| 1. |
- Alexandra, Wide, et al.
(författare)
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Fertility-related information received by young women and men with cancer : a population-based survey
- 2021
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Ingår i: Acta Oncologica. - : Taylor & Francis. - 0284-186X .- 1651-226X. ; 60:8, s. 976-983
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Tidskriftsartikel (refereegranskat)abstract
- Background: Infertility is a well-known sequela of cancer treatment. Despite guidelines recommending early discussions about risk of fertility impairment and fertility preservation options, not all patients of reproductive age receive such information.Aims: This study aimed to investigate young adult cancer patients' receipt of fertility-related information and use of fertility preservation, and to identify sociodemographic and clinical factors associated with receipt of information.Materials and methods: A population-based cross-sectional survey study was conducted with 1010 young adults with cancer in Sweden (response rate 67%). The inclusion criteria were: a previous diagnosis of breast cancer, cervical cancer, ovarian cancer, brain tumor, lymphoma or testicular cancer between 2016 and 2017, at an age between 18 and 39 years. Data were analyzed using logistic regression models.Results: A majority of men (81%) and women (78%) reported having received information about the potential impact of cancer/treatment on their fertility. A higher percentage of men than women reported being informed about fertility preservation (84% men vs. 40% women, p < .001) and using gamete or gonadal cryopreservation (71% men vs. 15% women, p < .001). Patients with brain tumors and patients without a pretreatment desire for children were less likely to report being informed about potential impact on their fertility and about fertility preservation. In addition, being born outside Sweden was negatively associated with reported receipt of information about impact of cancer treatment on fertility. Among women, older age (>35 years), non-heterosexuality and being a parent were additional factors negatively associated with reported receipt of information about fertility preservation.Conclusion: There is room for improvement in the equal provision of information about fertility issues to young adult cancer patients.
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| 2. |
- Bergstrom, Charlotta, et al.
(författare)
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Do young adults with cancer receive information about treatment- related impact on sex life? : Results from a population-based study
- 2023
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Ingår i: Cancer Medicine. - : WILEY. - 2045-7634. ; 12:8, s. 9893-9901
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Tidskriftsartikel (refereegranskat)abstract
- Background Sexual dysfunction is common following a cancer diagnosis in young adulthood (18-39 years) and problems related to sex life are ranked among the core concerns in this age group. Yet, few studies have investigated to what extent adults younger than 40, receive information from healthcare providers about the potential impact of cancer and its treatment on their sex life.Methods A population-based cross-sectional survey study was conducted with 1010 young adults 1.5 years after being diagnosed with cancer (response rate 67%). Patients with breast, cervical, ovarian and testicular cancer, lymphoma, and brain tumors were identified in national quality registries. Sociodemographic and clinical factors associated with receiving information were examined using multivariable binary logistic regression.Results Men to a higher extent than women reported having received information about potential cancer-related impact on their sex life (68% vs. 54%, p < 0.001). Receipt of information varied across diagnoses; in separate regression models, using lymphoma as reference, both women and men with brain tumors were less likely to receive information (women: OR 0.10, CI = 0.03-0.30; men: OR 0.37, CI = 0.16-0.85). More intensive treatment was associated with higher odds of receiving information in both women (OR 1.89; CI = 1.28-2.79) and men (OR 2.08; CI = 1.09-3.94). None of the sociodemographic factors were associated with receipt of information.Conclusions To improve sexual health communication to young adults with cancer, we recommend diagnosis-specific routines that clarify when in the disease trajectory to discuss these issues with patients and what to address in these conversations.
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| 3. |
- de Boniface, J., et al.
(författare)
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The generalisability of randomised clinical trials: an interim external validity analysis of the ongoing SENOMAC trial in sentinel lymph node-positive breast cancer
- 2020
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Ingår i: Breast Cancer Research and Treatment. - : Springer Science and Business Media LLC. - 0167-6806 .- 1573-7217. ; 180:1, s. 167-176
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Tidskriftsartikel (refereegranskat)abstract
- Purpose None of the key randomised trials on the omission of axillary lymph node dissection (ALND) in sentinel lymph-positive breast cancer have reported external validity, even though results indicate selection bias. Our aim was to assess the external validity of the ongoing randomised SENOMAC trial by comparing characteristics of Swedish SENOMAC trial participants with non-included eligible patients registered in the Swedish National Breast Cancer Register (NKBC). Methods In the ongoing non-inferiority European SENOMAC trial, clinically node-negative cT1-T3 breast cancer patients with up to two sentinel lymph node macrometastases are randomised to undergo completion ALND or not. Both breast-conserving surgery and mastectomy are eligible interventions. Data from NKBC were extracted for the years 2016 and 2017, and patient and tumour characteristics compared with Swedish trial participants from the same years. Results Overall, 306 NKBC cases from non-participating and 847 NKBC cases from participating sites (excluding SENOMAC participants) were compared with 463 SENOMAC trial participants. Patients belonging to the middle age groups (p = 0.015), with smaller tumours (p = 0.013) treated by breast-conserving therapy (50.3 versus 47.1 versus 65.2%, p < 0.001) and less nodal tumour burden (only 1 macrometastasis in 78.8 versus 79.9 versus 87.3%, p = 0.001) were over-represented in the trial population. Time trends indicated, however, that differences may be mitigated over time. Conclusions This interim external validity analysis specifically addresses selection mechanisms during an ongoing trial, potentially increasing generalisability by the time full accrual is reached. Similar validity checks should be an integral part of prospective clinical trials. Trial registration: NCT 02240472, retrospective registration date September 14, 2015 after trial initiation on January 31, 2015
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| 4. |
- Marklinder, Ingela, 1959-, et al.
(författare)
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A Structural Equation Model Demonstrating the Relationship between Food Safety Background, Knowledge, Attitudes and Behaviour among Swedish Students
- 2022
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Ingår i: Foods. - : MDPI. - 2304-8158. ; 11:11
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Tidskriftsartikel (refereegranskat)abstract
- Traditionally, food safety knowledge has been seen as a factor in improving food safety behaviour. However, the relationship between knowledge and behavior is complex. The aim of the present study was to investigate self-reported data from 408 university students regarding food safety background, knowledge, attitudes, and behaviour using Structural Equation Model (SEM) to examine the influence of different factors on food safety behaviour. The SEM was applied to four factors derived from the data: Background, Knowledge, Attitude and Behaviour. The novelty of this current investigation is the inclusion of the Background factor (genus; experience of cooking and handling different food items; experience of a food safety education course; the foremost sources of food safety knowledge). The factors were constructed from variables with sufficient factor loadings and set up in a predetermined structure confirmed to be valid in previous studies. The results, demonstrated as regression coefficients between factors, confirm that the Background factor strongly influenced Knowledge (0.842). The Knowledge factor, in turn, strongly affected Attitude (0.605), while it did not directly affect Behaviour (0.301) in the same way as Attitude. Attitude had a stronger influence on Behaviour (0.438) than Knowledge. Thus, the Attitude factor seemed to play a mediating role between Knowledge and Behaviour. This indicates that students ' attitudes towards the importance of food safety may have an impact on their food safety behavior, which should have implications for the development of food safety education. This warrants further investigation and practical development.
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| 5. |
- Marklinder, Ingela, et al.
(författare)
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Attitudes Related to Food Safety Behavior Among Students in Sweden
- 2021
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Ingår i: IAFP:s European Symposium on food safety. Virtual meeting 27-28 April 2021.. ; , s. 65-
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Konferensbidrag (refereegranskat)abstract
- Introduction: It has earlir been shown through an online questionnaire performed on 606 students from 24 different Swedish universities that the foremost sources of food safety knowledge were family and friends. However, more than a third of the students had experienced food safety education which was shown to provide knowledge and promoted more optimal food safety behavior.Purpose: Self-reported food safety attitudes, knowledge and behaviour among university students in Sweden were investigated through multivariate path analysis in order to identify factors' influence on behavior.Methods: A nationwide web-based questionnaire targeting university students in Sweden was distributed through social media, email and various university contacts. A structural equation model was applied on statistics from the questionnaire. Four factors: Background, Knowledge, Attitude and Behavior were derived from the data. The factors, built up from variables with sufficient factor loadings were set up in a predetermined structure. The structure was based on whether background affects knowledge and whether knowledge affects behavior and attitude, and whether attitude affects behavior. The structure has been confirmed valid in previous studies done.Results: The factor loadings were ranging from -1 to 1 where the closer to 1 indicates a stronger loading. Background affected knowledge (0.841). Attitude has a stronger influence on the Behavior (0.457) than Knowledge (0.278). However, Knowledge has directly a strong effect on Attitude (0.606). Out of 606 respiondents, 408 answers were deemed usable for the analysis. More than half of the variables have sufficient loadings to their respective factors to be included. The goodness-of-fit indices, indicated that the model had a good fit to the data, and this including hypothesis testing with a significance of < 0.005.Significance: It can be confirmed that background such as attending a food safety education strongly influenced knowledge. Knowledge in turns strongly affects attitudes but it does not directly affect bahavior. Thus, attitudes seemed to have a mediating role between food safety knowledge and behavior.
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| 6. |
- Marklinder, Ingela, et al.
(författare)
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Food safety knowledge, sources thereof and self-reported behaviour among university students in Sweden
- 2020
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Ingår i: Food Control. - : Elsevier. - 0956-7135 .- 1873-7129. ; 113
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Tidskriftsartikel (refereegranskat)abstract
- International studies have noted shortcomings in food safety knowledge and behaviour among university students. In general students do not constitute a pronounced risk group but there are wider implications. In a foreseeable future some of them will become pregnant and a majority will be responsible for vulnerable groups in their near environment. A crucial question exists, therefore, about their food safety knowledge and safe food handling practices. The aim of this study is to investigate food safety knowledge, sources thereof and self-reported food safety behavior among university students in Sweden. A quantitative study design using a web-based questionnaire was chosen as the data collection method. The questionnaire was distributed through social media and e-mail. Among the 606 respondents from 24 Swedish universities 80% were 18-30 years and 78% were women. The average number of correct answers on the knowledge questions was 7.61 out of 12 (63.4%). The foremost source of food safety knowledge was "Family and friends" (45%). Just 21.1% reported Food safety education as a source, although 35.6% had experience of a course in food hygiene/safety and/or microbiology. Respondents who reported "Family and friends" to be the foremost food safety source of knowledge also got a significantly lower rate of correct answers. Students who estimated their food safety knowledge to be good also had more correct answers. Experience of food safety education at secondary school/university/working place/polytechnic school significantly correlated with more correct answers on the knowledge questions and indicated a safer self-reported behaviour. Those with fewer correct answers also reported more unfavourable behaviours. The present study indicates that education promotes more optimal behaviors. The authors would suggest a more systematic food safety education at younger ages.
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| 7. |
- Marklinder, Ingela, 1959-, et al.
(författare)
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Food safety knowledge, sources thereof and self-reported behaviour among university students in Sweden
- 2020
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Ingår i: Food Control. - : Elsevier. - 0956-7135 .- 1873-7129. ; 113
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Tidskriftsartikel (refereegranskat)abstract
- International studies have noted shortcomings in food safety knowledge and behaviour among university students. In general students do not constitute a pronounced risk group but there are wider implications. In a foreseeable future some of them will become pregnant and a majority will be responsible for vulnerable groups in their near environment. A crucial question exists, therefore, about their food safety knowledge and safe food handling practices.The aim of this study is to investigate food safety knowledge, sources thereof and self-reported food safety behavior among university students in Sweden.A quantitative study design using a web-based questionnaire was chosen as the data collection method. The questionnaire was distributed through social media and e-mail.Among the 606 respondents from 24 Swedish universities 80% were 18-30 years and 78% were women. The average number of correct answers on the knowledge questions was 7.61 out of 12 (63.4%). The foremost source of food safety knowledge was "Family and friends" (45%). Just 21.1% reported Food safety education as a source, although 35.6% had experience of a course in food hygiene/safety and/or microbiology. Respondents who reported "Family and friends" to be the foremost food safety source of knowledge also got a significantly lower rate of correct answers. Students who estimated their food safety knowledge to be good also had more correct answers. Experience of food safety education at secondary school/university/working place/polytechnic school significantly correlated with more correct answers on the knowledge questions and indicated a safer self-reported behaviour. Those with fewer correct answers also reported more unfavourable behaviours. The present study indicates that education promotes more optimal behaviors. The authors would suggest a more systematic food safety education at younger ages.
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| 8. |
- Rodriguez-Wallberg, Kenny A., et al.
(författare)
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Prevalence and predictors for fertility-related distress among 1010 young adults 1.5 years following cancer diagnosis - results from the population-based Fex-Can Cohort study
- 2023
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Ingår i: Acta Oncologica. - : TAYLOR & FRANCIS LTD. - 0284-186X .- 1651-226X. ; 62:12, s. 1599-1606
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Tidskriftsartikel (refereegranskat)abstract
- Background: Cancer treatment during reproductive ages may negatively impact fertility and there is a need of firm knowledge about the prevalence and predictors of fertility-related distress. The aim was to examine fertility-related distress in a population-based sample of young women and men recently treated for cancer and to identify predictors for this outcome.Material and methods: This nationwide cohort study included 1010 individuals (694 women and 316 men), mean age 34.5 +/- 4.9 and 32.1 +/- 5.5, respectively, diagnosed with breast, cervical, ovarian, testicular cancers, brain tumors or lymphoma at ages 18-39 in Sweden. Participants completed a survey 1.5-year post-diagnosis to assess fertility-related distress (RCAC), emotional distress (HADS) and self-efficacy, as well as sociodemographic and clinical factors and fertility preservation. Logistic regression was used to examine associations between explanatory factors and high fertility-related distress (RCAC subscale mean >4).Results: Many participants (69% of women and 47% of men) had previous children and about half reported a wish for future children. High fertility-related distress was more prevalent among women (54%) than men (27%), and women were more likely than men to report distress concerning all but one RCAC dimension after adjustment for sociodemographic factors. Use of fertility preservation was unevenly distributed (15% of women and 71% of men) and was not associated with decreased fertility-related distress. In multivariable logistic regression models, a wish for future children, being single, not having previous children, symptoms of anxiety and low self-efficacy regarding one's ability to handle threats of infertility were associated with high fertility-related distress.Conclusion: This nationwide study found a high prevalence of fertility-related distress in young women and men recently treated for cancer and identified sociodemographic and psychological predictors. Fertility preservation was not found to act as a buffer against fertility-related distress, indicating the continuous need to identify strategies to alleviate fertility distress following cancer.
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| 9. |
- Wettergren, Lena, et al.
(författare)
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Prevalence and risk factors for sexual dysfunction in young women following a cancer diagnosis : a population-based study
- 2022
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Ingår i: Acta Oncologica. - : Taylor & Francis Group. - 0284-186X .- 1651-226X. ; 61:10, s. 1165-1172
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Tidskriftsartikel (refereegranskat)abstract
- Background: Self-reported sex problems among women diagnosed with reproductive and nonreproductive cancers before the age of 40 are not fully understood. This study aimed to determine sexual dysfunction in young women following a cancer diagnosis in relation to women of the general population. Furthermore, to identify factors associated with sexual dysfunction in women diagnosed with cancer.Materials and Methods: A population-based cross-sectional study with 694 young women was conducted 1.5 years after being diagnosed with cancer (response rate 72%). Potential participants were identified in national quality registries covering breast and gynecological cancer, lymphoma and brain tumors. The women with cancer were compared to a group of women drawn from the general population (N = 493). Sexual activity and function were assessed with the PROMIS® SexFS. Logistic regression was used to assess differences between women with cancer and the comparison group, and to identify factors associated with sexual dysfunction.Results: The majority of the women with cancer (83%) as well as the women from the comparison group (87%) reported having had sex the last month (partner sex and/or masturbation). More than 60% of the women with cancer (all diagnoses) reported sexual dysfunction in at least one of the measured domains. The women with cancer reported statistically significantly more problems than women of the comparison group across domains such as decreased interest in having sex, and vaginal and vulvar discomfort. Women with gynecological or breast cancer and those receiving more intense treatment were at particular high risk of sexual dysfunction (≥2 domains). Concurrent emotional distress and body image disturbance were associated with more dysfunction.Conclusion: The results underscore the need to routinely assess sexual health in clinical care and follow-up. Based on the results, development of interventions to support women to cope with cancer-related sexual dysfunction is recommended.
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