| 1. |
- Hellstadius, Ylva, et al.
(författare)
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A longitudinal assessment of psychological distress after oesophageal cancer surgery
- 2017
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Ingår i: Acta Oncologica. - : Taylor & Francis. - 0284-186X .- 1651-226X. ; 56:5, s. 746-752
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Tidskriftsartikel (refereegranskat)abstract
- Background: Psychological distress is common among patients with oesophageal cancer. However, little is known about the course and predictors of psychological distress among patients treated with curative intent. Therefore, the aim of this study was to explore the prevalence, course and predictors of anxiety and depression in patients operated for oesophageal cancer, from prior to surgery to 12 months post-operatively. Methods: A prospective cohort of patients with oesophageal cancer (n ¼ 218) were recruited from one high-volume specialist oesophago-gastric treatment centre (St Thomas’ Hospital, London, UK). Anxiety and depression were assessed prior to surgery, 6 and 12 months post-operatively. Mixed-effects modelling was performed to investigate changes over time and to estimate the association between clinical and socio-demographic predictor variables and anxiety and depression symptoms. Results: The proportion of patients with anxiety was 33% prior to surgery, 28% at 6 months, and 37% at 12 months. Prior to surgery, 20% reported depression, 27% at 6 months, and 32% at 12-month follow-up. Anxiety symptoms remained stable over time whereas depression symptoms appeared to increase from pre-surgery to 6 months, levelling off between 6 and 12 months. Younger age, female sex, living alone and more severe self-reported dysphagia (i.e., difficulty swallowing) predicted higher anxiety symptoms. In-hospital complications, greater limitations in activity status and more severe selfreported dysphagia were predictive of higher depression. Conclusions: Many patients report psychological distress during the first year following oesophageal cancer surgery. Whether improving the experience of swallowing difficulties may also reduce distress among these patients warrants further study.
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| 2. |
- Lagergren, Jesper, et al.
(författare)
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Marital status, education, and income in relation to the risk of esophaegal and gastric cancer by histological type and site
- 2016
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Ingår i: Cancer. - Stockholm : Wiley. - 0008-543X .- 1097-0142. ; 122:2, s. 207-212
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUNDMarital status, income, and education might influence the risk of esophageal and gastric cancer, but the literature is limited. A large study addressing subtypes of these tumors was used to clarify these associations.METHODSA nationwide, Swedish population–based cohort study from 1991 to 2010 included individuals who were 50 years old or older. Data on exposures, covariates, and outcomes were obtained from well-maintained registers. Four esophagogastric tumor subtypes were analyzed in combination and separately: esophageal adenocarcinoma, esophageal squamous cell carcinoma, cardia adenocarcinoma, and noncardia gastric adenocarcinoma. Poisson regression was used to estimate incidence rate ratios (IRRs) and 95% confidence intervals (CIs). Analyses were stratified by sex and adjusted for confounders.RESULTSAmong 4,734,227 participants (60,634,007 person-years), 24,095 developed esophageal or gastric cancer. In comparison with individuals in a long marriage, increased IRRs were found among participants who were in a shorter marriage or were never married, remarried, divorced, or widowed. These associations were indicated for each tumor subtype but were generally stronger for esophageal squamous cell carcinoma. Higher education and income were associated with decreased IRRs in a seemingly dose-response manner and similarly for each subtype. In comparison with the completion of only primary school, higher tertiary education rendered an IRR of 0.64 (95% CI, 0.60-0.69) for men and an IRR of 0.68 (95% CI, 0.61-0.75) for women. Comparing participants in the highest and lowest income brackets (highest 20% vs lowest 20%) revealed an IRR of 0.74 (95% CI, 0.70-0.79) for men and an IRR of 0.83 (95% CI, 0.76-0.91) for women.CONCLUSIONSDivorce, widowhood, living alone, low educational attainment, and low income increase the risk of each subtype of esophageal and gastric cancer. These associations require attention when high-risk individuals are being identified.
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| 3. |
- Lagergren, Lars, et al.
(författare)
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Integration i förening : kritiska reflektioner kring ett projekt
- 2009
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Ingår i: Educare. - : Malmö högskola, Lärarutbildningen. - 1653-1868 .- 2004-5190. ; :1, s. 43-59
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Tidskriftsartikel (refereegranskat)abstract
- This article discusses integration as a process rather than as a result or as a system of distribution, and takes its cue from Lave & Wenger’s concepts of “situated learning” and “legitimate peripheral participation”. By using integration as a process related concept the article analyzes both the intentions of an integration project as well as its consequences. The intention of the project was to simplify the integration of new members of the Swedish society by funnelling them into existing associations and clubs of their own choice in order to open up the considerable amount of social net works connections to these associations and clubs through their members. By becoming members of Swedish associations and clubs newcomers would also become aware of the importance of representation in Swedish society. The authors too see this result as an important step in the process of integration from a legitimate peripheral position towards the ever changing centre, e.g. integration as a result of various situated learning.
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| 4. |
- Andersson, Tina, et al.
(författare)
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Utvärdering av projektet Senior Sports School : hösten 2009
- 2010
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Det insamlade materialet ger ett entydigt resultat. En sällan skådad samstämmighet i omdömena råder, vilka också styrkts vid observationer under projektets gång. Samstämmigheten gäller även mellan projektets olika aktörer, ledare, deltagare och förenings-/företagsrepresentanter, var och en utifrån sitt perspektiv. Projektet Senior Sport School har haft ett dubbelt syfte, nämligen att: Tillsammans med Region Skåne, idrottsföreningar och Hushållningssällskapet vill Hässleholms kommun, Simrishamns kommun och Skåneidrotten genom Senior Sport School informera och inspirera äldre om möjligheterna till en aktiv roll inom idrotten såväl som (1) aktiv som (2) ledare. Projektet kan beskrivas i termer av succé – deltagarna har verkligen uppskattat kursen. Det talas genomgående om gemenskap, nya vänner, roligt att pröva på, komma igång, vara aktiv, etc. Denna sida kan sägas motsvara att vara aktiv i meningen aktivitet för deltagarens eget välbefinnande. Om projektets främsta mål däremot hade varit att rekrytera ledare till idrotten blir bilden en helt annan. Detta mål förblev på sin höjd halvt uttalad kursen igenom och resultatet kan i skrivande stund inte annat än beskrivas som ytterst magert. Tilläggas bör att om projektet anlagt ett uttalat fokus på att rekrytera ledare hade sannolikt gruppen intresserade minskat avsevärt. Poängteras bör att deltagarna i stor utsträckning uppfattar sig som ”redan frälsta” när det gäller att leva ett aktivt liv, dvs. projektet har inte nått nya grupper av seniora medborgare vilka är ovana vid aktivitet och idrott. De föreningar som besvarat enkäten säger att kontakten med projektledarna fungerat bra, men att de, med något undantag, inte såg att projektet skulle innebär en medlemsökning för den egna föreningen.
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| 6. |
- Ljung, Rickard, et al.
(författare)
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Socio-Demographic and Geographical Factors in Esophageal and Gastric Cancer Mortality in Sweden
- 2013
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 8:4, s. e62067-
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundSocio-demographic factors and area of residence might influence the development of esophageal and gastric cancer. Large-scale population-based research can determine the role of such factors.MethodsThis population-based cohort study included all Swedish residents aged 30–84 years in 1990–2007. Educational level, marital status, place of birth, and place of residence were evaluated with regard to mortality from esophageal or gastric cancer. Cox regression yielded hazard ratios (HR) with 95% confidence intervals (CI), adjusted for potential confounding.ResultsAmong 84 920 565 person-years, 5125 and 12 230 deaths occurred from esophageal cancer and gastric cancer, respectively. Higher educational level decreased the HR of esophageal cancer (HR = 0.61, 95%CI 0.42–0.90 in women, HR = 0.71, 95%CI 0.60–0.84 in men) and gastric cancer (HR = 0.80, 95%CI 0.63–1.03 in women, HR = 0.73, 95%CI 0.64–0.83 in men). Being unmarried increased HR of esophageal cancer (HR = 1.64, 95%CI 1.35–1.99 in women, HR = 1.64, 95%CI 1.50–1.80 in men), but not of gastric cancer. Being born in low density populated areas increased HR of gastric cancer (HR = 1.23, 95%CI 1.10–1.38 in women, HR = 1.37, 95%CI 1.25–1.50 in men), while no strong association was found with esophageal cancer. Living in densely populated areas increased HR of esophageal cancer (HR = 1.31, 95%CI 1.14–1.50 in women, HR = 1.40, 95%CI 1.29–1.51 in men), but not of gastric cancer.ConclusionThese socio-demographic inequalities in cancer mortality warrant efforts to investigate possible preventable mechanisms and to promote and support healthier lifestyles among deprived groups.
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