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1.
J Chem Phys ; 160(10)2024 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-38469909

RESUMO

Wave packet interferometry with vacuum ultraviolet light has been used to probe a complex region of the electronic spectrum of molecular nitrogen, N2. Wave packets of Rydberg and valence states were excited by using double pulses of vacuum ultraviolet (VUV), free-electron-laser (FEL) light. These wave packets were composed of contributions from multiple electronic states with a moderate principal quantum number (n ∼ 4-9) and a range of vibrational and rotational quantum numbers. The phase relationship of the two FEL pulses varied in time, but as demonstrated previously, a shot-by-shot analysis allows the spectra to be sorted according to the phase between the two pulses. The wave packets were probed by angle-resolved photoionization using an infrared pulse with a variable delay after the pair of excitation pulses. The photoelectron branching fractions and angular distributions display oscillations that depend on both the time delays and the relative phases of the VUV pulses. The combination of frequency, time delay, and phase selection provides significant control over the ionization process and ultimately improves the ability to analyze and assign complex molecular spectra.

2.
Sci Transl Med ; 15(704): eadg9452, 2023 07 12.
Artigo em Inglês | MEDLINE | ID: mdl-37437015

RESUMO

Suboptimal immunity to SARS-CoV-2 mRNA vaccination has frequently been observed in individuals with various immunodeficiencies. Given the increased antibody evasion properties of emerging SARS-CoV-2 subvariants, it is necessary to assess whether other components of adaptive immunity generate resilient and protective responses against infection. We assessed T cell responses in 279 individuals, covering five different immunodeficiencies and healthy controls, before and after booster mRNA vaccination, as well as after Omicron infection in a subset of patients. We observed robust and persistent Omicron-reactive T cell responses that increased markedly upon booster vaccination and correlated directly with antibody titers across all patient groups. Poor vaccination responsiveness in immunocompromised or elderly individuals was effectively counteracted by the administration of additional vaccine doses. Functionally, Omicron-reactive T cell responses exhibited a pronounced cytotoxic profile and signs of longevity, characterized by CD45RA+ effector memory subpopulations with stem cell-like properties and increased proliferative capacity. Regardless of underlying immunodeficiency, booster-vaccinated and Omicron-infected individuals appeared protected against severe disease and exhibited enhanced and diversified T cell responses against conserved and Omicron-specific epitopes. Our findings indicate that T cells retain the ability to generate highly functional responses against newly emerging variants, even after repeated antigen exposure and a robust immunological imprint from ancestral SARS-CoV-2 mRNA vaccination.


Assuntos
COVID-19 , Idoso , Humanos , COVID-19/prevenção & controle , SARS-CoV-2 , Linfócitos T , RNA Mensageiro/genética , Vacinação
3.
Proc Natl Acad Sci U S A ; 120(12): e2220320120, 2023 03 21.
Artigo em Inglês | MEDLINE | ID: mdl-36917669

RESUMO

Pre-existing SARS-CoV-2-reactive T cells have been identified in SARS-CoV-2-unexposed individuals, potentially modulating COVID-19 and vaccination outcomes. Here, we provide evidence that functional cross-reactive memory CD4+ T cell immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is established in early childhood, mirroring early seroconversion with seasonal human coronavirus OC43. Humoral and cellular immune responses against OC43 and SARS-CoV-2 were assessed in SARS-CoV-2-unexposed children (paired samples at age two and six) and adults (age 26 to 83). Pre-existing SARS-CoV-2-reactive CD4+ T cell responses targeting spike, nucleocapsid, and membrane were closely linked to the frequency of OC43-specific memory CD4+ T cells in childhood. The functional quality of the cross-reactive memory CD4+ T cell responses targeting SARS-CoV-2 spike, but not nucleocapsid, paralleled OC43-specific T cell responses. OC43-specific antibodies were prevalent already at age two. However, they did not increase further with age, contrasting with the antibody magnitudes against HKU1 (ß-coronavirus), 229E and NL63 (α-coronaviruses), rhinovirus, Epstein-Barr virus (EBV), and influenza virus, which increased after age two. The quality of the memory CD4+ T cell responses peaked at age six and subsequently declined with age, with diminished expression of interferon (IFN)-γ, interleukin (IL)-2, tumor necrosis factor (TNF), and CD38 in late adulthood. Age-dependent qualitative differences in the pre-existing SARS-CoV-2-reactive T cell responses may reflect the ability of the host to control coronavirus infections and respond to vaccination.


Assuntos
COVID-19 , Infecções por Vírus Epstein-Barr , Pré-Escolar , Adulto , Criança , Humanos , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , SARS-CoV-2 , Linfócitos T , Herpesvirus Humano 4 , Linfócitos T CD4-Positivos , Glicoproteína da Espícula de Coronavírus , Anticorpos Antivirais , Reações Cruzadas
4.
J Pathol ; 259(3): 236-253, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36367235

RESUMO

Lymph node (LN) lipomatosis is a common but rarely discussed phenomenon associated with aging that involves a gradual exchange of the LN parenchyma into adipose tissue. The mechanisms behind these changes and the effects on the LN are unknown. We show that LN lipomatosis starts in the medullary regions of the human LN and link the initiation of lipomatosis to transdifferentiation of LN fibroblasts into adipocytes. The latter is associated with a downregulation of lymphotoxin beta expression. We also show that isolated medullary and CD34+ fibroblasts, in contrast to the reticular cells of the T-cell zone, display an inherently higher sensitivity for adipogenesis. Progression of lipomatosis leads to a gradual loss of the medullary lymphatic network, but at later stages, collecting-like lymphatic vessels are found inside the adipose tissue. The stromal dysregulation includes a dramatic remodeling and dilation of the high endothelial venules associated with reduced density of naïve T-cells. Abnormal clustering of plasma cells is also observed. Thus, LN lipomatosis causes widespread stromal dysfunction with consequences for the immune contexture of the human LN. Our data warrant an increased awareness of LN lipomatosis as a factor contributing to decreased immune functions in the elderly and in disease. © 2022 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.


Assuntos
Transdiferenciação Celular , Lipomatose , Humanos , Idoso , Remodelação Vascular , Linfonodos/patologia , Lipomatose/metabolismo , Lipomatose/patologia , Envelhecimento
5.
Nat Med ; 28(3): 472-476, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-35042228

RESUMO

The emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron (B.1.1.529) variant of concern (VOC) has destabilized global efforts to control the impact of coronavirus disease 2019 (COVID-19). Recent data have suggested that B.1.1.529 can readily infect people with naturally acquired or vaccine-induced immunity, facilitated in some cases by viral escape from antibodies that neutralize ancestral SARS-CoV-2. However, severe disease appears to be relatively uncommon in such individuals, highlighting a potential role for other components of the adaptive immune system. We report here that SARS-CoV-2 spike-specific CD4+ and CD8+ T cells induced by prior infection or BNT162b2 vaccination provide extensive immune coverage against B.1.1.529. The median relative frequencies of SARS-CoV-2 spike-specific CD4+ T cells that cross-recognized B.1.1.529 in previously infected or BNT162b2-vaccinated individuals were 84% and 91%, respectively, and the corresponding median relative frequencies for SARS-CoV-2 spike-specific CD8+ T cells were 70% and 92%, respectively. Pairwise comparisons across groups further revealed that SARS-CoV-2 spike-reactive CD4+ and CD8+ T cells were functionally and phenotypically similar in response to the ancestral strain or B.1.1.529. Collectively, our data indicate that established SARS-CoV-2 spike-specific CD4+ and CD8+ T cell responses, especially after BNT162b2 vaccination, remain largely intact against B.1.1.529.


Assuntos
Linfócitos T CD4-Positivos/imunologia , Linfócitos T CD8-Positivos/imunologia , COVID-19 , Proteção Cruzada , SARS-CoV-2 , Anticorpos Antivirais , Vacina BNT162 , Humanos , Glicoproteína da Espícula de Coronavírus
6.
PLoS One ; 16(7): e0254673, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34270589

RESUMO

OBJECTIVES: The purpose was to analyze trends in intensity of care at End-of-life (EOL), in two cohorts of patients with lung or pancreatic cancer. SETTING: We used population-based registry data on health care utilization to describe proportions and intensity of care at EOL comparing the two cohorts (deceased in the years of 2010 and 2017 respectively) in the region of Stockholm, Sweden. PRIMARY AND SECONDARY OUTCOMES: Main outcomes were intensity of care during the last 30 days of life; systemic anticancer treatment (SACT), emergency department (ED) visits, length of stay (LOS) > 14 days, intensive care (ICU), death at acute care hospital and lack of referral to specialized palliative care (SPC) at home. The secondary outcomes were outpatient visits, place of death and hospitalizations, as well as radiotherapy and major surgery. A multivariable logistic regression analysis was used for associations. A moderation variable was added to assess for the effect of SPC at home between the cohorts. RESULTS: Intensity of care at EOL increased over time between the cohorts, especially use of SACT, increased with 10%, p<0.001, (n = 102/754 = 14% to n = 236/972 = 24%), ED visits with 7%, p<0.001, (n = 25/754 = 3% to n = 100/972 = 10%) and ICU care, 2%, p = 0.04, (n = 12/754 = 2% to n = 38/972 = 4%). High intensity of care at EOL were more likely among patients with lung cancer. The difference in use of SACT between the years, was moderated by SPC, with an increase of SACT, unstandardized coefficient ß; 0.87, SE = 0.27, p = 0.001, as well as the difference between the years in death at acute care hospitals, that decreased (ß = 0.69, SE = 0.26, p = 0.007). CONCLUSION: These findings underscore an increase of several aspects regarding intensity of care at EOL, and a need for further exploration of the optimal organization of EOL care. Our results indicate fragmentation of care and a need to better organize and coordinate care for vulnerable patients.


Assuntos
Utilização de Instalações e Serviços/tendências , Neoplasias Pulmonares/terapia , Neoplasias Pancreáticas/terapia , Assistência Terminal/tendências , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Neoplasias Pulmonares/epidemiologia , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/epidemiologia , Análise de Sobrevida , Suécia
7.
Opt Lett ; 46(10): 2356-2359, 2021 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-33988582

RESUMO

Extreme ultraviolet (XUV) light is notoriously difficult to control due to its strong interaction cross section with media. We demonstrate a method to overcome this problem by using opto-optical modulation guided by a geometrical model to shape XUV light. A bell-shaped infrared light pulse is shown to imprint a trace of its intensity profile onto the XUV light in the far-field, such that a change in the intensity profile of the infrared pulse leads to a change in the shape of the far-field XUV light. The geometrical model assists the user in predicting the effect of a specific intensity profile of the infrared pulse, thus enabling a deterministic process.

8.
J Chem Phys ; 154(14): 144305, 2021 Apr 14.
Artigo em Inglês | MEDLINE | ID: mdl-33858156

RESUMO

We have used the FERMI free-electron laser to perform time-resolved photoelectron imaging experiments on a complex group of resonances near 15.38 eV in the absorption spectrum of molecular nitrogen, N2, under jet-cooled conditions. The new data complement and extend the earlier work of Fushitani et al. [Opt. Express 27, 19702-19711 (2019)], who recorded time-resolved photoelectron spectra for this same group of resonances. Time-dependent oscillations are observed in both the photoelectron yields and the photoelectron angular distributions, providing insight into the interactions among the resonant intermediate states. In addition, for most states, we observe an exponential decay of the photoelectron yield that depends on the ionic final state. This observation can be rationalized by the different lifetimes for the intermediate states contributing to a particular ionization channel. Although there are nine resonances within the group, we show that by detecting individual photoelectron final states and their angular dependence, we can identify and differentiate quantum pathways within this complex system.

9.
Int J Sports Physiol Perform ; 16(8): 1140­1147, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-33588374

RESUMO

CONTEXT: Warming up in very cold climates and maintaining an elevated body temperature prior to a race is challenging for snow-sport athletes. PURPOSE: To investigate the effects of active (ACT), passive (PAS), and a combination of ACT and PAS (COM) warm-ups on maximal physical performance in a subzero environment among snow-sport athletes. METHODS: Ten junior alpine skiers completed 3 experimental trials in -7.2 (0.2)°C. The ACT involved 5 minutes of moderate cycling, 3 × 15-second accelerations, a 6-second sprint, 5 countermovement jumps (CMJs), and a 10-minute passive transition phase, while in PAS, participants wore a lower-body heated garment for 24 minutes. In COM, participants completed the active warm-up, then wore the heated garment during the transition phase. Two maximal CMJs and a 90-second maximal isokinetic cycling test followed the warm-up. RESULTS: CMJ performance was likely (P = .150) and very likely (P = .013) greater in ACT and COM, respectively, versus PAS. Average power output during the cycling test was likely (P = .074) greater in ACT and COM versus PAS. Participants felt likely to almost certainly warmer (P < .01) and more comfortable (P = .161) during ACT and COM versus PAS. In addition, participants felt likely warmer (P = .136) and very likely more comfortable (P = .161) in COM versus ACT. CONCLUSIONS: COM resulted in significantly improved CMJ performance versus PAS while both ACT and COM led to likely improved 90-second cycling performance. Participants felt significantly warmer during ACT and COM versus PAS and likely warmer in COM versus ACT. Therefore, a combined warm-up is recommended for alpine skiers performing in subzero temperatures.


Assuntos
Esportes , Exercício de Aquecimento , Atletas , Ciclismo , Humanos , Músculo Esquelético
10.
J Feline Med Surg ; 23(10): 945-951, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-33541237

RESUMO

OBJECTIVES: The aim of this study was to register long-term recurrence rates and mortality rates in cats diagnosed with feline idiopathic cystitis (FIC), with an observation period until death or a minimum of 10 years. METHODS: Data regarding recurrence of signs of feline lower urinary tract disease (FLUTD) and FLUTD-related mortality in cats diagnosed with FIC between 2003 and 2009 were obtained through structured telephone interviews with the cat owners from December 2018 until February 2019. The interviews were based on a standardised questionnaire covering whether the cat was still alive or not, whether death/euthanasia were due to FLUTD and whether the cat had experienced recurrent episodes of clinical signs of FLUTD. If recurrences had occurred, exact numbers or estimates of 1-3, 4-6 or >6 recurrences were recorded. RESULTS: The owners of 50/105 FIC cats included in a previous study (48%) were available for inclusion in the present study. At the time of the interview, only 6/50 cats (12%) were still alive. The FLUTD-related mortality rate was 20% (n = 10/50). Twenty-three cats (46%) had no recurrences, three cats (6%) were euthanased shortly after diagnosis, nine cats (18%) had 1-3 recurrences, three cats (6%) had 4-6 recurrences and six cats (12%) had >6 recurrences. For the remaining six cats, the number of recurrences was uncertain. CONCLUSIONS AND RELEVANCE: The long-term prognosis for cats diagnosed with FIC may, based on the results from the present study, be regarded as fairly good, as approximately 70% of the cats either recovered without additional episodes, experienced only a few recurrences, are still alive after a minimum of 10 years since inclusion in the study, or were euthanased for reasons unrelated to FLUTD.


Assuntos
Doenças do Gato , Cistite , Doenças Urológicas , Animais , Doenças do Gato/diagnóstico , Doenças do Gato/epidemiologia , Gatos , Cistite/diagnóstico , Cistite/epidemiologia , Cistite/veterinária , Seguimentos , Estudos Retrospectivos , Doenças Urológicas/veterinária
11.
Cancers (Basel) ; 13(2)2021 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-33430113

RESUMO

The tumor-draining lymph nodes (TDLNs) are primary sites for induction of tumor immunity. They are also common sites of metastasis, suggesting that tumor-induced mechanisms can subvert anti-tumor immune responses and promote metastatic seeding. The high endothelial venules (HEVs) together with CCL21-expressing fibroblastic reticular cells (FRCs) are essential for lymphocyte recruitment into the LNs. We established multicolor antibody panels for evaluation of HEVs and FRCs in TDLNs from breast cancer (BC) patients. Our data show that patients with invasive BC display extensive structural and molecular remodeling of the HEVs, including vessel dilation, thinning of the endothelium and discontinuous expression of the HEV-marker PNAd. Remodeling of the HEVs was associated with dysregulation of CCL21 in perivascular FRCs and with accumulation of CCL21-saturated lymphocytes, which we link to loss of CCL21-binding heparan sulfate in FRCs. These changes were rare or absent in LNs from patients with non-invasive BC and cancer-free organ donors and were observed independent of nodal metastasis. Thus, pre-metastatic dysregulation of core stromal and vascular functions within TDLNs reflect the primary tumor invasiveness in BC. This adds to the understanding of cancer-induced perturbation of the immune response and opens for prospects of vascular and stromal changes in TDLNs as potential biomarkers.

12.
Eur J Cancer Care (Engl) ; 30(2): e13361, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33216423

RESUMO

BACKGROUND: Improved cancer treatments and models of care (such as early palliative care) has developed during recent years. Aspects of healthcare utilisation-unplanned care have been used for evaluation of coordination and quality. The aim was to explore factors associated with cancer healthcare utilisation, during the first year after a cancer diagnosis. METHODS: Population-based registry and patient-reported data, (The European Organisation of Research and Treatment of Cancer (EORTC), QLQ- C30 questionnaire and study-specific questions) were collected. Descriptive statistics and multivariate regression models were performed. RESULTS: The sample consists of 1718 patients (haematological, gynaecological, upper gastrointestinal and head and neck cancers). Living alone were associated with unplanned hospital admissions (OR 1.35; 95% CI [1.15, 1.59], p < 0.001). Patients with specialised palliative home care had a higher likelihood of unplanned hospital admissions, (OR 4.35; 95% CI [3.22-5.91], p < 0.001) and re-admissions within 30 days, (OR, 5.8; 95% CI [4.12-8.19], p < 0.001). CONCLUSIONS: Sociodemographic and clinical factors, such as living alone and disease stage, is associated with healthcare utilisation. Patients with specialised palliative home care report lower levels of HRQoL and higher levels of unplanned care, and our findings stresses the importance of a holistic view when planning care.


Assuntos
Neoplasias de Cabeça e Pescoço , Qualidade de Vida , Humanos , Cuidados Paliativos , Aceitação pelo Paciente de Cuidados de Saúde , Inquéritos e Questionários
13.
BMJ Open ; 10(4): e035732, 2020 04 06.
Artigo em Inglês | MEDLINE | ID: mdl-32265249

RESUMO

OBJECTIVES: Inequalities in oral health have been on the rise globally. In Sweden, these differences exist not between regions, but among subgroups living in vulnerable situations. This study aims at understanding behavioural change after taking part in participatory oral health promotional activity among families living in socially disadvantaged neighbourhoods in Southern Sweden. SETTING: The current study involved citizens from a socially disadvantaged neighbourhood in Malmö, together with actors from the academic, public and private sectors. These neighbourhoods were characterised by high rates of unemployment, crime, low education levels and, most importantly, poor health. PARTICIPANTS: Families with children aged 7-14 years from the neighbourhood were invited to participate in the health promotional activities by a community representative, known as a health promoter, using snowball sampling. Between 8 and 12 families participated in the multistage focus groups over 6 months. Data were analysed using qualitative content analysis. RESULTS: Three main themes emerged from the analysis, providing an understanding of the determinants for behavioural change, including meaningful social interactions, family dynamics and health trajectories. The mothers in the study valued the social aspects of their participation; however, they believed that gaining knowledge in combination with social interaction made their presence also meaningful. Further, the participants recognised the role of family dynamics primarily the interactions within the family, family structure and traditional practices as influencing oral health-related behaviour among children. Participants reported having experienced a change in general health owing to changed behaviour. They started to understand the association between general health and oral health that further motivated them to follow healthier behavioural routines. CONCLUSIONS: The results from this study show that oral health promotion through reflection and dialogue with the communities, together with other stakeholders, may have the potential to influence behavioural change and empower participants to be future ambassadors for change.


Assuntos
Pesquisa Participativa Baseada na Comunidade , Adolescente , Criança , Promoção da Saúde , Humanos , Saúde Bucal , Suécia , Populações Vulneráveis
14.
J Adv Nurs ; 75(12): 3535-3543, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31441110

RESUMO

AIM: To explore the differences in perceived patient safety culture in cancer nurses working in Estonia, Germany, the Netherlands, and the United Kingdom. DESIGN: An exploratory cross-sectional survey. METHODS: In 2018, 393 cancer nurses completed the 12 dimensions of the Hospital Survey on Patient Safety Culture. RESULTS: The mean score for the overall patient safety grade was 61.3. The highest rated dimension was "teamwork within units" while "staffing" was the lowest in all four countries. Nurses in the Netherlands and in the United Kingdom, scored higher on "communication openness", the "frequency of events reported", and "non-punitive response to errors", than nurses from Estonia or Germany. We found statistically significant differences between the countries for the association between five of the 12 dimensions with the overall patient safety grade: overall perception of patient safety, communication openness, staffing, handoffs and transitions and non-punitive response to errors. CONCLUSION: Patient safety culture, as reported by cancer nurses, varies between European countries and contextual factors, such as recognition of the nursing role and education have an impact on it. Cancer nurses' role in promoting patient safety is a key concern and requires better recognition on a European and global level. IMPACT: Cancer Nursing Societies in any country can use these data as an indication on how to improve patient care in their country. Recognition of cancer nursing as a distinct specialty in nursing will help to improve patient safety.


Assuntos
Atitude do Pessoal de Saúde , Neoplasias/enfermagem , Enfermeiros Especialistas/psicologia , Segurança do Paciente/estatística & dados numéricos , Gestão da Segurança/estatística & dados numéricos , Estudos Transversais , Europa (Continente)/epidemiologia , Humanos , Enfermeiros Especialistas/estatística & dados numéricos , Papel do Profissional de Enfermagem , Enfermagem Oncológica/estatística & dados numéricos , Cultura Organizacional , Inquéritos e Questionários
15.
J Biol Chem ; 294(44): 15889-15897, 2019 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-31300555

RESUMO

The building blocks of DNA, dNTPs, can be produced de novo or can be salvaged from deoxyribonucleosides. However, to what extent the absence of de novo dNTP production can be compensated for by the salvage pathway is unknown. Here, we eliminated de novo dNTP synthesis in the mouse heart and skeletal muscle by inactivating ribonucleotide reductase (RNR), a key enzyme for the de novo production of dNTPs, at embryonic day 13. All other tissues had normal de novo dNTP synthesis and theoretically could supply heart and skeletal muscle with deoxyribonucleosides needed for dNTP production by salvage. We observed that the dNTP and NTP pools in WT postnatal hearts are unexpectedly asymmetric, with unusually high dGTP and GTP levels compared with those in whole mouse embryos or murine cell cultures. We found that RNR inactivation in heart led to strongly decreased dGTP and increased dCTP, dTTP, and dATP pools; aberrant DNA replication; defective expression of muscle-specific proteins; progressive heart abnormalities; disturbance of the cardiac conduction system; and lethality between the second and fourth weeks after birth. We conclude that dNTP salvage cannot substitute for de novo dNTP synthesis in the heart and that cardiomyocytes and myocytes initiate DNA replication despite an inadequate dNTP supply. We discuss the possible reasons for the observed asymmetry in dNTP and NTP pools in WT hearts.


Assuntos
Desoxirribonucleotídeos/biossíntese , Coração/crescimento & desenvolvimento , Miócitos Cardíacos/metabolismo , Animais , Replicação do DNA , Coração/fisiologia , Camundongos , Camundongos Endogâmicos C57BL , Proteínas Musculares/genética , Proteínas Musculares/metabolismo , Ribonucleotídeo Redutases/genética , Ribonucleotídeo Redutases/metabolismo
16.
Acta Oncol ; 57(10): 1303-1310, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29947281

RESUMO

BACKGROUND: Sweden's national cancer strategy points out several areas of cancer care that need improvements. Among them the need for supportive care resources to be accessible through the entire cancer trajectory and the reduction of socioeconomic inequalities. The aim of this study was to compare the patient-reported access to supportive care in the Stockholm-Gotland region between patients diagnosed in 2014 and 2016. The aim was also to describe how socioeconomic and other demographic factors impact access to supportive care. MATERIAL AND METHODS: All patients with gynaecological, head and neck, haematological and upper gastrointestinal cancers diagnosed in the Stockholm-Gotland regions were identified through the Swedish Cancer Registries. Data were collected via a questionnaire on demographic, socioeconomic factors and patients' perception (n = 1872) of access to supportive care. Data were summarized using descriptive statistics and logistic regression was used for relevant variables. RESULTS: Access to some supportive care resources, such as contact nurses (CNs) and individual written care plans (IWCPs) had significantly improved from 2014 to 2016. The proportion of patients that had received information about patient advocacy groups (PAGs) had also improved but remained on a relatively low level (29 and 35%, respectively). The proportion of patients being refereed to palliative care (PC) did not change between 2014 and 2016. In total, 10% of the patients reported to having received information on second medical opinion (SMO). Patients that had undergone multimodality cancer treatment were more likely to report access to supportive care, and those with lower education levels were more likely to have access to CNs and IWCPs. CONCLUSION: Access to some of the supportive care resources have shown improvements in the Stockholm-Gotland region but further efforts are required, especially regarding access to PC, information about PAGs and SMOs.


Assuntos
Acessibilidade aos Serviços de Saúde , Neoplasias/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Terapia Combinada , Estudos Transversais , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros , Cuidados Paliativos , Defesa do Paciente , Fatores Socioeconômicos
17.
Risk Anal ; 37(2): 305-314, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27164412

RESUMO

The present study considers the correlation between parenthood and worry about the consequences of climate change. Two approaches to gauging people's perceptions of the risks of climate change are compared: the classic approach, which measures risk perception, and the emotion-based approach, which measures feelings toward a risk object. The empirical material is based on a questionnaire-based survey of 3,529 people in Sweden, of whom 1,376 answered, giving a response rate of 39%. The results show that the correlation of parenthood and climate risk is significant when the emotional aspect is raised, but not when respondents were asked to do cognitive estimates of risk. Parenthood proves significant in all three questions that measure feelings, demonstrating that it is a determinant that serves to increase worry about climate change.

18.
Cult Health Sex ; 18(1): 45-57, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26242996

RESUMO

Subjective feelings of risk are a central feature of everyday life, and evidence shows that people who do not conform to contemporary normative notions are often more exposed to everyday risks than others. Despite this, normative notions are rarely acknowledged as risk objects. By drawing on the theory of 'doing' and 'undoing' risk, which combines intersectional and risk theory, this study contributes new perspectives on the everyday risks in contemporary society that face people who many would label as being 'at risk' - lesbian, gay, bisexual and transgender people. The study consists of five focus group interviews with lesbian, gay, bisexual and transgender people of different ages in Sweden. Findings pinpoint risks and how these are done and un-done in different spheres of interviewees' lives: the emotional risks prevailing in their private lives; the risk of discrimination at work and in relations with other institutions; and the risk of violence and harassment in public places. These risks are all related to the heteronormative order in which the mere fact of being lesbian, gay, bisexual and transgender is perceived as a risk.


Assuntos
Bissexualidade/psicologia , Homossexualidade Feminina/psicologia , Homossexualidade Masculina/psicologia , Preconceito , Estigma Social , Transexualidade/psicologia , Adulto , Feminino , Grupos Focais , Humanos , Masculino , Percepção Social , Suécia , Adulto Jovem
19.
Risk Anal ; 31(6): 1016-32, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21232063

RESUMO

Previous research has shown that white males have a relatively low perception of risks, known as the "white male effect" (WME). Many of the explanations of this effect refer to the privileged position of this particular demographic group in society, adducing white males' socio-economic resources, sense of control, worldviews, etc. It can thus be argued that inequality leads women and ethnic minorities to have higher risk perception than men and the ethnic majority. Therefore, the aim of this study is to investigate the WME in a gender-equal country, Sweden, to see if the pattern is similar to previous studies from the comparably less gender-equal United States. The empirical analyses are based on a national survey (n= 1,472) on the perception of risk conducted in Sweden in the winter of 2005. The results show that in Sweden there is no significant difference between men and women in risk perception, while people with foreign backgrounds perceive risks higher than native people. The chief finding is that there is no WME in Sweden, which we concluded results from the relative equality between the sexes in the country. On the other hand, ethnicity serves as a marker of inequality and discrimination in Sweden. Consequently, ethnicity, in terms of foreign background, mediates inequality, resulting in high risk perception. Equality therefore seems to be a fruitful concept with which to examine differences in risk perception between groups in society, and we propose that the "societal inequality effect" is a more proper description than the "WME."


Assuntos
Risco , Justiça Social , População Branca , Humanos , Masculino , Suécia , Estados Unidos
20.
Risk Anal ; 29(8): 1116-28, 2009 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-19473312

RESUMO

In evaluating complex new technologies, people are usually dependent on information provided by others, for example, experts or journalists, and have to determine whether they can trust these information sources. This article focuses on similarity as the basis for trust. The first experiment (N = 261) confirmed that a journalist writing about genetically modified (GM) food was trusted more when his attitude was congruent with that of his readers. In addition, the experiment showed that this effect was mediated by the perceived similarity of the journalist. The second experiment (N = 172) revealed that trust in a journalist writing about the focal domain of GM food was even influenced by him expressing a congruent attitude in an unrelated domain. This result supports a general similarity account of the congruence effect on trust, as opposed to a confirmatory bias account.


Assuntos
Biotecnologia/tendências , Produtos Agrícolas , Plantas Geneticamente Modificadas , Confiança , Adulto , Atitude , Feminino , Indústria Alimentícia , Técnicas Genéticas , Humanos , Jornalismo , Masculino , Pessoa de Meia-Idade , Opinião Pública , Risco
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