Natural Killer Cells and Antibodymediated Effects in Human Immunodeficiency Virus Infection

The human immunodeficiency virus (HIV-1) effectively avoids immunologic eradication. Certain characteristics of the virus contribute to this, including the specific targeting of the body s own defense system, the ability to hide in the host cell genome and the vast viral variability. Natural killer (NK) cells are important effectors in resistance to virus infections and there are indications that NK cells have a role also in HIV-1 infection. HIV-1 specific antibodies can cause neutralization of free virions, but also contribute to killing of infected cells through interaction with effector cells, such as NK cells. In this thesis the involvement of NK cells in acute and chronic HIV-1 infection has been studied and novel treatment modalities based on NK cells or antibodies have been examined. In our mouse model for acute HIV-1 infection, we show that NK cells have a role, since more infectious virus could be retrieved from NK cell depleted mice than normal mice after inoculation of spleen cells infected with a HIV-1/MuLV pseudovirus (paper III). In addition, frequency of NK cells at the site of injection of infected cells were increased and the NK cells had a more mature phenotype. These studies are interesting in relation to previous reports on an enhanced NK cell activity in acute HIV-1 infection in humans and highlight the importance of considering activation of NK cells in future treatment modalities targeted to HIV-1. One possible therapeutic strategy is activation of NK cells by blocking inhibitory NK cell receptors. The KIR binding antibody, 1-7F9, induced activation of NK cells from HIV-1 infected patients and healthy individuals, and the effect could be associated to KIR genotype of the blood donor (paper I). However, we could not detect increased NK cell recognition of HIV-1 infected compared uninfected autologous T cells. This lack of HIV-1 specific effect may be due to the in vitro system used. Phenotypic and functional differences in NK cells from patients that spontaneously control their disease were compared to NK cells from patients with viremia or healthy individuals, but no striking differences were found (paper I and II). NK cells can specifically kill antibody coated infected target cells in a process called antibody dependent cellular cytotoxicity (ADCC). The antibodies elicited in patients differed in ability to induce Env specific ADCC (paper II). Qualitative differences in HIV-specific ADCC antibody responses may thus contribute to control of disease. For induction of efficient antibody mediated killing, monoclonal antibodies may be chemically coupled to cytotoxic drugs. This treatment modality was examined in our model for acute HIV-1 infection and was found to contribute to eradication of HIV-1/MuLV infected cells in the mouse (paper IV). We conclude, based on our studies in the HIV-1/MuLV mouse model, that NK cell activity in acute HIV-1 infection may contribute to early control of infected cells and that HIV-1 envelope specific antibodies conjugated to drugs may efficiently resolve virus infected cells. In addition the possible differences in ADCC inducing antibodies in controller patients deserve further investigation, as do KIR blockade for the treatment of HIV-1 infection

Innovative Methods and Models of Collaboration in the Field of Pedagogical Prevention of Xenophobia, Anti-Semitism and Right-wing Extremism: Chances and Perspectives for a Better Cooperation between Formal and Non-formal Education in Germany

SummaryXenophobic, anti-Semitic and right-wing extremist attitudes continue to pose a serious problem and an ongoing challenge among German youth. Since problematic attitudes and risk groups change with time and according to political circumstances and social change, there is a constant need for the development of new practices and the innovative adaption of existing strategies of pedagogical prevention. Evaluations of German government model programs aimed at the pedagogical prevention of xenophobia, anti-Semitism and right-wing extremism show that sustainable prevention effects can be reached on the basis of productive cooperation between formal and non-formal educators. In order to improve their efforts toward prevention and cooperation, both partners have to refine their collaborative models and their methodology as well as to react better to changes in the composition of groups of participants and students in a society characterized by immigration and globalization.Key words: right-wing extremism, xenophobia, evaluation, prevention, non-formal education.German Youth Institute (Deutsches Jugendinstitut e.V.),Franckeplatz 1, Hs. 12-12, D-06110 Halle, Germany.Tel.: +49-345-6817828. E-Mail: [email protected] Xenophobic, anti-Semitic and right-wing extremist attitudes continue to pose a serious problem and an ongoing challenge among German youth. Since problematic attitudes and risk groups change with time and according to political circumstances and social change, there is a constant need for the development of new practices and the innovative adaption of existing strategies of pedagogical prevention. Evaluations of German government model programs aimed at the pedagogical prevention of xenophobia, anti-Semitism and right-wing extremism show that sustainable prevention effects can be reached on the basis of productive cooperation between formal and non-formal educators. In order to improve their efforts toward prevention and cooperation, both partners have to refine their collaborative models and their methodology as well as to react better to changes in the composition of groups of participants and students in a society characterized by immigration and globalization.Key words: right-wing extremism, xenophobia, evaluation, prevention, non-formal education.Novatoriški bendradarbiavimo metodaiirmodeliaiksenofobijos, antisemitizmo ir dešiniojo ekstremizmo pedagoginėje prevencijoje: geresnio bendradarbiavimo tarp formalaus ir neformalaus ugdymo galimybės ir perspektyvos VokietijojeSusanne JohanssonSantraukaKsenofobija, antisemitizmas, dešinysis ekstremizmas yra rimtos Vokietijos jaunimo problemos. Socialiniai ir politiniai pokyčiai sukuria naujų ideologijų ir socialinių grupių. Siekiant spręsti atsirandančias problemas, pedagoginės prevencijos praktikos turi būti atnaujinamos, vystomos. Vokietijos valstybinių ksenofobijos, antisemitizmo ir dešiniojo ekstremizmo pedagoginės prevencijos programų įvertinimas rodo, kad tvarią prevenciją galima pasiekti produktyviai bendradarbiaujant formaliems ir neformaliems ugdytojams. Norėdami pagerinti bendradarbiavimą, formalūs ir neformalūs ugdytojai turi pakeisti savo bendradarbiavimo ir darbo metodų modelius.Pagrindiniai žodžiai: dešinysis ekstremizmas, ksenofobija, įvertinimas, prevencija, neformalus ugdymas

A Scoping Review of the Relation Between Problem-based Learning and Professional Identity Development in Medical Education

There is a substantial amount of research pointing to the benefits of pedagogical approaches such as problem-based learning (PBL) and the importance of developing professional identity as a physician in medical education. The aim of this review is to investigate the existing literature concerned with the relation between PBL and professional identity development in undergraduate medical students. We performed a scoping review of six electronic databases to map out how the relation between PBL and professional identity development in undergraduate medical students is presented in the existing literature. Eight peer-reviewed full text articles were retrieved as eligible for review. The most important conclusion from our work is that even though the topic of professional identity development in medical education has been studied quite extensively, there is a lack of knowledge about how new types of pedagogical approaches such as how a PBL curriculum influences medical students’ professional identity development

Marknadsföring i förändring. En studie om användandet av medveten uppmärksamhet inom reklambranschen.

Syftet med denna uppsats är att undersöka hur kommunikations- och reklambyråer ser på de förändringar som sker i samhället. Vidare är vårt syfte att undersöka hur de arbetar för att effektivt kommunicera ut budskap till önskad mottagare genom att medvetet skapa uppmärksamhet. Vi har använt oss av en kvalitativ metod med ett abduktivt tillvägagångssätt där litteratur och empiri tillsammans legat till grund för det fortsatta arbetet. Vår empiri har utgjorts av åtta stycken kommunikations- och reklambyråer där fem stycken ingick i en första intervjuomgång och de övriga tre i en andra. Det finns en medvetenhet om att dagens samhälle står inför ständiga förändringar i och med faktorer som tillänglig teknik, information och på grund av att nya generationer växer upp. Vid planering av marknadsföringsaktiviteter görs en anpassning till dessa nya förutsättningar och det används olika metoder när budskap sänds ut men emellertid spelar det mindre roll vilken etikett de har

Evaluation of Interactive Voice Response (IVR) and postal survey in follow-up of children and adolescents discharged from psychiatric outpatient treatment: a randomized controlled trial

Systematic evaluation of child and adolescent psychiatric outpatient treatment is important but time-consuming. The aim of this paper was to study whether Interactive Voice Response (IVR) is a more effective method than a questionnaire sent by post when following up outpatient treatment in child and adolescent psychiatry. Eighty patients were recruited from a child and adolescent psychiatric outpatient unit in Sweden. One parent of each of the patients was randomized to complete the BCFPI follow-up form, using either IVR (n = 40) or postal survey (n = 40) one month after discharge. The response rate for complete answers was 65% in the IVR group and 38% in the postal survey group (p = 0.014). There was less need for reminders in the IVR group (p = 0.000). IVR is a promising and cost-effective method for evaluating evidence-based treatment in child and adolescent psychiatric care

Interactive voice response - an automated follow-up technique for adolescents discharged from acute psychiatric inpatient care : a randomised controlled trial

Follow-up methods must be easy for young people to handle. We examine Interactive Voice Response (IVR) as a method for collecting self-reported data. Sixty inpatients were recruited from a child and adolescent psychiatric emergency unit in Malmö, Sweden and called every second (N = 30) or every fourth (N = 30) day from discharge until first visit in outpatient care. A pre-recorded voice asked them to evaluate their current mood using their mobile phones. Average response rate was 91%, and 71% had a 100% response rate. Gender, age and length of inpatient treatment did not affect response rate, nor did randomisation. Boys estimated their current mood on average as 3.52 units higher than girls, CI = (2.65, 4.48). Automated IVR is a feasible method of collecting follow-up data among adolescents discharged from a psychiatric emergency unit