Bakgrund: Myalgisk encefalomyelit/ Chronic Fatigue Syndrome (ME/CFS) är en komplex kronisk sjukdom med okänd etiologi och utan medicinsk botande behandling. Kunskapen om sjukdomen är låg bland hälso-och sjukvårdspersonal vilket kan leda till att patienter får gå lång tid utan stöd. Sjuksköterskan är ansvarig att uppdatera sina kunskaper och stödja personerna genom personcentrerad vård för att uppnå hälsa och minska lidande. Genom att studera personers egna upplevelser av sjukdomen, utifrån deras livsvärld, kan ny kunskap och förståelse skapas.  Syfte: Att beskriva vuxna personers upplevelse av att leva med Myalgisk encefalomyelit/ Chronic Fatigue Syndrome (ME/CFS) Metod: Till metod valdes en kvalitativ litteraturstudie med en induktiv ansats baserad på två patografier och sju kapitel ur en antologi. Innehållsanalysen gjordes efter inspiration från Lundman och Hällgren Graneheims beskrivning, analysen skedde huvudsakligen manifest med latenta inslag. Resultat: Analysen resulterade i tre kategorier och sex underkategorier. I kategorin Sjukdomens konsekvenser begränsar livet framkom att personerna upplevde att livet begränsades på grund av de förändrade fysiska och mentala förmågorna. I kategorin Förändrat jag framkom att personerna upplevde att den de var förändrades. I kategorin, Svårigheter att hantera sjukdomen, framkom att personerna upplevde svårigheter att lära sig leva med och acceptera sjukdomen, men att de lärde sig hantera den med hjälp av olika strategier och ett nytt sätt att tänka. De beskrev även upplevelser av bristande kunskap, svårigheter att få en diagnos och en känsla av att inte bli tagen på allvar i kontakt med vården.   Slutsats: Myalgisk encefalomyelit/ Chronic Fatigue Syndrome (ME/CFS) har en djup påverkan på hela personen, fysiskt, mentalt och psykiskt liksom att den påverkar relationer, familjedynamik, funktionsförmåga, välbefinnande och vardagsliv. Sjukdomen är svår att lära sig leva med och det finns ett behov av stöd, strategier och information från sjukvården för att  underlätta personens anpassning till vardagen och välbefinnande.

Bakgrund: ME/CFS är en allvarlig, kronisk och komplex multisystemsjukdom som ofta och dramatiskt begränsar de drabbade personernas aktivitet. De vetenskapliga beläggen gällande effekten av interventioner riktade mot funktion och funktionsnedsättning är begränsade. Nuvarande kunskapsläge indikerar att arbetsterapeuten kan bidra i vården av personer med ME/CFS, men behov av vidare forskning finns. Syfte: Att med denna litteraturöversikt kartlägga och beskriva aktuell forskning gällande arbetsterapeutens roll för personer med diagnosen ME/CFS. Metod: Datainsamling för litteraturöversikten genomfördes baserat på utarbetade urvalskriterier i tre relevanta databaser; PubMed, CINAHL och PsycINFO och resulterade i tio artiklar, sju kvantitativa och tre kvalitativa studier. Studiernas kvalitet granskades och sedan utfördes en latent innehållsanalys. Resultat: Analysen resulterade i fyra kategorier: Att ge klientcentrerat stöd för strategier i aktivitet, Att justera terapeutiskt förhållningssätt vid aktivitetsanpassning, Att beakta gruppbehandlingens terapeutiska värde samt Att bidra till professionernas teamsamverkan. Slutsats: Arbetsterapeutens kompetens är ett viktigt bidrag i rehabiliteringen på grund av den komplexa aktivitetssituation som diagnosen innebär. / Background: ME/CFS is a serious, chronic and complex systemic disease which often and dramatically limits the activity of the affected. The existing scientific evidence of interventions regarding function and disability is limited. The current level of knowledge indicates that the occupational therapist can contribute to the care for people with ME/CFS, but there is a need for further research. Aim: The aim of this literature overview was to map out and describe current research regarding the role of the occupational therapist for people diagnosed with ME/CFS. Method: Data collection for the literature overview was conducted based on developed selection criterias in three relevant databases; PubMed, CINAHL and PsycINFO which resulted in ten articles, seven quantitative and three qualitative studies. The quality of the included studies were assessed and finally a latent content analysis was completed which resulted in four categories. Result: The content analysis resulted in four categories: to supply a client centered support for strategies in activity, to adjust therapeutic approach in occupational adaptation, to consider the therapeutic value of the group treatment, and to contribute to the professional team collaboration. Conclusion: The expertise of the occupational therapist is an important contribution to rehabilitation due to the complex occupational situation for people diagnosed with ME/CFS.

Många som drabbas av utmattningssyndrom (UMS) upplever en nedsatt kognitiv förmåga och att sjukdomen blir en brytpunkt och ett vägval som kräver en väl fungerande handlingsplan inför framtiden. Denna studie har intervjuat individer med UMS och frågat hur de ser på karriärvägledning, om den behövs och vilken typ av vägledning som de efterfrågar. Resultaten från de kvalitativa intervjuerna analyserades utifrån careershipteorin och konstruktivistisk teori och visar att personer med UMS är i behov av en livsförändring som kräver ny insikt, utsikt och framsikt för en lyckad återgång till arbetslivet och ett hälsosamt förhållningssätt till arbete och prestation. Vidare framkom det ett behov av ett holistiskt förhållningssätt där individens egen livshistoria sätts i centrum då det inte finns några mediciner eller färdiga lösningar som passar alla. Karriärkompetens och livslångt lärande är centrala delar av denna studie och med en fördjupad kunskap inom detta område kan en studie- och yrkesvägledarens insats, det vill säga karriärvägledning, vara till stor nytta för personer med UMS. / Many people who suffer from fatigue syndrome (UMS) experience a reduced cognitive ability that becomes a turning point, leading to a crossroad that requires a well-functioning action plan for the future. In this study, interviews with people that are or have been diagnosed with UMS have shared their opinions regarding career guidance, whether career guidance is needed, and what type of guidance they perceive as needed. The results from the qualitative interviews were analyzed drawing on careership theory and constructivist theory, showing that people with UMS are in need of a life change that requires new insight, perspective and foresight for a successful return to work and a healthy way of relating to work and accomplishment. Furthermore, the study shows that there is a need for a holistic approach where the individual's own life story is put at the center, since no medications or ready-made solutions that suit everyone exist. Career management skills and lifelong learning are central parts of this study and with an expertise within this area, a career counsellor’s contribution, i.e. career guidance, can be of great benefit to people with UMS.

Bakgrund: Orsaken till uppkomsten av myalgisk encefalomyelit/kroniskt trötthetssyndrom är inte helt utredd men vanligtvis debuterar sjukdomen efter en infektionssjukdom, exponering av miljögifter eller vid stress och större livshändelser. Symtomen är många och svårighetsgraden varierar. Det är en svårdiagnostiserad sjukdom utan specifika biomarkörer för diagnosställning. Sjukdomen är ännu outforskad vilket försämrar sjuksköterskans möjlighet att hjälpa personerna på ett personcentrerat sätt. Syfte: Syftet var att belysa erfarenheter av att leva med myalgisk encefalomyelit/kroniskt trötthetssyndrom. Metod: Studien utformades som en allmän litteraturstudie där tio resultatartiklar användes. Analys av resultatartiklarna genomfördes enligt Popenoe et al. (2021). Resultat: I resultatet identifierades tre huvudkategorier följt av åtta underkategorier. Resultatet visade att sjukdomen upplevdes ge fysiska och psykiska konsekvenser. Sjukdomens svårighetsgrad varierade men gemensamt var upplevelsen av stora begränsningar. Begränsningarna ledde ofta till frustration, ensamhet och ett behov att omvärdera sin identitet. Personer med myalgisk encefalomyelit/kroniskt trötthetssyndrom upplevde en oförståelse och okunskap hos omgivningen och inom vården. Resultatet visade också en stor variation av känslor rörande acceptans och återhämtning bland personerna. Konklusion: För att vården ska förbättras och tillvaron förändras för personer som lever med ME/CFS behövs mer kunskap och förståelse kring sjukdomen. / Background: The cause of myalgic encephalomyelitis/chronic fatigue syndrome is not completely understood, but usually the disease debuts after an infection, exposure to environmental toxins or during stress and major life events. The symptoms are many and varies in severity. It is difficult to diagnose the disease and there are no specific biomarkers for diagnosis. The disease is still unexplored which makes it hard for nurses to help these people in a person-centered way. Purpose/Aim: The purpose was to highlight experiences of living with myalgic encephalomyelitis/chronic fatigue syndrome. Method: The study was designed as a general literature study, where ten result articles were used. Analysis of the result articles were done according to Popeneo et al. (2021). Results: In the results, three main categories were identified, followed by eight subcategories. The results showed that the disease was perceived to give physical and psychological consequences. The degree of severity of the disease thus varied, but in general was the experience of major limitations. The limitations often led to frustration, loneliness and a need for re-evaluate one’s identity. Strategies for coping and an everyday planning was common. The lack of understanding and ignorance about the disease, created an obstacle between the healthcare and the patients. In addition, the results showed that feelings about recovery and acceptance varied. Conclusion: In order for care to improve and life to change for people living with ME/CFS, more knowledge and understanding about the disease is needed.

Today's social climate and working environments expose us to excessive expectations and demands and more and more people are diagnosed with stress-related illnesses. My degree project is an investigation of poetic design, healing spaces and fatigue syndrome and the importance of adapted health care environments that strengthen treatment and recovery. My mother has fatigue syndrome, she has been ill for over six years, and she still has severe symptoms that probably never fully will go way. So, the purpose of this project is, on the one hand an attempt to get a deeper understanding of her situation, and on the other, to shed some light on this illness that is getting more and more common, especially amongst women. Research shows that spending time in nature has healing effects for those with mental illness. Using my definition of poetic design as a method, I have transposed qualities of nature into an indoor environment that reconnects to humans deep and genetic relationship to nature. I am proposing a new type of health care space with a much-needed holistic approach. Focus is on treatments such as mindfulness, basal body awareness and yin yoga as well as different kinds of therapy and activities in a space close to nature. A holistic space including a garden, an indoor space and a piece of furniture that are designed to respond to the non-measurable and invisible symptoms of fatigue syndrome.

Chronic, noncommunicable diseases such as chronic fatigue syndrome (also known as myalgic encephalomyelitis) are rapidly becoming a worldwide epidemic that profoundly affects public health and productivity. Chronic fatigue syndrome (CFS) is characterised by severe and debilitating fatigue and although its etiology is still unknown, recent studies have found considerable evidence that mitochondrial dysfunction and oxidative stress might be responsible for the underlying energy deficit in these patients. Adenine and pyridine nucleotides could be used as potential biomarkers for energy related disorders such as chronic fatigue syndrome because of their various functions in the energy and redox pathways. The first part of this study focussed on developing a liquid chromatography electrosprayionisation tandem mass spectrometry (LC-ESI-MS/MS) method for the quantification of these nucleotides in blood samples. Due to the instability of nucleotides in biological matrices it was also necessary to find a suitable extraction method that would be able to stop enzymatic activity via protein precipitation. Out of the four extraction methods investigated during this study, deproteinisation of whole blood samples with perchloric acid produced the highest nucleotide abundances. Although nucleotide standards were found to be stable in perchloric acid, nucleotide levels in blood samples were not stabilised by addition of perchloric acid. The second part of this study consisted of measuring the nucleotide levels in blood samples of controls and possible CFS patients in order to test the proof of concept of the new LCESI- MS/MS method. Despite changes in the nucleotide levels due to perchloric acid and problems with nucleotide instability, it was still possible to distinguish between the two groups based on the results obtained with the new LC-ESI-MS/MS method. The newly developed LC-ESI-MS/MS method proved to be reliable and adequate for nucleotide quantification in whole blood samples, thus the aim of this study was achieved. / MSc (Biochemistry), North-West University, Potchefstroom Campus, 2014

In some of the most established and supposedly immutable liberal democracies, diverse social groups are losing con fi dence not only in established democratic institutions, but in the idea of liberal representative democracy itself. Meanwhile, an illiberal and anti-egalitarian transformation of democracy evolves at an apparently unstoppable pace. This democratic fatigue syndrome , the present article suggests, is qualitatively di ff erent from the crises of Democracy which have been debated for some considerable time. Focusing on mature democracies underpinned by the ideational tradition of European Enlightenment, the article theorizes this Syndrome and the striking transformation of democracy in terms of a dialectic process in which the very norm that once gave birth to the democratic project - the modernist idea of the autonomous subject - metamorphoses into its gravedigger, or at least into the driver of its radical reformulation. The article further develops aspects of my existing work on second-order emancipation and simulative democracy . Taking a theoretical rather than empirical approach, it aims to provide a conceptual framework for more empirically oriented analyses of changing forms of political articulation and participation.

Este estudo tem por objetivo avaliar o nível de desconforto, através da Escala Visual Analógica (EVA), o Mapa de Segmentos Corporais de Corlett e Bishop (MSC) e o Questionário de Fadiga de Chalder (EFC) em operadores de telemarketing. A coleta de dados foi realizada uma vez por semana, ao longo de 2 meses de aplicação do programa de exercícios. A análise estatística sugere diminuição do crescimento do desconforto postural nos dois grupos, sendo mais acentuada no grupo experimental. Foi observada também diminuição significativa dos níveis de EVA e redução da freqüência e da prevalência de segmentos doloridos no MSC, ao se comparar dados da primeira e da última semana do estudo realizado. Quanto à fadiga também houve melhora em todas as variáveis do questionário de Chalder, indicando presença de efeitos significativos na diminuição dos níveis de fadiga. Assim, os programa de exercícios mostraram-se efetivos para diminuir o desconforto músculo-esquelético e a fadiga entre os operadores de telemarketing / The objective of this survey is to assess the telemarketing operators discomfort and mental and physical fatigue at the airway company call center before and after applying an exercise program. The objective of this survey is to assess the telemarketing operators discomfort and mental and physical fatigue at the airway company call center before and after applying an exercise program. The body map of Corlett and Bishop with a visual analogic scale and the Chalder fatigue questionnaire was applied to 84 telemarketing operators from the experimental and control groups. The experimental group has attended a 10 minutes exercise daily session and the control group a 10 minutes daily rest break. The exercise showed that is more effective than a rest break to prevent discomfort development and is important to repetitive strain injuries prevention because discomfort is one of the main predictors of this group of diseases

Chronic, noncommunicable diseases such as chronic fatigue syndrome (also known as myalgic encephalomyelitis) are rapidly becoming a worldwide epidemic that profoundly affects public health and productivity. Chronic fatigue syndrome (CFS) is characterised by severe and debilitating fatigue and although its etiology is still unknown, recent studies have found considerable evidence that mitochondrial dysfunction and oxidative stress might be responsible for the underlying energy deficit in these patients. Adenine and pyridine nucleotides could be used as potential biomarkers for energy related disorders such as chronic fatigue syndrome because of their various functions in the energy and redox pathways. The first part of this study focussed on developing a liquid chromatography electrosprayionisation tandem mass spectrometry (LC-ESI-MS/MS) method for the quantification of these nucleotides in blood samples. Due to the instability of nucleotides in biological matrices it was also necessary to find a suitable extraction method that would be able to stop enzymatic activity via protein precipitation. Out of the four extraction methods investigated during this study, deproteinisation of whole blood samples with perchloric acid produced the highest nucleotide abundances. Although nucleotide standards were found to be stable in perchloric acid, nucleotide levels in blood samples were not stabilised by addition of perchloric acid. The second part of this study consisted of measuring the nucleotide levels in blood samples of controls and possible CFS patients in order to test the proof of concept of the new LCESI- MS/MS method. Despite changes in the nucleotide levels due to perchloric acid and problems with nucleotide instability, it was still possible to distinguish between the two groups based on the results obtained with the new LC-ESI-MS/MS method. The newly developed LC-ESI-MS/MS method proved to be reliable and adequate for nucleotide quantification in whole blood samples, thus the aim of this study was achieved. / MSc (Biochemistry), North-West University, Potchefstroom Campus, 2014

CFS/ME (Chronic Fatigue Syndrome/Myalgic Encephalomyelitis) is a distressing and potentially debilitating condition. It can also be understood as a contested condition, surrounded by controversy about its nature, causes and treatment. Previous research indicates that those affected experience this climate of contestation as a troubling and discrediting assault, not only on the nature of their condition, but also on their identities. However, little attention has been paid to the voices of young people living with CFS/ME. This thesis extends a relatively small literature in new directions, focusing a constructionist, discursive narrative lens on the accounts of ten young people (aged 13-18) living with a diagnosis of CFS/ME. Narratives constructed during repeated interviews over a year, and drawing on multimodal materials collected by participants over that period, were analysed for their content, structure and performance, with reference to the local and broader contexts of their production. This analysis demonstrates that teenagers construct rich, multi-layered narratives with the potential to enhance understanding of their situation and broader features of the social world. As they speak of the onset of illness, attempts to live with enduring, unpredictable symptoms and their psychosocial consequences, and (for some) the possibility of 'moving on' from the worst of illness, this analysis throws new light on how young people's narratives can be understood as simultaneously constructing the condition ('M.E.') and the identities of those involved ('me' and others), in ways that engage with, reflect and resist prevailing discourses. It is argued that the discursive contexts of CFS/ME and adolescence raise particular challenges for young people as they try to construct credible narratives that convey the full extent of their difficulties, while resisting stigmatising identities (eg, as 'complaining', 'lazy' or otherwise 'not normal'). This analysis highlights implications for them, their families and those who work professionally with them; and for the ongoing social construction of CFS/ME in young people.