| 41. |
- Ahlberg, Karin, 1965, et al.
(författare)
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Fatigue, psychological distress, coping and quality of life in patients with uterine cancer.
- 2004
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Ingår i: Journal of advanced nursing. - 0309-2402. ; 45:2, s. 205-13
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Cancer-related fatigue (CRF) is a subjectively experienced symptom that is multidimensional and multifactorial. Patients with cancer have identified fatigue as one of the major troubling symptoms and the primary cause of distress in their lives. AIMS: The major aim of the study was to examine how patients diagnosed with uterine cancer describe their experience of fatigue, psychological distress, coping resources and quality of life. A secondary aim was to describe the relationship between selected variables. METHOD: A descriptive and correlational design was used and the study was conducted at a university hospital in Sweden. The study population consisted of women, diagnosed with uterine cancer, who where scheduled to receive curative external radiation therapy. Sixty women participated in the study and data were collected through self-report instruments. Demographic and clinical data were extracted from patient records. The data were collected during year 2000-2002. The Conceptual Model of Symptom Management was used as a framework to guide the study. FINDINGS: Patients experienced a low grade of fatigue and psychological distress, but their functional status and global quality of life was high. Significant correlations were found between general fatigue and anxiety and also between general fatigue and depression. There was a significant negative correlation between general fatigue and coping resources. Depression explained 44% of the variance in general fatigue. CONCLUSIONS: The findings provide knowledge about predictors of CRF in women with uterine cancer, and can serve as a basis for future longitudinal studies in which different prophylactic strategies against therapy-related fatigue are prospectively studied.
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| 42. |
- Ahlberg, Karin, 1965, et al.
(författare)
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Levels of fatigue compared to levels of cytokines and hemoglobin during pelvic radiotherapy: a pilot study.
- 2004
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Ingår i: Biological research for nursing. - : SAGE Publications. - 1099-8004 .- 1552-4175. ; 5:3, s. 203-10
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Tidskriftsartikel (refereegranskat)abstract
- Cancer-related fatigue (CRF) is a prevalent and distressing symptom experienced by patients during cancer therapy. One proposed mechanism for the development of fatigue is the increased secretion of proinflammatory cytokines and/or the development of anemia. The major purpose of this pilot study was to investigate the levels of fatigue and cytokines during radiation therapy and determine whether there was a correlation between the two. A secondary purpose was to explore the relationships among hemoglobin values, cytokines, and fatigue. Participants included 15 women diagnosed with uterine cancer, who received curative external radiation therapy. Fatigue was assessed by a self-report instrument (Multidimensional Fatigue Inventory [MFI-20]) and hemoglobin and cytokines (Il-1, Il-6, and TNF-alpha) were measured before, during, and after radiotherapy. The degree of fatigue increased during radiotherapy without a significant change in IL-1, IL-6, or TNF-alpha levels. There was no significant correlation between changes in general fatigue and the changes in IL-1 and TNF-alpha. There was a significant negative correlation between the change in IL-6 and general fatigue. The hemoglobin levels did decrease significantly during radiotherapy, but there was no significant correlation between general fatigue and hemoglobin after 3 weeks of therapy or after the completion of therapy. In conclusion, pelvic radiotherapy in women with uterine cancer is associated with increased fatigue. There were no significant relationships between anemia or cytokine levels and fatigue. The pathogenesis of fatigue during radiation therapy remains to be elucidated.
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| 43. |
- Ahlberg, Kristina, 1954
(författare)
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Synvändor : universitetsstudenters berättelser om kvalitativa förändringar av sätt att erfara situationers mening under utbildningspraktik
- 2004
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The main purpose of this study has been to examine the questions: Do people experience view-turns? Can they describe them? What do the processes signify? A narrative method, with an open and dual-focussed interview question to students of medicine, nursing, occupational therapy and physiotherapy in their final term, was used to obtain accounts of university students? experiences of changing ways of experiencing during educational placement. The accounts revealed that all interviewed students except one had found it meaningful and possible to describe experienced processes of changing ways of experiencing. The accounts were analysed phenomenographically and two qualitatively different main categories were discerned, which were drawn directly from the students? descriptions: Addition of Something New, with subcategories Information and Result, and Restructuring of Awareness, with subcategories Figure/Ground, Difference/Similarity, Perspective and Whole/Part. Categorisation of the accounts was verified in a three-stage interjudge reliability test with three independent assessors. Significant difference between placing in the two main categories was found between accounts by students of medicine and those by students of nursing, occupational therapy and physiotherapy. Medical students? accounts were categorised predominantly as addition of something new, whilst accounts from nursing, occupational therapy and physiotherapy students were categorised almost exclusively as restructuring of awareness. This difference was elucidated by theoretical and historical connection to the Natural Attitude and the Philosophical Attitude described within early phenomenology. The described view-turns were theoretically elucidated with phenomenology, pragmatic meaning formation theory and gestalt theory. The theories, which each give a partial understanding of view-turns, all fail however to explain fully the findings of this study. Contradictions amongst the single-dimensional theoretical understandings offered are suggested to be reconciled through the variation theory of learning, by the premise of co-constitution of experiencing and the experienced. An element of contradiction is seen to be integral to dynamic processes of learning. The research question?s simultaneous focussing on two ways of experiencing something appears to have been decisive in revealing dynamic processes of changing ways of experiencing as well as way of experiencing.
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| 44. |
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| 45. |
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| 46. |
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| 47. |
- Ahlgren, Per
(författare)
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The effects of indexing strategy-query term combination on retrieval effectiveness in a Swedish full text database
- 2004
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis deals with Swedish full text retrieval and the problem of morphological variation of query terms in the document database. The study is an information retrieval experiment with a test collection. While no Swedish test collection was available, such a collection was constructed. It consists of a document database containing 161,336 news articles, and 52 topics with four-graded (0, 1, 2, 3) relevance assessments. The effects of indexing strategy-query term combination on retrieval effectiveness were studied. Three of five tested methods involved indexing strategies that used conflation, in the form of normalization. Further, two of these three combinations used indexing strategies that employed compound splitting. Normalization and compound splitting were performed by SWETWOL, a morphological analyzer for the Swedish language. A fourth combination attempted to group related terms by right hand truncation of query terms. A search expert performed the truncation. The four combinations were compared to each other and to a baseline combination, where no attempt was made to counteract the problem of morphological variation of query terms in the document database. Two situations were examined in the evaluation: the binary relevance situation and the multiple degree relevance situation. With regard to the binary relevance situation, where the three (positive) relevance degrees (1, 2, 3) were merged into one, and where precision was used as evaluation measure, the four alternative combinations outperformed the baseline. The best performing combination was the combination that used truncation. This combination performed better than or equal to a median precision value for 41 of the 52 topics. One reason for the relatively good performance of the truncation combination was the capacity of its queries to retrieve different parts of speech. In the multiple degree relevance situation, where the three (positive) relevance degrees were retained, retrieval effectiveness was taken to be the accumulated gain the user receives by examining the retrieval result up to given positions. The evaluation measure used was nDCG (normalized cumulated gain with discount). This measure credits retrieval methods that (1) rank highly relevant documents higher than less relevant ones, and (2) rank relevant (of any degree) documents high. With respect to (2), nDCG involves a discount component: a discount with regard to the relevance score of a relevant (of any degree) document is performed, and this discount is greater and greater, the higher position the document has in the ranked list of retrieved documents. In the multiple degree relevance situation, the five combinations were evaluated under four different user scenarios, where each scenario simulated a certain user type. Again, the four alternative combinations outperformed the baseline, for each user scenario. The truncation combination had the best performance under each user scenario. This outcome agreed with the performance result in the binary relevance situation. However, there were also differences between the two relevance situations. For 25 percent of the topics and with regard to one of the four user scenarios, the set of best performing combinations in the binary relevance situation was disjunct from the set of best performing combinations in the multiple degree relevance situation. The user scenario in question was such that almost all importance was placed on highly relevant documents, and the discount was sharp. The main conclusion of the thesis is that normalization and right hand truncation (performed by a search expert) enhanced retrieval effectiveness in comparison to the baseline, irrespective of which of the two relevance situations we consider. Further, the three indexing strategy-query term combinations based on normalization were almost as good as the combination that involves truncation. This holds for both relevance situations.
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| 48. |
- Ahlman, Håkan, 1947, et al.
(författare)
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Interventional treatment of the carcinoid syndrome
- 2004
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Ingår i: Neuroendocrinology. - 0028-3835. ; 80 Suppl 1, s. 67-73
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Tidskriftsartikel (refereegranskat)abstract
- Liver metastases imply a major problem in patients with carcinoid tumours and hormone overproduction. Patients with distant metastases can undergo resection for potential cure or for symptom palliation. In patients with bilobar liver metastases other interventions are at hand, e.g. local ablation or hepatic arterial embolization. In selected cases liver transplantation can be a treatment alternative. Prior to all interventions patients with midgut carcinoids are protected with somatostatin analogues to reduce hormone secretion. Patients with foregut carcinoids may present special problems with life-threatening release of histamine during interventions.
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| 49. |
- Ahlman, Håkan, 1947, et al.
(författare)
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Liver transplantation for treatment of metastatic neuroendocrine tumors
- 2004
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Ingår i: Annals of the New York Academy of Sciences. - 0077-8923. ; 1014, s. 265-9
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Tidskriftsartikel (refereegranskat)abstract
- Liver transplantation can be considered a therapeutic option for patients with neuroendocrine tumors only metastatic to the liver. Important selection criteria are well-differentiated tumors and a low proliferation rate (Ki67 <10%). In this series, orthopic liver transplantation offered good relief of symptoms and long disease-free intervals with initial survival of grafts and patients as in benign disease. The experience with multivisceral transplantation is still limited.
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| 50. |
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