<p>Background: The women who were called in for further examinations after a breast screening had all their examinations and test during one day. This organization has been conducted since 1993 in this clinic, but has not previously been evaluated. Aim: The aim of this study was to investigate the patients’ experiences of the organization, in a radiologic breastcancer clinic, where all the examinations and the test-results were given at the same day. Method: An empirical quantitative study was performed. The study was performed in eighty-one consecutive women who had an appointment for further investigations after a breast screening. A self-administered questionnaire was designed specifically for this study and mailed to the participants. Results: All of the participants where very satisfied to have all the examinations, tests, counseling with a doctor and to see a nurse in the same day. The results included both woman diagnosed with and without cancer and independent on the type or number of examinations the women had had.</p>

<p>Cancer is a common disease and due to problems with resistance against cancer drugs and the limited benefit from chemotherapy in many diagnoses, there is a need to develop new cancer drugs. In this thesis new methods to screen for cancer drugs and to evaluate their mechanism of action are discussed. </p><p>In Paper I, it was found that by studying the gene expression of a cell line panel and combining the data with sensitivity data of a number of cytotoxic drugs, it was possible to cluster compounds according to mechanism of action as well as identifying genes associated with chemosensitivity.</p><p>In Paper II, studies of compounds with selective activity in drug-resistant cell lines revealed the glucocorticoids as a group of interesting compounds. The glucocorticoid receptor was overexpressed in 8226/Dox40 and the difference in sensitivity was abolished when the cells were treated with a glucocorticoid receptor antagonist.</p><p>In Paper III, an image-based screening method for new proteasome inhibitors was successfully developed and the compounds disulfiram, PDTC and NSC 95397 were identified as inhibitors of the proteasome.</p><p>In Paper IV, disulfiram and PDTC were shown to induce cytotoxic activity, to inhibit the activation of the transcription factor NFkappaB and to inhibit the degradation of proteins normally degraded by the proteasome.</p><p>In Paper V, NSC 95397 was shown to be cytotoxic to all cells in the resistance-based cell line panel as well as to patient samples from a variety of cancer diagnoses. Connectivity Map was successfully used as a tool to propose a new mechanism of action of NSC 95397. The gene expression induced by NSC 95397-treatment was similar to that induced by several proteasome inhibitors not present in the Connectivity Map.</p>

Thesis (M.C.E.)--University of Delaware, 2006. / Principal faculty advisor: Ardeshir Faghri, Dept. of Civil & Environmental Engineering. Includes bibliographical references.

Colorectal cancer (CRC) is one of the most common causes of death from malignant disease. Nevertheless, no ideal screening method exists and there is a lack of prognostic and predictive factors to support clinical decisions and to aid the development of a more individualized treatment for patients with CRC. The aim of this thesis was to investigate early detection, prognostic and predictive factors of CRC. In the first paper, a novel method to collect cells for DNA quantification from the rectal mucosa was investigated. The sensitivity and specificity of this test to detect CRC or any pathology in colon and rectum were ultimately too low to be acceptable. In the second paper, the prognostic value of growth differentiation factor 15 (GDF 15) was evaluated in patients curatively operated for colorectal cancer. GDF 15 expression was demonstrated to be associated with a negative prognosis in patients with stages I-III and III disease. In the third paper, the prognostic value of BRAF, PIK3CA KRAS and MSI was evaluated in a cohort of patients with CRC stratified by disease and recurrence. The results indicated that patients with CRC stage III without recurrence have a higher frequency of BRAF mutation compared to stage III patients with recurrence. In the fourth paper, histopathological predictors of pathologic complete response (pCR) as well as the association between pre-treatment carcinoembryonic antigen (CEA) levels and pCR in non-smoking and smoking patients receiving preoperative chemo-radiotherapy for rectal cancer were evaluated. Only in non-smokers was a low CEA level significantly associated with pCR, suggesting that the predictive value of CEA for pCR in rectal cancer in smokers can be limited. In sum, this research has investigated a new method for CRC detection and further evaluated the clinical use of prognostic and predictive markers in CRC.

Background: The women who were called in for further examinations after a breast screening had all their examinations and test during one day. This organization has been conducted since 1993 in this clinic, but has not previously been evaluated. Aim: The aim of this study was to investigate the patients’ experiences of the organization, in a radiologic breastcancer clinic, where all the examinations and the test-results were given at the same day. Method: An empirical quantitative study was performed. The study was performed in eighty-one consecutive women who had an appointment for further investigations after a breast screening. A self-administered questionnaire was designed specifically for this study and mailed to the participants. Results: All of the participants where very satisfied to have all the examinations, tests, counseling with a doctor and to see a nurse in the same day. The results included both woman diagnosed with and without cancer and independent on the type or number of examinations the women had had.

Tidig upptäckt och intervention är av stor vikt när det gäller att komma till rätta med alkoholproblem. För att identifiera vilka som har alkoholproblem använder man sig inom vården av screeninginstrument. Dessa screeninginstrument kan distribueras på olika sätt, till exempel som enkät eller som intervju. Tidigare forskning har kommit fram till motstridiga resultat gällande vilket distributionssätt som ger den mest tillförlitliga informationen. Syftet med föreliggande studie är att undersöka om det finns skillnader i svar till följd av distributionssätt. Här undersöks enkät- respektive intervjumetod. De screeninginstrument som används i studien är Alcohol Use Disorders Identification Test och CAGE. Undersökningsdeltagare var 47 studenter vid Stockholms respektive Uppsala Universitet. Samtliga deltagare gjorde både enkät och intervju. Resultatet visade ingen signifikant skillnad mellan de båda distributionssätten avseende totalpoängen. Däremot fanns en signifikant skillnad mellan de båda distributionssätten i en enskild fråga på Alcohol Use Disorders Identification Test.

Fetal alcohol spectrum disorder (FASD) is the leading non-genetic cause of brain damage. In an effort to reduce alcohol-exposed pregnancies, steps are needed to identify at risk women as early as possible so that appropriate intervention can occur. The objective of this dissertation was to examine screening methods validated in identifying pregnant women at risk for consuming alcohol and illicit drugs during pregnancy. A systematic review identified three main approaches including maternal self-report, use of standardized questionnaires and detection via biological markers. Since most screening tools were developed in alcoholic women, it was important to examine performance in problem drinkers. Alcohol screening tools (ASQ), currently the best method of predicting prenatal problem drinking, were not effective in a cohort representative of problem drinkers. ASQ performance improved minimally, using higher thresholds, but not enough to be used alone. Provider’s knowledge of complexities inherent in women under their care is an important component in screening. As illicit drug use is an important predictor of problem drinking, identifying maternal risk factors associated with substance use was necessary. Increased rates of STD’s, untreated psychiatric disorders, binge drinking and heavy smoking were all identified as predictors of prenatal methamphetamine (MA) use. These factors, combined with high rates of unplanned pregnancies have serious adverse implications for the fetus. The most widely used method to screen for illicit substance use is based on a practice-based approach that relies heavily on maternal self-report. Most providers do not ask about alcohol and substance use in the absence of a high index of suspicion due to the assumption that patient will deny use. But evidence suggests that maternal account can be accurate in a supportive environment. The last study examines the agreement between self-reported data, in comparison to illicit drug use based on positive hair test results. A reasonable agreement between the two approaches of identification demonstrates that maternal self-report can be reliable in women who are motivated enough to seek prenatal care. No single approach is sufficient to effectively identify at risk women. However, combining two or more methods will improve screening and help reduce the number of alcohol-exposed pregnancies.

No description available.

Patient-related barriers may reduce the effectiveness of screening for depression. This study aimed to explore perceived barriers to participation in a Screening Program for Depression by hemodialysis patients. In a cross-sectional study of hemodialysis patients, the Perceived Barriers to Psychological Treatment questionnaire was used to measure barriers to the Screening Program. Of 160 participants, 73.1% perceived at least one barrier (95% CI, 66.2% to 80.0%). The most common barriers were concerns about the side effects of antidepressant medications (40%), concerns about having more medications (32%), feeling that the problem is not severe enough (23%), and perceiving no risk of depression (23%). A high depression score was an independent predictor of barriers related to perceiving no benefit of the Screening Program and psychological, social, and practical barriers. We believe that patient-related barriers need to be addressed before implementing any case identification and treatment program for depression.

Sammanfattning Bakgrund: I Sverige finns 30 000 – 40 000 personer med psykosdiagnos. Dessa är en utsatt grupp avseende metabola riskfaktorer, dels utifrån konsekvenser av sjukdomen, men också med anledning av den antipsykotiska medicineringen. Därför rekommenderas screening för metabola riskfaktorer i förebyggande syfte och för tidig upptäckt.Syfte: Syftet med studien var att undersöka personals erfarenheter av hinder och framgångsfaktorer i screeningarbetet. Metod: Semistrukturerade intervjuer genomfördes med 7 personal som arbetade med metabol screening på en psykiatrisk öppenvårdsmottagning. Data analyserades via kvalitativ innehållsanalys. Resultat: Resultatet visade att personalens engagemang och intresse var mycket viktigt för att screening skulle prioriteras. Vårdrelationen beskrevs som betydelsefull för motivationsarbetet. Tankar framfördes om möjliga förbättringar såsom att koncentrera arbetet med screening till en bestämd tidsperiod varje år för ökat fokus. Att skapa en påminnelsefunktion i det befintliga datajournalsystemet var en annan tanke. Slutsats: Studien visade att ökad tidspress och låg efterfrågan av resultatet krävde högt engagemang och intresse hos personalen för genomförande av screening. Nyckelord: screening, metabolt syndrom, neuroleptika, psykos, vårdrelation