| 1. |
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| 2. |
- Fransson, Per, et al.
(author)
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Ultra-hypofractionated versus conventionally fractionated radiotherapy for prostate cancer (HYPO-RT-PC) : patient-reported quality-of-life outcomes of a randomised, controlled, non-inferiority, phase 3 trial
- 2021
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In: The Lancet Oncology. - : Elsevier. - 1470-2045 .- 1474-5488. ; 22:2, s. 235-245
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Journal article (peer-reviewed)abstract
- BACKGROUND: The HYPO-RT-PC trial compared conventionally fractionated radiotherapy with ultra-hypofractionated radiotherapy in patients with localised prostate cancer. Ultra-hypofractionation was non-inferior to conventional fractionation regarding 5-year failure-free survival and toxicity. We aimed to assess whether patient-reported quality of life (QOL) differs between conventional fractionation and ultra-hypofractionation up to 6 years after treatment in the HYPO-RT-PC trial.METHODS: HYPO-RT-PC is a multicentre, open-label, randomised, controlled, non-inferiority, phase 3 trial done in 12 centres (seven university hospitals and five county hospitals) in Sweden and Denmark. Inclusion criteria were histologically verified intermediate-to-high-risk prostate cancer (defined as T1c-T3a with one or two of the following risk factors: stage T3a; Gleason score ≥7; and prostate-specific antigen 10-20 ng/mL with no evidence of lymph node involvement or distant metastases), age up to 75 years, and WHO performance status 0-2. Participants were randomly assigned (1:1) to conventional fractionation (78·0 Gy in 39 fractions, 5 days per week for 8 weeks) or ultra-hypofractionation (42·7 Gy in seven fractions, 3 days per week for 2·5 weeks) via a minimisation algorithm with stratification by trial centre, T-stage, Gleason score, and prostate-specific antigen. QOL was measured using the validated Prostate Cancer Symptom Scale (PCSS) and European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire (EORTC QLQ-C30) at baseline, the end of radiotherapy, months 3, 6, 12, and 24 after radiotherapy, every other year thereafter up to 10 years, and at 15 years. The primary endpoint (failure-free survival) has been reported elsewhere. Here we report QOL, a secondary endpoint analysed in the per-protocol population, up to 6 years after radiotherapy. The HYPO-RT-PC trial is registered with the ISRCTN registry, ISRCTN45905321.FINDINGS: Between July 1, 2005, and Nov 4, 2015, 1200 patients were enrolled and 1180 were randomly assigned (conventional fractionation n=591, ultra-hypofractionation n=589); 1165 patients (conventional fractionation n=582, ultra-hypofractionation n=583) were included in this QOL analysis. 158 (71%) of 223 patients in the conventional fractionation group and 146 (66%) of 220 in the ultra-hypofractionation group completed questionnaires at 6 years. The median follow-up was 48 months (IQR 25-72). In seven of ten bowel symptoms or problems the proportion of patients with clinically relevant deteriorations at the end of radiotherapy was significantly higher in the ultra-hypofractionation group than in the conventional fractionation group (stool frequency [p<0·0001], rush to toilet [p=0·0013], flatulence [p=0·0013], bowel cramp [p<0·0001], mucus [p=0·0014], blood in stool [p<0·0001], and limitation in daily activity [p=0·0014]). There were no statistically significant differences in the proportions of patients with clinically relevant acute urinary symptoms or problems (total 14 items) and sexual functioning between the two treatment groups at end of radiotherapy. Thereafter, there were no clinically relevant differences in urinary, bowel, or sexual functioning between the groups. At the 6-year follow-up there was no difference in the incidence of clinically relevant deterioration between the groups for overall urinary bother (43 [33%] of 132 for conventional fractionation vs 33 [28%] of 120 for ultra-hypofractionation; mean difference 5·1% [95% CI -4·4 to 14·6]; p=0·38), overall bowel bother (43 [33%] of 129 vs 34 [28%] of 123; 5·7% [-3·8 to 15·2]; p=0·33), overall sexual bother (75 [60%] of 126 vs 59 [50%] of 117; 9·1% [-1·4 to 19·6]; p=0·15), or global health/QOL (56 [42%] of 134 vs 46 [37%] of 125; 5·0% [-5·0 to 15·0]; p=0·41).INTERPRETATION: Although acute toxicity was higher for ultra-hypofractionation than conventional fractionation, this long-term patient-reported QOL analysis shows that ultra-hypofractionation was as well tolerated as conventional fractionation up to 6 years after completion of treatment. These findings support the use of ultra-hypofractionation radiotherapy for intermediate-to-high-risk prostate cancer.
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| 3. |
- Petersson, Jöran, et al.
(author)
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Teaching dimensional analysis in secondary school mathematics
- 2021
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In: Abstract book nofa8. - : Western Norway University of Applied Sciences.
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Conference paper (other academic/artistic)abstract
- AbstractIn its elementary form, the idea of dimensional analysis is to look at the unit of a magnitude, for example speed, and conclude that speed measured in m/s is a quotient having meters in the numerator and seconds in the denominator. However, despite dimensional analysis being a not un-common theme for research in mathematics education at tertiary level teaching, it seems in practice absent below that level. This is surprising since dimensional analysis is useful in mathematical problem solving involving proportionality. Even more so since, from halves and doubles in preschool to scalar multiplication in upper secondary school, proportionality permeates school mathematics and is well-researched (Lamon, 2007). Hence, the authors initiated a research project on how to teach dimensional analysis in school years 6-12. The novelty of this area made us choose didactical engineering (Artigue, 2015) as a theoretical framework suitable for developing the teaching of dimensional analysis. Accordingly, in a cycle of a priori and a posteriori analyses, the authors are developing an empirically based teaching model for dimensional analysis including the topic of constructing exercises for students. We present results from this on-going development project. ReferencesArtigue, M. (2015). Perspectives on Design Research: The Case of Didactical Engineering. In A. Bikner-Ahsbahs, C. Knipping, N. Presmeg. (Eds.). Approaches to Qualitative Research in Mathematics Education. Dordrecht: Springer.Lamon, S. J. (2007). Rational numbers and proportional reasoning: Towards a theoretical framework. In F.K. Lester (red) Second handbook of research on mathematics teaching and learning, vol 2 (pp. 629–668). Charlotte, NC: NCTM.
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| 4. |
- Sundgren, Per
(author)
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Kulturen och arbetarrörelsen : Kulturpolitiska strävanden från August Palm till Tage Erlander
- 2007
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Doctoral thesis (other academic/artistic)abstract
- This thesis comprises studies on a theme. The theme is cultural political ambitions in the Swedish labour movement from August Palm to Tage Erlander, from the first tentative steps of popular education at the end of the 19th century to the first cultural political programmes fifty years later. In the analyses of the various source material a dominant perspective has been opposition or conflict between high and low, elite and mass, fine culture and popular culture.What is striking is how political parties from the right to the left were often able to arrive at a political consensus on culture and education. In the building of a nation, the bourgeoisie and the labour movement both saw culture as having a class-bridging and socially cohesive function. The decisive conflict in the area of culture and cultural policy has been between the elite and the masses, between often academically educated leaders and their members and voters. Accordingly, the Social democrat Oscar Olsson and the right-wing Valfrid Palmgren together created the corporate solution that paved the way for an explosion of study circles and that would become a model for Swedish cultural policy. Challenging alternatives to the established popular education movement were posed by the weekly magazine Såningsmannen with its utilitarian view of literature and the class-struggle education that in the revolutionary years around 1920 was formed within the SSV/SKP.The first cultural political programmes that were presented after the war, namely the Communist “Democratic cultural programme” (1946/48) and the Social Democratic “Man and the present” (1952), heralded a completely new historical situation, in which culture and education no longer formed a self-evident unit.
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| 5. |
- Widmark, Anders, et al.
(author)
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Ultra-hypofractionated versus conventionally fractionated radiotherapy for prostate cancer : 5-year outcomes of the HYPO-RT-PC randomised, non-inferiority, phase 3 trial
- 2019
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In: The Lancet. - : Elsevier. - 0140-6736 .- 1474-547X. ; 394:10196, s. 385-395
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Journal article (peer-reviewed)abstract
- Background: Hypofractionated radiotherapy for prostate cancer has gained increased attention due to its proposed high radiation-fraction sensitivity. Recent reports from studies comparing moderately hypofractionated and conventionally fractionated radiotherapy support the clinical use of moderate hypofractionation. To date, there are no published randomised studies on ultra-hypofractionated radiotherapy. Here, we report the outcomes of the Scandinavian HYPO-RTPC phase 3 trial with the aim to show non-inferiority of ultra-hypofractionation compared with conventional fractionation.Methods: In this open-label, randomised, phase 3 non-inferiority trial done in 12 centres in Sweden and Denmark, we recruited men up to 75 years of age with intermediate-to-high-risk prostate cancer and a WHO performance status between 0 and 2. Patients were randomly assigned to ultra-hypofractionation (42.7 Gy in seven fractions, 3 days per week for 2.5 weeks) or conventional fractionated radiotherapy (78.0 Gy in 39 fractions, 5 days per week for 8 weeks). No androgen deprivation therapy was allowed. The primary endpoint was time to biochemical or clinical failure, analysed in the per-protocol population. The prespecified non-inferiority margin was 4% at 5 years, corresponding to a critical hazard ratio (HR) limit of 1.338. Physician-recorded toxicity was measured according to the Radiation Therapy Oncology Group (RTOG) morbidity scale and patient-reported outcome measurements with the Prostate Cancer Symptom Scale (PCSS) questionnaire. This trial is registered with the ISRCTN registry, number ISRCTN45905321.Findings: Between July 1, 2005, and Nov 4, 2015, 1200 patients were randomly assigned to conventional fractionation (n=602) or ultra-hypofractionation (n=598), of whom 1180 (591 conventional fractionation and 589 ultra-hypofractionation) constituted the per-protocol population. 1054 (89%) participants were intermediate risk and 126 (11%) were high risk. Median follow-up time was 5.0 years (IQR 3.1-7.0). The estimated failure-free survival at 5 years was 84% (95% CI 80-87) in both treatment groups, with an adjusted HR of 1.002 (95% CI 0.758-1.325; log-rank p=0.99). There was weak evidence of an increased frequency of acute physician-reported RTOG grade 2 or worse urinary toxicity in the ultra-hypofractionation group at end of radiotherapy (158 [28%] of 569 patients vs 132 [23%] of 578 patients; p=0.057). There were no significant differences in grade 2 or worse urinary or bowel late toxicity between the two treatment groups at any point after radiotherapy, except for an increase in urinary toxicity in the ultra-hypofractionation group compared to the conventional fractionation group at 1-year follow-up (32 [6%] of 528 patients vs 13 [2%] of 529 patients; (p=0.0037). We observed no differences between groups in frequencies at 5 years of RTOG grade 2 or worse urinary toxicity (11 [5%] of 243 patients for the ultra-hypofractionation group vs 12 [5%] of 249 for the conventional fractionation group; p=1.00) and bowel toxicity (three [1%] of 244 patients vs nine [4%] of 249 patients; p=0.14). Patient-reported outcomes revealed significantly higher levels of acute urinary and bowel symptoms in the ultra-hypofractionation group compared with the conventional fractionation group but no significant increases in late symptoms were found, except for increased urinary symptoms at 1-year follow-up, consistent with the physician-evaluated toxicity.Interpretation: Ultra-hypofractionated radiotherapy is non-inferior to conventionally fractionated radiotherapy for intermediate-to-high risk prostate cancer regarding failure-free survival. Early side-effects are more pronounced with ultra-hypofractionation compared with conventional fractionation whereas late toxicity is similar in both treatment groups. The results support the use of ultra-hypofractionation for radiotherapy of prostate cancer. Copyright (C) 2019 Elsevier Ltd. All rights reserved.
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| 6. |
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| 7. |
- Beckman, Claes, 1962-, et al.
(author)
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Verifying 3G licence requirements when every dB is worth a billion
- 2006
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In: First European Conference on Antennas & Propagation. - 9789290929376 ; , s. 1-4
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Conference paper (peer-reviewed)abstract
- In the year 2000, the Swedish Telecom regulator: “Post&Telestyrelsen”, PTS, granted in a “beauty contest” four licenses for operations of 3G systems. To verify the coverage and the license requirements, PTS, has developed a test procedure where the field strength of the primary Common Pilot Channel, CPICH, is measured in a drive test. Designing such a test constitutes a number of challenges mainly due to the fact that in 3G the accuracy in the measurement needs to be extremely high since even a small systematic error of ~1dB could in Sweden have the consequence that each operator would have to build an extra +1000 sites at a staggering cost of ~1billion SEK!The present paper gives an overview of the considerations behind the design of the test method used for verification of the 3G licence requirements in Sweden.
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| 8. |
- Beckman, Claes, 1962-, et al.
(author)
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Verifying 3G License Requirements : some Preliminary Swedish Results
- 2008
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In: The 68th IEEE Vehicular Technology Conference. - : IEEE. - 9781424417216 ; , s. 1-4
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Conference paper (peer-reviewed)abstract
- In the year 2000, the Swedish Telecom regulator “Post&Telestyrelsen” (PTS) granted in a “beauty contest” four licenses for operation of 3G mobile networks. Through this process, the licensees committed themselves to cover 8.860.000 inhabitants of the Swedish population. In order to verify the coverage and confirm compliance with the license requirements, PTS, developed a test procedure in close collaboration with the licensees. The present paper gives an overview of the considerations behind the design of the test method and presents some preliminary results. Today all Swedish 3G operators comply with the licence requirement and it is concluded that a method for verifying the requirement accepted by the licensees is an important tool for successful licensing of spectrum and fulfilment of licensing obligations.
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| 9. |
- Beckman Rehnman, Jeannette, et al.
(author)
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Increased corneal hysteresis after corneal collagen crosslinking : a study based on applanation resonance technology
- 2014
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In: JAMA ophthalmology. - : American Medical Association. - 2168-6165 .- 2168-6173. ; 132:12, s. 1426-1432
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Journal article (peer-reviewed)abstract
- Importance: A reliable tool for quantification of the biomechanical status of the cornea in conjunction with corneal collagen crosslinking (CXL) treatment is needed.Objective: To quantify the biomechanical effects of CXL in vivo.Design, Setting, and Participants: A prospective, open, case-control study was conducted at the Department of Ophthalmology, Umeå University, Umeå, Sweden. Participants included 28 patients (29 eyes) aged 18 to 28 years with progressive keratoconus and corresponding age- and sex-matched healthy individuals serving as controls. All participants were monitored during a 6-month period between October 13, 2009, and November 5, 2012.Main Outcomes and Measures: Corneal hysteresis after CXL for keratoconus.Results: A difference in corneal hysteresis between the control group and the patients with keratoconus was found at baseline, both with an applanation resonance tonometer (ART) and an ocular response analyzer (ORA), at mean (SD) values of -1.09 (1.92) mm Hg (99% CI, -2.26 to 0.07; P = .01) and -2.67 (2.55) mm Hg (99% CI, -4.05 to -1.32; P < .001), respectively. Increased corneal hysteresis was demonstrated with an ART 1 and 6 months after CXL, at 1.2 (2.4) mm Hg (99% CI,-0.1 to 2.5; P = .02) and 1.1 (2.7) mm Hg (99% CI, -0.3 to 2.6; P = .04), respectively, but not with ORA. A decrease in corneal thickness was seen 1 and 6 months after treatment (-24 [26] µm, P < .001; and -11 [21] µm, P = .01, respectively), and a corneal flattening of -0.6 (0.7) diopters was seen at 6 months (P < .001). No significant change in intraocular pressure was identified in patients with keratoconus with any method, except for an increase at 1 month with Goldmann applanation tonometry (P = .005).Conclusions and Relevance: To our knowledge ART is the first in vivo method able to assess the increased corneal hysteresis after CXL treatment. Given the large-scale use of CXL in modern keratoconus treatment, a tool with this capacity has a great potential value. Refinement of the ART method of measuring and quantifying corneal biomechanical properties will be a subject of further studies.
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| 10. |
- Beckman Rehnman, Jeannette, et al.
(author)
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Initial results from mechanical compression of the cornea during crosslinking for keratoconus
- 2014
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In: Acta Ophthalmologica. - : John Wiley & Sons. - 1755-375X .- 1755-3768. ; 92:7, s. 644-649
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Journal article (peer-reviewed)abstract
- Purpose: To compare refractive changes after corneal crosslinking with and without mechanical compression of the cornea.Methods: In a prospective, open, randomized case-control study conducted at the Department of Ophthalmology, Umeå University Hospital, Sweden, sixty eyes of 43 patients with progressive keratoconus aged 18-28 years planned for corneal crosslinking and corresponding age- and sex-matched control subjects were included. The patients were randomized to conventional corneal crosslinking (CXL; n = 30) or corneal crosslinking with mechanical compression using a flat rigid contact lens sutured to the cornea during treatment (CRXL; n = 30). Subjective refraction and ETDRS best spectacle-corrected visual acuity (BSCVA), axial length measurement, keratometry and pachymetry were performed before and 1 and 6 months after treatment.Results: The keratoconus patients had poorer BSCVA, higher refractive astigmatism and higher keratometry readings than the control subjects at baseline (p < 0.01). In the CXL group, BSCVA increased from 0.19 ± 0.26 to 0.14 ± 0.18 logMar (p = 0.03), and the spherical equivalent improved from -1.9 ± 2.8 D to -1.4 ± 2.4 D (p = 0.03). Maximum keratometry readings decreased after CXL from 53.1 ± 4.9 D to 52.6 ± 5.2 D (p = 0.02), and the axial length decreased in the CXL group, likely due to post-treatment corneal thinning (p = 0.03). In the CRXL group, all the above variables were unaltered (p > 0.05).Conclusion: At 6 months, the refractive results from CRXL did not surpass those of conventional CXL treatment. Rather, some variables indicated a slightly inferior effect. Possibly, stronger crosslinking would be necessary to stabilize the cornea in the flattened configuration achieved by the rigid contact lens.
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| 11. |
- Beckman Rehnman, Jeannette, 1969-
(author)
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New methods to evaluate the effect of conventional and modified crosslinking treatment for keratoconus
- 2015
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Doctoral thesis (other academic/artistic)abstract
- Background: Today corneal crosslinking with ultraviolet-A photoactivation of riboflavin is an established method to halt the progression of keratoconus. In some cases, when the refractive errors are large and the visual acuity is low, conventional corneal crosslinking may not be sufficient. In these cases it would be desirable with a treatment that both halts the progression and also reduces the refractive errors and improves the quality of vision.Aims: The aims of this thesis were to determine whether mechanical compression of the cornea during corneal crosslinking for keratoconus using a sutured rigid contact lens could improve the optical and visual outcomes of the treatment, and also to find methods to evaluate the effect of different corneal crosslinking treatment regimens.Methods: In a prospective, open, randomized case-control study, 60 eyes of 43 patients with progressive keratoconus, aged 18-28 years, planned for routine corneal crosslinking, and a corresponding age- and sex-matched control group was included. The patients were randomized to conventional corneal crosslinking (CXL; n=30) or corneal crosslinking with mechanical compression of the cornea during the treatment (CRXL; n=30).Biomicroscopy, autorefractometry, best spectacle corrected visual acuity, axial length measurement, Pentacam® HR Scheimpflug photography, pachymetry, intraocular pressure measurements and corneal biomechanical assessments were performed before treatment (baseline) and at 1 month and 6 months after the treatment.One of the articles evaluated and compared the optical and visual outcomes between CXL and CRXL, while the other three articles focused on methods to evaluate treatment effects. In Paper I, the corneal light scattering was manually quantified from Scheimpflug images throughout the corneal thickness at 8 measurements points, 0.0 to 3.0 mm from the corneal centre, in patients treated with CXL. In Paper IV the corneal densitometry (light scattering) was measured with the Pentacam® HR software, in 4 circular zones around the corneal apex and at 3 different depths of the corneal stroma, in both CXL and CRXL treated corneas. Paper III quantified the biomechanical effects of CXL in vivo.Results: Corneal light scattering after CXL showed distinctive spatial and temporal profiles and Applanation Resonance Tonometry (ART) -technology demonstrated an increased corneal hysteresis 1 and 6 months after CXL. When comparing the refractive and structural results after CXL and CRXL, CRXL failed to flatten the cornea, and the treatment did not show any benefits to conventional CXL treatment, some variables even indicated an inferior effect. Accordingly, the increase in corneal densitometry was also less pronounced after CRXL.Conclusions: Analysis of corneal light scattering/densitometry shows tissue changes at the expected treatment location, and may be a relevant variable in evaluating the crosslinking effect. ART -technology is an in vivo method with the potential to assess the increased corneal hysteresis after CXL treatment. By refining the method, ARTmay become a useful tool in the future. Unfortunately, CRXL does not improve the optical and visual outcomes after corneal crosslinking. Possibly, stronger crosslinking would be necessary to stabilize the cornea in a flattened position.
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| 12. |
- Beckman Rehnman, Jeannette, et al.
(author)
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Treatment Effect and Corneal Light Scattering With 2 Corneal Cross-linking Protocols : A Randomized Clinical Trial
- 2015
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In: JAMA ophthalmology. - : American Medical Association (AMA). - 2168-6165 .- 2168-6173. ; 133:11, s. 1254-1260
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Journal article (peer-reviewed)abstract
- Importance: We describe and evaluate a complementary method to indirectly quantify the treatment effect of corneal cross-linking (CXL). Additional methods to indirectly quantify the treatment effect of CXL are needed.Objective: To assess the spatial distribution and the time course of the increased corneal densitometry (corneal light backscatter) seen after CXL with riboflavin and UV-A irradiation.Design, Setting, and Participants: Open-label randomized clinical trial of 43 patients (60 eyes) who were 18 to 28 years of age and had progressive keratoconus and a plan to be treated with CXL at Umeå University Hospital, Umeå, Sweden. The patients were randomized to receive conventional CXL (n = 30) using the Dresden protocol or CXL with mechanical compression of the cornea using a flat rigid contact lens sutured to the cornea during the treatment (CRXL) (n = 30). All participants were followed up during a 6-month period from October 13, 2009, through May 31, 2012.Interventions: Corneal cross-linking according to the Dresden protocol or CRXL.Main Outcomes and Measures: Change in corneal densitometry after CXL and CRXL for keratoconus.Results: Of the original 60 eyes included, 4 had incomplete data. A densitometry increase was seen after both treatments that was deeper and more pronounced in the CXL group (difference between the groups at 1 month in the center layer, zone 0-2 mm, 5.02 grayscale units [GSU], 95% CI, 2.92-7.12 GSU; P < .001). This increase diminished with time but was still noticeable at 6 months (difference between the groups at 6 months in the center layer, zone 0-2 mm, 3.47 GSU; 95% CI, 1.72-5.23 GSU; P < .001) and was proportional to the reduction in corneal steepness (R = -0.45 and -0.56 for CXL and CRXL, respectively).Conclusions and Relevance: The degree of corneal light backscatter relates to the reduction in corneal steepness after cross-linking and may become a relevant complement to other methods in evaluating the cross-linking effect, for example, when comparing different treatment regimens.Trial Registration: clinicaltrials.gov Identifier: NCT02425150.
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| 13. |
- Björeland, Ulrika, et al.
(author)
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Hyaluronic acid spacer in prostate cancer radiotherapy : dosimetric effects, spacer stability and long-term toxicity and PRO in a phase II study
- 2023
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In: Radiation Oncology. - : BioMed Central (BMC). - 1748-717X. ; 18:1
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Journal article (peer-reviewed)abstract
- BACKGROUND: Perirectal spacers may be beneficial to reduce rectal side effects from radiotherapy (RT). Here, we present the impact of a hyaluronic acid (HA) perirectal spacer on rectal dose as well as spacer stability, long-term gastrointestinal (GI) and genitourinary (GU) toxicity and patient-reported outcome (PRO).METHODS: In this phase II study 81 patients with low- and intermediate-risk prostate cancer received transrectal injections with HA before external beam RT (78 Gy in 39 fractions). The HA spacer was evaluated with MRI four times; before (MR0) and after HA-injection (MR1), at the middle (MR2) and at the end (MR3) of RT. GI and GU toxicity was assessed by physician for up to five years according to the RTOG scale. PROs were collected using the Swedish National Prostate Cancer Registry and Prostate cancer symptom scale questionnaires.RESULTS: There was a significant reduction in rectal V70% (54.6 Gy) and V90% (70.2 Gy) between MR0 and MR1, as well as between MR0 to MR2 and MR3. From MR1 to MR2/MR3, HA thickness decreased with 28%/32% and CTV-rectum space with 19%/17% in the middle level. The cumulative late grade ≥ 2 GI toxicity at 5 years was 5% and the proportion of PRO moderate or severe overall bowel problems at 5 years follow-up was 12%. Cumulative late grade ≥ 2 GU toxicity at 5 years was 12% and moderate or severe overall urinary problems at 5 years were 10%.CONCLUSION: We show that the HA spacer reduced rectal dose and long-term toxicity.
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| 14. |
- Bäckström, Anders, et al.
(author)
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Religious Change in Northern Europe. : The Case of Sweden
- 2004
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Book (peer-reviewed)abstract
- Detta utgör den sammanfattande raporten från projektet vid Vetenskapsrådet "Från statskyrka till fri folkkyrka". Rapporten visar på den komplexa förändringsbild som gäller Svenska kyrkan inför kyrka stat reformen år 2000 men också religiösa institutioner i stort. Den nordiska religiösa modellen karakteriseras av högt medlemskap och deltagande i riter men med lågt engagemang och gudstro. Detta visar på en individuell integritet i trosfrågor men med samtidigt behov av en kuturell relatering.
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| 15. |
- Bäckström, Anders, et al.
(author)
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Religiös förändring i norra Europa : en studie av Sverige : "från statskyrka till fri folkkyrka" : slutrapport
- 2004
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Reports (other academic/artistic)abstract
- Detta är den svenska slutrapporten från projektet Från statskyrka till fri folkkyrka vid Vetenskapsrådet. Slurapporten visar på den komplexa situation som de nordiska folkkyrkorna står inför, med den Svenska kyrkan som exempel. Religionen privatiseras samtidigt som intresset att använda sig av kyrkans riter ligger högt. Detta tyder på en spesifikt nordisk paradox.År 1997 antogs projektet ”Från statskyrka till fri folkkyrka” av det svenska Vetenskapsrådet. Tretton självständiga delstudier har ur olika synvinklar belyst religiösa och sociala förändringsprocesser i Sverige från mitten av 1800-talet fram till idag. I denna slutrapport bearbetas och vidareutvecklas resultaten, insatta i ett sammanhang av aktuell religions- och samhällsvetenskaplig debatt.Det speciella i den svenska religiösa situationen har att göra med den tidigare starka integrationen mellan kyrka och stat. Successivt har relationen lösts upp, fram till separationen år 2000. Rapporten visar att religionen inte har spelat ut sin roll i det senmoderna samhället, utan förändras på sätt som tidigare forskning inte förutsett. I det globala tjänstesamhällets Sverige är människors trosliv starkt privatiserat, samtidigt som religionen på ett ibland överraskande sätt uppträder på den offentliga arenan. Religiösa institutioner och organisationer fungerar som existentiella och kollektiva resurser i sökandet efter livskvalitet och mening. Kyrkans auktoritet och legitimitet är inte längre kopplad till dess formella position, utan till dess upplevda värde för individ och samhälle.Nya sociala förhållanden öppnar i dag för kyrkan som social aktör, men också som samtalspartner i en dialog om samhällsutvecklingens riktning och mål.
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| 16. |
- Böös, Malin, et al.
(author)
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Who should record surgical complications? : Results from a third-party assessment of complications after radical cystectomy
- 2019
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In: Scandinavian journal of urology. - : Informa Healthcare. - 2168-1805 .- 2168-1813. ; 53:5, s. 339-343
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Journal article (peer-reviewed)abstract
- Objective: In Sweden complications after radical cystectomy have been reported to the nationwide population-based Swedish Cystectomy Registry since 2011. Here, validation of the reporting was assessed in two healthcare regions.Materials and methods: Complications were ascertained from patient records by a third party not involved in the care delivered to 429 randomly selected patients from 949 who had undergone radical cystectomy since 2011 in four hospitals. Without knowledge of the outcome in the primary registration, post-operative complications within 90 days post-operatively were assessed by an independent review of patient charts, and the results were compared with the primary reports in the Swedish Cystectomy Registry.Results: The third-party assessment identified post-operative complications in 310 patients (72%). Low-grade complications (Clavien-Dindo I-II) were noted in 110 (26%) of the patients in the primary registration, but increased to 182 (42%) in the validation (p < 0.00001). High-grade complications (Clavien-Dindo III-V) were reported in 113 (26%) patients in the primary registration, but in 128 (30%) of the patients in the validation (p = 0.02). According to the third-party assessment, 18 patients (4%) had Clavien-Dindo grade IV complications and 12 (3%) died within 90 days of surgery (Clavien-Dindo grade V); corresponding values in the primary registration were 15 (3%) and 9 (2%), respectively. The readmission rate within 90 days increased from 27 to 32% in the validation (p < 0.00001).Conclusions: Compared with registry data, third-party assessment revealed more complications and readmissions after radical cystectomy. Hence such evaluation may improve the validity of reported complication data.
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| 22. |
- Ekstrand, Thomas, et al.
(author)
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Welfare, Church and Gender in Sweden
- 2004
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In: Welfare, Church and Gender in Eight European Countries. - : Uppsala Institute for Diaconal and Social Studies. - 9197456551
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Book chapter (other academic/artistic)
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| 23. |
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| 24. |
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| 25. |
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| 26. |
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| 27. |
- Harding, Tobias, 1975-
(author)
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Nationalising Culture : The Reorganisation of National Culture in Swedish Cultural Policy 1970–2002
- 2007
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Doctoral thesis (other academic/artistic)abstract
- By comparative analysis of Swedish cultural policy (including art policy, heritage policy and Church policy) during the Riksdag periods of 1970-73, 1991-94, 1994-98 and 1998-2002 the relationship between cultural policy and the concept of the nation as a homogenous cultural community (defined by either an ethnic or a state-framed concept) is explored. Neoinstitutional analysis of cultural policy as an organisational field is combined with analysis of how the nation is conceived as an imagined community, and what values it strives to uphold to show how these values and concepts are institutionalised in its cultural policy and how this supports the legitimacy of the State as a nation-state.In the early seventies, when a general cultural policy was first established in Sweden, most of its fields were already institutionalised and bound by strong path dependencies, binding art policy to protecting universal aesthetic values within the state-framed nation and heritage policy to ethnic particularism while Church policy stood between universalism and ethnic particularism (which infected the relationship between Church and State). These contradictions were managed by strong borders between the fields. In the early seventies these were overlaid with a general cultural policy focused on universal civil values within the state-framed nation. Since then the conflict between Church and State has been defused and the norms of heritage policy have become closer to those of cultural policy at large by the claim that cultural heritage should be used to uphold civil values (e.g. democracy and tolerance). In the late nineties cultural policy has again become less integrated by new government initiatives with specific goals. Civil universal values remain dominant while concepts of the nation are increasingly multi-ethnic.
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| 28. |
- Lindqvist, Per-Arne, 1954-, et al.
(author)
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The Spin-Plane Double Probe Electric Field Instrument for MMS
- 2016
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In: Space Science Reviews. - : Springer Science+Business Media B.V.. - 0038-6308 .- 1572-9672. ; 199:1-4, s. 137-165
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Research review (peer-reviewed)abstract
- The Spin-plane double probe instrument (SDP) is part of the FIELDS instrument suite of the Magnetospheric Multiscale mission (MMS). Together with the Axial double probe instrument (ADP) and the Electron Drift Instrument (EDI), SDP will measure the 3-D electric field with an accuracy of 0.5 mV/m over the frequency range from DC to 100 kHz. SDP consists of 4 biased spherical probes extended on 60 m long wire booms 90(a similar to) apart in the spin plane, giving a 120 m baseline for each of the two spin-plane electric field components. The mechanical and electrical design of SDP is described, together with results from ground tests and calibration of the instrument.
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| 29. |
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| 30. |
- Pettersson, Per, et al.
(author)
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Welfare and Religion in Sweden
- 2004
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In: Welfare, Religion and Gender in Eight European Countries, Diakonivetenskapliga institutets skriftserie. - Uppsala : Diakonivetenskpliga institutet.
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Book chapter (other academic/artistic)
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| 31. |
- Rendek, Zlatica, et al.
(author)
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Early Tensile Loading in Nonsurgically Treated Achilles Tendon Ruptures Leads to a Larger Tendon Callus and a Lower Elastic Modulus : A Randomized Controlled Trial
- 2022
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In: American Journal of Sports Medicine. - : Sage Publications Inc. - 0363-5465 .- 1552-3365. ; 50:12, s. 3286-3298
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Journal article (peer-reviewed)abstract
- Background: Early tensile loading improves material properties of healing Achilles tendon ruptures in animal models and in surgically treated human ruptures. However, the effect of such rehabilitation in patients who are nonsurgically treated remains unknown. Hypothesis: In nonsurgically treated Achilles tendon ruptures, early tensile loading would lead to higher elastic modulus 19 weeks after the injury compared with controls. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: Between October 2015 and November 2018, a total of 40 nonsurgically treated patients with acute Achilles tendon rupture were randomized to an early tensile loading (loaded group) or control group. Tantalum bead markers were inserted percutaneously into the tendon stumps 2 weeks after the injury to allow high-precision measurements of callus deformation under mechanical testing. The loaded group used a training pedal twice daily to produce a gradual increase in tensile load during the following 5 weeks. Both groups were allowed full weightbearing in an ankle orthosis and unloaded range of motion exercises. Patients were followed clinically and via roentgen stereophotogrammetric analysis and computed tomography at 7, 19, and 52 weeks after the injury. Results: The mean +/- standard deviation elastic modulus at 19 weeks was 95.6 +/- 38.2 MPa in the loaded group and 108 +/- 45.2 MPa in controls (P = .37). The elastic modulus increased in both groups, although it was lower in the loaded group at all time points. Tendon cross-sectional area increased from 7 weeks to 19 weeks, from 231 +/- 99.5 to 388 +/- 142 mm(2) in the loaded group and from 188 +/- 65.4 to 335 +/- 87.2 mm(2) in controls (P < .001 for the effect of time). Cross-sectional area for the loaded group versus controls at 52 weeks was 302 +/- 62.4 mm(2) versus 252 +/- 49.2 mm(2), respectively (P = .03). Gap elongation was 7.35 +/- 13.9 mm in the loaded group versus 2.86 +/- 5.52 mm in controls (P = .27). Conclusion: Early tensile loading in nonsurgically treated Achilles tendon ruptures did not lead to higher elastic modulus in the healing tendon but altered the structural properties of the tendon via an increased tendon thickness. Registration: NCT0280575 (ClinicalTrials.gov identifier).
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| 32. |
- Rönningås, Ulrika, et al.
(author)
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Signs and symptoms in relation to progression, experiences of an uncertain illness situation in men with metastatic castration-resistant prostate cancer : A qualitative study
- 2022
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In: European Journal of Cancer Care. - : Wiley-Blackwell. - 0961-5423 .- 1365-2354. ; 31:4
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Journal article (peer-reviewed)abstract
- OBJECTIVE: Signs and symptoms are important in monitoring prostate cancer, but there is a lack of understanding about the men's interpretation of signs and symptoms in relation to disease progression in advanced phases of the disease. The aim was to illuminate the experience of signs and symptoms in relation to disease progression in men with metastatic castration-resistant prostate cancer (mCRPC).METHOD: Thirty longitudinal interviews were conducted with 11 men undergoing life-prolonging treatment for mCRPC. Conventional content analysis was used.RESULTS: The results illuminate an uncertainty that the men experience when interpreting signs and symptoms. The overarching theme was The experience of an uncertain illness situation within the framework of progression, with four subthemes: Symptoms triggering thoughts about disease progression; Making sense of signs, also in the absence of symptoms; Making sense of symptoms during treatment; Progression triggering thoughts about the remainder of life.CONCLUSION: In the uncertain illness situation, the men strive to make sense of signs and symptoms based on previous experiences and in relation to disease progression. Understanding the men's perspectives on signs and symptoms in this late phase may help health care professionals communicate about disease progression considering the balance between treatment outcome and quality of life.
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| 33. |
- Rönningås, Ulrika, et al.
(author)
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Symptoms and quality of life among men starting treatment for metastatic castration-resistant prostate cancer : a prospective multicenter study
- 2024
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In: BMC Palliative Care. - : BioMed Central (BMC). - 1472-684X. ; 23:1
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Journal article (peer-reviewed)abstract
- BACKGROUND: Men with metastatic castration-resistant prostate cancer (mCRPC) have an incurable disease. Along with prolonging life, symptom management is one of the main goals with treatment. This is also important from a palliative care perspective where the life prolonging outcomes should be balanced with quality of life (QoL) in this late phase. It is also essential in symptom management to view different dimensions of symptoms, for example how severe or distressing symptoms are, to support best QoL. Therefore, more knowledge is needed about the symptom experience when these treatments are initiated and thus the aim of this study was to describe different dimensions of symptoms in men with mCRPC starting their first-line of life-prolonging treatment, and to describe the association between symptom burden and QoL.METHODS: Baseline data from a prospective longitudinal study of 143 men with mCRPC starting their first-line life-prolonging treatment were used. Symptoms were measured using the Memorial Symptom Assessment Scale (MSAS) and global QoL was measured by the EORTC QLQ C-30. Data was analyzed using descriptive- and multivariable linear regression analyses.RESULTS: On average, the men had more than 10 symptoms (range 0-31 of 33). 50% or more reported sweats, lack of energy, pain, problems with sexual activity and sexual desire. The symptoms they reported as most severe, or most distressing were not always the ones that were reported as most frequent. There was an association between QoL and physical symptoms, and also between QoL, and analgesic use and prostate-specific antigen (PSA) values.CONCLUSION: Even if some men with mCRPC report many symptoms, the dimensions of severity and distress levels vary, and the most frequent symptoms was not always the most burdensome or distressing. There was an association between high physical symptom burden and QoL, suggesting that it is not the number of symptoms that affects QoL but rather the subjective perceived impact of the physical symptoms experienced. The knowledge of how men with mCRPC experience and perceive their symptoms may help health care professionals in symptom management aiming to improve QoL, which is a cornerstone in integrating early palliative care.
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| 34. |
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| 35. |
- Sun, Sun, et al.
(author)
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Is ultra-hypo-fractionated radiotherapy more cost-effective relative to conventional fractionation in treatment of prostate cancer? A cost–utility analysis alongside a randomized HYPO-RT-PC trial
- 2023
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In: European Journal of Health Economics. - : Springer. - 1618-7598 .- 1618-7601. ; 24, s. 237-246
-
Journal article (peer-reviewed)abstract
- Background: Economic evidence for comparing low fraction with ultra-hypo fractionated (UHF) radiation therapy in the treatment of intermediate-to-high-risk prostate cancer (PC) is lacking, especially in Europe. This study presents an economic evaluation performed alongside an ongoing clinical trial.Aim: To investigate up to 6 years’ follow-up whether conventional fractionation (CF, 78.0 Gy in 39 fractions, 5 days per week for 8 weeks) is more cost-effective than UHF (42.7 Gy in 7 fractions, 3 days per week for 2.5 weeks inclusive of 2 weekends) radiotherapy in treatment for patients with intermediate-to-high-risk PC.Method: HYPO-RT-PC trial is an open-label, randomized, multicenter (10 in Sweden; 2 in Denmark) phase-3 trial. Patients from Sweden (CF 434; UHF 445) were included in this study. The trial database was linked to the National Patient Registry (NPR). Costs for inpatient/non-primary outpatient care for each episode were retrieved. For calculating Quality-adjusted life years (QALYs), the EORTC QLQ-C30 questionnaire was mapped to the EQ-5D-3L index. Multivariable regression analyses were used to compare the difference in costs and QALYs, adjusting for age and baseline costs, and health status. The confidence interval for the difference in costs, QALYs and incremental cost-effectiveness ratio effectiveness ratio (ICER) was estimated by the bootstrap percentile method.Results: No significant differences were found in ICER between the two arms after 6 years of follow-up.Conclusion: The current study did not support that the ultra-hypo-fractionated treatment was more cost-effective than the conventional fraction treatment up to the sixth year of the trial.
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| 36. |
- Svärd, Per-Anders, 1973-
(author)
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Problem Animals : A Critical Genealogy of Animal Cruelty and Animal Welfare in Swedish Politics 1844–1944
- 2015
-
Doctoral thesis (other academic/artistic)abstract
- Despite growing academic interest in the human–animal relationship, little research has been directed toward the political regulation of animal treatment. Even less attention has been accorded to the emergence of the long dominant paradigm in this policy area, namely, the ideology of animal welfare. This book attempts to address this gap by chronicling the early history of animal politics in Sweden with the aim of producing a critical, deconstructive genealogy of animal cruelty and animal welfare. The study ranges from the first political debates about animal cruelty in 1844 to the institution of Sweden’s first comprehensive animal protection act in 1944. Taking a post-Marxist and psychoanalytically informed approach to discourse analysis, the study focuses on how the “problem” of animal cruelty was articulated in the parliamentary debates and government documents throughout the period: What was the problem of animal (mis)treatment represented to be? What kinds of animal (ab)use were rendered uncontroversial? What kind of affective investments and ideological fantasies underpinned these discursive constructions, and how did the problematizations change over time? The book contains six empirical chapters that deal with the most important legal revisions in the period as well as the parallel debates about animal experimentation and slaughter. Two major discursive regimes—an early “anti-cruelty regime” and a later “animal welfare regime”—are identified in the material, and the transition between them is theorized in terms of discursive antagonism and dislocation. Focusing on the conflict between competing discursive logics, the study charts a century of ideological struggles through which our modern attitudes toward animals were born. The book also offers a critical reinterpretation of the success story of animal welfare. Against the assumption that modern animal welfarism progressively grew out of the preceding anti-cruelty regime, the central claim of this book is that the “welfarist turn” that took place in the 1930s and 1940s also functioned to re-entrench society’s speciesist values and de-problematize the exploitation of animals for human purposes.
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| 37. |
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