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- Gunnarsson, Tommy, 1978-
(författare)
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MICROWAVE IMAGING OF BIOLOGICAL TISSUES: applied toward breast tumor detection
- 2007
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Microwave imaging is an efficient diagnostic modality for non-invasively visualizing dielectric contrasts of non-metallic bodies. An increasing interest of this field has been observed during the last decades. Many application areas in biomedicine have been issued, recently the breast tumor detection application using microwave imaging.Many groups are working in the field at the moment for several reasons. Breast cancer is a major health problem globally for women, while it is the second most common cancer form for women causing 0.3 % of the yearly female death in Sweden. Medical imaging is considered as the most effective way of diagnostic breast tumors, where X-ray mammography is the dominating technique. However, this imaging modality still suffers from some limitations. Many women, mostly young ones, have radiographically dense breasts, which means that the breast tissues containing high rates of fibroglandular tissues. In this case the density is very similar to the breast tumor and the diagnosis is very difficult. In this case alternative modalities like Magnetic Resonance Imaging (MRI) with contrast enhancement and Ultrasound imaging are used, however those are not suitable for large scale screening program.Another limitation is the false-negative and false-positive rate using mammography, in general 5–15 % of the tumors are not detected and many cases have to go though a breast biopsy to verify a tumor diagnosis. At last the mammography using breast compression sometimes painful, and utilizing ionizing X-rays. The big potential in microwave imaging is the reported high contrast of complex permittivity between fibroglandular tissues and tumor tissues in breasts and that it is a non-ionizing method which probably will be rather inexpensive.The goal with this work is to develop a microwave imaging system able to reconstruct quantitative images of a female breast. In the frame of this goal this Licentiate thesis contains a brief review of the ongoing research in the field of microwave imaging of biological tissues, with the major focus on the breast tumor application. Both imaging algorithms and experimental setups are included. A feasibility study is performed to analyze what response levels could be expected, in signal properties, in a breast tumor detection application. Also, the usability of a 3D microwave propagation simulator, (QW3D), in the setup development is investigated. This is done by using a simple antenna setup with a breast phantom with different tumor positions. From those results it is clear that strong responses are obtained by a tumor presence and the diffracted responses gives strong information about inhomogeneities inside the breast. The second part of this Licentiate thesis is done in collaboration between Mälardalen University and Supélec. Using the existing planar 2.45 GHz microwave camera and the iterative non-linear Newton Kantorovich code, developed at Département de Recherches en Electromagnétisme (DRE) at Supélec, as a starting point, a new platform for both real-time qualitative imaging and quantitative images of inhomogeneous objects are investigated. The focusing is related to breast tumor detection. For the moment the tomographic performance of the planar camera is verified in simulations through a comparison with other setups. Good calibration is observed, but still experimental work concerning phantom development etc. is needed before experimental results on breast tumor detection may be obtained.
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| 2. |
- Nahlén Bose, Catarina, et al.
(författare)
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Adaptation of Coping Effectiveness Training for Patients With Heart Failure and Patient-Reported Experience of the Intervention
- 2020
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Ingår i: Journal of Patient Experience. - : Sage Publications. - 2374-3735 .- 2374-3743. ; 7:6, s. 1054-1061
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Tidskriftsartikel (refereegranskat)abstract
- Although patients with chronic heart failure (CHF) often experience psychological distress, psychosocial aspects are not an integral part of their treatment and care. The aim is to describe the adaptation of Coping Effectiveness Training for patients with CHF and the participants? reported experiences. The intervention workbook and manual were translated into Swedish and adapted for patients with CHF. Patient-reported experience from 33 of 35 participants, that had completed the psychosocial intervention, was measured with an evaluation form consisting of closed and open-ended questions. Most participants thought they benefited from the intervention, were pleased with the structure and did not want to add anything to the program. The benefits experienced were learning how to cope with the illness and meeting other people to share and discuss experiences. There was a variation concerning the group process of how much direction should be given during the discussions. Overall, unique data from patient-reported experience measure showed that the participants were satisfied with the psychosocial intervention, applied for the first time to patients with CHF.
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| 3. |
- Nahlen Bose, Catarina, et al.
(författare)
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Assessment of Coping Strategies and Their Associations With Health Related Quality of Life in Patients With Chronic Heart Failure : the Brief COPE Restructured
- 2015
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Ingår i: Cardiology Research. - : Elmer Press, Inc.. - 1923-2829 .- 1923-2837. ; 6:2, s. 239-248
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Tidskriftsartikel (refereegranskat)abstract
- Background: Individuals with chronic heart failure (CHF) need to cope with both the physical limitations and the psychological impacts of the disease. Since some coping strategies are beneficial and others are linked to increased mortality and worse health-related quality of life (HRQoL), it is important to have a reliable and valid instrument to detect different coping styles. Brief COPE, a self-reporting questionnaire, has been previously used in the context of CHF. There is, however, currently a lack of consensus about the theoretical or empirical foundations for grouping the multiple coping strategies assessed by Brief COPE into higher order categories of coping. The main purpose of this study was to examine the structure of Brief COPE, founded on the higher order grouping of its subscales in order to establish an assessment model supported by theoretical considerations. Furthermore, the associations between these higher order categories of coping and HRQoL were examined to establish the predictive validity of the selected model in the context of CHF.Method: One hundred eighty-three patients diagnosed with CHF were recruited at a heart failure outpatient clinic or at a cardiac ward. Self-reported questionnaires were filled in to measure coping strategies and HRQoL. Confirmatory factor analyses were performed to investigate different hierarchical structures of Brief COPE found in the literature to assess coping strategies in patients with CHF. Regression analyses explored associations of aggregated coping strategies with HRQoL.Results: A four factorial structure of Brief COPE displayed the most adequate psychometric properties, consisting of problem focused coping, avoidant coping, socially supported coping and emotion focused coping. Avoidant coping was associated with worse HRQoL in CHF.Conclusions: This study provides support for a four-factor model of coping strategies in patients with CHF. This could facilitate assessment of coping both in clinical and research settings.
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| 4. |
- Nahlen Bose, Catarina, et al.
(författare)
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Evaluation of a Coping Effectiveness Training intervention in patients with chronic heart failure : a randomized controlled trial
- 2016
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press. - 1474-5151 .- 1873-1953. ; 15:7, s. 537-548
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Impaired emotional well-being has detrimental effects on health outcomes in patients with chronic heart failure (CHF).AIMS:To evaluate a nurse-led Coping Effectiveness Training (CET) group intervention for patients with CHF. It was hypothesized that CET would increase emotional well-being (primary outcome) and health-related quality (HRQoL) of life and improve clinical outcomes. Furthermore, changes in appraisal and coping as mediators of the intervention effect were examined.METHODS: Participants were randomized to either control group (n=51) receiving standard health care or CET intervention group (n=52). Self-assessments of positive affect, negative affect, depression, anxiety, HRQoL, illness perception, coping strategies and social support were performed pre- and post-intervention and after six weeks, six months and 12 months. Time to death and hospitalizations were measured during the entire follow-up (median 35 months, interquartile range 11 months).RESULTS: No significant improvements for emotional well-being and HRQoL in the intervention group compared with the control group were found. After excluding patients with clinical anxiety and depression at baseline the intervention group had significantly lower negative affect (p = 0.022). There were no significant differences regarding cardiovascular events between the groups. The intervention group had greater sense of control over their illness in the short-term (p = 0.036).CONCLUSION: CET intervention was found to increase sense of control over the illness in the short term. Psychosocial support programmes, like CET, for patients with CHF is currently lacking evidence for implementing in clinical practice. However, the results provide a basis for future studies with a modified CET intervention design and increased study size.
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| 5. |
- Nahlen Bose, Catarina, et al.
(författare)
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Patterns and the mediating role of avoidant coping style and illness perception on anxiety and depression in patients with chronic heart failure
- 2016
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 30:4, s. 704-713
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Emotional distress in patients with chronic heart failure (CHF) predicts mortality, hospital readmission and quality of life. The patient's avoidant coping style and beliefs about the disease have been linked to emotional distress in CHF. However, the pattern and transmitting effects of these variables are indefinite.AIM: This study aimed to examine the links between and the potential mediating role of illness perceptions and avoidant coping style on depression and anxiety in patients with CHF.METHOD: Self-assessment data from 103 patients with CHF were subjected to path analysis in two hypothesised models. The outcome measures were coping styles, illness perception, anxiety and depression.RESULTS: Avoidant coping had a direct adverse effect on anxiety and depression. The perception of symptom burden and personal control, significantly mediated the effect between avoidant coping and anxiety and depression.CONCLUSIONS: Avoidant coping style appears to influence not only emotional distress, but also a malignant symptom perception and low sense of control over the illness.
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| 6. |
- Stigson, Peter, 1974-
(författare)
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Reducing Swedish Carbon Dioxide Emissions from the Basic Industry and Energy Utilities : An Actor and Policy Analysis
- 2007
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of the thesis is to analyze the design of the present climate and energy policies. The main focus is on how the policy instruments affect the Swedish stakeholders who are included in the European Union’s Emission Trading Scheme (EU-ETS). In-depth interviews have been carried out with representatives from the basic industry, energy utilities as well as industrial and green organizations. The purpose is to illustrate have how these stakeholders view the current policy framework and what amendments that they view as necessary.Suggestions to the Government are given regarding the design of national policies and policy instruments to provide for an improved policy framework. The information and synthesis have furthermore been collected through extensive literature studies as well as participating at conferences and seminars.The thesis is written as a monograph in order to address a larger group of readers interested in the transition of energy systems towards sustainability as well as policy makers and Swedish stakeholders. The common understanding that the global energy systems have to undergo a transition to renewables and higher energy efficiency due to the earth’s finite sources of fossil fuels and uranium presents large challenges for policy makers and business sectors as well as the society in general.Global greenhouse gas (GHG) emissions have to be drastically reduced and the work to achieve this has started through international negotiations such as the Kyoto Protocol. As the present commitment levels are low, an important issue in a short-term perspective is to develop a more comprehensive and efficient system with a much wider participation and more stringent emission targets.In order to achieve current national policy goals and international GHG emission commitments the Swedish Government utilizes a number of policy instruments that are either nationally self-assumed or called for by international agreements or the European Union. The Swedish stakeholders that are included in the EU-ETS face a broad policy framework that has a large impact on their daily operations and future investment strategies. It is imperative for the policymakers, i.e. the Government, to act in accordance with the long-term perspective that the climate change issue and the transition of the energy system require. It is likewise important that any actions are in accordance with the operational and investment climate that the business sector faces. It is argued that these aspects are not fully considered as the success of the next national budget or term of public office seems to overshadow these issues. A long-term perspective is required to provide the business sector with stable and reliable incentives. This is needed to provide the economic conditions under which the businesses can realize investments that will result in emission reductions. Short-term policies reinforce the view of environmental investments as a form of risk investments. This negatively affects the possibility of the policy instruments to effectively achieve established policy goals.Paying attention to these requirements is however not a simple task for policy makers as it will require agreements between the political parties. This demonstrates the main political difficulty with climate change – the requirement of a long-term and full commitment by all state authorities. It should be noted that the thesis does not attempt to describe the Swedish policy makers as neglecting the urgency of acting to mitigate climate change. The national agenda is far to advanced from an international perspective for such statements. The thesis however pinpoints some important issues highlighted by stakeholders, within the business sector and other organizations, who are concerned with the present climate and energy policy framework.Some of the findings are as follows:• Reducing GHG emissions in order to combat climate change must include a long-term perspective• The design of policy instruments should consequently be long-term to increase the support for investments in GHG emission reducing technologies• The design of policies that promote low GHG production alternatives within the energy utilities should be improved• The large potential for reduced GHG emission available through fuel switching and energy efficiency improvements in the Swedish basic industry should be promoted by amended policies• Reformulate or abandon the national GHG emissions target goal with the current formulation• Strive for an emission rights allocation system that is as transparent, fair and predictable as possible• The policy framework should aim for a high level of stability through interaction with the affected stakeholders• These factors are inherently important for the overall efficiency of the policy framework
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