Kyrkogårdens förändringar

Syftet med denna studie är att se vad som har hänt i den svenska kyrkogårdens historia och vad som har förändrats på Östra kyrkogården och kvarter 4H sedan 1921 då det var invigning av den arkitekt Sigurd Lewerentz ritade Östra kyrkogården i Malmö. Och om kvarter 4H kan bli ett bättre kvarter om hänsyn tas till ett tillgängligare markmaterial. Med hjälp av arkivstudier har jag kunnat läsa om det har funnits annat markmaterial på platsen och när kalkstenen blev lagt på plats, samt varför det har skett en förändring. Det stora problemet på kvarter 4H är gångarna. Det krävs tillstånd från länsstyrelsen för att få ändra i kyrkogårdsmiljö. Det finns två lagar som man skall ta hänsyn till när det gäller förändring i en kyrkogårdsmiljö, nämligen kulturminneslagen och plan- och bygglagen. Dessa lagar arbetar mot varandra då kulturminneslagen skyddar kulturmiljöer, medan plan- och bygglagen främjar tillgängligheten. När det skall göras en förändring på en kyrkogård måste beslut fattas och bedömningar göras från fall till fall. I detta arbete tittar jag på hur det har sett ut på kvarter 4H under de år som har gått och vilket markmaterial som har använts samt vilket markmateriel som kan göra gångarna mer tillgängliga. Östra kyrkogården i Malmö, Limhamns kyrkogård i Malmö och Norra Begravningsplatsen i Stockholm är stadskyrkogårdar, och är exempel på vad som händer på en kyrkogård som ligger inne i en stad och som följer människans och stadens utveckling. Jag har i mitt arbete valt att använda mig av kvarter 18, 19 och 20 på Limhamns kyrkogård som referens för att se vad som har skett på denna plats, samt för att studera under vilken tidsperiod förändringarna har skett. Jag har även valt att titta på kvarter 20b på Norra Kyrkogården i Stockholm under samma tidsperiod för att se om det är liknande förändringar där. Att det blev just Limhamns kyrkogård var för att jag sökte en kyrkogård eller ett kvarter som skulle vara uppförda vid ungefär samma år som kvarter 4H på Östra kyrkogården. När det gäller kvarter 20b på Norra begravningsplatsen i Stockholm var jag ute efter ytterligare en plats som det skulle ha skett en förändring. Vid val av nytt markmaterial ska det passa in i kyrkogårdsmiljön. Att använda sig av gräs som Norra kyrkogården i Stockholm har gjort är inte en god idé med tanke på tillgängligheten för personer med handikapp. Grus är ett markmaterial som har använts på Limhamns kyrkogård i Malmö sedan den anlades 1897. Ur en historisk syn och tillgänglighets aspekt är grus ett bra exempel på markmaterial att använda sig av vid en nyanläggning på kvarter 4H på Östra kyrkogården

Kultur och hälsa : En fenomenologisk studie av den kulturella bakgrundens roll i individens hälsouppfattning

The aim of the study has been to see if there are cultural differences in the perception of health and, if so, analyze if this is something needed to be taken in consideration in Swedish healthcare, schools and so forth. The participants were children aged between nine and nineteen. The study was performed at Islamic center's Islamic free school in Rosengård, Malmö. We have used a phenomenological approach that encourages the participants to talk freely and in their own words about a given subject, in our case, health. To analyze the transcribed interviews we have used software, Minerva, an application of Meaning Constitution Analysis (MCA) developed by Roger Sages, lector at The University of Lund. The results show that all the participants, regardless of culture, feel that eating right and exercising are crucial for their health. Additional to this we have found that the participants have a very strong solidarity whit their family and their origin country. Apart from this we have found no overall perception of health

Compliance Challenges with the General Data Protection Regulation

The General Data Protection Regulation are coming as a response to the outdated Directive from 1995. With this, a lot tougher pressures are put on organisations regarding the demand for compliance, which is mainly done through higher penalties, giving organisations an in-citement to oblige. Seen from the perspective of information systems, organisations have to implement the requirements of the regulation into their data processes in order to stay compli-ant. In the literature there is a lack of understanding of what challenges organisations face when striving for compliance in information systems. The General Data Protection Regulation was used as a lens to examine the available compliance theory. This was done by interviewing employees working with and in organisations trying to comply with the General Data Protec-tion Regulation in positions such as security management, product management and project management. We found seven challenges and one sub-challenge concerning data processes that organisations face as they adjust to the General Data Protection Regulation.The General Data Protection Regulation are coming as a response to the outdated Directive from 1995. With this, a lot tougher pressures are put on organisations regarding the demand for compliance, which is mainly done through higher penalties, giving organisations an in-citement to oblige. Seen from the perspective of information systems, organisations have to implement the requirements of the regulation into their data processes in order to stay compli-ant. In the literature there is a lack of understanding of what challenges organisations face when striving for compliance in information systems. The General Data Protection Regulation was used as a lens to examine the available compliance theory. This was done by interviewing employees working with and in organisations trying to comply with the General Data Protec-tion Regulation in positions such as security management, product management and project management. We found seven challenges and one sub-challenge concerning data processes that organisations face as they adjust to the General Data Protection Regulation

Gastro-enteritis outbreak among Nordic patients with psoriasis in a health centre in Gran Canaria, Spain: a cohort study

BACKGROUND: Between November 2 and 10, 2002 several patients with psoriasis and personnel staying in the health centre in Gran Canaria, Spain fell ill with diarrhoea, vomiting or both. Patient original came from Norway, Sweden and Finland. The patient group was scheduled to stay until 8 November. A new group of patients were due to arrive from 7 November. METHODS: A retrospective cohort study was conducted to assess the extent of the outbreak, to identify the source and mode of transmission and to prevent similar problems in the following group. RESULTS: Altogether 41% (48/116) of persons staying at the centre fell ill. Norovirus infection was suspected based on clinical presentations and the fact that no bacteria were identified. Kaplan criteria were met. Five persons in this outbreak were hospitalised and the mean duration of diarrhoea was 3 days. The consequences of the illness were more severe compared to many other norovirus outbreaks, possibly because many of the cases suffered from chronic diseases and were treated with drugs reported to affect the immunity (methotrexate or steroids). During the two first days of the outbreak, the attack rate was higher in residents who had consumed dried fruit (adjusted RR = 3.1; 95% CI: 1.4–7.1) and strawberry jam (adjusted RR = 1.9; 95% CI: 0.9–4.1) than those who did not. In the following days, no association was found. The investigation suggests two modes of transmission: a common source for those who fell ill during the two first days of the outbreak and thereafter mainly person to person transmission. This is supported by a lower risk associated with the two food items at the end of the outbreak. CONCLUSIONS: We believe that the food items were contaminated by foodhandlers who reported sick before the outbreak started. Control measures were successfully implemented; food buffets were banned, strict hygiene measures were implemented and sick personnel stayed at home >48 hours after last symptoms

Epidemiology and Cost of Nosocomial Gastroenteritis, Avon, England, 2002–2003

Implementing control measures rapidly may be effective in controlling gastroenteritis outbreaks

Breast cancer response to neoadjuvant chemotherapy: predictive markers and relation with outcome

The aim of this study was to provide a better insight into breast cancer response to chemotherapy. Chemotherapy improves outcome in breast cancer patients. The effect of cytotoxic treatment cannot be predicted for individual patients. Therefore, the identification of tumour characteristics associated with tumour response and outcome is of great clinical interest. We studied 97 patients, who received anthracycline-based neoadjuvant chemotherapy. Tumour samples were taken prior to and after chemotherapy. We quantified the response to chemotherapy clinically and pathologically and determined histological and molecular tumour characteristics. We assessed changes in the expression of Bcl-2, ER, P53 HER2 and Ki-67. Association with response and outcome was tested for all parameters. The experimental results showed 15 clinical (17%) and three (3%) pathological complete remissions. There were 18 (20%) clinical vs 29 (33%) pathological nonresponders. The expression of most markers was similar before and after chemotherapy. Only Ki-67 was significantly decreased after chemotherapy. Factors correlated with response were: large tumour size, ER negativity, high Ki-67 count and positive P53 status. Tumour response and marker expression did not predict disease-free or overall survival. In conclusion, clinical and pathological response assessments are poorly associated. Proliferation decreases significantly after chemotherapy. ER negativity and a high proliferation index are associated with better response. HER2 status does not predict response, and outcome is not related to tumour response

Retrospective analysis of 119 Chinese noninflammatory locally advanced breast cancer cases treated with intravenous combination of vinorelbine and epirubicin as a neoadjuvant chemotherapy: a median follow-up of 63.4 months

<p>Abstract</p> <p>Background</p> <p>This study is a retrospective evaluation of the efficacy of neoadjuvant chemotherapy (NC) with a vinorelbine (V) and epirubicin (E) intravenous combination regimen and is aimed at identification of predictive markers for the long-term outcome in noninflammatory locally advanced breast cancer (NLABC).</p> <p>Methods</p> <p>One-hundred-and-nineteen patients with NLABC were identified from September 2001 to May 2006. Analysis was performed in March 2008, with a median follow-up of 63.4 months (range, 9-76 months). All patients were diagnosed with invasive breast cancer using 14 G core needle biopsy and treated with three cycles of VE before surgery. Local-regional radiotherapy was offered to all patients after the completion of chemotherapy followed by hormonal therapy according to hormone receptor status. Tissue sections cut from formalin-fixed paraffin-embedded blocks from biopsy specimens and postoperative tumor tissues were stained for the presence of estrogen receptor (ER), progesterone receptor (PgR), HER-2 (human epidermal growth factor receptor-2), and MIB-1(Ki-67).</p> <p>Results</p> <p>Patients characteristics were median age 52 years (range: 25-70 years); clinical TNM stage, stage IIB (n = 32), stage IIIA (n = 56), stage IIIB (n = 22) and stage IIIC (n = 9). All patients were evaluable for response: clinically complete response was documented in 27 patients (22.7%); 78 (65.6%) obtained partial response; stable disease was observed in 13 (10.9%); 1 patient (0.8%) had progressive disease. Pathological complete response was found in 22 cases (18.5%). Seventy-five patients were alive with no recurrence after a median follow-up of 63.4 months, the 5-year rates for disease-free survival and overall survival were 58.7% and 71.3%, respectively, after the start of NC. On multivariate analysis, the independent variables associated with increased risk of relapse and death were high pre-Ki-67(p = 0.012, p = 0.017, respectively), high post-Ki-67 expression (p = 0.045, p = 0.001, respectively), and non-pCR (p = 0.034, p = 0.027, respectively). A significantly increased risk of death was associated with lack of pre-ER expression (p = 0.002). Among patients with non-pCR, those with a pathological response at the tumor site with special involvement (i.e. skin, vessel and more than one quadrant) were at a higher risk of disease relapse and death (p < 0.001, p = 0.001, respectively).</p> <p>Conclusion</p> <p>This study suggests the promising use of a VE regimen as NC for Chinese NLABC after a median follow-up of 63.4 months. Pathological response in the tumor site, pre-Ki-67 and post-Ki-67 expression, and pre-ER expression were the important variables that predicted long-term outcome. Patients with pathological special involvement at the primary site after NC had the lowest survival rates.</p

Ki-67 can be used for further classification of triple negative breast cancer into two subtypes with different response and prognosis

This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Introduction: Triple negative breast cancer (TNBC) has a poorer survival, despite a higher response rate to neoadjuvant chemotherapy. The purpose of this study was to identify the predictive or prognostic value of Ki-67 among patients with TNBC treated with neoadjuvant chemotherapy, and the role of Ki-67 in further classification of TNBC. Methods: A total of 105 TNBC patients who received neoadjuvant docetaxel/doxorubicin chemotherapy were included in the present study. Pathologic complete response (pCR) rate, relapse-free survival (RFS), and overall survival (OS) were compared according to the level of Ki-67. Results: pCR was observed in 13.3% of patients. TNBC with high Ki-67 expression (>= 10%) showed a higher pCR rate to neoadjuvant chemotherapy than TNBC with low Ki-67 expression. None of the low Ki-67 group achieved pCR (18.2% in the high Ki-67 group vs. 0.0% in the low Ki-67 group, P = 0.019). However, a high Ki-67 expression was significantly associated with poor RFS and OS in TNBC, despite a higher pCR rate (P = 0.005, P = 0.019, respectively). In multivariate analysis, high Ki-67 was an independent prognostic factor for RFS in TNBC (hazard ratio = 7.82, P = 0.002). The high Ki-67 group showed a similar pattern of recurrence with overall TNBC, whereas the low Ki-67 group demonstrated a relatively constant hazard rate for relapse. Conclusions: TNBC with high Ki-67 was associated with a more aggressive clinical feature despite a higher pCR rate. High proliferation index Ki-67 can be used for further classification of TNBC into two subtypes with different responses and prognosis.

Elevated expression of polymorphonuclear leukocyte elastase in breast cancer tissue is associated with tamoxifen failure in patients with advanced disease

Besides a variety of other proteases, polymorphonuclear leukocyte elastase (PMN-E) is also suggested to play a role in the processes of tumour cell invasion and metastasis. Yet, there is only limited data available on the relation between the tumour level of PMN-E and prognosis in patients with primary breast cancer, and no published information exists on its relation with the efficacy of response to systemic therapy in patients with advanced breast cancer. In the present study, we have measured with enzyme-linked immunosorbent assay the levels of total PMN-E in cytosolic extracts of 463 primary breast tumours, and have correlated their levels with the rate and duration of response on first-line tamoxifen therapy (387 patients) or chemotherapy (76 patients) in patients with locally advanced and/or distant metastatic breast cancer. Furthermore, the probabilities of progression-free survival and postrelapse survival were studied in relation to the tumour levels of PMN-E. Our results show that in logistic regression analysis for response to tamoxifen treatment in patients with advanced disease, high PMN-E tumour levels were associated with a poor rate of response compared with those with low PMN-E levels (odds ratio: OR, 0.40; 95% CI, 0.22-0.73; P = 0.003). After correction for the contribution of the traditional predictive factors in multivariate analysis, the tumour PMN-E status was an independent predictor of response (P = 0.01). Furthermore, a high tumour PMN-E level was related with a poor progression-free survival (P<0.001) and postrelapse survival (P = 0.002) in a time-dependent analysis. In contrast, the tumour level of PMN-E was not significantly related with the efficacy of response to first-line chemotherapy in patients with advanced breast cancer. Our present results suggest that PMN-E is an independent predictive marker for the efficacy of tamoxifen treatment in patients with advanced breast cancer