Prostate cancer is a large and increasing medical problem both in Sweden and in the rest of the developed world, with about 300.000 new cases diagnosed world wide annually. Despite the high incidence of this disease, little is known about the aetiology of prostate cancer. The aim of this study was to try to understand more about the natural history and to find possible a etiological risk factors for this tumour. In a population based study of prostate cancer cases in northern Sweden it was found that the large increase in prostate cancer during the last two decades was mainly caused by well (Gl) and moderately (G2) differentiated tumours. However, the incidence of poorly differentiated (G3) tumours remained unchanged. The introduction of new diagnostic methods is the most plausible explanation for the increase of these low grade tumours. The relative survival in prostate cancer was found to be independent of patient age at diagnosis, indicating that tumour proliferation and the aggressiveness of this disease is equal in all ages. However, due to the increasing occurrence of concurrent diseases with growing age the number of lost years caused by prostate cancer decreases dramatically in older age groups. The overall cause specific mortality for prostate cancer was found to be around 50%. In accordance with most other cancer tumours, the annual mortality rate decreased with longer survival also for prostate cancer patients. In a study from the Swedish Twin Register it was found that the proband concordance rates for prostate cancer were 4,5 time greater among monozygotic compared to dizygotic twins. In a large nation-wide cohort study of men who had a father with prostate cancer, the overall standardised incidence ratio (SIR) was 1.70 for prostate cancer. Younger age at diagnosis among the fathers were associated with an increased risk among sons. This cohort study and the twin study indicates that both inherited and familial factors are of importance in a subgroup of prostate cancer patients. In a prospective case-control study, both a high body mass index (BMI) and a high food intake were found to be independent risk factors for prostate cancer. Both BMI and a high food intake might be indicators of a high fat diet, which so far is the most consistent exogenous risk factor for prostate cancer. The use of tobacco or alcoholic beverages were not associated with prostate cancer risk. / <p>Härtill 5 uppsatser</p> / digitalisering@umu

Text in Afrikaans / Die objek van studie in hierdie proefskrif is ietwat ongewoon. Die studie is outobiografies en is gegrond op die aanname dat daar tussen die psigoterapeut, sy geskiedenis, die wetenskap (etnografie en tweede-orde kubernetika) en die klient(e) 'n unieke patroonverband bestaan. Die psigoterapeut in die platteland het weens afstand of finansies nie altyd die voorreg om supervisie van 'n eksterne supervisor te ontvang nie. In so 'n situasie kan selfsupervisie, deurdat dit 'n proses van selfontdekking is, 'n belangrike rol in die psigoterapeut se selfontwikkeling speel. Selfsupervisie plaas die klem op die psigoterapeut as persoon en as terapeut; oor wie hy is, waar hy vandaan kom en waarheen hy binne die psigoterapeutiese proses op pad is. Vir enige psigoterapeut is dit belangrik om na 'n hoer vlak van psigoterapie te streef. Hierdie strewe impliseer 'n proses van selfondersoek, delwing, selfevaluasie en disseksie. Hierdie proses is aan die hand van dagboekinskrywings gedoen, waar die psigoterapeut sy daaglikse ervarings en gebeurtenisse vanuit die verlede interpreteer het. Dit plaas die psigoterapeut as hoofspeler, met sy familiegeskiedenis en huidige interpersoonlike opset as inherente deel van sy mondering, op die voorgrond. In hierdie proses word die psigoterapeut sentraal geplaas met die klem op eie verantwoordelikheid met betrekking tot die proses van selfsupervisie. Die probleme wat deur hierdie persoonlik gekleurde, wetenskaplike studie aangespreek word, is probleme wat die psigoterapeut deur middel van sy selfsupervisie ge1dentifiseer het. So 'n selfondersoek lei tot 'n diepere selfkennis wat die psigoterapeut tot voordeel van homself, sy gesinsisteem en klientsisteem kan gebruik. Hierdie studie is 'n poging om 'n nuwe wyse van navorsing te identifiseer. Dit is omvattend en lei tot persoonlike vervulling asook diepere selfkennis en is 'n man waardeur ander psigoterapeute ook hulself en hul werelde kan ontdek. Dit is 'n stadige en pynlike proses. Hoofstukke 1 tot 4 is die teoretiese, wetenskaplike beredenering van die studie en hoofstukke 5 tot 12 is 'n uitbeelding van die geskiedenis van die psigoterapeut. Hoofstuk 13 plaas selfsupervisie as selfevalueringsmetode binne die psigoterapeutiese beroep. / The object of this study somewhat unusual. The study is an autobiography based on the assumption that there exists an unique patterned connection between the psychotherapist, his history, science (ethnography and second-order cybernetics), and his clients. Due to distance or financial problems, a rural psychotherapist cannot experience the privilege of supervision with an external supervisor. In such a situation selfsupervision could play an important role in the self-development, because it includes a search of self that will lead to more effectiveness in psychotherapy. Self-supervision focuses on the psychotherapist as a person and therapist, who he is, where he comes from, and in what direction he, as a psychotherapist, is developing within the psychotherapeutic process. It is important to any psychotherapist to strive towards a higher level of psychotherapy. This implies a process of selfinvestigation, dissection and self-evaluation. This process was conducted by means of diary entries in which the psychotherapist interpreted his daily experiences and events in terms of his past. This places the psychotherapist, with his family history and current interpersonal situation, as intrinsic parts of himself, in the foreground. In this process the psychotherapist takes centre stage with emphasis on his responsibility concerning the process of self-supervision. The problems addressed by this personally coloured, scientific study, are problems that the psychotherapist identified through the process of self-supervision and introspection. Such introspection leads to a deeper personal knowledge which the psychotherapist can use to his own benefit but also to the benefit of his family and client system. This study is an attempt to identify a new way of research. It is comprehensive and leads to personal fulfilment and deeper self-knowledge and is also a method by which other psychotherapists could discover themselves and their worlds. It is a slow and painful process. Chapters 1 to 4 comprise of the theoretical rationale of the study and chapters 5 to 12 depict the history of the psychotherapist. Chapter 13 situates self-supervision as a method of self-evaluation in the profession of psychotherapy. / Psychology / D. Litt. et Phil.

Text in Afrikaans / Die objek van studie in hierdie proefskrif is ietwat ongewoon. Die studie is outobiografies en is gegrond op die aanname dat daar tussen die psigoterapeut, sy geskiedenis, die wetenskap (etnografie en tweede-orde kubernetika) en die klient(e) 'n unieke patroonverband bestaan. Die psigoterapeut in die platteland het weens afstand of finansies nie altyd die voorreg om supervisie van 'n eksterne supervisor te ontvang nie. In so 'n situasie kan selfsupervisie, deurdat dit 'n proses van selfontdekking is, 'n belangrike rol in die psigoterapeut se selfontwikkeling speel. Selfsupervisie plaas die klem op die psigoterapeut as persoon en as terapeut; oor wie hy is, waar hy vandaan kom en waarheen hy binne die psigoterapeutiese proses op pad is. Vir enige psigoterapeut is dit belangrik om na 'n hoer vlak van psigoterapie te streef. Hierdie strewe impliseer 'n proses van selfondersoek, delwing, selfevaluasie en disseksie. Hierdie proses is aan die hand van dagboekinskrywings gedoen, waar die psigoterapeut sy daaglikse ervarings en gebeurtenisse vanuit die verlede interpreteer het. Dit plaas die psigoterapeut as hoofspeler, met sy familiegeskiedenis en huidige interpersoonlike opset as inherente deel van sy mondering, op die voorgrond. In hierdie proses word die psigoterapeut sentraal geplaas met die klem op eie verantwoordelikheid met betrekking tot die proses van selfsupervisie. Die probleme wat deur hierdie persoonlik gekleurde, wetenskaplike studie aangespreek word, is probleme wat die psigoterapeut deur middel van sy selfsupervisie ge1dentifiseer het. So 'n selfondersoek lei tot 'n diepere selfkennis wat die psigoterapeut tot voordeel van homself, sy gesinsisteem en klientsisteem kan gebruik. Hierdie studie is 'n poging om 'n nuwe wyse van navorsing te identifiseer. Dit is omvattend en lei tot persoonlike vervulling asook diepere selfkennis en is 'n man waardeur ander psigoterapeute ook hulself en hul werelde kan ontdek. Dit is 'n stadige en pynlike proses. Hoofstukke 1 tot 4 is die teoretiese, wetenskaplike beredenering van die studie en hoofstukke 5 tot 12 is 'n uitbeelding van die geskiedenis van die psigoterapeut. Hoofstuk 13 plaas selfsupervisie as selfevalueringsmetode binne die psigoterapeutiese beroep. / The object of this study somewhat unusual. The study is an autobiography based on the assumption that there exists an unique patterned connection between the psychotherapist, his history, science (ethnography and second-order cybernetics), and his clients. Due to distance or financial problems, a rural psychotherapist cannot experience the privilege of supervision with an external supervisor. In such a situation selfsupervision could play an important role in the self-development, because it includes a search of self that will lead to more effectiveness in psychotherapy. Self-supervision focuses on the psychotherapist as a person and therapist, who he is, where he comes from, and in what direction he, as a psychotherapist, is developing within the psychotherapeutic process. It is important to any psychotherapist to strive towards a higher level of psychotherapy. This implies a process of selfinvestigation, dissection and self-evaluation. This process was conducted by means of diary entries in which the psychotherapist interpreted his daily experiences and events in terms of his past. This places the psychotherapist, with his family history and current interpersonal situation, as intrinsic parts of himself, in the foreground. In this process the psychotherapist takes centre stage with emphasis on his responsibility concerning the process of self-supervision. The problems addressed by this personally coloured, scientific study, are problems that the psychotherapist identified through the process of self-supervision and introspection. Such introspection leads to a deeper personal knowledge which the psychotherapist can use to his own benefit but also to the benefit of his family and client system. This study is an attempt to identify a new way of research. It is comprehensive and leads to personal fulfilment and deeper self-knowledge and is also a method by which other psychotherapists could discover themselves and their worlds. It is a slow and painful process. Chapters 1 to 4 comprise of the theoretical rationale of the study and chapters 5 to 12 depict the history of the psychotherapist. Chapter 13 situates self-supervision as a method of self-evaluation in the profession of psychotherapy. / Psychology / D. Litt. et Phil.