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- Engvall, Gunn, et al.
(author)
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It Is Tough and Tiring but It Works - Children's Experiences of Undergoing Radiotherapy
- 2016
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In: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 11:4
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Journal article (peer-reviewed)abstract
- Approximately 300 children ages 0 to 18 are diagnosed with cancer in Sweden every year, and 80 to 90 of them undergo radiotherapy treatment. The aim was to describe children's experiences of preparing for and undergoing radiotherapy, and furthermore to describe children's suggestions for improvement. Thirteen children between the ages of 5 and 15 with various cancer diagnoses were interviewed. Data was analyzed using qualitative content analysis. The findings revealed five categories: positive and negative experiences with hospital stays and practical arrangements; age-appropriate information, communication, and guidance to various degrees; struggle with emotions; use of distraction and other suitable coping strategies; and children's suggestions for improvement during radiotherapy. An overarching theme emerged: "It is tough and tiring but it works". Some key areas were: explanatory visits, the need for information and communication, being afraid, discomfort and suffering, the need for media distraction, dealing with emotions, and the need for support. A systematic, family-centered preparation program could possible help families prepare and individualized distraction during radiotherapy could contribute to reducing distress. Further studies with interventions could clarify successful programs.
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| 4. |
- Ångström-Brännström, Charlotte, et al.
(author)
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Children Undergoing Radiotherapy : Swedish Parents' Experiences and Suggestions for Improvement
- 2015
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In: PLOS ONE. - : Public library science. - 1932-6203. ; 10:10
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Journal article (peer-reviewed)abstract
- Approximately 300 children, from 0 to 18 years old, are diagnosed with cancer in Sweden every year. Of these children, 80-90 of them undergo radiotherapy treatment for their cancer. Although radiotherapy is an encounter with advanced technology, few studies have investigated the child's and the parent's view of the procedure. As part of an ongoing multi-center study aimed to improve patient preparation and the care environment in pediatric radiotherapy, this article reports the findings from interviews with parents at baseline. The aim of the present study was twofold: to describe parents' experience when their child undergoes radiotherapy treatment, and to report parents' suggestions for improvements during radiotherapy for their children. Sixteen mothers and sixteen fathers of children between 2-16 years old with various cancer diagnoses were interviewed. Data were analyzed using content analysis. The findings showed that cancer and treatment turns people's lives upside down, affecting the entire family. Further, the parents experience the child's suffering and must cope with intense feelings. Radiotherapy treatment includes preparation by skilled and empathetic staff. The parents gradually find that they can deal with the process; and lastly, parents have suggestions for improvements during the radiotherapy treatment. An overarching theme emerged: that despair gradually turns to a sense of security, with a sustained focus on and close interaction with the child. In conclusion, an extreme burden was experienced around the start of radiotherapy, though parents gradually coped with the process.
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| 5. |
- Ångström-Brännström, Charlotte, et al.
(author)
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Parents’ experiences and responses to an intervention for psychological preparation of children and families during the child’s radiotherapy
- 2018
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In: Journal of Pediatric Oncology Nursing. - : Sage Publications. - 1043-4542 .- 1532-8457. ; 35:2, s. 132-148
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Journal article (peer-reviewed)abstract
- The aim of this study was to evaluate parents’ experiences and responses to a systematic intervention for psychological preparation of children and families during the child’s radiotherapy (RT) treatment. In this case-control study at 3 pediatric RT centers, an intervention with a preparatory kit, including age-adjusted information on tablets, gift of a stuffed toy or a pair of headphones, a parent booklet, and toy models of the computed tomography and RT machines was implemented. For evaluation, a mixed methods data collection was conducted. A total of 113 parents of children undergoing RT were included—n = 59 in the baseline group and n = 54 in the intervention group. Health-related quality of life was rated low, but parents in the intervention group expressed less anxiety after the RT compared with the baseline group. They found information suitable for their young children, siblings, and friends were involved and the toy models were used for play. Parents expressed positive feelings due to close interaction with staff and each other within the family. The solutions developed within a human-centered design approach and shaped as a systematic family-centered strategy contributed to parents understanding and coping with the child’s RT.
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| 6. |
- Andersson, Axel G, et al.
(author)
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High Exposure to Perfluoroalkyl Substances and Antibody Responses to SARS-CoV-2 mRNA Vaccine-an Observational Study in Adults from Ronneby, Sweden.
- 2023
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In: Environmental health perspectives. - 1552-9924. ; 131:8
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Journal article (peer-reviewed)abstract
- Per- and polyfluoroalkyl substances (PFAS) are widely used, environmentally ubiquitous, and stable chemicals that have been associated with lower vaccine-induced antibody responses in children; however, data on adults are limited. The drinking water from one of the two waterworks in Ronneby, Sweden, was heavily contaminated for decades with PFAS from firefighting foams, primarily perfluorohexane sulfonic acid and perfluorooctanesulfonic acid (PFOS). Vaccination against SARS-CoV-2 offered a unique opportunity to investigate antibody responses to primary vaccination in adults who had been exposed to PFAS.Our objective was to evaluate associations between PFAS, across a wide range of exposure levels, and antibody responses in adults 5 wk and 6 months after a two-dose vaccination regime against SARS-CoV-2.Adults age 20-60 y from Ronneby (n=309, median PFOS serum level 47ng/mL, fifth to 95th percentile 4-213ng/mL) and a group with background exposure (n=47, median PFOS serum level 4ng/mL) received two doses of the Spikevax (Moderna) mRNA vaccine. The levels of seven PFAS were measured in serum before vaccination. Serum immunoglobulin G antibodies against the SARS-CoV-2 spike antigen (S-Abs) were measured before vaccination and at 5 wk (n=350) and 6 months (n=329) after the second vaccine dose. Linear regression analyses were fitted against current, historical, and prenatal exposure to PFAS, adjusting for sex, age, and smoking, excluding individuals with previous SARS-CoV-2-infection.PFAS exposure, regardless of how it was estimated, was not negatively associated with antibody levels 5 wk [current PFOS: -0.5% S-Abs/PFOS interquartile range (IQR); 95% confidence interval (CI): -8, 7] or 6 months (current PFOS: 3% S-Abs/PFOS IQR; 95% CI: -6, 12) after COVID-19 vaccination.Following a strict study protocol, rigorous study design, and few dropouts, we found no indication that PFAS exposure negatively affected antibody responses to COVID-19 mRNA vaccination for up to 6 months after vaccination. https://doi.org/10.1289/EHP11847.
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| 7. |
- Andersson, Maria, et al.
(author)
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Coinfection with Enteric Pathogens in East African Children with Acute Gastroenteritis-Associations and Interpretations
- 2018
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In: American Journal of Tropical Medicine and Hygiene. - : American Society of Tropical Medicine and Hygiene. - 0002-9637 .- 1476-1645. ; 98:6, s. 1566-1570
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Journal article (peer-reviewed)abstract
- Enteric coinfections among children in low-income countries are very common, but it is not well known if specific pathogen combinations are associated or have clinical importance. In this analysis, feces samples from children in Rwanda and Zanzibar less than 5 years of age, with (N = 994) or without (N = 324) acute diarrhea, were analyzed by realtime polymerase chain reaction targeting a wide range of pathogens. Associations were investigated by comparing codetection and mono-detection frequencies for all pairwise pathogen combinations. More than one pathogen was detected in 840 samples (65%). A negative association (coinfections being less common than expected from probability) was observed for rotavirus in combination with Shigella, Campylobacter, or norovirus genogroup II, but only in patients, which is statistically expected for agents that independently cause diarrhea. A positive correlation was observed, in both patients and controls, between Ct (threshold cycle) values for certain virulence factor genes in enteropathogenic Escherichia coli (EPEC) (eae and bfpA) and toxin genes in enterotoxigenic E. coli (eltB and estA), allowing estimation of how often these genes were present in the same bacteria. A significant positive association in patients only was observed for Shigella andEPEC-eae, suggesting that this coinfection might interact in a manner that enhances symptoms. Although interaction between pathogens that affect symptoms is rare, this work emphasizes the importance and difference in interpretation of coinfections depending on whether they are positively or negatively associated.
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| 8. |
- Andersson, Maria Eva, et al.
(author)
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Rapid Clearance and Frequent Reinfection With Enteric Pathogens Among Children With Acute Diarrhea in Zanzibar.
- 2017
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In: Clinical Infectious Diseases. - : Oxford University Press (OUP). - 1058-4838 .- 1537-6591. ; 65:8, s. 1371-1377
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Journal article (peer-reviewed)abstract
- Background: Acute infectious gastroenteritis is an important cause of illness and death among children in low-income countries. In addition to rotavirus vaccination, actions to improve nutrition status, sanitation, and water quality are important to reduce enteric infections, which are frequent also among asymptomatic children. The aim of this study was to investigate if the high prevalence of these infections reflects that they often are not cleared properly by the immune response or rather is due to frequent pathogen exposure.Methods: Rectal swabs were collected at time of acute diarrhea and 14 days later from 127 children, aged 2-59 months and living in rural Zanzibar, and were analyzed by real-time polymerase chain reaction targeting multiple pathogens.Results: At baseline, detection rates >20% were found for each of enterotoxigenic Escherichia coli, Shigella, Campylobacter, Cryptosporidium, norovirus GII, and adenovirus. At follow-up, a large proportion of the infections had become cleared (34-100%), or the pathogen load reduced, and this was observed also for agents that were presumably unrelated to diarrhea. Still, the detection frequencies at follow-up were for most agents as high as at baseline, because new infections had been acquired. Neither clearance nor reinfection was associated with moderate malnutrition, which was present in 21% of the children.Conclusions: Children residing in poor socioeconomic conditions, as in Zanzibar, are heavily exposed to enteric pathogens, but capable of rapidly clearing causative and coinfecting pathogens.
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| 9. |
- Aro, Rudolf, et al.
(author)
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Screening of Poly- and Perfluoroalkyl Substances (PFASs) and Extractable Organic Fluorine (EOF) in the Blood of Highly Exposed People
- 2020
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Reports (other academic/artistic)abstract
- This report summarises the findings of an investigation into the occurrence of poly- and perfluoroalkyl substances (PFASs) in the whole blood of people living in the municipality of Ronneby. A total of 20 whole blood samples from individuals who have known to been expose to PFASs via consumption of PFAS contaminated drinking water were analysed in this study. Using both liquid and supercritical chromatography coupled with tandem mass spectrometers a total of 63 PFASs were analysed. These results were then compared with extractable organofluorine (EOF) levels measured with combustion ion chromatography. The data from both target PFAS analysis and EOF was used to perform fluorine mass balance analysis.In general, the PFAS profile was dominated by long-chain perfluoroalkyl sulfonates (PFSAs with more than 6 fluorinated carbons), on average accounting for 97% of the total PFAS budget. The second most prominent PFAS class were long-chain perfluoroalkyl carboxylates (PFCAs with more than 7 fluorinated carbons), accounting for an additional 2.6% of the PFAS exposure. The average sum PFAS concentrations was 346 ng/g (from 74.1 ng/g to 715 ng/g). The average EOF concentration was 186 ng F/g and 79% of the EOF was explained by the target analytes.
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| 10. |
- Axmon, Anna, et al.
(author)
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Tidstrender för perfluorerade ämnen i plasma från svenska kvinnor 1987-2007
- 2014
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Reports (other academic/artistic)abstract
- Perfluorerade kemikalier (PFC) är en stor grupp ämnen som är misstänkt hormon- störande. De är svårnedbrytbara och stannar länge i både miljö och människa. De mest kända PFC är PFOS och PFOA. Dessa användes under många år för att im- pregnera textilier, skor, möbler och mattor, i golv- och bilvax och målarfärger, mm. Användningen började minska i början av detta århundrade då PFOS och PFOA ersattes av andra PFC. Vi använde sparade plasmaprover från 80 kvinnor. Proven togs ursprungligen mellan 1987 och 2007 i samband med bröstförminskningsoperationer, från kvinnor som vi- sade sig friska vid screening för ärftlig cancer och från kvinnor vars äkta män hade cancer. Proverna analyserades för ett antal olika PFC (se textruta nedan), och vi undersökte därefter tidstrender för varje kemikalie. Vi tittade dels på linjära tidstrender, dvs vi an- tog att förändringen i halter var lika stor för varje år, och dels på förändringar mellan perioderna före 1990, 1990-2000 och efter 2000. • PFNA och PFDA ökade över hela tidsperioden, men allra mest efter 2000. Från 1987 till 2007 ökade PFNA med 305% och PFDA med 312%. • PFUnDA ökade med 155% från 1987 till 2007. Detta berodde framför allt på en stor ökning från 2000 och framåt. • PFOS och PFOA låg som högst under perioden 1990-2000. Sett över hela studieperioden, dvs 1987 till 2007, minskade PFOS med 36% och PFOA med 7%. • Även PFHxS låg som högst under perioden 1990-2000. Till skillnad från PFOS och PFOA uppvisade PFHxS en ökning – 142% – mellan 1987 och 2007.
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