| 1. |
- Bilén, Anna-Karin, et al.
(författare)
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Miljökvalitetsmålen 2017 : Årlig uppföljning av miljömålen i Blekinge
- 2017
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Trots miljöarbetet varit framgångsrikt inom många områden är nuvarande styrmedel och åtgärder inte tillräckliga. Inte något av de miljömål som bedöms på regional nivå kommer att uppnås till år 2020. För Frisk luft är utvecklingen i miljön positiv. För övriga mål bedöms utvecklingen vara neutral eller negativ. Minskad biologisk mångfald påverkar tillsammans med klimatförändringar, övergödning och miljögifter många av de ekosystemtjänster som vi är beroende av för mänsklig välfärd och en hållbar samhällsutveckling. Obalans mellan den tätbefolkade kusten och den glesbyggda landsbygden är en utmaning i länet. Byggandet vid kusten ställer krav på en hänsynsfull bebyggelseutveckling som tydligt beaktar miljökvalitetsmålen. De mål som rör biologisk mångfald och bevarande av kulturmiljö följer en neutral eller negativ trend. I odlingslandskapet leder färre lantbrukare och brist på betesdjur till igenväxning av hagmarker. Livsmiljöer försvinner och arter får det svårare att överleva. Lagring av flisvirke sommartid utgör ett hot, främst mot insekter. För att god ekologisk status ska uppnås i vattendragen behövs ny vattenlagstiftning och mer resurser för tillsyn. I Blekinges kustvatten är övergödning ett stort miljöproblem och det krävs kraftfulla åtgärder för att minska näringsläckaget. Arbetet med vattenförsörjningsplaner behöver fortsätta för att trygga framtida dricksvattenförsörjning. De senaste årens fynd av PFAS i dricksvatten visar på vikten av att skydda vattentäkter, genomföra riskbedömningar och undersöka förekomst av föroreningar. Internationella överenskommelser om kemikalier och minskade utsläpp till luft och vatten är nödvändigt för att uppnå uppsatta mål. Dessutom behövs en omställning till ett samhälle som baseras på förnybar energi. För att skapa en hållbar framtid måste vi förändra vår livsstil och vår attityd till konsumtion. Åtgärder såsom kommunala insatser för en giftfri förskola och att ställa miljökrav vid upphandling är steg i rätt riktning. Det pågår alltså insatser som förbättrar tillståndet i miljön, men det går för långsamt. Det krävs mer resurser och modiga politiska beslut för att möjliggöra en hållbar framtid, den framtid som vi är skyldiga våra barn!
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| 2. |
- Karlsson, Anna, et al.
(författare)
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The effect of tinzaparin on biomarkers in FIGO stages III-IV ovarian cancer patients undergoing neoadjuvant chemotherapy - the TABANETOC trial : study protocol for a randomized clinical multicenter trial
- 2024
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Ingår i: Acta Oncologica. - : Medical Journals Sweden. - 0284-186X .- 1651-226X. ; 63, s. 581-585
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Tidskriftsartikel (refereegranskat)abstract
- Background: Tinzaparin, a low-molecular weight heparin (LMWH), has shown anti-neoplastic properties in animal models and in in vitro studies of human cancer cell lines. The reduction of CA-125 levels during neoadjuvant chemotherapy (NACT) in patients with epithelial ovarian cancer (EOC) co-varies with the prognosis; the larger the decrease in CA-125, the better the prognosis.Purpose: This study aims to evaluate the potential anti-neoplastic effects of tinzaparin by investigating changes in serum CA-125 levels in advanced EOC patients who receive NACT.Material and methods: This is an open randomized multicenter pilot trial. Forty patients with EOC selected to receive NACT will be randomized 1:1 to receive daily addition of tinzaparin or no tinzaparin. The processing and treatment of the patients will otherwise follow the recommendations in the Swedish National Guidelines for Ovarian Cancer. Before every cycle of chemotherapy, preoperatively, and 3 weeks after the last cycle of chemotherapy, a panel of biomarkers, including CA-125, will be measured.Patients: Inclusion criteria are women aged 18 years or older, World Health Organization performance status 0–1, histologically confirmed high-grade serous, endometrioid or clear cell EOC, International Federation of Gynecology and Obstetrics (FIGO) stages III-IV. In addition, a CA-125 level of ≥ 250 kIE/L at diagnosis. Exclusion criteria are contraindications to LMWH, ongoing or recent treatment with unfractionated heparin, LMWH, warfarin or non-vitamin K antagonist oral anticoagulants.Interpretation: This study will make an important contribution to the knowledge of the anti-neoplastic effects of tinzaparin in EOC patients and may thus guide the planning of a future study on the impact of tinzaparin on survival in EOC.
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| 3. |
- Karlsson, Anna, 1985-, et al.
(författare)
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The effect of tinzaparin on biomarkers in FIGO stages III-IV ovarian cancer patients undergoing neoadjuvant chemotherapy – the TABANETOC trial: study protocol for a randomized clinical multicenter trial
- 2024
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Ingår i: Acta Oncologica. - Uppsala : Medical Journals Sweden. - 0284-186X .- 1651-226X. ; 63, s. 581-585
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Tinzaparin, a low-molecular weight heparin (LMWH), has shown anti-neoplastic properties in animal models and in in vitro studies of human cancer cell lines. The reduction of CA-125 levels during neoadjuvant chemotherapy (NACT) in patients with epithelial ovarian cancer (EOC) co-varies with the prognosis; the larger the decrease in CA-125, the better the prognosis.Purpose: This study aims to evaluate the potential anti-neoplastic effects of tinzaparin by investigating changes in serum CA-125 levels in advanced EOC patients who receive NACT.Material and methods: This is an open randomized multicenter pilot trial. Forty patients with EOC selected to receive NACT will be randomized 1:1 to receive daily addition of tinzaparin or no tinzaparin. The processing and treatment of the patients will otherwise follow the recommendations in the Swedish National Guidelines for Ovarian Cancer. Before every cycle of chemotherapy, preoperatively, and 3 weeks after the last cycle of chemotherapy, a panel of biomarkers, including CA-125, will be measured.Patients: Inclusion criteria are women aged 18 years or older, World Health Organization performance status 0–1, histologically confirmed high-grade serous, endometrioid or clear cell EOC, International Federation of Gynecology and Obstetrics (FIGO) stages III-IV. In addition, a CA-125 level of ≥ 250 kIE/L at diagnosis. Exclusion criteria are contraindications to LMWH, ongoing or recent treatment with unfractionated heparin, LMWH, warfarin or non-vitamin K antagonist oral anticoagulants.Interpretation: This study will make an important contribution to the knowledge of the anti-neoplastic effects of tinzaparin in EOC patients and may thus guide the planning of a future study on the impact of tinzaparin on survival in EOC.
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| 4. |
- Strid, Anna, et al.
(författare)
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Adherence to the Swedish Dietary Guidelines and the Impact on Mortality and Climate in a Population-Based Cohort Study
- 2022
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Ingår i: Current Developments in Nutrition. - : Elsevier BV. - 2475-2991. ; 6:Suppl 1, s. 950-950
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Objectives To assess 1) the association between adherence to the Swedish dietary guidelines and all-cause mortality, and 2) the difference in greenhouse gas emissions (GHGE) from diets of participants with higher and lower adherence to the Swedish dietary guidelines. Methods Dietary data from the Swedish population-based cohort Västerbotten Intervention Programme (49,124 women and 47,651 men, 35–65 years at baseline), collected between the years 1990–2016, were used. Diet quality was assessed by the Swedish Healthy Eating Index for Adults 2015 (SHEIA15). SHEIA15 is based on the Swedish dietary guidelines from 2015, and includes assessments of intakes of vegetables and fruits, seafood, whole grains, fiber, monounsaturated fatty acids, polyunsaturated fatty acids, saturated fatty acids, red and processed meat and added sugar. GHGE of diets were estimated from life cycle assessment data, including CO2e from primary production to industry gate. Information on all-cause mortality was acquired from registers at the National Board of Health and Welfare in Sweden using personal identification numbers. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox proportional hazards regression, comparing the lowest and highest quintile of SHEIA15 score. Potential confounders were adjusted for. Difference in GHGE of diets was compared between the lowest and highest quintile of SHEIA15 score, using the Mann Whitney U test. Results Median follow-up times were for women 16.0 years and for men 14.7 years, during which time 3074 women and 4212 men died. For women the highest SHEIA15 score was associated with lower mortality compared with the lowest score (HR: 0.87; 95% CI: 0.77, 0.98; P = 0.027). No statistically significant difference in HR of mortality was found for the men with the highest SHEIA15 score compared with the lowest score (HR: 0.91; 95% CI: 0.82, 1.01; P = 0.083). The participants with the highest score of SHEIA15 had lower dietary GHGE compared to those with the lowest score in both women and men (P < 0.001). Conclusions Higher adherence to the Swedish dietary guidelines, estimated by SHEIA15, was associated with lower all-cause mortality for women, but not for men, and indicated lower GHGE from diets for both women and men. Funding Sources The Swedish Research Council for Environment, Agricultural Sciences and Spatial Planning (Formas).
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| 5. |
- Strid, Anna, et al.
(författare)
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Adherence to the Swedish dietary guidelines and the impact on mortality and climate in a population-based cohort study
- 2023
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Ingår i: Public Health Nutrition. - : Cambridge University Press. - 1368-9800 .- 1475-2727. ; 26, s. 2333-
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To assess the associations between adherence to the Swedish dietary guidelines and all-cause mortality and thus assessing the index' ability to predict health outcomes, as well as levels of dietary greenhouse gas emissions (GHGEs). Design: A longitudinal study 1990-2016 within the population-based cohort Västerbotten Intervention Programme. Dietary data were based on food frequency questionnaires. Diet quality was assessed by the Swedish Healthy Eating Index for Adults 2015 (SHEIA15), based on the 2015 Swedish dietary guidelines. Dietary GHGEs were estimated from life cycle assessment data including emissions from farm to industry gate. Hazard ratios (HRs) and 95% confidence intervals (CIs) of all-cause mortality were evaluated with Cox proportional hazards regression, and differences in median GHGEs were tested using the Kruskal-Wallis one-way ANOVA test, between quintiles of SHEIA15 score. Setting: Northern Sweden. Participants: In total, 49,124 women and 47,651 men, aged 35-65 years. Results: Median follow-up times were 16.0 years for women and 14.7 years for men, during which time 3074 women and 4212 men died. A consistent trend of lower all-cause mortality HRs for both sexes with higher SHEIA15 scores was demonstrated. For women, the all-cause mortality HR was 0.81 [(95% CI 0.71-0.92); p=0.001] and for men 0.90 [(95% CI 0.81-0.996); p=0.041] between the quintile with the highest SHEIA15 score compared with the quintile with the lowest SHEIA15 score. A consistent trend of lower estimated dietary GHGEs among both sexes with higher SHEIA15 scores was also found. Conclusions: Adherence to Swedish dietary guidelines, estimated by SHEIA15, seems to promote longevity and reduce dietary climate impact. © The Authors 2023.
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| 6. |
- Strid, Anna, et al.
(författare)
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Adherence to the Swedish dietary guidelines and the impact on mortality and climate in a population-based cohort study
- 2023
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Ingår i: Public Health Nutrition. - 1368-9800.
-
Tidskriftsartikel (refereegranskat)abstract
- Objective:To assess the associations between adherence to the Swedish dietary guidelines and all-cause mortality (i.e. assessing the index' ability to predict health outcomes), as well as levels of dietary greenhouse gas emissions (GHGEs). Design:A longitudinal study 1990-2016 within the population-based cohort Vasterbotten Intervention Programme. Dietary data were based on FFQs. Diet quality was assessed by the Swedish Healthy Eating Index for Adults 2015 (SHEIA15), based on the 2015 Swedish dietary guidelines. Dietary GHGEs were estimated from life cycle assessment data including emissions from farm to industry gate. Hazard ratios (HR) and 95 % CI of all-cause mortality were evaluated with Cox proportional hazards regression, and differences in median GHGEs were tested between quintiles of SHEIA15 score using the Kruskal-Wallis one-way ANOVA test. Setting:Northern Sweden. Participants:In total, 49 124 women and 47 651 men, aged 35-65 years. Results:Median follow-up times were 16 & BULL;0 years for women and 14 & BULL;7 years for men, during which time 3074 women and 4212 men died. A consistent trend of lower all-cause mortality HR for both sexes with higher SHEIA15 scores was demonstrated. For women, the all-cause mortality HR was 0 & BULL;81 ((95 % CI 0 & BULL;71, 0 & BULL;92); P = 0 & BULL;001) and for men 0 & BULL;90 ((95 % CI 0 & BULL;81, 0 & BULL;996); P = 0 & BULL;041) between the quintile with the highest SHEIA15 score compared with the quintile with the lowest SHEIA15 score. A consistent trend of lower estimated dietary GHGEs among both sexes with higher SHEIA15 scores was also found. Conclusions:Adherence to Swedish dietary guidelines, estimated by SHEIA15, seems to promote longevity and reduce dietary climate impact.
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| 7. |
- Bengtsson, Anna, 1973-, et al.
(författare)
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The beneficial effect over 3 years by pictorial information to patients and their physician about subclinical atherosclerosis and cardiovascular risk : results from the VIPVIZA randomized clinical trial
- 2021
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Ingår i: American Journal of Preventive Cardiology. - : Elsevier. - 2666-6677. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Non-adherence to guidelines and preventive measures is a major challenge, particularly so to ob- tain long-term adherence to lifestyle changes and recommended medication. The objective was to investigate if pictorial information regarding subclinical carotid atherosclerosis provided to individuals and physicians gave sustained effects on cardiovascular risk beyond the previously reported effect after 1 year and up to 3 years. Methods: A Prospective Randomized Open Blinded End-point (PROBE) trial. Within a CVD prevention program in Västerbotten County, Sweden, 3532 healthy individuals aged 40, 50 or 60 years were enrolled and 1:1 ran- domized to intervention ( n = 1749; pictorial information with additional prevention materials to participants and physicians) or control group ( n = 1783; no pictorial information to participants and physicians). Preventive measures were managed within primary care. Participants were investigated at baseline during 2013–2016 and at follow-up after 1 and 3 years. Results: A beneficial effect on cardiovascular risk was observed at 3-year follow-up; Framingham Risk Score (FRS) was 13.38 for the intervention group and 14.08 for the control group ( p = 0.047) and SCORE was 1.69 vs. 1.82 ( p = 0.022). The effect observed at 1-year was sustained over 3 years after adjustment for sex and education and more pronounced among participants with a severe atherosclerotic picture at baseline.Conclusions: This study provides evidence of sustained beneficial effects on the adherence to prevention guidelines over 3 years of pictorial information about subclinical carotid atherosclerosis, resulting in lower cardiovascular risk regardless of sex and educational level. Direct visualization of the underlying still subclinical atherosclerotic disease, rather than just indirect information about risk factors and statistical risk of future myocardial infarction, stroke and death, is one way to tackle the problem of non-adherence to prevention of cardiovascular diseases.
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| 8. |
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| 9. |
- Bilén, Anna-Karin, et al.
(författare)
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Miljökvalitetsmålen 2016 : Årlig uppföljning av miljökvalitetsmålen
- 2016
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- I Blekinge bedöms inte något miljökvalitetsmål vara möjligt att nå till år 2020. För att kunna lämna över ett hållbart samhälle till nästa generation krävs förebyggande arbete, ef?????????????????r. Ambitionerna måste öka och miljöfrågorna prioriteras högre på den politiska agendan.De mål som rör biologisk mångfald och bevarande av kulturmiljö följer enneutral eller negativ trend. I odlingslandskapet leder färre lantbrukare ochbrist på betesdjur till igenväxning av hagmarker. Livsmiljöer försvinner och????????????????????????????????????????,främst möte insekter.För att god ekologisk status ska uppnås i vattendragen behövs ny vattenlagstiftning och mer resurser för tillsyn. I Blekinges kustvatten är övergödning ett stort miljöproblem och det krävs kraftfulla åtgärder för att minska näringsläckaget. Arbetet med vattenförsörjningsplaner behöver fortsätta för att trygga framtida dricksvattenförsörjning. De senaste årens fynd av PFAS i dricksvatten visar på vikten av att skydda vattentäkter, genomföra riskbedömningar och undersöka förekomst av föroreningar.Obalans mellan den tätbefolkade kusten och den glesbyggda landsbygden är en utmaning i länet. Byggandet vid kusten ställer krav på en hänsynsfull bebyggelseutveckling som tydligt beaktar miljökvalitetsmålen.Internationella överenskommelser om kemikalier och minskade utsläpp till luft och vatten är nödvändigt för att uppnå uppsatta mål. Dessutom behövs en omställning till ett samhälle som baseras på förnybar energi. För att skapa en hållbar framtid måste vi förändra vår livsstil och vår attityd till konsumtion. Lokala och regionala åtgärder såsom arbete för en giftfri förskola och minskade utsläpp av mikroplaster är steg i rätt riktning.Minskad biologisk mångfald påverkar tillsammans med klimatförändringar, övergödning och miljögifter många av de ekosystemtjänster som vi är beroende av för mänsklig välfärd och en hållbar samhällsutveckling. Det pågår insatser som förbättrar tillståndet i miljön, men det går för långsamt. Det krävs mer resurser och modiga politiska beslut för att möjliggöra en hållbar framtid, den framtid som vi är skyldiga våra barn!
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| 10. |
- Granstam, Elisabet, et al.
(författare)
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Reduced occurrence of severe visual impairment after introduction of anti-Vascular Endothelial Growth Factor in wet age-related macular degeneration : a population- and register-based study from northern Sweden
- 2016
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Ingår i: Acta Ophthalmologica. - : Wiley. - 1755-375X .- 1755-3768. ; 94:7, s. 646-651
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Tidskriftsartikel (refereegranskat)abstract
- PurposeTo study the occurrence of severe visual impairment (SVI) and treatment outcome at 12months in patients treated for wet age-related macular degeneration (AMD) by use of data from the Swedish Macula Register (SMR) and referrals to the regional low vision clinics in five northern counties. MethodsReferrals to low vision clinics during 2005, 2009 and 2013 and treatment outcome at 12months from the SMR database from 2008 until 2013 in patients >65years of age in five northern counties were included in the survey. ResultsThe rate of referral due to AMD was significantly reduced during the time period (-48%; p<0.001). At 12months, a significant slight mean improvement in logMAR visual acuity (VA) was observed (-0.01, SD 0.37; p<0.001) after a mean of 5.02.3 anti-vascular endothelial growth factor (VEGF)-injections were administered. Age and low baseline VA was associated with less favourable visual outcome (p<0.001). ConclusionReferral rate to low vision clinic is a valuable tool for estimating occurrence of SVI and fell between the years 2005 until 2013. Data from the SMR showed improvement in visual acuity on the whole, but also identified patients at high risk for developing SVI during anti-VEGF-treatment.
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