg, M. J.
    van der Luijt, R. B.
    Aalfs, C. M.
    Waisfisz, Q.
    Wijnen, J.
    van Roozendaal, C. E. P.
    Peock, S.
    Cook, M.
    Frost, D.
    Oliver, C.
    Platte, R.
    Evans, D. G.
    Lalloo, F.
    Eeles, R.
    Izatt, L.
    Davidson, R.
    Chu, C.
    Eccles, D.
    Cole, T.
    Hodgson, S.
    Godwin, A. K.
    Stoppa-Lyonnet, D.
    Buecher, B.
    Léoné, M.
    Bressac-de Paillerets, B.
    Remenieras, A.
    Caron, O.
    Lenoir, G. M.
    Sevenet, N.
    Longy, M.
    Ferrer, S. F.
    Prieur, F.
    Goldgar, D.
    Miron, A.
    John, E. M.
    Buys, S. S.
    Daly, M. B.
    Hopper, J. L.
    Terry, M. B.
    Yassin, Y.
    Singer, C.
    Gschwantler-Kaulich, D.
    Staudigl, C.
    Hansen, T. V. O.
    Barkardottir, R. B.
    Kirchhoff, T.
    Pal, P.
    Kosarin, K.
    Offit, K.
    Piedmonte, M.
    Rodriguez, G. C.
    Wakeley, K.
    Boggess, J. F.
    Basil, J.
    Schwartz, P. E.
    Blank, S. V.
    Toland, A. E.
    Montagna, M.
    Casella, C.
    Imyanitov, E. N.
    Allavena, A.
    Schmutzler, R. K.
    Versmold, B.
    Engel, C.
    Meindl, A.
    Ditsch, N.
    Arnold, N.
    Niederacher, D.
    Deißler, H.
    Fiebig, B.
    Suttner, C.
    Schönbuchner, I.
    Gadzicki, D.
    Caldes, T.
    de la Hoya, M.
    Pooley, K. A.
    Easton, D. F.
    Chenevix-Trench, G.
    Common variants in LSP1, 2q35 and 8q24 and breast cancer risk for BRCA1 and BRCA2 mutation carriers2009In: Human Molecular Genetics, ISSN 0964-6906, E-ISSN 1460-2083, Vol. 18, no 22, p. 4442-4456Article in journal (Refereed)
    Abstract [en]

    Genome-wide association studies of breast cancer have identified multiple single nucleotide polymorphisms (SNPs) that are associated with increased breast cancer risks in the general population. In a previous study, we demonstrated that the minor alleles at three of these SNPs, in FGFR2, TNRC9 and MAP3K1, also confer increased risks of breast cancer for BRCA1 or BRCA2 mutation carriers. Three additional SNPs rs3817198 at LSP1, rs13387042 at 2q35 and rs13281615 at 8q24 have since been reported to be associated with breast cancer in the general population, and in this study we evaluated their association with breast cancer risk in 9442 BRCA1 and 5665 BRCA2 mutation carriers from 33 study centres. The minor allele of rs3817198 was associated with increased breast cancer risk only for BRCA2 mutation carriers [hazard ratio (HR) = 1.16, 95% CI: 1.07-1.25, P-trend = 2.8 × 10-4]. The best fit for the association of SNP rs13387042 at 2q35 with breast cancer risk was a dominant model for both BRCA1 and BRCA2 mutation carriers (BRCA1: HR = 1.14, 95% CI: 1.04-1.25, P = 0.0047; BRCA2: HR = 1.18 95% CI: 1.04-1.33, P = 0.0079). SNP rs13281615 at 8q24 was not associated with breast cancer for either BRCA1 or BRCA2 mutation carriers, but the estimated association for BRCA2 mutation carriers (per-allele HR = 1.06, 95% CI: 0.98-1.14) was consistent with odds ratio estimates derived from population-based case-control studies. The LSP1 and 2q35 SNPs appear to interact multiplicatively on breast cancer risk for BRCA2 mutation carriers. There was no evidence that the associations vary by mutation type depending on whether the mutated protein is predicted to be stable or not. 

  • 4.
    Bapili, Judi
    et al.
    Jönköping University, School of Health and Welfare.
    Crommert, Diana
    Jönköping University, School of Health and Welfare.
    Att leva med en kvinnlig partner som genomgår bröstcancerbehandling.: En litteraturöversikt med kvalitativ design2023Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: When a person is affected by breast cancer, their relatives are also affected, especially the partner of the person who is ill. With an increasing number of cancer cases, the number of family caregivers has also increased, according to research this has led to an increase in sick leave among partners of the breast cancer patient. In order to be able to respond to the nursing needs of relatives in an adequate way, increased knowledge is required regarding their experiences of life with a woman with breast cancer.

    Aim: The aim was to describe relatives' experience of living with a female partner undergoing breast cancer treatment.

    Method: A literature review with a qualitative method was conducted. A total of 12 articles were included via searches in the databases Cinahl, MEDLINE and Pubmed. The articles have been analyzed according to Friberg's five-step model.

    Result: The results of the literature review consisted of two themes and five subthemes. The themes were experiencing barriers as a result of the partner's illness and assuming the role of family carer. The results showed that relatives of people with breast cancer experienced a changed everyday life with changed roles, which affected their psychological and physical well-being. Family cohesion was seen as important in being able to manage everyday life with the presence of illness.

    Conclusion: In order to promote the well-being of relatives, it is important to manage both the emotional and practical aspects of their experience. By working family-focused, the nurse can promote relatives' participation in their partner's care, which can respond to their need for information, knowledge and strategies. This can help relatives clarify their role as relative carers.

    Keywords: cancer, partner, relative, experience, family-focused nursing.

    Download full text (pdf)
    fulltext
  • 5.
    Bergman, Annika
    Department of Medical and Clinical Genetics, Institute of Biomedicine, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
    On the genetics of hereditary breast/ovarian cancer: BRCA1, BRCA2 and beyond2006Doctoral thesis, comprehensive summary (Other academic)
  • 6.
    Bergman, Annika
    et al.
    Department of Clinical Genetics, Göteborg University, Göteborg, Sweden.
    Flodin, Anna
    Department of Clinical Genetics, Göteborg University, Göteborg, Sweden.
    Engwall, Yvonne
    Department of Clinical Genetics, Göteborg University, Göteborg, Sweden.
    Arkblad, Eva L.
    Department of Clinical Genetics, Göteborg University, Göteborg, Sweden.
    Berg, Kerstin
    Department of Clinical Genetics, Göteborg University, Göteborg, Sweden.
    Einbeigi, Zakaria
    Oncology, Sahlgrenska Academy at Göteborg University, Sahlgrenska University Hospital/östra, Göteborg, Sweden.
    Martinsson, Tommy
    Department of Clinical Genetics, Göteborg University, Göteborg, Sweden.
    Wahlström, Jan
    Department of Clinical Genetics, Göteborg University, Göteborg, Sweden.
    Karlsson, Per
    Oncology, Sahlgrenska Academy at Göteborg University, Sahlgrenska University Hospital/östra, Göteborg, Sweden.
    Nordling, Margareta
    Department of Clinical Genetics, Göteborg University, Göteborg, Sweden.
    A high frequency of germline BRCA1/2 mutations in western Sweden detected with complementary screening techniques2005In: Familial Cancer, ISSN 1389-9600, E-ISSN 1573-7292, Vol. 4, no 2, p. 89-96Article in journal (Refereed)
    Abstract [en]

    Dominant inheritance is presumed in 6-10% of breast and ovarian cancers. Mutations in BRCA1 and BRCA2 genes are the most commonly identified causative genes in such families. The frequency of mutation carriers with breast/ovarian cancer depends on the population studied, and display considerable variation that coincides with ethnic and geographical diversity. Mutation analyses were performed in 143 families registered at the Cancer Genetic Counseling Clinic of western Sweden. In a thorough mutation screening procedure, the entire BRCA1 and BRCA2 genes were analyzed using a combination of complementary mutation detection techniques. Mutations in either BRCA1 or BRCA2 were detected in 36% (52 out of 143) of all screened families. All families were clinically evaluated regarding age at diagnosis, type of cancer and number of cancer cases in the family. Among high-risk families, the mutation detection rate was 39% (46 out of 117). The detection rate observed among families with cases of ovarian cancer (42 out of 62, 68%), was substantially higher than in families with only breast cancer (10 out of 81, 12%). Age at ovarian cancer did not seem to have an effect on the detection rate. The analyses revealed 11 frameshift mutations, 4 nonsense mutations and 2 large deletions. Notably, the BRCA1 c.3171ins5 mutation accounted for 34 of 52 (65%) identified mutations. Seven mutations are novel: BRCA1c.409_410del; c.1912T>G; c.2228_2229del; c.3029delA; c.3433delA, a large deletion covering exons 1-3 of BRCA1and one BRCA2 mutation; BRCA2c.6287_6290del. We have shown that the founder mutation BRCA1 c.3171ins5 has a great influence on western Swedish breast/ovarian cancer families along with a high number of mutations unique for the region. In order to achieve a high mutation detection rate we suggest a combination of several detection techniques. 

  • 7.
    Bergman, Annika
    et al.
    Department of Clinical Genetics, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden.
    Karlsson, Per
    Department of Oncology, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden.
    Berggren, Jonna
    Department of Clinical Genetics, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden.
    Martinsson, Tommy
    Department of Clinical Genetics, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden.
    Björck, Karin
    Swegene Bioinformatics, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden.
    Nilsson, Staffan
    Swegene Bioinformatics, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden.
    Wahlström, Jan
    Department of Clinical Genetics, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden.
    Wallgren, Arne
    Department of Oncology, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden.
    Nordling, Margareta
    Department of Clinical Genetics, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden.
    Genome-wide linkage scan for breast cancer susceptibility loci in Swedish hereditary non-BRCA1/2 families: Suggestive linkage to 10q23.32-q25.32007In: Genes, Chromosomes and Cancer, ISSN 1045-2257, E-ISSN 1098-2264, Vol. 46, no 3, p. 302-309Article in journal (Refereed)
    Abstract [en]

    The two breast cancer genes BRCA1 and BRCA2 were identified more than 10 years ago and, depending on population, mutations in these genes are responsible for a varying percentage of familial breast cancer. In more than half the families, the increased risk of breast cancer cannot be explained by mutations in these genes, and the goal of this study was to locate novel susceptibility genes. One of the main difficulties in identifying the cause of hereditary non-BRCA1/BRCA2 breast cancer is genetic heterogeneity, possibly due to multiple, incompletely penetrant susceptibility genes, along with ethnic and geographic differences. In this study, one large family and 13 small to medium-sized families with multiple cases of breast cancer were analyzed by genome-wide linkage analysis. The genome scan was performed by genotype analysis of 10,000 SNP markers on microarrays. The strongest evidence of linkage (HLOD 2.34) was obtained on chromosome region 10q23.32-q25.3. A further two regions were identified, with LOD scores above 2.10 on 12q14-q21 and 19p13.3-q12. In a subset of families of western Swedish origin, two regions generated LOD scores exceeding 1.8: 10q23.32-q25.3 and 19q13.12-q13.32. The large family in the study exceeded LOD 1.5 in three regions: 10q23.32-q25.3, 19q13.12-q13.32, and 17p13. Our results indicate that one or more of the suggested regions may harbor genes that are involved in the development of breast cancer. 

  • 8.
    Bergman, Annika
    et al.
    Lundberg Laboratory for Cancer Research, Department of Pathology, The Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Göteborg, Sweden.
    Sahlin, Pelle
    Department of Plastic Surgery, The Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Göteborg, Sweden.
    Emanuelsson, Monica
    Oncology Center, Umeå University Hospital, Umeå, Sweden.
    Carén, Helena
    Department of Clinical Genetics, The Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Göteborg, Sweden.
    Tarnow, Peter
    Department of Plastic Surgery, The Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Göteborg, Sweden.
    Martinsson, Tommy
    Department of Clinical Genetics, The Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Göteborg, Sweden.
    Grönberg, Henrik
    Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden.
    Stenman, Göran
    Lundberg Laboratory for Cancer Research, Department of Pathology, The Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Göteborg, Sweden.
    Germline mutation screening of the Saethre-Chotzen-associated genes TWIST1 and FGFR3 in families with BRCA1/2-negative breast cancer2009In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 0284-4311, E-ISSN 1651-2073, Vol. 43, no 5, p. 251-255Article in journal (Refereed)
    Abstract [en]

    Saethre-Chotzen syndrome is one of the most common craniosynostosis syndromes. It is an autosomal dominantly inherited disorder with variable expression that is caused by germline mutations in the TWIST1 gene or more rarely in the FGFR2 or FGFR3 genes. We have previously reported that patients with Saethre-Chotzen syndrome have an increased risk of developing breast cancer. Here we have analysed a cohort of 26 women with BRCA1/2-negative hereditary breast cancer to study whether a proportion of these families might have mutations in Saethre-Chotzen-associated genes. DNA sequence analysis of TWIST1 showed no pathogenic mutations in the coding sequence in any of the 26 patients. MLPA (multiplex ligation-dependent probe amplification)-analysis also showed no alterations in copy numbers in any of the craniofacial disorder genes MSX2, ALX4, RUNX2, EFNB1, TWIST1, FGFR1, FGFR2,FGFR3, or FGFR4. Taken together, our findings indicate that mutations in Saethre-Chotzen-associated genes are uncommon or absent in BRCA1/2-negative patients with hereditary breast cancer.

  • 9.
    Björklund, Ann-Christin
    et al.
    Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Social Work. Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD.
    Santacroce, S. J.
    Enskär, Karin
    Malmö University.
    Björk, Maria
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    The documentation of everyday functioning in children with brain tumors in medical care, habilitation services and school – is there a coherent description?2019Conference paper (Refereed)
  • 10.
    Björklund, Ann-Christin
    et al.
    Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Social Work. Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD.
    Santacroce, Sheila Judge
    Univ N Carolina, Sch Nursing, Chapel Hill, NC, USA.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Björk, Maria
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    The Documentation of Everyday Functioning in Children with Brain Tumors in Medical Care, Habilitation Services and School - is There a Coherent Description?2019In: Pediatric Blood & Cancer, ISSN 1545-5009, E-ISSN 1545-5017, Vol. 66, no 4, SI, p. S437-S437Article in journal (Refereed)
  • 11.
    Brahm, Carl-Otto
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Department of Natural Science and Biomedicine. Department of Specialist Dental Care, Public Dental Service, Skövde, Sweden.
    Borg, Carina
    Department of Oral and Maxillofacial Surgery, Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Malm, Dan
    Jönköping University, School of Health and Welfare, HHJ, Department of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Fridlund, Bengt
    Jönköping University, School of Health and Welfare, HHJ, Department of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT. Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
    Lewin, Freddi
    Department of Oncology, Ryhov County Hospital, Jönköping, Sweden.
    Zemar, Ahmed
    Department of Orofacial Medicine, Public Dental Service, Linköping, Sweden.
    Nilsson, Peter
    Department of Oral and Maxillofacial Surgery, Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Papias, Apostolos
    Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.
    Henricson, Maria
    Jönköping University, School of Health and Welfare, HHJ, Department of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Patients with head and neck cancer treated with radiotherapy: Their experiences after 6 months of prophylactic tooth extractions and temporary removable dentures2021In: Clinical and Experimental Dental Research, E-ISSN 2057-4347, Vol. 7, no 5, p. 894-902Article in journal (Refereed)
    Abstract [en]

    Objectives: The impact of dental occlusion on the experiences of head and neck cancer patients and their oral, social and psychological functioning has been sparsely investigated. There is a lack of knowledge regarding the experience of tooth loss and dentures among patients treated for head and neck cancer. The aim of this study was to describe the experiences of head and neck cancer patients of prophylactic tooth extractions and temporary removable dentures, 6 months after radiotherapy treatment.

    Material and methods: An individual interview with 25 patients 6 months after radiotherapy was subjected to a qualitative content analysis.

    Results: Two categories, Impaired oral function and Belief in the future, and seven subcategories described the patients' experiences of temporary removable dentures during the first 6 months after prophylactic tooth extractions. The temporary removable dentures affected the patients' ability to chew, swallow and speak, caused pain, and were experienced as an enemy. Despite that, the patients were hopeful and had a wish for recovery, which gave them the energy to live.

    Conclusion: Prophylactic tooth extractions and temporary removable dentures 6 months after radiotherapy treatment affect head and neck cancer patients' recovery and everyday life. However, they have the will to take on these challenges, pertaining not only to themselves, but also to relatives and health professionals. At the individual level, the patient needs individualized professional support to get through the arduous procedure, from the acute situation until the end of the rehabilitation phase.

  • 12.
    Browall, Maria
    et al.
    The Sahlgrenska Academy at Göteborg University, Institute of Health and Care Sciences, Göteborg, Sweden / Department of Oncology, Division of Selected Clinical Specialties, Sahlgrenska University Hospital, Göteborg, Sweden.
    Ahlberg, Karin
    The Sahlgrenska Academy at Göteborg University, Institute of Health and Care Sciences, Göteborg, Sweden.
    Karlsson, Per
    The Sahlgrenska Academy at Göteborg University, Institute of Health and Care Sciences, Göteborg, Sweden / Department of Oncology, Southern Älvsborg Hospital, Borås, Sweden.
    Danielson, Ella
    The Sahlgrenska Academy at Göteborg University, Institute of Health and Care Sciences, Göteborg, Sweden / Department of Health Science, Mid Sweden University, Östersund, Sweden.
    Persson, Lars-Olof
    The Sahlgrenska Academy at Göteborg University, Institute of Health and Care Sciences, Göteborg, Sweden.
    Gaston-Johansson, Fannie
    School of Nursing, Johns Hopkins University, Baltimore, MD, USA.
    Health-related quality of life during adjuvant treatment for breast cancer among postmenopausal women2008In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 12, no 3, p. 180-189Article in journal (Refereed)
    Abstract [en]

    The purpose of the present study was twofold: first, to describe changes of Health-Related Quality of Life (HRQoL) during the adjuvant treatment among postmenopausal women with breast cancer; second, in the same population to identify the best predictors of Overall Quality of Life (QoL) after treatment, from perceived functioning, symptoms, emotional distress and clinical/demographic variables measured at baseline. The study group was 150 women (>= 55 years of age) scheduled for adjuvant chemotherapy (CT, n=75) or radiotherapy (RT, n=75). They were examined before (baseline), during and after completing the treatment. Data about QoL, perceived functioning, symptoms and emotional distress were collected with the European Organisation for Research and Treatment of Cancer (EORTC)-QLQ-C30, BR23 and Hospital Anxiety and Depression Scale (HADS) questionnaires. The general finding was that the adjuvant treatments were associated with decrease in overall QoL, physical and role functioning, anxiety and body image, as well as with increase in fatigue, dyspnoea, pain, nausea/vomiting, constipation and systemic therapy side effects measured over time. For women receiving CT, better emotional functioning and less pain at baseline predicted better overall QoL at the end of the treatment. For women receiving RT, better physical and emotional functioning, less breast symptoms and lower tumour stage at baseline predicted better overall QoL at the end of the treatment.

  • 13.
    Browall, Maria
    et al.
    Department of Oncology, Sahlgrenska University Hospital, Gothenburg 413 45, Sweden.
    Carlsson, Maria
    Department of Public Health and Caring Sciences, Döbelnsgatan 2, Uppsala 752 37, Sweden.
    Horvath, György
    Department of Oncology, Sahlgrenska University Hospital, Gothenburg 413 45, Sweden.
    Information needs of women with recently diagnosed ovarian cancer - A longitudinal study2004In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 8, no 3, p. 200-207Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate the information needs among patients with ovarian cancer and whether these information needs change over time. The information needs were evaluated three times, through structured interviews, and were based on the paired comparison approach developed by Degner and colleagues. A consecutive sample of patients (n=82) with recently diagnosed ovarian cancer was asked to participate.Sixty-four patients (78%) chose to participate. The three different measurements of participants' information needs revealed only small changes in these needs. The three most important information needs, in all measurements, were information about the likelihood of cure, information about the stage and spreading of the disease, and information about different treatment options. Information regarding sexual attractiveness was the lowest ranked item in all measurements. Regarding subgroups (age, education) the only significant difference throughout all measurements was that younger patients rated issues of sexual attractiveness higher than older patients (p=0.005).In this longitudinal study patients with ovarian cancer ranked information about the disease and its treatment (i.e. likelihood of cure, stage of disease, and treatment options) highest, and information about psychosocial aspects and self-care lowest. These findings are in accordance with the results from studies of women diagnosed with other types of cancer, which used the same methodology. © 2004 Elsevier Ltd. All rights reserved.

  • 14.
    Browall, Maria
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Jonkoping Univ, Dept Nursing, Jonkoping, Sweden..
    Fristedt, Sofi
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Smith, F.
    Reg Canc Ctr West, Dept Nursing, Gothenburg, Sweden..
    Abelsson, Anna
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Grynne, Annika
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Digi-Do: A digital information tool to support patients with breast cancer before, during, and after start of radiotherapy treatment2020In: Annals of Oncology, ISSN 0923-7534, E-ISSN 1569-8041, Vol. 31, no Supplement 4, p. S1126-S1126Article in journal (Refereed)
    Abstract [en]

    Radiation Therapy (RT) is a common treatment after breast cancer surgery. The high-tech environment and unfamiliar nature of RT can affect the patient’s experience of the treatment. Misconceptions or a lack of knowledge about RT processes can increase levels of anxiety and enhance feelings of being unprepared at the beginning of treatment. Moreover, the waiting time can be long and experienced as meaningless or even life threatening. For successful radiotherapy, the person often needs to be immobilized. A calm, well informed patient might enhance quality of treatment, both from patient and provider perspective. Waiting times can become meaningful instead of meaningless if used wisely for information and preparation for patients and loved ones.

  • 15.
    Browall, Maria
    et al.
    Sahlgrenska Academy at Göteborg University, Faculty of Health and Caring Sciences, Institute of Nursing, Göteborg, Sweden / Sahlgrenska Academy at Göteborg University, Faculty of Health and Caring Sciences, Institute of Nursing, SE 405 30 Göteborg, Sweden.
    Gaston-Johansson, Fannie
    Sahlgrenska Academy at Göteborg University, Faculty of Health and Caring Sciences, Institute of Nursing, Göteborg, Sweden / Johns Hopkins University, School of Nursing, Baltimore, MD, United States.
    Danielson, Ella
    Sahlgrenska Academy at Göteborg University, Faculty of Health and Caring Sciences, Institute of Nursing, Göteborg, Sweden.
    Postmenopausal women with breast cancer: Their experiences of the chemotherapy treatment period2006In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 29, no 1, p. 34-42Article in journal (Refereed)
    Abstract [en]

    This article illustrates the experience of 20 postmenopausal women with breast cancer who had received chemotherapy treatment. The interviews were of narrative nature and analyzed with content analysis. Four themes, including 12 subthemes, described these women's life during treatment as a journey from the negative experiences of fear of the unknown, affects on body and mind, to the more positive to get by, and a transformed life. The treatment was compared with an assault on the body, and the loss of their hair was experienced more negatively than the loss of a breast. The women described a feeling of imbalance in their relationships due to lack of support from those close to them. The support from healthcare professionals was experienced both positively and negatively, and many of the women revealed variation in the professional's attitude, knowledge, and empathy. The women who chose not to work during the treatment felt pressure from society and healthcare professionals to get back to work as soon as possible. For many, especially those in a leading position, this was experienced as very difficult. The women expressed a feeling of not being afraid of dying but wanted more time to prepare themselves.

  • 16.
    Browall, Maria M.
    et al.
    The Sahlgrenska Academy at Göteborg University, Institute of Health and Care Sciences, Göteborg, Sweden.
    Ahlberg, Karin M.
    The Sahlgrenska Academy at Göteborg University, Institute of Health and Care Sciences, Göteborg, Sweden / Department of Oncology, Sahlgrenska University Hospital, Göteborg, Sweden.
    Persson, Lars-Olof G.
    The Sahlgrenska Academy at Göteborg University, Institute of Health and Care Sciences, Göteborg, Sweden.
    Karlsson, Per O.
    Department of Oncology, Sahlgrenska University Hospital, Göteborg, Sweden / Department of Oncology, Southern Älvsborg Hospital, Borås, Sweden.
    Danielson, Ella B.
    The Sahlgrenska Academy at Göteborg University, Institute of Health and Care Sciences, Göteborg, Sweden.
    The impact of age on Health-Related Quality of Life (HRQoL) and symptoms among postmenopausal women with breast cancer receiving adjuvant chemotherapy2008In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 47, no 2, p. 207-215Article in journal (Refereed)
    Abstract [en]

    Background and purpose: Elderly women with breast cancer are often not given adjuvant chemotherapy (CT). One reason for this is that older women are believed to have more problems in tolerating side-effects of CT. The purpose of this study was to analyze the impact of age on health related quality of life (HRQoL) and symptoms in postmenopausal women with breast cancer undergoing adjuvant CT.

    Patients and methods: Eighty consecutive postmenopausal patients planned for CT were invited. Seventy-five agreed to participate (age 55-77 years). The patients completed two cancer-specific HRQoL questionnaires, The European Organisation for Research and Treatment of cancer (EORTC) EORTC-QLQ-C30, the EORTC-QLQ-BR23, and the Hospital Anxiety and Depression Scale (HADS) before, during, and 4 months after completion of treatment. The design was descriptional and longitudinal. Correlations were examined between age and change in HRQoL variables.

    Results: No significant correlations were found between age and any of the assessed HRQoL domains or symptom scales, except for dyspnoea and sexual functioning. Age was inversely correlated to change in dyspnoea from baseline through follow-up, whereas older women perceived their sexual functioning significantly lower at baseline.

    Conclusion: The results indicate that among postmenopausal patients in the age range 55-77 years consecutively selected for adjuvant CT age was not a predictor of decreased HRQoL. This supports the argument that age should not be used in isolation in decisions about adjuvant CT for breast cancer in elderly women.

  • 17.
    Browall, Maria
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Department of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Pakpour, Amir H.
    Jönköping University, School of Health and Welfare, HHJ, Department of Nursing Science. Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
    Melin-Johansson, Christina
    Department of Health Sciences, Palliative Research Centre, Ersta Sköndal Bräcke College, Stockholm, Sweden.
    Lundh Hagelin, Carina
    Department of Health Sciences, Palliative Research Centre, Ersta Sköndal Bräcke College, Stockholm, Sweden.
    Österlind, Jane
    Department of Health Sciences, Palliative Research Centre, Ersta Sköndal Bräcke College, Stockholm, Sweden.
    Henoch, Ingela
    Institute of Health and Care Sciences, Sahlgrenska Academy at the University of Gothenburg, Sweden; Department of Research and Development, Angered Hospital, Gothenburg, Sweden.
    Development and Psychometric Evaluation of a New Short Version of the Swedish Frommelt Attitudes Toward Care of the Dying Scale2021In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 44, no 4, p. 305-313Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The Frommelt Attitudes Toward Care of the Dying (FATCOD) is widely used as a measure of attitudes toward care of dying patients. However, poor factor structure and item redundancy have been reported across the literature.

    OBJECTIVE: A short version of the questionnaire is needed, to facilitate effective assessments of the attitudes of those caring for dying patients. The purpose of this study was to develop a FATCOD-Short Form and to secure its psychometric properties.

    INTERVENTIONS/METHODS: Data gathered from 1000 nurses in previous studies were pooled and reanalyzed. Principal components analysis and confirmatory factor analysis were utilized to assess the factor structure of the FATCOD-30. A Rasch model was used to evaluate the measurement functioning of the scale.

    RESULTS: Of the original 30 items, 9 items of FATCOD were chosen for retention in the short form based on the principal components analysis, floor or ceiling effects, interitem correlations, and item-total correlation. All 9 items had good internal reliability. Both confirmatory factor analysis and Rasch analysis supported the unidimensionality of the FATCOD-Short Form.

    CONCLUSIONS: The 9-item FATCOD-Short Form demonstrates evidence of acceptable validity and reliability to identify nurses' attitudes toward caring for dying persons because of its brevity and comprehensive content.

    IMPLICATIONS FOR PRACTICE: When changing curricula in nursing education or implementing new procedures in nursing practice, it is important to have valid instruments to evaluate the results of the change. Such instruments should not be too lengthy or complicated. FATCOD-Short Form is a brief and valid instrument that can be easily used.

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  • 18.
    Browall, Maria
    et al.
    Sahlgrenska Academy at Göteborg University, Institute of Health and Care Sciences, Göteborg, Sweden.
    Persson, L. -O
    Ahlberg, K.
    Karlsson, P.
    Danielson, E.
    Daily assessment of stressful events and coping among post-menopausal women with breast cancer treated with adjuvant chemotherapy: Original article2009In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 18, no 5, p. 507-516Article in journal (Refereed)
    Abstract [en]

    The purpose of the study was twofold: to examine what type of daily stressful events post-menopausal woman with breast cancer experience during adjuvant chemotherapy and how bothersome these are and to identify coping strategies used by these women used to manage such stressful events. The patient group comprised 75 consecutively invited women (≥55 years of age) at two university hospitals and one county hospital in Sweden. The Daily Coping Assessment was used to collect data over time. Data were analysed both qualitatively and quantitatively. Six categories of stressful events were identified: 'nausea and vomiting', 'fatigue', 'other symptoms', 'isolation and alienation', 'fear of the unknown' and 'being controlled by the treatment'. The first three categories were subsumed under the domain physical problems and the latter three under psychosocial problems. Almost 30% of the diary entries recorded no stressful event. Physical problems were three times as frequent as psychosocial problems. 'Nausea/vomiting' was the most frequently observed stressful event (21.6%). 'Isolation and alienation' and 'fear of the unknown' were less frequent, but when they occurred they were rated as the most distressing. Several coping strategies were used to manage each stressful event. The most common strategies were acceptance, relaxation and distraction. Religion was rarely used as a coping strategy. 

  • 19.
    Bäckström, Emelie
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Fridèn, Sara
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Vuxnas upplevelser av att leva med hjärntumör: - en litteraturöversikt2022Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: En hjärntumör kan vara lokaliserad på olika ställen i hjärnan och påverka olika funktioner i kroppen. Under sjukdomsförloppet är fysiska och psykiska symtom vanligt förekommande. Sjuksköterskan har en väsentlig roll i personens vård för att uppmärksamma patientens behov i hälsa och ohälsa.

    Syfte: Syftet var att beskriva vuxnas upplevelse av att leva med hjärntumör. 

    Metod: En litteraturöversikt med 13 vetenskapliga artiklar av kvalitativ metod sammanställdes och analyserades med induktivt förhållningsätt enligt Friberg. 

    Resultat: Resultatet visade hur personer med hjärntumör upplever sin vardag. Två huvudteman presenterades; att leva med symtom och hantera dessa och att uppleva en förändrad vardag. Sju subkategorier presenterades; fysiska symtom, kognitiva och psykiska symtom, copingstrategier, nya rutiner i vardagen, förlust av roller och relationer, anhörigas betydelse och att utmanas känslomässigt.  

    Slutsats: Litteraturöversikten visar att personer som drabbas av hjärntumör påverkas i vardagen. Många upplever kognitiva symtom vilket begränsar deras vardag. Copingstrategier sågs som en viktig del för att anpassa sig till sin nya vardag. Det fanns en oro och ångest kring symtom, prognos och sin framtid och hur detta skulle påverka deras vardag. Det finns behov av vidare forskning. Förslag på forskning skulle kunna vara sjuksköterskors upplevelse av att vårda en patient med hjärntumör. 

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  • 20. Chenevix-Trench, G.
    et al.
    Milne, R. L.
    Antoniou, A. C.
    Couch, F. J.
    Easton, D. F.
    Goldgar, D. E.
    An international initiative to identify genetic modifiers of cancer risk in BRCA1 and BRCA2 mutation carriers: The Consortium of Investigators of Modifiers of BRCA1 and BRCA2 (CIMBA)2007In: Breast Cancer Research, ISSN 1465-5411, E-ISSN 1465-542X, Vol. 9, no 2, article id 104Article in journal (Other academic)
    Abstract [en]

    BRCA1 and BRCA2 mutations exhibit variable penetrance that is likely to be accounted for, in part, by other genetic factors among carriers. However, studies aimed at identifying these factors have been limited in size and statistical power, and have yet to identify any convincingly validated modifiers of the BRCA1 and BRCA2 phenotype. To generate sufficient statistical power to identify modifier genes, the Consortium of Investigators of Modifiers of BRCA1 and BRCA2 (CIMBA) has been established. CIMBA contains about 30 affiliated groups who together have collected DNA and clinical data from approximately 10,000 BRCA1 and 5,000 BRCA2 utation carriers. Initial efforts by CIMBA to identify modifiers of breast cancer risk for BRCA1 and BRCA2 mutation carriers have focused on validation of common genetic variants previously associated with risk in smaller studies of carriers or unselected breast cancers. Future studies will involve replication of findings from pathway-based and genome-wide association studies in both unselected and familial breast cancer. The identification of genetic modifiers of breast cancer risk for BRCA1 and BRCA2 mutation carriers will lead to an improved understanding of breast cancer and may prove useful for the determination of individualized risk of cancer amongst carriers. 

  • 21.
    Coci, Anamaria Ioana
    Jönköping University, School of Education and Communication, HLK, CHILD.
    Health and functioning in everyday life of children who completed a brain tumor treatment: A longitudinal analysis on professionals’ records2022Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Children who have survived a brain tumor often experience late consequences as a result of the tumor itself, and/or treatment. The child’s ability to engage in daily activities may be restricted by these late consequences. Examples of these late consequences are challenges with their activity levels and engagement in daily activities. Therefore, it is important to study these children’s late consequences over time. The aim of the thesis is to use data from medical and school records linked to ICF, to investigate how the participation problems/ restrictions of children that completed cancer directed treatment for a brain tumor tend to occur simultaneously with codes from other ICF components, over time. For the present research the inclusion criteria were children that were followed by the habilitation service, school and health care for at least 4 years after completing their brain tumor treatment. Seven children were included in the study. For each child, records were obtained from habilitation, school and health care and a complete retrospective screening was conducted between February 2022 and April 2022. Problems in relation to everyday life were identified and linked to ICF codes and domains. Descriptive statistics was used to analyze the data, in order to see the re-occurrences of the ICF domains during the time and observe the trajectory and intensity of the problems. The results revealed that the problems linked to body functions were the most frequently mentioned ICF domain by all three services as well as over time. Problems over time related to activity and participation were less focused and little emphasis were focused on problems related to the environment. The pattern over time was very individual. In order to more prominent focus on the child’s everyday functioning, follow-up guidelines should also include the child's functioning in everyday life, and not only areas related to body function. To conclude, when caring for these children, it is important to also focus on the child’s function in everyday life and to individualize the care since the pattern of problems over time seems to be very individual.

  • 22.
    Darcy, Laura
    et al.
    Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Björk, Maria
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Young children's experiences of living an everyday life with cancer – A three year interview study2019In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 39, p. 1-9Article in journal (Refereed)
    Abstract [en]

    Purpose

    The young child's experiences of living with cancer are crucial to providing evidence based care. This study explores and describes experiences of everyday life of young children with cancer, over a three year period from diagnosis.

    Method

    This is a longitudinal, inductive interview study with young children with cancer, and their parents. Interviews from shortly after diagnosis, six and 12 months after diagnosis have been reanalysed. Interviews with the same children and their parents from 18 to 36 months after diagnosis have been analysed for the first time in the present paper. A longitudinal temporal analysis at category level for five synchronic data sets forms the basis for the results.

    Results

    The child living with cancer over a three year period is described as a child apart, striving to live an everyday life. This description is built on three categories: I want to be a child like any other, I need security and control and I feel lonely and left out. Young children with cancer actively strive to understand their illness, participate in care and live an ordinary everyday life- but with ongoing feelings of social isolation and loneliness.

    Conclusions

    Young children with cancer need access to and ongoing contact with peers and preschool. A structured follow-up throughout the cancer trajectory and not just during active treatment, is necessary. A child-centred philosophy of care would guide the child towards attainment of health and wellbeing.

  • 23.
    Darcy, Laura
    et al.
    Department of Caring Science, Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Social Work. Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Björk, Maria
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    The development of the Clinical Assessment Tool "Health and Everyday Functioning in Young Children with Cancer"2020In: Child Care Health and Development, ISSN 0305-1862, E-ISSN 1365-2214, Vol. 46, no 4, p. 445-456Article in journal (Refereed)
    Abstract [en]

    Key messages

    • The aim of this study was to select and validate the content of a clinical assessment tool (CAT) for health and everyday functioning in young children with cancer.
    • Items were developed based on frequently occurring ICF-CY codes identified in the transcripts of 12 interviews with young children with cancer and their parents.
    • The CAT consists of 52 items grouped in four dimensions, “The child her/himself”, “The child’s everyday life”, “The child’s need for support” and “The child’s contacts with health care”.
    • The items correlate well with known research results
    • The CAT can be used by both parents and health care personnel to highlight aspects of care for the young child with cancer
  • 24.
    Diaz Cruz, Maria Araceli
    Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Exploring vitamin D and steroid hormone receptors – from healthy elderly to prostate cancer cells2022Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The genetic background together with environmental factors and lifestyle are key contributors to the health of an individual. Genetic background is inherited and irreversible unless mutations occur. However, lifestyle habits (i.e., diet, stress, physical activity, smoking, and alcohol consumption) are modifiable factors that contribute to health or disease by affecting methylation of DNA, which regulates transcription of genes.

    One of the most relevant lifestyle habits for health is maintaining adequate vitamin D levels in the body as vitamin D promotes calcium and phosphate absorption, supports the nervous and immune system function, and protects bone and muscle structure. Extreme low levels of vitamin D, vitamin D deficiency, has become a global public health concern, especially in the elderly population as vitamin D deficiency can lead to several health problems such as bone fracture, decreased muscle strength, cardiovascular and autoimmune diseases, depression, and breast, pancreatic, and prostate cancer.

    Prostate cancer is an uncontrolled growth of cells within the prostate gland in the male reproductive system. Human prostate carcinomas are sensitive to androgens, and hormonal ablation therapy gives a temporary remission, followed by a relapse to an androgen-insensitive state. This indicates that steroid hormones, especially androgens, play a significant role in human prostatic carcinogenesis. The molecular effect of vitamin D as a steroid hormone and which steroid hormone receptor (SHR) mediates this effect are not fully understood.

    This research project aims to increase our knowledge about SHRs, primarily the vitamin D receptors, in both health and disease, focusing on genomic, epigenomic, and transcriptomic perspectives in healthy elderly individuals and prostate cancer cells.

    The results from the studies in this thesis could help us understand the importance of a healthy lifestyle, which includes vitamin D for health, where we found specific methylation markers involved in the down-regulation of cancer pathways that are associated with high physical activity and vitamin D supplementation. We have further confirmed that SHRs rarely work in isolation but rather as a crosstalk at the genomic level to regulate their transcription. Hopefully, this will help clarify the modulation of transcriptional responses in SHRs and explain the development of steroid hormone-dependent cancers such as prostate cancer. Last, but not least, we revealed that genetic and transcriptional markers are associated with the putative vitamin D receptor the protein disulfide isomerase family A member 3 (PDIA3). The genetic markers were detected in a healthy elderly population under vitamin D supplementation. The transcriptional markers, PDIA3, and a novel discovered isoform of PDIA3 (PDIA3N) were related to the androgen and cancer stage of prostate cancer cells and therefore are proposed as candidate markers for clinical diagnosis of prostate cancer.

    Altogether, these findings support the relevance of studying vitamin D and steroid hormone receptors, especially the PDIA3 receptor, to understand some of the factors related to healthy aging and the etiology and progression of prostate cancer.

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  • 25.
    Diaz Cruz, Maria Araceli
    et al.
    Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Karlsson, Sandra
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Szekeres, Ferenc
    Department of Biomedicine, School of Health Sciences, University of Skövde, Skövde, Sweden.
    Faresjö, Maria
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Lund, Dan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Larsson, Dennis
    Sahlgrenska University Hospital, Gothia Forum - for Clinical Research, Gothenburg, Sweden.
    Differential expression of protein disulfide-isomerase A3 isoforms, PDIA3 and PDIA3N, in human prostate cancer cell lines representing different stages of prostate cancer2021In: Molecular Biology Reports, ISSN 0301-4851, E-ISSN 1573-4978, Vol. 48, p. 2429-2436Article in journal (Refereed)
    Abstract [en]

    Prostate cancer (PCa) is a highly heterogeneous and unpredictable progressive disease. Sensitivity of PCa cells to androgens play a central role in tumor aggressiveness but biomarkers with high sensitivity and specificity that follow the progression of the disease has not yet been verified. The vitamin D endocrine system and its receptors, the Vitamin D Receptor (VDR) and the Protein Disulfide-Isomerase A3 (PDIA3), are related to anti-tumoral effects as well as carcinogenesis and have therefore been suggested as potential candidates for the prevention and therapy of several cancer forms, including PCa. In this study, we evaluated the mRNA expression of VDR and PDIA3 involved in vitamin D signaling in cell lines representing different stages of PCa (PNT2, P4E6, LNCaP, DU145 and PC3). This study further aimed to evaluate vitamin D receptors and their isoforms as potential markers for clinical diagnosis of PCa. A novel transcript isoform of PDIA3 (PDIA3N) was identified and found to be expressed in all PCa cell lines analyzed. Androgen-independent cell lines showed a higher mRNA expression ratio between PDIA3N/PDIA3 contrary to androgen-dependent cell lines that showed a lower mRNA expression ratio between PDIA3N/PDIA3. The structure of PDIA3N differed from PDIA3. PDIA3N was found to be a N-truncated isoform of PDIA3 and differences in protein structure suggests an altered protein function i.e. cell location, thioredoxin activity and affinity for 1,25(OH)2D3. Collectively, PDIA3 transcript isoforms, the ratio between PDIA3N/PDIA3 and especially PDIA3N, are proposed as candidate markers for future studies with different stages of PCa progression.

  • 26.
    Dimberg, Jan
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Andersson, Roland E.
    Department of Surgery, Jönköping, Region Jönköping County, and Department of Biomedical and Clinical Sciences, Faculty of Medicine, Linköping University, Linköping, Sweden.
    Haglund, Sofie
    Department of Laboratory Medicine, Jönköping, Region Jönköping County, and Department of Biomedical and Clinical Sciences, Faculty of Medicine, Linköping University, Linköping, Sweden.
    Genomic Profiling of Stage II Colorectal Cancer Identifies Candidate Genes Associated with Recurrence-Free Survival, Tumor Location, and Differentiation Grade.2020In: Oncology, ISSN 0030-2414, E-ISSN 1423-0232, Vol. 98, no 8, p. 575-582Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Identification of high-risk stage II colorectal cancer (CRC) patients, potential candidates for adjuvant chemotherapy, is challenging. Current clinical guidelines rely mainly on histopathological markers with relatively weak prognostic value. This motivates further search for prognostic markers.

    METHODS: This explorative study aimed to identify potential candidate gene mutations to facilitate differentiation between subgroups of patients with CRC stage II. Panel-based massive parallel sequencing was used to genetically characterize tumor tissues from 85 patients radically operated for CRC stage II, of which 12 developed recurrent cancer during follow-up. Genetic data was compared between patients with or without cancer recurrence, between tumors located in colon and in rectum, and for association with tumor differentiation grade.

    RESULTS: Genetic variation in ATM, C11ORF65 was associated with recurrence-free survival. Previous reports regarding the association between BRAF mutation and a higher age at diagnosis, and tumor location in colon were confirmed. APC, BRAF, or KRAS mutation was associated with tumor differentiation grade. Multiple correspondence analyses revealed no obvious clustering of patients with the studied clinical characteristics, indicating that the genetic signatures observed here were unique for each individual.

    CONCLUSIONS: Taken together, we have demonstrated the utility of panel-based massive parallel sequencing to explore the pathogenesis of CRC stage II. We have identified promising candidate gene mutations associated with cancer recurrence, tumor location, and differentiation grade in patients with CRC stage II, which merit further investigation.

  • 27.
    Dimberg, Jan
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Department of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Hong, Thaitrinh
    Vietnam National University.
    Nguyen, Linh Tu Thi
    Vietnam National University.
    Skarstedt, Marita
    Ryhov County Hospital, Jönköping, Sweden.
    Löfgren, Sture
    Ryhov County Hospital, Jönköping, Sweden.
    Matussek, Andreas
    Ryhov County Hospital, Jönköping, Sweden.
    Common 4977 bp deletion and novel alterations in mitochondrial DNA in Vietnamese patients with breast cancer2015In: SpringerPlus, E-ISSN 2193-1801, Vol. 4, p. 1-7, article id 58Article in journal (Refereed)
    Abstract [en]

    Mitochondrial DNA (mtDNA) has been proposed to be involved in carcinogenesis and ageing. The mtDNA 4977 bp deletion is one of the most frequently observed mtDNA mutations in human tissues and may play a role in breast cancer (BC). The aim of this study was to investigate the frequency of mtDNA 4977 bp deletion in BC tissue and its association with clinical factors.

    We determined the presence of the 4977 bp common deletion in cancer and normal paired tissue samples from 106 Vietnamese patients with BC by sequencing PCR products.

    The mtDNA 4977 bp deletion was significantly more frequent in normal tissue in comparison with paired cancer tissue. Moreover, the incidence of the 4977 bp deletion in BC tissue was significantly higher in patients with estrogen receptor (ER) positive as compared with ER negative BC tissue. Preliminary results showed, in cancerous tissue, a significantly higher incidence of novel deletions in the group of patients with lymph node metastasis in comparison with the patients with no lymph node metastasis.

    We have found 4977 bp deletion in mtDNA to be a common event in BC and with special reference to ER positive BC. In addition, the novel deletions were shown to be related to lymph node metastasis. Our finding may provide complementary information in prediction of clinical outcome including metastasis, recurrence and survival of patients with BC.

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  • 28.
    Dimberg, Jan
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Department of Clinical Diagnostics.
    Shamoun, Levar
    Department of Laboratory Medicine and Pathology, Region Jönköping County, Jönköping, Sweden.
    Johansson, Gustaf
    Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden.
    Landerholm, Kalle
    Department of Surgery, Region Jönköping County, Jönköping, Sweden; Department of Biomedical and Clinical Science, Linköping University, Linköping, Sweden.
    Wågsäter, Dick
    Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden.
    Emerging role and clinical implication of mRNA scavenger decapping enzyme in colorectal cancer2023In: Pathology, Research and Practice, ISSN 0344-0338, E-ISSN 1618-0631, Vol. 253, article id 155009Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Turnover of RNA is a regulated process that in part controls gene expression. This process is partly controlled by the scavenger decapping enzyme (DcpS). This study aimed to investigate the expression of DcpS in colorectal cancer (CRC) tissue, to evaluate its prognostic significance in patients with CRC and to investigate potentially targeted genes by DcpS.

    METHODS: Immunohistochemical analysis was used to determine localization of DcpS in normal and CRC tissue, western blot analysis for quantification of protein expression and qPCR for mRNA expression in normal and CRC tissue and expression in cell lines after silencing using siRNA. Gene array analysis was used to study regulation of genes after silencing of DcpS. Proliferation was studied using BRDU.

    RESULTS: DcpS expression was localized to the epithelial cells of both control and cancer tissue. Tumor and paired control tissue samples from 100 patients who underwent surgical resection for primary colorectal adenocarcinomas were utilized. mRNA and protein of DcpS was significantly up-regulated in the patients with CRC and the mRNA level was higher in rectal cancer tissue compared to colon cancer tissue (p < 0.05). Lowest tertile levels of DcpS mRNA in cancer tissue was associated with a decreased cancer-specific survival rate with a hazard ratio (HR) of 4.7 (95% CI=1.02-12.3), independent of disease stage. The low level of DcpS mRNA was a predictor of poorer survival in patients with rectal and disseminated cancer and in patients receiving adjuvant treatment (p < 0.05). After silencing DcpS in Caco-2 cancer cells, altered expression of several genes associated with RNA, cell cycle regulation, alternative splicing and microRNA was observed and resulted in 23% increase in proliferation.

    CONCLUSIONS: These results indicate that DcpS has potential as a prognostic factor for CRC but further studies in a broader cohort are warranted to evaluate the significance of the findings in the clinic.

  • 29.
    Dimberg, Jan
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Shamoun, Levar
    Department of Laboratory Medicine and Pathology, Region Jönköping County Hospital Ryhov, Jönköping, Sweden.
    Landerholm, Kalle
    Department of Surgery, Jönköping, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Andersson, Roland E.
    Department of Surgery, Jönköping, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Kolodziej, Blanka
    Department of Pathology, Region Jönköping County Hospital Ryhov, Jönköping, Sweden.
    Wågsäter, Dick
    Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden.
    Genetic variants of the IL2 gene related to risk and survival in patients with colorectal cancer2019In: Anticancer Research, ISSN 0250-7005, E-ISSN 1791-7530, Vol. 39, no 9, p. 4933-4940Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Interleukin 2 (IL2) is a significant factor activating T-cell-mediated immune response by stimulation of natural killer cells, T-cells and in development of regulatory T (Treg) cells. Recent studies have that IL2 participates in cancer development by modifying the local immune response. Based on the suggested role of the single nucleotide polymorphisms (SNPs) rs2069762, rs6822844 and rs11938795 of IL2 in the pathogenesis of certain diseases, the relationship of these SNPs with clinicopathological variables and their possible implication for prognosis and disease outcome were evaluated in a cohort of Swedish patients with colorectal cancer (CRC).

    MATERIALS AND METHODS: TaqMan SNP genotype assays based on polymerase chain reaction were used for analysis of the IL2 SNPs in 467 patients with CRC and 467 healthy controls. Expression analysis of IL2 in plasma and CRC tissue was also performed.

    RESULTS: The allelic variants T in rs11938795 and G in rs6822844 were significantly associated with a higher risk of CRC. Kaplan-Meier analysis showed that cancer-specific survival was worse for individuals with C allele for rs2069762 with stage II CRC and with T allele for rs6822844 with stage III CRC.

    CONCLUSION: SNPs rs2069762, rs6822844 and rs11938795 of the IL2 gene may be helpful as prognostic biomarkers in the follow-up and management of the patients.

  • 30.
    Dimberg, Jan
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Shamoun, Levar
    Department of Laboratory Medicine and Pathology, Region Jönköping County, Jönköping, Sweden.
    Landerholm, Kalle
    Department of Surgery, Region Jönköping County, Jönköping, Sweden.
    Wågsäter, Dick
    Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden.
    Effects of diabetes type 2 and metformin treatment in Swedish patients with colorectal cancer2022In: World Journal of Gastroenterology, ISSN 1007-9327, E-ISSN 2219-2840, Vol. 28, no 19, p. 2148-2151Article in journal (Refereed)
    Abstract [en]

    The association between type 2 diabetes mellitus (DM) and colorectal cancer (CRC) has been thoroughly investigated and reports have demonstrated that the risk of CRC is increased in DM patients. The association between DM and the survival of patients with CRC is controversial. Evidence suggests that metformin with its anti-inflammatory effects is a protective factor against the development of CRC among DM patients and that metformin therapy is associated with a better prognosis in patients with DM. In our cohort, we did not find any associations between the presence of DM or metformin and cancer specific survival or any relation to plasma levels of a panel of 40 inflammatory factors and irisin. On the other hand, we identified that the insulin-like growth factor binding protein 7 single nucleotide polymorphism rs2041437 was associated with DM in CRC patients. The dominance of the T bearing genotypes in patients with DM was statistically significant (P = 0.038), with an odds ratio of 1.66 (95% confidence interval: 1.03-2.69).

  • 31.
    Dimberg, Jan
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Skarstedt, Marita
    Division of Medical Diagnostics, Department of Laboratory Medicine, Region Jönköping County, Jönköping, Sweden.
    Slind Olsen, Renate
    Division of Medical Diagnostics, Department of Laboratory Medicine, Region Jönköping County, Jönköping, Sweden.
    Andersson, Roland E.
    Department of Surgery, Region Jönköping County, Jönköping, Sweden.
    Matussek, Andreas
    Division of Medical Diagnostics, Department of Laboratory Medicine, Region Jönköping County, Jönköping, Sweden.
    Gene polymorphism in DNA repair genes XRCC1 and XRCC6 and association with colorectal cancer in Swedish patients2016In: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), ISSN 0903-4641, E-ISSN 1600-0463, Vol. 124, no 9, p. 736-740Article in journal (Refereed)
    Abstract [en]

    The DNA repair genes XRCC1 and XRCC6 have been proposed to participate in the pathological process of cancer by modulating the DNA repair capacity. This study evaluated the susceptibility of the single-nucleotide polymorphisms (SNPs) XRCC1 (rs25487, G > A) and XRCC6 (rs2267437, C > G) to colorectal cancer (CRC) and their association with clinical parameters in Swedish patients with CRC. Using the TaqMan system, these SNPs were screened in 452 patients and 464 controls. No significant difference in genotype distribution was found between the patients and controls, or any significant association with cancer-specific or disease-free survival in patients. However, we showed that the carriers of allele A in XRCC1 (rs25487, G > A) were connected with a higher risk of disseminated CRC (Odds Ratio = 1.64; 95% Confidence Interval = 1.12–2.41, p = 0.012).

  • 32.
    Dimberg, Jan
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Slind Olsen, Renate
    Department of Laboratory Services, Ryhov County Hospital, Jönköping.
    Skarstedt, Marita
    Clinical Microbiology, Ryhov County Hospital, Jönköping.
    Löfgren, Sture
    Department of Laboratory Services, Ryhov County Hospital, Jönköping.
    Zar, Niklas
    Ryhov County Hospital, Jönköping.
    Matussek, Andreas
    Department of Laboratory Services, Ryhov County Hospital, Jönköping.
    Polymorphism of the p38 beta gene in patients with colorectal cancer2014In: Oncology Letters, ISSN 1792-1074, E-ISSN 1792-1082, Vol. 8, p. 1093-1095Article in journal (Refereed)
    Abstract [en]

    The p38 mitogen‑activated protein kinase (MAPK) signaling pathways have been proposed to participate in the pathological process of cancer by affecting inflammation, proliferation, metastasis and cell survival. A single nucleotide polymorphism (SNP; rs2235356, ‑1628A→G) in the promoter region of the p38β gene has been proposed as a genetic modifier for colorectal cancer (CRC) in a Chinese population. The present study evaluated the susceptibility of patients possessing this SNP to CRC, in addition to determining its association with clinical parameters in Swedish patients with CRC. Using the LightSNiP genotyping assay, this SNP was screened in 389 patients with CRC and 517 control subjects. No significant difference in the genotype distribution or in the allelic frequencies was identified between the two groups nor was any association identified with the clinical parameters. These findings indicate that the ‑1628A→G polymorphism of the p38β gene is not significantly associated with a susceptibility to CRC in a Swedish population.

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  • 33.
    Dimberg, Jan
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine.
    Ström, Karin
    Klinisk Mikrobiologi, Länssjukhuset Ryhov, Jönköping.
    Löfgren, Sture
    Klinisk Mikrobiologi, Länssjukhuset Ryhov, Jönköping.
    Zar, Niklas
    Kirurgkliniken, Länssjukhuset Ryhov, Jönköping.
    Hugander, Anders
    Kirurgkliniken, Länssjukhuset Ryhov, Jönköping.
    Matussek, Andreas
    Laboratoriemedicin, Länssjukhuset Ryhov, Jönköping.
    Expression of the serine protease inhibitor serpinA3 in human colorectal adenocarcinomas2011In: Oncology Letters, ISSN 1792-1074, Vol. 2, no 3, p. 413-418Article in journal (Refereed)
    Abstract [en]

    Proteases facilitate a number of steps in cancer progression. The serine protease inhibitors (serpins) are a protein superfamily with inhibitory activity against proteases. One of these proteases, serpinA3, appears to have a multifaceted role and is associated with inflammatory reactions, Alzheimer's disease, malignant melanoma and gastric cancer. To gain insight into the potential effect of serpinA3 on colorectal cancer (CRC) we determined whether serpinA3 is altered in colorectal tissue or plasma in CRC patients. Collectively, by using ELISA we noted a significantly lower serpinA3 level in cancer tissue compared to paired normal tissue. Moreover, the tumour serpinA3 level tended to be higher in disseminated disease as compared to localised disease. No significant difference in the plasma levels of serpinA3 was noted in the patients when compared to the controls. However, plasma serpinA3 and C-reactive protein (marker of inflammation) in the CRC patients and controls were significantly positively correlated. To confirm and detect localization of serpinA3 expression, immunohistochemistry was performed. Immunohistochemistry showed heterogeneous immunoreactivity in epithelial cells in the cancer and normal tissue and extracellular staining within bands of stroma as well as in some stromal cells. A Taq Man system was used to investigate a single nucleotide polymorphism (rs4934) in the serpinA3 signal sequence gene with supposed effect on serpinA3 secretion and expression. No significant difference was observed between CRC and control subjects regarding genotype and allelic distributions, nor were associations noted between clinical characteristics and serpinA3 levels. In conclusion, an altered serpinA3 concentration in CRC tissue may be a potential biomarker in CRC progression. SerpinA3 concentrations in plasma appear to be correlated with systemic inflammation, but do not appear to be specific to CRC patients. Further studies are warranted to improve our understanding of the role of serpinA3 in CRC.

  • 34.
    Dimberg, Jan
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Ström, Karin
    Dep. of Clinical Microbiology, Ryhov County Hospital Jönköping Sweden.
    Löfgren, Sture
    Dep. of Clinical Microbiology, Ryhov County Hospital, Jönköping, Sweden.
    Zar, Niklas
    Dep. of Surgery, Ryhov County Hospital, Jönköping, Sweden.
    Lindh, Mikael
    Department of Surgery, Ryhov County Hospital, Jönköping, Sweden.
    Matussek, Andreas
    Dep. of Laboratory Medicin, Ryhov County Hospital, Jönköping, Sweden.
    DNA promoter methylation status and protein expression of interleukin-8 in human colorectal adenocarcinomas2012In: International Journal of Colorectal Disease, ISSN 0179-1958, E-ISSN 1432-1262, Vol. 27, no 6, p. 709-714Article in journal (Refereed)
    Abstract [en]

    Background  Interleukin-8 (IL-8) also referred to as CXCL8, a member of the CXC chemokine family that attracts neutrophils and other leukocytes, has been associated with cancer. Angiogenesis is a prime regulator of tumour expansion and data support that IL-8 is a potent angiogenic factor. Epigenomic instability has been postulated to play a role for the development of multiple neoplasias including colorectal cancer (CRC). DNA methylation of cytosine residues in CpG dinucleotides leads to transcriptional silencing of associated genes.

    Method  In this study, we comparatively analysed the protein expression of IL-8 in plasma, tumour and paired normal tissue and methylation status of the IL-8 gene to evaluate its impact on CRC.

    Results  Collectively, by using Luminex technology, we noted a significantly higher IL-8 level in cancer tissue compared to paired normal tissue and that CRC patients exhibit significantly higher plasma levels than healthy controls. Analysed by methylation-specific polymerase chain reaction, we detected IL-8 hypomethylation in 64% of the cancerous tissue cases but no hypomethylation was found in paired normal tissue. We noted that the CRC patients with IL-8 hypomethylation revealed a significant higher level of IL-8 protein in cancerous tissue, which tended to be associated with distant metastasis. We also observed that patients with distant metastasis showed a significantly higher plasma level of IL-8 in relation to patients without distant metastasis.

    Conclusion  Our results suggest that the predominance of high plasma levels of IL-8 in patients with distant metastasis in combination with the hypomethylation of the IL-8 promoter region might be a useful marker of the disease advancement.

  • 35.
    Dimberg, Jan
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Thai, Trinh Hong
    Key Laboratory of Enzyme and Protein Technology, College of Science, Vietnam National University, Hanoi, Vietnam.
    Skarstedt, Marita
    Department of Clinical Microbiology, Ryhov County Hospital, Jönköping, Sweden.
    Löfgren, Sture
    Department of Clinical Microbiology, Ryhov County Hospital, Jönköping, Sweden.
    Zar, Niklas
    Department of Surgery, Ryhov County Hospital, Jönköping, Sweden.
    Matussek, Andreas
    Department of Laboratory Medicine, Ryhov County Hospital, Jönköping, Sweden.
    Detection of Cytomegalovirus DNA in Colorectal Tissue from Swedish and Vietnamese Patients with Colorectal Cancer2013In: Anticancer Research, ISSN 0250-7005, E-ISSN 1791-7530, Vol. 33, no 11, p. 4947-4950Article in journal (Refereed)
    Abstract [en]

    Background: Human cytomegalovirus (HCMV) has been implicated as a factor, which might be associated with colorectal cancer (CRC) progression. Data from studies with HCMV-infected tumour cell lines have highlighted an oncomodulatory potential of HCMV. In the present study, we aimed to evaluate the prevalence of HCMV DNA in CRC tissue compared to matched normal tissue, and its association with clinical factors.

    Patients and Methods: We used quantitative real-time polymerase chain reaction assay to detect HCMV DNA in 202 cancerous and paired normal tissue from Swedish (n=119) and Vietnamese (n=83) CRC patients.

    Results: Overall, the HCMV DNA rate was significantly higher in cancerous in relation to paired normal tissue. Furthermore, a significantly higher frequency (39.8%) of HCMV DNA was observed in cancer tissues from the Vietnamese patients compared to the Swedish patients (15.1%). The prevalence of HCMV DNA in CRC tissue of 50% of those with disseminated disease tended to be higher compared to those with localized disease, with a prevalence of 33.3% in Vietnamese patients.

    Conclusion: Our observations indicate that the prevalence of HCMV DNA differs significantly between cancer and matched normal tissues. Thus, these data support a possible role of CMV in CRC. Moreover, we noted differences between Swedish and Vietnamese patients, indicating a role of ethnicity.

  • 36.
    Dimberg, Jan
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Thai, Trinh Hong
    Vietnam National University.
    Skarstedt, Marita
    Ryhov County Hospital, Jönköping.
    Löfgren, Sture
    Ryhov County Hospital, Jönköping.
    Zar, Niklas
    Ryhov County Hospital, Jönköping.
    Matussek, Andreas
    Ryhov County Hospital, Jönköping.
    Novel and Differential Accumulation of Mitochondrial DNA Deletions in Swedish and Vietnamese Patients with Colorectal Cancer2014In: Anticancer Research, ISSN 0250-7005, E-ISSN 1791-7530, Vol. 34, no 1, p. 147-152Article in journal (Refereed)
    Abstract [en]

    Background: Mitochondrial DNA (mtDNA) has been proposed to be involved in carcinogenesis and aging. The mtDNA 4977 bp deletion is one of the most frequently observed mtDNA mutations in human tissues and may play a role in colorectal cancer (CRC). In the present study, we aimed to evaluate the frequency of mtDNA 4977 bp deletion in CRC tissues and its association with clinical factors. Patients and Methods: We determined the presence of the 4977 bp common deletion in cancer and normal paired tissue samples from 105 Swedish and 88 Vietnamese patients with CRC using polymerase chain reaction (PCR) assays. Results: The mtDNA 4977 bp deletion was shown to be significantly more frequent in normal tissues in comparison with paired cancer tissues in both Swedish and Vietnamese patients. The 4977 bp common deletion was significantly more frequent in cancer tissues of the Vietnamese patients compared to the Swedish patients, and in Vietnamese cancer tissues, the 4977 bp deletion was significantly over represented in those with localized disease compared to those with disseminated disease. Moreover, we detected nine novel mtDNA deletions and found a significantly higher rate of these in CRC tissues in Swedish in comparison to Vietnamese patients. Conclusion: The mtDNA 4977 bp deletion seems to have an impact on the clinical outcome of CRC in Vietnamese patients, that the Swedish patients accumulate more of the detected novel deletions in CRC tissue compared to Vietnamese patients probably indicates divergent mechanisms in colorectal carcinogenesis.

  • 37.
    Einbeigi, Z.
    et al.
    Department of Oncology, Sahlgrenska University Hospital, Göteborg, Sweden, Sweden.
    Bergman, Annika
    Department of Clinical Genetics, Sahlgrenska University Hospital, Göteborg, Sweden, Sweden.
    Kindblom, L.-G.
    Department of Pathology, Sahlgrenska University Hospital, Göteborg, Sweden, Sweden.
    Martinsson, T.
    Department of Clinical Genetics, Sahlgrenska University Hospital, Göteborg, Sweden, Sweden.
    Meis-Kindblom, J. M.
    Department of Pathology, Sahlgrenska University Hospital, Göteborg, Sweden, Sweden.
    Nordling, M.
    Department of Clinical Genetics, Sahlgrenska University Hospital, Göteborg, Sweden, Sweden.
    Suurküla, M.
    Department of Pathology, Sahlgrenska University Hospital, Göteborg, Sweden, Sweden.
    Wahlström, J.
    Department of Clinical Genetics, Sahlgrenska University Hospital, Göteborg, Sweden, Sweden.
    Wallgren, A.
    Department of Oncology, Sahlgrenska University Hospital, Göteborg, Sweden, Sweden.
    Karlsson, P.
    Department of Oncology, Sahlgrenska University Hospital, Göteborg, Sweden, Sweden.
    A founder mutation of the BRCA1 gene in Western Sweden associated with a high incidence of breast and ovarian cancer2001In: European Journal of Cancer, ISSN 0959-8049, E-ISSN 1879-0852, Vol. 37, no 15, p. 1904-1909Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe and characterise a founder mutation of the BRCA1 gene in western Sweden. Of 62 families screened for BRCA mutations, 24 had BRCA1 mutations and two had BRCA2 mutations. Tumours that occurred in family members were histologically reviewed and mutational status was analysed using archival paraffin-embedded tissues. The same BRCA1 mutation, 3171ins5, was found in 16 families who were clustered along the western coast of Sweden. Mutation analysis revealed a maternal linkage in 13 families and a paternal linkage in 3. There was complete agreement between mutation analysis results obtained from blood and archival tissues. The penetrance of breast or ovarian cancer by age 70 years was estimated to be between 59 and 93%. There were no differences in survivals between breast or ovarian cancer patients with the mutation and age-matched controls. Thus, a predominant BRCA1 gene founder mutation associated with a high risk of breast and ovarian cancer has been identified and found to occur in a restricted geographical area, thereby allowing timely and cost-effective mutation screening using blood samples or archival histological material. 

  • 38. Engel, C.
    et al.
    Versmold, B.
    Wappenschmidt, B.
    Simard, J.
    Easton, D. F.
    Peock, S.
    Cook, M.
    Oliver, C.
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    Arnold, N.
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    Niederacher, D.
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    Mai, P. L.
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    Association of the variants CASP8 D302H and CASP10 V410I with breast and ovarian cancer risk in BRCA1 and BRCA2 mutation carriers2010In: Cancer Epidemiology, Biomarkers and Prevention, ISSN 1055-9965, E-ISSN 1538-7755, Vol. 19, no 11, p. 2859-2868Article in journal (Refereed)
    Abstract [en]

    Background: The genes caspase-8 (CASP8) and caspase-10 (CASP10) functionally cooperate and play a key role in the initiation of apoptosis. Suppression of apoptosis is one of the major mechanisms underlying the origin and progression of cancer. Previous case-control studies have indicated that the polymorphisms CASP8 D302H and CASP10 V410I are associated with a reduced risk of breast cancer in the general population.

    Methods: To evaluate whether the CASP8 D302H (CASP10 V410I) polymorphisms modify breast or ovarian cancer risk in BRCA1 and BRCA2 mutation carriers, we analyzed 7,353 (7,227) subjects of white European origin provided by 19 (18) study groups that participate in the Consortium of Investigators of Modifiers of BRCA1/2 (CIMBA). A weighted cohort approach was used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI).

    Results: The minor allele of CASP8 D302H was significantly associated with a reduced risk of breast cancer (per-allele HR, 0.85; 95% CI, 0.76-0.97; Ptrend = 0.011) and ovarian cancer (per-allele HR, 0.69; 95% CI, 0.53-0.89; Ptrend = 0.004) for BRCA1 but not for BRCA2 mutation carriers. The CASP10 V410I polymorphism was not associated with breast or ovarian cancer risk for BRCA1 or BRCA2 mutation carriers.

    Conclusions: CASP8 D302H decreases breast and ovarian cancer risk for BRCA1 mutation carriers but not for BRCA2 mutation carriers.

    Impact: The combined application of these and other recently identified genetic riskmodifiers could in the future allow better individual risk calculation and could aid in the individualized counseling and decision making with respect to preventive options in BRCA1 mutation carriers.

  • 39.
    Enskär, Karin
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    Omvårdnad av barn med cancer1999Book (Other academic)
  • 40.
    Enskär, Karin
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Ljusegren, Gunilla
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Gimbler Berglund, Ingalill
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Eaton, Nicola
    Harding, Rosemary
    Mokoena, Joyce
    Chauke, Motsedisi
    Moleki, Maria
    Attitudes to and knowledge about pain and pain management, of nurses working with children with cancer: A comparative study between UK, South Africa and Sweden2007In: Journal of Research in Nursing, ISSN 1744-9871, Vol. 12, no 5, p. 501-515Article in journal (Refereed)
    Abstract [en]

    Pain is among the most common effects of cancer and its treatment. Children and young people with cancer often consider pain from procedures and treatment to be the worst aspect of their illness. This study aimed to i) identify and describe knowledge and attitudes to pain and pain management amongst nurses working with children with cancer and ii) compare the perspectives on pain and pain management of nurses from UK, South Africa and Sweden. 106 nurses working with children with cancer in UK, South Africa and Sweden completed Salanterä’s (1999) questionnaire on nurses’ attitudes to pain in children. Nurses had good levels of knowledge and positive attitudes to pain management, with Swedish nurses’ having higher levels of knowledge and a more positive attitude to pain management than nurses from UK or South Africa. A high level of knowledge was correlated to a more positive attitude to pain management. Knowledge levels need to be improved to ensure more positive attitudes to pain management, especially for nurses in South Africa. Swedish nurses’ level of knowledge about non-pharmacological pain management strategies has scope for improvement. British nurses may need to focus more on the sociology and psychology of pain.

  • 41.
    Faresjö, Maria
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    A useful guide for analysis of immune mediators in cancer by fluorochrome (Luminex) technique2020In: Immune mediators in cancer: Methods and protocols / [ed] I. Vancurova & Y. Zhu, Springer, 2020, p. 3-13Chapter in book (Refereed)
    Abstract [en]

    Immune cells and their mediators are key players in human cancer progression involving alternation in the number and function of immune cells, both peripheral and at the site of tumor. Through reliable predictive biomarkers, cancer can be predicted, and progression and response to therapy followed. Thereby immune biomarkers, e.g., cytokines and chemokines can serve as intermediate mediators of cancer diagnostics. Multiplex analysis of immune mediators in small blood volumes allows for rapid quantification of large number of circulating analytes. The fluorochrome (Luminex) technique is a bead-based sandwich immunoassay that combines the enzyme-linked immunosorbent assay (ELISA) with flow cytometry. The Luminex technique allows multiple immune mediators to be measured simultaneously in small volumes, and provides a convenient and sensitive tool for the detection of a large number of extracellular secreted cytokines and chemokines to be used in prediction and therapy prognosis of cancer.

    The technique is based on so-called microspheres (beads) that serve as a solid phase for molecular detection. These individually dyed microbeads have monoclonal antibodies directed against the cyto- and chemokines of interest and allow a simultaneous detection of up to nearly 100 cyto- and chemokines in a dual-laser flow analyzer. Immune mediators can be detected in serum and plasma samples as well as in cell culture supernatants from in vitro stimulated peripheral blood mononuclear cells (PBMC). This chapter describes the Luminex technique for detection of immune mediators in cancer by using magnetic bead sandwich immunoassay, with focus on some important pre-analytic factors, e.g., cell separation and cryopreservation and thawing of PBMC that may affect the outcome of detection of immune mediators. The Luminex technique thus represents a very suitable method to identify immune mediators in cancer tissues in order to diagnose and improve clinical outcome of cancer.

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    Vos, T.
    Vosoughi, K.
    Vu, G. T.
    Vujcic, I. S.
    Wabinga, H.
    Wachamo, T. M.
    Wagnew, F. S.
    Waheed, Y.
    Weldegebreal, F.
    Weldesamuel, G. T.
    Wijeratne, T.
    Wondafrash, D. Z.
    Wonde, T. E.
    Wondmieneh, A. B.
    Workie, H. M.
    Yadav, R.
    Yadegar, A.
    Yadollahpour, A.
    Yaseri, M.
    Yazdi-Feyzabadi, V.
    Yeshaneh, A.
    Yimam, M. A.
    Yimer, E. M.
    Yisma, E.
    Yonemoto, N.
    Younis, M. Z.
    Yousefi, B.
    Yousefifard, M.
    Yu, C.
    Zabeh, E.
    Zadnik, V.
    Moghadam, T. Z.
    Zaidi, Z.
    Zamani, M.
    Zandian, H.
    Zangeneh, A.
    Zaki, L.
    Zendehdel, K.
    Zenebe, Z. M.
    Zewale, T. A.
    Ziapour, A.
    Zodpey, S.
    Murray, C. J. L.
    Global Burden of Disease Cancer Collaboration, ,
    Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived with Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2017: A Systematic Analysis for the Global Burden of Disease Study2019In: JAMA Oncology, ISSN 2374-2437, E-ISSN 2374-2445, Vol. 5, no 12, p. 1749-1768Article in journal (Refereed)
    Abstract [en]

    Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data.

    Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning.

    Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence.

    Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572000 deaths and 15.2 million DALYs), and stomach cancer (542000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601000 deaths and 17.4 million DALYs), TBL cancer (596000 deaths and 12.6 million DALYs), and colorectal cancer (414000 deaths and 8.3 million DALYs).

    Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care. 

  • 43.
    Fristedt, Sofi
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Smith, Frida
    Regional Cancer Centre West, Gothenburg, Sweden; Department of Technology Management and Economics, Chalmers University of Technology, Gothenburg, Sweden.
    Grynne, Annika
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Browall, Maria
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Digi-Do: a digital information tool to support patients with breast cancer before, during, and after start of radiotherapy treatment: an RCT study protocol2021In: BMC Medical Informatics and Decision Making, E-ISSN 1472-6947, Vol. 21, article id 76Article in journal (Refereed)
    Abstract [en]

    Radiation Therapy (RT) is a common treatment after breast cancer surgery and a complex process using high energy X-rays to eradicate cancer cells, important in reducing the risk of local recurrence. The high-tech environment and unfamiliar nature of RT can affect the patient’s experience of the treatment. Misconceptions or lack of knowledge about RT processes can increase levels of anxiety and enhance feelings of being unprepared at the beginning of treatment. Moreover, the waiting time is often quite long. The primary aim of this study will be to evaluate whether a digital information tool with VR-technology and preparatory information can decrease distress as well as enhance the self-efficacy and health literacy of patients affected by breast cancer before, during, and after RT. A secondary aim will be to explore whether the digital information tool increase patient flow while maintaining or increasing the quality of care.

  • 44.
    Fritzell, K.
    et al.
    Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden.
    Hedberg, Berith
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Woudstra, A.
    Team Advies en Onderzoek, Municipal Health Service (GGD) Kennemerland, Haarlem, Netherlands.
    Forsberg, A.
    Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.
    Sventelius, M.
    Regional Cancer Centre, Gotland, Stockholm, Sweden.
    Kottorp, A.
    Faculty of Health and Society, Malmö University, Malmö, Sweden.
    Jervaeus, A.
    Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden.
    Making the BEST decision: The BESTa project development, implementation and evaluation of a digital Decision Aid in Swedish cancer screening programmes-a description of a research project2023In: PLOS ONE, E-ISSN 1932-6203, Vol. 18, no 12 December, article id e0294332Article in journal (Refereed)
    Abstract [en]

    Sweden has a long tradition of organized national population-based screening programmes. Participation rates differ between programmes and regions, being relatively high in some groups, but lower in others. To ensure an equity perspective on screening, it is desirable that individuals make an informed decision based on knowledge rather than ignorance, misconceptions, or fear. Decision Aids (DAs) are set to deliver information about different healthcare options and help individuals to visualize the values associated with each available option. DAs are not intended to guide individuals to choose one option over another. The advantage of an individual Decision Aid (iDA) is that individuals gain knowledge about cancer and screening by accessing one webpage with the possibility to communicate with health professionals and thereafter make their decision regarding participation. The objective is therefore to develop, implement and evaluate a digital iDA for individuals invited to cancer screening in Sweden. Methods This study encompasses a process-, implementation-, and outcome evaluation. Multiple methods will be applied including focus group discussions, individual interviews and the usage of the think aloud technique and self-reported questionnaire data. The project is based on The International Patient Decision Aid Standards (IPDAS) framework and the proposed model development process for DAs. Individuals aged 23 74, including women (the cervical-, breast-and CRC screening module) and men (the CRC screening module), will be included in the developmental process. Efforts will be made to recruit participants with selfreported physical and mental limitations, individuals without a permanent residence and ethnic minorities. Discussion To the best of our knowledge, the present study is the first attempt aimed at developing an iDA for use in the Swedish context. The iDA is intended to facilitate shared decision making about participation in screening. Furthermore, the iDA is expected to increase knowledge and raise awareness about cancer and cancer screening.

  • 45. Fürst, C.-J.
    et al.
    Gabrielsson-Järhult, Felicia
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Herbertsson, M.
    Fridh, M
    Opioid Inhalation for Dyspnoea in Patients with advanced cancer: A randomised controlled studie2003Conference paper (Refereed)
  • 46.
    Grynne, A.
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Department of Nursing Science. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Wångdahl, J.
    Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
    Fristedt, Sofi
    Jönköping University, School of Health and Welfare, HHJ, Department for Quality Improvement and Leadership. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Smith, F.
    Regional Cancer Centre West, Gothenburg, Sweden.
    Browall, Maria
    Jönköping University, School of Health and Welfare, HHJ, Department of Nursing Science. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Women's experience of the health information process involving a digital information tool before commencing radiation therapy for breast cancer: a deductive interview study2023In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 23, no 1Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Individuals undergoing radiation therapy for breast cancer frequently request information before, throughout and after the treatment as a means to reduce distress. Nevertheless, the provision of information to meet individuals needs from their level of health literacy is often overlooked. Thus, individuals information needs are often unmet, leading to reports of discontent. Internet and digital information technology has significantly augmented the available information and changed the way in which persons accesses and comprehends information. As health information is no longer explicitly obtained from healthcare professionals, it is essential to examine the sequences of the health information process in general, and in relation to health literacy. This paper reports on qualitative interviews, targeting women diagnosed with breast cancer who were given access to a health information technology tool, Digi-Do, before commencing radiation therapy, during, and after treatment. METHODS: A qualitative research design, inspired by the integrated health literacy model, was chosen to enable critical reflection by the participating women. Semi-structured interviews were conducted with 15 women with access to a digital information tool, named Digi-Do, in addition to receiving standard information (oral and written) before commencing radiation therapy, during, and after treatment. A deductive thematic analysis process was conducted. RESULTS: The results demonstrate how knowledge, competence, and motivation influence women's experience of the health information process. Three main themes were found: Meeting interactive and personal needs by engaging with health information; Critical recognition of sources of information; and Capability to communicate comprehended health information. The findings reflect the women's experience of the four competencies: to access, understand, appraise, and apply, essential elements of the health information process. CONCLUSIONS: We can conclude that there is a need for tailored digital information tools, such as the Digi-Do, to enable iterative access and use of reliable health information before, during and after the radiation therapy process. The Digi-Do can be seen as a valuable complement to the interpersonal communication with health care professionals, facilitating a better understanding, and enabling iterative access and use of reliable health information before, during and after the radiotherapy treatment. This enhances a sense of preparedness before treatment starts.

  • 47.
    Jiang, Nan
    Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Radiation-Induced Xerostomia in Chinese Patients with Head and Neck Cancer – An Explorative and Interventional study2021Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Radiation-induced xerostomia is a common oral complication of patients with head and neck cancer (HNC) undergoing radiotherapy (RT). This can lead to a series of functional oral disorders, particularly dental caries, and ultimately negatively affect their oral health and health-related quality of life (HRQoL).

    Aims: The overall aim of this thesis was to understand the living experience of radiation-induced xerostomia and to determine the effects of an integrated supportive program based on multicomponent oral care strategies in Chinese patients with HNC.

    Methods: A qualitative descriptive study was conducted to describe how patients (13 men and 7 women) with HNC experienced radiation-induced xerostomia (Ⅰ). A cross-sectional study of patients (n=80) with HNC was conducted to accomplish the validation of the Chinese version of the xerostomia questionnaire (XQ) (Ⅱ). A randomized controlled trial (n=79) was conducted to determine the effect of an integrated supportive program (with a combination of face-to-face health education and coaching sections) on xerostomia, saliva characteristics (Ⅲ), oral health, and HRQoL (IV).

    Results: Five categories emerged from the manifest content of the interviews: communication problems, physical problems, psychosocial problems, treatment problems, and relief strategies. The meaning underlying these categories formed a theme, which was the latent content of the interview: Due to lack of information regarding xerostomia, patients had to find their own ways to deal with the problem (Ⅰ). The Chinese version of XQ was a unidimensional scale (1-factor solution explained 75.6 of the total variance) and had good psychometric properties with excellent internal consistency (Cronbach’s α of 0.95), test-retest reliability (intraclass correlation coefficient of 0.92), and good criterion-related validity and content validity (Ⅱ). The integrated supportive program showed significant inter-group differences in xerostomia (P=0.046), unstimulated saliva flow rate (P=0.035), plaque index (P=0.038), Oral Health Impact Profile-14 (P=0.002), and Functional Assessment Cancer Therapy-Head & Neck (P=0.001) over the 12-month follow-up, with better outcomes in the intervention group (Ⅲ & Ⅳ).

    Conclusion: This thesis contributes knowledge regarding the experiences of living with xerostomia from a patient perspective, noting that xerostomia has a profound impact on a patient's physical, psychological, and social quality of life. There is lack of assessment tools for xerostomia in the Chinese population, and the Chinese version of XQ proved to be a valid and simple self-administered tool to measure and monitor the xerostomia level in patients with HNC. The integrated supportive program with multicomponent oral care strategies demonstrated positive effects on relieving xerostomia, increasing unstimulated saliva flow rate, and improving their oral health and HRQoL. These findings provide a basis for improvement in the management of xerostomia and oral health of Chinese patients with HNC through the integration of oral care in nursing.

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  • 48.
    Jiang, Nan
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Zhao, Yue
    Mårtensson, Jan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Stensson, Malin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Centre for Oral Health. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    The effects of an integrated supportive program on oral health and quality of life in patients with head and neck cancer undergoing radiotherapy: a randomized controlled trialManuscript (preprint) (Other academic)
  • 49.
    Jiang, Nan
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Zhao, Yue
    Stensson, Malin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Centre for Oral Health. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Mårtensson, Jan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    The effects of an integrated supportive program on xerostomia and salivary characteristics in patients with head and neck cancer undergoing radiotherapy: a randomized controlled trialManuscript (preprint) (Other academic)
  • 50.
    Johansson, Elvira
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Nursing Science.
    Åström, Elenore
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Nursing Science.
    Patienters upplevelser av diagnos och behandling vid akut myeloisk leukemi: En kvalitativ litteraturöversikt2023Independent thesis Basic level (university diploma), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Titel: Patienters upplevelser av diagnos och behandling vid akut myeloisk leukemi   

    Bakgrund: Akut myeloisk leukemi (AML) är den vanligaste formen av akut leukemi. Behandlingen och symtomen är påfrestande och långvariga, vilket inverkar på patienters livskvalitet. Genom god personcentrerad vård kan sjuksköterskan försöka tillgodose många av behoven som patienten kan få under vårdtiden. 

    Syfte: Att beskriva patienters upplevelser av att diagnostiseras med och genomgå behandling mot akut myeloisk leukemi.

    Metod: En litteraturöversikt med kvalitativ metod och induktiv ansats. Efter sökning i databaserna Cinahl, PubMed och PsyINFO samt artikelgranskning inkluderades tolv artiklar. Artiklarna analyserades genom Fribergs fem steg. 

    Resultat: Genom en sammanställning av artiklarna framkom det två olika teman (känslomässiga reaktioner och förändrad kroppsuppfattning) och sex olika subteman (att få ett obegripligt besked, känsla av att få svår och komplex information, känsla av isolering, förändrat utseende relaterat till symtom, fysiska symtom relaterat till behandling och känsla av att vara en börda).

    Slutsatser: I litteraturöversikten framkom det att beskedet om diagnosen var obegripligt. Patienterna upplevde att sjuksköterskan hade svårt att förmedla den komplexa informationen personcentrerat. Behandlingstiden orsakade att patienterna upplevde sig isolerade och att symtomen (illamående, trötthet och håravfall) påverkade patienternas vardagliga liv negativt. Sjuksköterskans stöd och undervisning relaterat till symtomhantering och omvårdnadsåtgärder till såväl patient och anhöriga är avgörande för att minska de negativa känslorna som framkom i resultatet. 

    Nyckelord: Cancer, cytostatikabehandling, personcentrerad vård, stamcellstransplantation

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