Widespread higher fractional anisotropy associates to better cognitive functions in individuals at ultra-high risk for psychosis

In schizophrenia patients, cognitive functions appear linked to widespread alterations in cerebral white matter microstructure. Here we examine patterns of associations between regional white matter and cognitive functions in individuals at ultra-high risk for psychosis. One hundred and sixteen individuals at ultra-high risk for psychosis and 49 matched healthy controls underwent 3 T magnetic resonance diffusion-weighted imaging and cognitive assessments. Group differences on fractional anisotropy were tested using tract-based spatial statistics. Group differences in cognitive functions, voxel-wise as well as regional fractional anisotropy were tested using univariate general linear modeling. Multivariate partial least squares correlation analyses tested for associations between patterns of regional fractional anisotropy and cognitive functions. Univariate analyses revealed significant impairments on cognitive functions and lower fractional anisotropy in superior longitudinal fasciculus and cingulate gyrus in individuals at ultra-high risk for psychosis. Partial least squares correlation analysis revealed different associations between patterns of regional fractional anisotropy and cognitive functions in individuals at ultra-high risk for psychosis compared to healthy controls. Widespread higher fractional anisotropy was associated with better cognitive functioning for individuals at ultra-high risk for psychosis, but not for the healthy controls. Furthermore, patterns of cognitive functions were associated with an interaction-effect on regional fractional anisotropy in fornix, medial lemniscus, uncinate fasciculus, and superior cerebellar peduncle. Aberrant associations between patterns of cognitive functions to white matter may be explained by dysmyelination

Relationer : I fritidshem

Det är viktigt med bra relationer då barnen behöver en trygg och säker miljö att både lära och utvecklas i. Syftet med arbetet är att beskriva pedagogers uppfattning om hur man skapar bra relationer på fritidshem. Uppsatsen är en fallstudie där vi blivit inspirerade att arbeta utifrån kvalitativ metod, där vi använt oss utav intervjuer för att samla information. I vår fallstudie har vi valt att fokusera oss på två fritidshem och gjort tre intervjuer. Resultatet visar fyra gemensamma teman, dessa teman är trivsel, samhörighet, relationer och samverkan. Sammanfattning av dessa teman är att trivsel handlar om trygghet och välbefinnande och grunden för detta är att det finns ordningsregler och tydliga riktlinjer på skolorna. Samhörighet kan vara gemensamma intressen och att man gör saker tillsammans med varandra. Relationer är en grund för att skolan ska uppfattas som trygg och säker, detta görs genom att pedagogerna arbetar över gränserna med andra avdelningar och barnen får på så vis möjlighet att skapa nya relationer. Samverkan ska ses som ett långsiktigt arbete, där pedagogerna har tydliga roller och gemensamma mål.Godkännandedatum: 2015-01-02</p

Koloniala perspektiv i samhällsorienterade läroböcker -En jämförelse av läroböckernas föreställningar och stereotypiseringar av svarta afrikaner under 1960-talet samt 2010-talet

Syftet med denna studie är att analysera de föreställningar av afrikaner som funnits under 1960-talet samt i 2010-talet. Den valda frågeställningen är följande: Hur gestaltar läroböcker i historia, geografi och samhällskunskap Afrikas invånare i bild och bildtext? Hur förändras den gestaltningen under efterkrigstiden? Detta görs genom att undersöka läroböcker i historia, geografi samt samhällskunskap. Undersökningen behandlar svenska läroböcker och utförs med två olika sorters bildanalyser. Undersökningen visar att eurocentriska och koloniala föreställningar präglar det undersökta läroböckernas bildmaterial. Den ena bildanalysen utförs med hjälp av en kvantitativ metod, där de strukturer som finns synliggörs med hjälp av antalet bilder i läroböckerna och utifrån en kategorisering av bildmaterialet. Den andra är kvalitativt grundat, där bilderna analyseras på ett fördjupat plan. Detta är relevant för läraryrket, dels då varje lärare borde vara kritisk till det läromedel som finns på marknaden idag. En annan anledning är även att lärare borde i sin undervisning kunna redogöra för vilka strukturer samt föreställningar kring Afrika och dess invånare som funnits genom tiderna inom historieämnet. Uppsatsens resultat visar att i hur afrikaner oftast framställs som maktlösa, svältande samt i behov av hjälp från omvärlden. Det som denna studie bidrar med är att synliggöra vilka stereotypiseringar samt föreställningar som funnits under 1960-talet samt 2010-talets kring svarta afrikaner. De slutsatser som kan dras är att det funnits en ökad representation av kvinnor och barn i 2010-talets läroböcker, vilket kan vara ett resultat av en ökad jämlikhet. En genomgående stereotyp som återfunnits i läroböcker från 1960-talet samt 2010-talet, är att afrikaner gestaltas som maktlösa och i behov av hjälp. Det finns dessutom koloniala rester i läroböcker kvar än idag, där afrikaner oftast framställs som fattiga och i misär i jämförelse med västerlänningar

Bronchial thermoplasty for the treatment of severe ashma: A single technology assessment

Key messages: Asthma is a chronic inflammatory illness affecting the airways. Severe asthma is defined as “asthma that is uncontrolled despite maximal optimised therapy and treatment of contributory factors, or that worsens when high dose treatment is decreased”. Patients suffering from severe treatment-resistant asthma currently have few available treatment options, for these patients, bronchial thermoplasty (BT) may be an alternative. BT is a device-based treatment option that uses temperature-controlled radio frequency energy to reduce the amount of airway smooth muscle within the airway wall. Overall, the current evidence base for bronchial thermoplasty indicates no clear and well documented positive health effect on the most important outcomes. This single-technology assessment shows that: • The effect of BT on mortality is uncertain • The risk of hospitalization increased during the BT treatment (first 12 weeks). • There was no difference in hospital admissions between BT and sham/control after 12 months. The clinical effectiveness data doesn’t demonstrate a clear difference between BT and control on the rate of exacerbations, hospitalisations, or visits to general practitioner or emergency room. As the central drivers of the suggested health economic model were thus found to be insufficiently documented, the submitted model was not further assessed. Absolute shortfall and severity are not estimated as cost effectiveness is not documented in a cost per QALY analysis. It is estimated that 1258 Norwegian patients with severe asthma may be eligible for bronchial thermoplasty each year. According to the manufacturer, the budget impact when treating 1258 patients with BT would require about 100 million NOK during the first year

The FOCUS trial:cognitive remediation plus standard treatment versus standard treatment for patients at ultra-high risk for psychosis: study protocol for a randomised controlled trial

Background: Cognitive deficits are a distinct feature among people at ultra-high risk (UHR) for psychosis and pose a barrier to functional recovery. Insufficient evidence exists on how to ameliorate these cognitive deficits in patients at UHR for psychosis and hence improve daily living and quality of life. The aim of the trial is to investigate whether cognitive remediation can improve cognitive and psychosocial function in patients at UHR for psychosis. Methods: The FOCUS trial (Function and Overall Cognition in Ultra-high risk States) is a randomised, parallel group, observer-blinded clinical trial enrolling 126 patients meeting the standardised criteria of being at UHR for psychosis. Patients are recruited from psychiatric in- and outpatient facilities in the Copenhagen catchment area. Patients are randomised to one of the two treatment arms: cognitive remediation plus standard treatment versus standard treatment. The cognitive remediation consists of 24 weekly group-based and manualised sessions targeting neurocognition and social cognition. In addition to the group sessions, the patients will be offered 12 individual sessions aiming at maximising the transfer of the effects of the cognitive training to their everyday lives. Follow-up assessments will be conducted at 6 and 12 months after randomisation. The primary outcome is the composite score on the Brief Assessment of Cognition in Schizophrenia at cessation of treatment after 6 months. Secondary outcomes are social and daily functioning, psychosis-like symptoms, negative symptomatology, and depressive symptomatology as measured with the Personal and Social Performance Scale, Brief Psychiatric Rating Scale-Expanded Version, Scale for the Assessment of Negative Symptoms, and the Montgomery-Åsberg Depression Rating Scale. Discussion: This is the first trial to evaluate the effects of neurocognitive and social cognitive remediation in UHR patients. The FOCUS trial results will provide evidence on the effect of targeted and comprehensive cognitive rehabilitation on cognition, daily living, and symptomatology as well as long-term outcome in preventing transition to psychosis in UHR patients. Trial registration: ClinicalTrials.gov NCT 02098408. Date of registration 18 March 2014

Social cognition in patients at ultra-high risk for psychosis:What is the relation to social skills and functioning?

AbstractObjectivePatients at ultra-high risk (UHR) for psychosis show significant impairments in functioning. It is essential to determine which factors influence functioning, as it may have implications for intervention strategies. This study examined whether social cognitive abilities and clinical symptoms are associated with functioning and social skills.MethodsThe study included 65 UHR patients and 30 healthy controls. Social cognitive function, social skills, and a broad range of functioning measures were assessed.ResultsThe UHR patients demonstrated significant decrements on The Awareness of Social Inferences Task total score (p=.046, d=.51), and on the CANTAB emotion recognition task total percent correct (p=.023, d=.54) displaying particular difficulties in negative affect recognition. The patients exhibited significant impairments in social skills measured with the High Risk Social Challenge (p˂.001, d=1.05). Aspects of emotion recognition were associated with role functioning and social skill performance. The level of attributional bias was associated with overall functioning, and theory of mind ability was associated with self-reported functioning. Negative symptoms were associated with all measures of functioning (p≤.05).ConclusionSignificant impairments in social cognition and social skills were found in UHR patients. The patients' social cognitive function was associated with overall functioning and social skills. Negative symptoms appear to play an important role for functioning. Research is needed to investigate how the relations between social cognition, social skills and functioning develop from the UHR state to the stage of manifest illness. Research into how deficits in social cognition and social skills can be ameliorated in UHR patients is warranted