Bakgrund: Urinblåsecancer finns i olika former och vid muskelinvasiv cancer är radikal operation den vanligaste behandlingen. Förutsatt att cancern inte spridit sig, då görs en cystektomi. Många människor har en naturlig förmåga att hantera kriser och skapar ny balans i tillvaron efter en påfrestande händelse i livet. Sjuksköterskan kan ge råd och stöd i situationen och bör då ha kunskap om förändringar i personens fysiska och psykiska tillstånd. Syfte: Syftet var att belysa hur personer som genomgått cystektomi på grund av urinblåsecancer upplevde att det dagliga livet påverkades. Metod: En litteraturstudie har gjorts där 15 vetenskapliga artiklar har granskats. Resultat: Personerna drabbades av olika problem efter cystektomin. Urinproblem, buk- och avföringsproblem och livsförändring var tydliga, men även problem med en förändrad kroppsuppfattning och problem med det sociala stödet kom fram. Slutsats: Det är olika faktorer som påverkar det dagliga livet efter en cystektomi. Kunskap i hur personerna kan reagera är viktig för sjuksköterskan, för att kunna bemöta problemen och ge råd och stöd om olika copingstrategier för att hantera situationen. Då kan individuell omvårdnad ges, utifrån varje persons behov. / Background: Bladder cancer exists in different forms and in muscle invasive cancer, radical surgery is the standard treatment. Assuming that the cancer has not spread, then, a cystectomy is done. Many people have a natural ability to handle crises and generate a new personal balance. A nurse can offer advice and support in the situation and should have knowledge of changes in the person's physical and mental condition. Aim: The aim was to illustrate how people who have undergone cystectomy because of bladder cancer felt that their daily lives were affected. Methods: A literature review has been done where 15 scientific papers have been reviewed. Results: The subjects suffered from various problems after cystectomy. Urinary Problems, abdominal and stool problems, and change in life were common, but also problems with an altered body image and problems with social support occurred. Conclusion: There are different factors that affect the daily lives after a cystectomy. Knowledge of how people might react is important for nurses, in order to address the problems and provide advice and support on various coping strategies to deal with the situation. When that is the case, individual care can be given, based on each person's needs.

No description available.

The purpose of this study was to describe experiences in daily social life of parents of children with psychotic illness. Five parents with long-term experience of psychotic illness have been interviewed. The frame of reference in emotion theories of Thomas Scheff and Randall Collins have been used to analyze the results. The study is qualitative and has a phenomenological approach to shed lights of meanings in daily social life. The following meanings was found: Openness with certain reservation shows that honesty is important for the feeling of solidarity, Social expectations in daily life describes the parents´own expectations as well as expectations from others. In The important confirmation the findings show that the parents´need understanding for the family situation, and the findings also show the importance of support for the family and the acceptance of the psychotic illness.

University of Macau / Faculty of Social Sciences and Humanities / Department of English

Rising obesity rates and low physical activity levels among children and youth are a global concern due to links to adverse health outcomes, poor quality of life, and an increased burden on the health care system. One response to the problem has been the implementation of school-based physical activity and nutrition policies. For example, the Ontario Ministry of Education’s Daily Physical Activity (DPA) Policy mandates that all elementary school students receive at least 20 minutes of physical activity per day. This exploratory research sought to understand the local-level factors shaping implementation of DPA, from the perspective of elementary school teachers and principals. Qualitative in-depth interviews were conducted with Ontario grade 1-8 teachers (n=14) and elementary school principals (n=5) regarding DPA implementation, facilitators, barriers, perceived outcomes, and suggestions for change. Interviews were audio recorded (with permission) and transcribed verbatim for subsequent thematic analysis using NVivo. Although all but two participants indicated they had implemented DPA, the majority reported that students were not meeting the requirement daily. Findings were organized using the Analysis Grid for Environments Linked to Obesity (ANGELO) framework. Implementation facilitators were focused within the microenvironment (i.e., classrooms and schools), while barriers were identified within both the micro- and macroenvironments (i.e., classrooms, schools, school boards, and the Ministry of Education). Both teachers and principals considered DPA a lower priority than other subjects, partly because of limited monitoring of implementation within schools and school boards. Participants discussed student benefits resulting from DPA; however, student fitness was not identified as a positive outcome- in fact, some questioned whether the policy is improving student physical activity levels. The results suggest the status of DPA results from a failure of implementation rather than a failure of concept. Participants believed increasing student physical activity levels was important; however, they argued that factors within the classroom, school, school board, and Ministry of Education limit the feasibility of delivering DPA. This thesis contributes to the limited literature regarding the evaluation of DPA implementation and outcomes by exploring the perspectives of teachers and principals implementing the policy. Substantive, methodological, and theoretical contributions to the school-based physical activity literature are discussed, followed by policy implications and directions for future research.

The aim of this thesis was to describe the medical, cognitive and psychosocial consequences of epilepsy in young adulthood. Four studies were carried out with this patient group. The first two papers were based on a follow-up study regarding young adults with epilepsy that investigated medical and psychosocial aspects and compared the present results with those five years earlier. We then conducted focus group interviews with young adults with epilepsy and subjective cognitive decline to assess the deeper meaning of living with epilepsy accompanied by cognitive difficulties. In the fourth study we studied cognitive dysfunction further, choosing the language function in young adults with epilepsy. We firstly examined whether language impairments were associated to functional brain alterations and secondly related the language performance to demographics, clinical data, Quality of Life (QoL) and self-esteem. The five-year follow up of 97 young adults with uncomplicated epilepsy revealed no improvement regarding seizure frequency or side effects from anti-epileptic drugs (AEDs) over time, even though many new-generation AEDs had been established during this period. During the study period 21% had recovered from epilepsy, Seizure frequency among those who still had epilepsy had not improved, and 42% had experienced seizures during the past year. New-generation anti-epileptic drugs (AEDs) had been introduced to PWE, especially to women. There is still need for new and more effective treatment options for this group in the future. It is essential to find alternative approaches to develop better treatment options for this group in the future. However QoL was normal compared to the general population, indicating that new options regarding treatment can have made an impact. Lower QoL was correlated to high seizure frequency and to cognitive side effects. Self-esteem and Sence of Coherence were impaired compared to the situation at adolescence. Self-esteem was correlated to seizure frequency and to side-effects of antiepileptic drugs. Sence of Coherence was not correlated to epilepsy-related factors in the same way as QoL, but mirrored the phenomenon of epilepsy. The qualitative study showed that the consequences of epilepsy are not only restricted to the consequences of seizures, but also concerns many other aspects of life. The interviews revealed four themes: “affecting the whole person“, “influencing daily life”, ”affecting relations” and ”meeting ignorance in society”. Another important factor was language function; when one loses some language ability, this gives a feeling of losing one’s capability. The fourth study examined language by neuropsychological methods and correlated this function to brain activation measured by fMRI. Language functions measured in verbal fluency and abstract language comprehension were impaired in participants with both generalized epilepsy and epilepsy of focal onset. Age at onset of epilepsy and education are the most important factors correlating to language function. An additional factor that impacts abstract language comprehension is the frequency of convulsive seizures, while use of topiramate /zonisamide affect verbal fluency negatively. QoL was not correlated to language impairments, but for patients with focal onset seizures there was a correlation between self-esteem and abstract language comprehension. The fMRI investigation revealed altered activity during language tasks in participants with epilepsy compared to controls. In epilepsy with focal seizures originating in the left hemisphere, we found increased bilateral activation of supporting areas, in the anterior mid-cingulate cortex and the anterior ventral insulae, indicating a compensational functional reorganization. In generalized epilepsy, the functional language network showed an imbalance, as this group expressed an inadequate suppression of activation in the anterior temporal lobe during semantic processing. Subtle language impairment can, even if it does not occur in everyday dialogue, be of importance and have consequences for the person affected. The negative consequences of language decline must be addressed in people with epilepsy of different etiology. Young adults with epilepsy are still substantially affected by the condition. The consequences are not only restricted to the seizures, but concern many aspects of life and there is a great need for new treatment options for this group in the future.

This study investigates the risk of arsenic (As) exposure from staple diet to the communities in rural Bengal, even when they have been supplied with As safe drinking water. The results indicate that average accumulation of As in rice grain increases with decrease of grain size [extra-long slender (ELS): 0.04 mg kg-1; long slender (LS): 0.10 mg kg-1; medium slender (MS): 0.16 mg kg-1 and short bold (SB): 0.33 mg kg-1], however people living in the rural villages mostly prefer brown colored SB type of rice because of its lower cost. Among the vegetables generally consumed in rural villages, the accumulation of As is highest in the leafy type of vegetables (0.21 mg kg-1), compared to non-leafy (0.07 mg kg-1) and root  vegetables (0.10 mg kg-1). Arsenic predominantly accumulates in rice (&gt;90%) and vegetables (almost 100%) in inorganic species [As(III &amp; V)]. The estimates of exposure via dietary and drinking water routes show that when people are consuming water with As concentration &lt;10 μg L-1, the total daily intake of inorganic As (TDI-iAs) exceeds the previous provisional tolerable daily intake (PTDI) value of 2.1 μg day-1 kg-1 BW, recommended by World Health Organization (WHO) in 35% of the cases due to consumption of rice. Considerably high concentration of As in urine and saliva despite drinking of As safe water (&lt;10 μg L-1) further supports that dietary intake of As, mainly through consumption of rice could be alternative pathway of As exposure among the population. When the level of As concentration in drinking water is above 10 μg L-1, the TDI-iAs exceeds the previous  PTDI for all the participants. These results imply that when rice consumption is a significant contributor to the TDI-iAs, supplying water with As concentration at current national drinking water standard for India and Bangladesh (50 μg L-1) would place many people above the safety threshold of PTDI. When As concentration in drinking water exceeds 50 μg L-1 As exposure through drinking water largely predominates over the exposure through dietary intake. It is found that the consumption of vegetables in rural Bengal does not pose  significant health threat to the population independently. It is also revealed that cooking of rice with high volume of As safe (&lt;10 μg L-1) water can decrease both total and inorganic As content in cooked rice. However, the assessment of As exposure risk indicates that despite such lowering in As concentrations, still consumption of cooked rice is a significant pathway of As exposure to the population in rural Bengal. This study suggests that any effort to mitigate the As exposure of the villagers in Bengal must consider the risk of As exposure from rice consumption together with drinking water. / <p>QC 20130919</p> / EAECA-EURINDIA 2009-1665

Detta examensarbete är en studie om matematik i vardagssituationer i en svensk förskola. Syftet med min studie var att undersöka vilken matematik som uppstår i av- och påklädningssituationer. Ytterligare ville jag ta reda på hur pedagoger arbetar för att lyfta fram och stimulera barnen för att upptäcka matematiken i dessa situationer. Jag har valt att göra en kvalitativ studie. I den empiriska undersökningen använder jag ostrukturerade observationer av pedagoger tillsammans med barnen i tamburen, som kompletteras med löpande protokoll. De kvalitativa intervjuerna med pedagogerna, som var inblandade i undersökningen, användes för att styrka det som observationerna visade. Resultaten visar att en del pedagoger använde av- och påklädningssituationerna för att synliggöra matematiska begrepp. I samtal med barnen utryckte de sig medvetet på ett matematiskt språk och förklarade begrepp för barnen i de situationer det behövdes.

Syfte: Litteraturstudiens syfte var att beskriva upplevelsen av MS-relaterad fatigue, hur den påverkade vardagen och val av egenvårdsstrategier. Metod: Beskrivande litteraturstudie. Resultatdelen innehåller 15 st vetenskapliga artiklar, varav 8 st har en kvantitativ ansats, 5 st har en kvalitativ ansats och 2 st har båda ansatserna. Artiklarna söktes i databaserna PubMed och Cinahl och genom manuell sökning. Resultat: MS-relaterad fatigue var en unik och individuell upplevelse. Fatigue hade en multidimensionell och handikappande inverkan på vardagen, som berörde såväl fysiska, psykiska, sociala och kognitiva aspekter. Personer med MS hade utvecklat olika egenvårdsstragier för att minska, förebygga och dölja konsekvenserna av fatigue. Tre av artiklarna saknade en tillräcklig beskrivning av inklusions- och exklusionkriterier. Fyra artiklar saknade en adekvat beskrivning av bortfall.  Slutsats: MS-relaterad fatigue bidrog till en försämring av fysiska, psykiska, sociala och kognitiva funktioner och stod i direkt relation till sämre livskvalitet. Befintliga egenvårdsstrategier kunde beskrivas utgå ifrån två olika teman: lindra och dölja konsekvenserna av fatigue. Levines bevarandemodell gav en omvårdnadsteoretisk förståelse av MS-relaterad fatigue som saknades i tidigare forskning. / Aim: The aim of this study was to describe the experience of MS-related fatigue, how it affected daily-living and different self-care strategies. Method: Descriptive literature study. The study contains 15 scientific papers, 8 had a quantitative approach, 5 had a qualitative approach and 2 included both approaches. The articles were found by using PubMed and Cinahl and by manual search. Results: MS-related fatigue was a unique and individual experience. Fatigue had a multidimensional and disabling impact on everyday life involving physical, psychological, social and cognitive aspects. People with MS had developed various self-care strategies to reduce, prevent and hide the effects of fatigue. Three of the articles lacked a sufficient description of inclusion and exclusion criteria. Four articles lacked an adequate description of the discontinuity of participation. Conclusion: MS-related fatigue contributed to a deterioration of the physical, psychological, social and cognitive functions and was directly related to lower quality of life. Existing self-care strategies could be described in two themes: to ease and hide the effects of fatigue. Levine's conservation model yielded a theoretical understanding of MS-related fatigue. Previous research did not incorporate a nursing theoretical understanding of MS-related fatigue.

Fatigue är ett vanligt förekommande symtom vid multipel skleros (MS). Denna ihållande och svåra trötthet beskrivs ofta som det svåraste MS-relaterade symtomet att hantera. Symtomet har en negativ påverkan på individens funktionella status samt på livskvaliteten. Syftet med litteraturstudien var att belysa upplevelserna av MS-relaterad fatigue samt hur symtomet påverkar det dagliga livet. Som metod användes en systematisk genomgång av tidigare forskning med en induktiv ansats. Forskning visar att fatigue upplevs som en oavbruten förlamande effekt som uppfattas skilja sig mycket från tidigare upplevd trötthet. Fatigue påverkar hela kroppen och leder till att kroppen blir svårare att styra och hantera. Den begränsade förmågan att utföra önskade aktiviteter påverkar individernas liv negativt. Individer med MS blir tvungna att reglera och planera sitt dagliga liv för att undvika och minska graden av fatigue. En bibehållen självkänsla samt en positiv attityd och en acceptans för sjukdomen och symtomet upplevs minska graden av fatigue. Kommande forskning bör fokusera på individanpassade metoder eller strategier som upplevs minska graden av fatigue.