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- Andersson, Inger, 1964
(author)
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Health-related quality of life after stem cell transplantation - The firs year
- 2010
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Doctoral thesis (other academic/artistic)abstract
- Health-related quality of life after stem cell transplantation – The first year Inger Andersson Institute of Health and Care Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden Abstract High-Dose Chemotherapy (HDC) followed by Stem Cell Transplantation (SCT) has been proven to be beneficial for a variety of haematological diseases, solid tumours and immune disorders. Despite improved care and treatment, SCT continues to produce significant long-term complications with impaired functioning and distressing symptoms. In this thesis the overall aim was to improve our knowledge about how SCT patients experience different types of transplantations and the effect it may have on their Health-Related Quality of Life (HRQoL) during the first year after SCT. Semi structured interviews were performed and two questionnaires, the European Organization for Research and Treatment of Cancer Quality of Life questionnaire (EORTC QLQ-C30) and the module, High-Dose-Chemotherapy (HDC-19), were administered. Health-related quality of life after allogeneic SCT following Reduced Intensity Conditioning (RIC) and MyeloAblative Conditioning (MAC) were compared. Both groups showed a similar pattern of development over time in functioning and symptoms, albeit more severe in the MAC group. One year after SCT there were no significant differences between the groups in global Quality of Life (QoL). However, RIC patients improved in global QoL back to baseline earlier compared to MAC patients. When allogeneic and autologous patients were compared, RIC patients seemed to recover in the same way as autologous patients and these two groups were closer in their scoring compared to MAC patients. The results emphasize the need to separate the two allogeneic groups when evaluating HRQoL after SCT. Symptoms related to the digestive system like; dry mouth, sore mouth, appetite loss and change of taste together with fatigue were among the most frequent reported symptoms throughout the SCT period for all three groups. In the MAC group, symptoms of dry mouth and change of taste even increased, and one year after SCT these symptoms were more pronounced compared to baseline. Four themes emerged from the data analysis of the interviews and illustrate how the participants described their life from discharge until one year after SCT; obstacles on the road to normality, to be part of a normal life, the chance to be cured overshadow everything and new values in life. The patients described that they felt restricted in life and had problems to manage the response from family and friends. Stem cell transplantation had changed their opportunities in life, meaning that plans for the future had to be altered, sometimes in a negative way. Stem cell transplantation is a demanding procedure that affects the patients HRQoL over a long period of time. Alleviation and management of distressing symptoms and impaired functioning are some of the most important tasks for the health care providers in order to contribute to a better health and life situation for SCT survivors.
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- Andersson, Inger, 1964, et al.
(author)
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Patients' perception of health-related quality of life during the first year after autologous and allogeneic stem cell transplantation.
- 2011
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In: European journal of cancer care. - : Hindawi Limited. - 1365-2354 .- 0961-5423. ; 20:3, s. 368-379
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Journal article (peer-reviewed)abstract
- Little attention has been paid to examine health-related quality of life (HRQoL) the first year post-transplant, despite that this period is crucial for returning to normal life and functioning and to prevent delayed psychosocial adjustment. The purpose of the present study was to describe HRQoL after autologous versus allogeneic stem cell transplantations during the first year post-transplant. The allogeneic group was further divided into two groups: allogeneic stem cell transplantation after reduced intensive conditioning and allogeneic stem cell transplantation after myeloablative conditioning. All together 202 patients were enrolled in the study. HRQoL was assessed by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the treatment-specific module High-Dose Chemotherapy (HDC-19). The questionnaires were filled out at six occasions (from inclusion to 12 months after transplantation). The reduced intensive conditioning group seemed to recover in the same way as the autologous group and these two groups were closer in their scoring compared with the myeloablative conditioning group. One month after the transplantation there were no significant differences in change scores between the autologous and reduced intensive conditioning group, and 1 year after the transplantation levels of symptoms and functioning were back to baseline or better. The myeloablative conditioning group, who perceived more symptoms and lower levels of functioning during the whole period, was still impaired in 10 out of 29 scales 1 year after the transplantation and no significant improvements compared with baseline were observed for this group.
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- Andersson, Inger S., et al.
(author)
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Perceptions of nursing care quality, in acute hospital settings measured by the Karen instruments
- 2013
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In: Journal of Nursing Management. - : Blackwell Publishing. - 0966-0429 .- 1365-2834. ; 21:1, s. 87-93
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Journal article (peer-reviewed)abstract
- Aims The objectives of this study were to measure the quality of nursing care from the perspectives of patients and personnel and to compare these perspectives. Background The perception of quality in nursing care is affected by patient needs and it is common that patients and personnel disagree on the nature of the quality. Thus, it is important to measure the quality from both perspectives. Method A total of 95 patients and 120 personnel from surgical and medical wards at a hospital in Sweden participated. The Karen instruments were used for data collection. A scale index was used for comparison of the perspectives. Results The patients and personnel were satisfied with the quality of care and there were no obvious differences in the total index. The different subscales indicated areas of lower care quality in need of improvement. Conclusion The quality of the care seemed to be satisfactory from the perspectives of both the patients and the personal. Further analysis from the subscale or a variable level is needed to define areas of lower care quality. Implications for Nursing Management Measurements have to be carried out continuously to guarantee care quality over time, as a result of organisational changes and financial cutbacks.
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- Chapman, Henry N, et al.
(author)
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Femtosecond X-ray protein nanocrystallography.
- 2011
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In: Nature. - : Springer Science and Business Media LLC. - 1476-4687 .- 0028-0836. ; 470:7332, s. 73-7
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Journal article (peer-reviewed)abstract
- X-ray crystallography provides the vast majority of macromolecular structures, but the success of the method relies on growing crystals of sufficient size. In conventional measurements, the necessary increase in X-ray dose to record data from crystals that are too small leads to extensive damage before a diffraction signal can be recorded. It is particularly challenging to obtain large, well-diffracting crystals of membrane proteins, for which fewer than 300 unique structures have been determined despite their importance in all living cells. Here we present a method for structure determination where single-crystal X-ray diffraction 'snapshots' are collected from a fully hydrated stream of nanocrystals using femtosecond pulses from a hard-X-ray free-electron laser, the Linac Coherent Light Source. We prove this concept with nanocrystals of photosystem I, one of the largest membrane protein complexes. More than 3,000,000 diffraction patterns were collected in this study, and a three-dimensional data set was assembled from individual photosystem I nanocrystals (∼200nm to 2μm in size). We mitigate the problem of radiation damage in crystallography by using pulses briefer than the timescale of most damage processes. This offers a new approach to structure determination of macromolecules that do not yield crystals of sufficient size for studies using conventional radiation sources or are particularly sensitive to radiation damage.
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- Forsgren, Nina, 1979-
(author)
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Structural studies of the surface adhesin SspB from Streptococcus gordonii
- 2010
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Doctoral thesis (other academic/artistic)abstract
- Surface proteins on microorganisms that build up the oral biofilm are key players in the formation of the biofilm. Antigen I/II proteins are surface adhesins found on virtually all oral streptococci and share a conserved multi-domain architecture. These adhesins bind surface components on other bacteria and on host cells. Thus, they are crucial for the development of the biofilm. The objective of this thesis work is the structural characterization of the large multi-domain Antigen I/II protein SspB from the primary colonizing commensal bacterium Streptococcus gordonii. The crystal structure of the variable domain of SspB was determined to 2.3 Å resolution. The domain comprises a β-supersandwich and a putative binding cleft stabilized by a calcium ion. Despite high similarity in the overall structure, the cleft within SspB is significantly smaller than the cleft within the homologous protein from Streptococcus mutans, indicating that different substrates may bind in the clefts. A screen for carbohydrate binding resulted in no hits for interaction with the SspB variable domain suggesting that the cleft may not be suitable for binding sugars. This thesis also presents the high resolution 1.5 Å structure of a truncated C-terminal domain of SspB, the first of an Antigen I/II C-domain. The structure contains two structurally related domains, each containing one calcium ion and one intramolecular isopeptide bond. The SspB protein shares the feature of intramoleular isopeptide bonds with other surface proteins from Gram positive bacteria, such as pili from Streptococcus pyogenes and Corynebacterium diphtheriae. Intramolecular isopeptide bonds are suggested to be a common feature for retaining stability in a harsh environment. The SspB adherence region, shown to be the recognition motif for Porphyromonas gingivalis attachment to S. gordonii, protrudes from the core protein as a handle available for recognition. In conclusion, this thesis work has provided new knowledge about the SspB protein and increased the understanding of the common structure of AgI/II proteins.
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- Hantke, Max F., et al.
(author)
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High-throughput imaging of heterogeneous cell organelles with an X-ray laser
- 2014
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In: Nature Photonics. - : Springer Science and Business Media LLC. - 1749-4885 .- 1749-4893. ; 8:12, s. 943-949
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Journal article (peer-reviewed)abstract
- We overcome two of the most daunting challenges in single-particle diffractive imaging: collecting many high-quality diffraction patterns on a small amount of sample and separating components from mixed samples. We demonstrate this on carboxysomes, which are polyhedral cell organelles that vary in size and facilitate up to 40% of Earth's carbon fixation. A new aerosol sample-injector allowed us to record 70,000 low-noise diffraction patterns in 12 min with the Linac Coherent Light Source running at 120 Hz. We separate different structures directly from the diffraction data and show that the size distribution is preserved during sample delivery. We automate phase retrieval and avoid reconstruction artefacts caused by missing modes. We attain the highest-resolution reconstructions on the smallest single biological objects imaged with an X-ray laser to date. These advances lay the foundations for accurate, high-throughput structure determination by flash-diffractive imaging and offer a means to study structure and structural heterogeneity in biology and elsewhere.
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- Hasse, Dirk, et al.
(author)
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Crystallization and preliminary X-ray diffraction analyses of the homodimeric glycine decarboxylase (P-protein) from the cyanobacterium Synechocystis sp. PCC 6803.
- 2010
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In: Acta Crystallographica. Section F. - 1744-3091 .- 1744-3091. ; 66:Pt 2, s. 187-191
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Journal article (peer-reviewed)abstract
- Glycine decarboxylase, or P-protein, is a major enzyme that is involved in the C(1) metabolism of all organisms and in the photorespiratory pathway of plants and cyanobacteria. The protein from Synechocystis sp. PCC 6803 is a homodimer with a mass of 215 kDa. Recombinant glycine decarboxylase was expressed in Escherichia coli and purified by metal-affinity, ion-exchange and gel-filtration chromatography. Crystals of P-protein that diffracted to a resolution of 2.1 A were obtained using the hanging-drop vapour-diffusion method at 291 K. X-ray diffraction data were collected from cryocooled crystals using synchrotron radiation. The crystals belonged to space group P2(1)2(1)2(1), with unit-cell parameters a = 96.30, b = 135.81, c = 179.08 A.
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