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Träfflista för sökning "WFRF:(Nygren Peter) srt2:(2020)"

Sökning: WFRF:(Nygren Peter) > (2020)

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1.
  • Forslund, Marina (författare)
  • A nutrition intervention in men with prostate cancer Exploring effects on bowel symptoms from radiotherapy, patient experience, and nutrient intake
  • 2020
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • <p><strong>Objective</strong> The main objective<strong> </strong>of this thesis<strong> </strong>was to<strong> </strong>explore the effects of a nutrition intervention on acute and late bowel symptoms in men with localised prostate cancer treated with pelvic radiotherapy (study I), participants’ experiences from receiving the nutrition intervention (study II), and associations with nutrient intakes (study III).</p><p><strong>Methods</strong> A total of 180 men with localised prostate cancer referred to curative radiotherapy targeting the prostate gland and pelvic lymph nodes were recruited to the trial. The participants were randomised to standard care plus a nutrition intervention aiming to modify fibre and lactose intakes (NIG; n=92) or standard care alone (SCG; n=88). Data on bowel symptoms and dietary intake were collected pre-treatment and at seven time points during a 26-month study period. Analyses of the effects of the nutrition intervention on bowel symptoms were conducted for the acute phase (up to 2 months post radiotherapy), and the late phase (7 to 24 months post radiotherapy). Semi-structured interviews were conducted with 15 participants from the NIG to explore experiences of the nutrition intervention.</p><p><strong>Results</strong> The nutrition intervention was associated with statistically significantly, but not clinically significantly, less bother from blood in stools and flatulence during the acute phase. The nutrition intervention was also associated with more bloated abdomen during the late phase (Study I). Social support, contributing to the greater good, prior knowledge, dietary information, and a small need for change facilitated adherence. While feeling limited, wanting to decide for themselves, the timing of the intervention, unmet expectations, and loss of motivation were described as barriers for adherence (Study II). A greater reduction of lactose was associated with decreased intake of calcium at the end of the radiotherapy period. A more modified fibre intake during the radiotherapy period was associated with increased vitamin C, but decreased selenium intake (Study III).</p><p><strong>Conclusions</strong> The effects from the nutrition intervention were small and inconclusive and do not support routine dietary advice aiming to modify fibre and lactose intakes as a mean to substantially reduce adverse effects from pelvic radiotherapy. Tailored nutritional interventions based on individual preferences, prior knowledge, and context, could enhance adherence. There were few associations between modified fibre and lactose intakes and nutrient intakes, thus, no recommendations can be made on whether such dietary advice should continue to be provided to men with prostate cancer undergoing pelvic radiotherapy.</p>
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2.
  • Forslund, Marina, et al. (författare)
  • Experiences of a nutrition intervention : A qualitative study within a randomised controlled trial in men undergoing radiotherapy for prostate cancer
  • 2020
  • Ingår i: Nutrition & Dietetics. - 1446-6368 .- 1747-0080. ; 77:2, s. 223-230
  • Tidskriftsartikel (refereegranskat)abstract
    • <p><strong>AIM:</strong> Men with prostate cancer undergoing radiotherapy may experience acute and late bowel symptoms. Nutrition interventions have shown some benefits, however, adherence tends to decline over time. Qualitative studies, carried out after an intervention, are important to help explain trial results. The aim of the present study was to explore patient experience of participating in a nutrition intervention in a randomised controlled trial, with a focus on facilitators and barriers to adherence.</p><p><strong>METHODS:</strong> Semistructured interviews were conducted with 15 men with prostate cancer recruited from a randomised controlled trial on a nutrition intervention during radiotherapy. Interviews were analysed with content analysis with an inductive approach.</p><p><strong>RESULTS:</strong> The informants were motivated to make dietary changes to avoid bowel symptoms. Social support, a feeling of contributing to the greater good, prior knowledge, dietary information and a small need for behaviour change facilitated adherence. Feeling limited, wanting to decide for themselves, the timing of the intervention, unmet expectations of dietary advice and loss of motivation, were described as barriers for adherence.</p><p><strong>CONCLUSIONS:</strong> Future nutrition intervention trials may benefit from involving significant others to a greater degree, as well as offering pre-set recipes and strategies to manage social events, and more sessions with the dietitian for patients in need of more support. Tailored interventions based on the individual's preferences, context and prior knowledge about food may further facilitate adherence.</p>
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3.
  • Hauffman, Anna (författare)
  • Internet-based Psychosocial Support Design, Effects and User Experience in the Cancer Setting
  • 2020
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • <p><strong>Background and Aim </strong>Being diagnosed with cancer is often described as a major loss of control leading to severe psychological distress and symptoms of anxiety and depression can continue to affect the individual in the long term. The cancer and its treatment may influence all dimensions of health, thus the psychosocial support provided needs to be multifaceted and easy accessed. Internet-based interventions may be one way to provide such support, but evidence is limited. This thesis aimed to investigate the design, effects, and experiences of internet-based psychosocial support in cancer.</p><p><strong>Methods and Results </strong>Study 1 encompassed a co-creation development process resulting in the interactive support provided as the first step in an internet-based stepped care intervention (iCAN-DO). The effects of iCAN-DO were investigated in a randomised controlled trial, targeting individuals newly diagnosed with cancer and concurrent self-reported symptoms of anxiety and depression (according to the Hospital Anxiety and Depression Scale). Step 1 had a psycho-educative content involving self-care strategies and was available to the intervention group during the ten-month study period. Step 2 comprised a guided internet-based cognitive behavior therapy (iCBT) program and was offered those without improvement in anxiety and depression after using Step 1. The results showed that iCAN-DO improved symptoms of depression compared with standard care, while symptoms of anxiety were largely unaffected. Most participants used Step 1, while only a few used Step 2.</p><p>In Study 2, aspects of usefulness, relevance, and usability in iCAN-DO were explored through qualitative interviews, analysed using content analysis. Results showed that standard healthcare did not meet the individuals' needs and iCAN-DO was used as complement, providing access to relevant, trustworthy information and support. Usability was affected by the perceived usefulness and ease of use of the intervention, as well as by the user´s circumstances in life and consequences of the cancer. The co-creation process in the development of Step 1 added relevance, but both steps 1 and 2 would have gained from being provided earlier, integrated into standard healthcare and more adaptable to the individual.</p><p><strong>Conclusion </strong>The thesis concluded that the internet-based intervention had positive effects on symptoms of depression in individuals newly diagnosed with cancer. Individuals with cancer experience several unmet needs in standard healthcare and since psycho-educative support including self-care advice seems feasible in this group, efforts are needed to incorporate internet-based support in regular oncology care. Since the intervention did not target all symptoms (i.e. anxiety) further research is needed on how to enhance efficacy and how to make iCBT more feasible for this group.</p>
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4.
  • Månsson, Christopher, Läkarexamen, 1977-, et al. (författare)
  • Ultrasound-guided Percutaneous Irreversible Electroporation for Treatment of Locally Recurrent Pancreatic Cancer After Surgical Resection
  • 2020
  • Ingår i: Anticancer Research. - INT INST ANTICANCER RESEARCH. - 0250-7005 .- 1791-7530. ; 40:5, s. 2771-2775
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Background/Aim: Irreversible electroporation (IRE) has recently been used as an experimental treatment for cancers including locally advanced pancreatic cancer. There is very limited data on IRE in pancreatic cancer that is locally recurrent after surgical resection. The aim of this study was to evaluate the safety and efficacy of IRE in this setting.</p><p>Patients and Methods: Ten patients with locally recurrent pancreatic cancer without distant metastases after surgical resection were included and treated with ultrasound-guided percutaneous IRE.</p><p>Results: Two patients had severe complications, of whom one died. Median disease-free survival was 3.3 months and overall median survival after IRE and resection was 16.5 and 42.7 months, respectively. Two patients are alive 42.1 and 23.9 months after the IRE without signs of local recurrence.</p><p>Conclusion: Percutaneous IRE in locally recurrent pancreatic cancer following curative resection is feasible, but should be regarded as a high-risk procedure that, at present, cannot be recommended outside of clinical trials. Further research is needed to select patients who might benefit from this treatment.</p>
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5.
  • Nygren, Jens M., 1976-, et al. (författare)
  • Examining the Ethical Implications of Health Care Technology Described in US and Swedish PhD Dissertations : Protocol for a Scoping Review
  • 2020
  • Ingår i: JMIR Research Protocols. - Toronto : J M I R Publications Inc.. - 1929-0748 .- 1929-0748. ; 9:1
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Background: The development of new biomedical technologies is accelerating at an unprecedented speed. These new technologies will undoubtedly bring solutions to long-standing problems and health conditions. However, they will likely also have a shadow side in the form of unintended effects or ethical implications accompanying them. It may be presumed that the research behind new technologies has been evaluated from an ethical perspective; however, the evidence that this has been done is scant.</p><p>Objective: The objective of this study is to gain an understanding, if and how PhD dissertations focused on health technologies describe actual or possible ethical issues resulting from their research.</p><p>Methods: The purpose of scoping reviews is to map a topic in the literature comprehensively and systematically to identify gaps in the literature or identify key evidence. The search strategy for this protocol will include electronic databases including ProQuest, Medline/Pubmed, Diva, SwePub and LIBRIS. Searches will be limited to PhD dissertations published in the US and Sweden in the last ten years. The study will be mapped in five stages: 1) identifying the research question, 2) identifying relevant studies, 3) study selection, 4) retrieving and charting the data, and 5) collating, summarizing and reporting the results.</p><p>Results: The findings of this study will indicate if and how researchers, PhD students and their supervisors, are considering ethics in their studies, including both research ethics and the ethical implications of their work. The findings can guide researchers in determining gaps and shortcomings in current doctoral education and offer a foundation to adjusting doctoral research education.</p><p>Conclusions: In a society where technology and research are advancing at speeds unknown to us before, we need to find new and more efficient ways to consider ethical issues and address them in a timelier manner. This study will offer an understanding of how ethics is currently being integrated into US and Swedish PhD dissertations and inform the future direction of ethics education at a doctoral level. © Jens M. Nygren, Hans-Peter de Ruiter. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 22.01.2020. </p>
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