| 346321. |
- Håkansson, Anna Schröder, et al.
(författare)
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Early phase clinical trials in pediatric oncology : Swedish pediatric oncologists’ experiences of balancing hope and expectations in life-threatening illnesses
- 2024
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Ingår i: Frontiers in Oncology. - : Frontiers Media S.A.. - 2234-943X. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To study Swedish pediatric oncologists’ practical and emotional experiences of referring, including and/or treating children in early-phase clinical trials.Methods: A nationwide study was conducted using a mixed-method approach. Structured interviews based on a study-specific questionnaire and participants’ personal reflections were utilized. Survey responses were analyzed using descriptive statistics, while participants’ comments were analyzed using thematic analysis. All interviews were recorded and transcribed verbatim.Results: In total, 29 physicians with 4 to 32 years of experience in pediatric oncology participated, with 19 (66%) having > 10 years of experience. Three themes appeared: 1) Optimization-based approach focused on finding the most suitable treatment and care for every child with a refractory/relapsed cancer eligible for an early-phase clinical trial; 2) Team-based approach aimed at establishing local and national consensus in decision-making for treatment options, including early-phase clinical trials and palliative care; 3) Family-based approach in which the physicians provided families with actionable information, listened to their desires, and endeavored to maintain hope in challenging circumstances. Several participants (40% with ≤ 10 years of experience and 58% with > 10 years of experience) viewed the early-phase clinical trial as a potential “chance of cure”. A majority (80%) of physicians with ≤ 10 years of experience, reported that they often or always felt personally and emotionally affected by communication regarding early-phase clinical trials. Delivering difficult news in cases of uncertain prognosis was identified as the major challenge. None of the study participants felt adequately prepared in terms of sufficient knowledge and experience regarding early-phase clinical trials. The physicians expressed a need for guidance and training in communication to address these challenges.Conclusions: Working with early-phase clinical trials highlight a field where physicians cannot solely rely on their expertise or past experiences, and where they are likely to be deeply emotionally involved. Physicians who care for children eligible for such studies require targeted educational initiatives and supervision.
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| 346322. |
- Håkansson, Andreas
(författare)
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Scale-down failed : dissimilarities between high-pressure-homogenizers of different scales due to failed mechanistic matching
- 2017
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Ingår i: Journal of Food Engineering. - : Elsevier Ltd.. - 0260-8774. ; 195, s. 31-39
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Tidskriftsartikel (refereegranskat)abstract
- The high-pressure homogenizer (HPH) is used extensively in the processing of non-solid foods. Food researchers and producers use HPHs of different scales, from laboratory-scale (∼10 L/h) to the largest production-scale machines (∼50 000 L/h). Hence, the process design and interpretation of academic findings regarding industrial condition requires an understanding of differences between scales. This contribution uses theoretical calculations to compare the hydrodynamics of the different scales and interpret differences in the mechanism of drop-breakup. Results indicate substantial differences between HPHs of different scales. The laboratory-scale HPH operates in the laminar regime whereas the production-scale is in the fully turbulent regime. The smaller scale machines are also less prone to cavitation and differ in their pressure profiles. This suggest that the HPHs of different scales should be seen as principally different emulsification processes. Conclusions on the effect or functionality of a HPH can therefore not readily be translate between scales.
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| 346323. |
- Håkansson, A., et al.
(författare)
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Self-exclusion and breaching of self-exclusion from gambling : a repeated survey study on the development of a nationwide self-exclusion service
- 2023
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Ingår i: Harm Reduction Journal. - 1477-7517. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Voluntary self-exclusion from gambling is a common harm reduction tool in individuals with a gambling disorder. Previous data have demonstrated that many gamblers breach their own self-exclusion, typically through other online services outside the jurisdiction in which they are self-excluded. The present study aimed to carry out a new follow-up measure—similar to previous studies in the same setting—of self-exclusion and its breaching in Sweden, in order to allow for the follow-up assessment of a nationwide, multi-operator self-exclusion system introduced in Sweden in 2019. Methods: A web survey to the web panel of a market survey company addressed 1505 past-year gamblers, who responded to a number of questions about gambling habits, including screening for gambling problems using the Problem Gambling Severity Index and self-exclusion-related items corresponding to previous studies. Results: Nine percent of past-year gamblers had self-excluded using the Spelpaus service. In logistic regression, self-exclusion was significantly associated with gambling problems, past-year online casino gambling, and absence of online poker gambling. Among self-excluders, 49 percent had ever gambled despite being self-excluded. Among those breaching their self-exclusion, the most common gambling types during self-exclusion were online casino (82 percent), sports betting (47 percent) and lotteries (43 percent). Discussion: Self-exclusion remains a popular harm reduction tool against problem gambling, more common than in previous studies, mostly in individuals with recent gambling problems and in online casino gamblers. However, breaching self-exclusion is somewhat more common than in previous research. Online casino represents the most common means of self-exclusion breaching. Policy-making in the area needs to further address the risk of breaching one’s self-exclusion and may further address the risk of overseas gambling.
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| 346324. |
- Håkansson, Anders, et al.
(författare)
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Self-exclusion from gambling—a measure of covid-19 impact on gambling in a highly online-based gambling market?
- 2021
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:14
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Tidskriftsartikel (refereegranskat)abstract
- The COVID-19 pandemic, and related changes of the gambling market, have been suspected to affect the risk of problem gambling. Despite media attention and political concern with this risk, study findings hitherto have been mixed. Voluntary self-exclusion from gambling was introduced on a national level in Sweden as a harm reduction tool in 2019, and this self-exclusion service in Sweden is a rare example of such an official, nationwide, multi-operator system. The present study aimed to evaluate whether short-term self-exclusion patterns were affected by different phases of COVID-19-related impacts on gambling markets in 2020. During the lock-down of sports in the spring months of 2020, three-month self-exclusion was unaffected, and one-month self-exclusion appeared to increase, though not more than in a recent period prior to COVID-19. Despite large differences in sports betting practices between women and men, self-exclusion patterns during COVID-19 were not apparently gender-specific. Altogether, self-exclusion from gambling, to date, does not appear to be affected by COVID-19-related changes in society, in contrast with beliefs about such changes producing greater help-seeking behavior in gamblers. Limitations are discussed, including the fact that in a recently introduced system, seasonality aspects and the autocorrelated nature of the data made substantial statistical measures unfeasible.
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| 346325. |
- Håkansson, Andreas, et al.
(författare)
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Simultaneous determination of fragmentation and coalescence rates during pilot-scale high-pressure homogenization
- 2013
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Ingår i: Journal of Food Engineering. - : Elsevier BV. - 0260-8774. ; 116:1, s. 7-13
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Tidskriftsartikel (refereegranskat)abstract
- The emulsification process is primarily determined by the rate of fragmentation and coalescence of emulsion drops. However, there is presently no fast, reliable method for measuring these rates for pilot and production scale high pressure homogenizers. In this paper a method for simultaneous estimating fragmentation and coalescence is developed and tested based on the work of Hounslow and Ni (2004). Kernel type as well as rate extraction is performed based on the development of the total number of drops when recirculation an emulsion through a high-pressure homogenizer. The method has many advantages such as not requiring any specialty chemicals or complex analytical equipment. All measurements are made using laser diffraction equipment that is already standard for analyzing the effect of homogenization. Experiments show fragmentation and coalescence rates close to that seen in previous studies and the scaling of coalescence rate and fragmentation with homogenizing pressure is in accordance with theory. (c) 2012 Elsevier Ltd. All rights reserved.
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| 346326. |
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| 346327. |
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| 346328. |
- Håkansson, Andreas, et al.
(författare)
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Studying the effects of adsorption, recoalescence and fragmentation in a high pressure homogenizer using a dynamic simulation model
- 2009
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Ingår i: Food Hydrocolloids. - : Elsevier BV. - 0268-005X. ; 23:4, s. 1177-1183
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Tidskriftsartikel (refereegranskat)abstract
- The emulsification in a high pressure homogenizer was studied using a dynamic simulation model based on the population balance equation. The model includes fragmentation, recoalescence and adsorption of macromolecular emulsifier and uses a simple flow model in order to link the hydrodynamics in the homogenizer to the three physical processes mentioned above. A computer model offers an interesting opportunity to study the effect of model assumptions on the overall outcome of the process. The computer model is also an interesting complement to experiments in this case since internal measurements in the active region of homogenization are very hard to carry out, due to small scales and high forces, and information on the spatial position of the different processes is of great importance in design. Based on a set of assumptions, mainly that the turbulent jet responsible for break-up can be described by a one dimensional model and that the macromolecular emulsifiers hindrance of recoalescence can be described by a wall like repulsion, it is shown that the active region of homogenization can be divided into two zones; a narrow zone with fast fragmentation and nearly no recoalescence in the most intense part of the region followed by a recoalescence zone as drop–drop interactions starts to dominate with decreasing turbulence intensity. The effect of operating parameters is seen to be close to the ones found from experiment. The results are discussed in relation to a flow field obtained by a simplistic CFD and assumptions made about hydrodynamics and emulsifier behavior.
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| 346329. |
- Håkansson, Anders, et al.
(författare)
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Suicide Attempt in Patients With Gambling Disorder—Associations With Comorbidity Including Substance Use Disorders
- 2020
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Ingår i: Frontiers in Psychiatry. - : Frontiers Media SA. - 1664-0640. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Background: Gambling disorder is known to be associated with increased risk of suicidal behavior. However, relatively little is known about how the risk of suicide attempts in gambling disorder is influenced by comorbid alcohol or drug use disorders, as well as other psychiatric conditions. Methods: The present study is a nationwide, diagnostic register study assessing the risk of suicide attempts (including fatal ones) in gambling disorder in Sweden in 2005–2016. Results: In a total of 2,099 individuals (23 percent women) with gambling disorder, 417 individuals had a suicide attempt (including 10 fatal cases of suicide) during the study period. Suicidal behavior was more common in patients with substance use disorders at any time during the study period (50 percent if both alcohol and drug use disorders were present, and 10 percent if none of these were present). In logistic regression, suicidal behavior was significantly associated with female gender (OR 2.13 [1.63–2.78]), mood disorders (OR 2.65 [2.00–3.50]), anxiety disorders (OR 1.78 [1.34–2.35]), and with alcohol (OR 1.95 [1.51–2.51]) or drug use disorders (OR 3.60 [2.76–4.69]), respectively. Conclusions: Suicidal behavior in clinical gambling disorder patients is common, but markedly more common in the presence of substance use and other comorbid disorders.
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| 346330. |
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