| 1. |
- Dunberger, Gail, et al.
(author)
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Cancer survivors' perception of participation in a long-term follow-up study.
- 2013
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In: Journal of medical ethics. - : BMJ. - 1473-4257 .- 0306-6800. ; 39:1, s. 41-5
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Journal article (peer-reviewed)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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| 2. |
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| 3. |
- Danielsson, Gun, et al.
(author)
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Bladder health in patients treated with BCG instillations for T1G2-G3 bladder cancer - a follow-up five years after the start of treatment
- 2018
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In: Scandinavian journal of urology. - : Medical Journals Sweden AB. - 2168-1805 .- 2168-1813. ; 52:5-6, s. 377-384
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Journal article (peer-reviewed)abstract
- Objective: Investigate symptoms and how they affect daily life in patients with Non-Muscle Invasive Bladder Cancer (NMIBC) treated with Bacillus Calmette-Guérin (BCG) instillations.Materials and methods: Patients treated with BCG were included. After an initial transurethral resection (TURB) followed by a second-look resection, the patients were given an induction course with BCG for 6 weeks followed by maintenance therapy for 2 years. The patients answered a questionnaire before, during and after the treatment. The questionnaire contained questions about specific symptoms combined with bother questions on how each symptom affected patients’ life.Results: In total, 113 of 116 patients responded to the first questionnaire. Thirty per cent of all patients were bothered by disease-specific symptoms before the start of BCG. Few patients reported fever, haematuria, illness or urinary tract symptoms. No difference in symptoms was found between patients with or without concomitant CIS (carcinoma in situ). Patients younger than 65 years of age reported a greater worry about the symptom burden in the future than those who were older. Patients younger than 65 years reported a decreased level of mental well-being.Conclusion: Patients with bladder cancer T1G2–G3 had disease-specific symptoms present already before the start of the BCG. The burden of symptoms was reduced over time and showed that the bladder might recover. BCG instillations had side-effects that negatively affected the patient’s well-being. It is important to record the patients’ baseline bladder and voiding status before as well as during the BCG-instillation period in order to understand symptoms caused by the treatment.
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| 4. |
- Gedeborg, Helena, et al.
(author)
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Samverkan lärare-studenter nyckeln till lyckad förändring
- 2007
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In: Läkartidningen. - 0023-7205. ; 104:38, s. 2689-2692
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Journal article (peer-reviewed)abstract
- Vår utgångspunkt är den nya kursen »Individ och samhälle« på den reformerade läkarutbildningens avslutande termin. Som lärare betonar vi vikten av att kompetensmål, arbetsformer och examination hänger samman på ett klart och tydligt sätt, så att de studerande styrs rätt i sitt lärande. Som studerande lyfter vi fram förutsättningarna för en aktiv studerandemedverkan: att involveras medan möjlighet till påverkan ännu finns, att bli väl insatta i de aktuella frågorna och, inte minst, att bli tagna på allvar. Nu återstår att se om de fina planerna håller måttet i den pedagogiska vardagen, också på lite längre sikt.
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| 5. |
- Lindh, Ingrid, et al.
(author)
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Feeding of mice with Arabidopsis thaliana expressing the HIV-1 subtype C p24 antigen gives rise to systemic immune responses
- 2008
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In: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS). - Oxford : Blackwell. - 0903-4641 .- 1600-0463 .- 0903-465X .- 1600-5503. ; 116:11, s. 985-994
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Journal article (peer-reviewed)abstract
- Development of transgenic edible plants, to be used as production, storage and delivery systems for recombinant vaccine antigens, is a promising strategy to obtain cost effective vaccines against infectious diseases, not the least for use in developing countries. Therefore, we used Agrobacterium tumefaciens-mediated gene transfer to introduce the p24 gag gene encoding the nucleocapsid protein from HIV-1 subtype C into the Arabidopsis thaliana plant genome. Eighteen plant lines were confirmed positive for the p24 gene by PCR, four of these lines showed an apparent homozygous phenotype when grown on selective medium and these lines also showed transcription of the p24 gene into its corresponding mRNA. The mRNA in all four cases generated the p24 protein in plants, as verified by western blot analysis. The plants were shown to contain between 0.2 µg and 0.5 µg p24 protein per g of fresh tissue. Analysis of the localisation of the p24 protein showed that stem tissue contained the largest amount of protein, more than twice as much as leaf tissue, whereas no p24 protein was detected in roots. By using Southern blotting, we found that 4, 2-3, 2 and 1 T-DNA insertion events took place in the four lines 1, 2, 7, and 10, respectively. The genetic insertions of line 1 were stable from the T1 to the T4 generation and gave rise to the p24 protein in all cases, as verified by western blotting. In mice fed with fresh transgenic A. thaliana (line 10), anti-gag IgG was obtained in serum after a booster injection with recombinant p37Gag. No immune response was observed after equal booster injection of untreated mice or mice fed with A. thaliana WT plants.
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| 6. |
- Thulin, Carl-Gustaf, et al.
(author)
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Ethical Considerations for Wildlife Reintroductions and Rewilding
- 2020
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In: Frontiers in Veterinary Science. - : Frontiers Media SA. - 2297-1769. ; 7
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Research review (peer-reviewed)abstract
- The recovery of many populations of large carnivores and herbivores in major parts of Europe and North America offers ecosystem services and opportunities for sustainable utilization of wildlife. Examples of services are hunting, meat, and skin, along with less invasive utilization such as ecotourism and wildlife spotting. An increasing number of studies also point out the ecosystem function, landscape engineering, and cascading effects of wildlife as values for human existence, biodiversity conservation, and ecosystem resilience. Within this framework, the concept of rewilding has emerged as a means to add to the wilderness through either supplementary release of wildlife species already present or reintroduction of species formerly present in a certain area. The latter involves translocation of species from other geographical areas, releases from captivity, feralization, retro-breeding, or de-domestication of breeds for which the wild ancestor is extinct. While all these initiatives aim to reverse some of the negative human impacts on life on earth, some pose challenges such as conflicts of interest between humans and wildlife in, for example, forestry, agriculture, traffic, or disease dynamics (e.g., zoonosis). There are also welfare aspects when managing wildlife populations with the purpose to serve humans or act as tools in landscape engineering. These welfare aspects are particularly apparent when it comes to releases of animals handled by humans, either from captivity or translocated from other geographical areas. An ethical values clash is that translocation can involve suffering of the actual individual, while also contributing to reintroduction of species and reestablishment of ecological functions. This paper describes wildlife recovery in Europe and North America and elaborates on ethical considerations raised by the use of wildlife for different purposes, in order to find ways forward that are acceptable to both the animals and humans involved. The reintroduction ethics aspects raised are finally formulated in 10 guidelines suggested for management efforts aimed at translocating wildlife or reestablishing wilderness areas.
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| 7. |
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| 8. |
- Thulin, Helena, et al.
(author)
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Defecation disturbances after cystectomy for urinary bladder cancer
- 2011
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In: BJU International. - : Blackwell Publishing Ltd. - 1464-4096 .- 1464-410X. ; 108:2, s. 196-203
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Journal article (peer-reviewed)abstract
- What’s known on the subject? and What does the study add?Functional gastrointestinal symptoms and problems are common after radical cystectomy with urinary diversion. This study adds new important epidemiological data on this group of symptoms. OBJECTIVE: To describe and compare long-term defecation disturbances in patients who had undergone a cystectomy due to urinary bladder cancer with non-continent urostomies, continent reservoirs and orthotopic neobladder urinary diversions. PATIENTS AND METHODS: During their follow-up we attempted to contact all men and women aged 30–80 years who had undergone cystectomy and urinary diversion at seven Swedish hospitals. During a qualitative phase we identified defecation disturbances as a distressful symptom and included this item in a study-specific questionnaire together with free-hand comments. The patients completed the questionnaire at home. Outcome variables were dichotomized and the results are presented as relative risks with 95% confidence interval. RESULTS: The questionnaire was returned from 452 (92%) of 491 identified patients. Up to 30% reported problems with the physiological emptying process of stool (bowel movement, sensory rectal function, awareness of need for defecation, motoric rectal and anal function, straining ability). A sense of decreased straining capacity was reported by 20% of the men and women with non-continent urostomy and 14% and 8% of those with continent reservoirs and orthotopic neobladders, respectively. CONCLUSIONS: Of the cystectomized individuals 30% reported problems with the physiological emptying process of stool (bowel movement, sensory rectal function, awareness of need for defecation, motoric rectal and anal function, straining ability). Those wanting to improve the situation for bladder cancer survivors may consider communicating before surgery the possibility of stool-emptying problems, and asking about them after surgery.
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| 9. |
- Thulin, Helena, et al.
(author)
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Hygiene and urinary tract infections after cystectomy in 452 Swedish survivors of bladder cancer.
- 2009
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In: BJU International. - 1464-4096 .- 1464-410X.
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Journal article (peer-reviewed)abstract
- OBJECTIVES To determine whether or not an improved hygiene can lessen the incidence of symptomatic urinary tract infections (UTIs) in patients treated by cystectomy for urinary bladder cancer. PATIENTS AND METHODS We attempted to contact during their follow-up all men and women aged 30-80 years who had undergone cystectomy and urinary diversion at seven Swedish hospitals. During a qualitative phase we identified hygienic measures and included them in a study-specific questionnaire. The patients completed the questionnaire at home. Outcome variables were dichotomized and the results presented as relative risks (RR) with 95% confidence interval. RESULTS We received the questionnaire from 452 (92%) of 491 identified patients. The proportion of patients who had a symptomatic UTI in the previous year was 22% for orthotopic neobladder and cutaneous continent reservoir, and 23% for non-continent urostomy diversion. The RR for a UTI was 1.1 (0.5-2.5) for 'never washing hands' before handling with catheters or ostomy material. Patients with diabetes mellitus had a RR of 2.1 (1.4-3.2) for having a symptomatic UTI. CONCLUSIONS We could not confirm lack of hygiene measures as a cause of UTI for men and women who had a cystectomy with urinary diversion. Patients with diabetes mellitus have a greater risk of contracting a UTI.
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| 10. |
- Thulin, Helena, et al.
(author)
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Sleep disturbances decrease self-assessed quality of life in individuals who have undergone cystectomy.
- 2010
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In: The Journal of urology. - : Ovid Technologies (Wolters Kluwer Health). - 1527-3792 .- 0022-5347. ; 184:1, s. 198-202
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Journal article (peer-reviewed)abstract
- The best possible urinary diversion after cystectomy, if any, is yet to be defined to our knowledge. Therefore, we investigated nocturnal urinary disturbances and quality of life in individuals who have undergone cystectomy with urinary diversion for bladder cancer.
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