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- Juhola, Sirkku, et al.
(författare)
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Adaptation decision-making in the Nordic countries: assessing the potential for joint action
- 2014
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Ingår i: Environment Systems and Decisions. - : Springer Science and Business Media LLC. - 2194-5403 .- 2194-5411. ; 34:4, s. 600-611
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Tidskriftsartikel (refereegranskat)abstract
- In a global context, the outlook for the Nordic region is relatively favourable, given its relatively stronger resiliency to climate change impacts in comparison to many other geo-political regions of the world. Overall, the projected climatic changes include increases in mean temperatures and in precipitation, although regional variations can be significant. The countries’ robust institutions and economies give them a strong capacity to adapt to these changes. Still, the need for adaptation to the changing climate has been and still is substantial, and in most of the region, there has been progress on the issue. This paper explores the potential for Nordic cooperation on adaptation; specifically, for the development of a regional adaptation strategy. In particular, it addresses two questions (1) What is the current state of adaptation in the Nordic countries? and (2) What are the potential benefits and weaknesses of a Nordic strategy for adaptation? In order to answer these two questions, this paper examines reviews the current national adaptation policies of each Nordic country and discusses the challenges facing a Nordic strategy and finally assesses the potential for common Nordic adaptation policy and further cooperation.
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- Schult, A. L., et al.
(författare)
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Detection of cancers and advanced adenomas in asymptomatic participants in colorectal cancer screening: a cross-sectional study
- 2021
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 11:7
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To assess detection rates for colorectal cancer (CRC) and advanced adenomas in asymptomatic CRC screening participants and bowel symptoms in association with CRC and advanced adenoma. DESIGN: Cross-sectional study. SETTING: Two screening centres. PARTICIPANTS: 42 554 men and women, aged 50-74 years, participating in a randomised CRC screening trial. 36 059 participants underwent a sigmoidoscopy (and follow-up colonoscopy if positive sigmoidoscopy) and 6495 underwent a colonoscopy after a positive faecal immunochemical test (FIT). PRIMARY AND SECONDARY OUTCOME MEASURES: Proportion of asymptomatic participants diagnosed with CRC or advanced adenomas. Prevalence of bowel symptoms (rectal bleeding, change in bowel habits, diarrhoea, constipation, bloating, alternating bowel habits, general symptoms, other bowel symptoms) recorded by the endoscopist and their association with CRC and advanced adenomas. RESULTS: Among sigmoidoscopy participants, 7336 (20.3%) reported at least one symptom. 120 (60%) out of 200 individuals with screen-detected CRC and 1301 (76.5%) out of 1700 with advanced adenoma were asymptomatic. Rectal bleeding was associated with detection of CRC and advanced adenoma (OR 4.3, 95%CI 3.1 to 6.1 and 1.8, 95%CI 1.5 to 2.1, respectively), while change in bowel habits only with CRC detection (OR 3.8, 95%CI 2.4 to 6.1). Among the FIT positives, 2173 (33.5%) reported at least one symptom. Out of 299 individuals with screen-detected CRC and 1639 with advanced adenoma, 167 (55.9%) and 1 175 (71.7%) were asymptomatic, respectively. Detection of CRC was associated with rectal bleeding (OR 1.8, 95%CI 1.4 to 2.3), change in bowel habits (OR 2.2, 95%CI 1.4 to 3.5) and abdominal pain (OR 1.8, 95%CI 1.2 to 2.7). CONCLUSIONS: Some bowel symptoms increased the likelihood of being diagnosed with CRC or advanced adenoma. However, the majority of individuals with these findings were asymptomatic. Asymptomatic individuals should be encouraged to participate in CRC screening. TRIAL REGISTRATION NUMBER: Clinicaltrials.gov Identifier: NCT01538550. © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
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