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

Kak's three-stage protocol of secure quantum communication revisited: Hitherto unknown strengths and weaknesses of the protocol

Kak's three-stage protocol for quantum key distribution is revisited with special focus on its hitherto unknown strengths and weaknesses. It is shown that this protocol can be used for secure direct quantum communication. Further, the implementability of this protocol in the realistic situation is analyzed by considering various Markovian noise models. It is found that the Kak's protocol and its variants in their original form can be implemented only in a restricted class of noisy channels, where the protocols can be transformed to corresponding protocols based on logical qubits in decoherence free subspace. Specifically, it is observed that Kak's protocol can be implemented in the presence of collective rotation and collective dephasing noise, but cannot be implemented in its original form in the presence of other types of noise, like amplitude damping and phase damping noise. Further, the performance of the protocol in the noisy environment is quantified by computing average fidelity under various noise models, and subsequently a set of preferred states for secure communication in noisy environment have also been identified.Comment: Kak's protocol is not suitable for quantum cryptography in presence of nois

Nucleon-induced reactions at intermediate energies: New data at 96 MeV and theoretical status

Double-differential cross sections for light charged particle production (up to A=4) were measured in 96 MeV neutron-induced reactions, at TSL laboratory cyclotron in Uppsala (Sweden). Measurements for three targets, Fe, Pb, and U, were performed using two independent devices, SCANDAL and MEDLEY. The data were recorded with low energy thresholds and for a wide angular range (20-160 degrees). The normalization procedure used to extract the cross sections is based on the np elastic scattering reaction that we measured and for which we present experimental results. A good control of the systematic uncertainties affecting the results is achieved. Calculations using the exciton model are reported. Two different theoretical approches proposed to improve its predictive power regarding the complex particle emission are tested. The capabilities of each approach is illustrated by comparison with the 96 MeV data that we measured, and with other experimental results available in the literature.Comment: 21 pages, 28 figure

Scandal - A Facility For Elastic Neutron Scattering Studies in the 50-130 MeV Range

A facility for detection of scattered neutrons in the energy interval 50−130 MeV, SCANDAL (SCAttered Nucleon Detection AssembLy), is part of the standard detection system at the 20-180 MeV neutron beam facility of the The Svedberg Laboratory, Uppsala. It has primarily been used for studies of elastic neutron scattering, but it has been employed for (n,p) and (n,d) reaction experiments as well. Results of recent experiments are presented to illustrate the performance of the spectrometer. Recently, the facility has been upgraded to perform also (n,Xn') experiments. For this purpose, a new converter, CLODIA, has been developed and installed. Preliminary results of the commissioning of CLODIA will be presented

Inhibition of fatty acid synthesis induces differentiation and reduces tumor burden in childhood neuroblastoma

Many metabolic pathways, including lipid metabolism, are rewired in tumors tosupport energy and biomass production and to allow adaptation to stressful en-vironments. Neuroblastoma is the second deadliest solid tumor in children. Ge-netic aberrations, as the amplification of theMYCN-oncogene, correlate stronglywith disease progression. Yet, there are only a few molecular targets successfullyexploited in the clinic. Here we show that inhibition of fatty acid synthesis led toincreased neural differentiation and reduced tumor burden in neuroblastomaxenograft experiments independently ofMYCN-status. This was accompaniedby reduced levels of the MYCN or c-MYC oncoproteins and activation of ERKsignaling. Importantly, the expression levels of genes involved inde novofattyacid synthesis showed prognostic value for neuroblastoma patients. Our findingsdemonstrate that inhibition ofde novofatty acid synthesis is a promising pharma-cological intervention strategy for the treatment of neuroblastoma indepen-dently ofMYCN-status

Capability in research on cognition and well-being in ageing and retirement

In this chapter, we outline our thoughts on capability in relation to previous and ongoing research projects conducted by the Adult Development and Ageing (ADA-Gero) Research Group located at the Department of Psychology, University of Gothenburg, Sweden. More specifically, we relate our research on cognitive ageing and subjective well-being to the overarching capability framework implemented as a theoretical platform in the AgeCap research consortium

Taxonomic annotation of public fungal ITS sequences from the built environment - A report from an April 10-11, 2017 workshop (Aberdeen, UK)

The UNITE database community gratefully acknowledges support from the Alfred P. Sloan Foundation. HN and CW gratefully acknowledges financial support from Stiftelsen Olle Engkvist Byggmästare, Stiftelsen Lars Hiertas Minne, Kapten Carl Stenholms Donationsfond, and Birgit och Birger Wålhströms Minnesfond. CW gratefully acknowledges a Marie Skłodowska-Curie post doctoral grant from the ERC. Leho Tedersoo is gratefully acknowledged for providing helpful feedback on an earlier draft of this manuscript.Peer reviewedPublisher PD

Mental distress, alcohol use and help-seeking among medical and business students: a cross-sectional comparative study

<p>Abstract</p> <p>Background</p> <p>Stress and distress among medical students are thoroughly studied and presumed to be particularly high, but comparative studies including other student groups are rare.</p> <p>Methods</p> <p>A web-based survey was distributed to 500 medical students and 500 business students. We compared levels of study stress (HESI), burnout (OLBI), alcohol habits (AUDIT) and depression (MDI), and analysed their relationship with self-assessed mental health problems by logistic regression, with respect to gender.</p> <p>Results</p> <p>Medical students' response rate was 81.6% and that of business students 69.4%. Business students scored higher on several study stress factors and on disengagement. Depression (OR 0.61, CI₉₅0.37;0.98) and harmful alcohol use (OR 0.55, CI₉₅0.37; 0.75) were both less common among medical students. However, harmful alcohol use was highly prevalent among male students in both groups (medical students 28.0%, business students 35.4%), and among female business students (25.0%). Mental health problems in need of treatment were equally common in both groups; 22.1% and 19.3%, respectively, and was associated with female sex (OR 2.01, CI₉₅1.32;3.04), exhaustion (OR 2.56, CI₉₅1.60;4.10), lower commitment to studies (OR 1.95, CI₉₅1.09;3.51) and financial concerns (OR 1.81 CI₉₅1.18;2.80)</p> <p>Conclusions</p> <p>Medical students may not be more stressed than other high achieving student populations. The more cohesive structure of medical school and a higher awareness of a healthy lifestyle may be beneficial factors.</p

Characterization of Spontaneous Bone Marrow Recovery after Sublethal Total Body Irradiation: Importance of the Osteoblastic/Adipocytic Balance

Many studies have already examined the hematopoietic recovery after irradiation but paid with very little attention to the bone marrow microenvironment. Nonetheless previous studies in a murine model of reversible radio-induced bone marrow aplasia have shown a significant increase in alkaline phosphatase activity (ALP) prior to hematopoietic regeneration. This increase in ALP activity was not due to cell proliferation but could be attributed to modifications of the properties of mesenchymal stem cells (MSC). We thus undertook a study to assess the kinetics of the evolution of MSC correlated to their hematopoietic supportive capacities in mice treated with sub lethal total body irradiation. In our study, colony-forming units – fibroblasts (CFU-Fs) assay showed a significant MSC rate increase in irradiated bone marrows. CFU-Fs colonies still possessed differentiation capacities of MSC but colonies from mice sacrificed 3 days after irradiation displayed high rates of ALP activity and a transient increase in osteoblastic markers expression while pparγ and neuropilin-1 decreased. Hematopoietic supportive capacities of CFU-Fs were also modified: as compared to controls, irradiated CFU-Fs significantly increased the proliferation rate of hematopoietic precursors and accelerated the differentiation toward the granulocytic lineage. Our data provide the first evidence of the key role exerted by the balance between osteoblasts and adipocytes in spontaneous bone marrow regeneration. First, (pre)osteoblast differentiation from MSC stimulated hematopoietic precursor's proliferation and granulopoietic regeneration. Then, in a second time (pre)osteoblasts progressively disappeared in favour of adipocytic cells which down regulated the proliferation and granulocytic differentiation and then contributed to a return to pre-irradiation conditions