Research on well-being is in its infancy and the term lacks a clear definition, yet it is an increasingly popular matter. The neurology underlying well-being is important in such research in order to understand what brain mechanisms are correlated with mental health. Even though objective measures such as brain imaging are increasingly used assessments in well-being and neuroscience studies, self-reports are widely used. Articles viewing such research often state that self-reports could be biased because the subjects may be affected by the weather the day of the self-report. No further explanations are however provided as to why or how those individuals would be affected by the weather, or by which weather conditions. The aim of this thesis is thus to find neurological explanations for how weather can affect well-being. Constituents of well-being will be reviewed together with brain bases of mental health in an attempt to find neural correlations of weather and well-being. How humans are affected by the weather is a limited research area and the findings are diverse on all aspects but the solar influence over the brain and mind. Man-made light was however found to be a substitute for the effect of sunlight on the brain. No strong relationship between weather and well-being were found based on existing literature. No significant neural correlations between mental well-being and different weather conditions was found either.

Since the use of opioids started to emerge for analgesic reasons in the 19th century with the synthetization of morphine, opioids have been studied rigorously to better understand its effects on the brain. This thesis shows that both the analgesic effects and the reinforcing effects of opioids are mediated by the same receptor, the mu opioid receptor (MOR). MOR activity has been correlated to both primary and secondary reinforcers and should be considered to cause positive reinforcement together with increases in dopamine transmission for all drugs of abuse, and not only in relation to opioids. Opioid tolerance, dependence and even addiction are to some extent thought to relate to opioids’ acute effect of cyclic adenosine monophosphate (cAMP) superactivation. Based upon these findings, the allostasis theory of addiction is considered to be the most suitable in defining opioid addiction. The theory claims that the mesolimbic dopamine system becomes sensitized, increasing the attractiveness of opioids. This while counteradaptation increases the pleasurable tolerance of opioids, encouraging the user to increase its intake for the same initial reward. Furthermore the theory claims that cAMP superactivation is causing an unfolding effect of neurobiological and neurochemical expressions which leads to the disorder of addiction. cAMP superactivation is mediating the negatively reinforcing aspects of opioid addiction together with changes to corticotropin-releasing factor (CRF) in the brain stress system, such as the hypothalamic-pituitary-adrenal (HPA) axis and the extended amygdala.

Attention is a cognitive mechanism that guides our perception in order to prioritize the limited resources to the most relevant information while ignoring distracting information. Attention can be voluntarily deployed to stimuli during tasks or goals, or the features of the stimulus can capture our attention either by being salient or being emotionally induced. Emotions affect multiple different cognitive processes such as attention because emotional stimuli can be relevant for defending or sustain life. This relationship between attention and emotion indicates that there should be interactive but distinct networks between these cognitive mechanisms as well as a modulative effect on perceptional and attentional systems. Emotions were in general demonstrating a facilitation affect on attentional and saccadic processes as well as broadening or narrowing the scope of attention. The reason behind emotions impact on attention was proposed to be for eliciting a change in the application of resources in order to solve the limited capacity problem and possibly to protect and sustain life. Inconsistent findings as well as limitations for emotional attention studies are discussed.

Neural entrainment quite recently became considered an important mechanism used by the brain to process stimuli with periodic qualities, such as the frequency and duration time of signals reaching sensory organs. An increasing amount of data strongly implies that the brain might be using neural entrainment as a mechanism to either directly process speech and/or to facilitate speech interpretation. Neural entrainment is therefore a promising marker to use for research of speech perception. This literature review aims to summarize the most recent findings within this area with the end-goal to be used as a basis for designing an EEG experiment intended to analyze speech perception as a means to distinguish human voices.    For this reason, data was collected from the scientific databases Europe PMC, Academic Search Premier, PsycINFO, PubMed, Scopus and Web of Science, where the keywords “EEG” + either the phrase “neural entrainment”, “neural oscillation”, or “cortical oscillation” were used to gather articles. Inclusion and exclusion criteria were then applied and the data was analyzed with the intention to answer the following research questions: “is it possible to observe neural entrainment to human voice/speech using EEG?”, “if so, what are the possibilities to use such neural entrainment as a marker for differentiating human voices from each other?” and “what is the nature of the mechanisms used by the brain to attain this entrainment?”. The resulting data from the articles indicated that, in order to yield reliable results when investigating neural entrainment to speech, the technique for analysis of brain activity could be done with EEG, a number of participants between 15-30 persons is enough, the spectral bands of interest are delta (<3 Hz), theta (4-8 Hz), beta (15-35 Hz) and gamma (>40 Hz), the method of analysis could be looking at both frequency and amplitude in the speech envelope, and finally the anatomical areas for investigating the brain’s ability to distinguish human voices using speech entrainment could be either areas within the auditory cortex or prefrontal areas involved in behavioral responses to speech processing.

When researchers began addressing the electrophysiology of conscious error awareness more than a decade ago, the role of the error-related negativity (ERN), alongside the subsequently occurring error positivity (Pe), was an obvious locus of attention given the fact that they are taken as indices of cortical error processing. In contrast to the clear-cut findings that link the amplitude of the Pe to error awareness, the association between the ERN amplitude and error awareness is vastly unclear, with a range of studies reporting significant differences in the ERN amplitude with respect to error awareness, while others observing no modulation of the ERN amplitude. One problem in the studies obtaining null findings is the fact that conclusions are drawn based on small sample sizes, increasing the probability of type II error, especially given the fact that the ERN elicited using various error awareness paradigms tends to be small. The aim of the present study was to therefore address the issue of type II error in order to draw more certain conclusions about the modulation of the ERN amplitude by conscious error awareness. Forty participants performed a manual response inhibition task optimised to examine error awareness. While the early and late Pe amplitudes showed the expected sensitivity to error awareness, the ERN results depicted a more complex picture. The ERN amplitude for unaware errors appeared more negative than that of aware errors, both numerically and on the grand average ERP. The unexpected findings were explained in terms of (a) latency issues in the present data, (b) characteristics of the manual response inhibition task used and the possibility that it elicits variation in neurocognitive processing, and (c), in relation to possible contamination by the contingent negative variation (CNV), an ERP component elicited during response preparation. Suggestions for future research on how to address the issues raised in the present paper are also discussed.

Syfte: Syftet med studien var att beskriva skötares uppfattningar av specialistsjuksköterskans kompetens i psykiatrisk vård. Metod: För att analysera detta fenomen gjordes en intervjustudie med kvalitativ design och en fenomenografisk analys tillämpades. Semistrukturerade intervjuer genomfördes där nio skötare verksamma i den psykiatriska vården vid tiden för intervjutillfället deltog. Med avsikt att finna variation bland uppfattningarna bearbetades och analyserades det transkriberade materialet i en analys omfattande sju steg. Resultat: Fyra kategorier av skötarnas uppfattningar identifierades: Osynlig kompetens, otydlig kompetens, synlig kompetens och tydlig kompetens. Relationen mellan dessa kategorier förhöll sig hierarkiskt i förhållande till i vilken grad specialistsjuksköterskans kompetens uppfattades. Slutsats: Skötarens uppfattningar ger uttryck för att det finns ett starkt behov av specialistsjuksköterskans kompetens samtidigt som man inte kan se hur den urskiljer sig från skötarens egen kompetens. Områden i specialistsjuksköterskans kompetens som har stor betydelse för och kompletterar skötarens egen kompetens värdesätts särskilt, såsom specialistsjuksköterskans arbetsledarroll, samarbetsförmåga, somatiska kunskap och helhetsbild av psykiatrin i övrigt. / Aim: The aim of this study was to describe how psychiatric aides’ understand the competence of specialist nurses in psychiatric care. Methods: In order to analyze this phenomenon, a phenomenographic interview study with qualitative design was carried out. Semi-structured interviews were conducted with nine psychiatric aides, working in psychiatric in-patient care at the time of the interview. In order to find the variation among the understandings, the transcribed material was processed and analyzed through an analyze method including seven steps. Results: Four categories of understandings were identified: invisible competence, unobvious competence, visible competence and obvious competence. The relationship between these different categories took a hierarchical structure in relation to the degree of which the specialist nurse competence was understood. Conclusions: The understandings of the psychiatric aides expresses the dependence of the specialist nurse's competence while at the same time one cannot see how it distinguishes itself from the psychiatric aides’ own competence. Areas of the specialist nurse competence that are of great importance for the psychiatric aides and complement their competence are especially valued, such as: the specialist nurse’s leadership, ability to cooperate, somatic knowledge and overall knowledge of psychiatry.

Ätproblem hos barn är relativt vanliga och existerar både hos i övrigt friska barn och hos barn med andra sjukdomar och diagnoser. I vissa fall är ätproblemen så allvarliga att de leder till malnutrition. Ofta delas ätproblem in i kategorier beroende på om man tycker sig se en medicinsk orsak eller inte, man skiljer därmed på organiska och icke-organiska problem. Detta arbete fokuserar främst på det som i litteraturen brukar kallas matvägran. Syftet var att belysa området i stort genom att presentera och diskutera aktuell litteratur och forskning om matvägran samt att kritiskt granska olika förklarings-modeller och begrepp. Tre fall av barn med matvägran beskrivs också. Beskrivningarna är baserade på information som lämnats av barnens mödrar i intervjuer och syftar till att beskriva hur naturalförloppet vid matvägran kan se ut samt att undersöka föräldrarnas attityder och känslor kring problemet i sig och kring vårdkontakter. Gemensamma drag var bland andra att barnen haft problem med att äta redan från början och att de alla kräkts frekvent. Mödrarna i de tre fallen beskriver också att de är besvikna över vården av deras barn. Genomgången av etiologi och orsaksteorier pekar mot att matvägran sannolikt är en komplex samverkan mellan en rad olika fysiologiska, psykologiska och miljömässiga faktorer. Att kalla besvären antingen organiska eller icke-organiska kan vara missvisande. Huruvida barnet uppvisar en ovilja eller aversion mot att äta borde vara avgörande för val av behandling och behandlingen bör utformas så att barnets integritet respekteras. / Feeding problems in children are common and exist both in otherwise healthy children and in children with medical conditions. In some cases the feeding problems are severe enough to cause malnutrition. A distinction is often made between organic feeding problems, which are thought to be caused by a medical condition and non-organic problems, where no obvious medical reason can be found. This study was primarily focused on what is referred to as food refusal. The aim of the study was to illuminate the area by presenting and discussing current research as well as critically view common terminology and theories. Three case studies of children with food refusal are also posed. The descriptions are based on information extracted from interviews of their mothers and aim to describe how the natural course of food refusal can present itself as well as to explore parental attitudes and feelings around the problem itself and around contacts with the health care system. Some of the common denominators were that the children all exhibited feeding problems from the beginning and that they have suffered frequent vomiting. The mothers have been disappointed with the care that their children have received. The review of etiology and theories points towards food refusal being a complex interplay between physiological, psychological and environmental factors. To label the problem as being either organic or non-organic can be misleading. Weather the child exhibits an aversion or unwillingness to eat should be an important aspect in choosing treatment form and respecting the child´s integrity should be a priority in treatment.

Dyskalkyli, eller specifik räknesvårighet, är en specifik inlärningsstörning som innebärstora svårigheter att handskas med siffror. Detta är en kvalitativ intervjustudie medföräldrar till ungdomar med dyskalkyli, där frågor kring skolgång, insatser och känslorkring diagnosen samt relationen mellan förälder och ungdom berörs. Åtta föräldrar, allamödrar till ungdomar med dyskalkyli som är mellan 12 och 19 år intervjuades.Analysen som gjordes är en så kallad tematisk analys. De åtta teman som studienresulterade i är: Från upptäckt till utredning, Hur påverkar diagnosen?, Livet utanförskolan, Skolans hantering av svårigheter och dyskalkyli, Föräldrars insatser, Relationentill skolan, Vilka insatser önskas? och Hur dyskalkylin påverkar idag och framtiden.Föräldrar upplevde skolgången som en jobbig tid för både dem och deras barn och imånga fall har kommunikationen mellan skola och hem brustit. Kunskapen omdyskalkyli upplevdes som otillräcklig i de berörda skolorna, vilket påverkadeungdomarna negativt. Föräldrar efterfrågade också tidigare identifikation och utredningav svårigheterna. Studien kom fram till att kunskapen om dyskalkyli i skolorna behöverförbättras för att dessa elever ska kunna bemötas på ett tillfredsställande sätt, derassvårigheter kunna identifieras tidigare samt för att kunna erbjuda tidigare insatser. / Developmental dyscalculia is a specific learning disability that involves greatdifficulties in dealing with numbers. This is a qualitative interview study with parents ofadolescents who have dyscalculia, which raises questions about schooling, interventionand feelings concerning the diagnosis as well as the relationship between adolescent andparent. Eight parents, all mothers of children between the ages of 12 and 19 wereinterviewed. The analysis made is a so called thematic analysis. The eight themes thatresulted from the study were: From discovery to assessment, The effect of the diagnosis,Life outside of school, The schools way of dealing with the difficulties, Parentscontributions, The relationship with the school, What types of interventions arerequested by the parents?, How dyscalculia affects today and in the future. Parents feltthe schooling was tough for them and their children and in many cases thecommunication between the school and the home had fallen short. The knowledge aboutdyscalculia in the schools was perceived as insufficient, which affected the youthsnegatively. The parents also requested earlier identification and assessment of thedifficulties. The study concludes that the knowledge about dyscalculia needsimprovement in the schools in order to give these students a better schooling, to be ableto identify their difficulties earlier and provide earlier intervention.

In the demyelinating autoimmune disease multiple sclerosis (MS) there is a great need for validated prognostic biomarkers that can give information about both prognosis and disease course. So far only clinical parameters have been shown to predict future outcome. CXCL13 is a potent B cell chemoattractant that has been suggested to be a potential biomarker candidate. The aim of this study was to investigate the usefulness of CXCL13 as a prognostic biomarker for MS. Clinical, paraclinical, laboratory and MRI data about a large group of MS patients and controls were collected. CXCL13 levels in cerebrospinal fluid (CSF) samples from these patients were determined by standard enzymelinked immunosorbent assay (ELISA). In general CXCL13 were increased in CSF in MS, especially in relapsing-remitting MS during relapses, i.e. with ongoing inflammations in the central nervous system. CXCL13 is a good candidate prognostic marker for MS, since newly diagnosed MS with high CXCL13 levels showed worsened disease course within five years. Most importantly, MS conversion occurred in higher rate in possible MS patients with high concentrations of CXCL13 in CSF, and in a shorter time point. This observation may support an early treatment decision in these patients. In conclusion, this study provides support for an association between CXCL13 levels in the CSF and later development of disease severity in MS.

Syfte: Urininkontinens är ett folkhälsoproblem som berör åtminstone 500 000 svenskar.  Studiens syfte var att kartlägga sjukgymnastisk behandling med bäckenbottenträning, vid urininkontinens hos kvinnor, på primärvårdsnivå i Uppsala län. Metod: Studien hade en kvantitativ och deskriptiv design. Data samlades in via en webbenkät som skickades till alla sjukgymnaster på primärvårdsnivå i Uppsala, både offentligt anställda och privata sjukgymnaster med landstingsavtal. Resultat: 96 sjukgymnaster tillfrågades om deltagande i studien varav 65 besvarade enkäten (68 %). Drygt hälften av respondenterna behandlade med bäckenbottenträning. Antalet patienter som behandlades var lågt. Det var få patienter som remitterades från andra vårdgivare. Den vanligaste kontaktvägen var att patienten besökte sjukgymnast av andra orsaker och själv påtalade eller tillfrågades om urininkontinens. Det sjukgymnastiska omhändertagandet omfattade anamnes, information om bäckenbotten och knipteknik, praktisk träning samt muntlig utvärdering. Nära hälften av respondenterna önskade mer utbildning inom området.   Konklusion: Resultatet från studien visade att sjukgymnaster på primärvårdsnivå var en underutnyttjad resurs i behandlingen av urininkontinens hos kvinnor. I framtiden skulle ett utökat samarbete mellan sjukgymnaster och andra vårdgivare på primärvårdsnivå kunna ge effektivare patientflöden, så att fler kvinnor kan erbjudas behandling. För att möjliggöra detta behöver sjukgymnasterna själva informera lokalt om sin kompetens till berörda vårdgivare. Det behövs också utbildningsinsatser för att fler ska känna sig säkra i att behandla med BBT. / Objectives:  Urinary incontinence is a public health problem affecting at least 500 000 Swedes. The aim of this study was to conduct a survey examining physiotherapy treatment of pelvic floor muscle training, for urinary incontinence in women, at the primary care level in the county of Uppsala. Method:  The study had a quantitative and descriptive design. Data were collected with an online questionnaire that was sent to all physiotherapists with public contracts working at the primary care level in the county of Uppsala. Results:  96 physiotherapists were asked to participate in the study and 65 of them answered the questionnaire (68 %). More than half of the respondents gave treatment consisting of pelvic floor muscle training. The number of patients who received treatment was low. Few patients were referred by other health-care workers. The most common way for the patients to receive treatment was that they visited the physiotherapist because of other health problems and the subject of urinary incontinence came up. The treatment usually included medical history, information about the pelvic floor muscles, instructions on appropriate muscle contraction, practical training and verbal evaluation. Almost half of the respondents requested more education within the field. Conclusion:  The results from this study showed that physiotherapists at the primary care level were an underutilized resource in the treatment of women with urinary incontinence. In the future, improved cooperation between physiotherapists and other health-care workers at the primary care level would increase the number of women receiving treatment. To facilitate this outcome, physiotherapists need to engage in outreach activities to inform other health-care workers regarding their competence in this field. In addition, further education is required in order to help physiotherapists feel more confident in providing pelvic floor muscle training.