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This thesis examines how narratives of illness become therapeutic narratives. The method is to engage closely with (mainly Australian) texts � literary accounts of illness � in order to identify key elements that effect a healing function (healing is distinguished from cure). Textual analysis is placed in the frame of medical information about the relevant conditions, and theoretical perspectives that provide a cultural and historical setting for illness writing. Bio-medical discourse foregrounds the clinical process of diagnosis, investigation and treatment and relegates the personal meanings of illness to secondary place. The thesis explores ways in which the patient�s account provides an alternative discourse that supplements � and at times challenges � the medical discourse. Illness foregrounds the body, and illness narratives confront the reality of embodied experience. Illness that is chronic or incurable, ageing, physical and mental decline, and the inescapable prospect of death confront the patient with the need to find meaning in experience. Narratives of illness may serve as ventilation, diversion or escape for the patient. They may provide practical help, information and consolation to family and carers, and others who suffer with the condition. These are valuable functions, but I argue that illness writing may embody more powerful therapeutic elements that transform and give meaning to the illness as part of the individual�s life story. Key therapeutic functions identified are perversity, empowerment and transformation. Healing can begin with the empowerment of telling one�s story. Illness stories may challenge the stigma and the subordination associated with disease. They can affirm a sense of belonging and community where illness intersects with other forms of marginalization. Powerful illness narratives are often characterised by perversity, overturning the assumptions of dominant cultural discourses � including those that place authority with the medical practitioner and demand acquiescence from the patient. The most powerful therapeutic narratives transform the story of illness into a new story.

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This thesis examines how narratives of illness become therapeutic narratives. The method is to engage closely with (mainly Australian) texts � literary accounts of illness � in order to identify key elements that effect a healing function (healing is distinguished from cure). Textual analysis is placed in the frame of medical information about the relevant conditions, and theoretical perspectives that provide a cultural and historical setting for illness writing. Bio-medical discourse foregrounds the clinical process of diagnosis, investigation and treatment and relegates the personal meanings of illness to secondary place. The thesis explores ways in which the patient�s account provides an alternative discourse that supplements � and at times challenges � the medical discourse. Illness foregrounds the body, and illness narratives confront the reality of embodied experience. Illness that is chronic or incurable, ageing, physical and mental decline, and the inescapable prospect of death confront the patient with the need to find meaning in experience. Narratives of illness may serve as ventilation, diversion or escape for the patient. They may provide practical help, information and consolation to family and carers, and others who suffer with the condition. These are valuable functions, but I argue that illness writing may embody more powerful therapeutic elements that transform and give meaning to the illness as part of the individual�s life story. Key therapeutic functions identified are perversity, empowerment and transformation. Healing can begin with the empowerment of telling one�s story. Illness stories may challenge the stigma and the subordination associated with disease. They can affirm a sense of belonging and community where illness intersects with other forms of marginalization. Powerful illness narratives are often characterised by perversity, overturning the assumptions of dominant cultural discourses � including those that place authority with the medical practitioner and demand acquiescence from the patient. The most powerful therapeutic narratives transform the story of illness into a new story.

Research has paid little attention to clients’ experience of the psychological assessment process, particularly in regard to the experiences of children and their parents. Advocates of collaborative assessment have long espoused the therapeutic benefits of providing feedback that can help clients better understand themselves and improve their lives (Finn & Tonsager, 1992; Fischer, 1970, 1985/1994). Finn, Tharinger, and colleagues (2007; 2009) have extended a semi-structured form of collaborative assessment, Therapeutic Assessment (TA), with children. One important aspect of their method, drawn from Fischer’s (1985/1994) example, is the creation of individualized fables that incorporate assessment findings into a child-friendly format. The fables are then shared with the child and parents as assessment feedback. This study evaluated whether receiving this type of individualized, developmentally appropriate feedback would affect how children and their parents report experiencing the assessment process. The assessment process, with the exception of child feedback, was standard for the setting. Participants were 32 children who underwent a neuropsychological evaluation at a private outpatient clinic, along with their parents. Multivariate and univariate statistics were used to test differences between two groups: an experimental group that received individualized fables as child-focused feedback and a control group. Children in the experimental group reported a greater sense of learning about themselves, a more positive relationship with their assessor, a greater sense of collaboration with the assessment process, and a sense that their parents learned more about them because of the assessment than did children in the control group. Parents in the experimental group reported a more positive relationship between their child and the assessor, a greater sense of collaboration with the assessment process, and higher satisfaction with clinic services compared to the control group. Limitations to the study, implications for assessment practice with children, and future directions for research are discussed. / text

In recent years a number of therapeutically useful immunotoxins have been produced using recombinant gene technology. In general, this involves fusion of a toxin gene with sequence encoding a variety of clinically relevant proteins or peptides. Using these techniques a recombinant immunotoxin has been engineered by fusing the genes encoding an antibody fragment with the sequence of a small cytolytic peptide, melittin. The antibody fragment consists of the antigen binding site derived from a murine monoclonal antibody K- 1-21, which binds to human free kappa light chains and recognises a specific epitope (KMA) expressed on the surface of human myeloma and lymphoma cells. The toxic portion of the molecule is melittin, a 26 amino acid, membrane lytic peptide which is a major component of bee venom. Using PCR a single chain Fv (scFv) was constructed by linking VH and VL genes with an oligonucleotide encoding a flexible, hydrophilic peptide. The melittin gene was synthesised as an oligonucleotide and extended by PCR. Nucleotide sequence encoding a linker peptide was added to the 5' end and a primer encoding a FLAG peptide was used to extend the 3' end. This gene construct was then ligated into the recombinant expression vector, pPOW scFv, to create the fusion gene encoding the recombinant immunotoxin. The gene construct was expressed in the periplasm of E.coli (TOPP2) using the secretion signal pelB . Expression of the foreign protein was monitored by western blot using a monoclonal antibody which recognises the FLAG peptide encoded at the carboxy terminal region of the gene construct. Expression of the recombinant immunotoxin was optimised and the resulting protein was purified using anti-FLAG M2 affinity chromatography. Antigen binding activity was assessed by ELISA and flow cytometry using a human myeloma cell line, HMy2, which expresses the KMA antigen.Binding of the immunotoxin to a control human cell line, K562, which does not express KMA on the cell surface was also assessed. The results indicated that the recombinant immunotoxin retained antigen binding specificity and it was cytotoxic towards the target cell line (HMy2).

In recent years a number of therapeutically useful immunotoxins have been produced using recombinant gene technology. In general, this involves fusion of a toxin gene with sequence encoding a variety of clinically relevant proteins or peptides. Using these techniques a recombinant immunotoxin has been engineered by fusing the genes encoding an antibody fragment with the sequence of a small cytolytic peptide, melittin. The antibody fragment consists of the antigen binding site derived from a murine monoclonal antibody K- 1-21, which binds to human free kappa light chains and recognises a specific epitope (KMA) expressed on the surface of human myeloma and lymphoma cells. The toxic portion of the molecule is melittin, a 26 amino acid, membrane lytic peptide which is a major component of bee venom. Using PCR a single chain Fv (scFv) was constructed by linking VH and VL genes with an oligonucleotide encoding a flexible, hydrophilic peptide. The melittin gene was synthesised as an oligonucleotide and extended by PCR. Nucleotide sequence encoding a linker peptide was added to the 5' end and a primer encoding a FLAG peptide was used to extend the 3' end. This gene construct was then ligated into the recombinant expression vector, pPOW scFv, to create the fusion gene encoding the recombinant immunotoxin. The gene construct was expressed in the periplasm of E.coli (TOPP2) using the secretion signal pelB . Expression of the foreign protein was monitored by western blot using a monoclonal antibody which recognises the FLAG peptide encoded at the carboxy terminal region of the gene construct. Expression of the recombinant immunotoxin was optimised and the resulting protein was purified using anti-FLAG M2 affinity chromatography. Antigen binding activity was assessed by ELISA and flow cytometry using a human myeloma cell line, HMy2, which expresses the KMA antigen.Binding of the immunotoxin to a control human cell line, K562, which does not express KMA on the cell surface was also assessed. The results indicated that the recombinant immunotoxin retained antigen binding specificity and it was cytotoxic towards the target cell line (HMy2).

Syftet med denna kvalitativa studie är att närmare undersöka den fronetiska kunskapen kring vad det är iterapeutisk behandling som hjälper människor i riskzonen att utveckla eller redan har utvecklat långvariganorexi. Genom tre material – min teoretiska och praktiska kunskap och tidigare kvalitativa forskning, enfallstudie från den kliniska verksamheten vid Anorexiamottagningen i Stockholm samt en fältstudie medintervjuer med en forskare och fem terapeuter från två olika enheter. Denna studie utforskar gemensammanämnare i behandling med särskilt fokus på vikten av terapeuternas perspektiv. Informanterna har ett holistisktperspektiv och arbetar med olika existentiella, integrativa och systemiska modeller. Det som står ut iinformanternas svar, och som bekräftas av familjen och klientens egen röst, är att personen bakom symtomentonas fram – särskilt inför sig själv – och att sjukdomen tonas ner. Viktigt är också att terapeuterna kan förmedlabåde sin tro på att det är en mänsklig möjlighet att bli fri från anorexi och att det även finns anledning att tro påden enskilda klientens möjligheter att återhämta sig. Andra teman av betydelse är hur man hanterar ångest,negativa självbilder, ambivalens och rädsla för förändring och hur man inviterar till reflexion över alternativasätt att komma vidare i livet utan sin ”bästa” vän Anorexia. Denna studie föreslår mitt material och familjernasberättelse och informanternas bidrag tillsammans frambringar en kollektiv fronetisk kunskap. Det öppnar för attfortsatt forskning går vidare med de aspekter som diskuteras i slutreflektionen. / The aim of hisqualitative study is to examine more closely the fronetic knowledge of what it is in a therapeutic treatment thathelps people who are on the edge to develop, or already have developed, long term anorexia. Through threematerials –my own theoretical and practical knowledge and previous qualitative research, one case study fromthe clinical praxis at the Anorexiamottagningen in Stockholm and one field study where one researcher and fivetherapists from two different unities are interviewed. The study has explored common denominators in treatmentwith special focus on the importance of the therapists ́ perspective. All informants have a holistic view and workwith different existential, integrative and systemic models. What stands out in the answers of the informants, andis confirmed by the family and the voice of the client, is that the person behind the symptoms is tuned up –especially for herself – and the illness is downplayed. It is also important that the therapists can mediate boththeir belief that it is a human possibility to become free from anorexia and that there is also good reason tobelieve in the possibility for the individual client to recoup. Other themes of importance are how to deal withanxiety, ambivalence, negative self-images and fear of change, and how to invite to reflection on alternativeways to proceed in life without their “best” friend, Anorexia. This study suggests that my material together withthe account of the family and the contribution of the informants at the treatment units and bring forth aconsiderable amount of collective phronetic knowledge. This suggests that future research look further into someof the aspects discussed in the final reflection.

Tidigare amerikanska studier av utredningsmetoden ”Therapeutic Assessment with Children and Families” (TA-C) visar att föräldrar så väl som barn upplever förbättringar av barnets psykiatriska symptom, samt av familjens globala funktionsförmåga och emotionella relaterande under utredningsprocessen. TA-C leder också till en ökad tillfredsställelse med den behandling som sedan erbjudits. Metod: En randomiserad kontrollerad pilotstudie inkluderande totalt 12 barn mellan 7-10 år och deras familjer genomfördes på en BUP mottagning inom Stockholms läns landsting. Barnen/ familjerna randomiserades till TA-C respektive traditionell utredning (TU). Den totala behandlingstiden utvärderades i de båda grupperna. Föräldra- skattning med ”Strengths and Difficulties Questionnaire” (SDQ), ”Outcome Rating Scale” (ORS) och ”Session Rating Scale (SRS). Dessutom barnskattning med Child Outcome Rating Scale (CORS) och Child Session Rating Scale (CSRS) samt kliniker bedömde global funktionsnivå med Children´s Global Assessment Scale (C-GAS) före och efter utredning. Resultat: Utredningstiden för TA-C gruppen var 68 dagar med i medeltal 11 sessioner och för TU gruppen 60 dagar med i medeltal 7,5 sessioner. Livstillfredsställelsen mätt med självskattningsformulären ORS och CORS var signifikant högre hos både föräldrarna och barnen vid genomförd TA-C jämfört med TU. Däremot uppvisade inte grupperna signifikanta skillnader i global funktionsnivå (CGAS), psykiatriska symtom (SDQ) eller i den självskattade alliansen mellan terapeut och föräldrar mätt med Session Rating Scale (SRS) eller mellan terapeut och barn mätt med Children Session Rating Scale (CSRS). Konklusion: I denna randomiserade kontrollerade pilotstudie av utredningsmetoden TA-C jämfört med TU framkom att TA-C gav ökad livstillfredsställelse hos både barnet och föräldrarna men inte förbättrad funktionsförmåga, psykisk symptomreduktion eller terapeutisk allians jämfört med TU. TA-C kan bidra till att skapa unika individ- och familjeanpassade åtgärdsförslag som bidrar till ökad livstillfredsställelse i vardagen vad gäller individuella och relationella aspekter hos både barnen och föräldrarna. Vi bedömer därför att TA-C har potential att fungera som ett värdefullt komplement till TU inom BUP.

In the present study, the Electromechanical Therapeutic Apparatus was examined to determine the extent to which its repeated use can influence intellectual performance and mood state. The Electromechanical Therapeutic Apparatus is a device designed to mildly stimulate the body and brain, while facilitating relaxation. Its three components include a rotating platform-bed; a weak, extremely-low-frequency, external-electric field; and music. In the present study, three groups were contrasted, a music-only group which served as a placebo; a group which combined motion-vestibular stimulation and music; and a group which combined motion-vestibular stimulation and music with an externalelectric field. The sample included 33 randomly selected men and women whose average age was 34.6 years.