| 1. |
- Almgren, Johanna, et al.
(author)
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Patients' Health Experiences of Post COVID-19 Condition – A Qualitative Study
- 2022
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In: International Journal of Environmental Research and Public Health. - Basel : MDPI. - 1661-7827 .- 1660-4601. ; 19:21
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Journal article (peer-reviewed)abstract
- Patients who suffer from long-term symptoms of COVID-19, described as post COVID-19 condition, are a new and large group of patients. There is a lack of knowledge concerning health experiences in this patient group. The aim of this study was to explore patients' health experiences of post COVID-19 condition. Data collection was performed through 14 semi-structured interviews. The qualitative content analysis resulted in six sub-categories, three categories, and an overall theme. Patients experienced symptoms of varying duration-ranging from 5-21 months. The results showed that patients' health experiences of post COVID-19 condition moved between uncertainty and new insights. This was shown by patients experiencing: (1) loss of abilities, including losing smell and taste and lacking energy, (2) loss of control, including being foreign to oneself and seeking answers, and (3) revaluation of life, including accepting the transformed body and prioritizing health. This study illustrates that patients living with post COVID-19 condition need to be treated with flexibility, based on each individual's unique challenges and experiences of the symptoms and the consequences for their health. © 2022 by the authors.
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| 2. |
- Carlsson, Ing-Marie, 1961-, et al.
(author)
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Creating a communication space in the healthcare context : Children’s perspective of using the eHealth service, Sisom
- 2021
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In: Journal of Child Health Care. - London : Sage Publications. - 1367-4935 .- 1741-2889. ; 25:1, s. 31-43
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Journal article (peer-reviewed)abstract
- According to the United Nation’s Convention of the Rights of the Child, children have the right to participate in their own healthcare and make their opinions heard. The aim of this study was thus to explore the impact of using an eHealth service, Sisom, to gain the children’s perspectives during their healthcare appointments. Data were gathered through individual interviews with a purposeful sample of 16 children, aged 6–13 years old, treated for different diseases and using the eHealth service, Sisom, during their healthcare appointments. The interviews were analysed using a constructivist grounded theory. The results showed that using Sisom made children’s voice heard by creating a communication space in the healthcare setting. This meant that the children got involved in the communication, were acknowledged as an important person who could give the answers to questions and were given time. Implementing the use of Sisom is a way to make children’s needs and preferences explicitly visible for decision-making in practice and thereby supporting the further development of child-centred care in practice. © The Author(s) 2020.
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| 3. |
- Demmelmaier, Ingrid, 1960-, et al.
(author)
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Does exercise intensity matter for fatigue during (neo-)adjuvant cancer treatment? The Phys-Can randomized clinical trial
- 2021
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In: Scandinavian Journal of Medicine and Science in Sports. - : Wiley. - 0905-7188 .- 1600-0838. ; 31:5, s. 1144-1159
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Journal article (peer-reviewed)abstract
- Exercise during cancer treatment improves cancer-related fatigue (CRF), but the importance of exercise intensity for CRF is unclear. We compared the effects of high- vs low-to-moderate-intensity exercise with or without additional behavior change support (BCS) on CRF in patients undergoing (neo-)adjuvant cancer treatment. This was a multicenter, 2x2 factorial design randomized controlled trial (Clinical Trials NCT02473003) in Sweden. Participants recently diagnosed with breast (n = 457), prostate (n = 97) or colorectal (n = 23) cancer undergoing (neo-)adjuvant treatment were randomized to high intensity (n = 144), low-to-moderate intensity (n = 144), high intensity with BCS (n = 144) or low-to-moderate intensity with BCS (n = 145). The 6-month exercise intervention included supervised resistance training and home-based endurance training. CRF was assessed by Multidimensional Fatigue Inventory (MFI, five subscales score range 4-20), and Functional Assessment of Chronic Illness Therapy-Fatigue scale (FACIT-F, score range 0-52). Multiple linear regression for main factorial effects was performed according to intention-to-treat, with post-intervention CRF as primary endpoint. Overall, 577 participants (mean age 58.7 years) were randomized. Participants randomized to high- vs low-to-moderate-intensity exercise had lower physical fatigue (MFI Physical Fatigue subscale; mean difference −1.05 [95% CI: −1.85, −0.25]), but the difference was not clinically important (ie <2). We found no differences in other CRF dimensions and no effect of additional BCS. There were few minor adverse events. For CRF, patients undergoing (neo-)adjuvant treatment for breast, prostate or colorectal cancer can safely exercise at high- or low-to-moderate intensity, according to their own preferences. Additional BCS does not provide extra benefit for CRF in supervised, well-controlled exercise interventions.
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| 4. |
- Fretland, Asmund Avdem, et al.
(author)
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Inflammatory Response After Laparoscopic Versus Open Resection of Colorectal Liver Metastases : Data From the Oslo-CoMet Trial.
- 2015
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In: Medicine. - 0025-7974 .- 1536-5964. ; 94:42, s. 1-7
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Journal article (peer-reviewed)abstract
- Laparoscopic and open liver resection have not been compared in randomized trials. The aim of the current study was to compare the inflammatory response after laparoscopic and open resection of colorectal liver metastases (CLM) in a randomized controlled trial.This was a predefined exploratory substudy within the Oslo CoMet-study. Forty-five patients with CLM were randomized to laparoscopic (n = 23) or open (n = 22) resection. Ethylenediaminetetraacetic acid-plasma samples were collected preoperatively and at defined time points during and after surgery and snap frozen at -80 C. A total of 25 markers were examined using luminex and enzyme-linked immunosorbent assay techniques: high-mobility box group 1(HMGB-1), cell-free DNA (cfDNA), cytokines, and terminal C5b-9 complement complex complement activation.Eight inflammatory markers increased significantly from baseline: HMGB-1, cfDNA, interleukin (IL)-6, C-reactive protein, macrophage inflammatory protein -1β, monocyte chemotactic protein -1, IL-10, and terminal C5b-9 complement complex. Peak levels were reached at the end of or shortly after surgery. Five markers, HMGB-1, cfDNA, IL-6, C-reactive protein, and macrophage inflammatory protein -1β, showed significantly higher levels in the open surgery group compared with the laparoscopic surgery group.Laparoscopic resection of CLM reduced the inflammatory response compared with open resection. The lower level of HMGB-1 is interesting because of the known association with oncogenesis.
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| 5. |
- Fölster, Jens, et al.
(author)
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Sjöar och vattendrag i Norrbotten : Utvärdering av vattenkemidata från miljöövervakningen 1984-2012
- 2014
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Reports (other academic/artistic)abstract
- Rapporten omfattar en utvärdering av flera decenniers mätningar av vattenkemi i 17 sjöar och 15vattendrag inom den nationella och regionala miljöövervakningen i Norrbottens län. Utvärderingenomfattar beskrivningen av tillståndet utifrån de senaste tre åren och en trendanalys påtidsserierna. Vattenförekomsterna har också klassats med avseende på ekologisk status enligtNaturvårdsverkets bedömningsgrunder.Resultaten visar på generellt hög eller god status med avseende på vattenkemi för alla sjöar utomBergträsket som hade höga klorofyllhalter och lågt siktdjup jämfört med referensvärdena. Halternatotalfosfor i Bergträsket liksom i Pahajärvi var så nära gränsvärdet för god status att detinte gick att ge en entydig klassning utifrån totalfosfor. Även vattendragen hade generellt högeller god status med undantag för Kitkiöjoki och Övre Lansjärv som hade totalfosforhalter straxöver gränsvärdet för god status, men inom felmarginalen för klassning.I de flesta vattenförekomsterna var fosfor det begränsande näringsämnet, men i två av vattendragetvar kväve begränsande och i fem vattendrag och sju sjöar var förhållandet mellan fosfor ochkväve inom området då båda ämnena kan vara begränsande. Många sjöar och vattendrag uppvisadetecken på minskande halter av näringsämnen.Sjöarna och vattendragen har generellt neutrala pH-värden och surhetstillståndet har ringa betydelseför de levande organismerna. Undantaget är Rokån som har pH-värden under fem orsakatav naturligt höga järnhalter. Den minskande försurningspåverkan från luftdeposition avspeglarsig i minskande halter av sulfat, men eftersom depositionsnivåerna är så låga har det ingen betydelsetillståndet i vattnet.Resultaten för vattnets färg, innehåll av baskatjoner och organsikt kol visar inte på några tydligatrender utan varierar som svar på förändringar i nederbörd mellan olika år.De uppmätta tungmetallhalterna i sjöar och vattendrag ligger i de flesta fall långt under gränsvärdena.Undantaget är zink i Latnjajaure och Hornavan där medelvärdet för perioden ligger liteöver respektive nära det dubbla gränsvärdet. För tungmetaller utan gränsvärden ligger halternanära bakgrundsvärdena, med några undantag där berggrunden ger ovanligt höga halter.
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| 6. |
- Fölster, Jens, et al.
(author)
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Sjöar och vattendrag i Västernorrland : Utvärdering av vattenkemidata från miljöövervakningen 1983-2011
- 2012
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Reports (other academic/artistic)abstract
- Resultat från tre decenniers miljöövervakning av vattenkemi i 10 sjöar och 13 vattendrag i Västernorrland har utvärderats. Utvärderingen omfattar beskrivningen av tillståndet utifrån de senaste tre åren och en trendanalys på tidsserierna. Vattenförekomsterna har också klassats med avseende på ekologisk status enligt Naturvårdsverkets bedömningsgrunder.Resultaten visar generellt på hög eller god ekologisk status utifrån vattenkemin för samtliga sjöar och vattendrag som ingick i studien med undantag för Västersel som hade en halt av Totalfosfor som var mer än det dubbla referensvärdet enligt bedömningsgrunder.Ingen av sjöarna eller vattendragen klassades som försurade enligt bedömningsgrunder, men Viksbäcken klassas som försurningspåverkad genom en expertbedömning mot bakgrund av höga halter oorganiskt aluminium och att vattendraget bedöms varit försurat 1980 enligt bedömningsgrunder. Trenderna i surhetsrelaterade parametrar avspeglar delvis det minskande försurningstrycket, men att förändringarna under perioden är så små att de troligen inte lett till förändringar i artsammansättningen. De största statistiskt signifikanta pH-ökningarna är kring 0,2 enheter på 22 år.Ingen av sjöarna klassades som övergödda utifrån fosforhalten och bara ett vattendrag, Västersel, klassade som övergött enligt bedömningsgrunder. Medelhalten av tot-P var 45 μg/l jämfört med referensvärdet 12 μg/l.S. Bergsjön hade ett siktdjup som var strax under hälften av det beräknade referensvärdet och får därför bara måttlig status. De övriga sjöarna uppnår hög eller god status med avseende på siktdjup.I fyra sjöar med metallanalyser var halterna långt under gränsvärdena för Cd, Pb, Ni och Cr. För Cu och Zn däremot låg halterna nära eller på gränsvärden satta av Naturvårdsverket och för Zn i Valasjön till och med över. I vattendragen var halterna långt under gränsvärdena med undantag för Västersel där medelvärdet för Zn låg nära gränsvärdet. Man kan inte utesluta att de höga halterna är naturliga och t. ex. beror på lokal variation i berggrunden.
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| 7. |
- Glimelius, Bengt, et al.
(author)
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U-CAN : a prospective longitudinal collection of biomaterials and clinical information from adult cancer patients in Sweden.
- 2018
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In: Acta Oncologica. - : Taylor & Francis. - 0284-186X .- 1651-226X. ; 57:2, s. 187-194
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Journal article (peer-reviewed)abstract
- Background: Progress in cancer biomarker discovery is dependent on access to high-quality biological materials and high-resolution clinical data from the same cases. To overcome current limitations, a systematic prospective longitudinal sampling of multidisciplinary clinical data, blood and tissue from cancer patients was therefore initiated in 2010 by Uppsala and Umeå Universities and involving their corresponding University Hospitals, which are referral centers for one third of the Swedish population.Material and Methods: Patients with cancer of selected types who are treated at one of the participating hospitals are eligible for inclusion. The healthcare-integrated sampling scheme encompasses clinical data, questionnaires, blood, fresh frozen and formalin-fixed paraffin-embedded tissue specimens, diagnostic slides and radiology bioimaging data.Results: In this ongoing effort, 12,265 patients with brain tumors, breast cancers, colorectal cancers, gynecological cancers, hematological malignancies, lung cancers, neuroendocrine tumors or prostate cancers have been included until the end of 2016. From the 6914 patients included during the first five years, 98% were sampled for blood at diagnosis, 83% had paraffin-embedded and 58% had fresh frozen tissues collected. For Uppsala County, 55% of all cancer patients were included in the cohort.Conclusions: Close collaboration between participating hospitals and universities enabled prospective, longitudinal biobanking of blood and tissues and collection of multidisciplinary clinical data from cancer patients in the U-CAN cohort. Here, we summarize the first five years of operations, present U-CAN as a highly valuable cohort that will contribute to enhanced cancer research and describe the procedures to access samples and data.
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| 8. |
- Hamreby, Kerstin, 1950-
(author)
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Flickor och pojkar i den sociala barnavården : Föreställningar om kön och sociala problem under 1900-talet
- 2004
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Doctoral thesis (other academic/artistic)abstract
- The topic of this study is girls and boys in the field of child welfare. The aim has been to trace and describe conceptions of gender, delinquency and social problems in child welfare from the end of the nineteenth century until the middle of the twentieth century. The sources of data in the study consist of legislative documents, journals and other historical literature representing the professional discourse. Two analytical approaches have been used. First, the sources were employed for descriptions of legislation and the legislative processes in child welfare. Second, the material was analyzed with a discursive approach to elucidate conceptions of gender and their importance in the legislative process and thus in the construction of social problems. Three main periods with different currants of ideas have been identified. In the first period moralism dominated. Thoughts about social problems were based in normative assumptions and scientific influences were rare. Child welfare legislation was deeply influenced by ideas of social control. Young people were to be controlled and disciplined especially through work: Girls through household work and care and boys through paid work. In the second period hygienism, ideas based in hygiene discourses, were the main trend. Genetically based arguments together with discussions about morality and poverty were used to explain social problems, and scientific methods were to be used to discipline and control young people. Proposals for measures take against social problems corresponded to two main lines, a hygienic-medical line and a social pedagogic line. The hygienic-medical line had a considerable influence on actions taken to prevent and deal with social problems. One example was the compulsory care and sterilization of certain young women to prevent them from reproducing. The social pedagogic line comprised parents’ education, the role of the family and sexual education. An increased use of psychological explanations for experiences and behaviour among individuals and groups was seen in the 1930’s; this marked the beginning of the third period, psychologism. During the period of psychologism, science, mainly represented by psychology and psychiatry, gradually achieved a greater impact in those processes where young people were categorized as social problems. If in the previous period external discipline was the means of control, in this period internalized self-discipline was to be the means of adjustment. The study showed that conceptions of girls and boys in child welfare were gendered throughout the first half of the twentieth century. This bias has had an impact on how girls and boys were treated in child welfare services. Discussions about social problems concerning girls were often about sexuality and sexual actions, and discussions concerning boys were about violence and criminality. Social problems among girls were seen above all as moral transgressions and social problems among boys as juridical transgressions. These differing conceptions are of great importance when considering how girls and boys were judged and treated according to the child welfare Acts in existence during the first part of the twentieth century.
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| 9. |
- Harris, Ulrika, et al.
(author)
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Parents’ Experiences of Direct and Indirect Implications of Sleep Quality on the Health of Children with ADHD : A Qualitative Study
- 2022
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In: International Journal of Environmental Research and Public Health. - Basel : MDPI. - 1661-7827 .- 1660-4601. ; 19:22
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Journal article (peer-reviewed)abstract
- Sleep problems represent a significant challenge for children with ADHD. However, lack of knowledge about how sleep affects children with ADHD in terms of their health and everyday life prevents the development and implementation of interventions to promote sleep. The aim of this study was to explore parents’ experiences of direct and indirect implications of sleep quality onthe health of children with ADHD. The study used an abductive qualitative design, with Tengland’s two-dimensional theory of health as a deductive analysis framework. Semi-structured interviews were conducted with 21 parents of children aged 6–13 with ADHD and sleep problems. The parents experienced that sleep influenced their children’s abilities to control emotional behaviour relatedto ADHD and to manage everyday life. Sleep also had an impact on the children’s well-being,in relation to both vitality and self-esteem. In conclusion, the results show important direct and indirect implications of sleep quality on the health of children with ADHD. This implies a need forgreater focus on sleep, to target both abilities and well-being in promoting health among childrenwith ADHD. © 2022 by the authors
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| 10. |
- Kronsell, Lisa, et al.
(author)
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Parents’ Perceptions of the Value of Children’s Participation in Pediatric Rehabilitation Services : A Phenomenographic Study
- 2021
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In: International Journal of Environmental Research and Public Health. - Basel : MDPI. - 1661-7827 .- 1660-4601. ; 18:20
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Journal article (peer-reviewed)abstract
- Ensuring that children have opportunities to be involved in decision-making regarding their own care is associated with quality improvement in pediatric rehabilitation. The aim of the study was to explore parents’ perceptions of the value of children’s participation in pediatric rehabilitation services. Semi-structured interviews were conducted with 17 parents of children with disabilities who visited pediatric rehabilitation services. A phenomenographic analysis method was used. Three categories developed from the analysis describing how participation generated value in terms of empowerment, self-awareness, and independence. The outcome space describes a hierarchical relationship between the categories and their influence on each other. Independence achieved through participation was a core aspect and is at the highest level in the hierarchy since it includes and depends on the outcomes from both empowerment and self-awareness. Parents’ perceptions of the value of children’s participation in pediatric rehabilitation services include the possibility for the child to use their entire capacity through values created in terms of empowerment, self-awareness, and independence, in order to live the best life possible. Children with disabilities are diverse as a group, and further research to identify barriers and facilitators of participation is needed to adjust interventions within pediatric rehabilitation services to ensure that children with disabilities can be increasingly empowered, self-aware, and independent. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
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