Pedagogers syn på Takk och dess betydelse i förskolan

Alla människor har ett behov att kommunicera med varandra. Då inte alla har förmågan att uttrycka sig via talet kan Tecken som alternativ och kompletterande kommunikation (Takk) vara ett alternativ . Syftet med min studie har varit att undersöka vilken betydelse Takk har för barn i behov av alternativ kommunikation i förskolan.   Genom intervjuer med pedagoger i ett arbetslag på en förskoleavdelning som har extra resurser, undersöker jag i vilka situationer som de använder Takk samt vad de anser om vilken betydelse Takk har för kommunikationen. Jag valde att begränsa studien till en förskola och ett arbetslag där det finns stor erfarenhet kring Takk.   Resultatet visar att pedagogerna använder Takk bland annat vid samlingar och vid matsituationen, de försöker även väva in det i leken. De anser att Takk kan var ett mycket bra stöd för språket och kommunikationen. Alla pedagogerna i arbetslaget är överens om att Takk är ett bra stöd för barnens språkutveckling

Motor performance after treatment of pilocytic astrocytoma in the posterior fossa in childhood

 Background:  Pilocytic astrocytoma is the most common brain tumour type in childhood located in the posterior fossa, and treated mainly with surgery. These tumours have low mortality, but knowledge concerning its long-term outcome is sparse.  Aims:  The aim was to investigate if patients treated for pilocytic astrocytoma in the posterior fossa had motor complications, including balance, motor and process skills.  Methods and results:  This descriptive single-centre study includes eight children and 12 adults, treated for pilocytic astrocytoma as children. Motor performance was investigated with Bruininks-Oseretsky Test of Motor Proficiency, Second Edition, and dynamic balance with the mini-balance evaluation systems test. Physiological cost index, six-minute walk test, hand grip strength and assessment of motor and process skills were also evaluated. Ten patients reported motor difficulties, mainly from the upper limbs. The motor performance test showed results within normal limits except for manual dexterity, which was significantly below mean (p = .008). In the dynamic balance test patients had significantly lower results compared with controls (p = .036). Physiological cost index, six-minute walk tests and hand grip strength showed results within normal limits. In the Assessment of Motor and Process Skills, patients over 16 years had significantly lower results compared with test norms for motor activities of daily living (ADL) and 30% of all patients scored below the cut-off level for difficulties with motor skills.  Conclusions:  Motor performance for patients treated for pilocytic astrocytoma in the posterior fossa in childhood is satisfactory but some patients display difficulties with balance, manual dexterity and ADL motor skills. Thus, it is important to identify those in need of motor follow-up and training

Perturbed NK Cell Homeostasis Associated with Disease Severity in Chronic Neutropenia

Abstract Neutrophils have been thought to play a critical role in terminal differentiation of NK cells. Whether this effect is direct or a consequence of global immune changes with effects on NK-cell homeostasis remains unknown. In this study, we used high-resolution flow and mass cytometry to examine NK-cell repertoires in 64 patients with neutropenia and 27 healthy age- and sex-matched donors. A subgroup of patients with chronic neutropenia showed severely disrupted NK-cell homeostasis manifesting as increased frequencies of CD56bright NK cells and a lack of mature CD56dim NK cells. These immature NK-cell repertoires were characterized by expression of the proliferation/exhaustion markers Ki-67, Tim-3, and TIGIT and displayed blunted tumor target cell responses. Systems-level immune mapping revealed that the changes in immunophenotypes were confined to NK cells, leaving T-cell differentiation intact. RNA sequencing of NK cells from these patients showed upregulation of a network of genes, including TNFSF9, CENPF, MKI67, and TOP2A, associated with apoptosis and the cell cycle, but different from the conventional CD56bright signatures. Profiling of 249 plasma proteins showed a coordinated enrichment of pathways related to apoptosis and cell turnover, which correlated with immature NK-cell repertoires. Notably, most of these patients exhibited severe-grade neutropenia, suggesting that the profoundly altered NK-cell homeostasis was connected to the severity of their underlying etiology. Hence, although our data suggest that neutrophils are dispensable for NK-cell development and differentiation, some patients displayed a specific gap in the NK repertoire, associated with poor cytotoxic function and more severe disease manifestations