Human Herpesvirus 6A (HHV-6A) and 6B (HHV-6B) are ubiquitous betaherpesviruses. Both viruses are associated with a variety of adult disorders including neurological disorder, such as multiple sclerosis and chronic fatigue syndrome. HHV-6 viruses are capable of establishing latency by integration into the telomeres of the host chromosome and are transmitted in a Mendelian manner in approximately one percent of the population. To date little is known about the immunological and neurological consequences of HHV-6 inheritance. This study focused on a unique population of individuals that inherited HHV-6 and present with chronic fatigue-like symptoms, including hypersomnia, generalized fatigue, headache, and short term and long term memory impairment. The central hypothesis of this study was that active replication of HHV-6 correlates with patient symptoms. To address this aim we first looked at the reactivation of integrated HHV-6 in vitro by inducing viral replication with epigenetic modifiers trichostatin A (TSA), valproic acid, sodium butyrate, and carbamazepine, and found TSA to be an effective method of inducing reactivation of HHV-6 from its integrated form. Additionally, a reactivated HHV-6A virus isolated from a patient with inherited HHV-6 was fully sequenced and the nucleotide and amino acid sequence was compared to that of fully sequenced HHV-6 laboratory strains, as well as the inherited virus. The reactivated virus was found to be very similar to the HHV-6A GS strain; however, there was some divergence at the right end of the viral genome and regions of the genome that do not contain herpesvirus core genes. Interestingly, the sequenced reactivated virus was found to differ from the HHV-6 virus which was inherited. Finally, HHV-6 replication was assessed by performing reverse transcriptase PCR assay for the viral glycoprotein U100 in patients receiving antiviral treatment. Results indicated that short term antiviral treatment was insufficient to abrogate viral replication, while treatment of six weeks or longer eliminated viral mRNA in patient blood samples. Furthermore, sequencing of the viral mRNA and inherited viral DNA indicate that the source of the mRNA detected in patient blood samples was an exogenously acquired HHV-6 virus, as the U100 glycoprotein sequences were not identical. Together these studies indicate that although HHV-6 can be reactivated from its integrated form, individuals in this unique population harbored an exogenous HHV-6 virus, in addition to the inherited virus; we termed this condition inherited herpesvirus syndrome. The fact that these individuals are able to acquire exogenous HHV-6 viruses suggest that there may be some level of immune tolerance or immune dysfunction; we suggest that further studies focus on uncovering the immune response to HHV-6 in individuals with an inherited form of the virus.

The aim of the study was to explore the methods used in horticultural therapy gardens in rehabilitating people suffering from fatigue syndrome. Nine horticultural therapy gardens were contacted of wich three chose to participate. Using case study as method e-mail interviews was carried out with the participants about their establishment and what kind of theories they based their methods upon. The material collected from the interviews was complemented with additional data from the establishments web pages and information pamphlets. Collected data was processed trough content analysis and then formed as background for the development of a program theory for horticultural therapy. The results show some variations in how the different establishments practice horticultural therapy and how they assess and follow up their work. The program theory of horticultural therapy contains gardening and residing in the garden, conversational therapy, autogenic exercise and stress managment. These activities are expected to lead to a higher degree of self perception, a reevaluation of one´s conceptions and higher self esteem. Through these activities the participants are given an increased ability to handle their lives, which in turn is thought to make it possible for them to return to work or studies. The abcense of clearly defined goals with the rehabilitation makes it difficult to determine how effective it is in bringing people with fatigue syndrome back to work. / Syftet med studien var att undersöka hur trädgårdsrehabilitering tillämpas av några verksamheter för att göra en jämförelse i syfte att påvisa likheter och skillnader. Nio verksamheter kontaktades varav tre valde att delta. En fallstudie utfördes där de tre verksamhetsansvariga intervjuades via e-post om sina verksamheters organisation och grundfilosofi samt hur verksamheten utväderades och följdes upp. Som komplement till intervjuerna granskades även verksamheternas presentationer av sig själva på hemsidor och i broschyrer. Resultatet ger en bild av hur tre verksamheter som bedriver trädgårdsrehabilitering för utmattningsdrabbade är utformade, samt i vilken utsträckning de gör utvärderinga och uppföljningar. Gemensamma inslag i rehabiliteringen var trädgårdsvistelse/aktiviteter, hantverksaktiviteter, samtal, stresshantering och avslappningsövningar. Utvärderingar och uppföljningar skedde i varierande grad och med olika mätinstrument. Som en del i att försöka tydliggöra de tänkta verkningsmekanismerna i trädgårdsrehabiliteringen och ge en översiktlig bild av metoden, utformades även en programteori. Den utgår från verksamheternas metoder samt vetenskaplig evidens inom området. Programteorin visar hur de tänkta aktiviteterna förväntas leda fram till slutresultatet. Den, för trädgårdsrehabilitering, utformade programteorin innehåller vistelse i trädgård och trädgårdsarbete, samtalsterapi, avslappningsövningar och stresshantering. Aktiviteterna förväntas leda till en ökad självinsikt, ett ändrat förhållningssätt och en bättre självkänsla, och genom det en ökad förmåga att hantera sin livssituation. Detta antas ge de förutsättningar som behövs för att kunna återgå till arbetsliv eller studier, alternativt fortsätta rehabiliteringen med arbetsträning. Avsaknaden av tydliga, mätbara mål med rehabiliteringen gör det svårt att värdera hur effektiv rehabiliteringsformen egentligen är på att återinföra utmattningsdrabbade i arbetslivet.

Relacionándolo con las ideas de John Gottman y Robert Levenson, y col. (Gottman, 1993; Levenson y col., 1994), así como otros autores (Smith y Friedermann, 1998; Heffner y col., 2004); en una enfermedad crónica como el síndrome de fatiga crónica (SFC) no sólo el bienestar físico y psicológico están relacionados entre si, sino que las relaciones interpersonales son importantes en el contexto de la salud física y psicológica. Por ello, las relaciones de apoyo cercanas tendrían una influencia sustancial en la adaptación de estos pacientes a su estilo de vida restringido y a la participación en tratamientos concretos (Chowance y Binik, 1982; Radley y Green, 1986, Cordingley y col., 2001). Características interpersonales (satisfacción en la pareja), así como intrapersonales (personalidad) son importantes en la adaptación a una patología crónica, lo cual tiene una implicación a largo plazo para la salud física (Kiecolt-Glaser y Newton, 2001; Roisman y col., 2007). La capacidad funcional en pacientes con SFC estaría deteriorada y limitaría no sólo la vertiente física sino también aspectos psicológicos y sociales. De igual modo, componentes psicosociales tendrían importancia en el paciente diagnosticado de SFC y podrían, incluso, estar asociados a mayor fatiga y deterioro físico (Silver y col., 2002). En el contexto familiar, el medir de forma más específica en mujeres con SFC estos componentes permitiría ver, no sólo si la pareja influye en la fisiología de la paciente sino también si existe una relación entre parámetros funcionales de la enferma y el bienestar de su entorno inmediato. Se escogió la capacidad funcional medida a través de una prueba de esfuerzo monitorizando la respuesta cardioventilatoria para demostrar esta interacción (Blazquez y col., 2010b; 2020c). Así pues, el objetivo principal fue confirmar la interrelación entre la capacidad funcional de pacientes con SFC y aspectos psicosociales y llegar a cuantificarla y definirla. Eso justificaría un mayor uso de intervenciones psico-socio-físicas. Teniendo en cuenta que las necesidades expresadas por los pacientes no están sólo relacionadas con la sintomatología física sino principalmente con malestares psicosociales (como, por ejemplo, cambios durante el ciclo vital familiar o la aparición de una disfunción sexual en el subsistema marital), el tratamiento para el SFC debería ser multidisciplinar (Goudsmit y col., 2009; Hurwitz y col., 2010). Entrelazando dichos aspectos quizás se podría aumentar el éxito de los tratamientos no farmacológicos (Powell y col., 2001). Por ello, una vez confirmada la importancia de incluir un tipo de intervención que contemple lo psico-socio-físico, se propuso la terapia a través de la danza y el movimiento, la cual ya había demostrado su eficacia con pacientes con fibromialgia pero hasta el momento no con SFC (Bojner-Horwitz y col, 2003; Horwitz y col., 2006; Blazquez y col., 2010d).

Diss. (sammanfattning) Stockholm : Karol. inst., 2005. / Härtill 5 uppsatser.

Thesis (Ph.D.)--University of Alberta, 2010. / A thesis submitted to the Faculty of Graduate Studies and Research in partial fulfillment of the requirements for the degree of Doctor of Philosophy, Department of Public Health Sciences. Title from pdf file main screen (viewed on April 28, 2010). Includes bibliographical references.

Ohälsa i form av stress har tilltagit under de senaste decennierna. Detta har lett till en ökning av antalet individer som årligen drabbas av sjukdomen utmattningssyndrom. Detta syndrom har nyligen accepterats som en egen diagnos men har ännu ingen konkret behandlingsmetod. En del av behandlingen kan utgöras av fysisk aktivitet. Trots detta ger inte alltid fysisk aktivitet önskvärd effekt. Detta kan till viss del bero på svårigheten att uppnå balans för individer med denna diagnos. Syftet med litteraturstudien är att beskriva individens upplevelse av fysisk aktivitet som behandling vid utmattningssyndrom. Författarna har valt att göra en litteraturstudie byggd på tolv artiklar av både kvalitativ och kvantitativ ansats. Detta för att utöka kunskapen inom området. Två kategorier identifierades utifrån artiklarna: “Att leva med utmattningssyndrom” och “Fysisk aktivitet som behandlingsmetod vid utmattningssyndrom”. Nämnda kategorier belyser bland annat svårigheter i nivåanpassning av fysisk aktivitet.  Resultatet visar att om aktiviteten inte individanpassas kan detta resultera i försämring av sjukdomen.

Background and Aims: Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) remains a poorly understood condition, shrouded by debate, stigma, and uncertainty. Unsurprisingly, the little available research suggests that caring for a Child or Young Person (CYP) affected by the condition can be extremely challenging. While the majority of available literature is quantitative in nature, there is some qualitative research examining the impact of having a CYP with CFS/ME on parents. However, there currently appear to be no studies examining the narratives of parents living with a CYP with CFS/ME. Therefore, this research aimed to hear how parents narrate their experiences of living with a CYP affected by CFS/ME, paying attention to how they construct their identity, and the contested condition. Methodology: This research drew on a qualitative approach that explored the narratives of the participants. A purposive sample of five parents of CYP affected by CFS/ME (5 mothers) was recruited for a single semi-structured interview. The interviews were audio-recorded, transcribed, and analysed using a narrative approach to explore what participants said and how they narrated their accounts. This was then situated within the social and cultural contexts that shaped them. Analysis and Findings: Multiple readings of the narratives allowed me to develop a summary of each individual's narrative account. These were presented, after which similarities and differences across narratives were considered. Analysis identified six areas of collective focus: 'stories of onset and diagnosis', 'stories of battle', 'stories of finding the person/people who can help', 'stories of impact', 'stories of seeking social support', and 'stories of coping and adjustment'. Participants' narratives were heavily influenced by dominant societal discourses surrounding CFS/ME and motherhood, and could be seen as a response to these narratives. Consequently, participants offered particular constructions of the condition, themselves, their CYP, and others that they had come into contact with. These findings are discussed with reference to their potential bearing for clinical practice, strengths and limitations of the methodology, and directions for future research.

Background Myalgic Encephalomyelitis/Chronic Fatigue Syndrome is a neurologic disease. Between 0,1-2,6% of the world’s population is estimated to have ME/CFS. Even though a lot of people are affected there is a lack of knowledge about the disease. Its symptomatology affects the whole body and is severely debilitating. It’s at utmost importance that this subject is studied so that nurses can get an increased knowledge about ME/CFS. Aim The aim was to highlight people's experiences of living with ME/CFS. Method A literature-based study based on analysis of ten qualitative scientific studies was performed. Results Four main themes and fourteen subthemes were revealed. The main themes were about changing living conditions, lack of knowledge, changes in the body and existential changes. Changes were a major part of the result and people with ME / CFS experienced that the changes could be both positive and negative. The results showed that there is a knowledge gap regarding ME / CFS, which has serious consequences for people with the diagnosis. Conclusion The conclusion of the study was that knowledge, information and support is important for people with ME / CFS. By working person-centered, the nurse can help people with ME / CFS feel better.

Background and Aims: Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) remains a poorly understood condition, shrouded in uncertainty and dispute. Research suggests this context to have a profound bearing on those touched by the condition, impacting significantly on their experience and the narratives constructed thereof. However, no studies examining the narratives of partners of individuals affected by CFS/ME appear to have been carried out to date. Based upon this gap in the literature, this study sought to hear the narratives of partners of adults living with CFS/ME, giving particular consideration to the ways in which these narratives were told to an outsider, and how the outsider may have influenced the narrative. Methodology: This study drew on a qualitative approach. A purposive sample of six partners of adults affected by CFS/ME (4 men and 2 women) was recruited. Individual interviews were conducted that were audio-recorded and transcribed. Narrative analysis was used to analyse the transcripts, focusing principally on how participants narrated their accounts, as well as on the content of narratives and the narrative and discursive features that shaped the telling of the accounts. Analysis and Findings: Multiple readings of the narratives identified two areas of collective focus within participants' accounts - 'stories from then' and 'stories from now'. Some similarities in how 'stories from now' were told were seen to emerge down gender lines. Notably participants' storytelling could be seen to represent a form of response to wider narratives that purvey around CFS/ME, with participants' being observed to construct particular meanings around CFS/ME, as well as particular 'identities' of themselves, their partner, their relationship and 'others' who had played a key role in their story of living with the condition. The findings are discussed in terms of their potential bearing for clinical practice and future research endeavours. In addition, the strengths and the limitations of the research are considered.

D.Ed. (Nursing) / This research aims at the description of a therapeutic approach relevant to the youth suffering from chronic fatigue syndrome and includes his family, school and peer group. According to relevant literature it appears that chronic fatigue impacts negatively upon the total functioning of the youth. The physical demands of the condition leads to continual school-absenteeism, dysfunctional socialising and variable familial relationships. The condition is not easily diagnosed in youth as symptoms are often ascribed to school-phobia, deviant behaviour and/or psychological problems. In view of the fact that the researcher is of the opinion that the condition of the youth is not readily understood by his peers, family and school, the researcher aims at examining the experience of the youth who manifests chronic fatigue syndrome. The youth forms part of a specific system which is also affected by the chronic-fatigue-syndrome. Thus the research is aligned to a systemic approach. The researcher has decided to follow a qualitative research approach, with the deliberate choice of two youths subjected to the utilisation of multiple data-gathering sources. Multiple data-gathering includes interviews, document analysis and observation. The data has been analysed with the assistance of two independent coders and central themes have been established. Case study reports have been complied according to processed data. Hereafter a literature-control was applied to compare the results of this research with other available research and to point out new insights into chronic-fatigue syndrome gained from this research.