| 1. |
- Hedelin, Maria, et al.
(author)
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Dietary intake of phytoestrogens, estrogen receptor-beta polymorphisms and the risk of prostate cancer
- 2006
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In: The Prostate. - Karolinska Inst, Dept Med Epidemiol & Biostat, SE-17177 Stockholm, Sweden. Orebro Univ Hosp, Dept Urol, Orebro, Sweden. Ctr Assessment Med Technol, Orebro, Sweden. Umea Univ, Dept Radiat Sci Oncol, Umea, Sweden. Harvard Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA 02115 USA. : Wiley-Liss. - 0270-4137 .- 1097-0045. ; 66:14, s. 1512-1520
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Journal article (peer-reviewed)abstract
- BACKGROUND: The causes of prostate cancer are poorly understood, but genetic factors may be more important than for many other malignancies, and dietary phytoestrogens may be protective. Because phytoestrogens bind tightly to the estrogen receptor-beta, we conducted an epidemiologic investigation of synergistic effects between phytoestrogen intake and estrogen receptor-beta gene polymorphisms. METHODS: We performed a population-based case-control study in Sweden. All participants reported their phytoestrogen intake and donated a blood sample. We identified four haplotype-tagging single nucleotide polymorphisms (htSNPs) and genotyped these htSNPs in 1314 prostate cancer patients and 782 controls. Odds ratios were estimated by multivariate logistic regression. Interactions between phytoestrogen intake and estrogen receptor-beta SNPs on prostate cancer risk were evaluated considering both multiplicative and additive effect scales. RESULTS: We found a significant multiplicative interaction (P = 0.04) between dietary intake of phytoestrogens and a promoter SNP in the estrogen receptor-beta gene (rs 2987983-13950), but not with any of the three other htSNPs (P = 0.11, 0.69, 0.85). Among carriers of the variant promoter alleles, we found strong inverse associations with increasing intake of total phytoestrogens (odds ratio for highest vs. lowest quartile = 0.43; P for trend <0.001), isoflavonoids (odds ratio = 0.63; P for trend = 0.05), and coumestrol (odds ratio = 0.57; P for trend = 0.003). We found no association between phytoestrogens and prostate cancer among carriers homozygous for the wild-type allele (TT). CONCLUSIONS: Our study provides strong evidence that high intake of phytoestrogens substantially reduce prostate cancer risk among men with specific polymorphic variation in the promoter region of the estrogen receptor-beta gene.
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| 2. |
- Hedelin, Maria, et al.
(author)
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Dietary phytoestrogen, serum enterolactone and risk of prostate cancer : the cancer prostate Sweden study (Sweden)
- 2006
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In: Cancer Causes and Control. - Karolinska Inst, Dept Med Epidemiol & Biostat, SE-17177 Stockholm, Sweden. Orebro Univ Hosp, Dept Urol, Orebro, Sweden. Ctr Assessment Med Technol, Orebro, Sweden. Univ Helsinki, Dept Clin Chem, SF-00100 Helsinki, Finland. Univ Helsinki, Inst Prevent Med Nutr & Canc, Folkhalsan Res Ctr, Helsinki, Finland. Umea Univ, Dept Radiat Sci Oncol, Umea, Sweden. : Springer. - 0957-5243 .- 1573-7225. ; 17:2, s. 169-180
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Journal article (peer-reviewed)abstract
- OBJECTIVE: Based on evidence that phytoestrogens may protect against prostate cancer, we evaluated the associations between serum enterolactone concentration or dietary phytoestrogen intake and risk of prostate cancer. METHODS: In our Swedish population-based case-control study, questionnaire-data were available for 1,499 prostate cancer cases and 1,130 controls, with serum enterolactone levels in a sub-group of 209 cases and 214 controls. Unconditional logistic regression was performed to estimate multivariate odds ratios (ORs) and 95% confidence intervals (CIs) for associations with risk of prostate cancer. RESULTS: High intake of food items rich in phytoestrogens was associated with a decreased risk of prostate cancer. The OR comparing the highest to the lowest quartile of intake was 0.74 (95% CI: 0.57-0.95; p-value for trend: 0.01). In contrast, we found no association between dietary intake of total or individual lignans or isoflavonoids and risk of prostate cancer. Intermediate serum levels of enterolactone were associated with a decreased risk of prostate cancer. The ORs comparing increasing quartiles of serum enterolactone concentration to the lowest quartile were, respectively, 0.28 (95% CI: 0.15-0.55), 0.63 (95% CI: 0.35-1.14) and 0.74 (95% CI: 0.41-1.32). CONCLUSIONS: Our results support the hypothesis that certain foods high in phytoestrogens are associated with a lower risk of prostate cancer.
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| 3. |
- Holmberg, Lars, et al.
(author)
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National comparisons of lung cancer survival in England, Norway and Sweden 2001-2004 : differences occur early in follow-up
- 2010
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In: Thorax. - : BMJ. - 0040-6376 .- 1468-3296. ; 65:5, s. 436-441
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Journal article (peer-reviewed)abstract
- BACKGROUND Countries with a similar expenditure on healthcare within Europe exhibit differences in lung cancer survival. Survival in lung cancer was studied in 2001-2004 in England, Norway and Sweden. METHODS Nationwide cancer registries in England, Norway and Sweden were used to identify 250 828 patients with lung cancer from England, 18 386 from Norway and 24 886 from Sweden diagnosed between 1996 and 2004, after exclusion of patients registered through death certificate only or with missing, zero or negative survival times. 5-Year relative survival was calculated by application of the period approach. The excess mortality between the countries was compared using a Poisson regression model. RESULTS In all subcategories of age, sex and follow-up period, the 5-year survival was lower in England than in Norway and Sweden. The age-standardised survival estimates were 6.5%, 9.3% and 11.3% for men and 8.4%, 13.5% and 15.9% for women in the respective countries in 2001-2004. The difference in excess risk of dying between the countries was predominantly confined to the first year of follow-up. The relative excess risk ratio during the first 3 months of follow-up comparing England with Norway 2001-2004 varied between 1.23 and 1.46, depending on sex and age, and between 1.56 and 1.91 comparing England with Sweden. CONCLUSION Access to healthcare and population awareness are likely to be major reasons for the differences, but it cannot be excluded that diagnostic and therapeutic activity play a role. Future improvements in lung cancer management may be seen early in follow-up.
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| 4. |
- Klint, Filippa, 1993-, et al.
(author)
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Social work practices with victims of violence among people with cognitive disabilities
- 2023
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In: Nordic Social Work Research. - : Routledge. - 2156-857X .- 2156-8588. ; , s. 1-15
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Journal article (peer-reviewed)abstract
- People with cognitive disabilities are exposed to significantly higher rates of violence in close relationships than the general population. However, social workers may find it challenging to identify victims among them, make risk assessments, and provide support. This study contributes to the field by describing and analysing social workers’ practices with victims of violence in close relationships among people with cognitive disabilities in Sweden. Analysis of five focus-group discussions including 20 social workers revealed four main themes that describe the practices used with these victims, ‘Competency’, ‘The system of collaboration’, ‘Protective and supportive measures’ and ‘Instruments and tools’. Sub-themes illuminate the differences in competency and resources offered to victims of violence in close relationships between mainstream victim services and disability services. Mainstream victim services have a lack of practices adapted for people with cognitive disabilities, and disability services have a lack of practices for victims of violence. Additionally, these services were found to have insufficient collaboration. The findings are discussed in relation to previous research and theory. We suggest that future research should investigate the prerequisites for services to collaborate.
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| 5. |
- Klint, Filippa, 1993-, et al.
(author)
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Social workers' perspective : identification and assessment of victims of intimate partner violence with cognitive disabilities in Sweden
- 2023
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Conference paper (peer-reviewed)abstract
- Background: In Sweden, social workers are responsible for identifying, assessing, and supporting victims of violence among people with and without disabilities. Research has shown that people with cognitive disabilities are more likely to become victims of intimate partner violence (IPV) than non-disabled people. Some reasons for the high rates of victimization that people with cognitive disabilities have reflect a dependence on others in everyday activities, limited access to adapted communication, and lack of education about the victimization of IPV for this group among professionals and social workers. Yet, there are no official disability-adapted assessments to support this work. Very few studies explore the type of adaptations needed to identify and assess the risk of violence against this group. Therefore, this study aims to explore how social workers identify and assess victims of IPV with cognitive disabilities.Method: An explorative and qualitative design using focus group interviews with five groups of social workers was conducted. Each group contained three to five social workers employed either at a municipality’s social services or NGO and having experience working with people with cognitive disabilities or IPV. Group discussions were led through six topics prompting participants to describe their experiences working with people with cognitive disabilities who are victims of IPV.Results: Preliminary results point to both challenges and good examples of the practices concerning identification, assessment, and support of victimization among people with cognitive disabilities focusing on the resources at different types of organizations to meet the needs of this group. Local adaptions of government-recommended assessment tools such as adding picture support or verbally elaborating definitions of IPV were common. Some difficulties in cooperation between and within institutions were also described.Conclusion: Final results and conclusions will be presented at the NNDR research conference in May 2023.
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| 6. |
- Klint, Markus, et al.
(author)
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Lymphogranuloma venereum prevalence in Sweden among men who have sex with men and characterization of Chlamydia trachomatis ompA genotypes
- 2006
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In: Journal of Clinical Microbiology. - 0095-1137 .- 1098-660X. ; 44:11, s. 4066-4071
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Journal article (peer-reviewed)abstract
- An outbreak of lymphogranuloma venereum (LGV) infections has recently been reported from The Netherlands and other European countries. The Swedish surveillance system has identified three LGV cases since 2004, all with clinically suspected infection in men who have sex with men (MSM). In order to assess the prevalence of LGV in a high-risk group of MSM and include clinically atypical cases, retrospective analysis of 197 Chlamydia trachomatis-infected men was performed. Sequencing of the ompA gene showed a different serotype distribution compared to recent Swedish studies in heterosexual populations. The most common types were G (45%), D (27%), and J (26%), whereas the normally predominant type E accounted for only 4% of the chlamydia cases. Furthermore, certain ompA genotype variants of the dominant serotypes were highly prevalent among MSM, and the reason for this is discussed. No additional case of LGV was detected by retrospective analysis of the high-risk MSM population. This indicates that, thus far, LGV in Sweden is only a result of sporadic import from infected MSM clusters abroad.
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| 7. |
- Klint, Åsa, et al.
(author)
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Dying With Unrelieved Pain-Prescription of Opioids Is Not Enough
- 2019
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In: Journal of Pain and Symptom Management. - : Elsevier BV. - 1873-6513 .- 0885-3924. ; 58:5, s. 1-791
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Journal article (peer-reviewed)abstract
- CONTEXT: Fear of pain resonates with most people, in particular, in relation to dying. Despite this, there are still people dying with unrelieved pain.OBJECTIVES: We quantified the risk, and investigated risk factors, for dying with unrelieved pain in a nationwide observational cohort study.METHODS: Using data from Swedish Register of Palliative Care, we analyzed 161,762 expected deaths during 2011-2015. The investigated risk factors included cause of death, place of death, absence of an end-of-life (EoL) conversation, and lack of contact with pain management expertise. Modified Poisson regression models were fitted to estimate risk ratios (RRs) and 95% confidence intervals (CIs) for dying with unrelieved pain.RESULTS: Unrelieved pain during the final week of life was reported for 25% of the patients with pain, despite prescription of opioids PRN in 97% of cases. Unrelieved pain was common both among patients dying of cancer and of nonmalignant chronic diseases. Statistically significant risk factors for unrelieved pain included hospital death (RR = 1.84, 95% CI 1.79-1.88) compared with dying in specialist palliative care, absence of an EoL conversation (RR = 1.42, 95% CI 1.38-1.45), and dying of cancer in the bones (RR = 1.13, 95% CI 1.08-1.18) or lung (RR = 1.10, 95% CI 1.06-1.13) compared with nonmalignant causes.CONCLUSION: Despite almost complete prescription of opioids PRN for patients with pain, patients die with unrelieved pain. Health care providers, hospitals in particular, need to focus more on pain in dying patients. An EoL conversation is one achievable intervention.
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| 8. |
- Klint, Åsa, et al.
(author)
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Rapportering till Cancerregistret kan förbättras
- 2009
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In: Läkartidningen. - 0023-7205 .- 1652-7518. ; 106:11, s. 752-3
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Journal article (peer-reviewed)abstract
- En studie som nyligen publicerades i Acta Oncologica pekar på brister i rapporteringen till Cancerregistret. Studien visar att fall av exempelvis hjärntumörer, lymfom och leukemier inte rapporteras till Cancerregistret i samma utsträckning som bröstcancer och urologiska cancerformer. Underrapporteringen varierar med bland annat typ av vårdinrättning och patientens kön och ålder. Artikeln identifierar problemområden som behöver åtgärdas för att förbättra täckningsgraden i Cancerregistret. Detaljer om uppgiftsskyldigheten till Cancerregistret finns i Socialstyrelsens föreskrift SOSFS 2006:15 (M).
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| 9. |
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| 10. |
- Lindgren, Åsa, et al.
(author)
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Defense mechanisms against grazing : a study of trypsin inhibitor responses to simulated grazing by the sedge Carex bigelowii
- 2007
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In: Oikos. - : Wiley. - 0030-1299 .- 1600-0706. ; 116:9, s. 1540-1546
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Journal article (peer-reviewed)abstract
- Trypsin inhibitors have been suggested to constitute an inducible defense in the sedge Carex bigelowii, and some former studies suggest that this might be a cause for the cyclic population dynamics in many alpine and arctic small mammals, for example lemmings (Lemmus lemmus). We investigated this further by using a method of simulated grazing (clipping) at different intensities, in three different habitats with varying resource availability, with different harvest times (hours after clipping), and two different stages of ramets (reproductive/vegetative) in a study from the Swedish mountain range. Our results do not indicate that C. bigelowii has an inducible defense constituted by an increase in trypsin inhibitor activity (TIA), but rather that the amount of soluble plant proteins (SPP) is lowered in wounded plants. The responses were somewhat different in the three habitats, with ramets growing in the marsh showing the highest ratio of TIA to SPP, due to low amounts of SPP. We did not find any significant effects of harvest time, or of the stage of the ramet that could support the hypothesis of an inducible defense. To conclude, we could not find any evidence for an inducible defense consisting of trypsin inhibitors in Carex bigelowii ramets, but we did find variations in the amount of SPP that may have nutritional consequences for herbivores.
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