| 1. |
- Botling, Johan, et al.
(author)
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Biomarker Discovery in Non-Small Cell Lung Cancer : Integrating Gene Expression Profiling, Meta-analysis, and Tissue Microarray Validation
- 2013
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In: Clinical Cancer Research. - 1078-0432 .- 1557-3265. ; 19:1, s. 194-204
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Journal article (peer-reviewed)abstract
- Purpose: Global gene expression profiling has been widely used in lung cancer research to identify clinically relevant molecular subtypes as well as to predict prognosis and therapy response. So far, the value of these multigene signatures in clinical practice is unclear, and the biologic importance of individual genes is difficult to assess, as the published signatures virtually do not overlap.Experimental Design: Here, we describe a novel single institute cohort, including 196 non-small lung cancers (NSCLC) with clinical information and long-term follow-up. Gene expression array data were used as a training set to screen for single genes with prognostic impact. The top 450 probe sets identified using a univariate Cox regression model (significance level P < 0.01) were tested in a meta-analysis including five publicly available independent lung cancer cohorts (n = 860).Results: The meta-analysis revealed 14 genes that were significantly associated with survival (P < 0.001) with a false discovery rate < 1%. The prognostic impact of one of these genes, the cell adhesion molecule 1 (CADM1), was confirmed by use of immunohistochemistry on tissue microarrays from 2 independent NSCLC cohorts, altogether including 617 NSCLC samples. Low CADM1 protein expression was significantly associated with shorter survival, with particular influence in the adenocarcinoma patient subgroup.Conclusions: Using a novel NSCLC cohort together with a meta-analysis validation approach, we have identified a set of single genes with independent prognostic impact. One of these genes, CADM1, was further established as an immunohistochemical marker with a potential application in clinical diagnostics. Clin Cancer Res; 19(1); 194-204. (c) 2012 AACR.
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| 2. |
- Franzén, Karin, et al.
(author)
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Validation of the Swedish version of the incontinence impact questionnaire and the urogenital distress inventory
- 2013
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In: Acta Obstetricia Et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 92:5, s. 555-561
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Journal article (peer-reviewed)abstract
- Objective. To validate the Swedish versions of the Incontinence Impact Questionnaire (IIQ-7) and Urogenital Distress Inventory (UDI-6). Design and setting. Prospective study, university hospital. Population and method. We analyzed reliability, validity, and responsiveness in a clinical sample of 96 women with urinary incontinence. Main outcome measures. Construct and criterion validity, reliability via test–retest and internal consistency. Responsiveness via calculation of effect size. Result. Test–retest reliability ranged from moderate to almost perfect. Cronbach's alpha was 0.39 (UDI-6) and 0.83 (IIQ-7). Effect size calculation of change after treatment demonstrated good responsiveness. The effect size at six months was moderate in the Stress Urinary Incontinence group and small in the Urge Urinary Incontinence + Mixed Urinary Incontinence group. There was a moderate to strong correlation between UDI-6 and IIQ-7 and treatment satisfaction at six, 12, and 24 months for both groups. Conclusion. The UDI-6 scale did not produce the same solid result in the psychometric analysis as the IIQ-7 scale, but these newly translated Swedish forms of UDI-6 and IIQ-7 show good responsiveness and are easy to administer and to fill out.
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| 3. |
- Franzén, Karin, 1958-, et al.
(author)
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Validation of the Swedish version of the Incontinence Impact Questionnaire, IIQ-7 and the Urogenital Distress Inventory, UDI-6.
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Other publication (other academic/artistic)abstract
- Introduction and hypothesis:The purpose was to validate the Swedish versions of the Incontinence Impact Questionnaire (IIQ-7) and Urogenital Distress Inventory (UDI-6). Methods: We analyzed reliability, validity, and responsiveness in a clinical sample of 96 women with UI. Result:Test-retest reliability ranged from moderate to almost perfect. Cronbach’s alpha was 0.39 (UDI-6) and 0.83 (IIQ-7). Effect size calculation of change after treatment demonstrated good responsiveness. The effect size at 6 months was moderate in the SUI group and small in the UUI+MUI group. There was a moderate to strong correlation between UDI-6 and IIQ-7 and treatment satisfaction at 6, 12, and 24 months for both groups. ConclusionThe Swedish UDI-6 and IIQ-7 show good responsiveness and are easy to administer and fill out. UDI-6 did not produce the same solid psychometrical results as IIQ-7, but both scales can be of clinical importance and are recommended for clinical use.
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| 4. |
- Mattsson, Johanna Sofia Margareta, 1985-, et al.
(author)
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Prognostic impact of COX-2 in non-small cell lung cancer : a comprehensive compartment-specific evaluation of tumor and stromal cell expression
- 2015
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In: Cancer Letters. - : Elsevier BV. - 0304-3835 .- 1872-7980. ; 356:2, s. 837-845
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Journal article (peer-reviewed)abstract
- Cyclooxygenase-2 (COX-2) is an enzyme that has been extensively investigated as a prognostic marker in cancer. In non-small cell lung cancer (NSCLC) previous results regarding the prognostic impact of COX-2 expression are inconsistent. Therefore we evaluated the association between transcript levels and overall survival in nine publicly available gene expression data sets (total n = 1337) and determined in situ compartment-specific tumor and stromal cell protein expression in two independent cohorts (n = 616). Gene expression did not show any correlation with clinical parameters or with overall survival. Protein expression in tumor and stromal cells did not correlate with any clinical parameter or with overall survival in one of the analyzed cohorts, while a significant association of high stromal expression with longer survival was observed in both univariate and multivariate analysis in the other cohort. Stromal expression of COX-2 has not been separately evaluated in NSCLC previously and may be a subject of further investigation, whereas the presented findings from this comprehensive compartment specific evaluation clearly reject the hypothesis of COX-2 tumor cell expression having a prognostic value in NSCLC. (C) 2014 Elsevier Ireland Ltd. All rights reserved.
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| 5. |
- Raoof, Mustafa, 1966-, et al.
(author)
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Health-Related Quality-of-Life (HRQoL) on an Average of 12 Years After Gastric Bypass Surgery
- 2015
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In: Obesity Surgery. - : Springer Science and Business Media LLC. - 0960-8923 .- 1708-0428. ; 25:7, s. 1119-1127
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Journal article (peer-reviewed)abstract
- It is evident that morbidly obese patients have a low health-related quality-of-life (HRQoL), and this low HRQoL has become a common reason for them to seek bariatric surgery. Several HRQoL studies demonstrate a dramatic postoperative improvement, but most of these have had a short follow-up period.An observational, cross-sectional study for HRQoL was conducted to study 486 patients (average age of 50.7 +/- 10.0 years, with 84 % of them being female) operated with gastric bypass (GBP) in the period 1993 to 2003 at the University Hospitals of A-rebro and Uppsala. Mean follow-up after gastric bypass was 11.5 +/- 2.7 years (range 7-17). Two HRQoL instruments were used, SF-36 and the Obesity-related Problems scale (OP). The study group was compared with two control groups, both matched for age and gender, one from the general population and one containing morbidly obese patients evaluated and awaiting bariatric surgery.The study group scored better in the SF-36 domains (all four physical domains and the vitality subscore) and OP scale compared to obese controls, but their HRQoL scores were lower than those of the general population. HRQoL was better among younger patients and in the following subgroups: men, patients with satisfactory weight loss, satisfied with the procedure, free from co-morbidities and gastrointestinal symptoms, employment, good oral status and those not hospitalised or regularly followed up for non-bariatric reasons.Long-term follow-up after GBP for morbid obesity showed better scores in most aspects of HRQoL compared to obese controls but did not achieve the levels of the general population. Patients with better medical outcome after gastric bypass operation had better HRQoL.
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| 6. |
- Svantesson, Mia, 1960-, et al.
(author)
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Outcomes of Moral Case Deliberation : the development of an evaluation instrument for clinical ethics support (the Euro-MCD)
- 2014
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In: BMC Medical Ethics. - London : BioMed Central. - 1472-6939. ; 15
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Journal article (peer-reviewed)abstract
- Background: Clinical ethics support, in particular Moral Case Deliberation, aims to support health care providers to manage ethically difficult situations. However, there is a lack of evaluation instruments regarding outcomes of clinical ethics support in general and regarding Moral Case Deliberation (MCD) in particular. There also is a lack of clarity and consensuses regarding which MCD outcomes are beneficial. In addition, MCD outcomes might be context-sensitive. Against this background, there is a need for a standardised but flexible outcome evaluation instrument. The aim of this study was to develop a multi-contextual evaluation instrument measuring health care providers' experiences and perceived importance of outcomes of Moral Case Deliberation.Methods: A multi-item instrument for assessing outcomes of Moral Case Deliberation (MCD) was constructed through an iterative process, founded on a literature review and modified through a multistep review by ethicists and health care providers. The instrument measures perceived importance of outcomes before and after MCD, as well as experienced outcomes during MCD and in daily work. A purposeful sample of 86 European participants contributed to a Delphi panel and content validity testing. The Delphi panel (n = 13), consisting of ethicists and ethics researchers, participated in three Delphi-rounds. Health care providers (n = 73) participated in the content validity testing through `think-aloud' interviews and a method using Content Validity Index.Results: The development process resulted in the European Moral Case Deliberation Outcomes Instrument (Euro-MCD), which consists of two sections, one to be completed before a participant's first MCD and the other after completing multiple MCDs. The instrument contains a few open-ended questions and 26 specific items with a corresponding rating/response scale representing various MCD outcomes. The items were categorised into the following six domains: Enhanced emotional support, Enhanced collaboration, Improved moral reflexivity, Improved moral attitude, Improvement on organizational level and Concrete results.Conclusions: A tentative instrument has been developed that seems to cover main outcomes of Moral Case Deliberation. The next step will be to test the Euro-MCD in a field study.
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| 7. |
- Abraham-Nordling, Mirna, et al.
(author)
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Incidence of hyperthyroidism in Sweden
- 2011
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In: European Journal of Endocrinology. - 0804-4643 .- 1479-683X. ; 165:6, s. 899-905
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Journal article (peer-reviewed)abstract
- Introduction: The incidence of hyperthyroidism has been reported in various countries to be 23-93/100000 inhabitants per year. This extended study has evaluated the incidence for similar to 40% of the Swedish population of 9 million inhabitants. Sweden is considered to be iodine sufficient country. Methods:All patients including children, who were newly diagnosed with overt hyperthyroidism in the years 2003-2005, were prospectively registered in a multicenter study. The inclusion criteria are as follows:clinical symptoms and/or signs of hyperthyroidism with plasma TSH concentration below 0.2 mIE/l and increased plasma levels of free/total triiodothyronine and/or free/total thyroxine. Patients with relapse of hyperthyroidism or thyroiditis were not included. The diagnosis of Graves' disease (GD), toxic multinodular goiter (TMNG) and solitary toxic adenoma (STA), smoking, initial treatment, occurrence of thyroid-associated eye symptoms/signs, and demographic data were registered. Results:A total of 2916 patients were diagnosed with de novo hyperthyroidism showing the total incidence of 27.6/100 000 inhabitants per year. The incidence of GD was 21.0/100 000 and toxic nodular goiter (TNG=STA+TMNG) occurred in 692 patients, corresponding to an annual incidence of 6.5/100 000. The incidence was higher in women compared with men (4.2:1). Seventy-five percent of the patients were diagnosed with GD, in whom thyroid-associated eye symptoms/signs occurred during diagnosis in every fifth patient. Geographical differences were observed. Conclusion:The incidence of hyperthyroidism in Sweden is in a lower range compared with international reports. Seventy-five percent of patients with hyperthyroidism had GD and 20% of them had thyroid-associated eye symptoms/signs during diagnosis. The observed geographical differences require further studies.
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| 8. |
- Andrén, Ove, 1963-, et al.
(author)
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MUC-1 gene is associated with prostate cancer death : a 20-year follow-up of a population-based study in Sweden
- 2007
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In: British Journal of Cancer. - London : Harcourt Publishers. - 0007-0920 .- 1532-1827. ; 97:6, s. 730-734
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Journal article (peer-reviewed)abstract
- Anti-adhesion mucins have proven to play an important part in the biology of several types of cancer. Therefore, we test the hypothesis that altered expression of MUC-1 is associated with prostate cancer progression. We retrieved archival tumour tissue from a population-based cohort of 195 men with localised prostate cancer (T1a-b, Nx, M0) that has been followed for up to 20 years with watchful waiting. Semi-automated, quantitative immunohistochemistry was undertaken to evaluate MUC-1 expression. We modelled prostate cancer-specific death as a function of MUC-1 levels accounting for age, Gleason grade and tumour extent, and calculated age-adjusted and multivariate adjusted hazard ratios (HR). Men that had tumours with an MUC-intensity lower or higher than normal tissue had a higher risk of dying in prostate cancer, independent of tumour extent and Gleason score (HR 5.1 and 4.5, respectively). Adjustment for Gleason grade and tumour stage did not alter the results. Men with a Gleason score >=7 and MUC-1 deviating from the normal had a 17 (RR=17.1 95% confidence interval=2.3–128) times higher risk to die in prostate cancer compared with men with Gleason score <7 and normal MUC-1 intensity. In summary, our data show that MUC-1 is an independent prognostic marker for prostate cancer death.
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| 9. |
- Bergh, Anne-Louise, et al.
(author)
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Nurses’ Patient Education Questionnaire : development and validation process
- 2015
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In: Journal of Research in Nursing. - : Sage Publications Ltd.. - 1744-9871 .- 1744-988X. ; 20:3, s. 181-200
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Journal article (peer-reviewed)abstract
- Abstract Conditions for nurses’ daily patient education work are unclear and require clarification. The aim was to develop and validate the Nurses’ Patient Education Questionnaire, a questionnaire that assesses nurses’ perceptions of appropriate conditions for patient education work: what nurses say they actually do and what they think about what they do. The questionnaire was developed from a literature review, resulting in the development of five domains. This was followed by ‘cognitive interviewing’ with 14 nurses and dialogue with 5 pedagogical experts. The five domains were identified as significant for assessing nurses’ beliefs and knowledge; education environment; health care organisation; interdisciplinary cooperation and collegial teamwork; and patient education activities. A content validity index was used for agreement of relevance and consensus of items by nurses (n¼10). The total number of items in the final questionnaire is 60, consisting of demographic items, what nurses report they do and perceptions about patient education in daily work. The questionnaire can be used by managers and nurses to identify possibilities and barriers to patient education in different care contexts.
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| 10. |
- Bergh, Anne-Louise, et al.
(author)
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Registered nurses' perceptions of conditions for patient education - focusing on aspects of competence
- 2014
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In: Scandinavian Journal of Caring Sciences. - : Wiley. - 1471-6712 .- 0283-9318. ; 28:3, s. 523-536
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Journal article (peer-reviewed)abstract
- Background: It is important to clarify nurses' perceptions of conditions for patient education in daily work as research findings are ambiguous. There is a gap between societal regulations on nurses' competence in accomplishment/achievement of patient education and research findings. Aim: The aim was to describe nurses' perceptions of conditions for patient education, focusing on aspects of competence. The aim was also to describe differences in conditions for nurses working in primary, municipal and hospital care. Methods: The study is a cross-sectional survey and is part of a project about nurses' patient-education. A randomized selection of nurses (842) received a questionnaire comprising 47 items concerning factual experience and attitudes to patient education and 13 background items. Questionnaires were returned by 83% of participants. Descriptive statistics, non-parametric tests and content analysis for open-ended items were used. Results: Nurses' perceptions of conditions for patient education differ between health-care settings. Primary care nurses are at an advantage in following research in patient education, perception of their own competence (prioritizing and knowing their mandate in patient teaching), pedagogical education and post graduate specializations. Conclusions: Nurses' patient education must be more visualized and appropriate conditions created at each workplace. In this change process, managers' support is considered vital.
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