European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD.

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is among the most common psychiatric disorders of childhood that persists into adulthood in the majority of cases. The evidence on persistence poses several difficulties for adult psychiatry considering the lack of expertise for diagnostic assessment, limited treatment options and patient facilities across Europe. METHODS: The European Network Adult ADHD, founded in 2003, aims to increase awareness of this disorder and improve knowledge and patient care for adults with ADHD across Europe. This Consensus Statement is one of the actions taken by the European Network Adult ADHD in order to support the clinician with research evidence and clinical experience from 18 European countries in which ADHD in adults is recognised and treated. RESULTS: Besides information on the genetics and neurobiology of ADHD, three major questions are addressed in this statement: (1) What is the clinical picture of ADHD in adults? (2) How can ADHD in adults be properly diagnosed? (3) How should ADHD in adults be effectively treated? CONCLUSIONS: ADHD often presents as an impairing lifelong condition in adults, yet it is currently underdiagnosed and treated in many European countries, leading to ineffective treatment and higher costs of illness. Expertise in diagnostic assessment and treatment of ADHD in adults must increase in psychiatry. Instruments for screening and diagnosis of ADHD in adults are available and appropriate treatments exist, although more research is needed in this age group

The museums of wishes : A Study of two Complementary Projects by Moderna museet

This study examines the processes behind two of Moderna museets complementary projects: The Museum of Wishes and The Second Museum of Wishes. The purpose of this study is to, by using these projects, examine the connection between collections and collectors, and to examine the relationship between museums, complements of the collection and representation. The aim is to compare the projects and find out if there were different reasons, methods or other significant factors that might have affected the processes. I intend to explain how these projects can be understood as a practice of complementary collecting by relating them both to collection theory and representation. My theoretical framework primarily consist of Susan Pearce’s research. I have chosen to incorporate her concepts of the poetics of collecting, the politics of collecting and the importance of earlier collected experience in my comparative study of the projects. In addition, I have also incorporated research about categories with the intention of relating it to Pearce. By studying literature that discusses the historical aspect of the projects, as well as articles, catalogues and documents that were contemporary with the projects, I have been able to compare the backgrounds as well as ideologies that might have influenced the projects. The result of this study shows that although there were many differences between the methods and processes, the art works that were collected during the projects can both be interpreted as a physical changing of the collection, a changing of the structure of the collection and a changing of the identity of the museum. What the museum gathered during the projects didn’t just represent what the organizer thought the museum needed, but can also be understood as a way of changing the standard of the collection in order to be able to compete with other museums or gathering more knowledge. This study is a two years master’s thesis in Museums and Cultural and Heritage Studies

The museums of wishes : A Study of two Complementary Projects by Moderna museet

This study examines the processes behind two of Moderna museets complementary projects: The Museum of Wishes and The Second Museum of Wishes. The purpose of this study is to, by using these projects, examine the connection between collections and collectors, and to examine the relationship between museums, complements of the collection and representation. The aim is to compare the projects and find out if there were different reasons, methods or other significant factors that might have affected the processes. I intend to explain how these projects can be understood as a practice of complementary collecting by relating them both to collection theory and representation. My theoretical framework primarily consist of Susan Pearce’s research. I have chosen to incorporate her concepts of the poetics of collecting, the politics of collecting and the importance of earlier collected experience in my comparative study of the projects. In addition, I have also incorporated research about categories with the intention of relating it to Pearce. By studying literature that discusses the historical aspect of the projects, as well as articles, catalogues and documents that were contemporary with the projects, I have been able to compare the backgrounds as well as ideologies that might have influenced the projects. The result of this study shows that although there were many differences between the methods and processes, the art works that were collected during the projects can both be interpreted as a physical changing of the collection, a changing of the structure of the collection and a changing of the identity of the museum. What the museum gathered during the projects didn’t just represent what the organizer thought the museum needed, but can also be understood as a way of changing the standard of the collection in order to be able to compete with other museums or gathering more knowledge. This study is a two years master’s thesis in Museums and Cultural and Heritage Studies

The museums of wishes : A Study of two Complementary Projects by Moderna museet

This study examines the processes behind two of Moderna museets complementary projects: The Museum of Wishes and The Second Museum of Wishes. The purpose of this study is to, by using these projects, examine the connection between collections and collectors, and to examine the relationship between museums, complements of the collection and representation. The aim is to compare the projects and find out if there were different reasons, methods or other significant factors that might have affected the processes. I intend to explain how these projects can be understood as a practice of complementary collecting by relating them both to collection theory and representation. My theoretical framework primarily consist of Susan Pearce’s research. I have chosen to incorporate her concepts of the poetics of collecting, the politics of collecting and the importance of earlier collected experience in my comparative study of the projects. In addition, I have also incorporated research about categories with the intention of relating it to Pearce. By studying literature that discusses the historical aspect of the projects, as well as articles, catalogues and documents that were contemporary with the projects, I have been able to compare the backgrounds as well as ideologies that might have influenced the projects. The result of this study shows that although there were many differences between the methods and processes, the art works that were collected during the projects can both be interpreted as a physical changing of the collection, a changing of the structure of the collection and a changing of the identity of the museum. What the museum gathered during the projects didn’t just represent what the organizer thought the museum needed, but can also be understood as a way of changing the standard of the collection in order to be able to compete with other museums or gathering more knowledge. This study is a two years master’s thesis in Museums and Cultural and Heritage Studies

Six hour work day - a courageous decision : To become an attractive employer

I studien undersöks hur arbetstagarnas arbetstillfredsställelse förändrats vis en arbetstidsförkortning. Arbetstidsförkortningens art är i form av en övergång ifrån åtta timmars arbetsdag till sex timmars arbetsdag med bibehållen heltidslön. Studien har genomförts vid ett mindre privat tjänsteföretag. Studiens syfte är att undersöka hur denna typ av arbetstidsförkortning förhåller sig till arbetstagarnas arbetstillfredsställelse och därmed öka förståelsen för de båda fenomenen. Det framkommer att arbetstagarnas arbetstillfredsställelse har förändrats sedan arbetstidsförkortningen. Gällande enskilda faktorer i arbetet har somliga faktorer minskat medan somliga faktorer ökat. I diskussionen framkommer att det föreligger en risk för ohälsa för arbetstagarna då det råder brist på stöd, minskad kontroll och ökade krav sedan arbetstidsförkortningen införts. Den föreliggande risken för ohälsa kan dock ses som acceptabel med tanke på den varierande arbetsbelastningen vilket innebär att arbetstagarna under perioder får tid för återhämtning. Trots omständigheterna råder en hög global arbetstillfredsställelse vilket i sin tur borde innebära att teorierna som brukats innehåller vissa brister då hänsyn till svängningar i arbetsbelastningen inte tagits. I resultatanalysen framkom tre teman vilka sågs relevanta för arbetstagarna och dess arbetstillfredsställelse. Dessa teman bestod av förändringar i relationer, förändringar i arbetet och förändringar i belöningar. Den teoretiska referensramen för studien innehåller förväntningsteorin, tvåfaktor teorin, kravkontroll- stödmodellen samt ansträngning- belöning- obalansmodellen. Datainsamling har skett med hjälp av fyra semistrukturerade intervjuer då respondenterna bestått av arbetstagare på det valda fallet som studerats. Studien är uppbyggt efter kvalitativ metod och har en fenomenologisk ansats. Studien har utformats i form av en fallstudie.The study examines how the employees job satisfaction has changed after a work reduction. This occurred in terms of changing the amount of working hours where the employees went from eight-hour work day to six-hour work day while maintaining full-time pay at a small private service company. The aim is to investigate how this type of work reduction is related to employees job satisfaction and thereby increase the understanding of the two phenomena. It appears that employees job satisfaction has changed since the reduction of working hours. Regarding the individual factors at the workplace some factors has declined while some factors has increased. In the discussion it appears that there is a risk of illness that can affect the employees due to lack of support, lack of control and increased demands. The current risk of illness can be seen as acceptable, given to the varying workload which means that employees during periods get time for recovery. Despite the circumstances prevailing high global job satisfaction, which in turn should mean that the theories that have been used, contains some shortcomings as regard to variations in workload is not taken. The resultsbased analysis revealed three themes which were seen appropriate for employees and their job satisfaction. These themes consisted of changes in relationships, changes in work and changes in rewards. The theoretical framework for the study includes the expectation theory, twofactor theory of the demand- control- support- model as well as the efforts- rewardimbalance- model. Data was collected using four semi-structured interviews where the respondents consisted of employees in the selected case. The study is designed for qualitative method and a phenomenological approach. The study has been designed in the form of a case study

Six hour work day - a courageous decision : To become an attractive employer

I studien undersöks hur arbetstagarnas arbetstillfredsställelse förändrats vis en arbetstidsförkortning. Arbetstidsförkortningens art är i form av en övergång ifrån åtta timmars arbetsdag till sex timmars arbetsdag med bibehållen heltidslön. Studien har genomförts vid ett mindre privat tjänsteföretag. Studiens syfte är att undersöka hur denna typ av arbetstidsförkortning förhåller sig till arbetstagarnas arbetstillfredsställelse och därmed öka förståelsen för de båda fenomenen. Det framkommer att arbetstagarnas arbetstillfredsställelse har förändrats sedan arbetstidsförkortningen. Gällande enskilda faktorer i arbetet har somliga faktorer minskat medan somliga faktorer ökat. I diskussionen framkommer att det föreligger en risk för ohälsa för arbetstagarna då det råder brist på stöd, minskad kontroll och ökade krav sedan arbetstidsförkortningen införts. Den föreliggande risken för ohälsa kan dock ses som acceptabel med tanke på den varierande arbetsbelastningen vilket innebär att arbetstagarna under perioder får tid för återhämtning. Trots omständigheterna råder en hög global arbetstillfredsställelse vilket i sin tur borde innebära att teorierna som brukats innehåller vissa brister då hänsyn till svängningar i arbetsbelastningen inte tagits. I resultatanalysen framkom tre teman vilka sågs relevanta för arbetstagarna och dess arbetstillfredsställelse. Dessa teman bestod av förändringar i relationer, förändringar i arbetet och förändringar i belöningar. Den teoretiska referensramen för studien innehåller förväntningsteorin, tvåfaktor teorin, kravkontroll- stödmodellen samt ansträngning- belöning- obalansmodellen. Datainsamling har skett med hjälp av fyra semistrukturerade intervjuer då respondenterna bestått av arbetstagare på det valda fallet som studerats. Studien är uppbyggt efter kvalitativ metod och har en fenomenologisk ansats. Studien har utformats i form av en fallstudie.The study examines how the employees job satisfaction has changed after a work reduction. This occurred in terms of changing the amount of working hours where the employees went from eight-hour work day to six-hour work day while maintaining full-time pay at a small private service company. The aim is to investigate how this type of work reduction is related to employees job satisfaction and thereby increase the understanding of the two phenomena. It appears that employees job satisfaction has changed since the reduction of working hours. Regarding the individual factors at the workplace some factors has declined while some factors has increased. In the discussion it appears that there is a risk of illness that can affect the employees due to lack of support, lack of control and increased demands. The current risk of illness can be seen as acceptable, given to the varying workload which means that employees during periods get time for recovery. Despite the circumstances prevailing high global job satisfaction, which in turn should mean that the theories that have been used, contains some shortcomings as regard to variations in workload is not taken. The resultsbased analysis revealed three themes which were seen appropriate for employees and their job satisfaction. These themes consisted of changes in relationships, changes in work and changes in rewards. The theoretical framework for the study includes the expectation theory, twofactor theory of the demand- control- support- model as well as the efforts- rewardimbalance- model. Data was collected using four semi-structured interviews where the respondents consisted of employees in the selected case. The study is designed for qualitative method and a phenomenological approach. The study has been designed in the form of a case study

Comparison of Freelite™ and N Latex serum free light chain assays in subjects with end stage kidney disease on haemodialysis

Background: Quantification of serum free light chains (FLC) is important in the diagnosis of plasma cell diseases where an abnormal kappa: lambda ratio infers a population of monoclonal plasma cells. The Freelite (TM) and N Latex assays have been validated in populations without kidney disease but there is a paucity of data relating to the use of these assays in end stage kidney disease (ESKD). The aim of the study was to compare FLC assay performance in ESKD patients on haemodialysis

How comparable are total human chorionic gonadotropin (hCGt) tumour markers assays?

Total human chorionic gonadotropin (hCGt) tumour marker testing is regarded as an "off label" application for most commercial methods. We compared four assays in patients with a hCGt tumour marker request. We hypothesised that regression slopes would be altered and that outliers would be more common with tumour marker than with pregnancy samples if the detection of malignancy associated hCG molecular forms differed amongst assays. Further such systematic differences would be obvious and large enough to change clinical management decisions. We measured hCGt in 390 samples from 137 females and 253 males with a tumour marker request and 208 pregnancy controls with the following methods: Access Total βhCG, Architect Total-βhCG, Cobas hCG + β and Immulite HCG. The between method regressions determined on tumour marker and pregnancy samples were not significantly different. The outlier rates were similar for male and female tumour marker and the pregnancy groups: 1.6% (95% confidence interval [CI] 0%-3.1%), 2.2% (95% CI 0%-4.7%) and 2.9% (95% CI 0.6%-5.2%). The outliers were randomly distributed amongst the methods and we were confident that they would not adversely influence clinical decisions. The hCGt results were clinically equivalent with no systematic difference amongst the four assays

Differential expression of pyloric atresia in junctional epidermolysis bullosa with ITGB4 mutations suggests that pyloric atresia is due to factors other than the mutations and not predictive of a poor outcome: three novel mutations and a review of the literature

Junctional epidermolysis bullosa with pyloric atresia (JEB-PA) is an autosomal recessive blistering disease including lethal and non-lethal variants due to mutations in ITGB4 and ITGA6. It is unclear whether PA is caused directly by the mutations in these genes or by other factors. Skin biopsies from patients with JEB were processed for immunofluorescence mapping. When staining for integrin β4 or α6 was absent or reduced, ITGB4 was screened for mutations. A review of known mutations of ITGB4 and the phenotypes of patients with JEB-PA was undertaken. Three novel ITGB4 mutations were identified in 3 families with JEB-PA: 2 splice-site and one insertion mutation. Two families with lethal phenotypes (EB-050 and EB-049) were due to combinations of premature termination codons and missense mutations (658delC/R252C and 3903dupC/G273D, respectively). The third family EB-013 has 2 JEB affected siblings; a brother with PA and a sister without PA. Both were homozygous for ITGB4 264G>A/3111-1G>A. Two cases had no gastrointestinal symptoms or signs of PA. PA is an inconstant feature of the subtype of epidermolysis bullosa known as JEB-PA. It is most likely that multiple factors influence the development of PA and its presence is not predictive of a poor outcome. It is possible that institutions that do not routinely screen immunofluorescence mapping for integrin α6β4 staining in the absence of PA are missing this form of epidermolysis bullosa

Evaluation of the Atellica TnIH cardiac troponin i assay and assessment of biological equivalence

Objectives: We evaluated the analytical performance characteristics and the biological equivalence of the Atellica TnIH assay. Methods: Precision, detection capability, linearity, and sex specific 99th percentiles were determined de novo. Classification of patients relative to the 99th percentiles was used to assess biological equivalence. Results: Analytical precision and detection capability of the Atellica TnIH assay is excellent with a limit of blank <1 ng/L and 62.5% of women and 93% of men had results above the limit of detection. The 99th percentiles (90% CI) in women were 49 ng/L (31-67) and 70 ng/L (48-121) in men. An asymmetrical distribution involving 5% of results was notable. Agreement was moderate (Kappa 0.58, 95% CI 0.53-0.63) with 20% of patients discordantly classified with Atellica TnIH below and Access hsTnI above the 99th percentiles. Serial results in 195 patients demonstrated good agreement (Kappa 0.84, 95% CI 0.77-0.90). Differences greater than the assay specific reference change values (z≥±1.96) occurred in 65% (95% CI 53-76%) of 99th percentile discordant patients compared to 2.7% (p<0.001) and 76% (p=0.17) of the concordant low and high cTnI groups respectively. Conclusions: The 99th percentile discordant and the concordantly elevated groups are more alike with respect to their z≥±1.96 rates. This favours an overestimated Atellica TnIH 99th percentile as more likely, and we hypothesize that antibody interference resulting in asymmetric scatter of nearly 5% samples may be the underlying mechanism. Analytical accuracy and interferences in cardiac troponin assays should be investigated and resolved with high priority. </p