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- Nilsson, Kerstin, et al.
(author, creator_code:000000023193205X_t)
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Can they Stay or Will They go?
- 2024
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In: Sustaniable Healthy Working life for All Ages. - Basel, Switzerland : MDPI. ; , s. 37-56
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Book chapter (other academic/artistic)abstract
- A larger amount of older people need to participate in working life due to the global demographic change. It is the employer, through the manager, who enables employees to have access to measures in the workplace that facilitate and enable a sustainable extended working life. The aim of this study was to evaluate work life factors associated with managers believing their employees can work versus wanting to work until age 65 or older. This cross-sectional study included 249 managers in the Swedish municipality sector. Logistic regression analysis was used to investigate associations between different univariate estimates and in data modelling using the SwAge-model. The result stated that 79% of managers believed their employees ‘can’ work and 58% of managers believed their employees ‘want to’ work until age 65 or older. Health, physical work environment, skills and competence are associated the strongest to managers believing employees ‘can’ work until age 65 or older. Insufficient social support at work and lacking possibilities for relocations associated the strongest to managers believing employees would not ‘want to’ work until age 65 or older. Though, several countries (especially in Europe) have included in their social policy measures that retirement age be increased after 65, proposing ages approaching 70. When these proposals become laws, through obligation, people will have no choice (if they want to or if they can continue working). However, people’s attitudes to work may be different (especially after the COVID-19 pandemic), and this analysis of the participating managers’ attitudes showed there is a difference between why employees ‘can’ versus ‘want’ to work respectively. Therefore, different strategies may be needed to contribute to employees both being able to and willing to participate in working life until an older age. These findings on managers’ perspectives, regarding whether they believe employees would be able to versus would want to work and the SwAge-model, will hopefully contribute to anincreased understanding of organisational actions and measures in the process of creating a sustainable extended working life and to increase senior employees’ employability.
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| 3. |
- Sjölund, Katarina, et al.
(author)
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Downsizing treatment with tyrosine kinase inhibitors in patients with advanced gastrointestinal stromal tumors improved resectability.
- 2010
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In: World journal of surgery. - : Springer Science and Business Media LLC. - 1432-2323 .- 0364-2313. ; 34:9, s. 2090-2097
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Journal article (peer-reviewed)abstract
- BACKGROUND: Gastrointestinal stromal tumors (GISTs) express the receptor tyrosine kinase KIT. Most GISTs have mutations in the KIT or PDGFRA gene, causing activation of tyrosine kinase. Imatinib, a tyrosine kinase inhibitor (TKI), is the first-line palliative treatment for advanced GISTs. Sunitinib was introduced for patients with mutations not responsive to imatinib. The aim was to compare the survival of patients with high-risk resected GISTs treated with TKI prior to surgery with historical controls and to determine if organ-preserving surgery was facilitated. METHODS: Ten high-risk GIST-patients had downsizing/adjuvant TKI treatment: nine with imatinib and one with sunitinib. The patients were matched with historical controls (n = 89) treated with surgery alone, from our population-based series (n = 259). Mutational analysis of KIT and PDGFRA was performed in all cases. The progression-free survival was calculated. RESULTS: The primary tumors decreased in mean diameter from 20.4 cm to 10.5 cm on downsizing imatinib. Four patients with R0 resection and a period of adjuvant imatinib had no recurrences versus 67% in the historical control group. Four patients with residual liver metastases have stable disease on continuous imatinib treatment after surgery. One patient has undergone reoperation with liver resection. The downsizing treatment led to organ-preserving surgery in nine patients and improved preoperative nutritional status in one patient. CONCLUSIONS: Downsizing TKI is recommended for patients with bulky tumors with invasion of adjacent organs. Sunitinib can be used for patients in case of imatinib resistance (e.g., wild-type GISTs), underlining the importance of mutational analysis for optimal surgical planning.
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| 6. |
- Arne, Gabriella, et al.
(author)
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Expression profiling of GIST: CD133 is associated with KIT exon 11 mutations, gastric location, and poor prognosis.
- 2011
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In: International journal of cancer. Journal international du cancer. - : Wiley. - 1097-0215 .- 0020-7136. ; 129:5, s. 1149-1161
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Journal article (peer-reviewed)abstract
- In gastrointestinal stromal tumors (GISTs), KIT exon 11 deletions are associated with poor prognosis. The aim of this study was to determine the gene expression profiles of GISTs carrying KIT exon 11 deletions and to identify genes associated with poor prognosis. Expression profiling was performed on 9 tumors with KIT exon 11 deletions and 7 without KIT exon 11 mutations using oligonucleotide microarrays. In addition, gene expression profiles for 35 GISTs were analyzed by meta-analysis. Expression of CD133 (prominin-1) protein was examined by tissue microarray (TMA) analysis of 204 GISTs from a population-based study in western Sweden. Survival analysis was performed on patients subjected to R0 resection (n=180) using the Cox proportional hazards model. Gene expression profiling, meta-analysis, and qPCR showed up regulation of CD133 in GISTs carrying KIT exon 11 deletions. Immunohistochemical analysis on TMA confirmed CD133 expression in 28% of all tumors. CD133 positivity was more frequent in gastric GISTs (48%) than in small intestinal GISTs (4%). CD133 positivity was also more frequent in GISTs with KIT exon 11 mutations (41%) than in tumors with mutations in KIT exon 9, PDGFRA, or wild-type tumors (0-17%). Univariate survival analysis showed a significant correlation between the presence of CD133 protein and shorter overall survival (hazard ratio=2.23, P=0.027). Multivariate analysis showed that CD133 provided additional information on patient survival compared to age, sex, NIH risk group and mutational status. CD133 is expressed in a subset of predominantly gastric GISTs with KIT exon 11 mutations and poor prognosis.
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| 7. |
- Arne, Gabriella, et al.
(author)
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Gastrointestinal stromal tumors (GISTs) express somatostatin receptors and bind radiolabeled somatostatin analogs.
- 2013
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In: Acta oncologica (Stockholm, Sweden). - 1651-226X .- 0284-186X. ; 52:4, s. 783-792
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Journal article (peer-reviewed)abstract
- Background. Gastrointestinal stromal tumors (GISTs) can be effectively treated with tyrosine kinase inhibitors (TKIs). However, some patients with GIST develop drug resistance, and alternative treatment strategies are therefore needed. The aim of this study was to analyze the expression of somatostatin receptors (SSTR) in GIST as a target for peptide receptor-mediated radiotherapy (PRRT). Material and methods. Expression profiling of SSTR1-5 was performed on biopsies from 34 GISTs (16 gastric tumors, 15 small intestinal tumors, and three rectal tumors). SSTR scintigraphy ((111)In-octreotide) and measurement of (111)In activity in tumor specimens was performed in seven patients. Uptake and internalization of (177)Lu- octreotate was studied in primary cell cultures from two patients. Results. Quantitative PCR analysis showed expression of SSTR1 and SSTR2 in the majority of tumors, while SSTR3-5 were expressed at low levels. Immunohistochemical analysis confirmed the presence of SSTR1 and SSTR2 proteins in all GISTs, and SSTR3-5 in a subset of tumors. Diagnostic imaging by SSTR scintigraphy, using (111)In-octreotide, demonstrated tumor uptake of (111)In in three of six GIST patients. Measurement of (111)In activity in excised tumor specimens from five patients gave tumor-to-blood (T/B) activity ratios of between eight and 96. Tumor cells in primary culture (gastric and small intestinal GIST) specifically bound and internalized (177)Lu when incubated with the therapeutic compound (177)Lu-octreotate for 4-48 hours (p < 0.05). Conclusion. Peptide receptor-mediated radiotherapy via SSTR may provide a novel treatment strategy in carefully selected GIST patients with TKI-resistant tumors.
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| 8. |
- Arvidsson, Inger, et al.
(author)
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Should I Stay or Should I Go? : Associations between Occupational Factors, Signs of Exhaustion, and the Intention to Change Workplace among Swedish Principals
- 2023
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In: Sustainable Healthy Working Life for All Ages. - : MDPI Books. ; , s. 139-158
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Book chapter (other academic/artistic)abstract
- A high turnover among principals may disrupt the continuity of leadership and negativelyaffect teachers and, by extension, the students. The aim was to investigate to what extent variouswork environment factors and signs of exhaustion were associated with reported intentions tochange workplace among principals working in compulsory schools. A web-based questionnaire wasadministered twice, in 2018 and in 2019. Part I of the study involved cross-sectional analyses of theassociations 2018 (n = 984) and 2019 (n = 884) between occupational factors, signs of exhaustion, andthe intention to change workplace, using Generalized Estimating Equations models. Part II involved631 principals who participated in both surveys. The patterns of intended and actual changes ofworkplace across two years were described, together with associated changes of occupational factorsand signs of exhaustion. Supportive management was associated with an intention to stay, whiledemanding role conflicts and the feeling of being squeezed between management and co-workers(buffer-function) were associated with the intention to change workplace. The principals whointended to change their workplace reported more signs of exhaustion. To increase retention amongprincipals, systematic efforts are probably needed at the national, municipal, and local level, in orderto improve their working conditions
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| 9. |
- Balkhed Östholm, Åse, 1972-, et al.
(author)
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Duration of travel-associated faecal colonisation with ESBL-producing Enterobacteriaceae - A one year follow-up study
- 2018
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In: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 13:10
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Journal article (peer-reviewed)abstract
- In a previous study, we found that 30% of individuals travelling outside Scandinavia acquired extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) in their faecal flora. The aim of this study was to determine the duration of travel-associated faecal colonisation with ESBL-PE, to assess risk factors for prolonged colonisation and to detect changes in antibiotic susceptibility during prolonged colonisation.
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| 10. |
- Berglund, Björn, et al.
(author)
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Clonal spread of carbapenem-resistant Klebsiella pneumoniae among patients at admission and discharge at a Vietnamese neonatal intensive care unit
- 2021
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In: Antimicrobial Resistance and Infection Control. - : BMC. - 2047-2994. ; 10:1
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Journal article (peer-reviewed)abstract
- Background The increasing prevalence of carbapenem-resistant Enterobacteriaceae (CRE) is a growing problem globally, particularly in low- to middle-income countries (LMICs). Previous studies have shown high rates of CRE colonisation among patients at hospitals in LMICs, with increased risk of hospital-acquired infections. Methods We isolated carbapenem-resistant Klebsiella pneumoniae (CRKP) from faecal samples collected in 2017 from patients at admission and discharge at a Vietnamese neonatal intensive care unit (NICU). 126 CRKP were whole-genome sequenced. The phylogenetic relationship between the isolates and between clinical CRKP isolates collected in 2012-2018 at the same hospital were investigated. Results NDM-type carbapenemase-(61%) and KPC-2-encoding genes (41%) were the most common carbapenem resistance genes observed among the admission and discharge isolates. Most isolates (56%) belonged to three distinct clonal clusters of ST15, carrying bla(KPC-2), bla(NDM-1) and bla(NDM-4), respectively. Each cluster also comprised clinical isolates from blood collected at the study hospital. The most dominant ST15 clone was shown to be related to isolates collected from the same hospital as far back as in 2012. Conclusions Highly resistant CRKP were found colonising admission and discharge patients at a Vietnamese NICU, emphasising the importance of continued monitoring. Whole-genome sequencing revealed a population of CRKP consisting mostly of ST15 isolates in three clonally related clusters, each related to blood isolates collected from the same hospital. Furthermore, clinical isolates collected from previous years (dating back to 2012) were shown to likely be clonally descended from ST15 isolates in the largest cluster, suggesting a successful hospital strain which can colonise inpatients.
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