Brain MR Spectroscopy Changes Precede Frontotemporal Lobar Degeneration Phenoconversion in Mapt Mutation Carriers.

Background and purposeThe objective of this study was to longitudinally investigate the trajectory of change in 1 H MRS measurements in asymptomatic MAPT mutation carriers who became symptomatic during follow-up, and to determine the time at which the neurochemical alterations accelerated during disease progression.MethodsWe identified eight MAPT mutations carriers who transitioned from asymptomatic to symptomatic disease during follow-up. All participants were longitudinally followed with an average of 7.75 years (range 4-11 years) and underwent two or more single voxel 1 H MRS examinations from the posterior cingulate voxel, with a total of 60 examinations. The rate of longitudinal change for each metabolite was estimated using linear mixed models. A flex point model was used to estimate the flex time point of the change in slope.ResultsThe decrease in the NAA/mI ratio accelerated 2.09 years prior to symptom onset, and continued to decline. A similar trajectory was observed in the presumed glial marker mI/Cr ratio accelerating 1.86 years prior to symptom onset.ConclusionsOur findings support the potential use of longitudinal 1 H MRS for monitoring the neurodegenerative progression in MAPT mutation carriers starting from the asymptomatic stage

Rates of lobar atrophy in asymptomatic MAPT mutation carriers.

IntroductionThe aim of this study was to investigate the rates of lobar atrophy in the asymptomatic microtubule-associated protein tau (MAPT) mutation carriers.MethodsMAPT mutation carriers (n = 14; 10 asymptomatic, 4 converters from asymptomatic to symptomatic) and noncarriers (n = 13) underwent structural magnetic resonance imaging and were followed annually with a median of 9.2 years. Longitudinal changes in lobar atrophy were analyzed using the tensor-based morphometry with symmetric normalization algorithm.ResultsThe rate of temporal lobe atrophy in asymptomatic MAPT mutation carriers was faster than that in noncarriers. Although the greatest rate of atrophy was observed in the temporal lobe in converters, they also had increased atrophy rates in the frontal and parietal lobes compared to noncarriers.DiscussionAccelerated decline in temporal lobe volume occurs in asymptomatic MAPT mutation carriers followed by the frontal and parietal lobe in those who have become symptomatic. The findings have implications for monitoring the progression of neurodegeneration during clinical trials in asymptomatic MAPT mutation carriers

Tactile massage and hypnosis as a health promotion for nurses in emergency care-a qualitative study

<p>Abstract</p> <p>Background</p> <p>This study explores nursing personnel's experiences and perceptions of receiving tactile massage and hypnosis during a personnel health promotion project. Nursing in a short term emergency ward environment can be emotionally and physically exhausting due to the stressful work environment and the high dependency patient care. A health promotion project integrating tactile massage and hypnosis with conventional physical activities was therefore introduced for nursing personnel working in this setting at a large university hospital in Sweden.</p> <p>Methods</p> <p>Four semi-structured focus group discussions were conducted with volunteer nursing personnel participants after the health promotion project had been completed. There were 16 participants in the focus groups and there were 57 in the health promotion intervention. The discussions were transcribed verbatim and analysed with qualitative content analysis.</p> <p>Results</p> <p>The findings indicated that tactile massage and hypnosis may contribute to reduced levels of stress and pain and increase work ability for some nursing personnel. The sense of well-being obtained in relation to health promotion intervention with tactile massage and hypnosis seemed to have positive implications for both work and leisure. Self-awareness, contentment and self-control may be contributing factors related to engaging in tactile massage and hypnosis that might help nursing personnel understand their patients and colleagues and helped them deal with difficult situations that occurred during their working hours.</p> <p>Conclusion</p> <p>The findings indicate that the integration of tactile massage and hypnosis in personnel health promotion may be valuable stress management options in addition to conventional physical activities.</p

Decreased Th1-Type Inflammatory Cytokine Expression in the Skin Is Associated with Persisting Symptoms after Treatment of Erythema Migrans

Background: Despite the good prognosis of erythema migrans (EM), some patients have persisting symptoms of various character and duration post-treatment. Several factors may affect the clinical outcome of EM, e. g. the early interaction between Borrelia (B.) burgdorferi and the host immune response, the B. burgdorferi genotype, antibiotic treatment as well as other clinical circumstances. Our study was designed to determine whether early cytokine expression in the skin and in peripheral blood in patients with EM is associated with the clinical outcome. Methods: A prospective follow-up study of 109 patients with EM was conducted at the A land Islands, Finland. Symptoms were evaluated at 3, 6, 12 and 24 months post-treatment. Skin biopsies from the EM and healthy skin were immunohistochemically analysed for expression of interleukin (IL)-4, IL-10, IL-12p70 and interferon (IFN)-gamma, as well as for B. burgdorferi DNA. Blood samples were analysed for B. burgdorferi antibodies, allergic predisposition and levels of systemic cytokines. Findings: None of the patients developed late manifestations of Lyme borreliosis. However, at the 6-month follow-up, 7 of 88 patients reported persisting symptoms of diverse character. Compared to asymptomatic patients, these 7 patients showed decreased expression of the Th1-associated cytokine IFN-gamma in the EM biopsies (p = 0.003). B. afzelii DNA was found in 48%, B. garinii in 15% and B. burgdorferi sensu stricto in 1% of the EM biopsies, and species distribution was the same in patients with and without post-treatment symptoms. The two groups did not differ regarding baseline patient characteristics, B. burgdorferi antibodies, allergic predisposition or systemic cytokine levels. Conclusion: Patients with persisting symptoms following an EM show a decreased Th1-type inflammatory response in infected skin early during the infection, which might reflect a dysregulation of the early immune response. This finding supports the importance of an early, local Th1-type response for optimal resolution of LB.Original Publication: Johanna Sjöwall, Linda Fryland, Marika Nordberg, Florence Sjögren, Ulf Garpmo, Christian Jansson, Sten-Anders Carlsson, Sven Bergstrom, Jan Ernerudh, Dag Nyman, Pia Forsberg and Christina Ekerfelt, Decreased Th1-Type Inflammatory Cytokine Expression in the Skin Is Associated with Persisting Symptoms after Treatment of Erythema Migrans, 2011, PLOS ONE, (6), 3, 0018220. http://dx.doi.org/10.1371/journal.pone.0018220 Copyright: Public Library of Science (PLoS) http://www.plos.org

Air pollution and lung cancer incidence in 17 European cohorts: prospective analyses from the European Study of Cohorts for Air Pollution Effects (ESCAPE)

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PROFESSORES DO PISA: A ESPERANÇA E A REALIZAÇÃO DA EDUCAÇÃO

RESUMO: As atividades do Programme for International Student Assessment (PISA) e os seus efeitos são diversos, sendo possível dizer que o PISA cria e forma uma fundamentação específica (HACKING, 1992) para discutir, falar e pensar sobre a educação. Neste estudo sobre as atividades do PISA, são analisadas as ideias sobre os professores, as atividades que realizam, e como estas são conceitualizadas no interior de uma narrativa própria ao PISA. Os resultados mostram que os professores são apresentados como sendo importantes e cruciais para a transformação e para o desenvolvimento da educação. Os professores também são representados como sendo essenciais para reduzir as "disparidades no desempenho" dos alunos medidas pelo teste PISA. Ademais, os "bons" professores e o ensino "eficaz" são descritos como os professores e as estratégias que conduzem a tal redução. Consequentemente, os principais relatórios do PISA enfatizam uma imagem dos professores como os atores que desenvolvem a educação e o ensino, e não como executantes de políticas determinadas pelo Estado. Deste modo, os professores são considerados como indicadores da eficácia dos sistemas de educação e importantes para elevar os padrões de desempenho, sendo assim considerados como a esperança e a realização da educação

The sense of well-being in a group of patients with gastro-intestinal cancer

The main purpose of this study was to describe patients with gastro-intestinal cancer and their general health and well-being during different stages of the disease. Questionnaires concerning coping ability, general health, well-being and the frequencies and occurrences of symptoms were used to collect data about the patient's pre- and post-surgical situation. Two of these questionnaires, the Health Index (Hl) and the General Health Rating Index (GHRI), were addressed to a randomly selected sample from Stockholm County, in order to obtain the reference values of healthy individuals. Ninety-six patients with gastro-intestinal cancer were examined before surgery. Of these, 79 were available for examination six weeks after surgery. One year after surgery, 69 patients remained in the study. The patients evaluated their well-being as rather good, both before and after surgery, although they reported symptoms such as flatulence, fatigue, sleep disorders, worry and pain. The first period at home, after discharge from the hospital, seems to be a critical period for the patients. Problem areas identified concerned fatigue, decreased energy and mobility, sleeping disorders, pain, nutrition, worry and wound problems. One year after surgery, the patients had not returned to a state of normal health. The cancer patients perceived their well-being and general health as worse than those of healthy individuals. The younger group of cancer patients rated their psychological well-being as worse one year after surgery, compared with that of the older ones. The intercorrelations between the Sense of Coherence (SOC), the HI and the GHRI were significant. Thus, the stronger the SOC, the better the perceived well-being and general health. No significant difference was found between the SOC score before and one year after surgery. It was concluded that both the Hl scale and the SOC scale should be tested for clinical use in assessing the need of nursing care of patients with gastro-intestinal cancer. The SOC may be useful as an indicator of the individual's ability to manage his or her self-care after the treatment. The patient treated for gastro-intestinal cancer needs long-term, individualised support, with emphasis on psychosocial factors, bowel function and fatigue. Social and marital status apparently affect the patients' sense of well-being. A social network may function as a buffer against the discomfort of having a cancer disease and improve the individual's sense of well-being

Arts Education and Comics : a Multifaceted yet Unutilized Didactical Tool?

Tecknade serier behandlas ofta som ett sidoprojekt inom bildundervisningen och verkar sällan ses som ett komplett lärandemål. Med detta arbete vill vi öka förståelsen för hur serier kan användas i bildundervisningen som ett didaktiskt verktyg med grund i relevant forskning. För att ta reda på mer om vilka möjligheter och begränsningar som finns gjordes en sammanställning av aktuell forskning inom ämnet. Vidare tittade vi på hur serier användes och presenterades i ett läromedel i bildämnet, relaterat till forskning om serier och även till multimodalitet. Materialet som analyserats är en del av ett formellt läromedel i bild från NE. Kort sagt fokuserade läromedlet främst på fakta om serier och inte så mycket på visuellt berättande. Den sammanställda forskningen visar på en generell nytta med att använda serier som multimodal och didaktisk resurs, vilket kontrasterar det formella läromedlets presentation av serier.