Thesis (Ph. D.)--University of Hong Kong, 2006. / Also available online.

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Stroke är en av de tre sjukdomar som årligen skördar flest antal vuxna liv – endast hjärtsjukdomar och cancer dödar fler. Bara i Sverige drabbas cirka 20 000 personer per år. Av dessa 20 000 Personer, räddas förstås många till livet. Sjukdomen är dock sällan komplikationsfri utan leder oftast till en rad konsekvenser, vilka i sin tur kan vara bestående såväl som temporära. Att insjukna i en stroke är en omvittnat obehaglig upplevelse – inte bara för de drabbade själva utan även för deras närmast anhöriga. De fysiska skador som ofta blir följd av en stroke, är oftast lätta att upptäcka. Något annat som inte är lika uppenbart, är den upplevelse av försämrad livskvalitet, som många patienter upplever till följd av att ha drabbats av en stroke. Syftet med denna studie har varit att beskriva hur patienter som har drabbats av stroke upplever sin livskvalitet utifrån tre perspektiv; fysiskt, psykiskt, samt socialt.  Underlaget till denna studie kommer från olika databaserna Medline, PubMed och Academic Search Elite. Genom att använda relevanta sökord på engelska så påträffades de artiklar som sedan använts i studien. Totalt har 17 artiklar granskats för att besvara studiens frågeställning. Artiklarnas relevans för studien varierade. Tillsammans bidrog dock alla 17 separata artiklar till förståelsen av problemställningen. Resultatet av undersökningen visade att personer med stroke upplever förändringar i sin livskvalitet när det gäller den psykiska, fysiska samt det sociala perspektivet. De försämringar som äger rum i samtliga perspektiv kan avvärjas med hjälp av bättre kommunikation mellan patient och vårdpersonal samt mellan anhöriga och vårdpersonal. En försämring av det ena perspektivet, innebär alltså även att de andra två perspektiven löper en överhängande risk att försämras.     Nyckelord: stroke, livskvalitet, omvårdnad / Stroke is one of the third most common diseases among adults today. Only in Sweden there’s approximately 20 000 persons that get diagnosed with stroke. Those who survive stroke have to live with the consequences, permanent as well as temporary. To suffer from stroke is an unpleasant experience, not only for those who suffer stroke, but also for their family and relatives. Apart from the psychical damages that arise from stroke, the patients also experience variation in their quality of life.   The aim of this study is to describe how stroke patients experience their own quality of life from a physical, mental and social point of view. The basic data which is the foundation for this study were found in the databases Medline, PubMed and Academic Search Elite. The searches were made with simple keywords to find the relevant articles. In total, 17 articles were reviewed in order to answer the question of the study. Although the relevance of the articles were varying, they all had in common that they contributed to an understanding for this study. The result of this study shows that people who suffer from stroke experiences have changes in their quality of life when it comes to the mental, physical and the social sphere. The decreases in their quality of life, no matter which sphere, can improve with better communication between patient and caregivers and to relatives and caregivers. Nevertheless, the different spheres are linked each other, and a decrease in quality of life in one sphere, often affects another.       Keywords: Stroke, quality of life, nursing

Abstract Aim: The aim of this study was to describe cancer patients’ experiences of quality of life and wellbeing in relation to yoga practice. Method: A descriptive qualitative study with semi structured interviews was carried out during the fall of 2009 at the University of Uppsala. Informants in the study were cancer patients who were participating in the yoga/psychotherapy group at the clinic of oncology at the Akademiska hospital in Uppsala. Result: Five out of six informants experienced that their quality of life and their wellbeing improved by practicing yoga. One informant had mixed feelings which were not due to the yoga practicing, but to the place where it was practiced. For her this place was associated with illness. Informants accentuated the importance of the fellowship in the yoga/psychotherapy group. They experienced that yoga practicing could not be separated from psychotherapy and vice versa. Informants believed that yoga and psychotherapy reinforced each other’s effect. The study showed that the yoga exercises had been of great help, for example, in connection with medical examinations or as a tool to cope with one’s situation, thoughts and/or secondary effects of the disease and pain experience. The yoga had strengthened the informants both physically, psychologically and spiritually. It helped them to cope with sleeping difficulties and respiratory difficulties. The study also shed light on two aspects previously not included in yoga research: respiratory difficulties and sexuality. Conclusion: The study displayed that the informants experienced that yoga had a positive effect on their quality of life and wellbeing. Further studies are suggested (qualitative and quantitative) that examine the joint influence of yoga/psychotherapy on the quality of life and wellbeing as well as the aspects “Breathing difficulties” and “Sexuality”.          Keywords: Yoga, cancer, quality of life, wellbeing

Högskolestudenters upplevda livskvalitet har varit ett eftersatt forskningsområde. Syftet med denna studie var att undersöka hur studenter på grund- respektive forskarutbildningen vid Stockholms universitet upplevde sin livskvalitet och jämföra resultaten med tidigare insamlade data från en normalgrupp. För att mäta den upplevda livskvaliteten användes formuläret Quality of life inventory, QOLI. Totalt inkom 1300 enkäter från studenter på grundutbildningen och 115 enkäter från studenter på forskarutbildningen. Resultaten visar att både studenter på grund- respektive forskarutbildningen skattar sin upplevda livskvalitet som signifikant lägre än normalgruppen. Vidare framkom att kvinnor skattar sin livskvalitet som högre än män och att gifta och samboende skattar sin livskvalitet som högre än ogifta. Resultaten överrensstämmer med den forskning som tidigare genomförts för högskolestudenters subjektivt upplevda livskvalitet.

The aim of this study was to describe how adolescents experiences their quality of life, and to compare if there are any differences in how they experiences their QOL depending on where they live, big town or smaller town. The aim was also to examine how adolescents experienced their schooling. The study is empirically, quantitative with a descriptive and comparative design. To measure quality of life a tried and tested instrument – Life Satisfaction Questionnaire (LSQ) was used. The questionnaire was distributed and collected by the authors.142 students participated, 79 from the larger city and 63 from the smaller city. The results of this study showed that adolescents, 16-19 years, rated their overall QOL as high and that there were no significant differences between the cities regarding on how the adolescents experienced their overall QOL. There were significant differences in some of the sub factors. There were significant differences in the factors ”physical symptoms”, influence of illness” and “Experience of every day meaningful activities”. Adolescents from the larger city experienced higher levels of meaningful activities, and adolescents in the smaller city experienced less physical symptoms and influence of illness. The results also showed that the adolescents rated their ability to manage their studies as high, and that there were few that felt depressed or/and bullied. The adolescents in this study felt that their schooling was represented of both a positive and a negative adjective. Funny and instructive recurred frequently, but also tough occurred often.

The medical management of ulcerative colitis in children often requires aggressive pharmacological therapy or colonic resection. We hypothesized that synbiotic therapy, consisting of <i>B. longum</i> R0175 and inulin would improve symptoms and quality of life (QOL) in children diagnosed with ulcerative colitis. Consenting pediatric subjects (8-18 years; n = 9) with ulcerative colitis in remission were provided synbiotic therapy, (Probiotic: <i>Bifidobacterium longum</i> R0175 2.0 x 1010 cfu/day; Prebiotic: 15 g/day of inulin) (n = 4) or placebo (maltodextrin + ascorbic acid capsule; 15 g/day of non-resistant maltodextrin) (n = 5) for ten months in a pilot study (Phase I). After ten months, the study was unblinded and synbiotic therapy was administered to eight pediatric subjects (Phase II). In attempt to increase sample size, three adult subjects with active UC were recruited and provided the synbiotic therapy (Phase III). In all phases of the research, QOL was measured using the Short Inflammatory Bowel Disease Questionnaire (SIBDQ). The SIBDQ was administered at baseline and every two months. Subjects kept a daily records of symptoms (stool consistency and frequency, presence of blood and mucous, presence of abdominal pain and overall feeling). Phase I QOL scores were significantly better for those receiving the synbiotic therapy versus the placebo (p = 0.014). Severe symptoms occurred in 60% of the control subjects, where as subjects receiving synbiotic therapy did not experience severe symptoms (p = 0.032). Phase II QOL scores were significantly better post-treatment with synbiotic therapy (p=0.034). One subject (steroid dependant) was able to wean off Prednisone® while receiving the synbiotic therapy; she remained in remission and was symptom free for over 26 months. In Phase III, synbiotic therapy did not induce remission in the adult subjects with active UC. No adverse effects were reported.<p>Synbiotic therapy consisting of <i>Bifidobacterium longum</i> R0175 and inulin, when provided in addition to conventional treatment, appears to be a safe and effective strategy for managing pediatric ulcerative colitis in remission.Further clinical trials are warranted to confirm these preliminary results.

The increase in the academic literature concerning the potential impacts that urban park systems can have over the life course of urban residents is beginning to be recognized by professionals in the fields of community quality of life studies, population health and in health geography. Typically urban spaces within Canada are designed to include a component of open space which can facilitate the recreation needs of residents. Within the City of Saskatoon neighbourhoods have such spaces in the form of neighbourhood parks, which are meant to facilitate passive or active recreation. Parks also provide open spaces of vegetation cover as opposed to the concrete and structural components of the city. Parks are meant to positively contribute to the residents lives and to the neighbourhood in which they are located. <p>In community quality of life studies, open spaces, such as parks along with other neighbourhood attributes, are often used to gauge residents perceptions of their immediate surroundings. The Saskatoon Quality of Life Project conducted by the Quality of Life Module at the Community-University Institute for Social Research (CUISR) conducted such a study in 2004 in which park spaces were related alongside other neighbourhood features such as transportation and social activities in order to capture residents perceptions of their community quality of life. <p>The purpose of this study is to look at how residents of differing socio-economic status (SES) neighbourhoods (one high SES and one low SES) perceive their neighbourhood park spaces and if their perceptions affect their perceived quality of life. In order to capture residents perceptions of their neighbourhood parks, face-to-face interviews were conducted with residents. In addition to the resident interviews, interviews were conducted with key informants as well as statistical analysis of secondary data from the 2004 Saskatoon Quality of Life Project was carried out. Results showed residents of different neighbourhood SES status shared common perceptions of their park spaces as well as how neighbourhood parks contributed to their quality of life.

Standard models in urban economics assume that the boundary of an urban area will expand as long as the present value of land for urban uses is greater than the present value of land for rural uses. Under this assumption, the boundary of the urban area is endogenously determined by the rent paid to rural landowners. But this assumption is not realistic. The physical expansion of many major urban areas in the United States is impeded by an exogenous boundary. For example, geographic growth of the three most populated metropolitan areas in the country is limited by an ocean or a Great Lake. In this thesis, we argue that such exogenous boundaries affect land prices throughout the urban area because inter-city migration is costly and these boundaries effectively constrain the supply of land. Specifically, we develop a theoretical model in support of this conclusion and show that prices are highest in cities with the most restrictive exogenous boundaries, ceteris paribus. This argument implies that researchers who do not control for exogenous boundaries could be introducing a systematic bias in their findings if they use land prices or rents to measure the value of public amenities in urban areas or the relative desirability of different cities.

Graduation date: 1993