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PURPOSE Balancing disease control and toxicity from chemotherapy and radiotherapy (RT) when treating early-stage classical Hodgkin lymphoma (cHL) is important. Available data on long-term toxicity after RT for cHL mostly refer to RT techniques no longer in use. We aimed to describe long-term toxicity from modern limited-field (LF)-RT after two or four cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD). PATIENTS AND METHODS This study included all patients with cHL treated with two or four cycles of ABVD and 30 Gy LF-RT during 1999-2005 in Sweden. Patients (n = 215) and comparators (n = 860), matched for age, gender, and region of residence, were cross-checked against national health registries for malignancies, diseases of the circulatory system (DCS), and diseases of the respiratory system (DRS) from the day of diagnosis of cHL. RESULTS The risk of a malignancy was higher for patients than comparators, hazard ratio (HR) 1.5 (95% CI, 1.0 to 2.4), as was the risk for DCS 1.5 (95% CI, 1.1 to 2.0) and for DRS 2.6 (95% CI, 1.6 to 4.3). The median followup was 16 years (range, 12-19 years). Of individual diagnoses in DCS, only venous thromboembolism was statistically significantly elevated. If the first 6 months (ie, time of active treatment for cHL) were excluded and censoring at relapse of cHL or diagnosis of any malignancy, the increased HR for venous thromboembolism diminished. Most of the excess risk for DRS consisted of asthma, HR 3.5 (95% CI, 1.8 to 6.8). Patients diagnosed with DRS were significantly younger than comparators. CONCLUSION Compared with toxicity from earlier RT techniques, excess morbidity was not eliminated, but lower than previously reported. The elevated risk of DRS was driven by diagnosis of asthma, which could in part be explained by misdiagnosis of persisting pulmonary toxicity., Funding Agencies|Stiftelsen Onkologiska Klinikens i Uppsala Forskningsfond; Swedish Cancer Society

Background: Working in pediatric palliative care means that nurses must care for their patients with a family-centered approach. In this type of care, it is important to consider children's rights and give adapted care according to the child's development stages. Nurses need to relate to the six core competencies as well as the four fundamental work responsibilities. Palliative care should also be rooted in the four cornerstones of palliative care. Aim: The aim was to highlight nurses' experiences of caring for children at the palliative stage. Method: A qualitative literature review with thematic analysis. Results: Three themes were identified: The importance of patient- and family-centered care, feelings that arise when caring for sick children and prerequisites for care. Conclusion: The nurses felt that the work was emotionally challenging. Being able to relieve the child's pain and be available to the family was seen as an important task to increase the child's quality of life. Palliative care is a global health challenge with several remaining barriers. Knowledge, education and experience can help to overcome these obstacles, create awareness of palliative care and therefore achieve qualitative care that should be equal for all., Bakgrund: Att arbeta inom den pediatriska palliativa vården innebär att sjuksköterskan behöver vårda familjecentrerat. Inom denna vårdform är det viktigt att beakta barns rättigheter och att ge dem anpassad vård utifrån barns olika utvecklingsstadier. Sjuksköterskan behöver i sitt arbete förhålla sig till sjuksköterskans sex kärnkompetenser samt sjuksköterskans fyra grundläggande ansvarsområden. Vården ska vara förankrad i de fyra hörnstenarna inom palliativ vård. Syfte: Syftet var att belysa sjuksköterskornas erfarenheter av att vårda barn i palliativt skede. Metod: En kvalitativ litteraturöversikt med tematisk analys. Resultat: Tre teman identifierades: Vikten av ett patient- och familjecentrerat vårdande, känslorna som uppkommer i vårdandet av svårt sjuka barn samt förutsättningar för vårdandet. Slutsats: Sjuksköterskorna upplevde att arbetet är känslomässigt utmanande. Att kunna lindra barnets smärta och finnas tillgänglig för familjen ansågs vara en viktig arbetsuppgift för att öka barnets livskvalitet. Palliativ vård är en global hälsoutmaning med flera kvarstående barriärer. Kunskap, utbildning och erfarenhet kan bidra till att komma över dessa hinder, skapa en medvetenhet kring palliativ vård och på så sätt uppnå en god och jämlik vård för alla.

When treating limited stage classical Hodgkin lymphoma (cHL), balancing treatment efficacy and toxicity is important. Toxicities after extended-field radiotherapy are well documented. Investigators have aimed at reducing toxicity without compromising efficacy, mainly by using combined modality treatment (CMT), i.e. chemotherapy and limited-field radiotherapy. In some clinical trials, radiotherapy has been omitted. We evaluated 364 patients with stage I-IIA cHL treated between 1999 and 2005. Patients were treated with two or four cycles of doxorubicin, bleomycin, vinblastine and dacarbazine (ABVD) according to presence of risk factors, followed by 30 Gy limited-field (reduced compared to involved-field) radiotherapy. After a median follow-up of 16 years for survival, freedom from progression at five and ten years was 93% and overall survival at 5 and 10 years was 98% and 96%, respectively. Only two relapses, out of 27, occurred after more than 5 years. There was no excess mortality compared to the general population. Of the analysed subgroups, only patients with progression within five years showed significant excess mortality. The absence of excess mortality questions the concept of omitting radiotherapy after short-term chemotherapy, a strategy that has been associated with an elevated risk of relapse but not yet with a proven reduced long-term excess mortality.

Based on an ethnographic study of predominantly white millennial Europeans in Singapore and Tokyo, this chapter argues that their boundary-making practices pinpoint the tension between what they deem to be cosmopolitan aspirations and their desire for embeddedness in the host cities. I focus on two separate domains where the migrants’ dilemma manifests, housing in Singapore and friendships in Tokyo, and argue that these Europeans strive for differentiation from the senior European expatriate community. While the millennial migrants regard integration into Singaporean and Japanese networks as a way to satisfy their cosmopolitan longings and as a proof of their cosmopolitan competence, structural circumstances and cultural differences increasingly push them towards an internationally-minded majoritarian foreign community. The comparative approach offers valuable insights into the dilemmas that occur when cosmopolitan ideals prove to be incompatible with migrants’ longing for embeddedness and demonstrates the changing nature of contemporary Europeans’ migration to Asian metropoles.

Introduction: Venous thromboembolism (VTE) is a common problem among patients with glioblastoma multi-forme (GBM) and with some other cancers. Here, we evaluated genetic and non-genetic potential risk factors for VTE among GBM patients. Materials and methods: A cohort of 139 patients treated with concomitant radiotherapy and temozolomide were included in the study. Next generation sequencing and genotyping approaches were applied to assess genetic risk factors in the haemostatic system. Clinical data including surgery, reoperation as well as blood group and patient information such as age and gender were available from patient records. Logistic regression analysis was performed to asses VTE risk. Results: In the study 47 patients (34%) were diagnosed for VTE during the course of their disease. When genetic and non-genetic potential risk factors were evaluated, only B blood group was found to be significantly associated with VTE incidence (odds ratio [OR] = 6.91; confidence interval [CI] = 2.19-24.14; P = 0.001). In contrast, A and O blood groups did not correlate with VTE risk. Frontal lobe tumor location also seemed to slightly increase VTE risk compared to other brain sites (OR = 3.14; CI = 1.1-10.7) although the significance level was at borderline (P = 0.05). Current study identified B blood group as the component in non-O blood groups that is responsible for increased VTE risk. Conclusion: In conclusion, these results suggest for the first time that B blood group is predictive for VTE incidence among patients with glioblastoma, information that may be potentially valuable when selecting GBM patients who are at risk for VTE for anticoagulant prophylaxis., Funding Agencies|Medical Research Council of Southeast Sweden (FORSS); County Council of Region Ostergotland, Sweden

Datakonsultföretaget Knowit AB har en kund som annonserar på Google AdWords. Denna uppsats fokuserar huvudsakligen på att hitta de olika inställningarna i AdWords som genererar köp av kundens produkt. Om en inställning ofta genererar klick men sällan köp av produkten är den inställningen inte lönsam.Responsvariabeln i denna uppsats är binär och indikerar på om ett klick på annonsen lett till köp av produkten eller inte. Eftersom responsvariabelns fördelning var skev har samplingstekniken SMOTE använts för att skapa fler observationer i minoritetsklassen. De statistiska metoder som använts och presenterats i uppsatsen är logistisk regression, neurala nätverk och beslutsträd.Resultatet gav att de fyra undersökta inställningarna påverkar sannolikheten för köp. Den första inställningen resulterade i att om dator används vid sökning på Google är sannolikheten att ett klick leder till köp betydligt högre än för mobil och surfplatta. Den andra inställningen resulterar i att en ”exakt matchning” för sökordet ger högst sannolikhet till köp och ”bred matchning” ger lägst sannolikhet. Den tredje inställningen visar att vilken veckodag annonsen klickas på påverkar sannolikheten för köp. På söndag är sannolikheten högst att ett klick leder till köp, och de två dagar som har lägst sannolikhet är lördag och tisdag. Slutligen har det undersökts om annonsens genomsnittsposition påverkar sannolikheten att produkten köps. Resultatet som gavs är att ju högre värde på genomsnittsposition, desto högre blir sannolikheten för köp., The data consultancy company Knowit AB has a client who advertises on Google AdWords. This thesis focuses mainly on finding which settings in AdWords generate purchases of the client’s product. If a setting frequently contributes to clicks but rarely to purchases of the product, the setting is not profitable.The target variable in this thesis is binary and indicates whether a click on the advertisement led to purchase of the product or not. Since the target variable’s distribution was skewed, the sampling technique SMOTE was used to create more observations in the minority class. The classification methods researched and presented in this thesis are logistic regression, neural networks and decision trees.The results showed that all four factor had significant affect on the probability of purchase. First, if a desktop or laptop computer was used to search on Google, the likelihood that a click leads to purchase is substantially higher compared to if a mobile or tablet was used. Second, an “exact match” setting for the keywords gives the highest probability of purchase and a “broad match” gives the lowest probability. Third, purchase rates are also affected by the day of the week. Sunday has the highest probability of purchase while Saturday and Tuesday have the lowest probability. Finally, an advertisement´s average position affects the likelihood of the product being purchased. The higher value of average position, the higher the likelihood of purchase.

Many African migrants residing abroad nurture a hope to one day return, at least temporarily, to their home country. In the wake of economic crises in the developed world, alongside rapid economic growth in parts of Africa, the impetus to 'return' is likely to increase. Such returnees are often portrayed as agents of development, bringing with them capital, knowledge and skills as well as connections and experience gained abroad. Yet, the reality is altogether more complex. In this much-needed volume, based on extensive original fieldwork, the authors reveal that there is all too often a gaping divide between abstract policy assumptions and migrants' actual practices. In contrast to the prevailing optimism of policies on migration and development, Africa's Return Migrants demonstrates that the capital obtained abroad is not always advantageous and that it can even hamper successful entrepreneurship and other forms of economic, political and social engagement., CONTENTS: 1. Introduction - Lisa Åkesson and Maria Eriksson Baaz -- 2. Successive flops and occasional feats: development contributions and thorny social navigation among Congolese return migrants - Maria Eriksson Baaz -- 3. Diaspora returnees to Somaliland: heroes of development or job-stealing scoundrels? - Laura Hammond -- 4. Pushing development: a case study of highly skilled male return migration to Ghana - Nauja Kleist -- 5. ‘Come back, invest, and advance the country’: policy myths and migrant realities of return and development in Senegal - Giulia Sinatti -- 6. The role of social capital in post-conflict business development: perspectives from returning migrants in Burundi -Tove Heggli Sagmo -- 7. Threatening mini-skirts: returnee South Sudanese adolescent girls and social change - Katarzyna Grabska -- 8. Obstacles and openings: returnees and small-scale businesses in Cape Verde - Lisa Åkesson