Background: Cancer-related pain is a major problem worldwide. Studies indicate that patients do not get an adequate pain relief. This creates a large suffering and results in major problems for the patient and their families. In order to minimize this kind of suffering caregivers need to understand how cancer-related pain is experienced by these patients, what it does to them and how it impacts their daily life.   Aim: The aim of this study was to describe patients´ experience of living with cancer-related pain. Method: The method used for this study was a qualitative literature study. Nine articles from 2002 to 2012 and from five different countries were analyzed. Results: The results of this study are presented in four main themes and ten subthemes. The main themes were: A feeling of powerlessness; Fears that limit; A change in daily life and Seeking for meaning and an end to the suffering. All themes and subthemes give a description of patients´ experience of living with cancer-related pain. Conclusion: It is a great suffering to have cancer and it is even a greater suffering experiencing pain on a daily basis. Despite this, some patients still could see their situation as something positive and wellbeing was created. The nurses’ role in this kind of situations is essential in order to understand what the patient is experiencing, how it impacts on the patient and its life and how wellbeing can be formed.

Since its creation in 1998, the Implicit Association Test (IAT) has become a commonly used measure in social psychology and related fields of research. Studies of the cognitive processes involved in the IAT are necessary to establish the validity of this measure and to suggest further refinements to its use and interpretation. The current thesis used ERPs to study cognitive processes associated with the IAT. The first experiment found significant differences in P300 amplitude in the Congruent and Incongruent conditions, which were interpreted as a reflection of greater equivocation in the Incongruent condition. The second experiment tested the task-set switching account of the IAT in much greater detail by analyzing each trial type separately. In the Congruent condition, all trial types elicited the same amplitude P300. Local probability, and the consequent checking and updating of working memory, was thought to be responsible for differences between trials of the Incongruent condition that required or did not require a task switch. The final experiment examined the role of working memory in the IAT by introducing obtrusive and irrelevant auditory stimuli. The results of Experiment 3 indicated that the introduction of an obtrusive and irrelevant auditory increment deviant has little overall effect on the IAT, and a similar effect on switch and no-switch trials within the Incongruent condition. This could have been because both the Congruent and Incongruent conditions of the IAT make such extensive demands on central processing resources that few are available to allow for the switching of attention, or it is possible that the IAT does not require significant updating of working memory. The usefulness of ERPs in the study of the IAT effect is demonstrated by the current research. In particular, the finding that behavioural results were not always consistent with the ERP results demonstrates that electrophysiological measures can complement traditional behavioural measures.

Med risk för långvarig stress bland anställda inom socialtjänsten, ställs höga krav på chefer i ett psykosocialt arbete. Då socialtjänst är ramstyrt, söker bistånd samt har svårigheter i prioritering av arbetet ställer detta frågan hur chefer upplever förutsättningen till det psykosociala arbetsmiljöarbetet. Sex chefer inom en socialförvaltning har intervjuats. Intervjuerna analyserades genom en innehållsanalys med ett manifest fokus. Resultaten visar en homogen upplevelse att med rätt inställning finns förutsättningar för ett arbete som gynnar den psykosociala arbetsmiljön. Det finns möjligheter som medvetenhet, interventioner för stress och visioner samt att den psykosociala arbetsmiljön diskuteras i olika forum och har kontinuerlig uppföljning.  Dock fanns hinder som sociala aktiviteter, arbetsbelastning, rekrytering och lokaler. Bristande resurser och bristande stöd från kommunalt styre motverkar interventioner på organisationsnivå för att förebygga stress och ohälsa på arbetsplatserna.  Resultaten tyder på att det behövs mer forskning för bättre vägledning och prioritering av den psykosociala arbetsmiljön inom socialtjänsten.

Forskning har visat på ledarskapets betydelsefulla roll för att främja hälsa och minimera arbetsrelaterad ohälsa. Detta samtidigt som ledares egen arbetsroll ofta kännetecknas av hög arbetsbelastning och påfrestning vilket är riskfaktorer för arbetsrelaterad stress och ohälsa. Studien undersöker upplevelser och hantering av stress på arbetsplatsen hos chefer med personalansvar. Även arbetsrelaterade resurser har undersökts för att synliggöra huruvida dessa inverkar vid hantering av stress. Sex individuella djupintervjuer med personalchefer genomfördes och databearbetningen gjordes med en kvalitativ innehållsanalys. Resultaten visar att stress hos cheferna var associerat med stort ansvar, krav på att prioritera mellan uppgifter, ansvar som inte matchas med tillräckliga befogenheter, hög arbetsbelastning samt för många olika arbetsuppgifter. Analysen identifierade fem olika copingstrategier: Kommunikativa, Kompensatoriska, Ansvarsbefriande och Avstängande, Icke-kommunikativa samt Distansierande. Strategierna delades in i konstruktiva och icke-konstruktiva kategorier. Detta då några strategier upplevdes främja hälsan medan andra upplevdes minska den. Kommunikativa arbetsrelaterade resurser användes kontinuerligt som strategier hos respondenterna.

During S phase of the cell cycle, newly synthesized histones are acetylated in the cytoplasm in patterns specific to DNA replication. Once incorporated into nucleosomes, these histones are rapidly deacetylated by enzymes known as histone deacetylases. Though common in all organisms, the significance of this molecular mechanism is not fully understood. Homologous to HDAC6 in humans and HDA1 in budding yeast, Tetrahymena histone deacetylase 2 (Thd2) has been identified as the only known histone deacetylase that performs this task in the unicellular eukaryote Tetrahymena thermophila. Localizing to the transcriptionally inactive germline nucleus, the micronucleus, Thd2 has been found to deacetylate histones H3 and H4 at K9 and/or K14. In order to gain further insight into the role of deposition-related deacetylation in chromatin maturation, the micronuclear morphology and modification status of H3K27, a known marker for heterochromatin in several eukaryotes, were examined in both vegetative and synchronized complete Δthd2 mutant cells. Immunofluorescence microscopy, DAPI staining and a western blot analysis revealed abnormal phenotypes and the conservation of H3K27 methylation in the absence of Thd2. These findings further indicate a role for Thd2 in the maintenance of chromatin structure and suggest the possibility of another mechanism required for deacetylation at H2K27. Essentially, this demonstrates the importance of deposition-related histone deacetylation in chromatin maturation after DNA replication and further maintenance of chromatin domains.

Problem: Many individuals with chronic illnesses such as stroke and ongoing activity limitations report self-perceived health related quality of life (HRQL) that is similar to that of healthy individuals. This phenomenon is termed response shift (RS). RS describes how people change: internal standards in assessing HRQL (recalibration), values (reprioritization), or how they define HRQL (reconceptualization), after an event such as stroke. Changes in HRQL post stroke may be inaccurate if RS is not taken into account. Increased knowledge of RS may affect the way in which HRQL measures are used, both clinically and in research. The overall objective was to assess RS in construct specific HRQL models post stroke: physical function, mental health, and participation. Methods: Data were analysed from the longitudinal study “Understanding Quality of Life Post-Stroke: A Study of Individuals and their Caregivers”. Six-hundred and seventy- eight persons with stroke at 1, 3, 6, and 12 months post stroke participated. Generic and stroke specific HRQL measures were collected. Descriptive analysis was completed with SAS, and identification of RS utilized structural equation modeling with LISREL. Results: Mean age of participants was 67 years (SD 14.8), and 45% were female. RS was identified in mental health using a framework which was developed for identifying RS statistically with multiple time points. RS was also identified in physical function where it had not been expected, possibly due to the self perceived nature of the response options. The effect size of change in physical function was affected by the presence of RS. The timing of RS in mental health and physical function was primarily around the 12 month time period, and predominantly recalibration RS. RS was also identified in participation. Conclusions: The framework that was developed was useful in identifying RS and incorporated important issues such as multiple testing and validation of the model. The presence of RS affects measurement of HRQL constructs post stroke; recalibration RS can be measured clinically with specific methods to account for RS. RS should also be measured in research studies to ensure accurate measurement of change. Future research should evaluate additional models in stroke and other populations. / October 2008

Since its creation in 1998, the Implicit Association Test (IAT) has become a commonly used measure in social psychology and related fields of research. Studies of the cognitive processes involved in the IAT are necessary to establish the validity of this measure and to suggest further refinements to its use and interpretation. The current thesis used ERPs to study cognitive processes associated with the IAT. The first experiment found significant differences in P300 amplitude in the Congruent and Incongruent conditions, which were interpreted as a reflection of greater equivocation in the Incongruent condition. The second experiment tested the task-set switching account of the IAT in much greater detail by analyzing each trial type separately. In the Congruent condition, all trial types elicited the same amplitude P300. Local probability, and the consequent checking and updating of working memory, was thought to be responsible for differences between trials of the Incongruent condition that required or did not require a task switch. The final experiment examined the role of working memory in the IAT by introducing obtrusive and irrelevant auditory stimuli. The results of Experiment 3 indicated that the introduction of an obtrusive and irrelevant auditory increment deviant has little overall effect on the IAT, and a similar effect on switch and no-switch trials within the Incongruent condition. This could have been because both the Congruent and Incongruent conditions of the IAT make such extensive demands on central processing resources that few are available to allow for the switching of attention, or it is possible that the IAT does not require significant updating of working memory. The usefulness of ERPs in the study of the IAT effect is demonstrated by the current research. In particular, the finding that behavioural results were not always consistent with the ERP results demonstrates that electrophysiological measures can complement traditional behavioural measures.

Syftet med denna studie var att undersöka introjektiv motivation och arbetsrelaterad stress. Studien grundades i Self-determination theory och delades upp i studie 1 och 2. Syftet med studie 1 var att undersöka huruvida introjektiv motivation kan delas upp i två motivationstyper. Ett mätinstrument utformades för att undersöka sambandet, med data från 77 respondenter. Resultatet visade på ett signifikant, positivt medelstarkt samband. Syftet med studie 2 var att undersöka huruvida det fanns ett samband mellan introjektiv motivation och arbetsrelaterad stress. Mätinstrumentet från studie 1 användes även i studie 2, med ett tillägg av Work Stress Questionnaire vilka 69 respondenter besvarade. Resultatet visade på ett signifikant, positivt svagt samband mellan introjektiv motivation och arbetsrelaterad stress. Studie 1 tyder på att introjektiv motivation kan vara ett unisont begrepp men vidare studier krävs. Studie 2 tyder på att introjektivt motiverade medarbetare upplever högre negativ stress alternativt att negativ stress leder till introjektiv motivation.

In this dissertation, the effect of mild sleep deprivation on attentional allocation and performance monitoring was investigated using a variety of event-related potential (ERP) paradigms with ecologically realistic periods of sleep deprivation. Seventeen female young adults completed several tasks under alert and sleepy conditions, after 3 and 20 hours of wakefulness, respectively. Objective behavioural measures of response times and error rates indicated virtually no decrements that could be attributed exclusively to sleepiness; however, there were consistent alterations in the ERPs indicative of subtly reduced attentional resources and performance monitoring. The first study (Chapter 2) examined the effect of distraction on the P300, an ERP component related to attention and stimulus processing. Participants performed an auditory oddball task with and without a secondary visual working memory task. Response times (RTs) and P300 amplitudes were affected by the addition of the secondary working memory task. However, an interaction showed that the P300 latency was significantly increased by the secondary task only in the sleepy condition, indicating that processing speed is impaired by a secondary task only when the participant is sleepy. The next study (Chapter 3) used a Go/NoGo contingent negative variation (CNV) task. The CNV is reflective of sustained attention, and is known to be associated with frontal lobe functioning. This task was performed twice, with and without a financial incentive for fast responses, to assess the effect of motivation. The P300 amplitude to the first stimulus and CNV prior to the second were clearly larger to Go stimuli for both levels of alertness when the participant was motivated by the financial incentive. However, with no incentive in the sleepy condition, there was reduced differentiation of the two types of stimuli, indicating a reduced ability to discriminate between important and less important information. In chapters 4 and 5, performance monitoring was examined using two tasks, the Eriksen Flanker task and the Anti-Saccade task, producing an ERP related to errors with two basic components: the error-negativity (Ne/ERN) and error-positivity (Pe), thought to be related to error recognition and error evaluation, respectively. In both data sets, the amplitude of the Ne/ERN was not significantly reduced by sleep deprivation, but the amplitude of the Pe was. In addition, smaller anti-saccade errors produced reduced Ne/ERN amplitudes compared to larger anti-saccade errors. Another marker of performance monitoring is post-error slowing, which was present in the flanker task only during the alert condition. These results indicate that error detection or recognition (Ne/ERN) appears to be relatively preserved during sleep deprivation, but further error evaluation (Pe) and compensation (post-error slowing) are impaired. Taken together, the findings demonstrate that even mild sleep deprivation has a subtle but reliable effect on electrocortical activity associated with attention and performance monitoring despite an absence of behavioural changes, indicating deleterious effects before behavioural changes are observed. Therefore, relying on behavioural tests to determine at what point an individual becomes unsafe to operate machinery or perform various tasks may be misleading.

Ongoing efforts to quantify changes in quality of life attributable to low vision rehabilitation have focused on the utility of a single test instrument to measure this multidimensional concept. It is hypothesized that quality of life is best assessed using multiple instruments to capture some of its component facets, including functional status and psychosocial impact. Low vision devices have a predictably spontaneous impact on functional vision status, but associated psychosocial impact occurs with different magnitudes and over more protracted time intervals. The National Eye Institute Visual Function Questionnaire (NEI VFQ-25) measures the functional status of individuals in key vision areas that are associated with quality of life. The Psychosocial Impact of Assistive Devices Scale (PIADS) is an instrument that measures the psychosocial impact of assistive device intervention in three quality of life domains: competence, adaptability, and self-esteem. 68 participants were obtained from an ongoing parent study. These participants were recruited through the Low Vision Clinic at the University of Waterloo. They had a primary diagnosis of age-related macular degeneration (ARMD) and were obtaining a CCTV system for the first time. Assessments from the parent study used in this thesis included follow-up from 2 weeks, 1 month, 3 months, and 6 months post-adoption of the CCTV. The two tests administered were to measure functional vision status (NEI VFQ-25) and perceived psychosocial impact (PIADS), according the framework outlined by the Consortium for Assistive Technology Outcomes Research (CATOR). Multivariate repeated-measures ANVOA results confirmed that CCTV systems have an immediate and robust effect on the daily visual functioning of their users, and that this effect is stable over long periods of device use. The psychosocial impact of CCTV device use peaks in the shorter term and then seems to wane in the longer term for reasons that are not yet understood. The NEI VFQ-25 and the PIADS appear to have differential sensitivity to important influences on low vision rehabilitation outcomes. This project has demonstrated the value of longitudinal outcomes research in low vision rehabilitation. After obtaining a CCTV, visual function status remains static while psychosocial impact is dynamic during 6-months of follow-up.