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Background: Cancer is a collective name for many different diseases and occurs when the balance in a cell is disturbed and transforms into a tumor cell. Cancer is one of the leading causes of death worldwide. Suffering from cancer affects a person physically and psychologically, and surviving cancer can be just as wearing.  Aim: The purpose of the study was to describe people's experiences of surviving a cancer disease. Method: A literature study was used as a method. 12 articles were selected for the result. The articles were found in the databases Cinahl and PsycInfo. Results: The result gave rise to three main themes: "Loss of trust in healthcare", "Living with consequences" and "Feelings about the future". With seven associated subthemes: "Not getting information", "Feeling forgotten", “Lack of identity”, “Strategies for change”, “Having someone to talk to”, "Not feeling safe'' and “Daring to dream”. The results show how complicated the aftercare of cancer can be, both for healthcare professionals but not least for cancer survivors. Experiences of having survived cancer differed depending on the support network around. Conclusion: The results of the study showed that the healthcare system is lacking in several aspects when it comes to aftercare for cancer survivors. Where the healthcare system failed, there were family, friends and people with similar experiences as support. Fear of relapse, fear of dying and anxiety were leading emotions in the study's results.

Objective: The multidisciplinary follow-up of patients with cleft lip with or without palate (CL/P) is organized differently in specialized centers worldwide. The aim of this study was to evaluate the different treatment needs of patients with different manifestations of CL/P and to potentially adapt the frequency and timing of checkup examinations accordingly. Design:We retrospectively analyzed the data of all patients attending the CL/P consultation hour at a tertiary care center between June 2005 and August 2020 (n=1126). We defined 3 groups of cleft entities: (1) isolated clefts of lip or lip and alveolus (CL/A), (2) isolated clefts of the hard and/or soft palate, and (3) complete clefts of lip, alveolus and palate (CLP). Timing and type of therapy recommendations given by the specialists of different disciplines were analyzed for statistical differences. Results: Patients with CLP made up the largest group (n=537), followed by patients with cleft of the soft palate (n=371) and CL ±A (n=218). There were significant differences between the groups with regard to type and frequency of treatment recommendations. A therapy was recommended in a high proportion of examinations in all groups at all ages. Conclusion: Although there are differences between cleft entities, the treatment need of patients with orofacial clefts is generally high during the growth period. Patients with CL/A showed a similarly high treatment demand and should be monitored closely. A close follow-up for patients with diagnosis of CL/P is crucial and measures should be taken to increase participation in followup appointments.

学位プログラム名: 京都大学大学院思修館 / 京都大学 / 0048 / 新制・課程博士 / 博士(総合学術) / 甲第21933号 / 総総博第8号 / 新制||総総||1(附属図書館) / 京都大学大学院総合生存学館総合生存学専攻 / (主査)教授 積山 薫, 教授 杉本 均, 教授 山口 栄一 / 学位規則第4条第1項該当 / Doctor of Philosophy / Kyoto University / DGAM

The purpose of this study is to contribute to an increased understanding of how preschool teachers work with reading aloud in preschool and what they think about reading aloud as a way of working for children's language development. To investigate this and to gather empirical evidence, we have used qualitative interviews where we interviewed ten working preschool teachers. The collected empirical evidence is processed through a thematic analysis. The investigation takes the socio-cultural theory as a point of departure, where we analyze the results based on theoretical concepts. The theoretical concepts have given us an increased understanding of the results that we have obtained. The results of this study show that reading aloud is used frequently, both spontaneously and planned in the preschool’s activities. The preschool teachers repeatedly mention in our interviews that reading aloud is a central part of the activities. The reading aloud is further described as something that can be used as a starting point for several different follow-up works. Furthermore, reading aloud is described as developing on several levels, not at least as language development. The conclusion made in this study is that reading aloud is a central part of the preschool’s activities. The reading aloud takes place both spontaneously and planned, and in this study we have been able to see how the preschool teachers continue to work with the reading aloud. / Syftet med undersökningen är att den ska bidra till en ökad förståelse för hurförskollärare arbetar med högläsning i förskolan och vad de anser omhögläsningen som ett arbetssätt för barns språkutveckling. För att undersökadetta och samla in empiri har vi använt oss av kvalitativa intervjuer där viintervjuade tio verksamma förskollärare. Den insamlade empirin bearbetasgenom en tematisk analys. Undersökningen tar utgångspunkt i densociokulturella teorin där vi utifrån teoretiska begrepp analyserar resultaten.De teoretiska begreppen har gett oss en ökad förståelse för de resultat som vifått. Resultatet av undersökningen visar att högläsning används frekvent, bådespontant och planerat i förskolans verksamhet. Förskollärarna nämneråterkommande i våra intervjuer att högläsningen är en central del iverksamheten. Högläsningen beskrivs vidare som något som kan användassom en utgångspunkt till flera olika uppföljningsarbeten. Högläsningenbeskrivs ytterligare som utvecklande på flera plan, inte minst somspråkutvecklande.Slutsatsen som görs i denna undersökning är att högläsning är en central del iförskolans verksamhet. Högläsningen sker både spontant och planerat och vihar i denna undersökning fått ta del av hur förskollärarna arbetar vidare medhögläsningen.

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Introduction Asthma is a common and heterogeneous disease in primary care. Asthma phenotypes are recognisable clusters of for example clinical characteristics. Current asthma symptoms and previous exacerbations are used to assess the level of asthma control. Asthma control is used clinically to plan follow-up strategies. Aim The aim of this study is to examine if an data-driven algorithm based on sex and age of onset can categorize an asthma population at a primary care center into three phenotypes with different risk of disease. To investigate if the results can be generalized by comparing to an epidemiological survey in Sweden. Secondary aims are to investigate if these phenotypes predict the level of follow-up and which factors influence asthma control. Methods In this cross-sectional study, 335 participants from one primary care site and 1442 participants from an epidemiological study were compared on sex, age, medical treatment, respiratory allergy, smoking, asthma symptoms and exacerbations. Logistic regression analyses focusing on factors affecting asthma control were performed in a consolidated dataset. Results An adult asthma population can easily be categorized according to the data-driven algorithm. However, these phenotypes do not predict follow-up strategies. Clinical follow-up based on level of asthma control, did not differ between the phenotypes. There were statistically significant differences between the phenotypes regarding respiratory allergy and smoking. In the logistic regression, smoking has the highest odds for poor asthma control. Conclusion The clinical use of the data-driven phenotypes were limited. Follow-up strategies are probably best based on traditional clinical outcomes like asthma control.

Syftet med studien var att undersöka patientupplevelsen vid behandling med sömnapnéskena hos patienter med diagnosen obstruktiv sömnapné utförda i allmän tandvårdspraxis. Studien genomfördes som en tvärsnittsundersökning i en av de större regionerna i Sverige, region Skåne. Undersökningen var retrospektiv i sin design och bestod av en enkät sänd till de patienter med en verifierad obstruktiv sömnapné som fått sin odontologiska behandling som ett led i sjukdomsbehandling. Behandlingen skulle ha pågått minst 6 månader. Enkäten skickades ut till 1148 patienter, varav 738 svarade (64 %). Enkäten bestod av 70 frågor och påståenden inom olika domäner som: allmänhälsa/livsstil, användning av sömnapnéskena, symtomförändringar, sömnrelaterade upplevelseförändringar, vårdbemötande, utvärdering av behandling, värde av behandling, förändringar i livssituation och dagsömnighet.Behandling med sömnapnéskena gav symtomlindring vid obstruktiv sömnapné för majoriteten av patienterna. Livskvalitet, somatiska och kognitiva symtom förändrades signifikant positivt för patienterna som använde sin behandling frekvent. Dagtröttheten reducerades för majoriteten av de behandlade patienterna. Nöjdhet med behandlingen och att rekommendera liknande behandling för en vän var hög.Behandling av obstruktiv sömnapné med intra-oral apparatur utförd i allmän praxis lindrade tillståndet och dess konsekvenser enligt patientens egenbedömning. / The purpose of this study was to investigate the patient’s experiences in treatment of obstructive sleep apnoea with a mandibular advancement oral appliance conducted in general dental practice. The study was conducted to study a cross-section of patients in one of the major regions of Sweden, region Scania. The study was retrospective in its design and consisted of a postal questionnaire to 1148 patients with a treatment period of more than 6 months. The questionnaire comprised 70 questions and assertions in various domains: general health/ lifestyle, use of oral appliance, changes in symptoms, sleep-related experience changes, evaluation of treatment, value of treatment, changes in life situation and daytime sleepiness. The responder rate was 64%. Treatment with oral appliance gave relief of symptoms in the majority of patients with obstructive sleep apnoea. Quality of life, somatic and cognitive symptoms changed significant positively in patients who used the treatment frequent. The daytime sleepiness was reduced for the majority of the treated patients. The satisfaction with the treatment and the will to recommend a similar treatment for a friend was high. Treatment of obstructive sleep apnoea with an oral appliance performed in general dental practice relieved the condition and its consequences according to the patient's own judgement.

Childhood anxiety disorders are often considered gateway disorders: having an anxiety disorder in youth is associated with a higher likelihood of developing a related psychological disorder in adulthood. Successfully treating youth with anxiety disorders may reduce the likelihood of subsequent anxiety, depressive, and substance use disorders later in life. This study evaluates follow-up outcomes associated with treatment for childhood anxiety by comparing successfully and unsuccessfully treated participants 16 years after the completion of treatment. A sample of 66 youth (ages 7 to 14 at time of initial study treatment, ages 18 to 32 at present follow-up) who had been diagnosed with an anxiety disorder and randomized to treatment in a randomized clinical trial on average 16.24 (SD = 3.56) years prior participated in the present follow-up evaluation that included self-report measures and a diagnostic interview conducted to assess anxiety, depression, and substance misuse. Results indicate that, relative to those who respond successfully to CBT intervention for an anxiety disorder in childhood, those who were less responsive to CBT for childhood anxiety had higher rates of panic disorder, alcohol dependence, and drug abuse in adulthood. The present study is the first to assess the 16-year follow-up effects of CBT treatment for an anxiety disorder in youth on anxiety, depression, and substance abuse through the period of young adulthood when these disorders are often seen. / Psychology