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- Forss, A, et al.
(author)
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'I got a letter ...' a qualitative study of women's reasoning about attendance in a cervical cancer screening programme in urban Sweden
- 2001
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In: Psycho-Oncology. - 1057-9249 .- 1099-1611. ; 10:1, s. 76-87
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Journal article (peer-reviewed)abstract
- Objective: This explorative study aims at investigating how 'healthy' women describe and reason about participation in a cervical cancer screening programme in Sweden. The study is part of a multidisciplinary research project studying a population-based cervical cancer-screening programme from the perspective of different actors. Setting and methods: Data collection took place at three ante-natal health centres (ANHCs) in demographically diverse areas in the Stockholm region in spring 1995. Interviews were conducted and audiotaped with 66 'healthp' women at the ANHCs immediately before taking a Papanicolau test. Open questions such as 'Why have you come here today?' and 'What kind of test will you take?' were used to initiate the interview. Verbatim transcripts were analysed with a modified phenomenographical method to identify and describe qualitatively different ways of understanding cervical cancer screening. Results: Four different ways of reasoning about cervical cancer screening are described, with only one similar to the biomedical rationale for screening with focus on attending for the test/results. Two types of reasoning refer to the invitation letter as a catalyst, with one emphasizing benefits in attendance and the second emphasizing hinders to attendance. A final way of reasoning focuses on the individual's own proactive role in prevention. Common themes are also identified. Implications: This study complements the research literature by providing a better knowledge base of the variations in reasoning among women attending screening, often seen as a homogenous group. It can contribute to better adapting the screening situation to the varied needs and expectations of the women who attend. Copyright (C) 2001 John Wiley & Sons, Ltd.
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- Forss, A., et al.
(author)
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Women's experiences of cervical cellular changes : An unintentional transition from health to liminality?
- 2004
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In: Sociology of Health and Illness. - : Wiley. - 0141-9889 .- 1467-9566. ; 26:3, s. 306-325
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Research review (peer-reviewed)abstract
- Cervical cancer screening is a preventive intervention directed towards women to both detect cervical cancer and identify those at risk for developing this disease. It has been argued that participation in screening programmes and early detection situations may lead to new kinds of sickness experiences. This article is based on qualitative phenomenological hermeneutical analysis of interviews with women who have received abnormal Pap smear test results through a population-based outreach screening programme in urban Sweden. The aim of this article is to illuminate the meaning, for the participating women, of the lived experience of receiving notification about an abnormal Pap smear result. The data are presented in terms of two themes: Pap smear for routine and recurrent confirmation of health and unexpected and ambiguous communication about Pap smear results. The findings are discussed as an unintentional transition from confirmation of health to liminality. Whereas medical diagnosis has been discussed as structuring the inchoate, an abnormal Pap smear did not create order for the interviewed women. On the contrary, the notification of an abnormal Pap smear created disorder as the women had expected to be confirmed as healthy but instead neither health nor disease were confirmed or excluded. Even 'simple' technology is shown to have an ontological dimension, with the ability to transform daily taken-for-grantedness of ourselves as primarily healthy to (potentially) unhealthy.
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- Lundgren, EL, et al.
(author)
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Midwives' descriptions of their familiarity with cancer - A qualitative study of midwives working with population-based cervical cancer screening in urban Sweden
- 2000
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In: Cancer Nursing. - 0162-220X .- 1538-9804. ; 23:5, s. 392-400
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Journal article (peer-reviewed)abstract
- Nurse-midwives are responsible for taking Papanicolaou (Pap) smears in Swedish population-based cervical cancer screening programs. A research project examining the screening program from the perspective of different stakeholders includes an interview study of 21 midwives working in Stockholm. This article explores the way the midwives describe cancer-related knowledge and aspects of screening, contrasting this with relevant findings from a substudy of 66 healthy women participating in screening. A semistructured interview guide with open-ended questions was used to investigate ideas about benefits and risks in the screening program, risk factors for cervical cancer, the reliability of the test itself, sources of information/knowledge relevant for cervical cancer screening, and the manner in which the midwife described her role in the screening program. The transcripts of the audiotaped interviews were analyzed thematically using a team approach. The interviewed midwives showed a great deal of consensus in their descriptions of lacking familiarity with cervical cancer and its prevention and treatment. The midwives said they lack recent education and knowledge, often avoiding use of the word "cancer" with women attending screening. It seems that the midwives experienced little professional guidance in discussing cancer-related issues with women attending the screening program. In this study, they appeared to rely on personal knowledge, valves, and experience instead.
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- Rydh, Anders, et al.
(author)
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Radioimmunoscintigraphy using an anti-prostate monoclonal antibody (E4) : a dosimetric evaluation.
- 2001
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In: Urological research. - : Springer Science and Business Media LLC. - 0300-5623 .- 1434-0879. ; 29:3, s. 216-20
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Journal article (peer-reviewed)abstract
- The aim of this study was to evaluate different strategies to increase the tumour radiation dose for experimental radioimmunotherapy using 125I-labelled monoclonal antibody (MAb) E4 in a nude mice model xenografted with DU-145 tumours. The effects from a single injection of the 125I-labelled MAb E4, the same total amount of radiolabelled MAb E4 divided into three repeated injections, and the effect of pre-targeting with non-labelled MAb E4 for reducing the amount of shed antigen were investigated. Based on repetitive quantitative radioimmunoscintigraphies, calculation of the tumour radiation dose delivered from the 125I-nuclide was performed for each strategy. The single injection strategy without pretargeting rendered the highest mean tumour radiation dose, i.e. 0.23 Gy/MBq. Pretargeting with non-labelled MAb E4 before a single injection of [125I]E4 resulted in a slightly lower mean tumour radiation dose, i.e. 0.19 Gy/MBq, compared to the single injection alone. An even lower mean tumour radiation dose, i.e. 0.14 Gy/MBq, was obtained when the same total administered amount of activity was divided into three separate injections given in 10-day intervals. We concluded that the single injection strategy is the most efficient when using MAb E4 in this tumour model. The tumour radiation doses were not increased by dividing the same amount of activity into three injections or by pretargeting with non-labelled MAb E4.
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- Widmark, A, et al.
(author)
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A systematic overview of radiation therapy effects in urinary bladder cancer
- 2003
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In: Acta Oncologica. - : Informa UK Limited. - 1651-226X .- 0284-186X. ; 42:5-6, s. 567-581
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Journal article (peer-reviewed)abstract
- A systematic review of radiation therapy trials in several turnout types was performed by The Swedish Council of Technology Assessment in Health Care (SBU). The procedures for evaluation of the scientific literature are described separately (Acta Oncol 2003; 42: 357-365). This synthesis of the literature on radiation therapy for urinary bladder cancer is based on data from 3 meta-analyses and 33 randomized trials. The studies include 4333 patients. The results were compared with those of a similar overview from 1996 including 15042 patients. The conclusions reached can be summarized as these points: There is moderate evidence for an overall survival benefit with preoperative radiotherapy followed by cystectomy compared to curative radiotherapy based on early studies (1964-1986). Since that time surgical as well as radiation techniques have developed considerably. Therefore. the conclusion may not be relevant to modern treatment of invasive urinary bladder carcinoma. There is only one small study reporting on curative radiotherapy where increased dose per fraction is compared with conventionally fractionated radiotherapy to the same total dose. Thus, no conclusions can be drawn concerning optimal fraction dose. A meta-analysis based on two studies on hyperfractionated radiotherapy gives moderate evidence of a survival benefit at 5 and 10 years and an increased local control rate compared with conventional fractionation. The documentation of local control and overall survival rate after split-course radiation treatment compared to continuous therapy is conflicting. No firm conclusions can be drawn. Four small and early studies have compared radiation treatment using neutrons with photon treatment. The reports favour therapy with photons with respect to overall treatment results. There is moderate evidence for this conclusion. There is fairly strong evidence in early studies that radiation treatment in combination with hyperbaric oxygen does not confer a treatment benefit compared to radiation in normal atmosphere. There is no indication of a treatment benefit with the addition of either hyperthermia or misonidazole. A large number of phase II studies, suggesting an increased possibility for bladder preservation with concomitant chemoradiotherapy compared to radiotherapy alone, have been reviewed in a previous SBU report on chemotherapy. Only one small randomized study has been reported where concomitant chemoradiotherapy with cisplatin is compared to radiation alone. No conclusion on the therapeutic benefit of combined treatment can be drawn. Large randomized studies are needed. There is some evidence that preoperative radiotherapy followed by cystectomy does not confer any significant survival benefit compared to cystectomy alone. There is moderate evidence that palliative radiotherapy of invasive bladder carcinoma can rapidly induce tumour-related symptom relief. There is moderate evidence that palliative hypofractionated radiotherapy, 3 fractions during one week, gives the same relief of symptoms as 10 fractions during 2 weeks.
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- Witek, HA, et al.
(author)
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Theoretical study of the unusual potential energy curve of the A (1)Sigma(+) state of AgH
- 2002
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In: Journal of Chemical Physics. - : AIP Publishing. - 0021-9606. ; 116:19, s. 8396-8406
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Journal article (peer-reviewed)abstract
- The A (1)Sigma(+) potential energy curve of AgH is studied by means of the second-order multistate multireference perturbation theory including the spin-orbit and relativistic effects. The anomalous behavior of the vibrational energy levels observed in experiment is reproduced well by theory. An analysis of the A (1)Sigma(+) wave function shows that at the internuclear distance of 4-6 Angstrom, a partial electron transfer from the 5p(z) orbital of silver to the 1s orbital of hydrogen occurs. This admixture of the ionic-like [core] 4d(10)1s(H)(2) configuration occurring in A (1)Sigma(+) due to two avoided crossings, namely X (1)Sigma(+) with A (1)Sigma(+) and A (1)Sigma(+) with C (1)Sigma(+), is found to be responsible for the unusual shape of the A (1)Sigma(+) potential energy curve: the effective potential is a superposition of a Morse-like covalent interaction between Ag and H, and the electrostatic ionic-like interaction between Ag+ and H-. We present spectroscopic parameters, vibrational levels, and rotational constants computed for a large number of vibrational levels and observe good agreement with available experimental data. The equilibrium distance agrees within 0.01 Angstrom and the vibrational frequency within 60 cm(-1) for the state-specific calculations. Larger relative discrepancy is observed for omega(e)x(e), about 30 cm(-1), however the non-Morse-like nature of the energy curve makes it impossible to describe the levels only with omega and omega(e)x(e), so that direct comparison is not well defined.
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