| 1. |
- Arman, M., et al.
(författare)
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Women's Perceptions and Beliefs About the Genesis of Their Breast Cancer
- 2006
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Ingår i: Cancer Nursing. - : Ovid Technologies (Wolters Kluwer Health). - 0162-220X .- 1538-9804. ; 29:2, s. 142-148
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Tidskriftsartikel (refereegranskat)abstract
- A person's belief is seen as a set of assumptions, depending on perceptions, and formed with the influence of experiences and social culture. With the aim of understanding the beliefs about the genesis of their illness, 118 (59 + 59) women with different stages of breast cancer were interviewed. Half of the sample had chosen complementary care in an anthroposophical hospital, and the other half was a matched group. Qualitative content analysis was used. Three themes emerged: (1) belief in a link to life lived (71%), (2) heredity as the sole genesis (4%), and (3) rejection of the question (25%). Under beliefs in a link to life lived, external aspects to the patient's own life (eg, diet and lifestyle) were cited, as well as inner aspects such as psychosocial problems and stress. The findings show that women are well informed about medical facts, although their beliefs reveal a holistic approach. The women's beliefs, where inner psychosocial factors are uppermost, point to a reverse of the causal ranking of medical advisors. The difference between the groups was that the matching sample was more likely to reject the influence of possible causes from life lived. In a caring perspective, women's perceptions of the genesis of their illness are in some cases turned to creative health activities that may increase well-being.
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| 2. |
- Carlsson, Marianne, et al.
(författare)
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A five-year follow-up of quality of life in women with breast cancer in anthroposophic and conventional care
- 2006
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Ingår i: Evidence-based Complementary and Alternative Medicine. - : Hindawi Limited. - 1741-427X .- 1741-4288. ; 3:4, s. 523-531
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Tidskriftsartikel (refereegranskat)abstract
- Complementary and alternative medicine is used by many cancer patients in most parts of the world, and its use is increasing. The aim of the present study was to examine, over 5 years, the perceived quality of life/life satisfaction in two samples of women with breast cancer who were treated with anthroposophic care or conventional medical treatment only. Data from admission, after I year and after 5 years are used for the comparisons. On admission to the study the women in anthroposophic care perceived their quality of life to be lower than that of the women in the conventional treatment group, especially for emotional, cognitive and social functioning and overall quality of life. Sixty women who actively chose treatment with anthroposophic medicine and 60 individually matched women treated with conventional medicine participated. Quality of life was measured by the EORTC QLQ-C30 and the Life Satisfaction Questionnaire. Twenty-six women within anthroposophic care and 31 women within conventional medicine survived the 5 years. Effect size (ES) estimation favored the anthroposophic group in seven of the subscales mostly measuring emotional functioning. The ES for four of the subscales favored the conventional treatment group, mostly concerning physical functioning. After 5 years there were improvements in overall quality of life and in emotional and social functioning compared to admission for the women in anthroposophic care. The improvements took place between admission and 1 year, but not further on. Only minor improvements were found in the matching group.
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| 3. |
- Carlsson, Marianne, et al.
(författare)
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Coping in women with breast cancer in complementary and conventional care over 5 years measured by the mental adjustment to cancer scale
- 2005
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Ingår i: Journal of Alternative and Complementary Medicine. - : Mary Ann Liebert Inc. - 1075-5535 .- 1557-7708. ; 11:3, s. 441-447
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Many patients with cancer, women more often than men, use complementary and alternative medicine (CAM) and care. Our aim was to examine coping over 5 years (November 1995 to January 1999) in two samples of women with breast cancer who were treated with anthroposophic care or conventional medical treatment. The present study is part of a larger study of the outcome of anthroposophic care for women with breast cancer. Design: A nonrandomized controlled trial design was used with individual matching and repeated measurements on six occasions (at admission, 1 month, 3 months, 6 months, 1 year, and 5 years). The matching was based on the following variables: stage of disease at entry, age, treatment during the 3 months before entering the study, and prognosis. Setting: An anthroposophic hospital and conventional hospitals in Sweden. Subjects: Sixty (60) women treated with anthroposophic medicine and 60 women from an oncology outpatient department participated. Forty-nine (49) women in anthroposophic care and 51 in the outpatient group survived 1 year, 26 women in anthroposophic care and 31 in the outpatient group survived 5 years. Intervention: An anthroposophic care program. Outcome measure: Coping was measured using the Mental Adjustment to Cancer scale. Repeat measures of analysis of variance (ANOVA) were used for within-group comparisons, and effect size (ES) was used for between-group comparisons. Results: The women in anthroposophic care showed more passive and anxious coping on admission, but this decreased over time. In the women in anthroposophic care, there were small ES improvements in fighting spirit and passive, anxious coping at 4 of the measured timepoints compared to admission. Conclusion: The choice of anthroposophic care could be seen as a possible way to cope with emotional distress in this group of women with breast cancer. © Mary Ann Liebert, Inc.
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| 4. |
- Koinberg, Inga-Lill, et al.
(författare)
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The usefulness of a multidisciplinary educational programme after breast cancer surgery : A prospective and comparative study
- 2006
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Ingår i: European Journal of Oncology Nursing. - London : Elsevier. - 1462-3889 .- 1532-2122. ; 10, s. 273-82
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to compare and evaluate a multidisciplinary educational programme with traditional follow-up visits to a physician after breast cancer surgery in terms of well-being, aspects of self-care and coping ability 1 year after diagnosis. A reduction in the intensity of follow-up after breast cancer surgery is recommended. New follow-up models are being debated and could be of interest. The study design was non-randomised and comparative. Ninety-six consecutively selected women with newly diagnosed breast cancer, classified as stage I or stage II, participated in either a multidisciplinary educational programme (n = 5 0), or traditional follow-up by a physician (n = 4 6). Three questionnaires were used: Functional Assessment of Cancer Therapy-General (FACT-G), a study specific questionnaire regarding self-care aspects (SCA) and Sense of Coherence (SOC). With the exception of physical well-being at baseline there was no significant difference between the groups. The women in the multidisciplinary educational programme increased their physical and functional well-being (P < 0.0 1). The women in traditional follow-up by a physician increased their functional well-being while social/family well-being (P < 0.0 1) decreased over time. There was a statistically significant difference in SOC (P < 0.0 0 1) in the traditional follow-up by a physician between baseline (mean=74.4, SD=12.4) and the 1-year follow up (mean=67.7, SD=11.4). Thus, women in the traditional follow-up by a physician scored lower in the area of SOC 1 year after diagnosis. A multidisciplinary educational programme may be an alternative to traditional follow-up by a physician after breast cancer surgery, but more research is needed about the financial benefits and effectiveness of such a programme.
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| 5. |
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| 6. |
- Reuther, Christina, et al.
(författare)
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E-therapists' views on the acceptability and feasibility of an internet-administered, guided, low-intensity cognitive behavioural therapy intervention for parents of children treated for cancer : A qualitative study
- 2024
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Ingår i: Digital Health. - : Sage Publications. - 2055-2076. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- Background: Childhood cancer treatment completion can be a period of vulnerability for parents and is associated with mental health difficulties such as depression and anxiety. We developed an internet-administered, guided, low-intensity cognitive behavioural therapy-based self-help intervention (EJDeR) for parents delivered on the U-CARE-portal (Portal). The acceptability and feasibility of EJDeR and study procedures were examined using a single-arm feasibility trial (ENGAGE). Results indicated that EJDeR and ENGAGE study procedures are acceptable and feasible, however, a need for clinical and technical modifications to EJDeR and refinements to ENGAGE study procedures was identified.Objectives: This study aimed to explore the acceptability and feasibility of EJDeR and ENGAGE study procedures from the perspective of e-therapists to inform clinical and technical modifications to EJDeR and refinements to study procedures prior to progression to a superiority randomised controlled trial.Methods: We conducted semi-structured interviews with 10 e-therapists. Data were analysed using manifest content analysis.Results: We identified three categories relating to the acceptability and feasibility of EJDeR: (a) Support to e-therapists (subcategories: Clinical supervision and Technical difficulties); (b) Guidance to parents (subcategories: Support protocols and Synchronous communication); and (c) Content (subcategories: Relevancy of the intervention and Pacing of the intervention). We identified four categories relating to the acceptability and feasibility of study procedures: (a) Recruitment and training of e-therapists (subcategories: Definition of the role and Training program); (b) Retention of parents (subcategories: Parent suitability and screening and Frequency of weekly Portal assessments); (c) Retention of e-therapists (subcategories: Administrative requirements and Communication with the research team); and (d) The Portal.Conclusions: EJDeR and study procedures were considered acceptable and feasible, however, clinical and technical modifications and refinements to study procedures were suggested to enhance acceptability and feasibility. Results may also inform implementation considerations for both EJDeR and other similar digital psychological interventions.Trial registration number ISRCTN 57233429
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| 7. |
- Rudholm, Tobias, et al.
(författare)
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Bravo capsule system optimizes intragastric pH monitoring over prolonged time : Effects of ghrelin on gastric acid and hormone secretion in the rat
- 2008
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Ingår i: World Journal of Gastroenterology. - : Baishideng Publishing Group Inc.. - 1007-9327 .- 2219-2840. ; 14:40, s. 6180-6187
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To evaluate measurements of intragastric pH with the Bravo capsule system over a prolonged time. Methods: A Bravo capsule was placed inside the rat gastric body and pH was studied for periods up to five consecutive. days. For comparison, a gastric fistula model was used. Effects of ghrelin and esomeprazole, with or without pentagastrin, on gastric pH were studied. In addition, effects of esomeprazole on plasma ghrelin, gastrin and somatostatin were analyzed. Results: All rats recovered after surgery. The average 24-h pH during free feeding was 2.3 +/- 0.1 (n = 20) with a variation of 18% +/- 6% over 5 d. Ghrelin, 2400 pmol/kg, t.i.d. increased pH from 1.7 +/- 0.1 to 3.1 +/- 0.3 (P < 0.01) as recorded with the Bravo system. After esomeprazole (1 mg/kg, 3 mg/kg and 5 mg/kg) there was a dose-dependent pH increase of maximally 3.4 +/- 0.1, with day-to-day variation over the entire period of 8% +/- 3%. The fistula and pH studies generated similar results. Acid inhibition with esomeprazole increased plasma ghrelin from 10 +/- 2 pmol/L to 65 +/- 26 pmol/L (P < 0.001), and somatostatin from 10 +/- 2 pmol/L to 67 +/- 18 pmol/L (P < 0.001). Conclusion: pH measurements with the Bravo capsule are reliable, and comparable to those of the gastric fistula model. The Bravo system optimizes accurate intragastric pH monitoring over prolonged periods and allows both short- and long-term evaluation of effects of drugs and hormones.
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| 8. |
- Rudholm, Tobias, et al.
(författare)
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Release of regulatory gut peptides somatostatin, neurotensin and vasoactive intestinal peptide by acid and hyperosmolal solutions in the intestine in conscious rats
- 2009
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Ingår i: Regulatory Peptides. - : Elsevier BV. - 0167-0115 .- 1873-1686. ; 152:1-3, s. 8-12
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Tidskriftsartikel (refereegranskat)abstract
- The impact of exposure of the intestinal mucosa to acid and hyperosmolal solutions on the release of the inhibitory gut peptides somatostatin (SOM), neurotensin (NT) and vasoactive intestinal peptide (VIP) was studied in conscious rats during pentagastrin-stimulated gastric acid secretion. The animals were equipped with a chronic gastric fistula to measure acid secretion and a jejunal Thiry-Vella loop for intestinal challenge with saline, hydrochloric acid (HCl, 200 mmol L-1) or hyperosmolal polyethylene glycol (PEG, 1200 mOsm kg(-1)). Gut peptide concentrations were measured in intestinal perfusates, and in plasma samples collected during stimulated acid secretion, and at the end of experiments with luminal challenge of the loops. After pentagastrin-stimulation acid secretion was dose-dependently inhibited by intravenous administration of the gastrin receptor antagonist gastrazole, as well as ranitidine and esomeprazole by maximally 73 +/- 10%; 95 +/- 3%; 90 10%, respectively. Acid perfusion of the Thiry-Vella loop caused a prominent release of SOM both to the lumen (from 7.2 +/- 5.0 to 1279 +/- 580 pmol L-1) and to the circulation (from 18 +/- 5.2 to 51 +/- 9.0 pmol L-1) simultaneously with an inhibition of gastric acid secretion. The release of NTand VIP was not affected to the same extent. PEG perfusion of the loop caused a release of SOM as well as NT and VIP, but less. Simultaneously acid secretion was slightly decreased. In conclusion, intestinal perfusion with acid or hyperosmolal solutions mainly releases SOM, which seems to exert a major inhibitory action in the gut, as shown by inhibition of acid secretion. The other peptides NT and VIP also participate in this action but to a much lesser degree. The operative pathways of these gut peptides hence involve both endocrine (SOM) and paracrine actions (SOM, NT, VIP) in order to exert inhibitory functions on the stomach. The inhibitory action of gastrazole, was in a similar range as that of SOM implying that physiological acid-induced inhibition of gastric acid may primarily be exerted through inhibition of gastrin endocrine secretion.
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| 9. |
- Stridh, Sara, et al.
(författare)
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Angiotensin converting enzyme inhibition blocks interstitial hyaluronan dissipation in the neonatal rat kidney via hyaluronan synthase 2 and hyaluronidase 1.
- 2011
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Ingår i: Matrix biology : journal of the International Society for Matrix Biology. - : Elsevier BV. - 1569-1802 .- 0945-053X. ; 30:1, s. 62-9
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Tidskriftsartikel (refereegranskat)abstract
- A functional renin-angiotensin system (RAS) is required for normal kidney development. Neonatal inhibition of the RAS in rats results in long-term pathological renal phenotype and causes hyaluronan (HA), which is involved in morphogenesis and inflammation, to accumulate. To elucidate the mechanisms, intrarenal HA content was followed during neonatal completion of nephrogenesis with or without angiotensin converting enzyme inhibition (ACEI) together with mRNA expression of hyaluronan synthases (HAS), hyaluronidases (Hyal), urinary hyaluronidase activity and cortical lymphatic vessels, which facilitate the drainage of HA from the tissue. In 6-8days old control rats cortical HA content was high and reduced by 93% on days 10-21, reaching adult low levels. Medullary HA content was high on days 6-8 and then reduced by 85% to 12-fold above cortical levels at day 21. In neonatally ACEI-treated rats the reduction in HA was abolished. Temporal expression of HAS2 corresponded with the reduction in HA content in the normal kidney. In ACEI-treated animals cortical HAS2 remained twice the expression of controls. Medullary Hyal1 increased in controls but decreased in ACEI-treated animals. Urine hyaluronidase activity decreased with time in control animals while in ACEI-treated animals it was initially 50% lower and did not change over time. Cells expressing the lymphatic endothelial mucoprotein podoplanin in ACEI-treated animals were increased 18-fold compared to controls suggesting compensation. In conclusion, the high renal HA content is rapidly reduced due to reduced HAS2 and increased Hyal1 mRNA expressions. Normal angiotensin II function is crucial for inducing these changes. Due to the extreme water-attracting and pro-inflammatory properties of HA, accumulation in the neonatally ACEI-treated kidneys may partly explain the pathological renal phenotype of the adult kidney, which include reduced urinary concentration ability and tubulointerstitial inflammation.
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| 10. |
- Stridh, Sara, et al.
(författare)
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C-peptide normalizes glomerular filtration rate in hyperfiltrating conscious diabetic rats
- 2009
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Ingår i: Oxygen transport to tissue xxx. - New York : Springer. - 9780387859972 - 0387859977 - 9780387859989 ; , s. 219-225
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Bokkapitel (refereegranskat)abstract
- Tubular electrolyte transport accounts for a major part of the oxygen consumed by the normal kidney. We have previously reported a close association between diabetes and increased oxygen usage, partly due to increased tubular electrolyte transport secondary to glomerular hyperfiltration during the early onset of diabetes. Several studies have shown that acute administration of C-peptide to diabetic rats with glomerular hyperfiltration results in normalized glomerular filtration rate (GFR). In this study, we validated a novel method for precise and repetitive GFR measurements in conscious rats and used C-peptide injection in diabetic rats for evaluation. First, GFR was determined in normoglycemic control rats before and after C-peptide administration. Thereafter, all rats were made diabetic by an i.v. streptozotocin injection. Fourteen days later, GFR was again determined before and after C-peptide administration. GFR was estimated from plasma clearance curves using a single bolus injection of FITC-inulin, followed by serial blood sampling over 155 min. FITC-inulin clearance was calculated using non-compartmental pharmacokinetic data analysis. Baseline GFR in normoglycemic controls was 2.10 +/- 0.18 ml/min, and was unaffected by C-peptide (2.23 +/- 0.14 ml/min). Diabetic rats had elevated GFR (3.06 +/- .034 ml/min), which was normalized by C-peptide (2.35 +/- 0.30 ml/min). In conclusion, the used method for estimation of GFR in conscious animals result in values that are in good agreement with those obtained from traditional GFR measurements on anaesthetized rats. However, multiple measurements from the same conscious subject can be obtained using this method. Furthermore, as previously shown on anaesthetized rats, C-peptide also normalizes GFR in hyperfiltrating conscious diabetic rats.
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