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Lee K.A.,University of California at San Francisco | Gay C.L.,University of California at San Francisco | Gay C.L.,Oslo University College | Lerdal A.,Lovisenberg Diakonale Hospital | And 3 more authors.
Brain, Behavior, and Immunity | Year: 2014

Fatigue has been associated with inflammation and cytokine activity among adults, but this relationship has not been evaluated among adults living with HIV. Diurnal patterns of fatigue have been previously identified in adults with HIV/AIDS. Thus, the purpose of this study was to describe these fatigue patterns in relation to cytokine plasma concentrations and gene polymorphisms. A convenience sample of 317 adults living with HIV/AIDS completed a measure of fatigue in the morning and evening for three consecutive days; participants reporting low levels of both morning and evening fatigue (n= 110) or high levels of fatigue in the morning and evening (n= 114) were included in the analysis, resulting in a final sample of 224 adults (151 men, 55 women, and 18 transgender). Plasma cytokines were analyzed, and genotyping was conducted for 15 candidate genes involved in cytokine signaling: interferon-gamma (IFNG), IFNG receptor 1 (IFNGR1), interleukins (IL), nuclear factor of kappa light polypeptide gene enhancer in B cells (NFKB-1 and -2), and tumor necrosis factor alpha (TNFA). Demographic and clinical variables were evaluated as potential covariates. Controlling for genomic estimates of ancestry and self-reported race/ethnicity and gender, the high fatigue pattern was associated with five single nucleotide polymorphisms (SNPs): IL1B rs1071676 and rs1143627, IL4 rs2243274, and TNFA rs1800683 and rs1041981. The IL1B and TNFA polymorphisms were not associated with plasma levels of IL-1β or TNFα, respectively. This study strengthens the evidence for an association between inflammation and fatigue. In this chronic illness population, the cytokine polymorphisms associated with high levels of morning and evening fatigue provide direction for future personalized medicine intervention research. © 2014 Elsevier Inc.

Lerdal A.,Lovisenberg Diakonale Hospital | Gay C.L.,Lovisenberg Diakonale Hospital | Gay C.L.,University of Oslo | Gay C.L.,University of California at San Francisco | Gay C.L.,Oslo University College
Neurology | Year: 2013

Objective: To determine whether fatigue in the acute phase following stroke predicts long-term patient-reported physical and mental health outcomes 18 months later. Methods: Patients (n5 96,mean age 67.8 years, SD 12.9) were assessed within 2weeks of hospital admission for first-ever stroke (acute phase) and 18 months later. Measures included the Fatigue Severity Scale and the Beck Depression Inventory II. The Short Form-36 was used to assess selfreported physical and mental health. Multivariate regression analysis was used to evaluate the relationship between acute phase fatigue and later health outcomes, controlling for relevant covariates. Results: Acute phase fatigue was associated with physical health at 18-month follow-up, but not with mental health. After adjusting for other potential predictors of health outcomes, including age, sex, cohabitation status, acute phase physical or mental health, and depressive symptoms, acute phase fatigue remained a significant predictor of later physical health but not of later mental health. The reverse relationships were also examined, but neither physical nor mental health in the acute phase predicted fatigue at 18 months; the best predictor of fatigue at 18-month followup was acute phase fatigue. Conclusions: These findings suggest that acute phase fatigue is an independent risk factor for poor physical health 18 months after stroke. Diagnosis and treatment of acute phase fatigue may improve physical health-related quality of life among stroke survivors. Effective treatments for poststroke fatigue, both in the acute phase and later in the recovery period, are needed. © 2013 American Academy of Neurology.

Solli H.P.,Lovisenberg Diakonale Hospital | Solli H.P.,University of Bergen | Rolvsjord R.,University of Bergen
Nordic Journal of Music Therapy | Year: 2015

Previous research studies regarding music therapy and severe mental illness have mainly adopted quantitative methodologies in order to study the effectiveness of music therapy interventions. Studies that have explored service users’ experiences of participation in music therapy are small in number, and almost nonexistent in the field of psychosis. This study aimed to explore how mental health patients with a diagnosis of psychosis experienced participation in music therapy, in general, and more specifically how they experienced music therapy in relation to their current mental state and life situation. Nine inpatients with psychosis were interviewed using a semi-structured interview focusing on the participants’ experiences of music therapy in individual sessions, groups, and performances. Through the use of interpretative phenomenological analysis, four super-ordinate themes central to the participants’ experiences were found: freedom, contact, well-being, and symptom reduction. Based on the findings, mental health recovery, positive mental health, and agency are proposed as constituting a better framework for music therapy in mental healthcare than a primary focus on symptom remission and functional improvement. © 2014, The Author(s). Published by Taylor & Francis.

Solli H.P.,Lovisenberg Diakonale Hospital | Solli H.P.,University of Bergen
Nordic Journal of Music Therapy | Year: 2015

Mental health difficulties are connected with major interpersonal and social challenges. Recent qualitative research indicates that music therapy can facilitate many of the core elements found to promote social recovery and social inclusion, findings also reflected in results from a growing body of effect studies. The objective of this study was to explore how music therapy might afford possibilities for social recovery to one man with psychosis admitted to a psychiatric intensive care unit. This was achieved by means of a qualitative case study featuring a description of the music therapeutic process alongside first-hand accounts of the participant’s subjective experiences. The data were analysed using interpretative phenomenological analysis (IPA). The findings are presented in a narrative form reflecting processes and activities considered particularly important for the process of social recovery. Theoretical perspectives from the recovery literature and current perspectives in music therapy are discussed with a view to the possible use of music therapy for strengthening agency, (re)building identity, developing positive relationships, and expanding social networks. © 2014 The Author(s). Published by Taylor & Francis.

Melum G.R.,University of Oslo | Farkas L.,University of Oslo | Scheel C.,University of Oslo | Van Dieren B.,University of Oslo | And 5 more authors.
The Journal of allergy and clinical immunology | Year: 2014

BACKGROUND: Thymic stromal lymphopoietin (TSLP) controls allergic TH2 inflammatory responses through induction of distinct activation programs in dendritic cells (DCs). However, knowledge about TSLP receptor expression and functional consequences of receptor activation by DCs residing in the human respiratory tract is limited.OBJECTIVE: We wanted to identify TSLP-responding DC populations in the human upper airway mucosa and assess the TSLP-mediated effects on such DCs in allergic airway responses.RESULTS: We found that the TSLP receptor was constitutively and preferentially expressed by myeloid CD1c(+) DCs in the human airway mucosa and that the density of this DC subset in nasal mucosa increased significantly after in vivo allergen challenge of patients with allergic rhinitis. In vitro, TSLP strongly enhanced the capacity of CD1c(+) DCs to activate allergen-specific memory CD4(+) T cells. Moreover, TSLP rapidly induced CCR7 expression on CD1c(+) DCs. However, TH2 cytokines attenuated TSLP-mediated CCR7 induction, thus inhibiting the TSLP-induced DC migration potential to the draining lymph nodes.CONCLUSION: Our results suggest that TSLP-mediated activation of human nasal mucosal CD1c(+) DCs triggers CCR7-dependent migration to the draining lymph nodes and enhances their capacity to initiate TH2 responses. However, the observation that TH2 cytokines abrogate the induction of CCR7 implies that during a TH2-mediated inflammatory reaction, TLSP-activated CD1c(+) DCs are retained in the inflamed tissue to further exacerbate local inflammation by activating local antigen-specific memory TH2 cells. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. All rights reserved.

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