The post COVID-19 syndrome (PCS) is an emerging phenomenon worldwide with enormous socioeconomic impact. While many patients describe neuropsychiatric deficits, the symptoms are yet to be assessed and defined systematically. In this prospective cohort study, we report on the results of a neuropsychiatric consultation implemented in May 2021. A cohort of 105 consecutive patients with merely mild acute course of disease was identified by its high symptom load 6 months post infection using a standardized neurocognitive and psychiatric-psychosomatic assessment. In this cohort, we found a strong correlation between higher scores in questionnaires for fatigue (MFI-20), somatization (PHQ15) and depression (PHQ9) and worse functional outcome as measured by the post COVID functional scale (PCFS). In contrast, neurocognitive scales correlated with age, but not with PCFS. Standard laboratory and cardiopulmonary biomarkers did not differ between the group of patients with predominant neuropsychiatric symptoms and a control group of neuropsychiatrically unaffected PCS patients. Our study delineates a phenotype of PCS dominated by symptoms of fatigue, somatisation and depression. The strong association of psychiatric and psychosomatic symptoms with the PCFS warrants a systematic evaluation of psychosocial side effects of the pandemic itself and psychiatric comorbidities on the long-term outcome of patients with SARS-CoV-2 infection.

A goal in conservation is that cultural heritage should be for everyone and therefore should be experienced by everyone. With ramps, lifts, Braille exhibitions, sign language interpreted tours, tours for the visually impaired, etc., adaptions are made for people with physical disabilities. The purpose of this paper is to highlight how the Nordic Museum works to reach people with neuropsychiatric disorders along with the specific needs and disabilities which may need to be met by the museum. The case study will aim to highlight problems and opportunities in pedagogy of exhibitions focused on neuropsychiatric disorders. Moreover, it provides an indication of how the works with these issues at the museums are implemented, etc., which can create a greater awareness for the various professions in museums and conservations. This has been examined by the means of interviews, with the unions that advocate groups of neuropsychiatric disorders, and observations of selected exhibitions and shows, museum space, some audioguide-tours and part of the museum's website. In addition, other interviews are made with a museum educator with experience in the subject and a museum educator and head of the department of hosts and shops from the Nordic Museum. The materials which are used are mainly written public reports, as for example the Nordic museum Annual 2015. The museum caterers mostly focus on physical disability. They have also focused on reading disabilities and dementia, in addition to the physical functional limitations. The museum does its best and have a desire to improve themselves, which is shown at their website. The educational tools and approaches, etc. is well thought through, but the focus here is primarily on children and not adults. Something that may be because they have more impressions for children than for adults, if one example is taken. Some of the unions advocate “design for all” and more focus on a different view from the society, as well as personal attitudes to face persons with neuropsychiatric disabilities. They believe this will also affect the museum's education in general. Also, the use of different types of media and interactions in the exhibitions, as well as peace in the museum hall will make an impact in the pedagogy of the museum. The conclusions are that it probably always will be development potential in the pedagogy of the museum. The Nordic Museum has come a long way in the use of several media, but the design could in some cases be fine-tuned. Awareness of neuropsychiatric disorders could also be developed, both in society and in museums. / Ett mål inom kulturvård är att kulturarvet ska finnas till för alla och därmed ska kunna upplevas av alla. Anpassningar till personer med fysiska funktionsnedsättningar görs till exempel med ramper, hissar, blindskrift på utställningar, teckentolkade visningar, visningar för personer med nedsatt syn etc. Syftet med uppsatsen är att belysa hur Nordiska museet riktar sig till personer med neuropsykiatriska funktionsnedsättningar, vilka åtgärder som görs och kan göras för att tillgängliggöra museet för dessa personer samt vad för behov som kan behöva tillmötesgås hos dessa personer. I sammanhanget får fallstudien syftet att belysa problem och möjligheter med utställningspedagogik inriktad mot neuropsykiatriska funktionsnedsättningar. Detta kan dessutom ge en indikation på hur arbetet med dessa frågor på museer ser ut etc., vilket kan skapa en större medvetenhet hos olika museala professioner samt inom kulturvårdens andra professioner. Detta har granskats med hjälp av intervjuer och korrespondens med förbund som representerar olika grupper inom neuropsykiatriska funktionsnedsättningar samt observationer av utvalda utställningar och visningar, museets lokaler, vissa audioguiderundor och delar av museets hemsida. Utöver detta har intervjuer gjorts med en museipedagog med erfarenhet i ämnet och en museipedagog samt sektionschefen för bl.a. museivärdar vid Nordiska museet. De material som har används är främst offentliga skriftliga källor, som exempelvis museets årsredovisning 2015. Museet riktar i första hand sitt tillgänglighetsarbete mot fysiska funktionsnedsättningar. För neuropsykiatriskt funktionsnedsatta fokuserar de i första hand på lässvårigheter samt demenssjukdomar. Museet gör sitt bästa och har en vilja att förbättras, vilket märks på exempelvis hemsidan. De pedagogiska verktygen och angreppssätten etc. är väl uttänkta, men fokusen ligger här främst på barn. Detta kan bero på att de har fler visningar för barn än för vuxna. En del av förbunden förespråkar design för alla samt mer fokus på en annan samhällssyn, samt personliga attityder emot personer med neuropsykiatriska funktionsnedsättningar. Detta är något som de tror kommer att påverka museets pedagogik i stort. I övrigt, gällande hela museets pedagogik, lägger de störst vikt på tydlighet, användning av olika typer av medier och interaktioner i utställningar samt försöka få fram ett lugn i lokalerna. Slutsatserna blir här att det troligen alltid kommer finnas utvecklingspotential inom museers pedagogik. På Nordiska museet har de kommit långt i användandet av flertalet medier, men utformningen skulle i vissa fall kunna finputsas. Medvetenheten kring neuropsykiatriska funktionsnedsättningar behöver och kan också utvecklas både i samhället och på museer.

Le tube digestif héberge une communauté microbienne complexe, le microbiote intestinal, dont les capacités métaboliques sont plus riches et diversifiées que celles codées par le génome de l'hôte. L'implication du microbiote intestinal dans divers aspects de la physiologie de l'hôte, comme le métabolisme nutritionnel et l'immunité, est depuis longtemps étudiée. En revanche, l'action potentielle du microbiote sur le développement et le fonctionnement du cerveau constitue une nouvelle piste de recherche, encore peu explorée. Dans ce contexte, nous avons réalisé une première étude générale de l'action du microbiote intestinal sur le cerveau en comparant les fonctions sensori-motrices, le comportement de type anxieux, l'état d'activation de l'axe hypothalamo-hypophyso-surrénalien et le profil cérébral des monoamines de rats F344 axéniques et conventionnels. Les résultats révèlent que, chez cette lignée particulièrement sensible au stress, l'absence de microbiote intestinal exacerbe le comportement de type anxieux et la réponse hormonale au stress, et atténue le métabolisme dopaminergique cérébral. Afin d'étudier par quel moyen le microbiote peut agir sur le cerveau, une seconde étude a été menée, ciblant un métabolite bactérien spécifique, l’indole, dont certains dérivés oxydés par le foie sont connus pour avoir des propriétés neuroactives. L'indole est un métabolite naturel du microbiote intestinal, dont la surproduction pourrait survenir lors d'une dysbiose du microbiote. Deux cas de surproduction ont été modélisés : chronique et aiguë. Dans les deux cas, des modifications importantes du comportement de l'hôte ont été observées. En situation de surproduction chronique, l'indole favorise des comportements de type anxieux et dépressif, tandis qu'une surproduction aiguë a un effet sédatif marqué. D'un point de vue mécanistique, nous confirmons que l’indole peut agir sur le système nerveux central par la voie sanguine impliquant les dérivés oxydés et montrons pour la première fois qu'il peut aussi agir en activant les noyaux cérébraux du nerf vague. / The gastro-intestinal tract hosts a complex microbial community, the gut microbiota, whose collective genome coding capacity vastly exceeds that of the host genome. The involvement of the gut microbiota in various aspects of the host physiology, such as the nutritional metabolism and the immunity, has long been studied. In contrast, the possible action of the gut microbiota on brain development and functioning is a new line of research, still poorly explored. In this context, we performed a first general study of the effect of gut microbiota on the brain by comparing the sensory-motor functions, the anxiety-like behaviour, the activation of the hypothalamic-pituitary-adrenal axis and the brain monoamine profile in germ-free and conventional F344 rats. The results show that, in this particularly stress-sensitive strain, absence of gut microbiota exacerbates the anxiety-like behaviour and neuroendocrine response to stress, and reduces brain dopamine metabolism. To investigate the means by which the microbiota can affect the brain, a second study was conducted, targeting a specific bacterial metabolite, indole, whose oxidative derivatives, produced by the liver, are known to have neuroactive properties. Indole is a natural metabolite of the gut microbiota, whoseoverproduction could occur during a microbiota dysbiosis. Two conditions of overproduction, namely chronic and acute, were modelled. In both cases, significant changes in the behaviour of the host were observed. In chronic overproduction, indole promotes anxiety- and depressive-like behaviours, while acute overproduction has a marked sedative effect. From a mechanistic point of view, we confirm that indole can act on the central nervous system through its oxidized derivatives and show for the first time that it can also act by activating the brain nuclei of the vagus nerve.

N-methyl-D-aspartate (NMDA) receptors are ligand-gated ion channels activated by agonist glutamate and co-agonist glycine. They play a key role in mediating the fast excitatory synaptic neurotransmission in the mammalian central nervous system. To create a functional heterotetrameric receptor, the presence of two GluN1 subunits combined with GluN2 or GluN3 subunits is necessary. Previous studies confirmed the importance of M3 transmembrane helix and extracellularly localized cysteines in regulation of surface expression of functional NMDA receptors. The aim of my thesis is to elucidate an influence of clinically relevant mutations in M3 transmembrane helix and the role of all known cysteines that form disulphide bonds on surface delivery of NMDA receptor expressed in heterologous monkey kidney fibroblasts cell culture (COS-7). Using molecular biology methods, immunocytochemistry and microscopy I found that the clinically relevant mutations M641I and Y647S in GluN1 subunit and also the mutations of particular cysteines forming disulphide bonds caused substantial decrease of surface expression of NMDA receptors. Furthermore, I discovered that the effect of mutated GluN1 subunits on decrease of surface expression depends on the subunit composition. The contribution of my results lies in elucidating the...

Submitted by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-06-30T18:20:36Z No. of bitstreams: 1 DIS_ALINE_ZUARDI_MAIA_COMPLETO.pdf: 2031061 bytes, checksum: fccbebad93bb1d333b02bf575d628353 (MD5) / Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-06-30T18:20:43Z (GMT) No. of bitstreams: 1 DIS_ALINE_ZUARDI_MAIA_COMPLETO.pdf: 2031061 bytes, checksum: fccbebad93bb1d333b02bf575d628353 (MD5) / Made available in DSpace on 2017-06-30T18:20:49Z (GMT). No. of bitstreams: 1 DIS_ALINE_ZUARDI_MAIA_COMPLETO.pdf: 2031061 bytes, checksum: fccbebad93bb1d333b02bf575d628353 (MD5) Previous issue date: 2017-03-22 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Oldest-old (80 years or more) have different profile them those aged 60 to 79, due to their larger decline in functionality, with involvement of disease, loss of social status, among others. As a result, there is a greater possibility to present mental disorders, the most common is depression. The objective of this project is to verify the effectiveness of two screening tools for the characterization of depression in the oldest-old. This is a quantitative, cross-sectional, observational, and analytical study. The sample size was 74 oldest-old, residents of the city Porto Alegre, RS, Brazil. After asking the identification and sociodemographic data the oldest-old answer the Mini International Neuropsychiatric Interview (MINI) to identify those depressed or not. Later, they responded the Geriatric Depression Scale 15 (GDS-15) and the Inventory Beck Depression II (BDI-II). From the diagnosis of MINI we calculated the sensitivity and specificity of the BDI-II and GDS-15 for different cutoff points, generating two ROC curves (Receiver Operating Characteristics). GDS-15 showed 100% sensitivity and 83% specificity, being the best cutoff point 6. The BDI-II obtained 100% sensitivity and 87% specificity, with cutoff point 15 indicated for this population. The BDI-II was more accurate than the GDS-15, although the last one presented more appropriated for epidemiologic studies. The two tools were effective for the screening of depressive symptomatology in Oldes- old. / Longevos (80 anos ou mais) possuem perfil diferente dos idosos com 60 at? 79 anos, com maior decl?nio das funcionalidades, acometimento de doen?as, org?nicas e mentais, perda do status social, entre outros. Como consequ?ncia, ocorre uma grande possibilidade de desencadeamento de transtornos mentais, sendo o mais comum a depress?o. O objetivo deste estudo ? verificar a efetividade de dois instrumentos de rastreio para a caracteriza??o da sintomatologia depressiva em longevos. Trata-se de um estudo quantitativo, transversal, observacional e anal?tico, sendo que a amostra foi composta por 74 longevos, residentes da cidade Porto Alegre, RS. Os dados de identifica??o do longevo foram coletados e foi realizada a aplica??o do Mini International Neuropsychiatric Interview (MINI), para caracterizar os longevos em depressivos ou n?o. Posteriormente, foram avaliadas a Escala de Depress?o Geri?trica 15 (GDS-15) e o Invent?rio de Depress?o de Beck II (BDI-II). A partir do diagn?stico do MINI, foram calculadas a sensibilidade e especificidade do BDI-II e GDS-15 para diferentes pontos de corte, gerando duas curvas ROC (Receiver Operating Characteristics). A GDS-15 apresentou sensibilidade de 100% e especificidade de 83%, sendo o melhor ponto de corte 6. O BDI-II obteve 100% de sensibilidade e 87% de especificidade, com ponto de corte 15 indicado para esta popula??o. O BDI-II mostrou-se mais exato do que a GDS-15, apesar deste ter melhor aplicabilidade para pesquisas epidemiol?gicas. Ambas as ferramentas foram eficazes para rastreio da sintomatologia depressiva em longevos.

This essay investigates the attitudes of social work students’ from Stockholm University, Sweden, towards people with autism and ADHD. The students participated in focus groups, where they discussed their thoughts and potential actions in the meeting with people with autism and ADHD. Through a thematic analysis, we identified the four following themes: perceptions; ignorance and its consequences; adaptation and actions tendencies; and needs of change. The results were then analyzed with a classic attitude theory. The results show that social work students mostly have positive attitudes towards people with autism and ADHD and that it is important to consider them like anybody else and to have knowledge about the disabilities, which leads to a helping and supporting preparedness towards them. Social work student has a strong will to help people with autism and ADHD but sometimes feel that society and organizations prevent them from doing so. In conclusion, social work students have a caring attitude, wants more knowledge about diagnoses and wants to help and do more for people with autism and ADHD.

Background: Data regarding both drug-related and non-drug-related costs in patients with Parkinson's disease (PD) are scarce, mainly due to the difficulties in data acquisition in experimental designs. Likewise, the reported impact of drug costs on total direct costs varies across different studies. In addition, the influence of comorbidities on both treatment costs and health-related quality of life has not been adequately evaluated. Methods: A sample of office-based neurologists (n = 315) in Germany was asked to examine up to five consecutive patients with PD (n = 1449) on a specified day during the study period. Patients of all ages were eligible and their evaluation was performed using standardized questionnaires. Results: PD-specific therapy costs increased with the stage of the disease, early onset of the disease and disease duration. The major costs were due to PD-related therapy, whereas other medications only resulted in minor costs. Disease stage mainly influenced direct therapy costs, with an observed increase of total daily costs from €7.3 to €11.3/day. In addition, disease onset at age < 65 years resulted in total daily costs of €11.2 compared to late onset of disease (> 75 years) with daily therapy costs of €5.3. In this patient group neuropsychiatric comorbidities such as dementia and depression were only insufficiently treated. In addition, these comorbidities severely affected health-related quality of life. Conclusion: Therapy costs were influenced by disease stage, disease onset as well as present comorbidities. Furthermore, comorbidities such as depression and dementia were diagnosed but were not adequately treated.

Attetion Deficit Hyperactivity Disorder, ADHD, är den vanligaste barnpsykiatriska diagnosen.Syftet med denna studie var att beskriva hur skolsköterskan erfar skolsituationen för elevermed ADHD-diagnos. Fyra till sex procent av alla elever i skolan har denna diagnos (ADHD).Skolsköterskan har i sin dagliga kontakt med elever möjlighet att tidigt upptäcka och även tillviss del förhindra utvecklandet av komplikationer. Orsaken till ADHD består främst avgenetiska anlag men sociala faktorer finns och de påverkar hur svår utvecklingen blir.Metoden var en kvalitativ innehållsanalys med induktiv ansats beskriven av Lundman ochHällgren Graneheim. Datainsamlingen gjordes genom intervjuer med sex skolsköterskor. Urdatamaterialet framträdde temat Att förväntas vara som andra, men inte kunna med treunderteman. Resultaten kan användas till att öka förståelsen för elever med ADHD och derasskolsituation. Förhoppningsvis kan insikten om problemets svårighetsgrad öka motivationenatt förbättra situationen i skolan för alla elever och vuxna. Det finns många saker sompåverkar situationen för elever med ADHD, med rätt resurser och förutsättningar gesmöjlighet att påverka elevens utveckling i positiv riktning. / Attention Deficit Hyperactivity Disorder, ADHD, is today the most common psychiatricdiagnosis among children. The purpose of this study was to describe school nurses̛experiences of the school situation of pupils with ADHD. Four to six percent of all schoolpupils have been diagnosed with this illness. Due to her daily contact with school children,the school nurse has the opportunity to assist in early detection of ADHD, and can to someextent even prevent the development of possible complications. Genetic predisposition is theprimary cause of ADHD but social factors affect the severity of its development. The methodin this study was qualitative content analysis with an inductive approach described byLundman och Hällgren Graneheim. The data collection was made through interviews with sixschool nurses. Based on the analysis, the theme; Expected to be like the others, but also notbeing able, emerged with three subthemes. The results can be used to increase theunderstanding of pupils with ADHD in their school situation. Hopefully, awareness of theproblem severity increases motivation to improve the situation in schools for all studentsand adults. There are many things that affect the situation for children with ADHD. With theright resources and conditions the opportunity to influence students' development in apositive direction occurs.

Attention Deficit Hyperactivity Disorder (ADHD) är ett neuropsykiatriskt funktionshinder som inte bara har ökat bland barn, utan även hos vuxna. Enligt Socialstyrelsen beror denna ökning på att det finns en större kunskap om diagnosen och symtomen märks tydligare i och med att vi nu lever i ett informationssamhälle med högre kognitiva krav. I framförallt USA har det blivit populärt att använda sig av ADHD-coacher som ett komplement till medicin och terapi. Metoden existerar i Sverige, men den ingår inte som en behandlingsform som erbjuds eller föreslås till individer som får diagnosen ADHD. Syftet med denna studie är att ge mer kunskap om ADHD-coaching samt att jämföra denna metod med andra behandlingsalternativ som ges till en individ med ADHD diagnos. Jag har utgått ifrån ett salutogent perspektiv med Antonovskys KASAM som stöd, då jag tittat på det kognitiva området och vidare empowerment i förhållande till det psykosociala stödet. Resultatet av studien visar på att det finns effektiva behandlingsmetoder för ADHD, men att införa ADHD-coaching som metod kan motiveras då denna metod är specifikt inriktad på ADHD och visar på effekt i U.S.A. Empirin i studien består av vetenskapliga artiklar och facklitteratur i ämnet. Det framgår också i studien att det finns behov av fler vetenskapliga studier både om ADHD-coaching som metod och om andra behandlingsmetoder för framförallt vuxna med ADHD diagnos. / Attention Deficit Hyperactivity Disorder (ADHD) is a neuropsychiatric impairment that not only has increased in children but also in adults. It is considered by the Swedish National Board that the increase directs us to a greater knowledge of the diagnosis and the symptoms are more noticeable now since we live in an information society with higher cognitive demands. Foremost in USA, it has become popular to use ADHD coaches as a method complementary to medicine and therapy. The method does exist in Sweden, but it is not a treatment that individuals are informed of or even suggested as a complementary. The purpose of this study is to increase awareness of ADHD Coaching and comparing the method to other treatments for people with ADHD. The results showed that there are effective methods for ADHD, but ADHD Coaching would be a good complementary as it is tailored for the symptoms of ADHD. Viewed from Antonovskys salutogenic perspective, I have used KASAM to support the cognitive aspect and I have used empowerment to support the psychosocial aspect of treatments. My studies and empirical material includes peer reviewed articles and literature on the subject. The results show a need for more empirical studies of ADHD Coaching as well as therapeutically methods for adults with ADHD in particular.

The aim of this scientific essay is to illuminate perceptions and interpretations about children's deviant behavior and how it affects the educators attitudes towards these children. The starting point for the essay is two different self-perceived situations where I experienced that "deviant" behavior and behaviors that causes trouble, referred to as “trouble-making” behaviors, quickly and carelessly identifies as consequences of the neuropsychiatric disability ADHD. The “diagnosis-label” creates a feeling of uncertainty for me because I know from experience that it provides more support and understanding of children's behaviors. At the same time, the instant association to ADHD leads to disregarding of other factors that generate "trouble-making" behaviors. The "problems" are not always connected to a disability, but a diagnosis of a disability provides, in reality, faster, more structured and well-designed support for the child compared to a child who shows "trouble-making" behaviors without a diagnosis. Therefore, it is interesting to investigate other circumstances that can create "trouble-making" behaviors and question function of the diagnosis as a creator of greater understanding of these behaviors. I would like to highlight different perspectives of behaviors that are perceived as deviating and negative, to create opportunities for educators to provide children support without the need of a disability to explain the reason why the child needs support. Greater knowledge of children's "trouble-making" behaviors can lead to more personalized support actions for the child, and to an understanding of how interpretations and prejudices influence children's ability to develop advantageous strategies for managing individual difficulties. The survey is based on the questions: What is “abnormal behavior” in preschool children? Can there be other causes of "trouble-making" behaviors than consequences of a neuropsychiatric disfunction? What significance does a formal diagnosis have for preschool children? / Syftet med denna vetenskapliga essä är att synliggöra föreställningar och tolkningar kring barns avvikande beteenden i förskolan och hur de påverkar pedagogers förhållningssätt gentemot dessa barn. Utgångspunkten för uppsatsen är två olika självupplevda situationer där jag fått känslan av att ”avvikande” och ”problemskapande” beteenden snabbt och ovarsamt identifieras som följder av den neuropsykiatriska funktionsnedsättningen ADHD. Jag själv känner en viss osäkerhet beträffande ”diagnos-stämpeln” eftersom jag av erfarenhet vet att en diagnos ger mer stöd och förståelse för barns beteenden, samtidigt som den hastiga kopplingen till ADHD resulterar i att andra faktorer som genererar ”problemskapande” beteenden negligeras. ”Problemen” är inte alltid är orsakade av en funktionsnedsättning men en diagnos ger, i realiteten, snabbare, mer strukturerade och välutformade stödinsatser för barnet jämfört med ett barn som uppvisar ”problemskapande” beteenden utan en diagnos. Därför är det intressant att undersöka andra omständigheter som kan ge upphov till ”problemskapande beteenden” och ifrågasätta diagnosens funktion som skapare av större förståelse för dessa beteenden. Jag vill synliggöra olika perspektiv på beteenden som uppfattas som avvikande och negativa för att på så sätt skapa möjligheter för pedagoger att ge barn stöd utan att orsaken till att barnet är i behov av stöd måste vara en funktionsnedsättning. Bredare kunskap om barns ”problemskapande” beteenden kan dels leda till mer anpassade stödinsatser för barnet, dels till förståelse för hur tolkningar och fördomar påverkar barns möjligheter att utveckla strategier som är mest fördelaktiga för att hantera individuella svårigheter. Undersökningen utgår från frågorna: Vad är ett avvikande beteende i förskolan? Finns det andra orsaker till ”problemskapande beteenden” som inte har med neuropsykiatriska funktionsnedsättningar att göra? Vad har en formell diagnos för betydelse för barn i förskolan?