| 1. |
- Jansen, Willemijn J, et al.
(författare)
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Prevalence Estimates of Amyloid Abnormality Across the Alzheimer Disease Clinical Spectrum.
- 2022
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Ingår i: JAMA neurology. - : American Medical Association (AMA). - 2168-6157 .- 2168-6149. ; 79:3, s. 228-243
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Tidskriftsartikel (refereegranskat)abstract
- One characteristic histopathological event in Alzheimer disease (AD) is cerebral amyloid aggregation, which can be detected by biomarkers in cerebrospinal fluid (CSF) and on positron emission tomography (PET) scans. Prevalence estimates of amyloid pathology are important for health care planning and clinical trial design.To estimate the prevalence of amyloid abnormality in persons with normal cognition, subjective cognitive decline, mild cognitive impairment, or clinical AD dementia and to examine the potential implications of cutoff methods, biomarker modality (CSF or PET), age, sex, APOE genotype, educational level, geographical region, and dementia severity for these estimates.This cross-sectional, individual-participant pooled study included participants from 85 Amyloid Biomarker Study cohorts. Data collection was performed from January 1, 2013, to December 31, 2020. Participants had normal cognition, subjective cognitive decline, mild cognitive impairment, or clinical AD dementia. Normal cognition and subjective cognitive decline were defined by normal scores on cognitive tests, with the presence of cognitive complaints defining subjective cognitive decline. Mild cognitive impairment and clinical AD dementia were diagnosed according to published criteria.Alzheimer disease biomarkers detected on PET or in CSF.Amyloid measurements were dichotomized as normal or abnormal using cohort-provided cutoffs for CSF or PET or by visual reading for PET. Adjusted data-driven cutoffs for abnormal amyloid were calculated using gaussian mixture modeling. Prevalence of amyloid abnormality was estimated according to age, sex, cognitive status, biomarker modality, APOE carrier status, educational level, geographical location, and dementia severity using generalized estimating equations.Among the 19097 participants (mean [SD] age, 69.1 [9.8] years; 10148 women [53.1%]) included, 10139 (53.1%) underwent an amyloid PET scan and 8958 (46.9%) had an amyloid CSF measurement. Using cohort-provided cutoffs, amyloid abnormality prevalences were similar to 2015 estimates for individuals without dementia and were similar across PET- and CSF-based estimates (24%; 95% CI, 21%-28%) in participants with normal cognition, 27% (95% CI, 21%-33%) in participants with subjective cognitive decline, and 51% (95% CI, 46%-56%) in participants with mild cognitive impairment, whereas for clinical AD dementia the estimates were higher for PET than CSF (87% vs 79%; mean difference, 8%; 95% CI, 0%-16%; P=.04). Gaussian mixture modeling-based cutoffs for amyloid measures on PET scans were similar to cohort-provided cutoffs and were not adjusted. Adjusted CSF cutoffs resulted in a 10% higher amyloid abnormality prevalence than PET-based estimates in persons with normal cognition (mean difference, 9%; 95% CI, 3%-15%; P=.004), subjective cognitive decline (9%; 95% CI, 3%-15%; P=.005), and mild cognitive impairment (10%; 95% CI, 3%-17%; P=.004), whereas the estimates were comparable in persons with clinical AD dementia (mean difference, 4%; 95% CI, -2% to 9%; P=.18).This study found that CSF-based estimates using adjusted data-driven cutoffs were up to 10% higher than PET-based estimates in people without dementia, whereas the results were similar among people with dementia. This finding suggests that preclinical and prodromal AD may be more prevalent than previously estimated, which has important implications for clinical trial recruitment strategies and health care planning policies.
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| 2. |
- Meeter, Lieke H.H., et al.
(författare)
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Clinical value of cerebrospinal fluid neurofilament light chain in semantic dementia
- 2019
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Ingår i: Journal of Neurology, Neurosurgery and Psychiatry. - : BMJ. - 0022-3050 .- 1468-330X. ; 90:9, s. 997-1004
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Tidskriftsartikel (refereegranskat)abstract
- Background: Semantic dementia (SD) is a neurodegenerative disorder characterised by progressive language problems falling within the clinicopathological spectrum of frontotemporal lobar degeneration (FTLD). The development of disease-modifying agents may be facilitated by the relative clinical and pathological homogeneity of SD, but we need robust monitoring biomarkers to measure their efficacy. In different FTLD subtypes, neurofilament light chain (NfL) is a promising marker, therefore we investigated the utility of cerebrospinal fluid (CSF) NfL in SD. Methods: This large retrospective multicentre study compared cross-sectional CSF NfL levels of 162 patients with SD with 65 controls. CSF NfL levels of patients were correlated with clinical parameters (including survival), neuropsychological test scores and regional grey matter atrophy (including longitudinal data in a subset). Results: CSF NfL levels were significantly higher in patients with SD (median: 2326 pg/mL, IQR: 1628-3593) than in controls (577 (446-766), p<0.001). Higher CSF NfL levels were moderately associated with naming impairment as measured by the Boston Naming Test (rs=-0.32, p=0.002) and with smaller grey matter volume of the parahippocampal gyri (rs=-0.31, p=0.004). However, cross-sectional CSF NfL levels were not associated with progression of grey matter atrophy and did not predict survival. Conclusion: CSF NfL is a promising biomarker in the diagnostic process of SD, although it has limited cross-sectional monitoring or prognostic abilities.
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| 3. |
- Mendonça, Marta, 1958-, et al.
(författare)
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A comparative analysis of university pedagogical centres’ activities in Mozambique and Sweden
- 2014
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Ingår i: A Nordic perspective. - Kristianstad : Kristianstad University Press. - 9789197942263 ; , s. 65-73
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Bokkapitel (refereegranskat)abstract
- Many universities around the globe consider raising the pedagogical competence of their teachers to be an important task. The common way of approaching this task is the creation within the university of a specialised centre in charge of staff pedagogical development. This study attempts to provide an analysis of activities conducted by two pedagogical centres situated in two dramatically different contexts: one of the poorest countries in the world (Mozambique) and one of the richest (Sweden). A qualitative study was carried out based on a comparative policy document analysis, on-site observations and semi-structured interviews with two staff members from both centres. Cultural-Historical Activity Theory (CHAT) provided a theoretical framework for the analysis. The collective activity system is taken as a unit of analysis that connects psychological, cultural and contextual perspectives (Engeström, 1999). We found that the official rhetoric of both universities explicitly focuses on the development of pedagogical competence for all categories of teachers. Therefore, as was expected, similarities were identified in the object and expected outcomes of the centres’ activity. However, due to significant differences in historical pre-conditions, cultural contexts and artefacts used for mediating activities in the two centres the findings revealed many differences in the corresponding collective activity systems. The study suggests that the implementation of pedagogical training at a university should carefully consider contextual, social and cultural factors shaping collective activity systems and if necessary construct compensatory artefacts to ameliorate possible frictions in the developmental process.
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| 4. |
- Mendonça, Marta, 1958-
(författare)
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Developing teaching and learning in Mozambican higher education : a study of the pedagogical development process at Eduardo Mondlane University
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis analyses the implementation of a student-centred learning approach at the Eduardo Mondlane University (UEM), in the context of the current curricular reform. The main objective of the thesis is to gain understanding of the implementation of a student-centred learning approach and how the innovation is related to the acquisition of teachers’ pedagogical competence at the above mentioned university. A sociocultural approach and more specifically Cultural Historical Activity Theory is used as a theoretical framework given that it provides a view of learning as a context based social activity. A qualitative approach based on document analysis, classroom observations and semi-structured interviews with different actors in the process of teaching, learning and teacher training was used. The findings of the three studies carried out and presented in four articles in the thesis show that the lecturers do not feel ownership of the curriculum reform introducing the new pedagogical approach, and revealed a conflict of interests in the process of implementation of the reform. Students appear to be unclear about the significance of the new approach and they cannot judge if it is correctly implemented. Contextual factors such as a high number of students in the classroom, poor infrastructure and inadequate access to educational resources also affect the students’ performance in their learning. The university teachers expressed a need for training and the creation of adequate material conditions in order to be able to apply the innovations. However, signs of positive attitudes towards this approach were also revealed by the informants, which demonstrates the existing potential of the reform. It was found that the role of the teacher is crucial in making students active, motivated and self-regulated. Moreover, the students’ active learning depends on several factors, such as contextual, social and psychological aspects of the process. In relation to the acquisition of teachers’ pedagogical competence, a comparative study of the official documents of Eduardo Mondlane University and Umeå University explicitly shows a focus on the development of pedagogical competence for all categories of teachers. However, due to significant differences in historical pre-conditions, cultural contexts and educational artefacts the findings revealed many differences in the corresponding collective activity systems. In conclusion, the thesis indicates that the implementation of student-centred learning at UEM depends on the availability of good educational infrastructure and also the development of human resources. Furthermore, less hierarchical communication at the university could accelerate the process.
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| 5. |
- Mendonça, Marta, et al.
(författare)
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Exploring an experience of active learning in higher education
- 2014
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Ingår i: Journal of education and training. - : Macrothink Institute. - 2330-9709. ; 1:2, s. 1-14
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Tidskriftsartikel (refereegranskat)abstract
- This article presents a subjective experience of attending a pedagogical training course for higher education teaching staff at Umea University, in Sweden. A participant observation was carried out based on an inductive approach. Data were collected through reports done in form of narratives at the end of eachsession. The analysis was done by critical reflection and the narratives were selected and thematically grouped according to the activities carried out during the course. Further, the analysis was supported by relevant literature related to educational theories that sustain student’s accountability in learning and interactive classes. The results of the study conclude that the role ofthe teacher is crucial to make students active, motivated and self-regulated. However, students’ active learning also depends on other factors such as contextual, social and psychological aspects. In addition, the communication involved in the process of teaching and learning develops confidence, empathy and achievement of good academic results.
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| 6. |
- Mendonça, Marta, 1958-, et al.
(författare)
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Inner tensions in changing pedagogical approaches in Mozambican higher education
- 2014
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Ingår i: Comprehensive Journal of Educational Research. - : Knowledgebase Publishers. - 2315-9421. ; 2:5, s. 60-69
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Tidskriftsartikel (refereegranskat)abstract
- The paper discusses tensions in the process of implementation of student-centered pedagogical approaches in Mozambican higher education. A qualitative study was carried out based on document analysis, classroom observations and semi-structured interviews at one selected university. The analysis of this data was based on an activity theory approach which connects psychological, cultural and contextual perspectives. Data collected in this study showed that the teachers did not feel ownership of the innovation and the students revealed difficulties in taking responsibility for their learning. Traditional ‘punitive’ assessment culture and the Mozambican ‘poverty context’ influenced pedagogical practice. Younger teachers appeared to have more interest in the innovation.
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| 7. |
- Mendonça, Marta, 1958-, et al.
(författare)
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Introducing a student-centred learning approach in current curriculum reform in Mozambican higher education
- 2012
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Ingår i: Education Inquiry. - Umeå : Umeå Universitet. - 2000-4508. ; 3:1, s. 37-48
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Tidskriftsartikel (refereegranskat)abstract
- The Eduardo Mondlane University (UEM) in Mozambique is introducing new participative forms of pedagogical practices into the process of its current curriculum reform. This article presents a case study of the introduction of a student-centred approach at one department and discusses some of the lecturers’ perceptions and experiences concerning the process. A qualitative study was carried out based on classroom observations and interviews. Activity theory was used in the analysisof the results. The findings show that the lecturers do not feel ownership of the curriculum reformintroducing student-centred learning. They express a need for training and the creation of adequatematerial conditions to apply the innovation. The findings also reveal contextual factors affecting student engagement in learning. In the conclusions, reflections are presented concerning the place of the generic values of learner-centeredness in the academic culture of the UEM.
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