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Sökning: hsv:(MEDICIN OCH HÄLSOVETENSKAP) hsv:(Klinisk medicin) > (2020) > Karlstads universitet

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1.
  • Malmberg Gavelin, Hanna, 1982-, et al. (författare)
  • Computerised cognitive training in Parkinson's disease : a protocol for a systematic review and updated meta-analysis
  • 2020
  • Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 10:11
  • Tidskriftsartikel (refereegranskat)abstract
    • INTRODUCTION: Cognitive impairment is recognised as an important non-motor symptom in Parkinson's disease (PD) and there is a need for evidence-based non-pharmacological interventions that may prevent or slow cognitive decline in this patient group. One such intervention is computerised cognitive training (CCT), which has shown efficacious for cognition across older adult populations. This systematic review aims to investigate the efficacy of CCT across cognitive, psychosocial and functional domains for people with PD and examine study and intervention design factors that could moderate CCT effects on cognition.METHODS AND ANALYSIS: Randomised controlled trials investigating the effects of CCT in patients with PD without dementia, on cognitive, psychosocial or functional outcomes, will be included. The primary outcome is overall cognitive function. Secondary outcomes are domain-specific cognitive function, psychosocial functioning and functional abilities. We systematically searched MEDLINE, Embase and PsycINFO through 14 May 2020 to identify relevant literature. Risk of bias will be assessed using the revised Cochrane Risk of Bias tool. Effect sizes will be calculated as standardised mean difference of baseline to postintervention change (Hedges' g) with 95% CI for each eligible outcome measure. Pooling of outcomes across studies will be conducted using random-effects models, accounting for dependency structure of effect sizes within studies. Heterogeneity will be assessed using τ2 and I2 statistic. Potential moderators, based on key study and intervention design factors, will be investigated using mixed-effects meta-regression models.ETHICS AND DISSEMINATION: No ethical approval is required. The findings will be disseminated in a peer-reviewed scientific journal.PROSPERO REGISTRATION NUMBER: CRD42020185386.
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2.
  • Carlén, Kristina, et al. (författare)
  • Sense of coherence predicts adolescent mental health
  • 2020
  • Ingår i: Journal of Affective Disorders. - : Elsevier. - 0165-0327 .- 1573-2517. ; 274, s. 1206-1210
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Strong sense of coherence (SOC) has been shown to predict good mental health among adults whereas its predictive value in adolescence is unclear. This life-course oriented prospective study explores whether SOC predicts mental health in a three-year follow-up. Methods: The data is part of the ongoing ‘Finnish Family Competence Study’ launched in 1986 in southwestern Finland (baseline n = 1287). The outcome variable was adolescent's mental health at 18 years of age, measured on the Development and Well-Being Assessment (DAWBA) scale. The main predictor was Antonovsky's SOC score (1987) measured at the age of 15. A total of 498 adolescents were included in the present analyses. Poisson regression was used by univariate and multivariable models using the parents’ age and socioeconomic status and adolescents’ gender as covariates. Results: Multivariable analysis showed that a one-unit increase in SOC decreased the relative risk of a DAWBA-based diagnosis by 4 % (RR [95% CI] 0.96 [0.94–0.98], p < 0.001). Limitations: Typical of very long follow-up, as in our study of nearly two decades, a substantial proportion of the original population-based cohort was lost to follow-up weakening the representability of our cohort. Conclusions: Sense of coherence is a useful and clinically sensitive tool to predict mental health in adolescence. The easily administered, coping-oriented SOC questionnaire is an appropriate instrument in screening for adolescents who would benefit from supportive measures to strengthen their mental well-being.
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3.
  • Lindmark, Ulrika, 1965- (författare)
  • Munhälsa hos äldre
  • 2020. - 3
  • Ingår i: Äldre och åldrande: grundbok i gerontologi<em> </em>. - Malmö : Gleerups Utbildning AB. - 9789151102689 ; , s. 111-120
  • Bokkapitel (populärvet., debatt m.m.)
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4.
  • Lin, Ping-I, et al. (författare)
  • Comparing DNA methylation profiles across different tissues associated with the diagnosis of pediatric asthma
  • 2020
  • Ingår i: Scientific Reports. - : Nature Publishing Group. - 2045-2322. ; 10:1
  • Tidskriftsartikel (refereegranskat)abstract
    • DNA methylation (DNAm) profiles in central airway epithelial cells (AECs) may play a key role in pathological processes in asthma. The goal of the current study is to compare the diagnostic performance of DNAm markers across three tissues: AECs, nasal epithelial cells (NECs), and peripheral blood mononuclear cells (PBMCs). Additionally, we focused on the results using the machine learning algorithm in the context of multi-locus effects to evaluate the diagnostic performance of the optimal subset of CpG sites. We obtained 74 subjects with asthma and 41 controls from AECs, 15 subjects with asthma and 14 controls from NECs, 697 subjects with asthma and 97 controls from PBMCs. Epigenome-wide DNA methylation levels in AECs, NECs and PBMCs were measured using the Infinium Human Methylation 450K BeadChip. Overlap analysis across the three different sample sources at the locus and pathway levels were studied to investigate shared or unique pathophysiological processes of asthma across tissues. Using the top 100 asthma-associated methylation markers as classifiers from each dataset, we found that both AEC- and NEC-based DNAm signatures exerted a lower classification error than the PBMC-based DNAm markers (p-value = 0.0002). The area-under-the-curve (AUC) analysis based on out-of-bag errors using the random forest classification algorithm revealed that PBMC-, NEC-, and AEC-based methylation data yielded 31 loci (AUC: 0.87), 8 loci (AUC: 0.99), and 4 loci (AUC: 0.97) from each optimal subset of tissue-specific markers, respectively. We also discovered the locus-locus interaction of DNAm levels of the CDH6 gene and RAPGEF3 gene might interact with each other to jointly predict the risk of asthma - which suggests the pivotal role of cell-cell junction in the pathological changes of asthma. Both AECs and NECs might provide better diagnostic accuracy and efficacy levels than PBMCs. Further research is warranted to evaluate how these tissue-specific DNAm markers classify and predict asthma risk.
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5.
  • Khorram-Manesh, Amir, 1958, et al. (författare)
  • Profiling Collapsing Half Marathon Runners-Emerging Risk Factors : Results from Gothenburg Half Marathon
  • 2020
  • Ingår i: Sports. - : MDPI. - 2075-4663. ; 8:1, s. 1-11
  • Tidskriftsartikel (refereegranskat)abstract
    • Among several serious medical conditions, arrhythmia and heat stroke are two important causes of death during endurance races. Clinically, collapsing might be the first sign of these serious conditions and may mimic the more common and benign exercise-associated collapse. Several risk factors have been reported in the literature. We aimed to conduct a qualitative study to find a perceived risk profile among runners who collapsed and who were transported by ambulances to the nearest hospital during Gothenburg's half marathon (2010-2017). Collapsing runners seem to lack the ability to make a decision to withdraw from the contest despite being exhausted. They feel the pain, but are unable to put meaning to their feeling, to adjust their pacing, and to handle other influences. Consequently, they do not overcome the problem or assess the situation. These individual mental characteristics may indicate a unique profile for collapsing runners. Pre-race health control and educational initiatives aiming at mental preparedness and information before endurance races might be a necessary step to avoid life-threatening complications.
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6.
  • Korhonen, Topi, et al. (författare)
  • Computational study of the effect of hypoxia on cancer response to radiation treatment
  • 2020
  • Ingår i: ROMAI Journal. - : The Romanian Society of Applied and Industrial Mathematics. - 1841-5512 .- 2065-7714. ; 16:2, s. 75-86
  • Tidskriftsartikel (refereegranskat)abstract
    • We perform a computational study of the propagation of the oxygen concentration within a two-dimensional slice of a heterogeneous tumour region where the position and shape of the blood vessels are known. Exploiting the parameters space, we explore which effect is noticeable what concerns the formation of hypoxic zones. We use this information to anticipate a patient-specific radiation treatment with a potentially controlled response of the cancer growth.
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7.
  • Anderzén Carlsson, Agneta, 1966-, et al. (författare)
  • Children’s Narratives of Support From Professionals when Experiencing Fear Related to Acute Lymphoblastic Leukemia
  • 2020
  • Ingår i: Pediatric Blood & Cancer. - : John Wiley & Sons. - 1545-5009 .- 1545-5017. ; 67:S4, s. 120-120
  • Tidskriftsartikel (refereegranskat)abstract
    • Children diagnosed with Acute Lymphoblastic Leukemia (ALL) typically face 2.5 years treatment, which initially is intense and includes frequent hospitalizations. Previous research has identified various fears during treatment: fear of getting needles, removal of adhesive tapes, having a feeding tube, taking tablets and the physical changes related to ALL itself, as well as to treatments. The children’s coping strategies develop during the course of illness. The literature on what children with ALL find to be supportive when experiencing fear is sparse. The aim of this presentation is thus to describe what children 5-9 years old find to be important support from professionals when experiencing fear related to ALL.
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8.
  • Costache, Madalina Elena, et al. (författare)
  • Higher- and lower-order personality traits and cluster subtypes in social anxiety disorder
  • 2020
  • Ingår i: PLOS ONE. - : PUBLIC LIBRARY SCIENCE. - 1932-6203. ; 15:4
  • Tidskriftsartikel (refereegranskat)abstract
    • Social anxiety disorder (SAD) can come in different forms, presenting problems for diagnostic classification. Here, we examined personality traits in a large sample of patients (N = 265) diagnosed with SAD in comparison to healthy controls (N = 164) by use of the Revised NEO Personality Inventory (NEO-PI-R) and Karolinska Scales of Personality (KSP). In addition, we identified subtypes of SAD based on cluster analysis of the NEO-PI-R Big Five personality dimensions. Significant group differences in personality traits between patients and controls were noted on all Big Five dimensions except agreeableness. Group differences were further noted on most lower-order facets of NEO-PI-R, and nearly all KSP variables. A logistic regression analysis showed, however, that only neuroticism and extraversion remained significant independent predictors of patient/control group when controlling for the effects of the other Big Five dimensions. Also, only neuroticism and extraversion yielded large effect sizes when SAD patients were compared to Swedish normative data for the NEO-PI-R. A two-step cluster analysis resulted in three separate clusters labelled Prototypical (33%), Introvert-Conscientious (29%), and Instable-Open (38%) SAD. Individuals in the Prototypical cluster deviated most on the Big Five dimensions and they were at the most severe end in profile analyses of social anxiety, self-rated fear during public speaking, trait anxiety, and anxiety-related KSP variables. While additional studies are needed to determine if personality subtypes in SAD differ in etiological and treatment-related factors, the present results demonstrate considerable personality heterogeneity in socially anxious individuals, further underscoring that SAD is a multidimensional disorder.
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9.
  • Dintica, Christina S., et al. (författare)
  • The relation of poor mastication with cognition and dementia risk : a population-based longitudinal study
  • 2020
  • Ingår i: Aging. - : Impact Journals LLC. - 1945-4589 .- 1945-4589. ; 12:9, s. 8536-8548
  • Tidskriftsartikel (refereegranskat)abstract
    • We investigated the effect of poor masticatory ability on cognitive trajectories and dementia risk in older adults. 544 cognitively intact adults aged =50 were followed for up to 22 years. Cognitive domains (verbal, spatial/fluid, memory, and perceptual speed) were assessed at baseline and follow-ups. Dementia was ascertained according to standard criteria. Masticatory ability was assessed using the Eichner Index and categorized according to the number of posterior occlusal zones: A (all four), B (3-1), and C (none).At baseline, 147 (27.0%) participants were in Eichner category A, 169 (31.1%) in B and 228 (41.9%) in C. After the age of 65, participants in Eichner category B and C showed an accelerated decline in spatial/fluid abilities (beta: -0.16, 95% CI: -0.30 to -0.03) and (beta: -0.15, 95% CI: -0.28 to -0.02), respectively. Over the follow-up, 52 incident dementia cases were identified. Eichner categories B or C were not associated with an increased risk of dementia, compared to category A (Hazard Ratio [HR]: 0.83, 95% CI: 0.39 to 1.76 and HR: 0.63, 95% CI: 0.30 to 1.29, respectively).Poor masticatory ability is associated with an accelerated cognitive decline in fluid/spatial abilities, however it was not related to a higher risk of dementia.
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10.
  • Domellöf, Magdalena Eriksson, et al. (författare)
  • Evaluating a frontostriatal working-memory updating-training paradigm in Parkinson's disease : the iPARK trial, a double-blinded randomized controlled trial
  • 2020
  • Ingår i: BMC Neurology. - : BMC. - 1471-2377. ; 20:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Cognitive decline and dementia are common in Parkinson's disease (PD). Cognitive deficits have been linked to the depletion of dopamine in the nigrostriatal pathway, but pharmacological treatments for PD have little evidence of improving or delaying cognitive decline. Therefore, exploring non-pharmacological treatment options is important. There have been some promising results of cognitive training interventions in PD, especially for improvements in working memory and executive functions. Yet, existing studies are often underpowered, lacking appropriate control condition, long term follow-up, a thorough description of the intervention and characteristics of the participants. Working memory updating training has previously shown to increase striatal activation in healthy young and old participants as well as dopaminergic neurotransmission in healthy young participants. In the light of dopamine dysfunction in PD, with negative effects on both motor and cognitive functions it is of interest to study if an impaired striatal system can be responsive to a non-invasive, non-pharmacological intervention. Methods and design: The iPARK trial is a double-blinded, randomized controlled trial with a parallel-group design that aims to recruit 80 patients with PD (during the period 02/2017-02/2023). Included patients need to have PD, Hoehn and Yahr staging I-III, be between 45 to 75 years of age and not have a diagnosis of dementia. All patients will undergo 30 sessions (6-8 weeks) of web-based cognitive training performed from home. The target intervention is a process-based training program targeting working memory updating. The placebo program is a low dose short-term memory program. A battery of neuropsychological tests and questionnaires will be performed before training, directly after training, and 16 weeks after training. Discussion: We expect that the iPARK trial will provide novel and clinically useful information on whether updating training is an effective cognitive training paradigm in PD. Further, it will hopefully contribute to a better understanding of cognitive function in PD and provide answers regarding cognitive plasticity as well as determining critical factors for a responsive striatal system.
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