| 31231. |
- Gjengset, Gunnar, 1946-
(author)
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Citizens and Nomads : The Literary Works of Matti Aikio with Emphasis on Bygden på elvenesset
- 2010
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In: Journal of Northern Studies. - Umeå : Umeå University & The Royal Skyttean Society. - 1654-5915. ; :1, s. 45-65
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Journal article (peer-reviewed)abstract
- The Sami author Matti Aikio from Karasjok made his debut in 1904 in Copenhagen with King Ahab. He was one of the world’s earliest indigenous authors, and presented his first novel to the Norwegian public with In Hide in 1906. The last of a total of six novels was The Parish on the Riverbank, launched posthumously in 1929. In this article I present a post-colonial reading of this last novel of his. My hypothesis is that he wrote his first Norwegian novel anew, but this time social success amongst the Sami population is dependent upon the conduct of Sami culture. All of his novels reflect upon different strategies at hand for members of an ethnic minority in times of an advancing European industry, economy and culture, heavily influenced by a social-Darwinist political and anthropological cosmology. Being the first registered Sami student of Norway, while writing his novels in Norwegian, Matti Aikio developed skills as a master of mimicry. Having experienced the importance of hybridity, he studies the limits of mimicry in his novels. This is the main project of his literary work, and with tools from post-colonial literary theories, this essay discusses the author’s attitudes to the possibilities of his own ethnic culture’s survival in the future.
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| 31232. |
- Gjertsen, Hege, et al.
(author)
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Work Inclusion for People with Intellectual Disabilities in Three Nordic Countries : The Current Policy and Challenges
- 2021
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In: Scandinavian Journal of Disability Research. - : Stockholm University Press. - 1501-7419 .- 1745-3011. ; 23:1, s. 360-370
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Journal article (peer-reviewed)abstract
- This article illuminates the work inclusion policies and strategies and the situation today when it comes to including people with intellectual disabilities in workplaces in Iceland, Norway, and Sweden. The article draws on official documents, previous research, and statistics. We discuss challenges regarding the current situation in the light of the United Nations Convention on the Rights of Persons with Disabilities (CRPD) and a social relational understanding of disability. The discrepancy between the current situation when it comes to work inclusion for people with intellectual disabilities in these three Nordic countries, and the perspective of human rights and work inclusion are of special interest as these have increasingly provided the framework for policies in relation to the participation of people with disabilities in the labour market. Approaches in Nordic labour market policies and practices must change to protect and promote the rights of people with intellectual disabilities at work.
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| 31233. |
- Gjesdal, Siv, et al.
(author)
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A study of coach-team perceptual distance concerning the coach-created motivational climate in youth sport
- 2019
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In: Scandinavian Journal of Medicine and Science in Sports. - : John Wiley & Sons. - 0905-7188 .- 1600-0838. ; 29:1, s. 132-143
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Journal article (peer-reviewed)abstract
- The purpose of this study was to examine whether coach-team perceptual distance regarding the coach-created motivational climate related to achievement goal orientations and affective responses. To this end, we used polynomial regression analysis with response surface methodology. The sample consisted of 1359 youth soccer players (57.8% male; M-age = 11.81 years, SD = 1.18), belonging to 87 different teams (M-size = 16.47), and 87 coaches (94.6% male, M-age = 42 years, SD = 5.67). Results showed that team perceptions of a coach-created mastery climate were positively related to team-rated task goal orientation and enjoyment, whereas team perceptions of a coach-created performance climate were positively related to team-rated ego goal orientation and anxiety, and negatively related to team-rated enjoyment. When the coach and the team were in perceptual agreement, the outcomes increased as both coach and team perceptions of the climate increased. In situations of perceptual disagreement, the most negative effects were seen when the coach held a more favorable perception of the motivational climate compared to the team. The findings highlight the importance of perceptual agreement between the coach and his/her team, contributing to the literature focusing on the effects of the coach-created motivational climate.
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| 31234. |
- Gkekas, Ioannis, 1981-, et al.
(author)
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Colon cancer patients with mismatch repair deficiency are more likely to present as acute surgical cases
- 2021
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In: European Journal of Cancer. - : Elsevier. - 0959-8049 .- 1879-0852. ; 157, s. 1-9
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Journal article (peer-reviewed)abstract
- Background: The effect of the genetic imprint on the emergency presentation of colon cancer remains unclear. The disparity between tumours evolving along different carcinogenetic pathways has not been studied systematically. This retrospective multicenter cohort study evaluates the association between mismatch repair status and the risk for acute surgery of colon cancer.Patients and methods: A retrospective multicenter cohort study including in total 870 patients from three different countries. Scandinavian cohort (Finland and Sweden), including a total of 412 patients operated between January 1, 1995 and December 31, 2010, was validated against a cohort from the Czech Republic, including a total of 458 patients, operated between January 1, 2018 and December 31, 2019. The proficiency or deficiency of mismatch repair was determined by immunohistochemistry. Primary outcome was the risk for acute colon cancer surgery given as the Odds Ratio (OR) in the univariable and multivariable analyses. Acute colon cancer surgery was defined as surgery performed during the same hospital admission as when the diagnosis of colon cancer was made.Results: Of the 870 patients (399 females [46%]) included in the analyses, median age at surgery was 69 [interquartile range, 61–76] years, deficient Mismatch Repair (dMMR) status was found in 190 patients (22%), and 179 patients (21%) underwent acute surgery during the same hospital admission as when the diagnosis of colon cancer was made. In the Scandinavian cohort, a significant association between dMMR status and acute surgery was seen in both the univariable (OR 1.82, 95% CI 1.11–3.02, P = 0.017) and the multivariable (OR = 2.21, 95% CI 1.28–3.95, P = 0.005) analyses. This was confirmed in the Czech validation cohort in both the univariable (OR = 1.94, 95% CI 1.09–3.26, P = 0.022) and the multivariable (OR = 1.77, 95% CI 1.15–3.18, P = 0.021) analyses.Conclusion: This multicenter study reveals a strong association between acute colon cancer surgery and dMMR tumour status.
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| 31235. |
- Gkekas, Ioannis, et al.
(author)
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Deficient mismatch repair as a prognostic marker in stage II colon cancer patients
- 2019
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In: European Journal of Surgical Oncology. - : Elsevier. - 0748-7983 .- 1532-2157. ; 45:10, s. 1854-1861
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Journal article (peer-reviewed)abstract
- BACKGROUND: A number of reports have evaluated the relationship between deficient DNA mismatch repair (dMMR) and colorectal cancer prognosis. Unfortunately, the exact prognostic role of dMMR has not been clearly established due to contradictory results. This study aims to determine the prognostic impact of dMRR in stage II colon cancer patients only. The appropriate identification of high-risk stage II colon cancers is of paramount importance in the selection of patients who may benefit from adjuvant treatment after surgery.METHODS: Four hundred and fifty-two patients with curative resection of stage II colon cancer were included. Hospital records were used as data source, providing clinical, surgical, pathology, oncology and follow-up information for statistical analysis focusing on overall survival (OS) and time to progression (TTP). Mismatch repair status was determined by immunohistochemistry. Patient survival was followed-up for a mean of 77·35 months.RESULTS: dMMR was detected in 93 of 452 patients (20·6%). No impact on overall survival (Log-Rank, p = 0·583, 95% CI 0·76-1·67). However, the hazard ratio 0·50 for TTP was highly significant (Log-Rank, p = 0·012, 95% CI 0·28-0·87) in patients with dMMR compared with those with mismatch repair proficient tumours (pMMR).CONCLUSIONS: Patients with dMMR tumours have a lower risk for recurrence compared to those with pMMR tumours, but this finding did not correlate to better overall survival.
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| 31236. |
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| 31237. |
- Gkekas, Ioannis, et al.
(author)
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Microsatellite instability as a prognostic factor in stage II colon cancer patients : a meta-analysis of published literature
- 2017
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In: Anticancer Research. - : Anticancer Research USA Inc.. - 0250-7005 .- 1791-7530. ; 37:12, s. 6563-6574
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Research review (peer-reviewed)abstract
- BACKGROUND/AIM: The prognostic role of microsatellite instability (MSI) in stage II colon cancer patients remains controversial despite the fact that it has been investigated in a number of studies. Hazard ratios differ considerably among these studies. We performed a meta-analysis to define the significance of MSI in this group of patients.MATERIALS AND METHODS: Studies indexed in PubMed presenting separate data on MSI status and survival outcomes for stage II colon cancer patients have been analyzed using fixed-effect meta-analysis of hazard ratio (HR) according to the method of Peto.RESULTS: Analysis was performed on 19 studies including 5,998 patients. A 47.3% of patients received postoperative chemotherapy and included 52.8% males and 47.2% females. Eight studies included some rectal cancer patients although this cohort was not clearly defined in 3 of these. MSI observed in 20.8% (mean) of patients (median 19.9%). HR for overall survival (OS) of MSI vs. microsatellite stable (MSS) tumors for the entire population: 0.73 (95% confidence interval (CI)=0.33-1.65); HR for disease-free survival (DFS):0.60 (95%CI=0.27-1.32). No statistical significant difference was found when studies analyzing MSI with genotyping (MG) and immunohistochemistry (IHC) were compared separately (MG vs. IHC: HR OS 0.45, 95%CI=0.10-2.05 vs. 0.95, 95%CI=0.57-1.58; HR DFS 0.51, 95%CI=0.14-1.85 vs. 0.67, 95%CI=0.26-1.70). However, numerically MSI determination with genotyping shows significantly lower hazard ratios for both DFS and OS. Separate analysis of studies describing colon cancer patients only showed HR OS 0.72 (95%CI=0.31-1.71); HR DFS 0.60 (95%CI=0.27-1.31).CONCLUSION: No significant relation was found between MSI status and OS or DFS. Routine determination of MSI status to guide postoperative management of stage II colon cancer patients cannot be recommended. New large scale high quality studies are needed to answer this question definitively, since currently analyzed studies vary considerably.
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| 31238. |
- Gkekas, Ioannis, et al.
(author)
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Mismatch repair status predicts survival after adjuvant treatment in stage II colon cancer patients.
- 2020
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In: Journal of Surgical Oncology. - : John Wiley & Sons. - 0022-4790 .- 1096-9098. ; 121:2, s. 392-401
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Journal article (peer-reviewed)abstract
- BACKGROUND AND OBJECTIVES: Stage II colon cancer is primarily a surgical disease. Only a still not well-defined subset of patients may benefit from postoperative adjuvant chemotherapy. The relationship between adjuvant chemotherapy and survival after relapse is furthermore still not definitely explored in this group of patients. A number of reports suggest some association between defective mismatch repair (dMMR) and colorectal cancer stage II prognosis, but due to contradictory results from existing studies, the exact predictive role is still not fully understood.METHODS: Retrospective multicenter study including 451 stage II colon cancer patients. The proficiency or deficiency of mismatch repair was tested using immunohistochemistry and analyzed in relationship to two survival outcomes: overall survival (OS) and postrelapse survival.RESULTS: Patients with dMMR (20.4%) derived no OS benefit from adjuvant chemotherapy (hazard ratio [HR], 1.05; 95% confidence interval [CI], 0.47-2.38; P = .897). Patients with proficient mismatch repair (pMMR) tumors receiving adjuvant chemotherapy had the significantly better OS in comparison to those not receiving chemotherapy (HR, 0.54; 95% CI, 0.35-0.82; P = .004). This relationship remained significant in multivariable analysis (HR, 0.42; 95% CI, 0.22-0.78; P = .007). Patients with pMMR relapsing after adjuvant treatment lived significantly longer than those relapsing without previous adjuvant treatment (HR, 0.55; 95% CI, 0.32-0.96; P = .033) and this result remained significant in the multivariable model (HR, 0.49; 95% CI, 0.26-0.93; P = .030).CONCLUSION: In stage II CC patients, adjuvant chemotherapy improves therapeutic outcomes only in patients with pMMR tumors. Survival after relapse in patients having received adjuvant chemotherapy is significantly longer for patients with pMMR. No survival benefit from adjuvant chemotherapy was seen among patients with dMMR tumors.
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| 31239. |
- Gkekas, Ioannis, 1981-, et al.
(author)
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Sporadic deficient mismatch repair in colorectal cancer increases the risk for non-colorectal malignancy : a European multicenter cohort study
- 2024
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In: Journal of Surgical Oncology. - : John Wiley & Sons. - 0022-4790 .- 1096-9098.
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Journal article (peer-reviewed)abstract
- Background and Objectives: Disparities between tumors arising via different sporadic carcinogenetic pathways have not been studied systematically. This retrospective multicenter cohort study evaluated the differences in the risk for non-colorectal malignancy between sporadic colorectal cancer (CRC) patients from different DNA mismatch repair status.Methods: A retrospective European multicenter cohort study including in total of 1706 CRC patients treated between 1996 and 2019 in three different countries. The proficiency (pMMR) or deficiency (dMMR) of mismatch repair was determined by immunohistochemistry. Cases were analyzed for tumor BRAFV600E mutation, and BRAF mutated tumors were further analyzed for hypermethylation status in the promoter region of MLH1 to distinguish between sporadic and hereditary cases. Swedish and Finish patients were matched with their respective National Cancer Registries. For the Czech cohort, thorough scrutiny of medical files was performed to identify any non-colorectal malignancy within 20 years before or after the diagnosis of CRC. Poisson regression analysis was performed to identify the incidence rates of non-colorectal malignancies. For validation purposes, standardized incidence ratios were calculated for the Swedish cases adjusted for age, year, and sex.Results: Of the 1706 CRC patients included in the analysis, 819 were female [48%], median age at surgery was 67 years [interquartile range: 60–75], and sporadic dMMR was found in 188 patients (11%). Patients with sporadic dMMR CRC had a higher incidence rate ratio (IRR) for non-colorectal malignancy before and after diagnosis compared to patients with a pMMR tumor, in both uni- (IRR = 2.49, 95% confidence interval [CI] = 1.89–3.31, p = 0.003) and multivariable analysis (IRR = 2.24, 95% CI = 1.67–3.01, p = 0.004). This association applied whether or not the non-colorectal tumor developed before or after the diagnosis of CRC in both uni- (IRR = 1.91, 95% CI = 1.28–2.98, p = 0.004), (IRR = 2.45, 95% CI = 1.72–3.49, p = 0.004) and multivariable analysis (IRR = 1.67,95% CI = 1.05–2.65, p = 0.029), (IRR = 2.35, 95% CI = 1.63–3.42, p = 0.005), respectively.Conclusion: In this retrospective European multicenter cohort study, patients with sporadic dMMR CRC had a higher risk for non-colorectal malignancy than those with pMMR CRC. These findings indicate the need for further studies to establish the need for and design of surveillance strategies for patients with dMMR CRC.
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| 31240. |
- Glader, A, et al.
(author)
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Byggnadsrelaterad ohälsa : Kompetensutveckling inom hälsovården
- 2014
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Reports (peer-reviewed)abstract
- Det finns ett stort behov av utbildning om inomhusmiljö och byggnadsrelaterad ohälsa, både inom ramen för grundläggande yrkesutbildningar och som fortbildningskurser för yrkesverksamma. Hälsoproblem som beror på dålig inomhusluft på arbetsplatsen utreds av företagshälsovården. Dock har de som jobbar inom företagshälsovård idag inte alltid tillräcklig kunskap om inomhusmiljö och byggnadsrelaterad ohälsa och saknar ofta beredskap att som sakkunniga delta i utredningar på arbetsplatser. För att förbättra vården bör personalen utbildas om bl.a. riskfaktorer för dålig inomhusluft, vanliga hälsobesvär och inverkan på arbetsförmåga och produktivitet, de psykosociala faktorernas betydelse samt ansvarsfrågor och hälsoekonomiska konsekvenser. Öppna digitala lärresurser (OER) och kurser på nätet (MOOCs) kan med fördel användas vid fortbildning av vårdpersonal. Nätbaserad utbildning underlättar för vårdpersonalen att själv kunna välja tidpunkt och målsättning. Därtill utgör OER även ett hjälpmedel för att utveckla kunskapsöverföringen mellan Sverige och Finland.
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