| 1. |
- Jakobsson, Malin, 1971-, et al.
(författare)
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Adolescents' lived experience of sleeping difficulties
- 2020
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Ingår i: Journal of Sleep Research.
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Konferensbidrag (refereegranskat)abstract
- Objectives/Introduction: Sleeping difficulties, including insufficient sleep, trouble falling asleep, waking up at night, or sleep that does not leave an individual rested, are increasingly prevalent among adolescents and have negative consequences for their’ health, well‐being, and education. It is of utmost importance to research adolescents’ sleep. A range of studies with different methodological perspectives are needed to inform and understand adolescents’ sleep. To date, there are few studies in sleep research that take a qualitative approach. Therefore, it is important to illuminate adolescents’ own experience of sleeping difficulties to acquire broader knowledge and the necessary evidence in order to provide preventive care interventions.Methods: The data were obtained from narrative interviews with 16 adolescents aged 14–15 in a Swedish city and were analyzed using the phenomenological hermeneutic method.Results: Four themes that illustrate the meaning of adolescents experience of sleeping difficulties emerged: feeling dejected when not falling asleep, experiencing the night as a struggle, searching for better sleep, and being affected the next day. The comprehensive understanding illuminates what being an adolescent with sleeping difficulties means; it is a challenge to go through the night; cope with the next day; and to harbor a panorama of emotions that emerge during the night, such as frustration, annoyance, concern, dejection, sadness, and fear. These emotions arise when the adolescent is unable to unwind and has concerns that grow during the night. The adolescent experience a feeling of being trapped in circumstances, all of which are incompatible with getting a good night's sleep.Conclusions: In order to understand adolescents’ sleeping difficulties, a comprehensive understanding of the context in which the adolescents live is needed. Adolescents need to navigate and find balance in relation to circumstances that may affect their sleep and that are often beyond their control, such as norms and values in society, in social media, in school, and in family and friend groups. By genuinely listening to the adolescents’ narratives about their sleeping difficulties and the context in which they interact will parents, professional caregivers, and researchers increase their understanding.
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| 2. |
- Jakobsson, Malin, 1971-, et al.
(författare)
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En obarmhärtigt lång väntan på att somna
- 2021
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Ingår i: Skolhälsan. - : Riksföreningen för skolsköterskor. - 0284-284X. ; :1
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- En vanlig uppfattning i samhället är att ungdomar som sover för lite är slarviga med rutiner och att skärmarna tar deras tid. Men är problematiken så enkel? Hur är det egentligen att ha sömnsvårigheter? En ny studie från Högskolan Borås ger en inblick i ungdomars egna upplevelser.
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| 3. |
- Jakobsson, Malin, 1971-, et al.
(författare)
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"I Want to Sleep, but I Can't" : Adolescents' Lived Experience of Sleeping Difficulties
- 2022
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Ingår i: Journal of School Nursing. - : Sage Publications. - 1059-8405 .- 1546-8364. ; 38:5, s. 449-458
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Tidskriftsartikel (refereegranskat)abstract
- Sleeping difficulties are increasingly prevalent among adolescents and have negative consequences for their health, well-being, and education. The aim of this study was to illuminate the meanings of adolescents' lived experiences of sleeping difficulties. The data were obtained from narrative interviews with 16 adolescents aged 14-15 in a Swedish city and were analyzed using the phenomenological hermeneutic method. The findings revealed four themes: feeling dejected when not falling asleep, experiencing the night as a struggle, searching for better sleep, and being affected the next day. The comprehensive understanding illuminates that being an adolescent with sleeping difficulties means it is challenging to go through the night and to cope the next day. It also means a feeling of being trapped by circumstances. As the adolescents' lived experiences become apparent, the possibility for parents, school nurses, and other professional caregivers to support adolescents' sleep increases.
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| 4. |
- Corneliusson, Laura, 1989-
(författare)
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Exploring resident health, wellbeing, and thriving in Swedish sheltered housing
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: As the population of older people is expected to increase in the coming decades, an increase in service demand will likely follow. Aging in place is common in Sweden, but may be associated with loneliness, anxiety, and other negative health effects. Swedish sheltered housing began to emerge around 2008, and was aimed at older people who felt socially isolated, anxious, or unsafe aging in place. Swedish sheltered housing was to be a form of independent housing, providing accommodation with increased opportunities for social participation and accessible spaces, but with no provision of health care services. Despite the emergence of such housing, and policy documents outlining anticipated benefits, the national and international scientific body of knowledge is small.Aim: The overall aim of this thesis was to explore the health, wellbeing and thriving of residents living in Swedish sheltered housing.Methods: This thesis is based on data from two data collections and registry data. The first data collection, the U-Age Sheltered Housing Survey Study, took place between October 2016 and January 2017, and consisted of surveys sent to residents living in Swedish sheltered housing, and to a matched control group. The matching criteria was age, sex and municipality of residence. The sample for the U-Age Sheltered Housing Survey Study consisted of 3,805 individuals: 1, 955 individuals living in sheltered housing, and 1,850 aging in place. The second data collection took place between April 2019 and January 2020, and consisted of semi-structured interviews in five sheltered housing accommodations which had participated in the U-age Sheltered Housing Survey Study. This data collection consisted of a total of seven group interviews with a sample of 38 residents. In addition, to enable longitudinal analyses, registry data on social services resource utilization and mortality was obtained from The Department of Health and Welfare in Sweden and Statistics Sweden. Data were analyzed using descriptive statistics, linear regression analyses with interaction variables, logistic regressions, and qualitative content analysis.Results: Residents living in Swedish sheltered housing generally reported lower self-rated health, lower health-related quality of life, lower functional status, and higher depressive mood, compared to those aging in place. With increasing level of depressive mood, and decreasing levels of self-rated health and functional status, those residing in sheltered housing generally reported higher levels of thriving, compared to those aging in place. A higher proportion of those living in Swedish sheltered housing received home care services, and received on average more home care service hours, compared to those aging in place. Furthermore, a higher proportion of residents living in sheltered housing had relocated to a nursing home and deceased over a 3-year period, compared to those aging in place. Rates of relocation to a nursing home and mortality were higher among those who lived in Swedish sheltered housing and received home care services, compared to those living in Swedish sheltered housing who did not receive home care services. Interviews with residents living in Swedish sheltered housing revealed four different levels to the experienced facilitators and barriers to thriving in Swedish sheltered housing: individual factors, social context, environmental factors and organizational context.Conclusions: There seems to be both a want, and a potential need, for health care related support among residents living in Swedish sheltered housing. Although residents in Swedish sheltered housing reported slightly lower self-rated wellbeing than older people aging in place, differences in wellbeing did not seem to be explained by type of accommodation per se. There do however seem to be aspects in Swedish sheltered housing that support thriving specifically among those with lower levels of health, lower functional status, and higher depressive mood, when compared to those aging in place. It seems possible that thriving in Swedish sheltered housing may be influenced by the interplay of various especially influential aspects, such as, but not limited to, levels of health, the services provided, the experience of the social environment, and the perceived support. Thereby, providing residents of Swedish sheltered housing with more health care related support and information could further support resident health and thriving. The findings of this thesis contribute to the currently limited pool of knowledge on health, wellbeing, and thriving in Swedish sheltered housing, and may assist in developing tailored services, support, and interventions for the demographic residing in this type of housing.
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| 5. |
- Dahlberg, Anna-Karin, et al.
(författare)
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Dispersal of persistent organic pollutants from fiber-contaminated sediments : biotic and abiotic pathways
- 2021
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Ingår i: Journal of Soils and Sediments. - : Springer Science and Business Media LLC. - 1439-0108 .- 1614-7480. ; 21:4, s. 1852-1865
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Tidskriftsartikel (refereegranskat)abstract
- PurposeNumerous sites contaminated with fiber emissions from pulp and paper industries are found in coastal areas of the Baltic Sea, but there is limited knowledge about the magnitude of dispersal of persistent organic pollutants (POPs) from these anthropogenic, organic-rich sediments called fiberbanks. The aim of this study was to quantify and compare different POP dispersal pathways from such fiberbanks. Dispersal mechanisms studied included abiotic and biotic routes (dissolved in water, particle-bound, and bioaccumulation).Materials and methodsContaminated fibrous sediments located in Ångermanälven River estuary in north-eastern Sweden were studied in sediment types representing different fiber content (i.e., fiberbanks, fiber-rich sediments, and less fiber impacted sediments). Sediment-to-water fluxes of dissolved contaminants (polychlorinated biphenyls (PCBs), hexachlorobenzene (HCB), and dichlorodiphenyltrichloroethane (DDT)) were measured in situ using benthic flux chambers. Particle resuspension was measured by sampling bottom water, before and after disturbing the sediment surface. Benthic biota was collected to determine the body burden of contaminants and to determine biota-pore water accumulation factors (BAFPW) and biota-sediment accumulation factors (BSAFs). In addition, concentrations of dissolved POPs in the water column were measured in field using passive samplers. Instrumental analysis was performed using gas chromatography coupled to a triple quadrupole mass spectrometer (GC-MS/MS).Results and discussionThe flux of dissolved Σ20PCBs was approximately two times higher from one of the investigated fiberbanks (3.4 ng m− 2 day− 1) compared to the other. The average particle burden of PCBs was also higher at this fiberbank after artificial disturbance (15 ng g−1 particle), which indicates that larger amounts of contaminants are likely to disperse via particle resuspension from this site compared to the other fiberbank (4.8 ng g− 1 particle). The difference might be associated with a layer of recently settled minerogenic material that covers one of the fiberbanks, which probably functions as a protective barrier. The lack of benthic biota implies that contaminant release by bioturbation is negligible in the studied fiberbanks. However, benthic biota from fiber-rich sediment showed bioaccumulation and biomagnification of contaminants.ConclusionsThe importance of diffusive flux from fiberbanks under undisturbed conditions became apparent when the different dispersal pathways were quantified. However, no dispersal pathway could be judged as irrelevant, since even under undisturbed conditions, advective particle transport was significant. Additionally, the uptake by biota and trophic transfer can be considerable. Quantification of dispersal routes and understanding of the relative importance of various pathways is critical for proper risk assessment and management of contaminated sediments.
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| 6. |
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| 7. |
- Dahlberg, Anna-Karin, 1982-, et al.
(författare)
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Persistent organic pollutants in wood fiber–contaminated sediments from the Baltic Sea
- 2020
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Ingår i: Journal of Soils and Sediments. - : Springer Science and Business Media LLC. - 1439-0108 .- 1614-7480. ; 20:5, s. 2471-2483
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Tidskriftsartikel (refereegranskat)abstract
- Many coastal areas in the Baltic Sea are contaminated with wood fiber and pollutants from pulp and paper industries. These anthropogenic, organic-rich, sediments (fiberbanks) have not been characterized and knowledge about their role as secondary sources for dispersal of persistent organic pollutants (POPs) is limited. Hence, the aim of this study was to elucidate the fate of POPs and the relationships between sorption (KD and KTOC), sediment type, and compound hydrophobicity (KOW) in fiber-contaminated sediments.
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| 8. |
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| 9. |
- Goransson, Gunnel, et al.
(författare)
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Assessing the Risk of Contaminant Dispersion From Fibrous Sediments of Industrial Origin
- 2021
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Ingår i: Frontiers in Marine Science. - : Frontiers Media S.A.. - 2296-7745. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- Unregulated discharges of wastewater from pulp and paper factories resulted in the formation of relatively thick organic (cellulose) rich sediments in shallow waters along the Swedish coast. These deposits are known as fiberbanks and are contaminated by persistent organic pollutants (POPs), metals and methylmercury, which can be dispersed by diffusion and advective processes coupled to propeller wash, high river discharges, strong wind waves and submarine landslides. Based on a case study of polychlorinated biphenyls (PCBs), one group of prevalent POPs in the fiberbanks, we present a probabilistic approach to estimate the potential risk of dispersion of fiberbank contaminants. The approach allows for estimation of the dispersal pathways that dominates the risk within a given time and provides more insight about the significance of various dispersion processes. We show that it is highly likely that chemical diffusion and advection triggered by ship-induced resuspension will disperse PCBs (sum of seven congeners; sigma 7PCB) above a threshold level for environmental impact, while the likelihood of river and wind-wave generated resuspension dispersion pathways are lower (similar to 20%, respectively). We further show that there is approximately 5% likelihood that a submarine landslide will disperse sigma 7PCB above the threshold level. The study implies that the governing parameters for risk assessment specifically should include reliable data on contaminant concentration, water depth above the fiberbank, estimation of concerned fiberbank areas, time duration of erosive fluid flows and measured diffusion. The approach provides insight into the importance of various dispersion processes. We suggest that it can be applied to support risk assessment, especially when there are limited available data and/or knowledge about the system under study.
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| 10. |
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| 11. |
- Jakobsson, Malin, 1971-, et al.
(författare)
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Adolescents’ own suggestions on how to support their sleep
- 2021
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Konferensbidrag (refereegranskat)abstract
- Objectives:Now recognized as a public health issue, sleeping difficulties among adolescents, mainly involving insufficient sleep, are common (Gradisar et al., 2011; Louzada, 2019; Saxvig et al., 2020). To avoid persistent sleeping difficulties, health-related problems, and school failure, it is of utmost importance to promote good sleep among adolescents. This study explores adolescents’ suggestions on how their sleep could be supported.Methods:Data were collected via eight focus group interviews with 43 adolescents aged 15–16 from different demographic areas in a Swedish city, 42% boys and 58% girls. Data were analyzed using qualitative content analysis (Lindgren et al., 2020). Results:The results describes the adolescents’ suggestions about how their sleep can be supported in three themes. Being supported by involved parentsEven though adolescents are starting to become independent individuals, they want support to sleep better. Above all, they want support from their parents in the form of routines, security, and knowledge about sleep.Being supported to achieve knowledge on the “whys” and “hows” of sleepAdolescents value knowledge and advice that they receive from those they trust because it is then perceived as targeted and personal. Adolescents also want school education about sleep to be more activity-based, as they find that learning and motivation increase with this type of pedagogy.Being guided into finding balance By being encouraged into activity, learning to deal with silence, as well as by receiving support by structures in school, the adolescents believe they can be guided to finding balance. Conclusions:Designing interventions and health promotions in line with what the adolescents suggest will create the conditions to successfully support adolescents’ sleep. These suggestions should be used by parents, health professionals, and the school, all of whom have the opportunity to influence adolescents; these strategies also need to be evaluated
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| 12. |
- Jakobsson, Malin, 1971-, et al.
(författare)
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Adolescents' Suggestions on how to Support Their Sleep : A Focus Group Study
- 2022
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Ingår i: Journal of School Nursing. - : Sage Publications. - 1059-8405 .- 1546-8364.
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Tidskriftsartikel (refereegranskat)abstract
- Sleeping difficulties among adolescents constitute a pressing public health issue, and it is of the utmost importance that these are approached from a health-promotion perspective. This study explores adolescents' suggestions on how their sleep could be supported. Data were collected via eight focus group interviews with 43 adolescents aged 15-16, in Sweden, and analyzed using qualitative content analysis. The results describe the adolescents' suggestions on how their sleep could be supported in three themes: being supported by involved parents- routines, engagement, and warmth are vital; being supported to achieve knowledge on the "whys" and "hows" of sleep-increased knowledge gives the ability to make well-grounded sleep choices; and being guided into finding balance-balance in life is difficult to achieve and adolescents desire support. Parents, school nurses, health professionals, and anyone who has the opportunity to improve and promote sleep should consider adolescents' suggestions.
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| 13. |
- Jakobsson, Malin, 1971-
(författare)
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”Jag vill sova, men kan inte” : Ungdomars perspektiv på faktorer som försvårar och främjar deras sömn
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Sleeping difficulties have become increasingly prevalent among adolescents and have negative consequences on their health, well-being, and education.Aim and methods: The overall aim of this thesis was to explore adolescents’ sleep and the factors that impede and promote their sleep. Study I describes the prevalence of self-reported sleep duration and sleeping difficulties and explores their associations with school stress, self-perception, and technology use among adolescents based on a questionnaire of n = 937 adolescents, aged 15–16. Study II describes reasons for sleeping difficulties as perceived by adolescents based on an open-ended question answered by n = 475 adolescents, aged 15–16. Study III illuminates adolescents’ lived experiences of sleeping difficulties based on narrative interviews with n = 16 adolescents, aged 14–15. Study IV explores adolescents’ suggestions on how their sleep could be supported, based on eight focus groups with n = 43 adolescents, aged 15–16.Results: Fifty-five percent of the adolescents slept less than the recommended eight hours per night. School stress and technology use were associated with short sleep duration, whereas school stress and self-perception were associated with sleeping difficulties (I). Stress, technology use, poor sleep habits, existential thoughts, needs, and suffering were all perceived as reasons for sleeping difficulties (II). Having sleeping difficulties makes it challenging to go through the night and cope with the following day. It also implies a feeling of being trapped by circumstances (III). To improve sleep, adolescents suggested receiving support from involved parents, achieving knowledge about on the “whys” and “hows” of sleep, and being guided into finding balance (IV).Conclusions: Sleeping difficulties affect adolescents’ daily lives and constitute a pressing health issue. In order to deal with sleeping difficulties, adolescents need to be encouraged to narrate their experiences and circumstances, be respectfully listened to and supported by their parents, school nurses, and other significant adults.
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| 14. |
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| 15. |
- Jakobsson, Malin, 1971-, et al.
(författare)
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Reasons for sleeping difficulties as perceived by adolescents
- 2020
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Ingår i: Journal of Sleep Research.
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Konferensbidrag (refereegranskat)abstract
- Objectives/Introduction: Sleeping difficulties are increasingly prevalent among adolescents worldwide and have negative consequences for health, well‐being, and education. In order to develop and implement health promotion about sleep, additional knowledge is required, especially knowledge based on adolescent´s own experiences. This kind of research is currently limited. This study aimed to describe reasons for sleeping difficulties as perceived by adolescents.Methods: This was a descriptive study, analyzing the data with qualitative and quantitative content analysis. Data was collected using an open ended question in a questionnaire; If you experience that you sleep too short, have trouble falling asleep, wake up at night or sleep not rested, please write what you think your sleeping difficulties may be due to. The participants consisted of 475 adolescents in grade nine (15–16 year), in 13 secondary schools, in a Swedish city.Results: The adolescent´s descriptions of reasons for sleeping difficulties are understood as an imbalance between requirements and preconditions. Requirements are about performing at school, doing activities, being social both digitally and in real life, having fun, taking care of their health, reflecting on the existence and the future. Preconditions can be about having time, structure and parental support, but also an ability to set your own limits. When the preconditions are insufficient to match the requirements, an imbalance occurs where sleep loses out. Six different categories described reasons for adolescents sleeping difficulties. The most prominent reason was stress followed by technology use and then poor sleep habits, existential thoughts, needs, and suffering.Conclusions: In order to avoid sleeping difficulties, adolescents need to deal with reasons such as stress, technology use, non‐existent sleeping habits, existential considerations, needs and various forms of suffering. Adolescents need support to find a functioning balance in everyday life, dealing with these reasons. The support is needed from especially parents but also from professional caregivers. All health professionals caring for adolescents should remain vigilant regarding the important issue of sleeping difficulties, as good sleep hygiene optimizes adolescents’ capability for health and development.
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| 16. |
- Jakobsson, Malin, 1971-, et al.
(författare)
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Reasons for sleeping difficulties as perceived by adolescents: A content analysis
- 2019
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712.
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Tidskriftsartikel (refereegranskat)abstract
- Sleeping difficulties are increasingly prevalent among adolescents worldwide and have negative consequences for adolescent health and education. The aim of this study was to describe the reasons for sleeping difficulties as perceived by adolescents. Sleeping difficulties include insufficient sleep, trouble falling asleep, waking up at night, or sleep that does not leave an individual rested. Data were collected in 2015 using an open-ended question. The sample consisted of n = 475 adolescents from a city in Sweden, aged 15–16 years, with self-assessed sleeping difficulties. The results described the reasons for the adolescents’ sleeping difficulties, at a general, thematic level, as an imbalance between requirements and preconditions, distributed to stress, technology use, poor sleep habits, existential thoughts, needs, and suffering. To find a balance in their daily lives, adolescents may need support from parents, school nurses, and school health services to deal with their sleeping difficulties.
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| 17. |
- Jakobsson, Malin, 1971-, et al.
(författare)
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Reasons of sleeping difficulties as perceived by adolescents
- 2020
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Ingår i: Reasons of sleeping difficulties as perceived by adolescents.
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Konferensbidrag (refereegranskat)abstract
- BackgroundSleeping difficulties are growing among adolescents worldwide. Research shows relationships between sleeping difficulties and reduced learning ability, memory impairment, hyperactivity, poorer school performance, lower grades, and increased risk of depression and anxiety. In order to develop and implement health promotion about sleep, additional knowledge is required, especially knowledge based on adolescent´s own experiences. This kind of research is currently limited both nationally and internationally. This study aimed to describe reasons for sleeping difficulties as perceived by adolescents. MethodsThis was a descriptive study, analyzing the data with qualitative and quantitative content analysis. Data was collected using an open ended question in a questionnaire; If you experience that you sleep too short, have trouble falling asleep, wake up at night or sleep not rested, please write what you think your sleeping difficulties may be due to. Background information, such as gender, housing, ethnicity and grades were collected too. The participants consisted of 475 adolescents in grade nine (15-16 year), in 13 secondary schools, in a Swedish city.ResultsThe adolescent´s descriptions of reasons for sleeping difficulties are understood as an imbalance between requirements and preconditions. Requirements are about performing at school, doing activities, being social both digitally and in real life, having fun, taking care of their health, reflecting on the existence and the future. Preconditions can be about having time, structure and parental support, but also an ability to set your own limits. When the preconditions are insufficient to match the requirements, an imbalance occurs where sleep loses out. Six different categories described reasons for adolescents sleeping difficulties. The most prominent reason was stress followed by technology use and then poor sleep habits, existential thoughts, needs, and suffering. ConclusionsIn order to avoid sleeping difficulties, adolescents need to deal with reasons such as stress, technology use, non-existent sleeping habits, existential considerations, needs and various forms of suffering. Adolescents need support to find a functioning balance in everyday life, dealing with these reasons. The support is needed from especially parents but also from the school nurse and school health services. The school nurses has an important role to prevent sleeping difficulties by addressing reasons for sleeping difficulties.
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| 18. |
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| 19. |
- Jakobsson, Malin, 1971-, et al.
(författare)
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Sleep duration and sleeping difficulties among adolescents: Exploring associations with school stress, self-perception, and technology use
- 2019
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 33:1, s. 197-206
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Tidskriftsartikel (refereegranskat)abstract
- Sleep duration and sleeping difficulties among adolescents: exploring associations with school stress, self-perception and technology use Sleeping problems are increasing among adolescents worldwide. This study aimed to describe the prevalence of self-reported sleep duration and sleeping difficulties, as well as to explore their associations with school stress, self-perception, that is how adolescents perceive their appearance and happiness, and technology use among adolescents. Data were collected in 2015 using a questionnaire. A total of 937 ninth grade adolescents, 15–16 years, from a city in western Sweden participated, resulting in a response rate of 83%. The result showed that 55% of the adolescents slept less than the recommended 8 hours per night and 11% had sleeping difficulties. School stress and technology use were associated with short sleep duration. School stress and self-perception were associated with sleeping difficulties. The girls had worse outcomes for sleeping difficulties, school stress, self-perception and technology use than the boys. Based on the results, there is a need for school nurses to implement preventive measures to improve adolescents’ sleep.
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| 20. |
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| 21. |
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| 22. |
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| 23. |
- Josefsson, Andreas, 1979, et al.
(författare)
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Circulating tumor cells mirror bone metastatic phenotype in prostate cancer
- 2018
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Ingår i: Oncotarget. - : Impact Journals, LLC. - 1949-2553. ; 9, s. 29403-29413
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Tidskriftsartikel (refereegranskat)abstract
- © Josefsson A et al. Circulating tumor cells (CTCs) are promising biomarkers in prostate cancer (PC) because they derive from primary tumor and metastatic tissues. In this study, we used quantitative real-time PCR (qPCR) to compare the expression profiles of 41 PC-related genes between paired CTC and spinal column metastasis samples from 22 PC patients that underwent surgery for spinal cord compression. We observed good concordance between the gene expression profiles in the CTC and metastasis samples in most of the PC patients. Expression of nine genes (AGR2, AKR1C3, AR, CDH1, FOLH1, HER2, KRT19, MDK, and SPINK1) showed a significant correlation between the CTC and metastasis samples. Hierarchical clustering analysis showed a similar grouping of PC patients based on the expression of these nine genes in both CTC and metastasis samples. Our findings demonstrate that CTCs mirror gene expression patterns in tissue metastasis samples from PC patients. Although low detection frequency of certain genes is a limitation in CTCs, our results indicate the potential for CTC phenotyping as a tool to improve individualized therapy in metastatic prostate cancer.
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| 24. |
- Josefsson, Andreas, 1979, et al.
(författare)
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Gene expression alterations during development of castration-resistant prostate cancer are detected in circulating tumor cells
- 2020
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Ingår i: Cancers. - : MDPI AG. - 2072-6694. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- Development of castration-resistant prostate cancer (CRPC) is associated with alterations in gene expression involved in steroidogenesis and androgen signaling. This study investigates whether gene expression changes related to CRPC development can be identified in circulating tumor cells (CTCs). Gene expression in paired CTC samples from 29 patients, before androgen deprivation therapy (ADT) and at CRPC relapse, was compared using a panel including 47 genes related to prostate cancer progression on a qPCR platform. Fourteen genes displayed significantly changed gene expression in CTCs at CRPC relapse compared to before start of ADT. The genes with increased expression at CRPC relapse were related to steroidogenesis, AR-signaling, and anti-apoptosis. In contrast, expression of prostate markers was downregulated at CRPC. We also show that midkine (MDK) expression in CTCs from metastatic hormone-sensitive prostate cancer (mHSPC) was associated to short cancer-specific survival (CSS). In conclusion, this study shows that gene expression patterns in CTCs reflect the development of CRPC, and that MDK expression levels in CTCs are prognostic for cancer-specific survival in mHSPC. This study emphasizes the role of CTCs in exploring mechanisms of therapy resistance, as well as a promising biomarker for prognostic and treatment-predictive purposes in advanced mHSPC. © 2019 by the authors. Licensee MDPI, Basel, Switzerland.
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| 25. |
- Pusa, Susanna, 1982-
(författare)
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Vägen mot implementering av familjecentrerad omvårdnad
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Bakgrund: När människor är inkluderade i varandras liv påverkar en förändring av livssituationen hos en person även de övriga personerna som står den nära. Det innebär att när en person drabbas av ohälsa eller sjukdom påverkas även personens familj. Familjens upplevelse av den situation som uppstår i samband med ohälsa kan dessutom negativt påverka familjemedlemmarnas medvetenhet om familjens tillgängliga styrkor och resurser, vilket i sin tur kan påverka familjers kamp för att återfå och bibehålla hälsa. Traditionellt sett har vården fokuserat på att erbjuda stöd på personnivå, och främst då till patienter. De senaste decennierna har dock en tendens uppmärksammats till ökad förståelse för att hela familjen behöver inkluderas i omvårdnaden. Att anamma ett familjecentrerat förhållningssätt – det vill säga, att se och möta familjen som en enhet och som ett system – har visat sig ha flera fördelar utifrån såväl patient- och familje- som sjuksköterskeperspektiv. Detta har medfört en efterfrågan på forskning om hur familjecentrerad omvårdnad kan läras ut och implementeras i den kliniska hälso- och sjukvården.Syfte: Det övergripande syftet med avhandlingen är att belysa erfarenheter av stöd från distriktssköterskor/sjuksköterskor till familjer i ordinärt boende, samt att utvärdera implementering av familjecentrerade samtal.Metod: Avhandlingen inkluderar tre studier med kvalitativ design och en studie med mixad-metod design. I delstudie I samlades data in genom tio fokusgruppintervjuer med 36 distriktssköterskor och analyserades sedan med en fenomenologisk hermeneutisk metod. Datainsamlingen för delstudie II bestod av ljudinspelade familjecentrerade samtal med sju familjer, samt sju avslutande brev riktade till familjerna som distriktssköterskorna/sjuksköterskorna skrev efter samtalen med familjerna. Familjesamtalen och breven analyserades med hjälp av kvalitativ innehållsanalys. I delstudie III analyserades individuella intervjuer med 21 distriktssköterskor/sjuksköterskor med kvalitativ innehållsanalys. Mixad metod användes i delstudie IV, där kvantitativa data från instrumentet Families’ Importance in Nursing Care – Nurses’ Attitudes (FINC-NA) integrerades med kvalitativa data från individuella intervjuer med 14 distriktssköterskor/sjuksköterskor.Resultat: Resultatet visar att distriktssköterskor/sjuksköterskor strävar efter att stödja familjer (I, IV) och att familjecentrerad omvårdnad i form av familjecentrerade samtal kan vara ett sätt att stöda familjer att dela med sig av sina upplevelser och känslor både inom familjen och med distriktssköterskan/ sjuksköterskan (II, IV). Det upplevda stödet från såväl familjen som distriktssköterskan/sjuksköterskan ansågs värdefullt för att bättre hantera situationen och framtiden (II). Distriktssköterskorna/sjuksköterskorna uppfattade den webbaserade utbildningen i familjecentrerad omvårdnad inklusive familjecentrerade samtal som överlag funktionell och välanpassad (III). Utbildningen med den påföljande implementeringen beskrevs bidra till ett förändrat förhållningssätt hos dem, där de tänkte och arbetade mer inkluderande och stödjande gentemot familjer, även när de inte utförde familjecentrerade samtal enligt den tänkta strukturen (III, IV). Utvärderingen av implementeringen av de familjecentrerade samtalen visade att införandet av familjecentrerade samtal fortgick även om de inte hade implementerats fullt ut som avsett. Acceptans och lämplighet utvärderades överlag positivt, dock framkom personliga, sociala och organisatoriska hinder, vilka påverkade genomförandet, användningen och metodtroheten (IV).Konklusion: Stöd från distriktssköterskor/sjuksköterskor till familjer är en omvårdnadshandling som förutsätter medveten omsorg i ett aktivt möte med familjen, där varje enskild person, men även familjen som enhet, behöver beaktas. Detta stöd för familjers hälsa kan ske genom familjecentrerad omvårdnad. En webbaserad utbildning för distriktssköterskor/sjuksköterskor i familjecentrerad omvårdnad och familjecentrerade samtal utgör ett adekvat steg i processen att implementera detta arbetssätt i den kliniska verksamheten. Sammanfattningsvis bidrar avhandlingen till kunskap om hur stödjande familjecentrerade samtal kan implementeras i klinisk verksamhet och vilka aspekter som kan påverka detta.
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