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  • 1.
    Darcy, Laura
    et al.
    University of Borås, School of Health Science. University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Björk, M
    Enkär, K
    Knutsson, Susanne
    University of Borås, School of Health Science.
    The process of striving for an ordinary, everyday life, in young children living with cancer, at six months and one year post diagnosis2014In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 18, no 6, p. 605-612Article in journal (Refereed)
    Abstract [en]

    Purpose Health care focus is shifting from solely looking at surviving cancer to elements of attention relating to living with it on a daily basis.The young child's experiences are crucial to providing evidence based care. The aim of this study was to explore the everyday life of young children as expressed by the child and parents at six months and one year post diagnosis. Methods Interviews were conducted with children and their parents connected to a paediatric oncology unit in Southern Sweden. A qualitative content analysis of interview data from two time points, six months and one year post diagnosis, was carried out. Results The process of living with cancer at six months and at one year post diagnosis revealed the child's striving for an ordinary, everyday life. Experiences over time of gaining control, making a normality of the illness and treatment and feeling lonely were described. Conclusion Nurses have a major role to play in the process of striving for a new normal in the world post-diagnosis, and provide essential roles by giving the young child information, making them participatory in their care and encouraging access to both parents and peers. Understanding this role and addressing these issues regularly can assist the young child in the transition to living with cancer. Longitudinal studies with young children are vital in capturing their experiences through the cancer trajectory and necessary to ensure quality care.

  • 2.
    Darcy, Laura
    et al.
    University of Borås, School of Health Science.
    Enkär, K
    Granlund, M
    Someonsson, R J
    Peterson, C
    Björk, M
    Health and functioning in the everyday lives of young children with cancer: documenting with the International Classification of Functioning, Disability & Health – Children & Youth (ICF-CY)2014In: Child Care Health and Development, ISSN 0305-1862, E-ISSN 1365-2214, Vol. 41, no 3, p. 475-482Article in journal (Refereed)
    Abstract [en]

    Background Health care focus is shifting for children from surviving childhood cancer to living with it on a daily basis. There is a need to document health and function in the everyday lives of young children with cancer using the multidimensional framework and language of the International Classification of Functioning, Disability and Health – Children and Youth (ICF-CY). Aims The aims of this study were (1) to document health and functioning in the everyday lives of young children with cancer using ICF-CY codes and (2) to identify a comprehensive code set that can aid clinical assessment. Method Interviews with children diagnosed with cancer and their parents, were transcribed, reviewed for content and coded to the ICF-CY using linking procedures. Results A comprehensive code set (n = 70) for childhood cancer was identified. The majority of content identified to codes was related to activity and participation describing social relations with family, peers and professionals, preschool attendance and play, as well as issues related to support and independence.

  • 3.
    Darcy, Laura
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare. Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.
    Enskär, Karin
    Högskolan i Jönköping, HHJ, Avd. för omvårdnad.
    Björk, Maria
    Högskolan i Jönköping, HHJ, Avd. för omvårdnad.
    Young children's experiences of living an everyday life with cancer – A three year interview study2018In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122Article in journal (Refereed)
    Abstract [en]

    Purpose

    The young child's experiences of living with cancer are crucial to providing evidence based care. This study explores and describes experiences of everyday life of young children with cancer, over a three year period from diagnosis.

    Method

    This is a longitudinal, inductive interview study with young children with cancer, and their parents. Interviews from shortly after diagnosis, six and 12 months after diagnosis have been reanalysed. Interviews with the same children and their parents from 18 to 36 months after diagnosis have been analysed for the first time in the present paper. A longitudinal temporal analysis at category level for five synchronic data sets forms the basis for the results.

    Results

    The child living with cancer over a three year period is described as a child apart, striving to live an everyday life. This description is built on three categories: I want to be a child like any other, I need security and control and I feel lonely and left out. Young children with cancer actively strive to understand their illness, participate in care and live an ordinary everyday life- but with ongoing feelings of social isolation and loneliness.

    Conclusions

    Young children with cancer need access to and ongoing contact with peers and preschool. A structured follow-up throughout the cancer trajectory and not just during active treatment, is necessary. A child-centred philosophy of care would guide the child towards attainment of health and wellbeing.

  • 4.
    Darcy, Laura
    et al.
    University of Borås, School of Health Science.
    Enskär, Karin
    Granlind, Mats
    Simeonsson, Rune J
    Peterson, Christina
    Björk, Maria
    Health and functioning in the everyday lives of young children with cancer: documenting with the International Classification of Functioning, Disability and Health – Children and Youth (ICF-CY)2014In: Child Care Health and Development, ISSN 0305-1862, E-ISSN 1365-2214Article in journal (Refereed)
    Abstract [en]

    Background Health care focus is shifting for children from surviving childhood cancer to living with it on a daily basis. There is a need to document health and function in the everyday lives of young children with cancer using the multidimensional framework and language of the International Classification of Functioning, Disability and Health – Children and Youth (ICF-CY). Aims The aims of this study were (1) to document health and functioning in the everyday lives of young children with cancer using ICF-CY codes and (2) to identify a comprehensive code set that can aid clinical assessment. Method Interviews with children diagnosed with cancer and their parents, were transcribed, reviewed for content and coded to the ICF-CY using linking procedures. Results A comprehensive code set (n = 70) for childhood cancer was identified. The majority of content identified to codes was related to activity and participation describing social relations with family, peers and professionals, preschool attendance and play, as well as issues related to support and independence. Conclusions The ICF-CY can be used to document the nature and range of characteristics and consequences of cancer experienced by children. The identified comprehensive code set could be helpful to health care professionals, parents and teachers in assessing and supporting young children’s health and everyday life through the cancer trajectory. The comprehensive code set could be developed as a clinical assessment tool for those caring for young children with cancer. The universal language of the ICF-CY means that the utility of a clinical assessment tool based on identified codes can have wide reaching effects for the care of young children with cancer.

  • 5. Fernandez-Llatas, Carlos
    et al.
    Gatta, Roberto
    Seoane, Fernando
    University of Borås, Faculty of Textiles, Engineering and Business. University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Valentini, Vincenzo
    Editorial: Artificial intelligence in process modelling in oncology2023In: Frontiers in Oncology, E-ISSN 2234-943X, Vol. 13Article in journal (Other academic)
  • 6.
    Hedén, Lena E
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    von Essen, Louise
    Ljungman, Gustaf
    Effect of morphine in needle procedures in children with cancer.2011In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 15, no 10Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The aim was to investigate whether children experience less fear, distress, and/or pain when they receive oral morphine vs. placebo before a needle is inserted in a subcutaneously implanted intravenous port when combined with topical anesthesia.

    METHOD: Fifty children 1-18 years of age who were treated in a pediatric oncology and hematology setting were included consecutively when undergoing routine needle insertion into an intravenous port. All children were subjected to one needle insertion following topical anesthetic (EMLA) application in this randomized, triple-blind, placebo-controlled study comparing orally administered morphine (n=26) 0.25 mg/kg body weight with placebo (n=24). The patients' fear, distress, and pain were reported by parents, nurses and the children themselves (if ≥ 7 years of age) on 0-100 mm Visual Analogue Scales. In addition, observational methods were used to measure distress and procedure pain.

    RESULTS: No differences between the morphine and the placebo group were found with respect to age, weight, height, physical status, sex, weeks from diagnosis, or weeks from latest needle insertion. According to, parents, nurses, and children, oral morphine at a dose of 0.25 mg/kg body weight did not reduce fear, distress or pain compared with placebo.

    CONCLUSION: We could not reject the null hypothesis that there is no difference between the oral morphine and placebo groups assuming an effect size of 15 mm on VAS. Therefore it seems that oral morphine at 0.25 mg/kg does not give any additional reduction of fear, distress or pain compared with placebo when combined with topical anesthesia in pediatric patients undergoing subcutaneous port needle insertion, and would not be expected to be of any advantage for similar procedures such as venipuncture and venous cannulation when topical anesthesia is used.

  • 7.
    Hedén, Lena
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Pöder, Ulrika
    von Essen, Louise
    Ljungman, Gustaf
    Parents' perceptions of their child's symptom burden during and after cancer treatment.2013In: Journal of Pain and Symptom Management, ISSN 0885-3924, E-ISSN 1873-6513, Vol. 46, no 3Article in journal (Refereed)
    Abstract [en]

    CONTEXT: Previously reported studies of children with cancer mostly provide cross-sectional knowledge of the prevalence of symptoms but do not show when during the disease trajectory and after the end of successful treatment certain symptoms are most prevalent and/or distressing.

    OBJECTIVES: The aim was to describe parents' perceptions of their child's symptom burden longitudinally during and after cancer treatment and to investigate whether parents' perceptions vary with child characteristics and parent gender.

    METHODS: One hundred sixty parents (49% fathers) of 89 children answered a modified version of the Memorial Symptom Assessment Scale (MSAS) 10-18 at six different time points from one week after the child's diagnosis (T1) to 12-18 months after the end of successful treatment (T6).

    RESULTS: Feeling drowsy, pain, and lack of energy are initially the most prevalent symptoms. During treatment, the most prevalent symptom is less hair than usual. Pain, feeling sad, and nausea are initially the most distressing symptoms. Pain is both prevalent and distressing throughout the treatment. The child's symptom burden decreases over time. There is no difference regarding the reported symptom burden between the parents of a daughter or a son, or parents of a child older or younger than seven years of age. Mothers' and fathers' assessments of the symptom number, total MSAS and the subscales, are associated, but mothers' assessments are often higher than fathers' assessments.

    CONCLUSION: The prevalence and distress of symptoms and symptom burden decrease over time. However, even though the cancer is cured, feeling sad is reported as being prevalent and psychological distress is an issue. A dialogue between staff and the family about distressing symptoms and when they can be expected may increase acceptance and adaptation in children and parents during the disease trajectory.

  • 8.
    Hedén, Lena
    et al.
    University of Borås, School of Health Science. University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    von Essen, Louise
    Ljungman, Gustaf
    Effect of high-dose paracetamol on needle procedures in children with cancer: a RCT2014In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 103, no 3, p. 314-319Article in journal (Refereed)
    Abstract [en]

    AIM: The aim was to investigate whether children experience less pain, fear and/or distress when they receive high-dose paracetamol compared with placebo, using a needle insertion in a subcutaneously implanted intravenous port as a model. METHODS: Fifty-one children ranging from 1 to 18 years of age being treated in a paediatric oncology setting were included consecutively when undergoing routine needle insertion into a subcutaneously implanted intravenous port. All children were subjected to one needle insertion following topical anaesthetic (EMLA) application in this double-blind, placebo-controlled RCT, comparing orally administered paracetamol (n = 24) 40 mg/kg body weight (max 2000 mg) with placebo (n = 27). The patients' pain, fear and distress were reported by parents, nurses and children (≥7 years of age) using 0- to 100-mm visual analogue scales (VAS). In addition, pain observation, procedure time and cortisol reduction were assessed. RESULTS: No differences between the paracetamol and the placebo group were found with respect to demographic characteristics. According to VAS reports, paracetamol did not reduce pain, fear and distress compared with placebo. Pain observation, cortisol reduction and procedure time did not differ between the study groups. CONCLUSION: Paracetamol provides no additive effect in reducing pain, fear and distress when combined with topical anaesthesia in children undergoing port needle insertion.

  • 9. Karlsson, Katarina
    The Children's Action-Reaction Assessment Tool (CARAT) as an observational tool for assessing pain management: An initial validation study with children undergoing needle procedures.2019In: 51 st congress of the international society of paediatrics oncolgy (SIOP), Wiley, 2019, Vol. 66Conference paper (Refereed)
  • 10. Karlsson, Sandra
    et al.
    Ståhl, Fredrik
    University of Borås, School of Health Science.
    Larsson, Dennis
    Molecular diagnostic markers in endometrial carcinoma: an overview2013In: Journal of Oncopathology, ISSN 2052-5931, Vol. 1, no 2, p. 145-150Article in journal (Refereed)
    Abstract [en]

    Endometrial, ovarian, and cervical cancers are three of the most common malignancies of the female reproductive organs and the most common cause of gynecological cancer deaths in the Western world. Approximately 80% or more of endometrial cancers are low-grade, estrogen-dependent, endometrioid adenocarcinoma (type I), whereas 20% are high-grade endometrial carcinomas (type II) associated with poor prognosis. Although endometrial cancer is usually diagnosed at an early stage, still almost 20% of the patients present with advanced disease. Thus, there is a need for highly sensitive markers that can distinguish between high- and low-risk endometrial carcinoma. To date, however, there are no validated molecular markers for endometrial cancer. Recent genomic and proteomic-based anaes show great promise for the discovery of new and more useful biomarkers. In this review, we will discuss the currently reported biomarkers that hold potential as diagnostic tools for endometrial cancer.

  • 11.
    Mentink, Marit
    et al.
    Nivel (Netherlands Institute of Health Services Research), Otterstraat 118, 3512 CR Utrecht, The Netherlands;Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Geert Grooteplein Zuid 21, 6525 EZ Nijmegen, The Netherlands.
    Verbeek, Daniëlle
    Praktijk Integratieve Oncologie, Heesterpoort 18, 9713 KZ Groningen, The Netherlands.
    Noordman, Janneke
    Nivel (Netherlands Institute of Health Services Research), Otterstraat 118, 3512 CR Utrecht, The Netherlands.
    Timmer-Bonte, Anja
    Department of Medical Oncology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands.
    von Rosenstiel, Ines
    Department of Integrative Oncology, Rijnstate Hospital, Wagnerlaan 55, 6815 AD Arnhem, The Netherlands.
    van Dulmen, Sandra
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare. Nivel (Netherlands Institute of Health Services Research), Otterstraat 118, 3512 CR Utrecht, The Netherlands;Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Geert Grooteplein Zuid 21, 6525 EZ Nijmegen, The Netherlands;Faculty of Caring Science, University of Borås, Work Life and Social Welfare, Allégatan 1, 501 90 Borås, Sweden.
    The Effects of Complementary Therapies on Patient-Reported Outcomes: An Overview of Recent Systematic Reviews in Oncology2023In: Cancers, E-ISSN 2072-6694, Vol. 15, no 18, article id 4513Article, review/survey (Refereed)
    Abstract [en]

    Many patients with cancer make use of complementary medicine alongside conventional medicine, but clinicians in oncology often lack the knowledge to adequately advise patients on the evidence base for complementary therapies. This study aims to provide an overview of recently published systematic reviews that assess the effects of complementary therapies on patient-reported health outcomes in patients with cancer. Systematic reviews, including a meta-analysis of at least two randomized controlled trials, were identified from the PubMed, Embase, Cochrane Library, CINAHL and PsycINFO databases. The methodological quality was assessed with AMSTAR 2. One hundred systematic reviews were included. The results suggest that several complementary therapies can improve health outcomes reported by patients with cancer, such as acupuncture to relieve pain, music interventions to reduce anxiety and yoga to improve cancer-related fatigue. The side effects related to complementary therapy use are generally mild. The results remain inconclusive for some intervention–outcome combinations. Many of the included systematic reviews insufficiently assessed the causes and impact of bias in their interpretation of the results. This overview of systematic reviews can support clinicians in counselling their patients on this topic and provide directions for future research and clinical practice guidelines in the field of complementary medicine.

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  • 12.
    Toyinbo, O
    et al.
    World Bank Africa Centre of Excellence for Public Health and Toxicological Research, University of Port Harcourt, Choba, Nigeria.
    Hägerhed, Linda
    University of Borås, Faculty of Textiles, Engineering and Business.
    Dimitroulopoulou, S
    Air Quality and Public Health, Radiation Chemicals and Environment, UK Health Security Agency, Chilton, UK.
    Dudzinska, M
    Department of Indoor and Outdoor Air Quality, Faculty of Environmental Engineering, Lublin University of Technology, Lublin, Poland.
    Emmerich, S
    National Institute of Standards and Technology, Gaithersburg, Maryland, USA.
    Hemming, D
    CETEC Foray Limited, London, UK.
    Park, J H
    Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA.
    Haverinen-Shaughnessy, U
    Indoor Air Program, The University of Tulsa, Tulsa, Oklahoma, USA; Faculty of Technology, Civil Engineering Research Unit, The University of Oulu, Oulu, Finland.
    Open database for international and national indoor environmental quality guidelines2022In: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 32, no 4Article in journal (Refereed)
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