Mechanisms underlying activation of neural stem cells in the adult central nervous system

À la fin du 19e siècle, Dr. Ramón y Cajal, un pionnier scientifique, a découvert les éléments cellulaires individuels, appelés neurones, composant le système nerveux. Il a également remarqué la complexité de ce système et a mentionné l’impossibilité de ces nouveaux neurones à être intégrés dans le système nerveux adulte. Une de ses citations reconnues : “Dans les centres adultes, les chemins nerveux sont fixes, terminés, immuables. Tout doit mourir, rien ne peut être régénérer” est représentative du dogme de l’époque (Ramón y Cajal 1928). D’importantes études effectuées dans les années 1960-1970 suggèrent un point de vue différent. Il a été démontré que les nouveaux neurones peuvent être générés à l’âge adulte, mais cette découverte a créé un scepticisme omniprésent au sein de la communauté scientifique. Il a fallu 30 ans pour que le concept de neurogenèse adulte soit largement accepté. Cette découverte, en plus de nombreuses avancées techniques, a ouvert la porte à de nouvelles cibles thérapeutiques potentielles pour les maladies neurodégénératives. Les cellules souches neurales (CSNs) adultes résident principalement dans deux niches du cerveau : la zone sous-ventriculaire des ventricules latéraux et le gyrus dentelé de l’hippocampe. En condition physiologique, le niveau de neurogenèse est relativement élevé dans la zone sous-ventriculaire contrairement à l’hippocampe où certaines étapes sont limitantes. En revanche, la moelle épinière est plutôt définie comme un environnement en quiescence. Une des principales questions qui a été soulevée suite à ces découvertes est : comment peut-on activer les CSNs adultes afin d’augmenter les niveaux de neurogenèse ? Dans l’hippocampe, la capacité de l’environnement enrichi (incluant la stimulation cognitive, l’exercice et les interactions sociales) à promouvoir la neurogenèse hippocampale a déjà été démontrée. La plasticité de cette région est importante, car elle peut jouer un rôle clé dans la récupération de déficits au niveau de la mémoire et l’apprentissage. Dans la moelle épinière, des études effectuées in vitro ont démontré que les cellules épendymaires situées autour du canal central ont des capacités d’auto-renouvellement et de multipotence (neurones, astrocytes, oligodendrocytes). Il est intéressant de noter qu’in vivo, suite à une lésion de la moelle épinière, les cellules épendymaires sont activées, peuvent s’auto-renouveller, mais peuvent seulement ii donner naissance à des cellules de type gliale (astrocytes et oligodendrocytes). Cette nouvelle fonction post-lésion démontre que la plasticité est encore possible dans un environnement en quiescence et peut être exploité afin de développer des stratégies de réparation endogènes dans la moelle épinière. Les CSNs adultes jouent un rôle important dans le maintien des fonctions physiologiques du cerveau sain et dans la réparation neuronale suite à une lésion. Cependant, il y a peu de données sur les mécanismes qui permettent l'activation des CSNs en quiescence permettant de maintenir ces fonctions. L'objectif général est d'élucider les mécanismes sous-jacents à l'activation des CSNs dans le système nerveux central adulte. Pour répondre à cet objectif, nous avons mis en place deux approches complémentaires chez les souris adultes : 1) L'activation des CSNs hippocampales par l'environnement enrichi (EE) et 2) l'activation des CSNs de la moelle épinière par la neuroinflammation suite à une lésion. De plus, 3) afin d’obtenir plus d’information sur les mécanismes moléculaires de ces modèles, nous utiliserons des approches transcriptomiques afin d’ouvrir de nouvelles perspectives. Le premier projet consiste à établir de nouveaux mécanismes cellulaires et moléculaires à travers lesquels l’environnement enrichi module la plasticité du cerveau adulte. Nous avons tout d’abord évalué la contribution de chacune des composantes de l’environnement enrichi à la neurogenèse hippocampale (Chapitre II). L’exercice volontaire promeut la neurogenèse, tandis que le contexte social augmente l’activation neuronale. Par la suite, nous avons déterminé l’effet de ces composantes sur les performances comportementales et sur le transcriptome à l’aide d’un labyrinthe radial à huit bras afin d’évaluer la mémoire spatiale et un test de reconnaissante d’objets nouveaux ainsi qu’un RNA-Seq, respectivement (Chapitre III). Les coureurs ont démontré une mémoire spatiale de rappel à court-terme plus forte, tandis que les souris exposées aux interactions sociales ont eu une plus grande flexibilité cognitive à abandonner leurs anciens souvenirs. Étonnamment, l’analyse du RNA-Seq a permis d’identifier des différences claires dans l’expression des transcripts entre les coureurs de courte et longue distance, en plus des souris sociales (dans l’environnement complexe). iii Le second projet consiste à découvrir comment les cellules épendymaires acquièrent les propriétés des CSNs in vitro ou la multipotence suite aux lésions in vivo (Chapitre IV). Une analyse du RNA-Seq a révélé que le transforming growth factor-β1 (TGF-β1) agit comme un régulateur, en amont des changements significatifs suite à une lésion de la moelle épinière. Nous avons alors confirmé la présence de cette cytokine suite à la lésion et caractérisé son rôle sur la prolifération, différentiation, et survie des cellules initiatrices de neurosphères de la moelle épinière. Nos résultats suggèrent que TGF-β1 régule l’acquisition et l’expression des propriétés de cellules souches sur les cellules épendymaires provenant de la moelle épinière.

Ecotoxicological assessment of sediments from the Santos and São Vicente estuarine system- Brazil

O sedimento representa um importante depósito de contaminantes e uma fonte de contaminação para a cadeia alimentar aquática. Testes de toxicidade usando anfípodos como organismos-teste são empregados para avaliar sedimentos marinhos e estuarinos, juntamente com análises químicas. O presente trabalho tem como objetivo avaliar a qualidade de sedimentos de seis estações situadas no Sistema Estuarino e Portuário de Santos e São Vicente (São Paulo-Brasil), usando testes de toxicidade aguda com sedimento com anfípodos (Tiburonella viscana) e análises químicas de metais, PCB, e PAH. Outros parâmetros do sedimento foram analisados, como carbono orgânico e granulometria. Foram observados níveis de contaminação mais altos na porção interna do estuário onde se localiza o Porto de Santos e a zona industrial. Os testes de toxicidade mostraram resultados adversos significantes para a maioria das amostras testadas, e os sedimentos da porção interna do estuário apresentaram toxicidade mais alta. As análises de componentes principais indicaram uma relação forte entre contaminação do sedimento e toxicidade. As correlações positivas destes fatores nas amostras estudadas foram usadas para estabelecer os pesos das concentrações químicas que estão associadas com os efeitos adversos. Tais análises permitiram estimar valores limiares de efeito para a contaminação de sedimento através de análises multivariadas, identificando os contaminantes associados com o efeito biológico. Estes valores sugeridos são: Cu, 69.0; Pb, 17.4; Zn, 73.3(mg.kg-1); PAHs, 0.5 (mg.kg-1) e PCBs, 0.1 (µg.kg-1).

Challenges and Opportunities in Transforming Laser System Industry to Deliver Integrated Product and Service Offers

Part 4: Transition Towards Product-Service Systems

A simple approach to integrate the ecotoxicological and chemical data for the establishment of environmental risk levels

O presente trabalho utilizou métodos multivariados e matemáticos para integrar dados químicos e ecotoxicológicos obtidos para o Sistema Estuarino de Santos e para a região próxima à zona de lançamento do emissário submarino de Santos, com a finalidade de estabelecer com maior exatidão os riscos ambientais, e assim identificar áreas prioritárias e orientar programas de controle e políticas públicas. Para ambos os conjuntos de dados, as violações de valores numéricos de qualidade de sedimento tenderam a estar associadas com a ocorrência de toxicidade. Para o estuário, essa tendência foi corroborada pelas correlações entre a toxicidade e as concentrações de HPAs e Cu, enquanto para a região do emissário, pela correlação entre toxicidade e conteúdo de mercúrio no sedimento. Valores normalizados em relação às medias foram calculados para cada amostra, permitindo classificá-las de acordo com a toxicidade e a contaminação. As análises de agrupamento confirmaram os resultados das classificações. Para os dados de sistema estuarino, houve a separação das amostras em três categorias: as estações SSV-2, SSV-3 e SSV-4 encontram-se sob maior risco, seguidas da estação SSV-6. As estações SSV-1 e SSV-5 demonstraram melhores condições. Já em relação ao emissário, as amostras 1 e 2 apresentaram melhores condições, enquanto a estação 5 pareceu apresentar um maior risco, seguida das estações 3 e 4 que tiveram apenas alguns indícios de alteração.

The influence of different photosynthetically active radiation levels on Ananas comosus (var. erectifolius LB Smith) plant sunder multiple cropping systems in the upland region of the Guama River, eastern Amazonia.

2016

Levels of dioxin-like PCBs in low-volume serum samples of male patients attending fertility clinics

An accurate and easy method for the extraction, cleanup, and HRGC-HRMS analysis of dioxin-like PCBs (DL-PCBs) in low-volume serum samples (1 mL) was developed. Serum samples were extracted several times using n-hexane and purified by acid washing. Recovery rates of labeled congeners ranged from 70 to 110 % and the limits of detection were below 1 pg/g on lipid basis. Although human studies are limited and contradictory, several studies have shown that DL-PCBs can have adverse effects on the male reproductive system. In this way, the present method was applied to 21 serum samples of male patients attending fertility clinics. The total levels obtained for the patients ranged from 6.90 to 84.1 pg WHO-TEQ/g lipid, with a mean value of 20.3 pg WHO-TEQ/g lipid. The predominant PCBs (the sum of PCB 118, 156, and 105) contributed 67 % to the mean concentration of total DL-PCBs in the samples analyzed.

Changes in the storage and sink of carbon dioxide in subsurface atmospheres controlled by climate-driven processes: the case of the Ojo Guareña karst system

A comprehensive environmental monitoring program was conducted in the Ojo Guareña cave system (Spain), one of the longest cave systems in Europe, to assess the magnitude of the spatiotemporal changes in carbon dioxide gas (CO2) in the cave–soil–atmosphere profile. The key climate-driven processes involved in gas exchange, primarily gas diffusion and cave ventilation due to advective forces, were characterized. The spatial distributions of both processes were described through measurements of CO2 and its carbon isotopic signal (δ13C[CO2]) from exterior, soil and cave air samples analyzed by cavity ring-down spectroscopy (CRDS). The trigger mechanisms of air advection (temperature or air density differences or barometric imbalances) were controlled by continuous logging systems. Radon monitoring was also used to characterize the changing airflow that results in a predictable seasonal or daily pattern of CO2 concentrations and its carbon isotopic signal. Large daily oscillations of CO2 levels, ranging from 680 to 1900 ppm day−1 on average, were registered during the daily oscillations of the exterior air temperature around the cave air temperature. These daily variations in CO2 concentration were unobservable once the outside air temperature was continuously below the cave temperature and a prevailing advective-renewal of cave air was established, such that the daily-averaged concentrations of CO2 reached minimum values close to atmospheric background. The daily pulses of CO2 and other tracer gases such as radon (222Rn) were smoothed in the inner cave locations, where fluctuation of both gases was primarily correlated with medium-term changes in air pressure. A pooled analysis of these data provided evidence that atmospheric air that is inhaled into dynamically ventilated caves can then return to the lower troposphere as CO2-rich cave air.

Serum levels of lycopene, beta-carotene, and retinol and their correlation with sperm DNA damage in normospermic and infertile men

Background: Oxidative stress in reproductive system leads to sperm DNA damage and sperm membrane lipid peroxidation and may play an important role in the pathogenesis of male infertility, especially in idiopathic cases. Antioxidants such as carotenoids function against free radical damages. Objective: The aim of this study was to determine the levels of lycopene, beta-carotene and retinol in serum and their relationship with sperm DNA damage and lipid peroxidation in infertile and normospermic males. Materials and Methods: Sixty two infertile men and 71 normospermic men participated in this study. Blood and semen samples were collected from all subjects. Sperm DNA damage was measured using TUNEL method. Carotenoids, retinol, and malonedildehyde in serum were also determined. Results: DNA fragmentation was higher in infertile group comparing to control group. Serum levels of lycopene, beta-carotene and, vitamin A in infertile men were significantly lower than normospermic men (p< 0.001, =0.005, and =0.003 respectively). While serum MDA was not significantly different between two groups, MDA in seminal plasma of infertile men was significantly higher than control group (p< 0.001). Conclusion: We concluded that lycopene, beta-carotene, and retinol can reduce sperm DNA fragmentation and lipid peroxidation through their antioxidant effect. Therefore the DNA fragmentation assay and determination of antioxidants factors such as lycopene, beta-carotene and retinol, along with sperm analysis can be useful in diagnosis and treatment of men with idiopathic infertility.

A REMOTE SENSING APPROACH TO CHARACTERIZE THE HYDROGEOLOGY OF MOUNTAINOUS AREAS: APPLICATION TO THE QUITO AQUIFER SYSTEM (QAS), ECUADOR

Climate change, intensive use, and population growth are threatening the availability of water resources. New sources of water, better knowledge of existing ones, and improved water management strategies are of paramount importance. Ground water is often considered as primary water source due to its advantages in terms of quantity, spatial distribution, and natural quality. Remote sensing techniques afford scientists a unique opportunity to characterize landscapes in order to assess groundwater resources, particularly in tectonically influenced areas. Aquifers in volcanic basins are considered the most productive aquifers in Latin America. Although topography is considered the primary driving force for groundwater flows in mountainous terrains, tectonic activity increases the complexity of these groundwater systems by altering the integrity of sedimentary rock units and the overlying drainage networks. Structural controls affect the primary hydraulic properties of the rock formations by developing barriers to flow in some cases and zones of preferential infiltration and subterranean in others. The study area focuses on the Quito Aquifer System (QAS) in Ecuador. The characterization of the hydrogeology started with a lineament analysis based on a combined remote sensing and digital terrain analysis approach. The application of classical tools for regional hydrogeological evaluation and shallow geophysical methods were useful to evaluate the impact of faulting and fracturing on the aquifer system. Given the spatial extension of the area and the complexity of the system, two levels of analysis were applied in this study. At the regional level, a lineament map was created for the QAS. Relationships between fractures, faults and lineaments and the configuration of the groundwater flow on the QAS were determined. At the local level, on the Plateaus region of the QAS, a detailed lineament map was obtained by using high-spatial-resolution satellite imagery and aspect map derived from a digital elevation model (DEM). This map was complemented by the analysis of morphotectonic indicators and shallow geophysics that characterize fracture patterns. The development of the groundwater flow system was studied, drawing upon data pertaining to the aquifer system physical characteristics and topography. Hydrochemistry was used to ascertain the groundwater evolution and verify the correspondence of the flow patterns proposed in the flow system analysis. Isotopic analysis was employed to verify the origin of groundwater. The results of this study show that tectonism plays a very important role for the hydrology of the QAS. The results also demonstrate that faults influence a great deal of the topographic characteristics of the QAS and subsequently the configuration of the groundwater flow. Moreover, for the Plateaus region, the results demonstrate that the aquifer flow systems are affected by secondary porosity. This is a new conceptualization of the functioning of the aquifers on the QAS that will significantly contribute to the development of better strategies for the management of this important water resource.

Electrochemical Immunosensing of Cortisol in an Automated Microfluidic System Towards Point-of-Care Applications

This dissertation describes the development of a label-free, electrochemical immunosensing platform integrated into a low-cost microfluidic system for the sensitive, selective and accurate detection of cortisol, a steroid hormone co-related with many physiological disorders. Abnormal levels of cortisol is indicative of conditions such as Cushing’s syndrome, Addison’s disease, adrenal insufficiencies and more recently post-traumatic stress disorder (PTSD). Electrochemical detection of immuno-complex formation is utilized for the sensitive detection of Cortisol using Anti-Cortisol antibodies immobilized on sensing electrodes. Electrochemical detection techniques such as cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS) have been utilized for the characterization and sensing of the label-free detection of Cortisol. The utilization of nanomaterial’s as the immobilizing matrix for Anti-cortisol antibodies that leads to improved sensor response has been explored. A hybrid nano-composite of Polyanaline-Ag/AgO film has been fabricated onto Au substrate using electrophoretic deposition for the preparation of electrochemical immunosening of cortisol. Using a conventional 3-electrode electrochemical cell, a linear sensing range of 1pM to 1µM at a sensitivity of 66µA/M and detection limit of 0.64pg/mL has been demonstrated for detection of cortisol. Alternately, a self-assembled monolayer (SAM) of dithiobis(succinimidylpropionte) (DTSP) has been fabricated for the modification of sensing electrode to immobilize with Anti-Cortisol antibodies. To increase the sensitivity at lower detection limit and to develop a point-of-care sensing platform, the DTSP-SAM has been fabricated on micromachined interdigitated microelectrodes (µIDE). Detection of cortisol is demonstrated at a sensitivity of 20.7µA/M and detection limit of 10pg/mL for a linear sensing range of 10pM to 200nM using the µIDE’s. A simple, low-cost microfluidic system is designed using low-temperature co-fired ceramics (LTCC) technology for the integration of the electrochemical cortisol immunosensor and automation of the immunoassay. For the first time, the non-specific adsorption of analyte on LTCC has been characterized for microfluidic applications. The design, fabrication technique and fluidic characterization of the immunoassay are presented. The DTSP-SAM based electrochemical immunosensor on µIDE is integrated into the LTCC microfluidic system and cortisol detection is achieved in the microfluidic system in a fully automated assay. The fully automated microfluidic immunosensor hold great promise for accurate, sensitive detection of cortisol in point-of-care applications.

Oral vaccination with heat inactivated Mycobacterium bovis activates the complement system to protect against tuberculosis

Tuberculosis (TB) remains a pandemic affecting billions of people worldwide, thus stressing the need for new vaccines. Defining the correlates of vaccine protection is essential to achieve this goal. In this study, we used the wild boar model for mycobacterial infection and TB to characterize the protective mechanisms elicited by a new heat inactivated Mycobacterium bovis vaccine (IV). Oral vaccination with the IV resulted in significantly lower culture and lesion scores, particularly in the thorax, suggesting that the IV might provide a novel vaccine for TB control with special impact on the prevention of pulmonary disease, which is one of the limitations of current vaccines. Oral vaccination with the IV induced an adaptive antibody response and activation of the innate immune response including the complement component C3 and inflammasome. Mycobacterial DNA/RNA was not involved in inflammasome activation but increased C3 production by a still unknown mechanism. The results also suggested a protective mechanism mediated by the activation of IFN-γ producing CD8+ T cells by MHC I antigen presenting dendritic cells (DCs) in response to vaccination with the IV, without a clear role for Th1 CD4+ T cells. These results support a role for DCs in triggering the immune response to the IV through a mechanism similar to the phagocyte response to PAMPs with a central role for C3 in protection against mycobacterial infection. Higher C3 levels may allow increased opsonophagocytosis and effective bacterial clearance, while interfering with CR3-mediated opsonic and nonopsonic phagocytosis of mycobacteria, a process that could be enhanced by specific antibodies against mycobacterial proteins induced by vaccination with the IV. These results suggest that the IV acts through novel mechanisms to protect against TB in wild boar.

Dynamics and diversity of Escherichia coli in animals and system management of the manure on a commercial farrow-to-finish pig farm

The objective of this study was to determine the dynamics and diversity of Escherichia coli populations in animal and environmental lines of a commercial farrow-to-finish pig farm in Spain along a full production cycle (July 2008 to July 2009), with special attention to antimicrobial resistance and the presence of integrons. In the animal line, a total of 256 isolates were collected from pregnant sows (10 samples and 20 isolates), 1-week-old piglets (20 samples and 40 isolates), unweaned piglets (20 samples and 38 isolates), growers (20 samples and 40 isolates), and the finishers' floor pen (6 samples and 118 isolates); from the underfloor pits and farm slurry tank environmental lines, 100 and 119 isolates, respectively, were collected. Our results showed that E. coli populations in the pig fecal microbiota and in the farm environment are highly dynamic and show high levels of diversity. These issues have been proven through DNA-based typing data (repetitive extragenic palindromic PCR [REP-PCR]) and phenotypic typing data (antimicrobial resistance profile comprising 19 antimicrobials). Clustering of the sampling groups based on their REP-PCR typing results showed that the spatial features (the line) had a stronger weight than the temporal features (sampling week) for the clustering of E. coli populations; this weight was less significant when clustering was performed based on resistotypes. Among animals, finishers harbored an E. coli population different from those of the remaining animal populations studied, considering REP-PCR fingerprints and resistotypes. This population, the most important from a public health perspective, demonstrated the lowest levels of antimicrobial resistance and integron presence.

Safe operation of transmission system considering EV at distribution level

In this paper, the IEEE 14 bus test system is used in order to perform adequacy assessment of a transmission system when large scale integration of electric vehicles is considered at distribution levels. In this framework, the symmetric/constr ained fuzzy power flow (SFPF/CFPF) was proposed. The SFPF/CFPF models are suitable to quantify the adequacy of transmission network to satisfy “reasonable demands for the transmission of electricity” as defined, for instance, in the European Directive 2009/72/EC. In this framework, electric vehicles of different types will be treated as fuzzy loads configuring part of the “reasonable demands”. With this study, it is also intended to show how to evaluate the amount of EVs that can be safely accommodated to the grid meeting a certain adequacy level.

Examining Levels of Automation in the Wood Processing Industry - A case study

Companies operating in the wood processing industry need to increase their productivity by implementing automation technologies in their production systems. An increasing global competition and rising raw material prizes challenge their competitiveness. Yet, too extensive automation brings risks such as a deterioration in situation awareness and operator deskilling. The concept of Levels of Automation is generally seen as means to achieve a balanced task allocation between the operators’ skills and competences and the need for automation technology relieving the humans from repetitive or hazardous work activities. The aim of this thesis was to examine to what extent existing methods for assessing Levels of Automation in production processes are applicable in the wood processing industry when focusing on an improved competitiveness of production systems. This was done by answering the following research questions (RQ): RQ1: What method is most appropriate to be applied with measuring Levels of Automation in the wood processing industry? RQ2: How can the measurement of Levels of Automation contribute to an improved competitiveness of the wood processing industry’s production processes? Literature reviews were used to identify the main characteristics of the wood processing industry affecting its automation potential and appropriate assessment methods for Levels of Automation in order to answer RQ1. When selecting the most suitable method, factors like the relevance to the target industry, application complexity or operational level the method is penetrating were important. The DYNAMO++ method, which covers both a rather quantitative technical-physical and a more qualitative social-cognitive dimension, was seen as most appropriate when taking into account these factors. To answer RQ 2, a case study was undertaken at a major Swedish manufacturer of interior wood products to point out paths how the measurement of Levels of Automation contributes to an improved competitiveness of the wood processing industry. The focus was on the task level on shop floor and concrete improvement suggestions were elaborated after applying the measurement method for Levels of Automation. Main aspects considered for generalization were enhancements regarding ergonomics in process design and cognitive support tools for shop-floor personnel through task standardization. Furthermore, difficulties regarding the automation of grading and sorting processes due to the heterogeneous material properties of wood argue for a suitable arrangement of human intervention options in terms of work task allocation.  The application of a modified version of DYNAMO++ reveals its pros and cons during a case study which covers a high operator involvement in the improvement process and the distinct predisposition of DYNAMO++ to be applied in an assembly system.

Using health-related quality of life instruments for children with long-term conditions : On the basis of a national quality registry system

Introduction: There has been a continuous development of new technologies in healthcare that are derived from national quality registries. However, this innovation needs to be translated into the workflow of healthcare delivery, to enable children with long-term conditions to get the best support possible to manage their health during everyday life. Since children living with long-term conditions experience different interference levels in their lives, healthcare professionals need to assess the impact of care on children’s day-to-day lives, as a complement to biomedical assessments. Aim: The overall aim of this thesis was to explore and describe the use of instruments about health-related quality of life (HRQOL) in outpatient care for children with long-term conditions on the basis of a national quality registry system. Methods: The research was conducted by using comparative, cross-sectional and explorative designs and data collection was performed by using different methods. The questionnaire DISABKIDS Chronic Generic Measure -37 was used as well as semi-structured interviews and video-recordings from consultations. Altogether, 156 children (8–18 years) and nine healthcare professionals participated in the studies. Children with Type 1 Diabetes (T1D) (n 131) answered the questionnaire DISABKIDS and children with rheumatic diseases, kidney diseases and T1D (n 25) were interviewed after their consultation at the outpatient clinic after the web-DISABKIDS had been used. In total, nine healthcare professionals used the HRQOL instrument as an assessment tool during the encounters which was video-recorded (n 21). Quantitative deductive content analysis was used to describe content in different HRQOL instruments. Statistical inference was used to analyse results from DISABKIDS and qualitative content analysis was used to analyse the interviews and video-recordings. Results: The findings showed that based on a biopsychosocial perspective, both generic and disease-specific instruments should be used to gain a comprehensive evaluation of the child’s HRQOL. The DISABKIDS instrument is applicable when describing different aspects of health concerning children with T1D. When DISABKIDS was used in the encounters, children expressed positive experiences about sharing their results with the healthcare professional. It was discovered that different approaches led to different outcomes for the child when the healthcare professionals were using DISABKIDS during the encounter. When an instructing approach is used, the child’s ability to learn more about their health and how to improve their health is limited. When an inviting or engaging approach is used by the professional, the child may become more involved during the conversations. Conclusions: It could be argued that instruments of HRQOL could be used as a complement to biomedical variables, to promote a biopsychosocial perspective on the child’s health. According to the children in this thesis, feedback on their results after answering to web-DISABKIDS is important, which implies that healthcare professionals need to prioritize time for discussions about results from HRQOL instruments in the encounters. If healthcare professionals involve the child in the discussion of the results of the HRQOL, misinterpreted answers could be corrected during the conversation. Concurrently, this claims that healthcare professionals invite and engage the child.