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| 2. |
- Ander, Malin, et al.
(författare)
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Exploration of psychological distress experienced by survivors of adolescent cancer reporting a need for psychological support
- 2018
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 13:4
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Tidskriftsartikel (refereegranskat)abstract
- Objective In this qualitative study, we aimed to provide an in-depth exploration of cancer-related psychological distress experienced by young survivors of cancer during adolescence reporting a need for psychological support.MethodsTwo individual interviews were held with ten young survivors of cancer diagnosed in adolescence. The interviews were audio-recorded and transcribed verbatim. Analysis followed the guidelines for inductive qualitative manifest content analysis.ResultsThe survivors described distress experienced during and after the end of treatment. Five categories comprising 14 subcategories were generated. The categories included: A tough treatment, Marked and hindered, Not feeling good enough, Struggling with the fragility of life, and finally, An ongoing battle with emotions.Conclusion Young survivors of adolescent cancer reporting a need for psychological support described feeling physically, socially, and mentally marked by the cancer experience. They struggled with powerlessness, insecurity, social disconnection, loneliness, and feelings of being unimportant and a failure, and had difficulties understanding and managing their experiences. These concerns should be addressed in psychological treatments for the population irrespective of which approach or model is used to understand survivors’ difficulties. A transdiagnostic approach targeting processes that underpin different manifestations of distress may be effective.
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| 4. |
- Kamsvåg-Magnusson, Tove, 1986-, et al.
(författare)
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Parents and children's perceptions of distress related to oral mucositis during haematopoietic stem cell transplantation
- 2014
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Ingår i: Acta Pædiatrica. - : Wiley. - 1651-2227 .- 0803-5253. ; 103:6, s. 630-636
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Tidskriftsartikel (refereegranskat)abstract
- AimOral mucositis is a common and debilitating side effect of haematopoietic stem cell transplantation. Our study investigated parents' and children's experiences of oral mucositis treatment and whether the parents' perceptions accurately reflected the children's views. MethodsWe analysed 71 questionnaires completed by the parents of children who had undergone haematopoietic stem cell transplantation, together with 38 questionnaires completed by children who were 7 years of age or over. ResultsThe parent proxy and child self-reports showed good to excellent agreement. For example, 86% of the parents and 83% of the children reported oral pain and 44% of the parents and 47% of the children reported difficulty swallowing often or very often. The majority of the parents (61%) were satisfied with the pain treatment that had been given to their child. However, the treatment provided for oral mucositis was not altogether consistent. ConclusionOral mucositis affected the majority of the children undergoing haematopoietic stem cell transplantation, causing considerable pain and discomfort. The parent proxy reports proved to be reliable and are an important supplement to child self-reports on symptoms related to oral mucositis. But there is a clear need to establish more evidence-based care for children suffering from oral mucositis.
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| 5. |
- Kassa, Ann-Marie, et al.
(författare)
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Children and adolescents with VACTERL association : health-related quality of life and psychological well-being in children and adolescents and their parents
- 2020
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Ingår i: Quality of Life Research. - : Springer Science and Business Media LLC. - 0962-9343 .- 1573-2649. ; 29:4, s. 913-924
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: VACTERL association is a rare and complex condition of congenital malformations, often requiring repeated surgery and entailing various physical sequelae. Due to scarcity of knowledge, the study aim was to investigate self-reported health-related quality of life (HRQoL), anxiety, depression and self-concept in children and adolescents with VACTERL association and self-reported anxiety and depression in their parents.METHODS: Patients aged 8-17 years with VACTERL association and their parents were recruited from three of four Swedish paediatric surgical centres during 2015-2019. The well-established validated questionnaires DISABKIDS, Beck Youth Inventories, Beck Anxiety Inventory and Beck Depression Inventory were sent to the families. Data were analysed using descriptives, t tests and multivariable analysis. Results were compared with norm groups and reference samples.RESULTS: The questionnaires were returned by 40 patients, 38 mothers and 33 fathers. The mean HRQoL was M = 80.4, comparable to children with asthma (M = 80.2) and diabetes (M = 79.5). Self-reported psychological well-being was comparable to the norm group of Swedish school children, and was significantly higher than a clinical sample. Factors negatively influencing children's HRQoL and psychological well-being were identified. The parents' self-reports of anxiety and depression were comparable to non-clinical samples.CONCLUSIONS: Although children and adolescents with VACTERL association reported similar HRQoL to those of European children with chronic conditions, their psychological well-being was comparable to Swedish school children in general. Nevertheless, some individuals among both children and parents were in need of extra support. This attained knowledge is valuable when counselling parents regarding the prognosis for children with VACTERL association.
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| 6. |
- Koppner, Jenny, et al.
(författare)
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Factors affecting self-perceived mental health in the general older population during the COVID-19 pandemic: a cross-sectional study
- 2024
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Ingår i: BMC Public Health. - : BMC. - 1471-2458. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Mental health problems among older people are large public health concerns but often go unrecognized and undertreated. During COVID - 19 several restrictions regarding social contacts were launched, primarily for the old. The objective of this study is to investigate which factors that had the main negative affect on mental health in the older population during the pandemic. Method A cross-sectional cohort study set in Swedish primary care during the pandemic years 2021-2022. The population constitutes of 70-80-years-old, N = 260. Instruments used are Geriatric depression scale 20 (GDS20); Hospital anxiety and depression scale (HADS), and Perceived stress scale 10 (PSS10). Sociodemography and risk factors are explored. Outcome measures are factors independently associated with decreased mental health. Analyses were performed for the group as a whole and with logistic regression models comparing individuals who stated they were mentally affected by the pandemic to individuals who stated they were not. Results Participants who stated they were mentally affected by the COVID - 19 pandemic reported significantly higher levels of anxiety (p < 0.001), depression (p < 0.001), and stress (p = 0.026) compared to those who stated they were not mentally affected. Explanatory regression models of up to 50% showed that following factors were prominent among individuals who reported a decline in their mental health due to the COVID - 19 pandemic (n = 24); impaired social life (OR 20.29, p < 0.001, CI 4.53-90.81), change in physical activity (OR 5.28, p = 0.01, CI 1.49-18.72), perceived family situation (OR 31.90, p = 0,007, CI 2,53-402.42), mild/moderate and high anxiety (OR 4.94, p = 0.034, CI 1.13-21.60, OR 7.96, p = 0.035, CI 1.16-54.53 respectively), and female gender (OR 6.52, p = 0.029, CI 1.22-34.92). Conclusion Anxiety, family situation, social life and change in physical activity were the main factors influencing the 70-80-years-old's self-perceived mental health during the COVID - 19 pandemic. Long-term effects of social restrictions on mental health in the older population need to be further investigated.
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| 7. |
- Koppner, Jenny, 1973-
(författare)
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Stress and mental health in populations of societies exposed to extraordinary circumstances : with focus on perceived and biological stress, perceived health, psychosocial factors, and sense of coherence
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- As our societies have grown larger, and communications have become global and fast-paced, our bodies and minds have been subjected to a mental stress different from the "fight or flight" situations we have adapted to through evolution. Furthermore, mental health issues are now seen to be on the rise all over the world. Globalisation has enabled social crises of different origins, e.g. financial or biological, to influence nations worldwide and spread faster than ever before. This thesis aims to investigate how populations are affected in regard to stress and mental health by the extraordinary circumstances of the global financial crisis of 2008 and the COVID-19 pandemic of 2020-2023.The first two studies in this thesis focus on the effects of the financial crisis on young adults (Paper I) and adults in working ages (Paper II). Greece was severely affected by the global financial crisis of 2008 and went into a decade long recession, whereas Scandinavian countries were less affected. University students were recruited from the psychology and medicine programs in Athens, Greece and Linköping, Sweden. Primary care visitors were recruited consecutively at primary health care centres (PHCC) in Greece, Sweden, and Norway. Data was collected in connection to recruitment. All participants filled out the same short questionnaire and gave hair samples that were analysed for cortisol concentrations (HCC) as a biological measure of stress.Papers III and IV are based on the Healthy OLD-study and investigate mental health, stress, and coping in older adults (70-80 years) during the COVID-19 pandemic. This age group was particularly vulnerable to the virus and therefore subjected to protective restrictions like social isolation. Participants were randomly recruited from five PHCC in south-east Sweden. Data was collected during one visit at the participant’s own PHCC and consisted of a comprehensive questionnaire, biometrics, and samples of blood, hair, and saliva. In Paper III only the questionnaire was used, and in Paper IV both the questionnaire and hair samples (analysed for HCC) were used.In Papers I and II the Greek participants reported a significantly higher occurrence of self-reported stress, anxiety, and depressive symptoms than their Swedish/Scandinavian peers. They also experienced more serious life events, and less hope for the future. In Paper I, cortisol levels were significantly lower for the Greek participants than the Swedish, which could indicate a fatigued Hypothalamic-Pituitary-Adrenal (HPA) axis due to longterm stress exposure, and/or genetic differences, and/or cultural differences. However, there was no significant difference in cortisol values between adults in working ages for Greeks and Scandinavians in Paper II, although significantly poorer overall health was reported in the Greek population compared to the Scandinavian population in Paper II. The strongest predictors explaining self-reported poor health were being Greek and feeling hopeless about the future. The strongest predictors for high perceived stress were moderate and high anxiety, and moderate depression.In Paper III social distancing was the factor most participants found had affected them the most during the COVID-19 pandemic. The participants who stated they had suffered a decline in mental health due to the COVID-19 pandemic reported more anxiety, depression, and stress than the participants who stated they had not been affected mentally. Risk factors for experiencing deteriorating mental health due to the pandemic were found to be a negative change in social life, experiencing a bad family situation, a change in physical activity, anxiety, and being a woman.In Paper IV, a low sense of coherence was significantly associated with anxiety, self-reported poor financial status, little belief in the future, and perceived negative mental effect from the COVID-19 pandemic. Anxiety was found to be a possible mediator between being mentally affected and sense of coherence. No association was found between sense of coherence and hair cortisol levels in this study. In general, women reported poorer mental health and quality of life than men, but there was no significant difference in hair cortisol levels.To conclude, the findings of this thesis show a high occurrence of stress, anxiety, and depression in adults living in societies exposed to financial crisis or the COVID-19 pandemic. Symptoms of anxiety and depression were shown to be predictors of high levels of perceived stress in young adults. Anxiety was especially prominent in older adults during the pandemic and is suggested to be a mediator in the association between sense of coherence (SoC) and participants who reported a decline in mental health due to the pandemic. A multitude of psychosocial factors were strongly correlated with SoC, respectively those mentally affected by the pandemic. Young Greek adults presented with lower HCC than their Swedish peers, which could be caused by fatigue of the HPA axis due to long-term stress exposure.The aim of this thesis does not have a direct clinical application, but the high occurrence of mental health issues, especially anxiety, found among adults living in societies exposed to extreme events emphasizes the importance of actively asking a patient how he/she is affected by a difficult life event, not least older women.
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| 8. |
- Koppner, Jenny, et al.
(författare)
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Stress and perceived health among primary care visitors in two corners of Europe: Scandinavia and Greece
- 2020
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Ingår i: International Journal of Health Geographics. - : BMC. - 1476-072X. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- Background The global financial crisis emerging in 2008 struck Greece especially hard, whereas Scandinavian countries were less affected. This has created a unique opportunity to study the long-term effect of community stress on populations. Increasing frequencies of mental health issues and poorer perceived health among the Greek population have been reported. The physiological marker of long-term stress, cortisol in hair, is applied in this study together with measures of perceived health and stress, depression and anxiety. Our aim was to study self-reported and physiological stress, perceived health, including mental health, in the general population of Greece compared to Scandinavia, in order to assess long-term effects of the economic crisis on these parameters. Methods A cross-sectional comparative study of adult (18-65 years) Primary Health Care visitors from semi-rural areas in Greece (n = 84) and Scandinavia (n = 140). Data collection was performed in 2012, and encompassed a questionnaire with a variety of health and stress indicators as well as hair samples for analyzes of cortisol levels. Results The Greek sample reported significantly poorer overall health (p < 0.0001) than the Scandinavians and a significantly higher perceived stress (p < 0.0001). The Greeks were also less hopeful of the future (p < 0.0001), and to a larger extent fulfilled the HAD criteria for depression (p < 0.0001) and anxiety (p = 0.002). The strongest predictors explaining ill health in logistic regressions were being Greek (p = 0.001) and feeling hopeless about the future p = 0.001, OR = 6.00 (CI 2.10-14.88). Strong predictors in logistic regressions for high perceived stress were anxiety: high (p < 0.0001) and medium (p = 0.0001), as well as medium depression (p = 0.02). Conclusions Greek adult Primary Health Care visitors perceived their health more negatively than the Scandinavians, including a higher presence of depression, anxiety, and a lower hope for the future. The Greeks also reported higher perceived stress, but this was not reflected in higher cortisol levels. The findings presented here, identify possible adverse long-term effects of the economic crisis in the examined Greek population that are not seen in the Scandinavian cohort. These differences may also be interpreted against the background of socio-cultural differences in the northern and south-eastern corners of Europe.
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| 9. |
- Najar, Deman Hadi, et al.
(författare)
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Pharmacokinetic Properties of the Nephrotoxin Orellanine in Rats
- 2018
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Ingår i: Toxins. - : MDPI AG. - 2072-6651. ; 10:8
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Tidskriftsartikel (refereegranskat)abstract
- Orellanine is a nephrotoxin found in mushrooms of the Cortinarius family. Accidental intake of this substance may cause renal failure. Orellanine is specific for proximal tubular cells and could, therefore, potentially be used as treatment for metastatic renal cancer, which originates from these cells. However, more information is needed about the distribution and elimination of orellanine from the body to understand its potential use for therapy. In this study, 5 mg/kg orellanine (unlabeled and H-3-labeled) was injected intravenously in rats (Wistar and Sprague Dawley). Distribution was measured (Wistar rats, n = 10, n = 12) using radioluminography and the highest amount of orellanine was found in the kidney cortex and bladder at all time-points investigated. The pharmacokinetic properties of orellanine were investigated using LC-MS/MS and -scintillation to measure the amount of orellanine in plasma. Three groups of rats were investigated: control rats with intact kidneys (n = 10) and two groups with bilateral renal artery ligation (n = 7) where animals in one of these groups were treated with peritoneal dialysis (n = 8). Using LC-MS/MS, the half-life of orellanine was found to be 109 +/- 6 min in the controls. In the groups with ligated renal arteries, orellanine had a half-life of 756 +/- 98 min without and 238 +/- 28 min with dialysis. Thus, orellanine was almost exclusively eliminated by glomerular filtration as well as by peritoneal dialysis.
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| 10. |
- Schank, Jesse R., et al.
(författare)
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The kappa opioid receptor antagonist JDTic attenuates alcohol seeking and withdrawal anxiety
- 2012
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Ingår i: Addiction Biology. - : Wiley-Blackwell. - 1355-6215 .- 1369-1600. ; 17:3, s. 634-647
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Tidskriftsartikel (refereegranskat)abstract
- The role of kappa-opioid receptors (KOR) in the regulation of alcohol-related behaviors is not completely understood. For example, alcohol consumption has been reported to increase following treatment with KOR antagonists in rats, but was decreased in mice with genetic deletion of KOR. Recent studies have further suggested that KOR antagonists may selectively decrease alcohol self-administration in rats following a history of dependence. We assessed the effects of the KOR antagonist JDTic on alcohol self-administration, reinstatement of alcohol seeking induced by alcohol-associated cues or stress, and acute alcohol withdrawal-induced anxiety ('hangover anxiety'). JDTic dose-dependently reversed hangover anxiety when given 48 hours prior to testing, a time interval corresponding to the previously demonstrated anxiolytic efficacy of this drug. In contrast, JDTic decreased alcohol self-administration and cue-induced reinstatement of alcohol seeking when administered 2 hours prior to testing, but not at longer pre-treatment times. For comparison, we determined that the prototypical KOR antagonist nor-binaltorphimine can suppress self-administration of alcohol at 2 hours pre-treatment time, mimicking our observations with JDTic. The effects of JDTic were behaviorally specific, as it had no effect on stress-induced reinstatement of alcohol seeking, self-administration of sucrose, or locomotor activity. Further, we demonstrate that at a 2 hours pre-treatment time JDTic antagonized the antinociceptive effects of the KOR agonist U50,488H but had no effect on morphine-induced behaviors. Our results provide additional evidence for the involvement of KOR in regulation of alcohol-related behaviors and provide support for KOR antagonists, including JDTic, to be evaluated as medications for alcoholism.
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