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Women’s lived experience in an Icelandic prison and their experience of treatment options inside and out of prison
No full textTo access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadTilgangur: Konur sem hafa afplánað refsidóma hafa flestar, ef ekki
nær allar, einhverja áfallasögu að baki. Þær glíma við flókinn vanda
sem einkennist af vímuefnanotkun og afleiðingum hennar. Lítið er
vitað um reynsluheim þeirra í íslenskum fangelsum og af meðferðarúrræðum innan og utan fangelsis. Tilgangur rannsóknarinnar er að
auka þekkingu og dýpka skilning á þeirri reynslu þeirra.
Aðferð: Í þessari fyrirbærafræðilegu rannsókn tóku þátt níu konur á
aldrinum 20–45 ára. Þær áttu allar við vímuefnavanda að stríða og
höfðu allar leitað sér meðferðar við honum. Tekin voru tvö viðtöl við
allar nema tvær, samtals 16 viðtöl.
Niðurstöður: Konurnar höfðu allar leitað sér aðstoðar vegna vímuefnavanda fyrir afplánun. Þær höfðu leitað í flest meðferðarúrræði
sem í boði voru hér á landi, og höfðu einnig leitað sér vímuefnameðferðar erlendis. Flestar konurnar notuðu vímuefni um æð og
glímdu við heilsufarsvanda því tengdan. Konurnar höfðu flestar orðið
fyrir einhvers konar áföllum í æsku eða á fullorðinsárum. Var vímuefnaneyslan einhvers konar bjargráð til að flýja eða lifa af erfiðar
aðstæður. Vímuefnaneyslunni fylgdi síðan mikil vanlíðan, depurð og
kvíði. Meirihluti þeirra voru mæður og höfðu misst börn sín frá sér
vegna vímuefnanotkunarinnar. Konurnar óskuðu þess flestallar að
unnið væri úr áföllum þeirra meðan vímuefnameðferðin færi fram
þar sem þær töldu vímuefnaneyslu sína vera nátengda þeim áföllum
sem þær höfðu orðið fyrir. Þeim fannst mikilvægt að virkara meðferðarstarf væri í fangelsum og kvörtuðu undan iðjuleysi sem þeim
fannst ekki einungis erfitt heldur einnig auka vanlíðan þeirra og fíkn
í vímuefni. Ályktanir: Rannsókn þessi sýnir að mikilvægt er að nýta
viturlegar en nú er gert þann tíma sem konur afplána refsidóm, t.d.
með því að veita meðferð við vímuefnavanda og við þeim áföllum
sem þær hafa orðið fyrir sem börn, unglingar og fullorðnar konur.Aim: A vast majority of former female inmates have a history of
trauma and tend to have complex issues marked by substance use
and its consequences. e experience of female inmates in Icelandic prisons and their experience of addiction treatments during
or aer incarceration is not well documented. e aim of this
study is to explore that experience.
Method: Nine women, 20–40 years old, participated in this phenomenological study. All participants had substance use problems
and had sought treatment for it. Two interviews were conducted
with each participant, except for two participants, sixteen interviews in total.
Results: All the women had sought help for addiction before incarceration. ey had tried most of the addiction treatments available in Iceland in addition to treatments available abroad. Majority
of them used substances intravenously and suffered from health
complications thereof. Most of the participants had suffered traumas, in childhood and in adult life. Substance use was perceived
as a method of escaping orsurviving difficult circumstances. Much
sadness, melancholy and anxiety followed the substance use. Most
of the participants were mothers and had lost custody of their children due to their substance abuse. Most of the women expressed
a wish for a trauma-based drug treatment program as they believed their drug abuse was caused by the traumas they had experienced. ey called for a more active treatment program in prisons
and complained about idleness, which they felt increased their discomfort and drug craving.
Conclusion: is study shows that the incarceration period of
women should be used more wisely—both for addiction treatment
and for treatment for recovery from traumas they have experienced, during childhood, adolescence and in adult life.
Keywords: women, prison, trauma, substance addiction, female
inmate, phenomenology, interview
Risk of digestive cancers in a cohort of 69 460 five-year survivors of childhood cancer in Europe: the PanCareSurFup study.
No full textTo access publisher's full text version of this article click on the hyperlink belowBackground: Survivors of childhood cancer are at risk of subsequent primary neoplasms (SPNs), but the risk of developing specific digestive SPNs beyond age 40 years remains uncertain. We investigated risks of specific digestive SPNs within the largest available cohort worldwide.
Methods: The PanCareSurFup cohort includes 69 460 five-year survivors of childhood cancer from 12 countries in Europe. Risks of digestive SPNs were quantified using standardised incidence ratios (SIRs), absolute excess risks and cumulative incidence.
Results: 427 digestive SPNs (214 colorectal, 62 liver, 48 stomach, 44 pancreas, 59 other) were diagnosed in 413 survivors. Wilms tumour (WT) and Hodgkin lymphoma (HL) survivors were at greatest risk (SIR 12.1; 95% CI 9.6 to 15.1; SIR 7.3; 95% CI 5.9 to 9.0, respectively). The cumulative incidence increased the most steeply with increasing age for WT survivors, reaching 7.4% by age 55% and 9.6% by age 60 years (1.0% expected based on general population rates). Regarding colorectal SPNs, WT and HL survivors were at greatest risk; both seven times that expected. By age 55 years, 2.3% of both WT (95% CI 1.4 to 3.9) and HL (95% CI 1.6 to 3.2) survivors had developed a colorectal SPN-comparable to the risk among members of the general population with at least two first-degree relatives affected.
Conclusions: Colonoscopy surveillance before age 55 is recommended in many European countries for individuals with a family history of colorectal cancer, but not for WT and HL survivors despite a comparable risk profile. Clinically, serious consideration should be given to the implementation of colonoscopy surveillance while further evaluation of its benefits, harms and cost-effectiveness in WT and HL survivors is undertaken.
Keywords: CANCER EPIDEMIOLOGY; COLORECTAL CANCER; COLORECTAL CANCER SCREENING; GASTROINTESTINAL CANCER.European Commission
Fondation Force de recherche sur le cancer de l'enfant (FORCE)
Fondazione AIRC per la ricerca sul cancro
Compagnia di San Paolo
Fondo Chiara Rama ONLUS
Swedish Childhood Cancer Fund
French Association for Cancer Research (ARC)
French National Research Agency (ANR)
Institut National du Cancer (INCA) France
Pfizer Foundation for Children and Adolescent Health
Slovenian Research Agency - Slovenia
Swiss Paediatric Oncology Group
Swiss Cancer League
Swiss Cancer Research foundation KFS-02783-02-2011
Swiss National Science Foundation (SNSF)
European Commission
KWF Kankerbestrijding
Norwegian Childhood Cancer Foundation
Children with Cancer U
Forty year old female with cough and chest pain
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Acute Kidney Injury After Acute Repair of Type A Aortic Dissection.
No full textTo access publisher's full text version of this article click on the hyperlink belowBackground: The aim of this study was to examine the incidence, risk factors, and outcomes of patients with acute kidney injury (AKI) after surgery for acute type A aortic dissection (ATAAD) using the Nordic Consortium for Acute Type A Aortic Dissection registry.
Methods: Patients who underwent ATAAD surgery at 8 Nordic centers from 2005 to 2014 were analyzed for AKI according to the RIFLE criteria. Patients who died intraoperatively, those who had missing baseline or postoperative serum creatinine, and patients on preoperative renal replacement therapy were excluded.
Results: AKI occurred in 382 of 941 patients (40.6%), and postoperative dialysis was required for 105 patients (11.0%). Renal malperfusion was present preoperatively in 42 patients (5.1%), of whom 69.0% developed postoperative AKI. In multivariable analysis patient-related predictors of AKI included age (per 10 years; odds ratio [OR], 1.30; 95% confidence interval [CI], 1.15-1.48), body mass index >30 kg/m2 (OR, 2.16; 95% CI, 1.51-3.09), renal malperfusion (OR, 4.39; 95% CI, 2.23-9.07), and other malperfusion (OR, 2.10; 95% CI, 1.55-2.86). Perioperative predictors were cardiopulmonary bypass time (per 10 minutes; OR, 1.04; 95% CI, 1.02-1.07) and red blood cell transfusion (OR per transfused unit, 1.08; 95% CI, 1.06-1.10). Rates of 30-day mortality were 17.0% in the AKI group compared with 6.6% in the non-AKI group (P < .001). In 30-day survivors AKI was an independent predictor of long-term mortality (hazard ratio, 1.86; 95% CI; 1.24-2.79).
Conclusions: AKI is a common complication after surgery for ATAAD and independently predicts adverse long-term outcome. Of note one-third of patients presenting with renal malperfusion did not develop postoperative AKI, possibly because of restoration of renal blood flow with surgical repair. Mortality risk persists beyond the perioperative period, indicating that close clinical follow-up of these patients is required.Landspitali University Hospital Research Fund
University of Iceland Research Fun
Vitamin D status and association with gestational diabetes mellitus in a pregnant cohort in Iceland.
Get PDFTo access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadBackground: Vitamin D deficiency has been associated with an increased risk of gestational diabetes mellitus (GDM), one of the most common pregnancy complications. The vitamin D status has never previously been studied in pregnant women in Iceland.
Objective: The aim of this research study was to evaluate the vitamin D status of an Icelandic cohort of pregnant women and the association between the vitamin D status and the GDM incidence.
Design: Subjects included pregnant women (n = 938) who attended their first ultrasound appointment, during gestational weeks 11-14, between October 2017 and March 2018. The use of supplements containing vitamin D over the previous 3 months, height, pre-pregnancy weight, and social status were assessed using a questionnaire, and blood samples were drawn for analyzing the serum 25‑hydroxyvitamin D (25OHD) concentration. Information regarding the incidence of GDM later in pregnancy was collected from medical records.
Results: The mean ± standard deviation of the serum 25OHD (S-25OHD) concentration in this cohort was 63±24 nmol/L. The proportion of women with an S-25OHD concentration of ≥ 50 nmol/L (which is considered adequate) was 70%, whereas 25% had concentrations between 30 and 49.9 nmol/L (insufficient) and 5% had concentrations < 30 nmol/L (deficient). The majority of women (n = 766, 82%) used supplements containing vitamin D on a daily basis. A gradual decrease in the proportion of women diagnosed with GDM was reported with increasing S-25OHD concentrations, going from 17.8% in the group with S-25OHD concentrations < 30 nmol/L to 12.8% in the group with S-25OHD concentrations ≥75 nmol/L; however, the association was not significant (P for trend = 0.11).
Conclusion: Approximately one-third of this cohort had S-25OHD concentrations below adequate levels (< 50 nmol/L) during the first trimester of pregnancy, which may suggest that necessary action must be taken to increase their vitamin D levels. No clear association was observed between the vitamin D status and GDM in this study.
Keywords: cod liver oil; gestational diabetes mellitus; nutritional status; pregnancy; supplements; vitamin D.University of Iceland Research Fund
Science Fund of Landspitali National University Hospita
The warfare against private enterprise in health care has begun
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Mikilvægt að viðra tilfinningar eftir erfiða atburði
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Educational needs and disease-related knowledge of patients with coronary heart disease: Cross-sectional study at hospital discharge
No full textTo access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadVegna forvarna og betri meðferðar lifa fleiri með
kransæðasjúkdóm en áður og eykur það þörf fyrir fræðslu
frá heilbrigðisstarfsfólki. Tilgangur rannsóknarinnar var að
lýsa sjúkdómstengdri þekkingu og fræðsluþörfum sjúklinga
með kransæðasjúkdóm við útskrift af sjúkrahúsi.
Í þessari lýsandi þversniðsrannsókn, sem gerð var 2017-
2018, tóku þátt fullorðnir einstaklingar sem lögðust
inn á sjúkrahús vegna bráðs kransæðaheilkennis,
kransæðavíkkunar eða kransæðahjáveituaðgerðar. Við
útskrift af sjúkrahúsi var gögnum safnað úr sjúkraskrá,
með mælingum og þátttakendur svöruðu spurningalistum.
Sjúkdómstengd þekking var metin með mælitækinu
Þekking-KRANS sem inniheldur 20 fullyrðingar, flokkaðar í
fimm þekkingarsvið. Möguleg stig á heildarkvarða eru 0-20
og á hverju þekkingarsviði 0-4. Þátttakendur voru einnig
beðnir um að meta fræðsluþarfir sínar varðandi 15 atriði er
tengjast kransæðasjúkdómi á 4 stiga kvarða (1 = mjög lítil
þörf, til 4 = mjög mikil þörf).
Þekking þátttakenda (N = 445, 80% karlar, meðalaldur
64,1 ár (sf 9,1)) mældist að meðaltali 13,6 (sf 3,3), þekking
mældist mest á sviði næringar (M 3,2; sf 10,0) og minnst á
sviði sálfélagslegrar áhættu sem tengist kransæðasjúkdómi
(M 2,4; sf 1,0) (p < 0,001). Menntun, reykingar, trú á eigin
getu, aldur og fyrri sjúkrahúslega vegna kransæðasjúkdóms
skýrðu 16% af breytileika í þekkingu (F 14,223; R2 0,159;
p < 0,001). Yfir 70% sjúklinga höfðu mikla eða mjög mikla
þörf fyrir fræðslu um sjúkdóminn og meðferð hans.
Við útskrift af sjúkrahúsi mældist sjúkdómstengd þekking
einstaklinga með kransæðasjúkdóm viðunandi en þó höfðu
þeir enn miklar fræðsluþarfir sem mikilvægt er að uppfylla.
Við sjúklingafræðslu þurfa hjúkrunarfræðingar að hafa í
huga að aldur, menntun, fyrri saga um kransæðasjúkdóm,
reykingar og trú á eigin getu eru þættir sem geta haft
áhrif á hvernig fræðsla skilar sér í betri þekkingu.
Eftirfylgd hjúkrunarfræðinga á göngudeild og aukin
fjarheilbrigðisþjónusta gætu verið fýsilegir kostir til að
uppfylla fræðsluþarfir eftir útskrift af sjúkrahúsi.
Tilgangur
ÚTDRÁTTUR
Aðferð
Niðurstöður
Lykilorð:
Fræðsluþarfir, kransæðasjúkdómur, sjálfsumönnun,
sjúklingafræðsla, þekking.Secondary prevention and improved treatment
have resulted in an increased number of people
living with coronary heart disease (CHD) in need of
patient education from healthcare professionals.
The aim of this study was to describe the diseaserelated knowledge and educational needs of CHD
patients at hospital discharge.
This cross-sectional study was conducted in
2017-2018. The participants were adults admitted
to Icelandic hospitals because of acute coronary
syndrome, percutaneous coronary interveniton,
or coronary artery bypass grafting surgery.
Data were collected at hospital discharge from
medical records, physical measurements, and
questionnaires. Disease-related knowledge
was assessed with the Coronary Artery Disease
Education Questionnaire-short version (CADE-QSV) consisting of 20 assertions categorized into five
subscales. The possible scores for the total list are
0-20 and 0-4 for each subscale. The participants
were also asked to evaluate their educational needs
regarding 15 items about CHD on a four-point scale
(1 = very little need to 4 = very high need).
The mean total knowledge score of the participants
(N = 445; 80% males; mean age 64.1 years [SD
9.1]) was 13.6 (sf 3.3). The highest scores were for
nutrition (M 3.2; SD 10.0) and the lowest were for CHD
psychosocial risk factors (M 2.4; SD 1.0) (p < 0.001).
Education, smoking, self-confidence, age, and prior
CHD-related hospitalization explained 16% of the
variation in knowledge (F 14.223; R2 0.159; p < 0.001).
Over 70% of patients had a high or very high need for
education regarding the disease and its treatment.
At hospital discharge, CHD patients’ diseaserelated knowledge was acceptable. However,
their educational needs were still high and remain
important to fulfill. When providing patient education
nurses need to recognize that age, education, prior
CHD hospitalization, smoking, and self-confidence
are factors that can affect how patient education
translates into knowledge. Nurses’ follow-up in
outpatient clinics and, to a greater extent telehealth
could be feasible options for fulfilling patients’
educational needs after discharge.
Aim
ENGLISH SUMMARY
Educational needs and disease-related
knowledge of patients with coronary heart
disease: Cross-sectional study at hospital
discharge
Method
Results
Key words:
Coronary heart disease, information needs,
knowledge, patient education, self-careByggðastofnun,
Vísindasjóður Landspítala, Vísindasjóður Sjúkrahússins á
Akureyri, Rannsókna- og vísindasjóður hjúkrunarfræðinga,
Vísindasjóður Félags íslenskra hjúkrunarfræðinga (B-hluti),
Vísindasjóður Háskólans á Akureyri, Hjartavernd Norðurlands,
Menningar- og viðurkenningarsjóður KE
Detection of phenotype-specific therapeutic vulnerabilities in breast cells using a CRISPR loss-of-function screen.
Get PDFTo access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadCellular phenotype plasticity between the epithelial and mesenchymal states has been linked to metastasis and heterogeneous responses to cancer therapy, and remains a challenge for the treatment of triple-negative breast cancer (TNBC). Here, we used isogenic human breast epithelial cell lines, D492 and D492M, representing the epithelial and mesenchymal phenotypes, respectively. We employed a CRISPR-Cas9 loss-of-function screen targeting a 2240-gene 'druggable genome' to identify phenotype-specific vulnerabilities. Cells with the epithelial phenotype were more vulnerable to the loss of genes related to EGFR-RAS-MAPK signaling, while the mesenchymal-like cells had increased sensitivity to knockout of G2 -M cell cycle regulators. Furthermore, we discovered knockouts that sensitize to the mTOR inhibitor everolimus and the chemotherapeutic drug fluorouracil in a phenotype-specific manner. Specifically, loss of EGFR and fatty acid synthase (FASN) increased the effectiveness of the drugs in the epithelial and mesenchymal phenotypes, respectively. These phenotype-associated genetic vulnerabilities were confirmed using targeted inhibitors of EGFR (gefitinib), G2 -M transition (STLC), and FASN (Fasnall). In conclusion, a CRISPR-Cas9 loss-of-function screen enables the identification of phenotype-specific genetic vulnerabilities that can pinpoint actionable targets and promising therapeutic combinations.Research Council of Norway
European Commission
Appeared in source as:Norwegian Research Council
Norwegian Cancer Society
United States Department of Health & Human Services
National Institutes of Health (NIH) - US
Unexplained sudden death: next-generation sequencing to the rescue?
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