| 1. |
- Alexandra, Wide, et al.
(author)
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Fertility-related information received by young women and men with cancer : a population-based survey
- 2021
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In: Acta Oncologica. - : Taylor & Francis. - 0284-186X .- 1651-226X. ; 60:8, s. 976-983
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Journal article (peer-reviewed)abstract
- Background: Infertility is a well-known sequela of cancer treatment. Despite guidelines recommending early discussions about risk of fertility impairment and fertility preservation options, not all patients of reproductive age receive such information.Aims: This study aimed to investigate young adult cancer patients' receipt of fertility-related information and use of fertility preservation, and to identify sociodemographic and clinical factors associated with receipt of information.Materials and methods: A population-based cross-sectional survey study was conducted with 1010 young adults with cancer in Sweden (response rate 67%). The inclusion criteria were: a previous diagnosis of breast cancer, cervical cancer, ovarian cancer, brain tumor, lymphoma or testicular cancer between 2016 and 2017, at an age between 18 and 39 years. Data were analyzed using logistic regression models.Results: A majority of men (81%) and women (78%) reported having received information about the potential impact of cancer/treatment on their fertility. A higher percentage of men than women reported being informed about fertility preservation (84% men vs. 40% women, p < .001) and using gamete or gonadal cryopreservation (71% men vs. 15% women, p < .001). Patients with brain tumors and patients without a pretreatment desire for children were less likely to report being informed about potential impact on their fertility and about fertility preservation. In addition, being born outside Sweden was negatively associated with reported receipt of information about impact of cancer treatment on fertility. Among women, older age (>35 years), non-heterosexuality and being a parent were additional factors negatively associated with reported receipt of information about fertility preservation.Conclusion: There is room for improvement in the equal provision of information about fertility issues to young adult cancer patients.
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| 2. |
- Bergstrom, Charlotta, et al.
(author)
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Do young adults with cancer receive information about treatment- related impact on sex life? : Results from a population-based study
- 2023
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In: Cancer Medicine. - : WILEY. - 2045-7634. ; 12:8, s. 9893-9901
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Journal article (peer-reviewed)abstract
- Background Sexual dysfunction is common following a cancer diagnosis in young adulthood (18-39 years) and problems related to sex life are ranked among the core concerns in this age group. Yet, few studies have investigated to what extent adults younger than 40, receive information from healthcare providers about the potential impact of cancer and its treatment on their sex life.Methods A population-based cross-sectional survey study was conducted with 1010 young adults 1.5 years after being diagnosed with cancer (response rate 67%). Patients with breast, cervical, ovarian and testicular cancer, lymphoma, and brain tumors were identified in national quality registries. Sociodemographic and clinical factors associated with receiving information were examined using multivariable binary logistic regression.Results Men to a higher extent than women reported having received information about potential cancer-related impact on their sex life (68% vs. 54%, p < 0.001). Receipt of information varied across diagnoses; in separate regression models, using lymphoma as reference, both women and men with brain tumors were less likely to receive information (women: OR 0.10, CI = 0.03-0.30; men: OR 0.37, CI = 0.16-0.85). More intensive treatment was associated with higher odds of receiving information in both women (OR 1.89; CI = 1.28-2.79) and men (OR 2.08; CI = 1.09-3.94). None of the sociodemographic factors were associated with receipt of information.Conclusions To improve sexual health communication to young adults with cancer, we recommend diagnosis-specific routines that clarify when in the disease trajectory to discuss these issues with patients and what to address in these conversations.
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| 3. |
- Borgfeldt, Christer, et al.
(author)
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Survival in endometrial cancer in relation to minimally invasive surgery or open surgery : a Swedish Gynecologic Cancer Group (SweGCG) study
- 2021
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In: BMC Cancer. - : BioMed Central (BMC). - 1471-2407. ; 21:1
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Journal article (peer-reviewed)abstract
- BackgroundThe aim of this study was to analyze overall survival in endometrial cancer patients’ FIGO stages I-III in relation to surgical approach; minimally invasive (MIS) or open surgery (laparotomy).MethodsA population-based retrospective study of 7275 endometrial cancer patients included in the Swedish Quality Registry for Gynecologic Cancer diagnosed from 2010 to 2018. Cox proportional hazard models were used in univariable and multivariable survival analyses.ResultsIn univariable analysis open surgery was associated with worse overall survival compared with MIS hazard ratio, HR, 1.39 (95% CI 1.18–1.63) while in the multivariable analysis, surgical approach (MIS vs open surgery) was not associated with overall survival after adjustment for known risk factors (HR 1.12, 95% CI 0.95–1.32). Higher FIGO stage, non-endometrioid histology, non-diploid tumors, lymphovascular space invasion and increasing age were independent risk factors for overall survival.ConclusionThe minimal invasive or open surgical approach did not show any impact on survival for patients with endometrial cancer stages I-III when known prognostic risk factors were included in the multivariable analyses.
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| 4. |
- Dahm-Kähler, Pernilla, 1964, et al.
(author)
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Has time to chemotherapy from primary debulking surgery in advanced ovarian cancer an impact on survival?- A population-based nationwide SweGCG study
- 2024
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In: GYNECOLOGIC ONCOLOGY. - : ACADEMIC PRESS INC ELSEVIER SCIENCE. - 0090-8258 .- 1095-6859. ; 186, s. 69-76
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Journal article (peer-reviewed)abstract
- Objective. The aim of the study was to investigate if time to start chemotherapy (TTC) after primary debulking surgery (PDS) impacted relative survival (RS) in advanced epithelial ovarian/fallopian tube/primary peritoneal cancer (EOC). Methods. Nationwide population-based study of women with EOC FIGO stages IIIC-IV, registered 2008-2018 in the Swedish Quality Register for Gynecologic Cancer, treated with PDS and chemotherapy. TTC was categorized into; <= 21 days, 22-28 days, 29-35 days, 36-42 days and > 42 days. Relative survival (RS) was estimated using the Pohar-Perme estimate of net survival. Multivariable analyses of excess mortality rate ratios (EMRRs) were estimated by Poisson regression models. Results. In total, 1694 women were included. The median age was 65.0 years. Older age and no residual disease were more common in TTC >42 days than 0-21 days. The RS at 5-years was 37.9% and did not differ between TTC groups. In the R0 (no residual disease) cohort (n = 806), 2-year RS was higher in TTC <= 21 days (91.6%) and 22-28 days (91.4%) than TTC >42 days (79.1%). TTC >42 days (EMRR 2.33, p = 0.026), FIGO stage IV (EMRR 1.83, p = 0.007) and non-serous histology (EMRR 4.20, p < 0.001) were associated with 2-year worse excess mortality compared to TTC 0-21 days, in the R0 cohort. TTC was associated with 2-year survival in the R0 cohort in FIGO stage IV but not in stage IIIC. TTC was not associated with RS in patients with residual disease. Conclusions. For the entire cohort, stage IV, non-serous morphology and residual disease, but not TTC, influenced 5-year relative survival. However, longer TTC was associated with a poorer 2-year survival for those without residual disease after PDS. (c) 2024 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
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| 5. |
- Do, Lan, et al.
(author)
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Anti-CD74 IgA autoantibodies in radiographic axial spondyloarthritis : a longitudinal Swedish study
- 2021
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In: Rheumatology. - : Oxford University Press. - 1462-0324 .- 1462-0332 .- 1310-0505. ; 60:9, s. 4085-4093
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Journal article (peer-reviewed)abstract
- OBJECTIVES: Antibodies against anti-CD74 are related to axial spondyloarthritis (axSpA). The objectives were (i) to study IgA anti-CD74 in radiographic (r)-axSpA patients in the Backbone cohort and to calculate the sensitivity and specificity of anti-CD74, (ii) to study the fluctuation of IgA anti-CD74 levels in prospectively collected samples, and (iii) to explore the relation between IgA anti-CD74 and radiographic spinal changes.METHODS: IgA anti-CD74 was analysed by ELISA in 155 patients with r-axSpA and age- and sex-matched controls. BASDAI, ASDAS, BASFI and BASMI were assessed and spinal radiographs were scored for r-axSpA-related changes with mSASSS. Previously donated samples, before inclusion in the Backbone study, were identified in the Medical Biobank of Northern Sweden.RESULTS: A total of 155 patients comprising 69% men and 31% women, age [mean (s.d.)] 55.5 (11.4) years and 152 (98.1%) HLA-B27 positive, were included. The plasma level of IgA anti-CD74 was significantly higher in the patients [median (interquartile range), 12.9 (7.9-17.9) U/ml] compared with controls [10.9 (7.2-14.6) U/ml, P = 0.003]. IgA anti-CD74 was above the cut-off level of 20 U/ml in 36/155 (23.2%) patients and in 15/151 (9.9%) controls (P = 0.002). Multivariable logistic regression analyses revealed ≥1 syndesmophyte associated with IgA anti-CD74 (odds ratio 5.64; 95% CI: 1.02, 35.58; P = 0.048) adjusted for hsCRP, smoking, BMI, sex and age. No distinct pattern of IgA anti-CD74 over time was revealed.CONCLUSION: Plasma levels of IgA anti-CD74 were increased in r-axSpA and independently associated with radiographic spinal changes, which suggests that IgA anti-CD74 could play a role in the pathogenies of r-axSpA.
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| 6. |
- Eliasson, Kristina, et al.
(author)
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Company representatives’ experiences of occupational health surveillance for workers exposed to hand-intensive work : A qualitative study
- 2021
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In: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 18:4
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Journal article (peer-reviewed)abstract
- Exposure assessment seldom precedes the medical health checks in occupational health surveillance. In order to emphasize the interconnection between exposure assessment and medical health checks, a process model was developed. The process model aimed to guide employers and Occupational Health Service providers through the execution of occupational health surveillance. The objective of this qualitative study is to explore company representatives’ experiences of the process model, in terms of feasibility and values, and to identify factors that facilitate or impede the process. Thirty-three company representatives from ten companies were interviewed. Interviews were analyzed using content analysis. The company representatives experienced that the model contributed to increased risk awareness and understanding of the exposure effects on workers’ health. They valued the exposure assessments performed by an ergonomics expert, which led to the discovery of previously unidentified risks. The feasibility was facilitated by: a joint start-up meeting in which the process was planned, clear communication between the involved parties, and clarity regarding the process ownership. The findings reveal that a guiding process model is valuable for the execution of occupational health surveillance. However, the model should not only define the components included; a practical guide concerning how the process can be executed is also needed.
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| 7. |
- Eliasson, Kristina, et al.
(author)
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Does occupational health surveillance lead to risk reduction for workers exposed to hand-intensive work?
- 2023
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In: Applied Ergonomics. - : Elsevier. - 0003-6870 .- 1872-9126. ; 112
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Journal article (peer-reviewed)abstract
- This mixed method study aimed to describe what risk-reducing actions were proposed by ergonomists after the execution of a guided process for occupational health surveillance for workers exposed to hand-intensive work in ten companies. Another aim was to describe the exposed workers' proposals for risk-reducing actions, including their perceptions of potential changes in the self-assessed exposure levels and work-related pain. Several actions, targeting organizational, technical, and/or individual measures were proposed. Proposals from the ergonomists more often targeted the personal measures, whereas the workers' proposals targeted technology or organizational changes. Six companies implemented at least one of the action proposals. These action proposals were not related to evaluation metrics, nor were they evaluated. This study indicates that both ergonomists and companies need guidance on how to improve to work in a participatory process for the implementation and evaluation of risk-reducing actions, e.g., by how to better include workers’ experiences.
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| 8. |
- Eliasson, Kristina, et al.
(author)
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Ergonomists’ experiences of executing occupational health surveillance for workers exposed to hand-intensive work : a qualitative exploration
- 2022
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In: BMC Health Services Research. - : BioMed Central (BMC). - 1472-6963. ; 22:1
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Journal article (peer-reviewed)abstract
- Background: In order to reduce work-related upper limb disorders, the Swedish Work Environment Authority introduced an occupational health surveillance targeting hand-intensive work. A process model, aimed at supporting the employers as well as the occupational health service provider (i.e., ergonomist) in the work process with the occupational health surveillance, was developed. The objective of this qualitative study was to explore ergonomists’ experiences of the execution of occupational health surveillance for hand-intensive work when following the novel process model as well as factors influencing the execution.Methods: Semi-structured individual interviews were conducted with ten ergonomists on one occasion regarding their experience of following the work process. Qualitative content analysis with an inductive approach was used for analyzing the data.Results: The ergonomists’ experiences were summarized in one theme “A joint roadmap supporting a participatory process” and two categories “Clear structure provided by the components” and “The process influenced by collaboration and context”. The ergonomists valued being guided by the systematics of the model, which provided structure and clarity in their work. Factors affecting the execution were related to communication deficiencies and uncertainties regarding expectations between different roles and functions (e.g., ergonomists and contact person, lack of information to workers). Additional factors, for instance, companies’ routines and the ergonomist’s intra-organizational support, such as access to IT-resources, could also affect the process.Conclusions: The findings reveal that this process model facilitates the ergonomists’ work and cooperation with a client company. However, the process model needs to be developed and accompanied by a guideline with information related to the process, including e.g., description of a start-up meeting and of the roles/functions of the involved parties.
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| 9. |
- Eliasson, Kristina, 1979-
(author)
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Ergonomists’ risk assessments : From guesstimates to strategic approaches
- 2020
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Doctoral thesis (other academic/artistic)abstract
- Musculoskeletal disorders are among the most prevalent causes of work-related ill-health, consequently risk assessments of hazardous factors related to these disorders are important for prevention. Occupational Health Services (OHS) providers are independent experts, supporting employers regarding work environment issues and rehabilitation. Ergonomists represents one of the professions within OHS, and risk assessment regarding musculoskeletal disorders is within the scope of their work tasks. The overall objective was to explore Swedish ergonomists’ practices and approaches with risk assessments, in order to contribute new knowledge about how ergonomists’ work methods can be further developed to improve prevention of work-related musculoskeletal disorders. Paper I explored the process of risk assessment assignments and the ergonomists’ use of observation-based risk-assessment tools. The result showed a lack of systematic approaches regarding risk assessment assignments and limited use and knowledge of observation-based risk-assessment tools. In Paper II inter-observer and intra-observer reliability of risk assessments, without the use of an explicit observational method were assessed. The results showed a non-acceptable reliability. Paper III explored ergonomists experiences of an e-learning concept for knowledge translation in the OHS context. The e-learning concept was considered as feasible. The knowledge translation inspired increased use of risk-assessment tools, changes in the risk assessment procedures, e.g. selection of tools, and employing a participatory approach. Paper IV described the development of a process model for occupational health surveillance for workers exposed to hand-intensive work (HIW-model), and the studies that will explore the model. Paper V explored company representatives’ experiences of the HIW-model, and factors which facilitated the execution of the model. The model contributed to increased risk awareness and understanding of how individual workers’ musculoskeletal ill-health relates to exposures in work. Facilitating factors were: a joint start-up meeting in which the process was planned, clear communication, and clarity regarding the ownership of the process. In conclusion, the findings showed that ergonomists’ expertise is needed in the entire risk management process and not only in the risk assessment phase. In this process, the ergonomists need to be active and take the expert role (which includes a stocked toolbox) and support the employer through the whole risk management process from initiation to evaluation of risk controlling measures.
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| 10. |
- Eliasson, Kristina, et al.
(author)
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Study protocol for a qualitative research project exploring an occupational health surveillance model for workers exposed to hand-intensive work
- 2020
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In: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 17:17
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Journal article (peer-reviewed)abstract
- The objective of this study protocol is to describe the development of a process model for occupational health surveillance for workers exposed to hand-intensive work (the HIW-model), and to describe the studies that will explore the model. The studies are designed to: (1) explore stakeholders' experiences of the model, and (2) explore if, and how, the model affects actions for reduction of exposure to hand-intensive work. The study protocol presents a research project that is described as two studies. The first study will explore company representatives' and ergonomists' experiences of the execution of the HIW-model and its various components concerning feasibility and values. Semi-structured interviews will constitute the data source. The second study will explore whether the execution of the HIW-model leads to work environmental changes, such as actions for reduction of exposure to hand-intensive work, and whether these potential actions are based on the ergonomist's feedback of the exposure assessment and the medical health checks. A mixed method approach will be applied, in which the data sources will be comprised of semi-structured interviews, questionnaires, and documents. The project is expected to generate knowledge regarding the values of the HIW-model. The project is anticipated to shed light on factors that facilitate or impede execution of the model from the different stakeholders' perspectives; the employer's as having the legal responsibility for the work environment, and the occupational health service consultants', being the work environment experts supporting the employers.
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