| 1. |
- Agnér, Ulf, et al.
(author)
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Norra Hammarbyhamnen : Tillbaka till kvrtersstaden
- 2018
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Reports (other academic/artistic)abstract
- Denna publikation är ett resultat av läsåret 2017-2018 i kursen Restaureringskonst vid Kungl. Konsthögskolan, arkitekturavdelningen. Årets tema var bostadsarkitektur. Förvalta, förädla, förvanska? Under läsåret undersöktes bostadsarkitekturen som kulturarv, hur bostadshus och bostadsområden förvaltas, förädlas alternativt förvanskas genom restaureringsåtgärder, förtätningar och omvandlingar. II läsårets projektstudie ingick fem bostadsområden i södra Stockholm, utvalda för att representera varsin epok i 1900-talets bostadsutveckling. En projektgrupp för varje bostadsområde gjorde studier i olika skalor, från den utvalda lägenhetens detaljer, trapphuset och bostadshuset, gården och gatan till stadsdelsnivån.
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| 2. |
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| 3. |
- Anderberg, Eva, et al.
(author)
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Diabetes and pregnancy: women's opinions about the care provided during the childbearing year.
- 2009
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In: Scandinavian Journal of Caring Sciences. - : Wiley. - 1471-6712 .- 0283-9318. ; 23:1, s. 161-170
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Journal article (peer-reviewed)abstract
- Scand J Caring Sci; 2009 Diabetes and pregnancy: women's opinions about the care provided during the childbearing yearBackground: The extended programmes for pregnant women with diabetes, needed to improve pregnancy outcome, might negatively influence the experience of expecting a baby. Aim: To investigate opinions about care during pregnancy, childbirth and the postnatal period among women with diabetes mellitus (DM) and gestational DM (GDM). Method: A four-part questionnaire was constructed, covering the childbearing year, with a focus on treatment and information. A total of 156 women were asked to participate (53 DM, 103 GDM), three refused. The questionnaire was anonymous. Results: The reply frequency was 94%. Of all answers, 95% fell in neutral-satisfied range (Lickert scale 2-5). Three answering patterns deviated positively (care on Specialist Antenatal Clinic, accessibility, and participation-responsibility-respect). Four patterns deviated negatively (information flow, preparation, postpartum care and postpartum check-up). Increased supervision caused problems with time for the family and at work. Comments showed focus on diabetes, forcing the healthy pregnancy aspects into the background. The answers concerning treatment indicated satisfaction (4 + 5 Lickert scale). Women with GDM felt badly prepared before the glucose tolerance test. It was doubtful whether they had been able to make an informed choice about participating. Lack of knowledge among staff was pointed out. Need for more written material was expressed. Conclusion: Satisfaction with care was shown. A discussion about the implication of informed choice with both staff and mothers are needed. Sharper implementation of the diabetes-care-chain was also an area for improvement.
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| 4. |
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| 5. |
- Anderberg, Eva
(author)
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GENERAL ORAL GLUCOSE TOLERANCE TEST DURING PREGNANCY, AN OPPORTUNITY FOR IMPROVED PREGNANCY OUTCOME AND IMPROVED FUTURE HEALTH.
- 2010
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Doctoral thesis (other academic/artistic)abstract
- Gestational diabetes mellitus (GDM) is associated with a risk of adverse pregnancy outcome and is a predictor of subsequent diabetes. The aims of this work were to describe a reliable routine to diagnose abnormal glucose tolerance during pregnancy, to investigate women’s opinions of the specialist care provided, to determine the prevalence of diabetes one year after giving birth, and to elucidate the effect of abnormal glucose tolerance on pregnancy outcome and on the women’s future health. Routines for a general decentralised oral glucose tolerance test (OGTT) at antenatal clinics, with high quality and high compliance of the patients are described. Perinatal outcome was determined and compared for the years 1995-1999 and 2000-2003, and in two geographical areas with different screening routines (OGTT and random glucose measurements, RGM). The routine use of OGTTs identified twice as many cases of GDM as RGM. Those not identified with RGM were as affected. The women’s opinions of the extended care programme were analysed using a questionnaire. The results showed great satisfaction with the care provided, especially the sound knowledge of the staff. However, a desire for better preparation before the OGTT, better information flow and more information on normal pregnancy was expressed. Women delivered in 2003-2005 who had undergone an OGTT during pregnancy participated in a follow-up study 1-2 years after delivery. Different cut-off limits were used for 2-h capillary plasma glucose concentrations at OGTT during pregnancy. GDM >10.0 mmol/L, gestational impaired glucose tolerance (GIGT) 8.6-9.9 mmol/L, and a control group <8.6 mmol/L. At follow-up, 11% (n=160) of the GDM group, 4% (n=309) of the GIGT group and none of the controls had diabetes. When diagnosed with GIGT a retest was offered. Two-thirds of the women with diabetes after GIGT were found in the group diagnosed as having GDM after retest during pregnancy. Adverse pregnancy outcome was observed in both the GDM and GIGT groups compared with the controls. Women with previous GDM were more than 3 times as likely as a group to consume health care resources in a year after delivery (odds ratio 3.5, 95% CI 2.5-5.0), leading to an average 50% higher cost (p<0.001). Annual excess cost was apparent up to 7 years after childbirth (p<0.01). A general routine OGTT during pregnancy identifies women with GDM, providing the opportunity to improve the pregnancy outcome and to make lifestyle changes that can improve the future health of both mother and child.
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| 6. |
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| 7. |
- Anderberg, Eva, et al.
(author)
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Prevalence of impaired glucose tolerance and diabetes after gestational diabetes mellitus comparing different cut-off criteria for abnormal glucose tolerance during pregnancy.
- 2011
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In: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 90, s. 1252-1258
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Journal article (peer-reviewed)abstract
- Objective. To determine the prevalence of diabetes and impaired glucose tolerance after gestational diabetes mellitus in relation to different categories of glucose tolerance during pregnancy. Design. Prospective study. Setting. Four delivery departments and three hospitals in southern Sweden took part in recruitment and follow-up. Population. Women undergoing a 75 g oral glucose tolerance test during pregnancy delivering in 2003-2005. Methods. At first follow-up, 1-2 years after delivery, 29% of eligible women with abnormal glucose tolerance during pregnancy had an oral glucose tolerance test; 160 with gestational diabetes, 309 with gestational impaired glucose tolerance, in addition to 167 control women. Cut-off levels defining gestational diabetes and impaired glucose tolerance were 2-hour capillary blood glucose levels 9.0 and 7.8 mmol/l or plasma glucose 10.0 and 8.6 mmol/l, respectively. Main outcome measures. Frequency of abnormal test results at follow-up. Results: Diabetes was diagnosed in 11% and impaired glucose tolerance in 24% of women with gestational diabetes vs. 4% and 23% in those with gestational impaired glucose tolerance. Combining women with abnormal test results during pregnancy revealed diabetes or impaired glucose tolerance in 29% as compared to 10% among controls; the odds ratio (95% confidence interval) for having abnormal test results was 3.3 (1.8-5.9) in a multivariate logistic regression analysis. Conclusions: Lowering the cut-off level for gestational diabetes to also include the category of impaired glucose tolerance would identify a high percentage of women with diabetes and impaired glucose tolerance postpartum, they constitute target groups for intervention and/or diabetes prevention.
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| 8. |
- Anderberg, Eva, et al.
(author)
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The impact of gestational diabetes mellitus on pregnancy outcome comparing different cut-off criteria for abnormal glucose tolerance.
- 2010
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In: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 89:12, s. 1532-1537
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Journal article (peer-reviewed)abstract
- Abstract Objective. To examine pregnancy outcomes in relation to different categories of glucose tolerance during pregnancy. Design. Prospective observational cohort study. Setting. Patient recruitment and data collection were performed in four delivery departments in southern Sweden. Population. Women delivering during 2003-2005; 306 with gestational diabetes mellitus, 744 with gestational impaired glucose tolerance and 329 randomly selected controls. Methods. All women were offered a 75 g oral glucose tolerance test during pregnancy. On the basis of their capillary 2-hour plasma glucose concentrations, three groups were identified: gestational diabetes mellitus (>10.0 mmol/l), gestational impaired glucose tolerance (8.6-9.9 mmol/l) and controls (<8.6 mmol/l). Data for the groups were compared using a population-based database. Main outcome measures. Maternal and fetal outcomes. Results. For the gestational diabetes mellitus group, adjusted odds ratios (95% confidence intervals) for hypertensive disorders during pregnancy and induction of labor and emergency cesarean section were 2.7 (1.3-5.8), 3.1 (1.8-5.2) and 2.5 (1.5-4.4), respectively; and for Apgar score <7 at 5 minutes, need for neonatal intensive care >1 day and large-for-gestational age infant were 9.6 (1.2-78.0), 5.2 (2.8-9.6) and 2.5 (1.3-5.1), respectively. The increases in odds ratios for the gestational impaired glucose tolerance group were less pronounced but still significant for hypertension during pregnancy, induction of labor, large-for-gestational age infant and use of neonatal intensive care >1 day, with odds ratios (95% confidence interval) 2.0 (1.0-4.1), 1.8 (1.1-3.0), 2.1 (1.1-3.9) and 2.1 (1.1-3.8), respectively. Conclusions. These data indicate that even limited degrees of maternal hyperglycemia may affect the outcome of pregnancy.
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| 9. |
- Anderberg, Eva, et al.
(author)
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Use of healthcare resources after gestational diabetes mellitus: A longitudinal case-control analysis.
- 2012
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In: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 40:4, s. 385-390
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Journal article (peer-reviewed)abstract
- AIMS: To analyse whether gestational diabetes mellitus (GDM) was associated with increases in healthcare utilisation after delivery. METHODS: A longitudinal case-control registry-based study of 579 women with GDM delivered in 1995-2001. Two controls for each case were selected from the Swedish National Board of Health and Welfare, matched for year of birth, year of delivery, and municipality of residence. Data regarding healthcare utilisation was provided by the Patients' Administrative System in Skåne County, Sweden, covering the period from the years of delivery up to year 2009. RESULTS: Women with previous GDM had higher mean number of contacts and total cost in the years after delivery as compared to controls, also when excluding utilisation related to subsequent pregnancies and childbirth. By year 2009, 31% of women with prior GDM were diagnosed with diabetes, compared to 1% of controls. Women diagnosed with diabetes were more likely to use health care (odds ratio 14.22, 95% confidence interval 5.87-34.45) controlling for age and time since delivery, whereas cases not diagnosed with diabetes did not differ from controls. The average annual cost of healthcare utilisation was 101% higher (p<0.001) for women with diabetes 10 years after delivery compared to controls. CONCLUSIONS: GDM was associated with higher healthcare utilisation postpartum for women who had a diabetes diagnosis. The results call for implementation of structured programmes to follow up women with GDM postpartum for early detection of diabetes and effective management, which may have the potential for improved health and savings in healthcare costs.
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| 10. |
- Anderberg, Mats, 1961-, et al.
(author)
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Strukturerade intervjuer inom missbruksvården : - som en grund för kunskapsutveckling
- 2009
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Doctoral thesis (other academic/artistic)abstract
- Anderberg, Mats & Dahlberg, Mikael (2009). Strukturerade intervjuer inom missbruksvården – som en grund för kunskapsutveckling (Structured interviews in substance abuse treatment - as a foundation for the development of knowledge). In the discussion on knowledge development in social work, structured interviews have attracted an increasing amount of attention. The aim of this thesis is to examine and analyze how structured interviews can serve as a basis in the compilation and development of knowledge for practice and research in addiction treatment. More precisely, it means a problematization of the methodological issues that are of central importance in studying treatment outcomes, in which structured interviews form the basis. The methodological aspects in focus here are scientific concepts such as reliability, validity and specific factors in the evaluation of treatment interventions. A further objective is to outline a model for analysis when compiling and evaluating treatment outcome. The five empirical studies have been conducted in their natural context, in organisations in which structured interviews with clients are carried out as an everyday routine and used for e.g. treatment planning. The structured interview DOK (a Swedish abbreviation for Documentation of clients) is used as a basis and an example for the empirical studies in this thesis. The validation studies show that the DOK interview generally attains a good level of reliability and validity, but also contains a small number of variables that do not live up to the requirements which may be imposed. Deficiencies in operationalization and question construction seem to have a large impact. Another conclusion is that it is possible to carry out validation studies, where each variable is examined separately and evaluated with the aid of both sound methodological starting points and relevant statistical theory. Another of the central questions, the thesis addresses, is how structured interviews can be used as a basis for evaluation of treatment. The two studies which highlight this issue show that it is obvious that structured interviews are suitable for such a purpose, through its standardized form and multi-dimensional nature. Validation of structured interviews or evaluation of social interventions should not be reduced to single numbers or values. The multidimensional nature of the structured interview shall also be reflected in the results and analysis. The thesis presents an analysis model for evaluating treatment outcome in relation to two empirical examples and foregoing theoretical starting points. Our view is that structured interviews can provide a link between practice and research and thus contribute to the development of knowledge in social work and substance abuse treatment.
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| 11. |
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| 12. |
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| 13. |
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| 14. |
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| 15. |
- Bojner Horwitz, Eva, 1965-
(author)
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Dance/Movement Therapy in Fibromyalgia Patients : Aspects and Consequences of Verbal, Visual and Hormonal Analyses
- 2004
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Doctoral thesis (other academic/artistic)abstract
- This thesis presents hormonal, emotional, physical and visual status changes in female fibromyalgia (FMS) patients after treatment with the Creative Art therapy; dance/movement therapy, compared to controls. FMS is a syndrome of chronic pain involving musculoskeletal aches, stiffness and pain where perturbations in the stress-axis and high scores on somatic anxiety and muscular tension also have been found. The study comprises thirty-six female FMS patients divided in treatment- and control group. Serum concentrations of the hormones prolactin, dehydroepiandrosterone sulphate (DHEA-S), cortisol and neuropeptide Y (NPY) in plasma and cortisol in saliva were analysed. Different verbal self-rating scales concerning well-being, pain, personality and life events among other things have been used. Assessments of the condition of the FMS patients affected by video-viewing were evaluated together with interviews about the self-perception phenomenon of video viewing (a phenomenological hermeneutic method). The results of the study show that six months of dance/movement therapy appears sufficient to improve both psychological and physical function, as indicated by the visual analyses. The video interpretation technique (VIT) and self-figure drawings captured treatment effects that were not evident from verbal scales or reflected in hormone levels. The biological markers probably need a longer treatment period to activate the HPA axis and its inter-related hormones and peptides. The use of different assessment techniques most likely has affected the treatment outcome. Difficulties perceiving information through verbal/cognitive modalities as well as alexithymia are factors discussed. The VIT may be useful for early identification of maladaptive movement patterns and as a mirror of facial and bodily expressions of emotions. In conclusion, this study indicates that both the dance/movement therapy and the VIT have had great influence on the FMS patient’s well-being, self-perception and perception of pain.
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| 16. |
- Bojner Horwitz, Eva, et al.
(author)
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Dance/movement therapy in fibromyalgia patients : Changes in self-figure drawings and their relation to verbal self-rating scales
- 2006
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In: The arts in psychotherapy. - : Elsevier BV. - 0197-4556 .- 1873-5878. ; 33:1, s. 11-25
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Journal article (peer-reviewed)abstract
- This study evaluates if verbally oriented scales are as effective as the visual instruments of self-figure drawing and video interpretation in detecting treatment responses after 6 months of dance/movement therapy in fibromyalgia patients.The self-figure drawing and video interpretation technique captured treatment effects that were not seen on verbal scales. In the self-figure drawings, significant differences were seen in the variables “amount of body details” and “amount of paper use in percent” between the treatment group and controls after dance/movement therapy. The treatment group showed a significant increase in the “amount of body details” and “amount of paper use in percent” compared to controls. Specific parts of the verbally oriented ratings in CPRS, “bodily discomfort” and “compulsive act,” were positively correlated to “number of different colours.” The variable “pain and ache” in the CPRS indicated a negative correlation to the “amount of paper use in percent,” i.e. the more pain, the less paper used.The use of different assessment techniques may affect the treatment outcome and verbal instrumentation may not be the most appropriate in this patient group. Difficulties perceiving information through verbal/cognitive modalities as well as alexithymia are factors that are discussed.
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| 17. |
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| 18. |
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| 19. |
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| 20. |
- Bojner Horwitz, Eva, 1965-, et al.
(author)
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Theater for, by and with fibromyalgia patients : evaluation of emotional expression using video interpretation
- 2010
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In: The arts in psychotherapy. - : Elsevier BV. - 0197-4556 .- 1873-5878. ; 37:1, s. 13-19
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Journal article (peer-reviewed)abstract
- The healing function of theatre is reflected in all human cultures. Today, therapists and scientists work with psychodrama and drama therapy, often describing theatre as the art form closest to life itself.In a unique cooperation between professional actors and a dance movement therapist/pain researcher, patients with fibromyalgia have first been trained in body- and voice expression and thereafter acted out a drama onstage together with professional actors. A video interpretation technique was used to help patients interpret their own emotional expressions towards other actors and evaluate their perceived pain and self-rated health.The results of this experimental study show that the variation of emotional expression from video interpretation is dependent upon whether or not the patient acts with an actor. The intensity of emotional expression increases significantly when acting together with a professional actor. The results also show an increase in self-rated health and a decrease in pain after three months of using this theatre-based technique. A correlation between strong emotional expression and decreased pain was also observed. However, when patients did not actively participate in a theatre play, their self-estimated pain was not significantly decreased.In this study, the cross-fertilization of culture/expressive arts and health care is presented as a new resource for pain treatment. In particular there may be a link between intense emotional expressions when acting with professional actors and decreased perceptions of pain. The paper also discusses the potential therapeutic value of working with professional actors in the treatment of other pain patients. Hopefully, this “healing theatre” can contribute to developing collaboration between actors and creative art therapists and stimulate controlled studies of evidence-based science.
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| 21. |
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| 22. |
- Ekelund, Magnus, et al.
(author)
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Genetic prediction of postpartum diabetes in women with gestational diabetes mellitus
- 2012
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In: Diabetes Research and Clinical Practice. - : Elsevier BV. - 1872-8227 .- 0168-8227. ; 97:3, s. 394-398
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Journal article (peer-reviewed)abstract
- Aims: To examine whether genetic variants that predispose individuals to type 2 diabetes (T2D) could predict the development of diabetes after gestational diabetes mellitus (GDM). Methods: 13 SNPs (FTO rs8050136, CDKAL1 rs7754840 and rs7756992, CDKN2A/2B rs10811661, HHEX rs1111875, IGF2BP2 rs1470579 and rs4402960, SLC30A8 rs13266634, TCF7L2 rs7903146, PPARG rs1801282, GCK rs1799884, HNF1A rs1169288, and KCNJ11 rs5219) were genotyped in 793 women with GDM after a median follow-up of 57 months. Results: After adjustment for age and ethnicity, the TCF7L2 rs7903146 and the FTO rs8050136 variants significantly predicted postpartum diabetes; hazard ratio (95% confidence interval 1.29 (1.01-1.66) and 1.36 (1.06-1.74), respectively (additive model) versus 1.45 (1.01-2.08) and 1.56 (1.06-2.29) (dominant model)). Adjusting for BMI attenuated the effect of the FTO variant, suggesting that the effect was mediated through its effect on BMI. Combining all risk alleles to a weighted risk score was significantly associated with the risk of postpartum diabetes (hazard ratio 1.11, 95% confidence interval 1.05-1.18, p = 0.00016 after adjustment for age and ethnicity). Conclusions: The TCF7L2 rs7903146 and FTO rs8050136 polymorphisms, and particularly a weighted risk score of T2D risk alleles, predict diabetes after GDM. Further studies in other populations are needed to confirm our results. (C) 2012 Elsevier Ireland Ltd. All rights reserved.
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| 23. |
- Eskilsson, Anja, et al.
(author)
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Decompression of the greater occipital nerve improves outcome in patients with chronic headache and neck pain — a retrospective cohort study
- 2021
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In: Acta Neurochirurgica. - : Springer Science and Business Media LLC. - 0001-6268 .- 0942-0940. ; 163:9, s. 2425-2433
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Journal article (peer-reviewed)abstract
- Background: Compression of the greater occipital nerve (GON) may contribute to chronic headache, neck pain, and migraine in a subset of patients. We aimed to evaluate whether GON decompression could reduce pain and improve quality of life in patients with occipital neuralgia and chronic headache and neck pain. Methods: In this retrospective cohort study, selected patients with neck pain and headache referred to a single neurosurgical center were analyzed. Patients (n = 22) with suspected GON neuralgia based on nerve block or clinical criteria were included. All patients presented with occipital pain spreading frontally and to the neck in various degree. Surgical decompression was performed under local anesthesia. Follow-up was made by an assessor not involved in the treatment of the patients, by telephone 2–5 years after the surgical procedure and an interview protocol was used to collect information. The data from the follow-up protocols were then analyzed and reported. Results: When analyzing the follow-up protocols, decreased headache/migraine was reported in 77% and neck pain was reduced in 55% of the patients. Conclusions: Decompression of GON(s) may reduce neck pain and headache in selected patients with persistent headache, neck pain, and clinical signs of GON neuralgia. Based on the limitations of the present retrospective study, the results should be considered with caution.
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| 24. |
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| 25. |
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| 26. |
- Ignell, Claes, et al.
(author)
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Model for individual prediction of diabetes up to 5 years after gestational diabetes mellitus
- 2016
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In: SpringerPlus. - : Springer Science and Business Media LLC. - 2193-1801. ; 5
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Journal article (peer-reviewed)abstract
- AIMS: To identify predictors of diabetes development up to 5 years after gestational diabetes mellitus (GDM) and to develop a prediction model for individual use.METHODS: Five years after GDM, a 75-g oral glucose tolerance test (OGTT) was performed in 362 women, excluding women already diagnosed with diabetes at 1- to 2-year follow-up or later (n = 45). All but 21 women had results from follow-up at 1-2 years, while 84 women were lost from that point. Predictive variables were identified by logistic regression analysis.RESULTS: Five years after GDM, 28/362 women (8 %) were diagnosed with diabetes whereas 187/362 (52 %) had normal glucose tolerance (NGT). Of the latter, 139/187 (74 %) also had NGT at 1- to 2-year follow-up. In simple regression analysis, using NGT at 1-2 years and at 5 years as the reference, diabetes at 1- to 2-year follow-up or later was clearly associated with easily assessable clinical variables, such as BMI at 1- to 2-year follow-up, 2-h OGTT glucose concentration during pregnancy, and non-European origin (P < 0.0001). A prediction model based on these variables resulting in 86 % correct classifications, with an area under the receiver-operating characteristic curve of 0.91 (95 % CI 0.86-0.95), was applied in a function-sheet line diagram illustrating the individual effect of weight on diabetes risk.CONCLUSIONS: The results highlight the importance of BMI as a potentially modifiable risk factor for diabetes after GDM. Our proposed prediction model performed well, and should encourage validation in other populations in future studies.
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| 27. |
- Ignell, Claes, et al.
(author)
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Trends in the prevalence of gestational diabetes mellitus in southern Sweden, 2003-2012.
- 2014
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In: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 93:4, s. 420-424
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Journal article (peer-reviewed)abstract
- There is accumulating evidence that gestational diabetes (GDM) is a growing problem. The lack of internationally standardized diagnostic procedures prevents consistent diagnosis and the burden of GDM must be determined in country-specific studies. In southern Sweden, GDM is defined as a 2-hour capillary plasma glucose concentration of ≥10.0 mmol/L during a universal 75 g oral glucose tolerance test. We report the crude prevalence of GDM during the years 2003-2012. Of 156 144 women who gave birth, 2.2% were diagnosed with GDM. When the effect of time on the prevalence of GDM was assessed in a log-linear Poisson model, an overall increase in prevalence of 35% was predicted, corresponding to an average annual increase of 3.4%. Predicted prevalence was 1.9 (95% CI 1.8-2.0) in 2003 and 2.6 (2.4-2.7) in 2012 (p<0.0001). Due to a simultaneous rise in birth rate, the number of women diagnosed with GDM increased by 64%. This article is protected by copyright. All rights reserved.
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| 28. |
- Janson, Martin, et al.
(author)
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Analysis of patient selection and external validity in the Swedish contribution to the COLOR trial.
- 2009
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In: Surgical endoscopy. - : Springer Science and Business Media LLC. - 1432-2218 .- 0930-2794. ; 23:8, s. 1764-9
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Journal article (peer-reviewed)abstract
- OBJECTIVE: The colon cancer laparoscopic or open resection (COLOR) trial is an international, randomised controlled trial comparing outcomes of open and laparoscopic surgery for colon cancer. The main purpose of this study was to determine representability by comparing included and nonincluded patients in the participating Swedish centres. DESIGN: At eight centres, which included 391 of the 422 Swedish patients, a local database search was performed to identify retrospectively all patients (n = 2,384) who underwent surgery for colon cancer during the inclusion period, and data was retrieved from medical records. RESULTS: Four hundred fifty-six patients were randomised, 65 of whom were excluded post randomisation (group 2), leaving 391 patients in the study (group 1). For 1,566 patients, valid exclusion criteria were found (group 3). Thus, 362 patients were eligible but not included (group 4). Relative to group 1, patients in group 4 had a significantly higher American Society of Anaesthesiologists (ASA) score, more advanced tumour stage and difference regarding the resections performed. Results showed that 1470 patients (62%) could be calculated as feasible for laparoscopic colon resection (LCR) in a clinical, nontrial situation. CONCLUSIONS: The study population in the Swedish part of the COLOR trial was representative of the eligible population with the exception of comorbidity, where those actually included had less severe comorbidity than the nonincluded but eligible patients. In Sweden, 50-60% of colon cancer patients can be operated on by laparoscopy.
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| 29. |
- Janson, M., et al.
(author)
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Data validation in an economic evaluation of surgery for colon cancer
- 2005
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In: International journal of technology assessment in health care. - 0266-4623 .- 1471-6348. ; 21:2, s. 246-52
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Journal article (peer-reviewed)abstract
- OBJECTIVES: This study aimed to validate the accuracy of data retrieved in a prospective multicenter trial, the purpose of which was an economic evaluation of two techniques of surgery for colon cancer. METHODS: Within the Swedish contribution of the COLOR trial (Colon Cancer Open or Laparoscopic Resection), an economic evaluation of open versus laparoscopic surgical techniques was conducted. Data were collected by case record forms (CRF), patient diaries, and telephone surveys every 2 weeks. The study period was 12 weeks, and the perspective was societal. Data from the first consecutive forty patients to complete the health economic study protocol were validated. Retrieved data were compared with data from medical records and data from local social security offices for agreement. RESULTS: Statistically significant differences were found for duration of anesthesia, length of surgery, number of outpatient consultations by doctors and district nurses, complication rate, and the use of central venous lines. No significant differences were observed concerning length of hospital stay, disposable instruments cost, and time off work, all of which heavily influence total costs. CONCLUSIONS: The present method of data collection regarding resources used in this setting seems to produce accurate data for economic evaluation; however, relative to complication rates, the method did not retrieve accurate data.
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| 30. |
- Janson, M., et al.
(author)
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Randomized clinical trial of the costs of open and laparoscopic surgery for colonic cancer
- 2004
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In: The British journal of surgery. - : Oxford University Press (OUP). - 0007-1323 .- 1365-2168. ; 91:4, s. 409-17
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Journal article (peer-reviewed)abstract
- BACKGROUND: There has been no randomized clinical trial of the costs of laparoscopic colonic resection (LCR) compared with those of open colonic resection (OCR) in the treatment of colonic cancer. METHODS: A subset of Swedish patients included in the Colon Cancer Open Or Laparoscopic Resection (COLOR) trial was included in a prospective cost analysis; costs were calculated up to 12 weeks after surgery. All relevant costs to society were included. No effects of the procedures, such as quality of life or survival, were taken into account. RESULTS: Two hundred and ten patients were included in the primary analysis, 98 of whom had LCR and 112 OCR. Total costs to society did not differ significantly between groups (difference in means for LCR versus OCR euro1846; P = 0.104). The cost of operation was significantly higher for LCR than for OCR (difference in means euro1171; P < 0.001), as was the cost of the first admission (difference in means euro1556; P = 0.015) and the total cost to the healthcare system (difference in means euro2244; P = 0.018). CONCLUSION: Within 12 weeks of surgery for colonic cancer, there was no difference in total costs to society incurred by LCR and OCR. The LCR procedure, however, was more costly to the healthcare system.
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| 31. |
- Janson, M., et al.
(author)
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Randomized trial of health-related quality of life after open and laparoscopic surgery for colon cancer
- 2007
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In: Surgical endoscopy. - 1432-2218. ; 21:5, s. 747-53
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Journal article (peer-reviewed)abstract
- BACKGROUND: Randomized controlled trials (RCTs) have reported improved or unchanged three-year survival following laparoscopic colon resection (LCR) for colon cancer compared with that following open resection (OCR). The aim of this study was to determine health-related quality of life (HRQL) in patients randomized to laparoscopic or open resection for colon cancer. METHODS: In total, 285 patients (130 LCR, 155 OCR) from seven Swedish centers were included. HRQL was assessed preoperatively and at 2, 4, and 12 weeks postoperatively with the EQ-5D and EORTC QLQ-C30 instruments. RESULTS: The LCR patients did significantly better on the social function component of the EORTC QLQ-C30 at two and four weeks and on the role function component at two weeks. CONCLUSION: Laparoscopic resection for colon cancer improved quality of life during the first postoperative month.
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| 32. |
- Jerneck, Anne, et al.
(author)
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Structuring Sustainability Science
- 2011
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In: Sustainability Science. - : Springer Science and Business Media LLC. - 1862-4057 .- 1862-4065. ; 6:1, s. 69-82
-
Journal article (peer-reviewed)abstract
- It is urgent in science and society to address climate change and other sustainability challenges such as biodiversity loss, deforestation, depletion of marine fish stocks, global ill-health, land degradation, land use change and water scarcity. Sustainability science (SS) is an attempt to bridge the natural and social sciences for seeking creative solutions to these complex challenges. In this article, we propose a research agenda that advances the methodological and theoretical understanding of what SS can be, how it can be pursued and what it can contribute. The key focus is on knowledge structuring. For that purpose, we designed a generic research platform organised as a three-dimensional matrix comprising three components: core themes (scientific understanding, sustainability goals, sustainability pathways); cross-cutting critical and problem- solving approaches; and any combination of the sustainability challenges above. As an example, we insert four sustainability challenges into the matrix (biodiversity loss, climate change, land use changes, water scarcity). Based on the matrix with the four challenges, we discuss three issues for advancing theory and methodology in SS: how new synergies across natural and social sciences can be created; how integrated theories for understanding and responding to complex sustainability issues can be developed; and how theories and concepts in economics, gender studies, geography, political science and sociology can be applied in SS. The generic research platform serves to structure and create new knowledge in SS and is a tool for exploring any set of sustainability challenges. The combined critical and problem- solving approach is essential.
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| 33. |
- Jönsson, Bodil, et al.
(author)
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Ethics in the Making
- 2005
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In: Design Philosophy Papers. - Queensland, Australia : Team D/E/S. - 1448-7136. ; :4, s. 1-8
-
Journal article (peer-reviewed)abstract
- Applied ethics in research is no longer regarded as a concern exclusive to the medical field. Exemplars in ethics from other fields such as design are, however, meagre, as are relevant practical and design applied guidelines. The more ethically grounded a given area of research is, the greater the chance it can contribute to long-term, meaningful breakthroughs in knowledge. An improved ethics in design can enable a critical questioning that in turn leads to entirely new research questions.The mere involvement of human subjects and the application of safety provisions in design research do not guarantee it will meet ethical considerations, best practices or standards. The entire complex interaction with users offers intriguing possibilities and risks, or can result in mediocrity in areas such as: preparation and implementation that is worth the research person’s time; respect for users’ contributions; dignified treatment; feedback in an iterative and interactive process with mutual information and inspiration; and products and processes that are truly influenced by the users. This reasoning applies to all, but with special distinction to people who are disabled and elderly. Starting with specific needs as opposed to more general ones (the latter of which result in the necessity for more abstract specifications for the multitudes) can, above and beyond the ethical dimension, also result in increased innovation and effectiveness for society on the whole. Proceeding from the particular to the general is of considerable value, for ethical reasons as well as for sheer effectiveness.Involving persons with a variety of disabilities in product development helps to ensure innovative and useworthy products.[1] One of many prerequisites for ethically sound user involvement is that all participants are aware of the interference taking place in an iterative design process.An elaboration of ethical aspects in design can be valuable for different stakeholders (user organisations, NGOs and the design community) and, of course, for the relevance of resulting products and processes. A more considerate ethical approach could have substantial economical value due to the higher relevance of the results. There has been a considerable increase in the ethical expectations placed on businesses and professions in recent years. Scores of organisations have reacted by developing ethical codes of conduct and professional guidelines to explicitly state their values and principles.[2] Moreover, the drafting of a code of ethics can be seen as an indication of professionalism in an emerging profession.[3]
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| 34. |
- Jönsson, Bodil, et al.
(author)
-
Ethics in the making
- 2005
-
In: Design Philosophy Papers. - : Routledge. - 1448-7136. ; :4
-
Journal article (peer-reviewed)abstract
- Applied ethics in research is no longer regarded as a concern exclusive to the medical field. Exemplars in ethics from other fields such as design are, however, meagre, as are relevant practical and design applied guidelines. The more ethically grounded a given area of research is, the greater the chance it can contribute to long-term, meaningful breakthroughs in knowledge. An improved ethics in design can enable a critical questioning that in turn leads to entirely new research questions.
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| 35. |
- Jönsson, Bodil, et al.
(author)
-
Situated research and design for everyday life
- 2004
-
Reports (other academic/artistic)abstract
- This paper elaborates theoretical and methodological aspects of design processes in a disability context and aims to relate them to other sciences. It particularly emphasizes situated aspects of research: the need for being there, with the users in their
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| 36. |
- Jönsson, Bodil, et al.
(author)
-
Situated research and design for everyday life
- 2005
-
In: Proceedings of Nordes, Nordic Design Research.
-
Conference paper (peer-reviewed)abstract
- This paper presents examples of different aspects of design in a disability context with the aim of revealing some of its fundamentals. It particularly emphasizes situated aspects of research: the need for being there, with the users in their daily lives – where the action is.
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| 37. |
- Lilje, Stina
(author)
-
Aspects of musculoskeletal pain interfering with normal life and naprapathic manual therapy from a health technology assessment perspective
- 2015
-
Doctoral thesis (other academic/artistic)abstract
- IntroductionMusculoskeletal pain is one of the most common reasons for seeking health care. If a patient’s disorders remain after conventional primary care, a referral to secondary care is often made, yet many referrals on the waiting lists concern patients who are not in need of surgery. Manual therapy has a lot of “proved experience” but is not routine in the Swedish national health care system today. There is a lack of scientific evidence for its treatment and cost effects.AimsThe overall aim of this thesis was to increase the knowledge of musculoskeletal pain that interferes with normal life. Specific aims were to investigate if musculoskeletal pain in older adults is associated with heavy physical and negative psychosocial workloads through life, and to deepen the knowledge of the treatment and cost effects of naprapathic manual therapy (NMT), and of older adults' experiences of reminders of home exercises through mHealth.MethodsStudy I is a cross sectional study (n=641) that investigates associations between musculoskeletal pain interfering with normal life in older adults and physical and psychological loads through life. Study II is a randomised controlled trial (n=78) that compares NMT with standard orthopaedic care for “low priority” orthopaedic outpatients. Study III (n=1) is a case study that describes the treatment effects of NMT in a patient diagnosed with adhesive capsulitis. Study IV is a cost consequence analysis (n=78), where the costs and the health economic gains in study II were analyzed. Study V is a qualitative interview study (n=8) exploring older adults’ experiences of text messages as reminders of home exercises after NMT.Results The results in Study I were that psychosocial and physical workloads are associated with musculoskeletal pain that interferes with normal life in older adults. NMT for low priority orthopaedic outpatients yielded larger improvements in pain, physical function and perceived recovery compared with standard orthopaedic care (Study II). NMT for the acromio-clavicular joint, for adhesive capsulitis resulted in significant pain relief and perceived recovery, decreased sleeping disorders and medication (Study III). The health gains for naprapathy were higher compared with standard orthopaedic care, and the costs significantly lower (Study IV). Study V concluded that the use of SMS:s as reminders of home exercises after NMT were appreciated by the patients, and stimulated them to practice memorising and to create.Conclusion This thesis suggests that pain in older adults is associated with heavy physical and negative psychosocial workloads through life. NMT may be cost effective for low priority orthopaedic outpatients of working age with musculoskeletal disorders that are not likely to benefit from orthopaedic surgery, and was effective in a patient diagnosed with adhesive capsulitis. mHealth used to remind older adults of home exercises stimulates the patients to create own routines for continued compliance.
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| 38. |
- Lilje, Stina Charlotta, et al.
(author)
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Experiences of Older Adults With Mobile Phone Text Messaging as Reminders of Home Exercises After Specialized Manual Therapy for Recurrent Low Back Pain : A Qualitative Study
- 2017
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In: JMIR mhealth and uhealth. - : J M I R Publications. - 2291-5222. ; 5:3
-
Journal article (peer-reviewed)abstract
- BACKGROUND: Clinical experience of manual therapy for musculoskeletal pain is that patients often suffer from recurrent pain and disorders, but that they do not continue to perform their physical home exercises when they are free from symptoms. The chance of positive long-term effects of manual therapy would probably increase if patients were reminded that they are to continue to perform their exercises. Mobile phone text messaging (short messaging service, SMS) is increasingly used as an innovative intervention to remind patient to exercise. However, there are only a few studies on such interventions in the field of low back pain (LBP). Qualitative studies of patients' experiences of receiving text messages as reminders of home exercises after manual treatment for recurrent LBP have to the best of our knowledge never been published.OBJECTIVES: The aim of this study was to explore older persons' common experiences of receiving reminders of home exercises through mobile phone text messaging after specialized manual therapy for recurrent LBP.METHODS: A total of 7 men and 8 women (67-86 years), who had sought specialized manual therapy (Naprapathic manual therapy) for recurrent LBP were included in the study. Individual one-way text messages as reminders of home exercises (to be performed on a daily basis) were sent to each patient every third day for 3 weeks, then once a week for another 2 weeks. Semistructured interviews with 2 broad, open-ended questions were held and data were analyzed with systematic text condensation, based on Giorgi's principles of psychological phenomenological analysis.RESULTS: The participants appreciated the messages, which were perceived as timely and usable, and also stimulated memorizing. The messages made the participants reflect on the aim of the exercise, value of being reminded, and on their improvement in pain. During the interviews, the participants created their own routines for continued adherence to the exercises.CONCLUSIONS: It seems plausible that mobile phone text messaging may serve as a useful tool for patient empowerment with regard to recurrent LBP in older persons. Further studies are needed to explore whether future compliance with the exercises will be as large if the participants are not being interviewed.
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| 39. |
- Lilje, Stina C., et al.
(author)
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Negative psychosocial and heavy physical workloads associated with musculoskeletal pain interfering with normal life in older adults : Cross-sectional analysis
- 2015
-
In: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 43:5, s. 453-459
-
Journal article (peer-reviewed)abstract
- Aims: Pain is one of the most frequent reasons for seeking health care, and is thus a public health problem. Although there is a progressive increase in pain and impaired physical function with age, few studies are performed on older adults. The aim of this study was to investigate if there are associations between musculoskeletal pain interfering with normal life in older adults and physical and psychosocial workloads through life. Methods: The association of heavy physical workload and negative psychosocial workload and musculoskeletal pain interfering with normal life (SF 12) was analyzed by multiple logistic regression. The model was adjusted for eight background covariates: age, gender, growing-up environment, educational level, if living alone or not, obesity, smoking, and leisure physical activity. Results: Negative psychosocial and heavy physical workloads were independently associated with musculoskeletal pain interfering with normal life (adjusted OR: 4.44, 95% CI: 2.84-6.92), and (adjusted OR: 1.88, 95% CI: 1.20-2.93), respectively. The background covariates female gender and higher education were also associated with musculoskeletal pain interfering with normal life, and physical leisure activity was inversely associated. Conclusions: The findings suggest that negative psychosocial and heavy physical workloads are strongly associated with musculoskeletal pain interfering with normal life in older adults.
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| 40. |
- Lilje, Stina, et al.
(author)
-
The importance of weak physical performance in older adults for the development of musculoskeletal pain that interferes with normal life : A prospective cohort study
- 2019
-
In: Scandinavian Journal of Pain. - : De Gruyter. - 1877-8860 .- 1877-8879. ; 19:4, s. 789-796
-
Journal article (peer-reviewed)abstract
- There are associations between pain, comorbidity and risk of falling, and falling increases the risk of mortality in older persons, but few studies have investigated the development of pain as a result of impaired physical function. The aim of this study was to examine possible associations between weak physical performance and the development of musculoskeletal pain that interferes with normal life in a sample of older adults. The sample derived from a national, longitudinal multicenter study; the Swedish National Study on Ageing and Care; SNAC-B. The participants (n = 490) were between 60 and 78 years at the baseline examinations. Three variables were chosen for the exposure physical function, from the baseline examinations; One Leg Stand, Grip strength and Sit-to-Stand. The outcome musculoskeletal pain that interferes with normal life was measured using EQ5D and SF-12 6 years later, and logistic regression was used to investigate possible associations between the exposures and the outcome. Maximum grip strength (Grippit) was inversely associated with musculoskeletal pain that interferes with normal life (OR 2.31; 95% CI 1.15-4.61), and One-Leg Stand and Sit-to-Stand were not associated with the development of pain (OR 1.30; 95% CI 0.64-2.64) and (OR 0.91; 95% CI 0.45-1.86), respectively. Weak grip strength was inversely associated with the development of musculoskeletal pain that interferes with normal life in older adults. Impaired proprioceptive function, strength and mobility in elderly with pain have been found in earlier research. Since pain increases the risk of falling, it is important to investigate if it may develop as a function of an impaired physical function. The results of the present study could be of importance for future prevention programs aiming to protect elderly from falling.
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| 41. |
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| 42. |
- Papadopoulou, Anastasia, et al.
(author)
-
HLA-DQB1 genotypes and islet cell autoantibodies against GAD65 and IA-2 in relation to development of diabetes post partum in women with gestational diabetes mellitus.
- 2012
-
In: Diabetes Research and Clinical Practice. - : Elsevier BV. - 1872-8227 .- 0168-8227. ; 95, s. 260-264
-
Journal article (peer-reviewed)abstract
- AIMS: To study HLA-DQB1 genes and islet cell autoantibodies against glutamic acid decarboxylase 65 (GADA) and insulinoma antigen-2 (IA-2A) in relation to diabetes post partum in mothers with diagnosed gestational diabetes mellitus (GDM). METHODS: During 2003-2004, women undergoing a 75g oral glucose tolerance test (OGTT) during pregnancy were invited to participate in the Mamma Study. Cut-off level defining GDM was a 2-h capillary blood glucose of 7.8mmol/L. 1-2 years after delivery a 75g OGTT was performed, GADA and IA-2A were measured and HLA-DQB1 genes analysed. Data were available for 452 mothers with previous GDM and 168 randomly selected control subjects. RESULTS: HLA-DQB1*0602 was negatively associated with GDM (p=0.033) and with development of diabetes post partum (p=0.017), whereas high risk HLA were not associated with GDM or with diabetes. The presence of GADA post partum was positively associated with diabetes post partum (p=0.0009), but not with impaired glucose tolerance. CONCLUSIONS: Mothers with GDM and HLA-DQB1*0602 were less likely to develop diabetes after pregnancy, and type 1 diabetes associated high risk HLA genes did not predict type 1 diabetes post partum. Additionally, GADA were positively associated with diabetes development.
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| 43. |
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| 44. |
- Schölin, Johnna, 1970, et al.
(author)
-
Bowel obstruction after laparoscopic and open colon resection for cancer : results of 5 years of follow-up in a randomized trial
- 2011
-
In: Surgical Endoscopy. - : Springer Science and Business Media LLC. - 0930-2794 .- 1432-2218. ; 25:12, s. 3755-3760
-
Journal article (peer-reviewed)abstract
- BACKGROUND: Postoperative bowel obstruction caused by intra-abdominal adhesions occurs after all types of abdominal surgery. It has been suggested that the laparoscopic technique should reduce the risk for adhesion formation and thus for postoperative bowel obstruction. This study was designed to compare the incidence of bowel obstruction in a randomized trial where laparoscopic and open resection for colon cancer was compared. METHODS: A retrospective analysis was performed, collecting data of episodes of bowel obstruction with or without surgery. Only episodes treated in the hospital where the index surgery took place were included. Data for 786 patients were collected for the 5-year period after cancer surgery. RESULTS: Baseline characteristics for the evaluated laparoscopic (n = 383) and open (n = 403) groups were comparable. The cumulative obstruction percentages at 5 years for the open and laparoscopic groups were 6.5 and 5.1% respectively and did not significantly differ from each other. Tumor stage seemed to influence the risk for bowel obstruction: 2.8% in stage I, 6.6% in stage II, and 7% in stage III, but the differences were not significant. CONCLUSIONS: This analysis does not support the hypothesis that laparoscopy leads to fewer episodes of bowel obstruction compared with open surgery.
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| 45. |
- Ternblad, Eva Maria, et al.
(author)
-
Do preschoolers ‘Game the system’? : a case study of children’s intelligent (Mis)use of a teachable agent based play-&-learn game in mathematics
- 2018
-
In: Artificial Intelligence in Education : 19th International Conference, AIED 2018, Proceedings - 19th International Conference, AIED 2018, Proceedings. - Cham : Springer International Publishing. - 0302-9743 .- 1611-3349. - 9783319938424 - 9783319938431 ; 10947 LNAI, s. 557-569
-
Conference paper (peer-reviewed)abstract
- For learning to take place in digital learning environments, learners need to use educational software – more or less – as intended. However, previous studies show that some school children, instead of trying to learn and master a skill, choose to systematically exploit or outsmart the system to gain progress. But what about preschoolers? The present study explores the presence of this kind of behavioral patterns among preschoolers who use a teachable agent-based play-&-learn game in early math. We analyzed behavioral data logs together with interviews and observations. We also analyzed action patterns deviating from the pedagogical design intentions in terms of non-harmful gaming, harmful gaming, and wheel-spinning. Our results reveal that even if pedagogically not intended use of the game did occur, harmful gaming was rare. Interestingly, the results also indicate an unexpected awareness in children of what it means to learn and to teach. Finally, we present a series of possible adjustments of the used software in order to decrease gaming-like behavior or strategies that signalize insufficient skills or poor learning.
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| 46. |
- Thorsteinsdottir, Thordis, et al.
(author)
-
LAPPRO: A prospective multicentre comparative study of robot-assisted laparoscopic and retropubic radical prostatectomy for prostate cancer.
- 2011
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In: Scandinavian journal of urology and nephrology. - : Informa UK Limited. - 1651-2065 .- 0036-5599.
-
Journal article (peer-reviewed)abstract
- Abstract Objective. This study describes the study design and procedures for a prospective, non-randomized trial comparing open retropubic and robot-assisted laparoscopic radical prostatectomy regarding functional and oncological outcomes. Material and methods. The aim was to achieve a detailed prospective registration of symptoms experienced by patients using validated questionnaires in addition to documentation of surgical details, clinical examinations, medical facts and resource use. Four patient questionnaires and six case-report forms were especially designed to collect data before, during and after surgery with a follow-up time of 2 years. The primary endpoint is urinary leakage 1 year after surgery. Secondary endpoints include erectile dysfunction, oncological outcome, quality of life and cost-effectiveness at 3, 12 and 24 months after surgery. Results. The study started in September 2008 with accrual continuing to October 2011. Twelve urological departments in Sweden well established in performing radical prostatectomy are participating. Personal contact with the participating departments and patients was established to ascertain a high response rate. To reach 80% statistical power to detect a difference of 5 absolute per cent in incidence of urinary leakage, 700 men in the retropubic group and 1400 in the robotic group are needed. Conclusions. The Swedish healthcare context is well suited to performing multicentre long-term prospective clinical trials. The similar care protocols and congruent specialist training are particularly favourable. The LAPPRO trial aims to compare the two surgical techniques in aspects of short- and long-term functional and oncological outcome, cost effectiveness and quality of life, supplying new knowledge to support future decisions in treatment strategies for prostate cancer.
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| 47. |
- Veldkamp, R., et al.
(author)
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Laparoscopic resection of colon Cancer: consensus of the European Association of Endoscopic Surgery (EAES)
- 2004
-
In: Surgical endoscopy. - : Springer Science and Business Media LLC. - 1432-2218 .- 0930-2794. ; 18:8, s. 1163-85
-
Journal article (peer-reviewed)abstract
- BACKGROUND: The European Association of Endoscopic Surgery (EAES) initiated a consensus development conference on the laparoscopic resection of colon cancer during the annual congress in Lisbon, Portugal, in June 2002. METHODS: A systematic review of the current literature was combined with the opinions, of experts in the field of colon cancer surgery to formulate evidence-based statements and recommendations on the laparoscopic resection of colon cancer. RESULTS: Advanced age, obesity, and previous abdominal operations are not considered absolute contraindications for laparoscopic colon cancer surgery. The most common cause for conversion is the presence of bulky or invasive tumors. Laparoscopic operation takes longer to perform than the open counterpart, but the outcome is similar in terms of specimen size and pathological examination. Immediate postoperative morbidity and mortality are comparable for laparoscopic and open colonic cancer surgery. The laparoscopically operated patients had less postoperative pain, better-preserved pulmonary function, earlier restoration of gastrointestinal function, and an earlier discharge from the hospital. The postoperative stress response is lower after laparoscopic colectomy. The incidence of port site metastases is <1%. Survival after laparoscopic resection of colon cancer appears to be at least equal to survival after open resection. The costs of laparoscopic surgery for colon cancer are higher than those for open surgery. CONCLUSION: Laparoscopic resection of colon cancer is a safe and feasible procedure that improves short-term outcome. Results regarding the long-term survival of patients enrolled in large multicenter trials will determine its role in general surgery.
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