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- Larsson, Kjerstin, 1952-
(författare)
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Quality of Life and Coping with Ulcerative colitis and Crohn's disease
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis was to investigate health-related quality of life (HRQoL) and coping strategies for individuals with ulcerative colitis (UC) or Crohn’s disease (CD), and to study the effect of a group-based patient information on anxiety/depression and HRQoL. HRQoL and anxiety/depression were investigated (n=492) (Study I). In Study II, anxiety/depression, HRQoL, satisfaction with information and evaluation of the patient information were studied (n=49). Coping with disease activity was investigated in 166 patients reporting current exacerbation (Study III). Fifteen patients were interviewed about disease-related stress, how this is managed and the need of support from the health care (Study IV). Patients with UC reported better HRQoL and less anxiety/depression than did patients with CD during both remission and exacerbation. Satisfaction with information had increased at follow-up 6 months after patient information. The information and the possibility to discuss with lecturers and group members were valued as most important. No change was found in anxiety/depression or HRQoL at follow-up. Both problem-focused and emotion-focused strategies were employed to cope with disease activity, with no difference between patients with UC or CD. The urgent need of toilet availability and stress associated to social situations were the major disease-related stressors. This stress was managed by finding out the location of toilets, bringing toilet paper and extra underwear and emptying bowel before an activity. The patients wanted information and possibilities to talk to experienced staff and to other patients about how to live with the disease. This thesis shows that HRQoL for some patients with UC, and primarily for patients with CD, is impaired. Thus medical staff should be observant of the psychosocial well-being of patients with CD and also of patients with relapse. Methods to identify and support patients with anxiety/depression and poor HRQoL need to be developed. Interventions should target the patient’s specific problems and at appropriate times.
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| 2. |
- Lundholm, Karin, 1976-
(författare)
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Fate of Cu, Cr, As and some other trace elements during combustion of recovered waste fuels
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The increased use of biomass and recovered waste fuels in favor of fossil fuels for heat and power production is an important step towards a sustainable future. Combustion of waste fuels also offers several advantages over traditional landfilling, such as substantial volume reduction, detoxification of pathological wastes, and reduction of toxic leaches and greenhouse gas (methane) formation from landfills. However, combustion of recovered waste fuels emits more harmful trace elements than combustion of other fuels. These elements are distributed between bottom ash, fly ash and flue gas, depending on the elements partitioning and enrichment behavior. Volatilized harmful trace elements are mainly enriched in the submicron fly ash fraction. If emitted to the atmosphere, submicron particles can penetrate deep into the alveoli of the lungs, causing severe impacts on human health. Consequently, to reduce ash related problems and to control the emissions to the atmosphere, there is an increased need for understanding the physicochemical processes involved in ash transformation, including particle formation.The objective of this thesis was to carefully and systematically study the fate of trace elements during combustion, i.e. the chemical form of the elements and the partitioning behavior, by means of chemical equilibrium model calculations, X-ray diffraction, microscopy techniques and various spectroscopy methods. The influence of some fuel additives was also analyzed. Primarily, the elements copper, chromium and arsenic were studied.An initial review and evaluation of the content of thermodynamical data in commercial thermochemical databases used for chemical equilibrium model calculations showed that there was a significant difference in number of included phases and species between databases. Thermodynamical data also differed between databases, although in general less for condensed phases than for gaseous species. A state-of-the-art database for Cu, Cr and As was compiled and used for further chemical equilibrium model calculations. The fate of Cu, Cr and As was determined in combustion experiments on wood impregnated with copper, chromium and arsenic (CCA) in a bench scale reactor (15 kW). The results showed that global chemical equilibrium model calculations predicted the overall fate of Cu, Cr and As in bottom ash and ash particles quite well. However, compared to the experimental results the global model overpredicted the formation of refractory calcium arsenates, thus the arsenic volatilization was found to be higher then the predicted volatilization. In terms of chromium volatility, copper was found to be an important refractory element forming stable CuCrO2(s) and CuCr2O4(s) that suppressed the formation of CrO2(OH)2(g). The retention and speciation of Cu, Cr and As in bottom ash was further determined from combustion experiments of CCA wood fuel particles in a single particle reactor. Local chemical equilibrium model calculations were performed to simulate the combustion stages of a burning CCA treated wood fuel particle: drying, devolatilization, char burning and post-combustion. The results from the work showed that a mix of global and local chemical equilibrium model calculations is needed to describe the reality and that the combustion stages are partially overlapping. The fate of harmful trace elements, including Cu, Cr and As, was finally studied in full scale (65 MW) combustion experiments. Particles from the raw flue gas emissions were sampled and analyzed. The comparison with chemical equilibrium model calculations showed that the model explained the results well, but due to lack of thermodynamic data for K2ZnCl4(s), the formation of this phase could not be predicted.
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| 3. |
- Winterling, Jeanette, 1972-
(författare)
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Hope and Despair : Philosophy of life, expectations and optimism in cancer patients and their spouses
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The general aim was to explore philosophy of life, expectations and optimism in patients and spouses in two different cancer situations, and to determine whether these aspects had relevance for psychological distress and quality of life. The first situation was being newly diagnosed with advanced cancer. Data on philosophy of life, optimism and psychological distress were gathered on one occasion (I). In addition, changes in life were described using a qualitative approach in a sub-sample (II). The second situation was having completed curative cancer treatment. Data on expectations for the recovery period, optimism, psychological distress and quality of life were gathered on three occasions (III). Moreover, expectations and how these turned out were described using a qualitative approach in a sub-sample (IV). The results show that being diagnosed with an advanced cancer influenced aspects of patients’ and spouses’ philosophy of life, including that existential questions were common and were related to higher psychological distress (I). All experienced substantial mental changes in life, often also physical, practical and sometimes positive changes. Patients more often seemed to accept their situation and prepared themselves for death, whereas spouses had more difficulties in handling the situation (II). Patients who had completed curative treatment generally had higher expectations for the recovery period than did their spouses, and patients expectations were fulfilled to a lesser degree, however, this generally had little importance for psychological distress or quality of life (III). Patients’ expectation for their recovery period was generally that they would get well. For those whose recovery period had been tough, expectations were often unfulfilled, but they were often satisfied with their current life anyway owing to positive changes (IV). Being optimistic was the most beneficial for decreased psychological distress in both samples, as well as for better quality of life in the recovery group (I, III).
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