Functional Somatic Symptoms in Children and Adolescents

This open access book sets out the stress-system model for functional somatic symptoms in children and adolescents. The book begins by exploring the initial encounter between the paediatrician, child, and family, moves through the assessment process, including the formulation and the treatment contract, and then describes the various forms of treatment that are designed to settle the child’s dysregulated stress system. This approach both provides a new understanding of how such symptoms emerge – typically, through a history of recurrent or chronic stress, either physical or psychological – and points the way to effective assessment, management, and treatment that put the child (and family) back on the road to health and well-being

Tumor HPV status, level of regulatory T cells and macrophage infiltration predict up to 20-year non-disease-specific survival in oropharynx squamous cell carcinoma patients

Oropharynx squamous cell carcinoma (OPSCC) is of special interest because human papilloma virus (HPV) and/or smoking cause this disease. Influxes of inflammatory cells into such tumors are known to vary with prognoses. Aims: To study whether the density of tumor-infiltrating T lymphocytes and tumor-infiltrating macrophages predicted general 20-year overall survival (OS), as well as OS with only disease-specific survival (DSS) patients included. Methods: Biopsies from patients treated for OPSCC (n = 180) were stained by immunohistochemistry and the tumor cell macrophage (CD68), pan T lymphocytes (CD3), and regulatory T lymphocytes (Foxp3) densities were determined. The HE-determined percentage of matured tumor cells and the rate of invasion were calculated, and stromal desmoplasia were performed. Tumor HPV presence was studied by PCR. Twenty-year OS and five-year DSS patients were determined. Results: Tumor HPV status strongly predicted survival. High tumor infiltration of CD3, Foxp3 and CD68-positive cells predicted better twenty-year OS, with and without HPV stratification. Foxp3 and CD68 levels predicted OS, and 20-year among DSS patients, primarily among HPV(+) patients. Tumor HE-derived variables did not predict such survival. Conclusions: Tumor HPV status, level of Foxp3 tumor-infiltrating lymphocytes and CD68 tumor-infiltrating macrophages predicted up to 20-year OS of both all patients and disease-specific survived patients.publishedVersio

SARS-CoV-2 susceptibility and COVID-19 disease severity are associated with genetic variants affecting gene expression in a variety of tissues

Variability in SARS-CoV-2 susceptibility and COVID-19 disease severity between individuals is partly due to genetic factors. Here, we identify 4 genomic loci with suggestive associations for SARS-CoV-2 susceptibility and 19 for COVID-19 disease severity. Four of these 23 loci likely have an ethnicity-specific component. Genome-wide association study (GWAS) signals in 11 loci colocalize with expression quantitative trait loci (eQTLs) associated with the expression of 20 genes in 62 tissues/cell types (range: 1:43 tissues/gene), including lung, brain, heart, muscle, and skin as well as the digestive system and immune system. We perform genetic fine mapping to compute 99% credible SNP sets, which identify 10 GWAS loci that have eight or fewer SNPs in the credible set, including three loci with one single likely causal SNP. Our study suggests that the diverse symptoms and disease severity of COVID-19 observed between individuals is associated with variants across the genome, affecting gene expression levels in a wide variety of tissue types

Chronic fatigue syndromes: real illnesses that people can recover from

The ‘Oslo Chronic Fatigue Consortium’ consists of researchers and clinicians who question the current narrative that chronic fatigue syndromes, including post-covid conditions, are incurable diseases. Instead, we propose an alternative view, based on research, which offers more hope to patients. Whilst we regard the symptoms of these conditions as real, we propose that they are more likely to reflect the brain's response to a range of biological, psychological, and social factors, rather than a specific disease process. Possible causes include persistent activation of the neurobiological stress response, accompanied by associated changes in immunological, hormonal, cognitive and behavioural domains. We further propose that the symptoms are more likely to persist if they are perceived as threatening, and all activities that are perceived to worsen them are avoided. We also question the idea that the best way to cope with the illness is by prolonged rest, social isolation, and sensory deprivation. Instead, we propose that recovery is often possible if patients are helped to adopt a less threatening understanding of their symptoms and are supported in a gradual return to normal activities. Finally, we call for a much more open and constructive dialogue about these conditions. This dialogue should include a wider range of views, including those of patients who have recovered from them

A first update on mapping the human genetic architecture of COVID-19

peer reviewe

Access as transaction. A discourse analysis of users’ construction of value and cost on Facebook, Netflix and Fanfiction.net.

Internet services are big business, but what exactly are the service providers selling, with no physical product? And what are the costumers paying, when so often, the services are evidently free? Truth is, it really doesn't matter. From the viewpoint of both the user and the service provider, what is important is what the user perceives as the price and the product. In order to investigate the perceived price and product of web services, I conducted interviews with users of three web services, two of which is free in the traditional sense. I asked the users what they felt that they were getting from - and paying for the use of a web service. Using discourse analysis on the interviews of users from three web services, Facebook, Netflix and Fanficton.net, I examined how the users of the web services constructed the goods of digital services. During the course of my investigation I built a theoretical framework based on the ideas of Graaber, Kluckhohn, Plato, Kant, Hardt & Negri, where value is determined by the beholder's assessment of an item as valuable. I created a definition of a good", based on Marshall's definition, which to greater extent allow for intangible objects. After analyzing the interviews, I discovered that the goods of digital services fit roughly into the categories of: entertainment, communication/relationships, practicality, content, user-mass, addiction/dependency/loyalty, I also saw how the users of the services drew on the discourses of two different transactional practices, with Fanfiction.net as a representative of gift-economy, Netflix as belonging to the discourse of traditional economy, and Facebook as a hybrid of both economies. In the end, I discussed the power relations between the service and the users, and possible counter-power strategies attempted by the user, along with the insights and useful perspectives I think I gained trough this research process and possible future paths of exploration. A deeper understanding of how the trades of web services is perceived and constructed is valuable for both sides of the transaction: The users gains awareness about their own position in services they use almost everyday, enabling a more conscious attitude towards the choices they make. Web service providers get an insight to which features their users really value, and which prices they mind - and don't mind paying

Functional Somatic Symptoms in Children and Adolescents

This open access book sets out the stress-system model for functional somatic symptoms in children and adolescents. The book begins by exploring the initial encounter between the paediatrician, child, and family, moves through the assessment process, including the formulation and the treatment contract, and then describes the various forms of treatment that are designed to settle the child’s dysregulated stress system. This approach both provides a new understanding of how such symptoms emerge – typically, through a history of recurrent or chronic stress, either physical or psychological – and points the way to effective assessment, management, and treatment that put the child (and family) back on the road to health and well-being