Psychosocial situation and work after breast cancer surgery - women's experiences

Background: Breast cancer is the most common cancer among women. Nowadays, most women survive the disease, and many working women continue in paid employment. Nevertheless, there is little scientific knowledge of working after breast cancer surgery and of how various stakeholders support women after a breast cancer diagnosis. Aim: The aim of this thesis is to explore women’s work situation after breast cancer surgery, with special focus on how women experience interactions with different stakeholders, and on women’s reflections and actions with regard to work. Methods: Four studies, based on information about women aged 26-63, living in Stockholm, who had had breast cancer surgery, were conducted. In studies I and II, data from four focus group interviews with 23 women, who had had breast cancer surgery three to thirteen months previously, were analyzed by means of qualitative content analysis and thematic analysis, respectively. For studies III and IV, questionnaire and treatment registry data on 605 women working at time of diagnosis were analyzed by means of descriptive statistics, and univariate and multivariable logistic regressions. Results: Study I revealed that the women had encountered many different stakeholders regarding issues of paid employment. These encounters involved information exchange and adjustments, and reflected attitudes towards sickness absence and the women themselves. Examples concern the issues of job retention or sickness absence, e.g., of an inflexible interpretation of sickness absence regulations, and of a lack of information on the side-effects of treatment. Study II focused on women’s reflections and actions with regard to work. Several of the women had worked, at least to some extent, during the cancer trajectory. The following three action themes were identified: returning to work or not, asking for adjustments or not, and disclosing one’s disease or not. Five themes with regard to reflections were found: health and function, the value of work, self-esteem and integrity, social circumstances, and relationships at work. Women who continued to work throughout the treatment period tended to refer to work as a normalizing factor, but others wanted to focus on rehabilitation and were on sick leave. At the time of breast cancer were the vast majority of women working full-time and when answering the questionnaire were 61% sickness absent, whereof the majority on full-time. The results of Study III furthermore showed that women shortly after breast cancer surgery valued their paid work highly, and found it to be one of the most important aspects of life. Low job satisfaction and younger age were associated with being on sick leave. Social support at work and adjustment of work was explored in Study IV. It was found that many women received social support from their colleagues and supervisors. Low perceived social support from supervisors and low work-adjustment opportunities were associated with being on sick leave, even after controlling for socio-demographic factors, work posture, axillary surgery, and planned adjuvant chemotherapy. Conclusion: All stakeholders involved in women’s circumstances after breast cancer surgery need to pay great attention to psychosocial factors, such as being flexible in providing support, solutions and information, and taking into account women’s preferences and perceived competence. These are considerations of essential importance to the women, and may have a bearing on being sickness absent or returning to work

Electronic structure of GaAs1-xNx alloy by soft-X-ray absorption and emission: Origin of the reduced optical efficiency

The local electronic structure of N atoms in a diluted GaAs1-xNx (x=3%) alloy, in view of applications in optoelectronics, is determined for the first time using soft-X-ray absorption (SXA) and emission (SXE). Deviations from crystalline GaN, in particular in the conduction band, are dramatic. Employing the orbital character and elemental specificity of the SXE/SXA spectroscopies, we identify a charge transfer from the N atoms at the valence band maximum, reducing the overlap with the wavefunction in conduction band minimum, as the main factor limiting the optical efficiency of GaAs1-xNx alloys. Moreover, a k-conserving process of resonant inelastic x-ray scattering involving the L1 derived valence and conduction states is discovered.Comment: 3 pages, physica status solidi (Rapid Research Notes), in pres

Ecosystem properties and principles of living systems as foundation for sustainable agriculture – Critical reviews of environmental assessment tools, key findings and questions from a course process

With increasing demands on limited resources worldwide, there is a growing interest in sustainable patterns of utilisation and production. Ecological agriculture is a response to these concerns. To assess progress and compliance, standard and comprehensive measures of resource requirements, impacts and agro-ecological health are needed. Assessment tools should also be rapid, standardized, userfriendly, meaningful to public policy and applicable to management. Fully considering these requirements confounds the development of integrated methods. Currently, there are many methodologies for monitoring performance, each with its own foundations, assumptions, goals, and outcomes, dependent upon agency agenda or academic orientation. Clearly, a concept of sustainability must address biophysical, ecological, economic, and sociocultural foundations. Assessment indicators and criteria, however, are generally limited, lacking integration, and at times in conflict with one another. A result is that certification criteria, indicators, and assessment methods are not based on a consistent, underlying conceptual framework and often lack a management focus. Ecosystem properties and principles of living systems, including self-organisation, renewal, embeddedness, emergence and commensurate response provide foundation for sustainability assessments and may be appropriate focal points for critical thinking in an evaluation of current methods and standards. A systems framework may also help facilitate a comprehensive approach and promote a context for meaningful discourse. Without holistic accounts, sustainable progress remains an illdefined concept and an elusive goal. Our intent, in the work with this report, was to use systems ecology as a pedagogic basis for learning and discussion to: - Articulate general and common characteristics of living systems. - Identify principles, properties and patterns inherent in natural ecosystems. - Use these findings as foci in a dialogue about attributes of sustainability to: a. develop a model for communicating scientific rationale. b. critically evaluate environmental assessment tools for application in land-use. c. propose appropriate criteria for a comprehensive assessment and expanded definition of ecological land use

Quantum-dot thermometry

We present a method for the measurement of a temperature differential across a single quantum dot that has transmission resonances that are separated in energy by much more than the thermal energy. We determine numerically that the method is accurate to within a few percent across a wide range of parameters. The proposed method measures the temperature of the electrons that enter the quantum dot and will be useful in experiments that aim to test theory which predicts quantum dots are highly-efficient thermoelectrics.Comment: 3 pages, 4 Figure

Journal Staff

Primary Immunodeficiencies (PID) are genetically inherited disorders characterized by defects of the immune system, leading to increased susceptibility to infection. Due to the variety of clinical symptoms and the complexity of current diagnostic procedures, accurate diagnosis of PID is often difficult in daily clinical practice. Thanks to the advent of "next generation'' sequencing technologies and target enrichment methods, the development of multiplex diagnostic assays is now possible. In this study, we applied a selector-based target enrichment assay to detect disease-causing mutations in 179 known PID genes. The usefulness of this assay for molecular diagnosis of PID was investigated by sequencing DNA from 33 patients, 18 of which had at least one known causal mutation at the onset of the experiment. We were able to identify the disease causing mutations in 60% of the investigated patients, indicating that the majority of PID cases could be resolved using a targeted sequencing approach. Causal mutations identified in the unknown patient samples were located in STAT3, IGLL1, RNF168 and PGM3. Based on our results, we propose a stepwise approach for PID diagnostics, involving targeted resequencing, followed by whole transcriptome and/or whole genome sequencing if causative variants are not found in the targeted exons

Timelike self-similar spherically symmetric perfect-fluid models

Einstein's field equations for timelike self-similar spherically symmetric perfect-fluid models are investigated. The field equations are rewritten as a first-order system of autonomous differential equations. Dimensionless variables are chosen in such a way that the number of equations in the coupled system is reduced as far as possible and so that the reduced phase space becomes compact and regular. The system is subsequently analysed qualitatively using the theory of dynamical systems.Comment: 23 pages, 6 eps-figure

Granitic groundwater colloids sampling and characterisation: the strategy for artefact elimination

Colloids were separated by submicro-filtration of granitic groundwater samples collected at-line under in-situ thermodynamic conditions after down-hole groundwater sampling and transfer at the well head. The methodology avoids the generation of artefacts produced by pH changes due to CO2 exchange, yielding potential carbonate precipitation, or by O2 contamination yielding oxidized insoluble phases. The enhanced pressure and the anoxic conditions are also maintained through the filtering procedure. This procedure was carried out after a period of regular sampling of groundwater pumped to the ground surface and continuous on-line long-term measurements (weeks, months) of chemical and physical parameters in the unbroken sample water both at the ground surface and at depth down-hole. Colloid samples were characterized on the submicro-filtration membrane by scanning electron microscopy. Under deep granite groundwater conditions, natural colloids occur sparsely. The colloid concentration was determined C col ∼1 and ∼50μg L−1 for sizes ranging from 50 to 200nm or n col ∼ 3.9 × 109 and 47 × 109 L−1 for sizes larger than 50nm for KFM11A, Forsmark, and KLX17A, Laxemar, Oskarshamn, respectively, Sweden. These colloids are expected to be clay particles with an average size smaller than 200nm for the Na-Ca-Cl and Na-Cl groundwaters (pH 7.6 and 8.00, ionic strength ∼10−1 and ∼10−2 mol L−1, respectively, for KFM11A and KLX17A), the colloid concentrations were comparable with values previously reported in the literatur

Electrical control of spins and giant g-factors in ring-like coupled quantum dots

Emerging theoretical concepts for quantum technologies have driven a continuous search for structures where a quantum state, such as spin, can be manipulated efficiently. Central to many concepts is the ability to control a system by electric and magnetic fields, relying on strong spin-orbit interaction and a large g-factor. Here, we present a new mechanism for spin and orbital manipulation using small electric and magnetic fields. By hybridizing specific quantum dot states at two points inside InAs nanowires, nearly perfect quantum rings form. Large and highly anisotropic effective g-factors are observed, explained by a strong orbital contribution. Importantly, we find that the orbital and spin-orbital contributions can be efficiently quenched by simply detuning the individual quantum dot levels with an electric field. In this way, we demonstrate not only control of the effective g-factor from 80 to almost 0 for the same charge state, but also electrostatic change of the ground state spin