| 1. |
- Alevronta, Eleftheria, et al.
(författare)
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Dose-response relationships for an atomized symptom of fecal incontinence after gynecological radiotherapy.
- 2013
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Ingår i: Acta oncologica (Stockholm, Sweden). - : Taylor & Francis. - 1651-226X .- 0284-186X. ; 52:4, s. 719-26
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Tidskriftsartikel (refereegranskat)abstract
- Purpose. The aim of this study was to investigate what bowel organ and delivered dose levels are most relevant for the development of 'emptying of all stools into clothing without forewarning' so that the related dose-responses could be derived as an aid in avoiding this distressing symptom in the future. Material and methods. Of the 77 gynecological cancer survivors treated with radiotherapy (RT) for gynecological cancer, 13 developed the symptom. The survivors were treated between 1991 and 2003. The anal-sphincter region, the rectum, the sigmoid and the small intestines were all delineated and the dose-volume histograms were exported for each patient. The dose-volume parameters were estimated fitting the data to the Relative Seriality (RS), the Lyman and the generalized Equivalent Uniform Dose (gEUD) model. Results. The dose-response parameters for all three models and four organs at risk (OARs) were estimated. The data from the sigmoid fits the studied models best: D50 was 58.8 and 59.5 Gy (RS, Lyman), γ50 was 1.60 and 1.57 (RS, Lyman), s was 0.32, n was 0.13 and a was 7.7 (RS, Lyman, gEUD). The estimated volume parameters indicate that the investigated OARs behave serially for this endpoint. Our results for the three models studied indicate that they have the same predictive power (similar LL values) for the symptom as a function of the dose for all investigated OARs. Conclusions. In our study, the anal-sphincter region and sigmoid fit our data best, but all OARs were found to have steep dose-responses for 'emptying of all stools into clothing without forewarning' and thus, the outcome can be predicted with an NTCP model. In addition, the dose to the four studied OARs may be considered when minimizing the risk of the symptom.
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| 2. |
- Dunberger, Gail, et al.
(författare)
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Cancer survivors' perception of participation in a long-term follow-up study.
- 2013
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Ingår i: Journal of medical ethics. - : BMJ. - 1473-4257 .- 0306-6800. ; 39:1, s. 41-5
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Tidskriftsartikel (refereegranskat)abstract
- Every year medical researchers make contact with a large number of cancer survivors with the aim of evaluating cancer treatment. For this reason we decided to investigate how Swedish cancer survivors perceived their participation in research studies focusing on the long-term consequences of being a survivor of gynaecological or urinary bladder cancer. Data were collected by means of two study-specific postal questionnaires, both consisting of questions covering physical symptoms, well-being and the experience of being a cancer survivor. Both questionnaires also included questions evaluating the participants' experience of being research subjects. The questionnaires were developed in close co-operation with cancer survivors. The study population consisted of 1068 cancer survivors. Of these, 95% (n=1003) reported that they thought the study was valuable and 54% (n=559) that they had been positively affected by participating. Four per cent (n=39) expressed that they had been negatively affected by their participation in the study. The vast majority of the cancer survivors thought that participating in their particular study was valuable.
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| 3. |
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| 4. |
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| 5. |
- Dunberger, Gail, et al.
(författare)
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Loose stools lead to fecal incontinence among gynecological cancer survivors.
- 2011
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Ingår i: Acta oncologica (Stockholm, Sweden). - : Taylor & Francis. - 1651-226X .- 0284-186X. ; 50:2, s. 233-42
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Background. Many patients treated with radiotherapy to the pelvic region report a change in bowel habits. Loose stools, urgency and fecal incontinence may have a significant impact on daily life and social functioning. Material and methods. We attempted to follow up 789 women, treated with pelvic radiotherapy for a gynecological cancer during 1991 to 2003 at two departments of gynecological oncology in Sweden. A control group of 478 women from the Swedish Population Registry was also included. As a preparatory study, we made in-depth interviews with 26 women previously treated for gynecological cancer. Based on their narratives, we constructed a study-specific questionnaire including 351 questions and validated it face-to-face. The questionnaire covered questions of physical symptoms originating in the pelvis, demographics, psychological and quality of life factors. In relation to bowel symptoms, 60 questions were asked. Results. Six-hundred and sixteen (78%) gynecological cancer survivors and 344 (72%) control women participated. Two-hundred and twenty-six (37%) cancer survivors reported loose stools at least once a week. Eighty-three percent of the survivors with loose stools every day reported defecation urgency with fecal leakage, compared to 20% of cancer survivors without loose stools. Cancer survivors with loose stools at least once a week were 7.7 times more likely to suffer from defecation urgency with fecal leakage (95% CI 4.4-13.3) compared to those who had loose stools once a month or less. In order to avoid loose stools affected survivors with loose stools often skipped meals (13%), made an active choice of food (47%) and preferentially used prescribed medication (36%). Discussion. There is a relation between loose stools and defecation urgency with fecal leakage among long-term gynecological cancer survivors treated with pelvic radiotherapy. Targeting loose stools can possibly help survivors to decrease frequency of fecal leakage.
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| 6. |
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| 7. |
- Hallström, Helena, et al.
(författare)
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Coffee consumption and CYP1A2 genotype in relation to bone mineral density of the proximal femur in elderly men and women : a cohort study
- 2010
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Ingår i: Nutrition & Metabolism. - : Springer Science and Business Media LLC. - 1743-7075. ; 7, s. 12-
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT: BACKGROUND: Drinking coffee has been linked to reduced calcium conservation, but it is less clear whether it leads to sustained bone mineral loss and if individual predisposition for caffeine metabolism might be important in this context. Therefore, the relation between consumption of coffee and bone mineral density (BMD) at the proximal femur in men and women was studied, taking into account, for the first time, genotypes for cytochrome P450 1A2 (CYP1A2) associated with metabolism of caffeine. METHODS: Dietary intakes of 359 men and 358 women (aged 72 years), participants of the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS), were assessed by a 7-day food diary. Two years later, BMD for total proximal femur, femoral neck and trochanteric regions of the proximal femur were measured by Dual-energy X-ray absorptiometry (DXA). Genotypes of CYP1A2 were determined. Adjusted means of BMD for each category of coffee consumption were calculated. RESULTS: Men consuming 4 cups of coffee or more per day had 4% lower BMD at the proximal femur (p = 0.04) compared with low or non-consumers of coffee. This difference was not observed in women. In high consumers of coffee, those with rapid metabolism of caffeine (C/C genotype) had lower BMD at the femoral neck (p = 0.01) and at the trochanter (p = 0.03) than slow metabolizers (T/T and C/T genotypes). Calcium intake did not modify the relation between coffee and BMD. CONCLUSION: High consumption of coffee seems to contribute to a reduction in BMD of the proximal femur in elderly men, but not in women. BMD was lower in high consumers of coffee with rapid metabolism of caffeine, suggesting that rapid metabolizers of caffeine may constitute a risk group for bone loss induced by coffee.
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| 8. |
- Lind, Carl, et al.
(författare)
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RAMP - Development of a risk assessment tool
- 2012
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Ingår i: NES2012 Ergonomics for sustainability and growth. - Stockholm. - 9789163711497 ; , s. 14s-
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Konferensbidrag (refereegranskat)abstract
- IntroductionManual Materials Handling (MMH) and working in awkward postures are still important causes of MSDs. Proper ergonomic conditions can contribute to reduce absence from work, and are important prerequisites to ensure high quality and productivity. Risk assessment can be used to improve the working conditions by identifying important risk factors and support communication between key stakeholders in order to improve the working conditions.This paper presents an ongoing project called RAMP (Risk management Assessment tool for Manual handling Proactively), reported e.g. at NES 2011. The aim of the project is to develop a freely accessible load ergonomic risk assessment tool and to gain knowledge of contributing factors for implementation and usability of such a tool. The RAMP-tool is developed for assessing risk of MSDs, support communication of the main risk factors among stakeholders and support effective interventions. The project, mainly financed by AFA Insurance, is conducted in collaboration between KTH and companies in the manufacturing industry, mainly Arla Foods and Scania CV.MethodsThis far an overview of risk assessment tools which can be used to assess MMH activities and potentially be used by companies or OSH personnel has been performed including e.g. KIM, QEC, ART Tool, SES and Washington State Checklist. Interviews with companies in the manufacturing industry have been performed to gain insight of the companies’ use of risk assessment tools and their perception of their usability.ResultsThe tool consists of two levels, RAMP I and RAMP II. The first level is intended for quick screening of work stations of occurrence (or not) of risk factors. If the screening indicates an occurrence of a risk factor, a more thorough analysis with the second level could be performed. RAMP II can be used for a more detailed analysis of the exposure to risk factors and point out the direction of possible improvements in order to reduce the exposure.A first prototype of the RAMP I has been evaluated by users, including managers, health and safety representatives, OSH personnel and workers.The tool will be further evaluated and refined after feedback from users. A preliminary version of the RAMP I will be presented at the conference and also preliminary results from the user tests.
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| 9. |
- Lind, Carl, et al.
(författare)
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RAMP: Risk Management Assessment Tool for Manual Handling Proactively
- 2014
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Ingår i: HUMAN FACTORS IN ORGANIZATIONAL DESIGN AND MANAGEMENT – XINORDIC ERGONOMICS SOCIETY ANNUAL CONFERENCE – 46. ; , s. 107-110
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Konferensbidrag (refereegranskat)abstract
- This paper presents an IT-based risk management tool called RAMP, risk assessment management tool for manual handling proactively. The tool consists of a checklist (RAMP I) and an assessment tool (RAMP II) which can be used to assess physicalrisk factors associated with manual handling activities in the production industry. The tool provides guidance for action plans and evaluations to promote improvement of occupational health and safety work at company level. Examples of the tool, its development and evaluation are presented.
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| 10. |
- Lind, Helena
(författare)
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Antifungal properties of dairy propionibacteria
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Today global agriculture is facing major challenges. The world's population is growing rapidly and we need to meet the increasing need for food with new strategies, including environmentally sustainable practices. Production must be enhanced with optimised resource utilisation and improved storage and distribution techniques. In addition, consumer demands for a reduction in artificial preservatives require innovative research thinking. The use of microorganisms as biopreservatives has many advantages. They often originate from environments similar to those where they will be used, making their presence natural. Bacteria such as lactic acid bacteria and dairy propionibacteria produce weak organic acids with good preserving capacity and several other antimicrobial compounds. Dairy propionibacteria possess additional advantageous features such as high production of vitamin b₁₂ and folic acid. Some strains also produce exopolysaccharides, useful for texture enhancement in dairy products. This thesis focuses on the antifungal properties of dairy propionibacteria. An important part of their antifungal capacity is due to the production of organic acids. The effect of these acids at different ph and different concentrations against eight spoilage fungi was investigated. A ph-dependent growth inhibition effect was detected, with Penicillium roqueforti being the most sensitive fungal species. In addition, dairy propionibacteria produce a number of other compounds with antifungal activity. Identification of 3-phenyl lactic acid and several antifungal peptides present in the growth medium was made after separation with a solid phase extraction column and hplc. The antifungal activity was monitored by screening against Aspergillus fumigatus. Strong enhancement of the antifungal activity from dairy propionibacteria in combination with glycerol was demonstrated. Addition of 500 mm glycerol to the upper layer in an overlay assay reduced the growth of some spoilage fungi completely. An antifungal strain of Propionibacterium jensenii was combined with Lactobacillus fermentum in a biopreserving culture used in moist grain preservation. The addition of glycerol to the system enhanced production of propionic acid in some cases, and an earlier decline in ph was detected. However, this combination of bacteria was not able to reduce the growth of P. roqueforti.
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