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  • 1.
    Banaem, Hossein Y.
    et al.
    Tehran University of Medical Sciences, Iran.
    Ahmadian, Alireza
    Tehran University of Medical Sciences, Iran.
    Saberi, Hooshangh
    Tehran University of Medical Sciences, Iran.
    Daneshmehr, Alireza
    Univiversity of Tehran, Iran.
    Khodadad, Davood
    Tehran University of Medical Sciences, Iran.
    Brain tumor modeling: glioma growth and interaction with chemotherapy2011In: Proc. SPIE 8285, International Conference on Graphic and Image Processing (ICGIP 2011), SPIE - International Society for Optical Engineering, 2011, article id 82851MConference paper (Refereed)
    Abstract [en]

    In last decade increasingly mathematical models of tumor growths have been studied, particularly on solid tumors which growth mainly caused by cellular proliferation. In this paper we propose a modified model to simulate the growth of gliomas in different stages. Glioma growth is modeled by a reaction-advection-diffusion. We begin with a model of untreated gliomas and continue with models of polyclonal glioma following chemotherapy. From relatively simple assumptions involving homogeneous brain tissue bounded by a few gross anatomical landmarks (ventricles and skull) the models have been expanded to include heterogeneous brain tissue with different motilities of glioma cells in grey and white matter. Tumor growth is characterized by a dangerous change in the control mechanisms, which normally maintain a balance between the rate of proliferation and the rate of apoptosis (controlled cell death). Result shows that this model closes to clinical finding and can simulate brain tumor behavior properly.

  • 2.
    Beiranvand, Samira
    et al.
    Ahvaz Jundishapur University of Medical Sciences, Iran.
    Zarea, Kourosh
    Ahvaz Jundishapur University of Medical Sciences, Iran.
    Ghanbari, Saeed
    Shiraz University of Medical Sciences, Iran.
    Tuvesson, Hanna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Blekinge Institute of Technology.
    Keikhaei, Bijan
    Ahvaz Jundishapur University of Medical Sciences, Iran.
    Ten years incidence of cancer in Iran: a systematic review and meta-analysis2018In: Clinical Epidemiology and Global Health, ISSN 2452-0918, Vol. 6, no 2, p. 94-102Article in journal (Refereed)
    Abstract [en]

    Background

    Designing and implementation of screening programs depend on greatly epidemiologic basic data in every country. Also Variation in the incidence of various cancers in our country has been a favorite topic.

    Objectives

    This systematic review was conducted to provide an overall perspective about incidence, geographical and age distribution of cancers in Iran.

    Methods

    A comprehensive search were done according to MOOSE guideline criteria in national and international databases for selecting eligible articles from 2005 to 2015. After screening titles and abstracts, duplicated and irrelevant studies were excluded. Selected papers are written in Persian or English. The standard error of the cancer incidence was calculated based on the binomial distribution. Because of the significant heterogeneity observed among the results, we used a random-effects model combine the results of the primary studies. Moreover, a sensitivity analysis was undertaken to explore the effects of the risk of bias and other sources of heterogeneity.

    Results

    Overall 16 articles met eligibility criteria for inclusion. The total incidence of cancer was 19.4 and 17.2 per hundred thousand of people in males and females respectively. The five most common cancers in male were: Lymphoma, leukemia, esophagus, stomach, colorectal and in the female are: breast, colorectal, stomach, thyroid and esophagus. The highest incidence rate was seen in Golestan Province and in the age group over 65 years.

    Conclusion

    According to increasing incidence rate of cancers in Iran, Development, holding and accomplish of universal public cancer control program should be the first precedence for health policy.

  • 3.
    Björklund, Margereth
    et al.
    Jönköping University, Sweden.
    Fridlund, Bengt
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Mårtensson, Jan
    Jönköping University, Sweden.
    Experiences of psychological flow as described by people diagnosed with and treated for head and neck cancer2019In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 43, p. 1-8, article id 101671Article in journal (Refereed)
    Abstract [en]

    Purpose: To describe flow as experienced by people diagnosed with and treated for head and neck cancer. Method: A descriptive design based on a deductive qualitative content analysis was used to explain Csikszentmihalyi's flow theory from the perspective of people living with head and neck cancer. Interviews were conducted with seven participants diagnosed with and treated for different forms and stages of head and neck cancer. Results: Experiences of flow were associated with people's interests, skill levels and actions involving and creating both happiness and the feeling of something worth living for. Optimal flow was a state of consciousness in which mind and body work together, and the people were completely absorbed in an activity related to nature, hobbies or family. Microflow occurred as part of everyday life, relieving stress and anxiety and helping them to focus on their daily routines. This included humming, listening to the radio or watching TV. Conclusions: The peoples inner strength and desire to feel better made flow possible, and they used unknown skills that enhanced self-satisfaction. Managing self-care activities increased feelings of control, participation and enjoyment. This calls for person-centred care with a salutogenic approach based on the peoples own interests, skill levels and actions; what makes the person feel happy.

  • 4.
    Buetti-Dinh, Antoine
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences. Università della Svizzera Italiana, Italy;Swiss Institute of Bioinformatics, Switzerland.
    Friedman, Ran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Computer simulations of the signalling network in FLT3+-acute myeloid leukaemia: indications for an optimal dosage of inhibitors against FLT3 and CDK62018In: BMC Bioinformatics, ISSN 1471-2105, E-ISSN 1471-2105, Vol. 19, p. 1-13, article id 155Article in journal (Refereed)
    Abstract [en]

    Background

    Mutations in the FMS-like tyrosine kinase 3 (FLT3) are associated with uncontrolled cellular functions that contribute to the development of acute myeloid leukaemia (AML). We performed computer simulations of the FLT3-dependent signalling network in order to study the pathways that are involved in AML development and resistance to targeted therapies.

    Results

    Analysis of the simulations revealed the presence of alternative pathways through phosphoinositide 3 kinase (PI3K) and SH2-containing sequence proteins (SHC), that could overcome inhibition of FLT3. Inhibition of cyclin dependent kinase 6 (CDK6), a related molecular target, was also tested in the simulation but was not found to yield sufficient benefits alone.

    Conclusions

    The PI3K pathway provided a basis for resistance to treatments. Alternative signalling pathways could not, however, restore cancer growth signals (proliferation and loss of apoptosis) to the same levels as prior to treatment, which may explain why FLT3 resistance mutations are the most common resistance mechanism. Finally, sensitivity analysis suggested the existence of optimal doses of FLT3 and CDK6 inhibitors in terms of efficacy and toxicity.

  • 5.
    Buetti-Dinh, Antoine
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences. Univ Svizzera Italiana, Switzerland;Swiss Inst Bioinformat, Switzerland.
    Jensen, Rebecca
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences. Univ Svizzera Italiana, Switzerland;Swiss Inst Bioinformat, Switzerland.
    Friedman, Ran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    A computational study of hedgehog signalling involved in basal cell carcinoma reveals the potential and limitation of combination therapy2018In: BMC Cancer, ISSN 1471-2407, E-ISSN 1471-2407, Vol. 18, no 1, p. 1-8, article id 569Article in journal (Refereed)
    Abstract [en]

    Background: The smoothened (SMO) receptor is an essential component of the Sonic hedgehog (SHH) signalling, which is associated with the development of skin basal cell carcinoma (BCC). SMO inhibitors are indicated for BCC patients when surgical treatment or radiation therapy are not possible. Unfortunately, SMO inhibitors are not always well tolerated due to severe side effects, and their therapeutical success is limited by resistance mutations. Methods: We investigated how common are resistance-causing mutations in two genomic databases which are not linked to BCC or other cancers, namely 1000 Genomes and ExAC. To examine the potential for combination therapy or other treatments, we further performed knowledge-based simulations of SHH signalling, in the presence or absence of SMO and PI3K/Akt inhibitors. Results: The database analysis revealed that of 18 known mutations associated with Vismodegib-resistance, three were identified in the databases. Treatment of individuals carrying such mutations is thus liable to fail a priori. Analysis of the simulations suggested that a combined inhibition of SMO and the PI3K/Akt signalling pathway may provide an effective reduction in tumour proliferation. However, the inhibition dosage of SMO and PI3K/Akt depended on the activity of phosphodiesterases (PDEs). Under high PDEs activities, SMO became the most important control node of the network. By applying PDEs inhibition, the control potential of SMO decreased and P13K appeared as a significant factor in controlling tumour proliferation. Conclusions: Our systems biology approach employs knowledge-based computer simulations to help interpret the large amount of data available in public databases, and provides application-oriented solutions for improved cancer resistance treatments.

  • 6.
    Buetti-Dinh, Antoine
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences. Univ Svizzera Italiana, Switzerland;Swiss Inst Bioinformat, Switzerland.
    O'Hare, Thomas
    Univ Utah, USA;Huntsman Canc Inst, USA.
    Friedman, Ran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Sensitivity Analysis of the NPM-ALK Signalling Network Reveals Important Pathways for Anaplastic Large Cell Lymphoma Combination Therapy2016In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 9, article id e0163011Article in journal (Refereed)
    Abstract [en]

    A large subset of anaplastic large cell lymphoma (ALCL) patients harbour a somatic aberration in which anaplastic lymphoma kinase (ALK) is fused to nucleophosmin (NPM) resulting in a constitutively active signalling fusion protein, NPM-ALK. We computationally simulated the signalling network which mediates pathological cell survival and proliferation through NPM-ALK to identify therapeutically targetable nodes through which it may be possible to regain control of the tumourigenic process. The simulations reveal the predominant role of the VAV1-CDC42 (cell division control protein 42) pathway in NPM-ALK-driven cellular proliferation and of the Ras / mitogen-activated ERK kinase (MEK) / extracellular signal-regulated kinase (ERK) cascade in controlling cell survival. Our results also highlight the importance of a group of interleukins together with the Janus kinase 3 (JAK3) / signal transducer and activator of transcription 3 (STAT3) signalling in the development of NPM-ALK derived ALCL. Depending on the activity of JAK3 and STAT3, the system may also be sensitive to activation of protein tyrosine phosphatase-1 (SHP1), which has an inhibitory effect on cell survival and proliferation. The identification of signalling pathways active in tumourigenic processes is of fundamental importance for effective therapies. The prediction of alternative pathways that circumvent classical therapeutic targets opens the way to preventive approaches for countering the emergence of cancer resistance.

  • 7.
    Cronberg, Johanna
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Englund, Alice
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Kvinnors erfarenheter om hur livet förändrats efter att ha behandlats för gynekologisk cancer: En kvalitativ litteraturstudie2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Varje år drabbas flera kvinnor i Sverige av gynekologisk cancer. Behandlingarna leder till många biverkningar och kvinnorna tvingas leva med dessa följder i resten av sitt liv. Detta problem är viktigt att belysa för att kunna hjälpa kvinnor i framtiden att bli mer förberedda på förändringarna och för att sjuksköterskorna ska kunna ge de bästa stödet. 

    Syfte: Syftet var att beskriva kvinnors erfarenheter av hur livet förändrats efter att ha behandlats för gynekologisk cancer. 

    Metod: En litteraturstudie med kvalitativ design, med en induktivansats.  Analysen av de 10 vetenskapliga artiklarna är gjord utifrån Graneheim & Lundmans manifesta innehållsanalys.  

    Resultat: Resultatet visade att kvinnor upplever en förändring på flera olika sätt. Kategorier som togs fram var upplevelsen av att vara kvinna, upplevelser av sexualitetens förändringar och att inte känna igen sig själv och sin kropp. Kvinnor pratade exempelvis om informationsbrist, inkontinensbesvär, temperaturförändringar och smärta och oro i samband med sexuella relationer. 

    Slutsats: Cancer kan påverka en människa på många olika sätt både fysiskt och emotionellt. Kvinnor som går igenom och överlevt gynekologisk cancer är i stort behov av stöd. Information är en av de viktigaste delarna för att kunna förstå den förändrade kroppen.

  • 8.
    Friedman, Ran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Drug resistance in cancer: molecular evolution and compensatory proliferation2016In: OncoTarget, ISSN 1949-2553, E-ISSN 1949-2553, Vol. 7, no 11, p. 11746-11755Article in journal (Refereed)
    Abstract [en]

    Targeted therapies have revolutionized cancer treatment. Unfortunately, their success is limited due to the development of drug resistance within the tumor, which is an evolutionary process. Understanding how drug resistance evolves is a prerequisite to a better success of targeted therapies. Resistance is usually explained as a response to evolutionary pressure imposed by treatment. Thus, evolutionary understanding can and should be used in the design and treatment of cancer. In this article, drug-resistance to targeted therapies is reviewed from an evolutionary standpoint. The concept of apoptosis-induced compensatory proliferation (AICP) is developed. It is shown that AICP helps to explain some of the phenomena that are observed experimentally in cancers. Finally, potential drug targets are suggested in light of AICP.

  • 9.
    Friedman, Ran
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Boye, Kjetil
    Flatmark, Kjersti
    Molecular modelling and simulations in cancer research2013In: Biochimica et Biophysica Acta. CR. Reviews on Cancer, ISSN 0304-419X, E-ISSN 1879-2561, Vol. 1836, no 1, p. 1-14Article, review/survey (Refereed)
    Abstract [en]

    The complexity of cancer and the vast amount of experimental data available have made computer-aided approaches necessary. Biomolecular modelling techniques are becoming increasingly easier to use, whereas hardware and software are becoming better and cheaper. Cross-talk between theoretical and experimental scientists dealing with cancer-research from a molecular approach, however, is still uncommon. This is in contrast to other fields, such as amyloid-related diseases, where molecular modelling studies are widely acknowledged. The aim of this review paper is therefore to expose some of the more common approaches in molecular modelling to cancer scientists in simple terms, illustrating success stories while also revealing the limitations of computational studies at the molecular level.

  • 10.
    Gren, Cim
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Köhnke, Emma
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    COPINGSTRATEGIER HOS PATIENTER MED AVANCERAD CANCER: En litteraturstudie utifrån ett patientperspektiv2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Cancerfallen i Sverige har fördubblats sedan 1970-talet och om cirka 20 år uppskattas 100 000 nya personer insjukna i cancer per år. Att drabbas av cancer anses vara en av de mest stressfyllda situationer en person kan uppleva och sjukdomen påverkar patienten både fysiskt, psykiskt och existentiellt. För att lättare hantera sin nya vardag kan patienten behöva tillämpa olika copingstrategier som används för att hantera svåra påfrestningar. 

    Syfte: Syftet med studien var att utifrån ett patientperspektiv beskriva copingstrategier som kan hjälpa patienter med avancerad cancer. 

    Metod: En litteraturstudie med 14 kvalitativa vetenskapliga artiklar genomfördes. Artiklarna analyserades utifrån Lundman och Hällgren-Graneheims (2017) manifesta innehållsanalys. 

    Resultat: Resultatet delades in i fyra kategorier och tretton underkategorier. Kategorierna som framkom var; Viljan att styra över sitt liv, uppmuntrande känslor, socialt stöd samt andligt stöd.

    Slutsats: Sjuksköterskan behöver agera på ett sådant sätt att patientens hälsa ökar och lidandet minskar. Sjuksköterskan behöver också utgå ifrån patientens unika och subjektiva livsvärld eftersom det är först då som patientens copingstrategier kan identifieras och stärkas. Tillgodosedda copingstrategier leder till att patientens vardag och liv kan genomsyras av en känsla av hanterbarhet, begriplighet och meningsfullhet.

  • 11.
    Gunnarsson, Anna
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Nylander, Linnea
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    FÖRÄLDER TILL EN ÄNGEL: Upplevelser av välbefinnande och lidande efter att barn avlidit i cancer2011Independent thesis Basic level (degree of Bachelor), 15 credits / 22,5 HE creditsStudent thesis
    Abstract [sv]

    SAMMANFATTNING

    Bakgrund: Årligen dör ett av fyra cancerdiagnostiserade barn i Sverige. Föräldrarnas liv efter förlusten förändras för alltid och reaktionerna kan variera. Efter förlusten är föräldrarna i stort behov av stöd från sina nätverk. De måste lära sig att leva med förlusten och de får kämpa för att komma tillbaka till vardagen. Syfte: Syftet med studien var att beskriva hur föräldrarna upplevde välbefinnande respektive lidande upp till två år efter att deras barn avlidit i cancer. Metod: Studien utgår från fem självbiografier som analyserades med kvalitativ innehållsanalys. Resultat: Att förlora sitt barn skapar många blandade känslor hos föräldrarna, allt från sorg till lättnad. Föräldrarna är i behov av stöd efter den livsomvälvande upplevelsen. Barnen är en del av familjerna då minnena alltid lever kvar. Syskonen är en avgörande faktor för föräldrarnas kamp att fortsätta den nya vardagen. Föräldrarna lär sig att leva med saknaden och sorgen. Slutsats: Att förlora ett barn är en traumatisk händelse som skapar många olika känslor. Att få bra stöd är viktigt för föräldrarna som bearbetar händelsen på olika sätt. Minnena av barnen finns alltid hos föräldrarna så länge de lever och de genomgår förändringar efter att barnen har avlidit.

  • 12.
    Harris, Michael
    et al.
    University of Bath, UK.
    Frey, Peter
    Universität Bern, Switzerland.
    Esteva, Magdalena
    Majorca Primary Health Care Department, Spain;Instituto de Investigación sanitaria Illes Balears (idISBA), Spain.
    Gašparović Babić, Svjetlana
    University of Rijeka, Croatia.
    Marzo-Castillejo, Mercè
    Institut Català de la Salut, Spain.
    Petek, Davorina
    University of Ljubljana, Slovenia.
    Petek Ster, Marija
    University of Ljubljana, Slovenia.
    Thulesius, Hans
    Lund University, Sweden.
    How the probability of presentation to a primary care clinician correlates with cancer survival rates: a European survey using vignettes.2017In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 35, no 1, p. 27-34Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: European cancer survival rates vary widely. System factors, including whether or not primary care physicians (PCPs) are gatekeepers, may account for some of these differences. This study explores where patients who may have cancer are likely to present for medical care in different European countries, and how probability of presentation to a primary care clinician correlates with cancer survival rates.

    DESIGN: Seventy-eight PCPs in a range of European countries assessed four vignettes representing patients who might have cancer, and consensus groups agreed how likely those patients were to present to different clinicians in their own countries. These data were compared with national cancer survival rates.

    SETTING: A total of 14 countries.

    SUBJECTS: Consensus groups of PCPs.

    MAIN OUTCOME MEASURES: Probability of initial presentation to a PCP for four clinical vignettes.

    RESULTS: There was no significant correlation between overall national 1-year relative cancer survival rates and the probability of initial presentation to a PCP (r  = -0.16, 95% CI -0.39 to 0.08). Within that there was large variation depending on the type of cancer, with a significantly poorer lung cancer survival in countries where patients were more likely to initially consult a PCP (lung r = -0.57, 95% CI -0.83 to -0.12; ovary: r = -0.13, 95% CI -0.57 to 0.38; breast r = 0.14, 95% CI -0.36 to 0.58; bowel: r = 0.20, 95% CI -0.31 to 0.62).

    CONCLUSIONS: There were wide variations in the degree of gatekeeping between countries, with no simple binary model as to whether or not a country has a "PCP-as-gatekeeper" system. While there was case-by-case variation, there was no overall evidence of a link between a higher probability of initial consultation with a PCP and poorer cancer survival. KEY POINTS European cancer survival rates vary widely, and health system factors may account for some of these differences. The data from 14 European countries show a wide variation in the probability of initial presentation to a PCP. The degree to which PCPs act as gatekeepers varies considerably from country to country. There is no overall evidence of a link between a higher probability of initial presentation to a PCP and poorer cancer survival.

  • 13.
    Harris, Michael
    et al.
    Univ Bath, UK;Univ Bern, Switzerland.
    Thulesius, Hans
    Lund University, Sweden;Region Kronoberg, Sweden.
    Neves, Ana Luisa
    Imperial Coll London, UK;Univ Porto, Portugal.
    Harker, Sophie
    Univ Bath, UK.
    Koskela, Tuomas
    Tampere Univ, Finland.
    Petek, Davorina
    Univ Ljubljana, Slovenia.
    Hoffman, Robert
    Tel Aviv Univ, Israel.
    Brekke, Mette
    Univ Oslo, Norway.
    Buczkowski, Krzysztof
    Nicolaus Copernicus Univ, Poland.
    Buono, Nicola
    Natl Soc Med Educ Gen Practice SNaMID, Italy.
    Costiug, Emiliana
    Iuliu Hatieganu Univ Med & Pharm, Romania.
    Dinant, Geert-Jan
    Maastricht Univ, Netherlands.
    Foreva, Gergana
    Med Ctr BROD, Bulgaria.
    Jakob, Eva
    Ctr Saude Sarria, Spain.
    Marzo-Castillejo, Merce
    Inst Catala Salut, Spain.
    Murchie, Peter
    Univ Aberdeen, UK.
    Sawicka-Powierza, Jolanta
    Med Univ Bialystok, Poland.
    Schneider, Antonius
    Tech Univ Munich, Germany.
    Smyrnakis, Emmanouil
    Aristotle Univ Thessaloniki, Greece.
    Streit, Sven
    Univ Bern, Switzerland.
    Taylor, Gordon
    Univ Exeter, UK.
    Vedsted, Peter
    Aarhus Univ, Denmark.
    Weltermann, Birgitta
    Univ Bonn, Germany.
    Esteva, Magdalena
    Carlos III Inst Hlth RedIAPP RETICS, Spain.
    How European primary care practitioners think the timeliness of cancer diagnosis can be improved: a thematic analysis2019In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 9, p. 1-10, article id e030169Article in journal (Refereed)
    Abstract [en]

    Background National European cancer survival rates vary widely. Prolonged diagnostic intervals are thought to be a key factor in explaining these variations. Primary care practitioners (PCPs) frequently play a crucial role during initial cancer diagnosis; their knowledge could be used to improve the planning of more effective approaches to earlier cancer diagnosis. Objectives This study sought the views of PCPs from across Europe on how they thought the timeliness of cancer diagnosis could be improved. Design In an online survey, a final open-ended question asked PCPs how they thought the speed of diagnosis of cancer in primary care could be improved. Thematic analysis was used to analyse the data. Setting A primary care study, with participating centres in 20 European countries. Participants A total of 1352 PCPs answered the final survey question, with a median of 48 per country. Results The main themes identified were: patient-related factors, including health education; care provider-related factors, including continuing medical education; improving communication and interprofessional partnership, particularly between primary and secondary care; factors relating to health system organisation and policies, including improving access to healthcare; easier primary care access to diagnostic tests; and use of information technology. Re-allocation of funding to support timely diagnosis was seen as an issue affecting all of these. Conclusions To achieve more timely cancer diagnosis, health systems need to facilitate earlier patient presentation through education and better access to care, have well-educated clinicians with good access to investigations and better information technology, and adequate primary care cancer diagnostic pathway funding.

  • 14.
    Harris, Michael
    et al.
    University of Bath, UK;University of Bern, Switzerland.
    Vedsted, Peter
    Aarhus University, Denmark.
    Esteva, Magdalena
    Balearic Islands Health Research Institute (IdISBa), Spain.
    Murchie, Peter
    University of Aberdeen, UK.
    Aubin-Auger, Isabelle
    Université Paris Diderot, France.
    Azuri, Joseph
    Tel Aviv University, Israel.
    Brekke, Mette
    University of Oslo, Norway.
    Buczkowski, Krzysztof
    Nicolaus Copernicus University, Poland.
    Buono, Nicola
    National Society of Medical Education in General Practice (SNaMID), Italy.
    Costiug, Emiliana
    Iuliu Hatieganu University of Medicine and Pharmacy, Romania.
    Dinant, Geert-Jan
    Maastricht University, Netherlands.
    Foreva, Gergana
    Medical Center BROD, Plovdiv, Bulgaria.
    Gašparović Babić, Svjetlana
    The Teaching Institute of Public Health of Primorsko-goranska County, Croatia.
    Hoffman, Robert
    Tel Aviv University, Israel.
    Jakob, Eva
    Centro de Saúde Sarria, Spain.
    Koskela, Tuomas H
    University of Tampere, Finland.
    Marzo-Castillejo, Mercè
    Institut Catala De La Salut, Spain.
    Neves, Ana Luísa
    Imperial College London, UK;University of Porto, Porto, Portugal.
    Petek, Davorina
    University of Ljubljana, Slovenia.
    Petek Ster, Marija
    University of Ljubljana, Slovenia.
    Sawicka-Powierza, Jolanta
    Medical University of Bialystok, Poland.
    Schneider, Antonius
    Technische Universität München, Germany.
    Smyrnakis, Emmanouil
    Aristotle University of Thessaloniki, Greece.
    Streit, Sven
    University of Bern, Switzerland.
    Thulesius, Hans
    Lund University, Sweden.
    Weltermann, Birgitta
    University of Bonn, Germany.
    Taylor, Gordon
    University of Bath, UK.
    Identifying important health system factors that influence primary care practitioners' referrals for cancer suspicion: a European cross-sectional survey.2018In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 8, no 9, p. 1-13, article id e022904Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Cancer survival and stage of disease at diagnosis and treatment vary widely across Europe. These differences may be partly due to variations in access to investigations and specialists. However, evidence to explain how different national health systems influence primary care practitioners' (PCPs') referral decisions is lacking.This study analyses health system factors potentially influencing PCPs' referral decision-making when consulting with patients who may have cancer, and how these vary between European countries.

    DESIGN: Based on a content-validity consensus, a list of 45 items relating to a PCP's decisions to refer patients with potential cancer symptoms for further investigation was reduced to 20 items. An online questionnaire with the 20 items was answered by PCPs on a five-point Likert scale, indicating how much each item affected their own decision-making in patients that could have cancer. An exploratory factor analysis identified the factors underlying PCPs' referral decision-making.

    SETTING: A primary care study; 25 participating centres in 20 European countries.

    PARTICIPANTS: 1830 PCPs completed the survey. The median response rate for participating centres was 20.7%.

    OUTCOME MEASURES: The factors derived from items related to PCPs' referral decision-making. Mean factor scores were produced for each country, allowing comparisons.

    RESULTS: Factor analysis identified five underlying factors: PCPs' ability to refer; degree of direct patient access to secondary care; PCPs' perceptions of being under pressure; expectations of PCPs' role; and extent to which PCPs believe that quality comes before cost in their health systems. These accounted for 47.4% of the observed variance between individual responses.

    CONCLUSIONS: Five healthcare system factors influencing PCPs' referral decision-making in 20 European countries were identified. The factors varied considerably between European countries. Knowledge of these factors could assist development of health service policies to produce better cancer outcomes, and inform future research to compare national cancer diagnostic pathways and outcomes.

  • 15.
    Holm, Maja
    et al.
    Karolinska Institutet ; Ersta Sköndal Bräcke University College.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University.
    Carlander, Ida
    Ersta Sköndal Bräcke University College ; Karolinska Institutet.
    Wengström, Yvonne
    Karolinska Institutet ; Örebro University.
    Ohlen, Joakim
    Ersta Sköndal Bräcke University College ; University of Gothenburg.
    Alvariza, Anette
    Karolinska Institutet ; Ersta Sköndal Bräcke University College ; Dalen Hosp, Stockholm.
    Characteristics of the Family Caregivers Who Did Not Benefit From a Successful Psychoeducational Group Intervention During Palliative Cancer Care A Prospective Correlational Study2017In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 40, no 1, p. 76-83Article in journal (Refereed)
    Abstract [en]

    Background: Although there has been a steady increase in intervention studies aimed toward supporting family caregivers in palliative cancer care, they often report modest effect sizes and there is a lack of knowledge about possible barriers to intervention effectiveness. Objective: The aim of this study is to explore the characteristics of family caregivers who did not benefit from a successful psychoeducational group intervention compared with the characteristics of those who did. Intervention/Methods: A psychoeducational intervention for family caregivers was delivered at 10 palliative settings in Sweden. Questionnaires were used to collect data at baseline and following the intervention. The Preparedness for Caregiving Scale was the main outcome for the study and was used to decide whether or not the family caregiver had benefited from the intervention (Preparedness for Caregiving Scale difference score <= 0 vs >= 1). Results: A total of 82 family caregivers completed the intervention and follow-up. Caregivers who did not benefit from the intervention had significantly higher ratings of their preparedness and competence for caregiving and their health at baseline compared with the group who benefited. They also experienced lower levels of environmental burden and a trend toward fewer symptoms of depression. Conclusions: Family caregivers who did not benefit from the intervention tended to be less vulnerable at baseline. Hence, the potential to improve their ratings was smaller than for the group who did benefit. Implications for Practice: Determining family caregivers in cancer and palliative care who are more likely to benefit from an intervention needs to be explored further in research.

  • 16.
    Johansson, Sophie
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Henriksson, Emelie
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    "MITT BARN HAR CANCER": En bloggbaserad litteraturstudie om föräldrars upplevelser av att leva med ett cancersjukt barn2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: I Sverige insjuknar ungefär ett barn om dagen i cancer. När ett barn drabbas av cancer påverkas hela familjen. Föräldrarna upplever en rädsla över bieffekter, behandling samt att förlora sitt barn och diskuterar oftast inte sina upplevelser med vårdpersonalen vilket leder till ökad oro och onödigt lidande. Föräldrarna har ofta en stor roll i barnets möjlighet att finna välbefinnande och det är därför viktigt att tillvarata deras erfarenheter och upplevelser. Syfte: Syftet med studien var att belysa föräldrars upplevelse av att leva med ett cancersjukt barn. Metod: Studien grundades på en kvalitativ metod utifrån fem bloggar. En kvalitativ manifest innehållsanalys utifrån Lundman och Hällgren Graneheims (2012) användes för att finna det centrala i materialet. Resultat: Föräldrars upplevelser av att leva med ett cancersjukt barn innebar en stor emotionell påverkan där oro och rädsla var de främsta fynden. Genom att tillämpa copingstrategier samt leva i nuet kunde föräldrarna bättre hantera vardagen. Sjukhusmiljön frambringade både positiva och negativa känslor hos föräldrarna och en känsla av utsatthet i samband med vårdmiljön framkom. Slutsats: Föräldrars upplevelser bör uppmärksammas och de behöver stöd från vårdpersonalen. Bättre samordning och kommunikation samt en kontaktperson kan vara lämpliga åtgärder för att främja föräldrarnas välbefinnande.

  • 17.
    Lindström, Jonathan
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    de Wijn, Astrid S.
    Norwegian University of Science and Technology, Norway.
    Friedman, Ran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Stochastic modelling of tyrosine kinase inhibitor rotation therapy in chronic myeloid leukaemia2019In: BMC Cancer, ISSN 1471-2407, E-ISSN 1471-2407, Vol. 19, p. 1-13, article id 508Article in journal (Refereed)
    Abstract [en]

    BackgroundResistance towards targeted cancer treatments caused by single nucleotide variations is a major issue in many malignancies. Currently, there are a number of available drugs for chronic myeloid leukaemia (CML), which are overcome by different sets of mutations. The main aim of this study was to explore if it can be possible to exploit this and create a treatment protocol that outperforms each drug on its own.MethodsWe present a computer program to test different treatment protocols against CML, based on available resistance mutation growth data. The evolution of a relatively stable pool of cancer stem cells is modelled as a stochastic process, with the growth of cells expressing a tumourigenic protein (here, Abl1) and any emerging mutants determined principally by the drugs used in the therapy.ResultsThere can be some benefit to Bosutinib-Ponatinib rotation therapy even if the mutation status is unknown, whereas Imatinib-Nilotinib rotation is unlikely to improve the outcomes. Furthermore, an interplay between growth inhibition and selection effects generates a non-linear relationship between drug doses and the risk of developing resistance.ConclusionsDrug rotation therapy might be able to delay the onset of resistance in CML patients without costly ongoing observation of mutation status. Moreover, the simulations give credence to the suggestion that lower drug concentrations may achieve better results following major molecular response in CML.

  • 18.
    Möllerberg, Marie-Louise
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Skåne University Hospital.
    Sandgren, Anna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Lithman, T.
    Lund University.
    Noreen, D.
    Lund University.
    Olsson, H.
    Skåne University Hospital;Lund University.
    Sjövall, K.
    Skåne University Hospital;Lund University.
    The effects of a cancer diagnosis on the health of a patient's partner: a population-based registry study of cancer in Sweden2016In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 25, no 5, p. 744-752Article in journal (Refereed)
    Abstract [en]

    The aim of this population-based registry study was to explore how cancer influences the health of partners, by examining the onset of new diagnoses for partners, health care use and health care costs among partners living with patients with cancer. The sample consisted of partners of patients with cancer (N = 10 353) and partners of age- and sex-matched controls who did not have cancer (N = 74 592). Diagnoses, health care use and health care costs were studied for a continuous period starting 1 year before the date of cancer diagnosis and continued for 3 years. One year after cancer diagnosis, partners of patients with cancer had significantly more mood disorders, reactions to severe stress and ischaemic heart disease than they exhibited in the year before the diagnosis. Among partners of patients with cancer, the type of cancer was associated with the extent and form of increased health care use and costs; both health care use and costs increased among partners of patients with liver cancer, lung cancer, colon cancer and miscellaneous other cancers. The risk of poorer health varied according to the type of cancer diagnosed, and appeared related to the severity and prognosis of that diagnosis.

  • 19.
    Möllerberg, Marie-Louise
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Sandgren, Anna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Swahnberg, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Benzein, Eva
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Familial interaction patterns during the palliative phase of a family member living with cancer2017In: European Journal of Cancer, ISSN 0959-8049, E-ISSN 1879-0852, Vol. 72, p. S162-S162Article in journal (Other academic)
  • 20.
    Nicholson, Brian D
    et al.
    University of Oxford, UK.
    Goyder, Clare R
    University of Oxford, UK.
    Bankhead, Clare R
    University of Oxford, UK.
    Toftegaard, Berit S
    Aarhus University, Denmark.
    Rose, Peter W
    University of Oxford, UK.
    Thulesius, Hans
    Lund University, Sweden.
    Vedsted, Peter
    Aarhus University, Denmark.
    Perera, Rafael
    University of Oxford, UK.
    Responsibility for follow-up during the diagnostic process in primary care: a secondary analysis of International Cancer Benchmarking Partnership data.2018In: British Journal of General Practice, ISSN 0960-1643, E-ISSN 1478-5242, Vol. 68, no 670, p. e323-e332Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: It is unclear to what extent primary care practitioners (PCPs) should retain responsibility for follow-up to ensure that patients are monitored until their symptoms or signs are explained.

    AIM: To explore the extent to which PCPs retain responsibility for diagnostic follow-up actions across 11 international jurisdictions.

    DESIGN AND SETTING: A secondary analysis of survey data from the International Cancer Benchmarking Partnership.

    METHOD: The authors counted the proportion of 2879 PCPs who retained responsibility for each area of follow-up (appointments, test results, and non-attenders). Proportions were weighted by the sample size of each jurisdiction. Pooled estimates were obtained using a random-effects model, and UK estimates were compared with non-UK ones. Free-text responses were analysed to contextualise quantitative findings using a modified grounded theory approach.

    RESULTS: PCPs varied in their retention of responsibility for follow-up from 19% to 97% across jurisdictions and area of follow-up. Test reconciliation was inadequate in most jurisdictions. Significantly fewer UK PCPs retained responsibility for test result communication (73% versus 85%, P = 0.04) and non-attender follow-up (78% versus 93%, P<0.01) compared with non-UK PCPs. PCPs have developed bespoke, inconsistent solutions to follow-up. In cases of greatest concern, 'double safety netting' is described, where both patient and PCP retain responsibility.

    CONCLUSION: The degree to which PCPs retain responsibility for follow-up is dependent on their level of concern about the patient and their primary care system's properties. Integrated systems to support follow-up are at present underutilised, and research into their development, uptake, and effectiveness seems warranted.

  • 21.
    Novotny, Ann
    University of Kalmar, School of Pure and Applied Natural Sciences.
    Aspects of Non-Neuronal Signalling Functions of Acetylcholine in Colorectal Cancer: Roles for the α7nAChR2009Doctoral thesis, comprehensive summary (Other academic)
  • 22.
    Novotny, Ann
    et al.
    University of Gothenburg.
    Rydberg, Kristin
    Karlstad University.
    Nilsson, Linn
    Kungälv District Hospital.
    Khorram-Manesh, Amir
    Växjö Central Hospital.
    Nordgren, Svante
    University of Gothenburg.
    Delbro, Dick
    University of Gothenburg ; Karlstad University.
    Nylund, Gunnar
    Södra Älvsborg's Hospital.
    Is acetylcholine a signaling molecule for human colon cancer progression?2011In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 46, no 4, p. 446-455Article in journal (Refereed)
    Abstract [en]

    Objective. Non-neuronal acetylcholine (ACh) has been suggested to be a mediator for the development of various types of cancer. We analyzed a possible role for this molecule in carcinogenesis and/or progression of human colon cancer, in patient biopsies harvested from the colon during surgery. We addressed whether ACh synthesis (by choline acetyltransferase) and/or degradation (by ACh esterase), as well as the expression of the α7-subtype of the nicotinic ACh receptors, and the peptide ligand at the α7 receptors, secreted mammalian Ly6/urokinase-type plasminogen activator receptor-related protein-1, respectively, are deranged in tumor tissue as compared with macroscopically tumor-free colon tissue. Methods. A total of 38 patients were grouped for analysis based on their respective Dukes stage (either Dukes A + B or C + D). A mucosal tissue sample was harvested from macroscopically tumor-free colon tissue (i.e. control tissue), as well as from the tumor, and protein lysates were prepared for quantitative Western blotting. Full-thickness specimens were taken for immunohistochemistry. Results. For all the above named markers, there was a significant difference between control and tumor tissue with regard to protein levels, and there was, in addition, a significant difference in protein levels between the Dukes A + B and C + D groups. Conclusion. The current findings may suggest a role for ACh in colon carcinogenesis/cancer progression; the data obtained could have prognostic and/or therapeutic significance for this disease.

  • 23.
    Rose, Peter W.
    et al.
    Univ Oxford, UK.
    Hamilton, Willie
    Univ Exeter, UK.
    Aldersey, Kate
    Canc Res UK, UK.
    Barisic, Andriana
    Canc Care Ontario, Canada.
    Dawes, Martin
    Univ British Columbia, Canada.
    Foot, Catherine
    Kings Fund, UK.
    Grunfeld, Eva
    Ontario Inst Canc Res, Canada;Univ Toronto, Canada.
    Hart, Nigel
    Queens Univ Belfast, UK.
    Neal, Richard D.
    Bangor Univ, UK.
    Pirotta, Marie
    Primary Hlth Care Res Evaluat & Dev, Australia.
    Sisler, Jeffrey
    Univ Manitoba, Canada.
    Thulesius, Hans
    Lund University, Sweden.
    Vedsted, Peter
    Aarhus Univ, Denmark.
    Young, Jane
    Univ Sydney, Australia.
    Rubin, Greg
    Univ Durham, UK.
    Development of a survey instrument to investigate the primary care factors related to differences in cancer diagnosis between international jurisdictions2014In: BMC Family Practice, ISSN 1471-2296, E-ISSN 1471-2296, Vol. 15, p. 1-8, article id 122Article in journal (Refereed)
    Abstract [en]

    Background: Survival rates following a diagnosis of cancer vary between countries. The International Cancer Benchmarking Partnership (ICBP), a collaboration between six countries with primary care led health services, was set up in 2009 to investigate the causes of these differences. Module 3 of this collaboration hypothesised that an association exists between the readiness of primary care physicians (PCP) to investigate for cancer - the 'threshold' risk level at which they investigate or refer to a specialist for consideration of possible cancer - and survival for that cancer (lung, colorectal and ovarian). We describe the development of an international survey instrument to test this hypothesis. Methods: The work was led by an academic steering group in England. They agreed that an online survey was the most pragmatic way of identifying differences between the jurisdictions. Research questions were identified through clinical experience and expert knowledge of the relevant literature. A survey comprising a set of direct questions and five clinical scenarios was developed to investigate the hypothesis. The survey content was discussed and refined concurrently and repeatedly with international partners. The survey was validated using an iterative process in England. Following validation the survey was adapted to be relevant to the health systems operating in other jurisdictions and translated into Danish, Norwegian and Swedish, and into Canadian and Australian English. Results: This work has produced a survey with face, content and cross cultural validity that will be circulated in all six countries. It could also form a benchmark for similar surveys in countries with similar health care systems. Conclusions: The vignettes could also be used as educational resources. This study is likely to impact on healthcare policy and practice in participating countries.

  • 24.
    Rose, Peter W.
    et al.
    Univ Oxford, UK.
    Rubin, Greg
    Univ Durham, UK.
    Perera-Salazar, Rafael
    Univ Oxford, UK.
    Almberg, Sigrun Saur
    Norwegian Univ Sci & Technol, Norway.
    Barisic, Andriana
    Canc Care Ontario, Canada.
    Dawes, Martin
    Univ British Columbia, Canada.
    Grunfeld, Eva
    Ontario Inst Canc Res, Canada;Univ Toronto, Canada.
    Hart, Nigel
    Queens Univ Belfast, UK.
    Nea, Richard D.
    Bangor Univ, UK.
    Pirotta, Marie
    Primary Hlth Care Res Evaluat & Dev, Australia.
    Sisler, Jeffrey
    Univ Manitoba, Canada.
    Konrad, Gerald
    Univ Manitoba, Canada.
    Toftegaard, Berit Skjodeberg
    Aarhus Univ, Denmark.
    Thulesius, Hans
    Region Kronoberg, Sweden..
    Vedsted, Peter
    Aarhus Univ, Denmark.
    Young, Jane
    Univ Sydney, Australia.
    Hamilton, Willie
    Univ Exeter, UK.
    Explaining variation in cancer survival between 11 jurisdictions in the International Cancer Benchmarking Partnership: a primary care vignette survey2015In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 5, no 5, p. 1-14, article id e007212Article in journal (Refereed)
    Abstract [en]

    Objectives: The International Cancer Benchmarking Partnership (ICBP) is a collaboration between 6 countries and 12 jurisdictions with similar primary care-led health services. This study investigates primary care physician (PCP) behaviour and systems that may contribute to the timeliness of investigating for cancer and subsequently, international survival differences. Design: A validated survey administered to PCPs via the internet set out in two parts: direct questions on primary care structure and practice relating to cancer diagnosis, and clinical vignettes, assessing management of scenarios relating to the diagnosis of lung, colorectal or ovarian cancer. Participants: 2795 PCPs in 11 jurisdictions: New South Wales and Victoria (Australia), British Columbia, Manitoba, Ontario (Canada), England, Northern Ireland, Wales (UK), Denmark, Norway and Sweden. Primary and secondary outcome measures: Analysis compared the cumulative proportion of PCPs in each jurisdiction opting to investigate or refer at each phase for each vignette with 1-year survival, and conditional 5-year survival rates for the relevant cancer and jurisdiction. Logistic regression was used to explore whether PCP characteristics or system differences in each jurisdiction affected the readiness to investigate. Results: 4 of 5 vignettes showed a statistically significant correlation (p<0.05 or better) between readiness to investigate or refer to secondary care at the first phase of each vignette and cancer survival rates for that jurisdiction. No consistent associations were found between readiness to investigate and selected PCP demographics, practice or health system variables. Conclusions: We demonstrate a correlation between the readiness of PCPs to investigate symptoms indicative of cancer and cancer survival rates, one of the first possible explanations for the variation in cancer survival between ICBP countries. No specific health system features consistently explained these findings. Some jurisdictions may consider lowering thresholds for PCPs to investigate for cancer-either directly, or by specialist referral, to improve outcomes.

  • 25.
    Sandén, Ulrika
    et al.
    Lund University, Sweden.
    Harrysson, Lars
    Lund University, Sweden.
    Thulesius, Hans
    Lund University, Sweden.
    Nilsson, Fredrik
    Lund University, Sweden.
    Exploring health navigating design: momentary contentment in a cancer context.2017In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 12, no 1, p. 1-12, article id 1374809Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The technocratic and medicalized model of healthcare is rarely optimal for patients. By connecting two different studies we explore the possibilities of increasing quality of life in cancer care.

    METHODS: The first study captures survival strategies in a historically isolated Arctic village in Norway resulting in Momentary contentment theory, which emerged from analysing four years of participant observation and interview data. The second study conceptualizes everyday life of cancer patients based on in-depth interviews with 19 cancer patients; this was conceptualized as Navigating a new life situation. Both studies used classic grounded theory methodology. The connection between the studies is based on a health design approach.

    RESULTS: We found a fit between cancer patients challenging life conditions and harsh everyday life in an Arctic village. Death, treatments and dependence have become natural parts of life where the importance of creating spaces-of-moments and a Sense of Safety is imminent to well-being. While the cancer patients are in a new life situation, the Arctic people show a natural ability to handle uncertainties.

    CONCLUSION: By innovation theories connected to design thinking, Momentary contentment theory modified to fit cancer care would eventually be a way to improve cancer patients' quality of life.

  • 26.
    Sigfridsson, Marie
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Kvinnors upplevelse av att leva med bröstcancer: Ur ett patientperspektiv2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 27. Skoog, Peter
    et al.
    Stenström, Ulf
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Education, Psychology and Sport Science.
    Självundersökning med hjälp av video bra för melanompatienter2012In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 109, no 22, p. 1094-1095Article in journal (Refereed)
    Abstract [sv]

    Självundersökning efter operation för malignt melanom kan reducera mortaliteten.

    44 patienter, varav hälften förutom muntlig information fick en video om självundersökning efter malignt melanom, kontrollerades sex månader efter operation avseende kunskap om hur en korrekt självundersökning ska utföras. De fick även skatta sitt välbefinnande före och efter operation.

    Resultatet visade att de som erhöll videon hade bättre resultat vid kunskapskontrollen och förbättrade sitt välbefinnande jämfört med dem som erhöll endast muntlig information.

    Videon tycks vara ett verktyg i vården av dessa patienter som bidrar till att minska återbesöken och frigöra tid för nybesök.

  • 28.
    Sonesson, Hannah
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Immunhistokemi - Utvärdering av antikropp mot pHH3 som potentiell markör för mitos vid diagnostisering av duktal bröstcancer2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Ductal carcinoma of the breast is the most common form of invasive breast tumours. The grading system for breast cancer is defined by Elston and Ellis and is based on three criterions. One of these criterions is the mitotic count in pathological sections of breast carcinomas stained with Hematoxylin Eosin. A common method often applied as a complement in diagnosis of breast carcinoma is immunohistochemical staining with use of antibodies directed against Ki67, a proliferation marker. Phosphohistone H3 is a histone protein that is located in the cell nucleus. The protein is believed to be a specific marker for mitosis since it only is phosphorylated during mitosis, and to some extent at the end of the G2-phase. The purpose of this study was to evaluate pHH3 as a potential marker for mitosis when diagnosing ductal breast cancer. The purpose was also to compare the method to mitotic figuring and the count of Ki67-positive cells, and to study the inter-individual variability when assessing the histological sections. The material consisted of 20 biopsies containing invasive ductal breast cancer. The sections were stained using IHC and all sections were evaluated microscopically. Cells positive for pHH3, Ki67 and mitotic cells were quantified, by three doctors. From the doctors results an average value was determined for each case and method. To be able to compare the methods the coefficient of variation was calculated. The average value of the coefficient of variation was determined for each method and also the standard deviation (SD). The coefficient of variation showed average values of 0,21 for Ki67 +/- 0,10 SD, 0,33 for pHH3 +/- 0,14 SD and 0,46 for mitotic figuring +/- 0,34 SD. The correlation coefficients for the methods and each doctor showed dispersion. The correlations showed average values of r = 0,78 for Ki67 and pHH3, r = 0,74 for Ki67 and mitosis and r = 0,83 for pHH3 and mitosis. According to this study it seems as though anti-pHH3 could complement the other methods. However explicit criteria which defines a threshold value of which cells should be considered pHH3-positive needs to be established. The inter-individual differences seem to decrease using antipHH3 compared with mitotic counting, which is more time consuming. Although the minimum difference can be seen when assessing anti-Ki67 as a proliferation marker.

  • 29.
    Thulesius, Hans
    et al.
    Region Kronoberg.
    Håkansson, Anders
    Department of Community Medicine, Malmö.
    Petersson, Kerstin
    Kronoberg county Research Centre;Lund university.
    Balancing: a basic process in end-of-life cancer care.2003In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 13, no 10, p. 1353-1377Article in journal (Refereed)
    Abstract [en]

    In this grounded theory study, the authors interviewed caregivers and patients in end-of-life cancer care and found Balancing to be a fundamental process explaining the problem-solving strategies of most participants and offering a comprehensive perspective on both health care in general and end-of-life cancer care in particular. Balancing stages were Weighing--sensing needs and wishes signaled by patients, gauging them against caregiver resources in diagnosing and care planning; Shifting--breaking bad news, changing care places, and treatments; and Compensating--controlling symptoms, educating and team-working, prioritizing and "stretching" time, innovating care methods, improvising, and maintaining the homeostasis of hope. The Balancing outcome is characterized by Compromising, or "Walking a fine line," at best an optimized situation, at worst a deceit.

  • 30.
    Tågerud, Sven
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Patienten bör inte behöva betala för betydelsefulla test2019In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 116, no 16-17Article in journal (Other (popular science, discussion, etc.))
  • 31.
    Wells, M.
    et al.
    Univ Stirling, UK.
    Campbell, P.
    Glasgow Caledonian Univ, UK.
    Torrens, C.
    Glasgow Caledonian Univ, UK.
    Charalambous, A.
    Cyprus Univ Technol, Cyprus.
    Sharp, L.
    Regionalt CancerCentrum - Stockholm Gotland.
    Wiseman, T.
    Royal Marsden NHS Fdn Trust, UK;Univ Southampton, UK.
    Östlund, Ulrika
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Patiraki, E.
    Univ Athens, Greece.
    Nohavova, I.
    Charles Univ Prague, Czech Republic.
    Domenech-Climent, N.
    Alicante Univ, Spain.
    Oldenmenger, W.
    Erasmus MC Canc Inst, Netherlands.
    Kelly, D.
    Univ Cardiff, UK.
    Recognising European Cancer Nursing (RECaN): A systematic review of trial evidence that helps to identify the roles and interventions of nurses caring for patients with cancer2017In: European Journal of Cancer, ISSN 0959-8049, E-ISSN 1879-0852, Vol. 72, p. S4-S4Article in journal (Other academic)
  • 32. Wilde Björling, Camilla
    et al.
    Lagerlund, Magnus
    Östlund, Martin
    Linnaeus University, Faculty of Science and Engineering, School of Computer Science, Physics and Mathematics.
    Johansson, Pauline
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Axelsson, Clara
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Johnsson, Stefan
    Can patients be better prepared and more satisfied during the course of radiation therapy by using iPad's?2012In: Radiotherapy and Oncology: Vol. 103 Supplement 1, 2012, p. S30-Conference paper (Refereed)
  • 33.
    Wilkens, Jens
    et al.
    The National Board of Health and Welfare, Sweden;Lund University, Sweden.
    Thulesius, Hans
    Lund University, Sweden.
    Schmidt, Ingrid
    The National Board of Health and Welfare, Sweden.
    Carlsson, Christina
    The National Board of Health and Welfare, Sweden;Lund university, Sweden.
    The 2015 National Cancer Program in Sweden: Introducing standardized care pathways in a decentralized system.2016In: Health Policy, ISSN 0168-8510, E-ISSN 1872-6054, Vol. 120, no 12, p. 1378-1382Article in journal (Refereed)
    Abstract [en]

    Starting in 2015, the Swedish government has initiated a national reform to standardize cancer patient pathways and thereby eventually speed up treatment of cancer. Cancer care in Sweden is characterized by high survival rates and a generally high quality albeit long waiting times. The objective with the new national program to standardize cancer care pathways is to reduce these waiting times, increase patient satisfaction with cancer care and reduce regional inequalities. A new time-point for measuring the start of a care process is introduced called well-founded suspicion, which is individually designed for each cancer diagnosis. While medical guidelines are well established earlier, the standardisation is achieved by defining time boundaries for each step in the process. The cancer reform program is a collaborative effort initiated and incentivized by the central government while multi-professional groups develop the time-bound standardized care pathways, which the regional authorities are responsible for implementing. The broad stakeholder engagement and time-bound guidelines are interesting approaches to study for other countries that need to streamline care processes.

  • 34.
    Y Banaem, Hossein
    et al.
    Tehran University of Medical Science, Iran.
    Ahmadian, Alireza
    Tehran University of Medical Science, Iran.
    Saberi, Hooshangh
    Tehran University of Medical Science, Iran.
    Daneshmehr, Alireza
    University of Tehran, Iran.
    Khodadad, Davood
    Tehran University of Medical Science, Iran.
    Brain tumor modeling: glioma growth and interaction with chemotherapy2011In: International Conference on Graphic and Image Processing (ICGIP 2011) / [ed] Yi Xie, Yanjun Zheng, 2011, article id 82851MConference paper (Refereed)
    Abstract [en]

    In last decade increasingly mathematical models of tumor growths have been studied, particularly on solid tumors which growth mainly caused by cellular proliferation. In this paper we propose a modified model to simulate the growth of gliomas in different stages. Glioma growth is modeled by a reaction-advection-diffusion. We begin with a model of untreated gliomas and continue with models of polyclonal glioma following chemotherapy. From relatively simple assumptions involving homogeneous brain tissue bounded by a few gross anatomical landmarks (ventricles and skull) the models have been expanded to include heterogeneous brain tissue with different motilities of glioma cells in grey and white matter. Tumor growth is characterized by a dangerous change in the control mechanisms, which normally maintain a balance between the rate of proliferation and the rate of apoptosis (controlled cell death). Result shows that this model closes to clinical finding and can simulate brain tumor behavior properly.

  • 35.
    Zabriskie, Matthew S.
    et al.
    University of Utah, USA.
    Eide, Christopher A.
    Oregon Health & Science University, USA;Howard Hughes Medical Institute, USA.
    Tantravahi, Srinivas K.
    University of Utah, USA.
    Vellore, Nadeem A.
    University of Utah, USA.
    Estrada, Johanna
    University of Utah, USA.
    Nicolini, Franck E.
    Centre Hospitalier Lyon Sud, France.
    Khoury, Hanna J.
    Emory University, USA.
    Larson, Richard A.
    University of Chicago, USA.
    Konopleva, Marina
    University of Texas, USA.
    Cortes, Jorge E.
    University of Texas, USA.
    Kantarjian, Hagop
    University of Texas, USA.
    Jabbour, Elias J.
    University of Texas, USA.
    Kornblau, Steven M.
    University of Texas, USA.
    Lipton, Jeffrey H.
    University of Toronto, Canada.
    Rea, Delphine
    Hospital Saint-Louis, France.
    Stenke, Leif
    Karolinska Institutet.
    Barbany, Gisela
    Karolinska Institutet.
    Lange, Thoralf
    University of Leipzig, Germany.
    Hernandez-Boluda, Juan-Carlos
    Hospital Clı´nico Universitario, Spain.
    Ossenkoppele, Gert J.
    VU University Medical Center, Netherlands.
    Press, Richard D.
    Oregon Health & Science University, USA.
    Chuah, Charles
    Singapore General Hospital, Singapore.
    Goldberg, Stuart L.
    John Theurer Cancer Center at Hackensack University Medical Center, USA.
    Wetzler, Meir
    Roswell Park Cancer Institute, USA.
    Mahon, Francois-Xavier
    Centre Hospitalier Universitaire de Bordeaux, France.
    Etienne, Gabriel
    Institut Bergonie, France.
    Baccarani, Michele
    University of Bologna, Italy.
    Soverini, Simona
    University of Bologna, Italy.
    Rosti, Gianantonio
    University of Bologna, Italy.
    Rousselot, Philippe
    Université de Versailles, France.
    Friedman, Ran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Deininger, Marie
    University of Utah, USA.
    Reynolds, Kimberly R.
    University of Utah, USA.
    Heaton, William L.
    University of Utah, USA.
    Eiring, Anna M.
    University of Utah, USA.
    Pomicter, Anthony D.
    University of Utah, USA.
    Khorashad, Jamshid S.
    University of Utah, USA.
    Kelley, Todd W.
    University of Utah, USA.
    Baron, Riccardo
    University of Utah, USA.
    Druker, Brian J.
    Oregon Health & Science University Knight Cancer Institute, USA;Howard Hughes Medical Institute, USA.
    Deininger, Michael W.
    University of Utah, USA.
    O'Hare, Thomas
    University of Utah, USA.
    BCR-ABL1 Compound Mutations Combining Key Kinase Domain Positions Confer Clinical Resistance to Ponatinib in Ph Chromosome-Positive Leukemia2014In: Cancer Cell, ISSN 1535-6108, E-ISSN 1878-3686, Vol. 26, no 3, p. 428-442Article in journal (Refereed)
    Abstract [en]

    Ponatinib is the only currently approved tyrosine kinase inhibitor (TKI) that suppresses all BCR-ABL1 single mutants in Philadelphia chromosome-positive (Ph+) leukemia, including the recalcitrant BCR-ABL1(T315I) mutant. However, emergence of compound mutations in a BCR-ABL1 allele may confer ponatinib resistance. We found that clinically reported BCR-ABL1 compound mutants center on 12 key positions and confer varying resistance to imatinib, nilotinib, dasatinib, ponatinib, rebastinib, and bosutinib. T315I-inclusive compound mutants confer high-level resistance to TKIs, including ponatinib. In vitro resistance profiling was predictive of treatment outcomes in Ph+ leukemia patients. Structural explanations for compound mutation-based resistance were obtained through molecular dynamics simulations. Our findings demonstrate that BCR-ABL1 compound mutants confer different levels of TKI resistance, necessitating rational treatment selection to optimize clinical outcome.

1 - 35 of 35
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