Psychosomatic aspects on diabetes and chronic pain Alexithymia, depression and salivary cortisol The Affect School and Script Analysis Therapy

This thesis explores links between psyche and soma in diabetes and in chronic benign pain (CBP). Interventions with Affect School and Script Analysis (ASSA) compared to Basic Body Awareness Therapy (BBAT) are tried. In a feasibility and treatment efficacy study we offered ASSA to 59 patients with CBP, and 54 (92%) completed. Alexithymia prevalence went from 33% to 11% (p = 0.013), depression from 59% to 48% (p = 0.18), and anxiety from 78% to 50% (p = 0.002) in 46 respondents, and social relations improved (p 70 mmol/mol, which was associated with depression (AOR 4.8), abdominal obesity (AOR 4.3), and smoking (AOR 3.0). Alexithymia and anxiety were linked with depression. In a cross sectional study of 196 T1D patients, associations between high MSC (≥9.3 nmol/L), depression, HbA1c, and intra individual, behavioural and environmental factors were explored. 34 patients (17%) had MSC ≥9.3 nmol/L, which was associated with smoking (AOR 5.5), spring season (AOR 4.3), physical inactivity (AOR 3.9), depression (AOR 3.1), and older age (AOR 1.08; (per year)). HbA1c >70 mmol/mol (AOR 4.2) and MSC ≥9.3 nmol/L (AOR 4.4) were independently linked with depression. Conclusions are that alexithymia was linked with depression, which in sum was associated with both high HbA1c and high MSC in T1D patients. ASSA showed reduced alexithymia, anxiety and depression and improved social relations in CBP patients. ASSA for selected patients with diabetes will be further evaluated in an RCT

Post-polio syndrome : analysis of inflammation and immune modulation

Poliomyelitis is a viral infection, which affects the anterior horn cells of the spinal cord leaving patients with different levels and distribution of muscle weakness and loss of, or decreased, function. This situation has previously been regarded as a stable condition. However, following recovery from poliomyelitis, with or without remaining symptoms and after a stable period, some polio patients may develop Post-polio Syndrome (PPS), a syndrome characterized by new or increasing muscular weakness, pain, fatigue, and sensitivity to cold. The findings of increased cytokine levels in cerebrospinal fluid and peripheral blood has led to the conclusion that there is an inflammatory process underway in PPS. One of the most common symptoms, in addition to muscle weakness, is pain and some earlier studies have presented evidence of an inflammatory process in muscle. This was confirmed in this research based on the findings of an elevated expression of the enzymes in the Prostaglandin E2 (PGE2) pathway, i.e. mPGES-1, COX-2, COX-1 and cPGES. This may explain muscle pain and opens new perspectives for specific treatment. It has been speculated that the inflammation in PPS may have an autoimmune background. In this research there were no circulating immune complexes in the blood of the PPS patients. This reduces the possibility that the inflammation is driven by a complement mediated autoimmune process. In some chronic inflammatory conditions there is an increase of blood lipids. In earlier studies of PPS patients, blood lipid levels have been found to be increased. In this study the blood lipids were normal, and thus, the inflammation does not appear to give rise to hyperlipidaemia. The inflammation in PPS patients is down-regulated by immune-modulatory treatment, by means of IvIg, which is followed by a clinical improvement. However, it has been difficult to pinpoint and characterize responders and non-responders. When re-evaluating the PPS diagnosis 2-8 years after the treatment, patients still considered as suffering from PPS experienced a better outcome of the treatment than patients with a stable condition, i.e. non- PPS. This opens up for speculation that PPS may be divided into two different subgroups, unstable patients with PPS driven by an inflammatory process and stable patients with a slower deterioration possibly due to ageing and concomitant disorders

Affect School for chronic benign pain patients showed improved alexithymia assessments with TAS-20

<p>Abstract</p> <p>Background</p> <p>Alexithymia is a disturbance associated with psychosomatic disorders, pain syndromes, and a variety of psychiatric disorders. The Affect School (AS) based on Tomkins Affect Theory is a therapy focusing on innate affects and their physiological expressions, feelings, emotions and scripts. In this pilot study we tried the AS-intervention method in patients with chronic benign pain.</p> <p>Methods</p> <p>The AS-intervention, with 8 weekly group sessions and 10 individual sessions, was offered to 59 patients with chronic non-malignant pain at a pain rehabilitation clinic in Sweden 2004-2005. Pre and post intervention assessments were done with the Hospital Anxiety and Depression scale (HAD), the Toronto Alexithymia Scale-20 (TAS-20), the Visual Analogue Scale for pain assessment (VAS-pain), the European Quality of Life health barometer (EQoL) and the Stress and Crisis Inventory-93 (SCI-93). After the group sessions we used Bergdahl's Questionnaire for assessing changes in interpersonal relations, general well-being and evaluation of AS.</p> <p>Results</p> <p>The AS intervention was completed by 54 out of 59 (92%) patients. Significant reductions in total TAS-20 post-test scores (p = 0.0006) as well as TAS-20 DIF and DDF factors (Difficulties Identifying Feelings, and Difficulties Describing Feelings) were seen (p = 0.0001, and p = 0.0008) while the EOT factor (Externally Oriented Thinking) did not change. Improvements of HAD-depression scores (p = 0.04), EQoL (p = 0.02) and self-assessed changes in relations to others (p < 0.001) were also seen. After Bonferroni Correction for Multiple Analyses the TAS-20 test score reduction was still significant as well as Bergdahl's test after group sessions. The HAD, EQoL, SCI-93, and VAS-pain scores were not significantly changed. The AS-intervention was ranked high by the participants.</p> <p>Conclusions</p> <p>This pilot study involving 59 patients with chronic benign pain indicates that the alexithymia DIF and DDF, as well as depression, social relations and quality of life may be improved by the Affect School therapeutic intervention.</p

Fruit scent and observer colour vision shape food-selection strategies in wild capuchin monkeys

The senses play critical roles in helping animals evaluate foods, including fruits that can change both in colour and scent during ripening to attract frugivores. Although numerous studies have assessed the impact of colour on fruit selection, comparatively little is known about fruit scent and how olfactory and visual data are integrated during foraging. We combine 25 months of behavioural data on 75 wild, white-faced capuchins (Cebus imitator) with measurements of fruit colours and scents from 18 dietary plant species. We show that frequency of fruit-directed olfactory behaviour is positively correlated with increases in the volume of fruit odours produced during ripening. Monkeys with red-green colour blindness sniffed fruits more often, indicating that increased reliance on olfaction is a behavioural strategy that mitigates decreased capacity to detect red-green colour contrast. These results demonstrate a complex interaction among fruit traits, sensory capacities and foraging strategies, which help explain variation in primate behaviour.https://www.nature.com/articles/s41467-019-10250-9Published versio

Pengembangan Media Pembelajaran Pop – Up Book Untuk Meningkatkan Motivasi Belajar Siswa Kelas IV SD

Penelitian ini bertujuan, 1) mendeskripsikan pengembangan media pembelajaran pop – up book&nbsp; untuk meningkatkan motivasi belajar siswa, 2) untuk mendeskripsikan apakah pengembangan media pembelajaran pop – up book efektif dalam meningkatkan motivasi belajar siswa pada tema 6 subtema 1 keanekaragaman hewan dan tumbuhan kelas IV di SD Negeri Ujong Tanjong. Jenis penelitian yang digunakan adalah Research and Development dengan prosedural penelitian dan pengembangan dari Borg and Gall. Instrument dalam penelitian ini adalah lembar validasi ahli media dan ahli materi, serta lembar angket respon siswa dan angket respon guru, semua motivasi belajar dari setiap siswa terlihat lebih meningkat selama proses pembelajaran menggunakan media pop – up berlangsung, hal itu dapat dilihat dari angket respon siswa. Media pembelajaran pop – up book ini dibuat menggunakan PicsArt Photo Studio dan Microsoft Word 2010. Berdasarkan analisis data penilaian ahli media sebesar 3,33 dengan kategori “valid”, penilaian ahli materi sebesar 3,60 dengan kategori “valid”, penilaian respon tenaga pendidik sebesar 3,60 dengan kategori “valid”, penilaian respon peserta didik pada uji coba I sebesar 95,8% dengan kategori “sangat baik” dan pada uji voba II sebesar 98,3% dengan kriteria “sangat baik”. Sehingga pop – up book materi keanekaragaman hewan dan tumbuhan memenuhi kriteria untuk digunakan sebagai media pembelajaran

Plan&Do - A Technology Probe Supporting Children with Intellectual Disabilities in Leisure Activities

In this paper, we discuss possibilities for how digital tools can support children with intellectual disabilities to carry out leisure activities. Leisure activities play an important role for physiological and psychological well-being, but children with intellectual disabilities carry out less leisure activities than others. In order to investigate what factors are important for supporting children with intellectual disabilities to carry out leisure activities, we have developed a mobile application, Plan&amp;Do, acting as a technology probe. The contribution of this paper is based on results from a situated evaluation, and consist of a raised awareness of the many challenges parents and children face when choosing and preparing for taking part in a leisure activity, as well as early results from how this can be supported, and directions for future work

Internet-delivered cognitive behavior therapy for adolescents with irritable bowel syndrome : a randomized controlled trial

OBJECTIVES: Few treatments have been able to effectively manage pediatric irritable bowel syndrome (IBS). Internet-delivered cognitive behavior therapy (Internet-CBT) based on exposure for abdominal symptoms is effective for adult IBS. The objective of this study was to evaluate the efficacy of Internet-CBT based on behavioral exposure for adolescents with IBS. METHODS: Adolescents with IBS fulfilling the Rome III criteria were randomized to either Internet-CBT or a wait-list control. The Internet-CBT was a 10-week intervention where the main component was exposure to IBS symptoms by reduction of avoidance of abdominal symptoms and instead stepwise provocation of symptoms. The primary outcome was total score on Gastrointestinal Symptoms Rating Scale for IBS (GSRS-IBS). Secondary outcomes included adolescent- and parent-rated quality of life and parent-rated gastrointestinal symptoms. Difference between groups was assessed from pretreatment to posttreatment and the Internet-CBT group was also evaluated at 6 months after treatment completion. RESULTS: A total of 101 adolescents with IBS (13-17 years of age) were included in this study. Dropout rates were low (6%) and all randomized patients were included in intent-to-treat analyses based on mixed effects models. Analyses showed a significant larger pretreatment to posttreatment change on the primary outcome GSRS-IBS (B=-6.42, P=0.006, effect size Cohen's d=0.45, 95% confidence interval (0.12, 0.77)) and on almost all secondary outcomes for the Internet-CBT group compared with the control group. After 6 months, the results were stable or significantly improved. CONCLUSIONS: Internet-CBT based on exposure exercises for adolescents with IBS can effectively improve gastrointestinal symptoms and quality of life.Jane and Dan Olsson foundation, 4-1559/2013Kempe-Carlgrenska foundationRuth and Richard Julin foundation, 2012Juli0048Ishizu Matsumurais DonationMajblomman foundationBengt Ihre research fellowshipBengt Ihre foundation, SLS-331861The Samariten foundationThe Swedish society of medicine, SLS-331681, SLS-410501VärkstadststiftelsenGadelius foundationSwedish Research Council, 521-2013-2846Regional agreement on medical training and clinical research between Stockholm County Council and Karolinska Institutet, 20130129Accepte

Impaired immunity and high attack rates caused by SARS-CoV-2 variants among vaccinated long-term care facility residents

Introduction: Long-term care facilities (LTCF) residents are at high risk for severe coronavirus disease 2019 (COVID-19), and therefore, COVID-19 vaccinations were prioritized for residents and personnel in Finland at the beginning of 2021. Methods: We investigated COVID-19 outbreaks in two LTCFs, where residents were once or twice vaccinated. After the outbreaks we measured immunoglobulin G (IgG) antibodies to severe acute respiratory syndrome coronavirus 2 spike glycoprotein, neutralizing antibody (NAb) titers, and cell-mediated immunity markers from residents and healthcare workers (HCWs). Results: In LTFC-1, the outbreak was caused by an Alpha variant (B.1.1.7) and the attack rate (AR) among once vaccinated residents was 23%. In LTCF-2 the outbreak was caused by a Beta variant (B.1.351). Its AR was 47% although all residents had received their second dose 1 month before the outbreak. We observed that vaccination had induced lower IgG concentrations, NAb titers and cell-mediated immune responses in residents compared to HCWs. Only 1/8 residents had NAb to the Beta variant after two vaccine doses. Conclusions: The vaccinated elderly remain susceptible to breakthrough infections caused by Alpha and Beta variants. The weaker vaccine response in the elderly needs to be addressed in vaccination protocols, while new variants capable of evading vaccine-induced immunity continue to emerge.Peer reviewe

Human subsistence and signatures of selection on chemosensory genes

Chemosensation (olfaction, taste) is essential for detecting and assessing foods, such that dietary shifts elicit evolutionary changes in vertebrate chemosensory genes. The transition from hunting and gathering to agriculture dramatically altered how humans acquire food. Recent genetic and linguistic studies suggest agriculture may have precipitated olfactory degeneration. Here, we explore the effects of subsistence behaviors on olfactory (OR) and taste (TASR) receptor genes among rainforest foragers and neighboring agriculturalists in Africa and Southeast Asia. We analyze 378 functional OR and 26 functional TASR genes in 133 individuals across populations in Uganda (Twa, Sua, BaKiga) and the Philippines (Agta, Mamanwa, Manobo) with differing subsistence histories. We find no evidence of relaxed selection on chemosensory genes in agricultural populations. However, we identify subsistence-related signatures of local adaptation on chemosensory genes within each geographic region. Our results highlight the importance of culture, subsistence economy, and drift in human chemosensory perception.R01 GM115656 - NIGMS NIH HHSPublished versio