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- Beral, V, et al.
(författare)
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Alcohol, tobacco and breast cancer - collaborative reanalysis of individual data from 53 epidemiological studies, including 58515 women with breast cancer and 95067 women without the disease
- 2002
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Ingår i: British Journal of Cancer. - : Springer Science and Business Media LLC. - 1532-1827 .- 0007-0920. ; 87, s. 1234-45
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Tidskriftsartikel (refereegranskat)abstract
- Alcohol and tobacco consumption are closely correlated and published results on their association with breast cancer have not always allowed adequately for confounding between these exposures. Over 80% of the relevant information worldwide on alcohol and tobacco consumption and breast cancer were collated, checked and analysed centrally. Analyses included 58515 women with invasive breast cancer and 95067 controls from 53 studies. Relative risks of breast cancer were estimated, after stratifying by study, age, parity and, where appropriate, women's age when their first child was born and consumption of alcohol and tobacco. The average consumption of alcohol reported by controls from developed countries was 6.0 g per day, i.e. about half a unit/drink of alcohol per day, and was greater in ever-smokers than never-smokers, (8.4 g per day and 5.0 g per day, respectively). Compared with women who reported drinking no alcohol, the relative risk of breast cancer was 1.32 (1.19 - 1.45, P < 0.00001) for an intake of 35 - 44 g per day alcohol, and 1.46 (1.33 - 1.61, P < 0.00001) for greater than or equal to 45 g per day alcohol. The relative risk of breast cancer increased by 7.1% (95% CI 5.5-8.7%; P<0.00001) for each additional 10 g per day intake of alcohol, i.e. for each extra unit or drink of alcohol consumed on a daily basis. This increase was the same in ever-smokers and never-smokers (7.1 % per 10 g per day, P < 0.00001, in each group). By contrast, the relationship between smoking and breast cancer was substantially confounded by the effect of alcohol. When analyses were restricted to 22 255 women with breast cancer and 40 832 controls who reported drinking no alcohol, smoking was not associated with breast cancer (compared to never-smokers, relative risk for ever-smokers= 1.03, 95% CI 0.98 - 1.07, and for current smokers=0.99, 0.92 - 1.05). The results for alcohol and for tobacco did not vary substantially across studies, study designs, or according to 15 personal characteristics of the women; nor were the findings materially confounded by any of these factors. If the observed relationship for alcohol is causal, these results suggest that about 4% of the breast cancers in developed countries are attributable to alcohol. In developing countries, where alcohol consumption among controls averaged only 0.4 g per day, alcohol would have a negligible effect on the incidence of breast cancer. In conclusion, smoking has little or no independent effect on the risk of developing breast cancer; the effect of alcohol on breast cancer needs to be interpreted in the context of its beneficial effects, in moderation, on cardiovascular disease and its harmful effects on cirrhosis and cancers of the mouth, larynx, oesophagus and liver. (C) 2002 Cancer Research UK.
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- Kehoe, Laura, et al.
(författare)
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Make EU trade with Brazil sustainable
- 2019
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Ingår i: Science. - : American Association for the Advancement of Science (AAAS). - 0036-8075 .- 1095-9203. ; 364:6438, s. 341-
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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- Persson, N, et al.
(författare)
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Biologisk denitrifikation av dricksvatten - Biological denitrification of drinking water
- 2006
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Ingår i: Vatten: tidskrift för vattenvård /Journal of Water Management and research. - 0042-2886. ; 62:4, s. 323-333
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- A pilot-plant study, made to clarify whether biological denitrification is a possible and suitable method for nitrate reduction of drinking water in Sweden is presented. The concentration of nitrate-nitrogen in un-treated water was 10–15 mg/l. The reactor was a 1.2 m aluminium tube with a inner diameter of 0.19 m. 0.75 m was filled with Filtralite®, expanded clay, through which the nitrate-contaminated water was forced to flow upwards with a velocity of 0.5 m/h. The system was run with artificial nitrate-polluted potable water from the three pumps during a week. The nitrate was then added to the water by using a solution of sodium nitrate. As carbon-source, sodium acetate was used. The Hydraulic Retention Time (HRT) of the system was 5.9 h, of which approximately 2.6 hours were within the bacterial support material. The C:N ratio was found to be below 1.5 and the system was very stable. Since the process will not work as long as oxygen is present, oxygen was degassed, but the importance of trace oxygen amounts could not be decided, since it wasn’t possible to decrease the oxygen to really low concentrations in the water prior inlet to the reactor. It was concluded that it is possible to use biological denitrification for drinking water. Post-treatment in an aerated reactor will be needed to ensure that no carbon or nitrite-nitrogen comes into the potable water.
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- Adane, A, et al.
(författare)
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Exploring data quality and use of the routine health information system in Ethiopia: a mixed-methods study
- 2021
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Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 11:12, s. e050356-
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Tidskriftsartikel (refereegranskat)abstract
- A routine health information system (RHIS) enables decision making in the healthcare system. We aimed to analyse data quality at the district and regional level and explore factors and perceptions affecting the quality and use of routine data.DesignThis was a mixed-methods study. We used the WHO toolkit for analysing data quality and interviewed staff at the point of data generation and along with the flow of data. Data were analysed using the Performance of Routine Information System Management framework.SettingThis study was performed in eight districts in four regions of Ethiopia. The study was nested within a 2-year programme of the Operational Research and Coaching for government Analysts.ParticipantsWe visited 45 health posts, 1 district hospital, 16 health centres and 8 district offices for analysis of routine RHIS data and interviewed 117 staff members for the qualitative assessment.Outcome measuresWe assessed availability of source documents, completeness, timeliness and accuracy of reporting of routine data, and explored data quality and use perceptions.ResultsThere was variable quality of both indicator and data element. Data on maternal health and immunisation were of higher quality than data on child nutrition. Issues ranged from simple organisational factors, such as availability of register books, to intricate technical issues, like complexity of indicators and choice of denominators based on population estimates. Respondents showed knowledge of the reporting procedures, but also demonstrated limited skills, lack of supportive supervision and reporting to please the next level. We saw limited examples of the use of data by the staff who were responsible for data reporting.ConclusionWe identified important organisational, technical, behavioural and process factors that need further attention to improve the quality and use of RHIS data in Ethiopia.
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