Health-Related Quality of Life and Needs of Care and Support of Adult Tanzanians with Cancer: A Mixed-Methods Study.

Cancer is among the three leading causes of death in low income countries and the highest increase with regard to incidence figures for cancer diseases are found in these countries. This is the first report of the health-related quality of life (HRQOL) and needs of care and support of adult Tanzanians with cancer. A mixed-methods design was used. The study was conducted at Ocean Road Cancer Institute (ORCI) in Dar es Salaam, Tanzania. One hundred and one patients with a variety of cancer diagnoses treated and cared for at ORCI answered the Kiswahili version of the EORTC QLQ-C30 investigating HRQOL. Thirty-two of the patients participated in focus group interviews discussing needs of care and support. Data from focus group interviews were analyzed with content analysis. The findings show that the patients, both women and men, report a low quality of life, especially with regard to physical, role, and social function and a high level of symptoms and problems especially with financial difficulties and pain. Financial difficulties are reported to a remarkably high extent by both women and men. The patients, both women and men report least problems with emotional function. A content analysis of the interview data revealed needs of food and water, hygienic needs, emotional needs, spiritual needs, financial needs, and needs of closeness to cancer care and treatment services. The high score for pain points out that ORCI is facing severe challenges regarding care and treatment. However, when considering this finding it should be noted that the pain subscale of the Kiswahili version of the EORTC QLQ-C30 did not reach acceptable internal consistency and showed less than satisfactory convergent validity. This also applies to the subscales cognitive function and global health/quality of life. Attention should be drawn to meet the identified needs of Tanzanian cancer patients while hospitalized but also when at home. Increased accessibility of mosquito nets, pads, and pain-killers would help to fulfil some needs

Professional Emotions in Court

Professional Emotions in Court examines the paramount role of emotions in the legal professions and in the functioning of the democratic judicial system. Based on extensive interview and observation data in Sweden, the authors highlight the silenced background emotions and the tacitly habituated emotion management in the daily work at courts and prosecution offices. Following participants ‘backstage’ – whether at the office or at lunch – in order to observe preparations for and reflections on the performance in court itself, this book sheds light on the emotionality of courtroom interactions, such as professional collaboration, negotiations, and challenges, with the analysis of micro-interactions being situated in the broader structural regime of the legal system – the emotive-cognitive judicial frame – throughout. A demonstration of the false dichotomy between emotion and reason that lies behind the assumption of a judicial system that operates rationally and without emotion, Professional Emotions in Court reveals how this assumption shapes professionals’ perceptions and performance of their work, but hampers emotional reflexivity, and questions whether the judicial system might gain in legitimacy if the role of emotional processes were recognized and reflected upon

Professional Emotions in Court

Professional Emotions in Court examines the paramount role of emotions in the legal professions and in the functioning of the democratic judicial system. Based on extensive interview and observation data in Sweden, the authors highlight the silenced background emotions and the tacitly habituated emotion management in the daily work at courts and prosecution offices. Following participants ‘backstage’ – whether at the office or at lunch – in order to observe preparations for and reflections on the performance in court itself, this book sheds light on the emotionality of courtroom interactions, such as professional collaboration, negotiations, and challenges, with the analysis of micro-interactions being situated in the broader structural regime of the legal system – the emotive-cognitive judicial frame – throughout. A demonstration of the false dichotomy between emotion and reason that lies behind the assumption of a judicial system that operates rationally and without emotion, Professional Emotions in Court reveals how this assumption shapes professionals’ perceptions and performance of their work, but hampers emotional reflexivity, and questions whether the judicial system might gain in legitimacy if the role of emotional processes were recognized and reflected upon

Thermal and Photon Stimulated Reactions on Metal Particles

<p>The interaction between molecules and solid surfaces influence our daily lives in many ways. One important example is heterogeneous catalysis where surface reactions, for example, are used for production of chemicals and exhaust after-treatment. As surface reactions are complex, various different approaches are needed to explore the fundamental processes.</p> <p>One route is to study reactions at well-defined single crystal surfaces under ultra-high vacuum (UHV) conditions. However, as the reaction pathways may depend on pressure, ideally we would like to track how and if the interactions change with pressure. Furthermore, technical catalysts generally consist of nanometre-sized particles supported by an oxide material. This introduces the complexity of particle size-dependence, as well as effects arising from interactions between the reactants and the support material.</p> <p>The studies in this thesis range from fundamental studies in UHV to experiments under ambient conditions. Structure-wise, the studies encompass single crystal substrates and model catalysts. Furthermore, surface processes are stimulated by both thermal and photon energy.</p> <p>The fundamental aspects of thermally driven interactions of NO and water with sodium supported on a single crystal C(0001) surface were studied in UHV. Moreover, the influence of silver particle size (and to some extent shape) on the efficiency of photon driven desorption of NO from the Ag/C(0001) system was explored.</p> <p>Model catalysts were studied under ambient conditions by use of indirect nanoplasmonic sensing (INPS). In particular, INPS was used to determine the apparent activation energy for hydrogen oxidation as a function of platinum nanoparticle size, and to track the sintering of platinum clusters.</p

Study protocol for the Fex-Can Childhood project An observational study and a randomized controlled trial focusing on sexual dysfunction and fertility-related distress in young adult survivors of childhood cancer

Background: This study protocol describes the Fex-Can Childhood project, comprising two studies: The Fex-Can Childhood observational study (OS) and the Fex-Can Childhood randomized controlled trial (RCT). The Fex-Can Childhood OS aims to determine the prevalence and predictors of sexual dysfunction and fertility-related distress in young adult childhood cancer survivors (aged 19-40) compared to an age matched comparison group; the Fex-Can Childhood RCT will evaluate the effect of a web-based psycho-educational intervention (Fex-Can intervention) on sexual dysfunction and fertility-related distress. Methods: The Fex-Can Childhood OS will have a population-based cross-sectional design. All individuals treated for childhood cancer in Sweden at the age of 0 to 17 years (current age 19-40) will be identified through the National Quality Registry for Childhood Cancer. Established self-reported instruments will be used to measure sexual function, fertility-related distress, body image, anxiety and depression, and health-related quality of life. Self-efficacy related to sexual function and fertility, and fertility-related knowledge, will be assessed by study-specific measures. Clinical variables will be collected from the registry. Results will be compared to an age-matched comparison group from the general population. Participants in the Fex-Can Childhood OS who report a high level of sexual dysfunction and/or fertility-related distress will be invited to participate in the RCT. The Fex-Can intervention comprises two programs: The Fex-Can Sex and the Fex-Can Fertility targeting sexual dysfunction and fertility-related distress, respectively. The control condition will be a wait-list. Sexual function and fertility-related distress will be the primary outcomes. The secondary outcomes include body image, anxiety and depression, health-related quality of life and self-efficacy related to sexual function and fertility. Post- and follow-up assessments will be conducted directly after end of intervention (primary end point), at 3 months and 6 months after end of intervention. Additionally, a process-evaluation including study-specific items and a qualitative interview will be conducted. Discussion: The Fex-Can Childhood project will advance knowledge in the areas of sexual function and fertility-related distress among young adult survivors of childhood cancer. If the Fex-Can intervention proves to be efficacious, steps will be taken to implement it in the follow-up care provided to this population.Peer reviewe

Psychometric properties of the DISABKIDS Chronic Generic Module (DCGM-37) when used in children undergoing treatment for cancer

Background: The aim was to evaluate data quality and psychometric properties of an instrument for measurement of health-related quality of life: DISABKIDS Chronic Generic Module (DCGM-37) used in school-aged children with cancer. Methods: All school-children diagnosed with cancer in Sweden during a two-and-a-half year period were invited to participate in the study. Analysis was performed on combined data from two assessments, two and-a-half and five months after start of cancer treatment (n = 170). The instrument was examined with respect to feasibility, data quality, reliability and construct and criterion-based validity. Results: Missing items per dimension ranged from 0 to 5.3 percent, with a majority below three percent. Cronbach's alpha values exceeded 0.70 for all dimensions. There was support for the suggested groupings of items into dimensions for all but six of the 36 items of the DCGM-37 included in this study. The instrument discriminated satisfactorily between diagnoses reflecting treatment burden. Conclusions: The results indicate satisfactory data quality and reliability of the DCGM-37 when used in children undergoing treatment for cancer. Evaluation of construct validity showed generally acceptable results, although not entirely supporting the suggested dimensionality. Continued psychometric evaluation in a larger sample of children during and after treatment for cancer is recommended