<p>The aim the thesis was to investigate, the prevalence of Lower Urinary Tract Symptoms (LUTS). Moreover, we examine symptom severity and different levels of distress and describe how different symptoms from the lower urinary tract affect the self-assessed health, sadness, happiness and the quality of life in men. </p><p>The studies are based on two data collections. In the first data collection, all men aged 40 – 80 years (n=2571) living in the Swedish community received a postal questionnaire. Twelve months later, 504 men who had earlier reported LUTS and 504 who had not reported symptoms were asked to complete the DAN-PSS and the SF-36 questionnaires. </p><p>The overall prevalence of LUTS was 24%. Post-micturition dribbling (21%) was the most frequent symptom, and stress incontinence (2%) was the least frequent symptom. Urge incontinence, stress incontinence and “other” incontinence cause a high level of distress, even if the symptoms do not occur very often. Men experiencing mild, moderate or severe urge, stress or “other incontinence” had lower mean scores for all of the eight dimensions measured by the SF-36 than men without the same symptoms. Men experiencing a moderate/severe degree of weak stream or nocturia reported a poorer quality of life in all dimensions compared to men with a mild level of the same symptoms. The total burden of moderate/severe LUTS is related to self-assessed health, sadness and happiness. For each of the 12 specific LUTS, men with mild, moderate or severe symptoms had lower scores for self-assessed health and happiness, and higher scores for self-assessed sadness, than men without the same symptoms. </p><p>In conclusions, one of every four men reports LUTS. Urinary incontinence causes high level of distress even to men who experience this symptom rarely. LUTS have a negative impact on quality of life, health, sadness and happiness. </p>

The present thesis investigated family history and neurobiology of social phobia. Social phobia is a disabling disorder characterized by a marked fear of scrutiny in a variety of social situations. By using a validated questionnaire, study I related family history of excessive social anxiety to social phobia and avoidant personality disorder in epidemiologically identified probands in the Swedish general population. A two- to threefold increased relative risk of social anxiety was observed for both diagnostic groups. Thus, having an affected family member is associated with approximately a doubled risk for both social phobia and avoidant personality disorder. The neurobiological studies explored situational and anticipatory elicited anxiety by means of positron emission tomography and 15O-water. Study II examined the functional neuroanatomy of social anxiety provocation in social phobics and a healthy comparison group during a public speaking task. Social phobia symptomatology was associated with higher neural activity in the amygdaloid complex, i.e. "the alarm system" of the brain, and lower activity in the prefrontal cortex. Study III examined the neural correlates of anxiety elicited by the anticipation of public speaking in individuals with social phobia. Anticipatory anxiety was accompanied by enhanced regional cerebral blood flow in the dorsolateral prefrontal and inferior temporal cortices as well as in the amygdaloid-hippocampal region. Brain blood flow was lower in the temporal pole and in the cerebellum. These results suggest that social phobia has a neuroanatomical basis in a highly sensitive fear network centered in the amygdaloid-hippocampal region and encompassing the prefrontal cortex.

The present thesis explored the neurobiological basis of three aspects of defense behaviors in humans. Positron emission tomography methodology was used, and changes in regional cerebral blood flow (rCBF) were measured as an index of neural activity. Firstly, brain function was studied in a group of patients suffering from combat-related posttraumatic stress disorder, using a symptom provocation paradigm with combat sounds in order to elicit fear. Exposure to auditory trauma reminders relative to neutral sounds was associated with increased rCBF in sensorimotor areas, the cerebellar vermis, the periaqueductal gray matter, and the right amygdala, whereas decreased activity was observed in the retrosplenial area of the posterior cingulate cortex. Secondly, the neural circuitry mediating the acoustic startle response and its habituation was studied in a group of healthy subjects. During acoustic startle stimulation as compared to a resting condition, increased rCBF was found in a medial posterior area of the pons corresponding to the nucleus reticularis pontis caudalis. As a result of startle repetition, altered activity was found in the cerebellum, pointing to its involvement in startle habituation. Thirdly, neural activity associated with startle modulation by phobic fear was studied in a group of subjects with specific animal phobias during exposure to pictures of their feared and non-feared objects, paired and unpaired with acoustic startle stimuli. As a result of startle potentiation, increased rCBF was found in the left amygdaloid-hippocampal region, and medially in the affective division of the anterior cingulate cortex. In conclusion, these results provide evidence for the involvement of limbic and paralimbic brain areas during fear provocation and fear-potentiated startle and for a similar neurocircuitry underlying startle in humans and animals.

The aim the thesis was to investigate, the prevalence of Lower Urinary Tract Symptoms (LUTS). Moreover, we examine symptom severity and different levels of distress and describe how different symptoms from the lower urinary tract affect the self-assessed health, sadness, happiness and the quality of life in men. The studies are based on two data collections. In the first data collection, all men aged 40 – 80 years (n=2571) living in the Swedish community received a postal questionnaire. Twelve months later, 504 men who had earlier reported LUTS and 504 who had not reported symptoms were asked to complete the DAN-PSS and the SF-36 questionnaires. The overall prevalence of LUTS was 24%. Post-micturition dribbling (21%) was the most frequent symptom, and stress incontinence (2%) was the least frequent symptom. Urge incontinence, stress incontinence and “other” incontinence cause a high level of distress, even if the symptoms do not occur very often. Men experiencing mild, moderate or severe urge, stress or “other incontinence” had lower mean scores for all of the eight dimensions measured by the SF-36 than men without the same symptoms. Men experiencing a moderate/severe degree of weak stream or nocturia reported a poorer quality of life in all dimensions compared to men with a mild level of the same symptoms. The total burden of moderate/severe LUTS is related to self-assessed health, sadness and happiness. For each of the 12 specific LUTS, men with mild, moderate or severe symptoms had lower scores for self-assessed health and happiness, and higher scores for self-assessed sadness, than men without the same symptoms. In conclusions, one of every four men reports LUTS. Urinary incontinence causes high level of distress even to men who experience this symptom rarely. LUTS have a negative impact on quality of life, health, sadness and happiness.

Syftet med denna studie var att, utifrån litteraturen, redogöra för vilka faktorer som patienter, anhöriga och sjuksköterskor anser viktiga i den palliativa vården i hemmet. Artikelsökning på vetenskapliga artiklar gjordes i databaserna Pub Med och AcademicSearchElite. En begräns-ning gjordes på årtalen 1999 – 2007 och olika sökordskombinationer användes utifrån sökor-den palliative care, nursing at home, caregivers, need a nurse at home, quality of life, rehabili-tation och advanced nurse. Exklusionskriterier var artiklar som inkluderade barn och AIDS-sjuka. Resultatet visade att det var stor samstämmighet mellan patienter, anhöriga och sjuk-sköterskor beträffande vad som karaktäriserar den palliativa vården i hemmet. Resultatet kun-de kategoriseras som kommunikation, stöd, symptomlindring och information. För att patien-ter med behov av palliativ vård ska kunna vårdas hemma, krävs det att sjuksköterskor har kompetens inom dessa områden för att alla berörda ska orka med den vården i hemmet. Det finns ett behov av kompetensutveckling inom palliativ vård för professionella vårdare, allt för att patienter som väljer att vårdas i hemmet i palliativt skede ska få ett så värdigt slut som möjligt. / The aim of this study was to, on the basis of the literature, give an account of what factors patients, relatives and nurses think is important in the palliative care at home. Searches of scientific articles were done in the databases Pub Med and AcademicSearch- Elite. A limita-tion on the year of 1999 – 2007 was done and various combinations of key words was used on the basis of the words palliative care, nursing at home, caregivers, need a nurse at home, quality of life, rehabilitation and advanced nurse. Exclusion criterions were articles which in-volved children and AIDS-patients. The results exhibitioner that it was a big consensus be-tween patients, relatives and nurses concerning what characteristics of the palliative care at home. The result could categorizes as communication, support, symptom relieve and informa-tion. To allow care at home for patients who be in need of palliative care, demands that nurses have competence within those subject areas so all included will be able to manage that care at home. There is a need of competence development in palliative care for professional carers, all for the patients who chose to be take cared of at home in the palliative phase, that they can have a dignified end as possible.

In this work, I have studied whether if one can detect AD / HD in preschool. I have read some literature and searched on the Internet. I have also tried to get to interview people who are familiar with this topic, which has not been easy. I have questioned 13 persons if they would participate in an interview, but most have refused because they do not have time. I succeeded anyhow to get three persons, two special educators and a nurse on the BVC. Special Student teachers are working to put the various educational activities in the preschool / school when children are in need of assistance. Children nurse is working with children to look up at the controls as they come in and where they can see if there is something not as it should. The answer I came up with through the literature and interviews is that AD / HD is a neuro-psychiatric disability and is logically divided into three groups that they have to Impulsivity problems, over activity and attention problems. Special Student teachers tell of the symptoms / signs of AD / HD as the first notice are that the children with AD / HD have problems in concentrating in a task. What distinguishes boys from girls is that boys are more hyperactive and ports in more trouble than girls do. Girls are more reclusive and shy and have been easier to become depressed and anxious. It is difficult to detect AD / HD in preschool unless the kids have severe problems with attention, impulsivity and over activity  I also got answer to that one can detect AD / HD if you're looking for it, but it’s not the essential, the important is to support children with AD / HD in the learning and development. Special Student teachers talked a lot of work how to help children in preschool with various educational activities such as solid framework, transparency and daily schedules. They can also work in small groups but that is not always suitable for all children. Then we can bring the children who have problems at the front near the teacher in order to give praise and jacking.

Aim: To examine prospectively over a period of 4 years the profile of cannabis dependence and the risk of specific dependence criteria in a community sample of adolescents. Methods: A representative community sample of 2446 young adults aged 14–24 years at baseline was followed up over a period of 4 years. Frequency of use measures and of criteria for DSM-IV dependence were assessed by standardized diagnostic interview measures (CIDI). To explore the nature of this association, frequency of use and concomitant use of other psychoactive substances was considered. Results: 30% of the sample were cannabis users. Among all users 35% met at least one dependence criterion. Most frequently reported dependence criteria among all users were withdrawal (17%), tolerance (15%), loss of control (14%) and continued use despite a health problem (13%). Even without concomitant use of other illicit drugs, 22% of low frequency users and 81% of high frequency users met at least one dependence criterion. Symptom patterns were similar in high and low frequency users. The occurrence of a dependence syndrome or of specific dependence criteria could not be attributed to the use of other illicit drugs or to comorbid nicotine and alcohol dependence. Conclusions: Regular cannabis use in adolescence is associated with the development of a dependence syndrome. This association cannot be explained by the concomitant use of other illicit substances or by comorbid nicotine and alcohol dependence.

Some children develop externalizing and internalizing behavior problems at an early age. Previous research has often treated these children as a homogeneous group, the purpose of this study is to show that this group of children is in fact heterogeneous. Data from theSOFIAstudy was used and preschool pedagogues were informants. The sample contained 2121 boys and girls between 3-5 years. Groups of children with the behavior problems and the risk factors AD/HD symptoms, fearlessness and callous-unemotional traits were created. What different constellations of the behavior problems and the risk factors are there, and what constellations of risk factors occur in the constellations of behavior problems? Preschool children with externalizing and internalizing problems is a very heterogeneous group since children with the same constellation of behavior problems have different constellations of risk factors, this also shows heterogeneity regarding the risk factors. / Vissa barn utvecklar tidigt externaliserade och internaliserade beteendeproblem. Tidigare forskning har ofta behandlat dessa barn som en homogen grupp, denna studies syfte är att påvisa att dessa barn istället är en heterogen grupp. Data ifrån SOFIA studien användes där förskolepedagoger var informanter. Urvalet var 2121 pojkar och flickor mellan 3-5 år. Grupper av barn med beteendeproblemen och riskfaktorerna AD/HD symptom, oräddhet och brist i empati - flackt känsloliv skapades. Vilka olika konstellationer av beteendeproblemen och riskfaktorerna finns, och vilka konstellationer av riskfaktorerna förekommer i konstellationerna av beteendeproblemen? Förskolebarn med externaliserade och internaliserade problem är en mycket heterogen grupp då barn med samma konstellationer av beteendeproblemen har olika konstellationer av riskfaktorer närvarande, detta påvisar också heterogenitet vad gäller riskfaktorerna.

This study aimed to examine the quality of life (QOL) and well-being of haemodialysis patients and the relationship of two components of perceived expressed emotion (criticism/hostility and emotional over-involvement) and other psychosocial resources within the Conservation of Resources Model. Demographic variables and haemodialysis related information of patients, classified as resources, were also included in the study. One hundred and six haemodialysis patients voluntarily participated in the study. Before the main study, for evaluating the psychometric properties of the Symptom Distress Scale (SDS), Coping Self-Efficacy Scale (CSES), and Perceived Expressed Emotion Scale (PEES) a pilot study was conducted with the fifty-three haemodialysis patients. Results of the pilot study provided support for the reliability and validity of scales. For the main study, optimism, self-esteem, and perceived social support were taken as resources and were also included as measures. In order to test the main hypothesis of the studies a series of regression analyses were conducted. The results of the analysis revealed that predictors of well-being were age, self esteem, criticism/hostility factor of perceived expressed emotion and coping self-efficacy / predictors of physical health component of QOL were age, education, presence of additional diagnosis, and coping self-efficacy. Moreover, it was found that predictors of mental health component of QOL were the presence of additional diagnosis and coping self-efficacy / and predictors of the mean score of QOL were age, presence of additional diagnosis, self-esteem, and coping self-efficacy. Directions of the relationship between age, education, presence of additional diagnosis, and criticism/hostility were negative with the outcome variables, whereas, directions of the relationship between self-esteem and coping self-efficacy were positive with the outcome variables. The mediational role of coping self-efficacy in the association between resources and outcome variables were also investigated. Mediator effect of coping self-efficacy was found only for two variables. Firstly, the effect of duration of haemodialysis treatment was mediated by the coping self-efficacy for the well being measure. Second, coping self-efficacy carries the influence of the family income to the mean score of QOL. After discussing the findings of the present study in the light of the literature, the limitations and the clinical implications of the results and directions for the future studies were suggested.

Diss. (sammanfattning) Umeå : Umeå universitet, 2010. / Härtill 4 uppsatser.