| 1. |
- Aarseth, Espen, et al.
(författare)
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Scholars' open debate paper on the World Health Organization ICD-11 Gaming Disorder proposal
- 2017
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Ingår i: Journal of Behavioral Addictions. - : AKADEMIAI KIADO RT. - 2062-5871 .- 2063-5303. ; 6:3, s. 267-270
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Concerns about problematic gaming behaviors deserve our full attention. However, we claim that it is far from clear that these problems can or should be attributed to a new disorder. The empirical basis for a Gaming Disorder proposal, such as in the new ICD-11, suffers from fundamental issues. Our main concerns are the low quality of the research base, the fact that the current operationalization leans too heavily on substance use and gambling criteria, and the lack of consensus on symptomatology and assessment of problematic gaming. The act of formalizing this disorder, even as a proposal, has negative medical, scientific, public-health, societal, and human rights fallout that should be considered. Of particular concern are moral panics around the harm of video gaming. They might result in premature application of diagnosis in the medical community and the treatment of abundant false-positive cases, especially for children and adolescents. Second, research will be locked into a confirmatory approach, rather than an exploration of the boundaries of normal versus pathological. Third, the healthy majority of gamers will be affected negatively. We expect that the premature inclusion of Gaming Disorder as a diagnosis in ICD-11 will cause significant stigma to the millions of children who play video games as a part of a normal, healthy life. At this point, suggesting formal diagnoses and categories is premature: the ICD-11 proposal for Gaming Disorder should be removed to avoid a waste of public health resources as well as to avoid causing harm to healthy video gamers around the world.
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| 2. |
- Enevold, Jessica, et al.
(författare)
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Problem Gaming in an everyday perspective (Research Panel)
- 2015
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Ingår i: Proceedings of DiGRA 2015: Diversity of Play: Games-Cultures- Identities.
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Konferensbidrag (refereegranskat)abstract
- In this panel we take a critical look at problem gaming. We question existing approaches that tend to draw on concepts from clinical psychology and we introduce everyday life and the general wellbeing of youth as an alternative perspective.
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| 3. |
- Janson, Christer, et al.
(författare)
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Pharmacological treatment of asthma in a cohort of adults during a 20-year period : results from the European Community Respiratory Health Survey I, II and III
- 2019
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Ingår i: ERJ Open Research. - : European Respiratory Society. - 2312-0541. ; 5:1
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Tidskriftsartikel (refereegranskat)abstract
- Asthma often remains uncontrolled, despite the fact that the pharmacological treatment has undergone large changes. We studied changes in the treatment of asthma over a 20-year period and identified factors associated with the regular use of inhaled corticosteroid (ICS) treatment. Changes in the use of medication were determined in 4617 randomly selected subjects, while changes in adults with persistent asthma were analysed in 369 participants. The study compares data from three surveys in 24 centres in 11 countries. The use of ICSs increased from 1.7% to 5.9% in the general population and the regular use of ICSs increased from 19% to 34% among persistent asthmatic subjects. The proportion of asthmatic subjects reporting asthma attacks in the last 12 months decreased, while the proportion that had seen a doctor in the last 12 months remained unchanged (42%). Subjects with asthma who had experienced attacks or had seen a doctor were more likely to use ICSs on a regular basis. Although ICS use has increased, only one-third of subjects with persistent asthma take ICSs on a regular basis. Less than half had seen a doctor during the last year. This indicates that underuse of ICSs and lack of regular healthcare contacts remains a problem in the management of asthma.
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| 4. |
- Jensen, Line, et al.
(författare)
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Carbohydrate restricted recovery from long term endurance exercise does not affect gene responses involved in mitochondrial biogenesis in highly trained athletes
- 2015
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Ingår i: Physiological Reports. - : Wiley. - 2051-817X. ; 3:2
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to determine if the metabolic adaptations, particularly PGC-1a and downstream metabolic genes were affected by restricting CHO following an endurance exercise bout in trained endurance athletes. A second aim was to compare baseline expression level of these genes to untrained. Elite endurance athletes (VO2max 66 ± 2 mL·kg-1·min-1, n = 15) completed 4 h cycling at ~56% VO2max. During the first 4 h recovery subjects were provided with either CHO or only H2O and thereafter both groups received CHO. Muscle biopsies were collected before, after, and 4 and 24 h after exercise. Also, resting biopsies were collected from untrained subjects (n = 8). Exercise decreased glycogen by 67.7 ± 4.0% (from 699 ± 26.1 to 239 ± 29.5 mmol·kg-1·dw-1) with no difference between groups. Whereas 4 h of recovery with CHO partly replenished glycogen, the H2O group remained at post exercise level; nevertheless, the gene expression was not different between groups. Glycogen and most gene expression levels returned to baseline by 24 h in both CHO and H2O. Baseline mRNA expression of NRF-1, COX-IV, GLUT4 and PPAR-α gene targets were higher in trained compared to untrained. Additionally, the proportion of type I muscle fibers positively correlated with baseline mRNA for PGC-1α, TFAM, NRF-1, COX-IV, PPAR-α, and GLUT4 for both trained and untrained. CHO restriction during recovery from glycogen depleting exercise does not improve the mRNA response of markers of mitochondrial biogenesis. Further, baseline gene expression of key metabolic pathways is higher in trained than untrained.
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| 5. |
- Nielsen, T. Rune, et al.
(författare)
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Cognitive Advantages in Adult Turkish Bilingual Immigrants - a Question of the Chicken or the Egg
- 2019
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Ingår i: Journal of Cross-Cultural Gerontology. - : SPRINGER. - 0169-3816 .- 1573-0719. ; 34:2, s. 115-129
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Tidskriftsartikel (refereegranskat)abstract
- A number of studies suggest both cognitive disadvantages and advantages of bilingualism. In the current study, it is attempted to provide an account of the cognitive advantages associated with bilingualism in a Turkish immigrant population in Denmark.The total sample consisted of 71 middle-aged and older adults born and raised in Turkey who had migrated to Denmark in their teenage years or later. All participants were assessed with a neuropsychological test battery and degree of Turkish-Danish bilingualism was estimated via rater assessment according to a three-point scale. Associations between bilingualism and cognitive function were established for five cognitive domains: executive function, memory, language, visuospatial function and speed. Analysis of covariance was used to estimate the independent association between bilingualism and cognitive function for each cognitive domain. Covariates included education, gender, ethnicity, and proportion of life lived in Denmark. In unadjusted analyses, greater degree of bilingualism was associated with better executive functioning (pamp;lt;.001), visuospatial functioning (p=.002) and speed (pamp;lt;.001). However, in analyses adjusted for covariates only executive functioning (p=.01) and task switching ability (p=.01) remained significant, while a trend for better memory function was found in those with a high degree of bilingualism (p=.07).The current study indicates that bilingual Turkish immigrants have better executive functioning and episodic memory compared to Turkish immigrant monolinguals. Whether this is due to the effects of bilingualism or reflects inherent cognitive abilities in those able to acquire bilingualism in later life remains to be resolved.
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| 6. |
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| 7. |
- Nielsen, T. Rune, et al.
(författare)
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Validation of a brief Multicultural Cognitive Examination (MCE) for evaluation of dementia
- 2019
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Ingår i: International Journal of Geriatric Psychiatry. - : Wiley. - 0885-6230 .- 1099-1166. ; 34:7, s. 982-989
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aims of this study were to present the psychometric properties of a newly designed cognitive screening instrument, the Multicultural Cognitive Examination (MCE), and to compare it with the Rowland Universal Dementia Assessment Scale (RUDAS) in a multicultural population. Methods: The study was a Western European cross-sectional multicenter study. The MCE consists of four components evaluating separate cognitive functions and was constructed by adding measures of memory, verbal fluency, and visuospatial function to the RUDAS to create a scale with 0 to 100 points. Results: A total of 66 patients with dementia and 123 cognitively intact participants were included across six memory clinics; 96 had minority ethnic background, and 93 had majority ethnic background. Moderate to large differences were present between patients with dementia and control participants on all MCE components. The MCE significantly improved diagnostic accuracy compared with using the RUDAS alone, with area under the curves of.918,.984, and.991 for the RUDAS, MCE composite, and demographically corrected composite scores, respectively. Diagnostic accuracy of the MCE did not significantly differ between minority and majority ethnic groups. Across MCE subcomponents, patients with Alzheimer's disease (AD) dementia performed significantly poorer on the memory component compared with those with non-AD dementia. Conclusions: The MCE is a brief cross-cultural cognitive screening instrument that expands evaluation of the cognitive functions covered by the RUDAS, does not require any specialized training, and may be useful for classification of mild dementia or dementia subtypes.
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| 8. |
- Nielsen, T. Rune, et al.
(författare)
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Validation of a European Cross-Cultural Neuropsychological Test Battery (CNTB) for evaluation of dementia
- 2019
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Ingår i: International Journal of Geriatric Psychiatry. - : Wiley. - 0885-6230 .- 1099-1166. ; 34:1, s. 144-152
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aims of this study were to establish the diagnostic accuracy of the European Cross-Cultural Neuropsychological Test Battery (CNTB) for dementia in different ethnic populations in Western Europe, to examine its ability to differentiate cognitive impairment profiles for dementia subtypes, and to assess the impact of demographic variables on diagnostic properties. Methods: The study was a Western European cross-sectional multi-center study. A total of 66 patients with dementia and 118 cognitively intact participants were included across six memory clinics; 93 had ethnic minority background and 91 had ethnic majority background. Tests in the CNTB cover global cognitive function, memory, language, executive functions, and visuospatial functions. Results: Significant differences with moderate to large effect sizes were present between patients with dementia and control participants on all CNTB measures. Area under the curves (AUC) ranged from.62 to.99 with a mean AUC across all measures of.83. Comparison of ethnic minority and majority groups generally revealed higher sensitivity in the minority group but no significant difference in the mean AUC's across all measures (.84 vs78, P =.42). Comparison of impairment profiles for patients with Alzheimer's disease (AD) and non-AD dementia revealed that AD patients were significantly more impaired on the memory domain, whereas patients with non-AD dementia were more impaired on the executive functions domain. Conclusions: The CNTB was found to have promising cross-cultural diagnostic properties for evaluation of dementia in the targeted minority and majority populations and could represent a valid cross-cultural alternative to other well-established neuropsychological test batteries when assessing patients from these populations.
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| 9. |
- Nielsen, T. Rune, et al.
(författare)
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Validation of the Rowland Universal Dementia Assessment Scale (RUDAS) in a multicultural sample across five Western European countries : diagnostic accuracy and normative data
- 2019
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Ingår i: International Psychogeriatrics. - 1041-6102. ; 31:2, s. 287-296
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Tidskriftsartikel (refereegranskat)abstract
- Background:: With increasing cultural diversity and growing elderly immigrant populations in Western European countries, the availability of brief cognitive screening instruments adequate for assessment of dementia in people from diverse backgrounds becomes increasingly important. The aim of the present study was to investigate diagnostic accuracy of the Rowland Universal Dementia Assessment Scale (RUDAS) in a multicultural sample and to calculate normative data as a basis for demographic adjustment of RUDAS scores. Methods:: The study was a prospective international cross-sectional multi-center study. Receiver operating characteristic curve analysis was used to examine diagnostic accuracy. Regression analysis was used to assess the impact of demographic variables. Results:: Data was collected from 341 cognitively intact participants and 80 people with dementia with a wide age- and educational range. Of the 421 included participants, 239 (57%) had immigrant background. The RUDAS had high diagnostic accuracy with an area under the curve (AUC) of 0.93. The optimal cut-off score was <25 (sensitivity 0.80, specificity 0.90). Regression analysis revealed that RUDAS scores were mainly affected by education and were unrelated to data collection site and immigrant status. Education-adjusted normative data was calculated as a basis for education adjustment of RUDAS scores. Applying education-adjusted RUDAS scores slightly but significantly improved diagnostic accuracy with an AUC of 0.95. Conclusion:: We found the RUDAS to have excellent diagnostic properties in our multicultural sample. However, we suggest that RUDAS scores should be adjusted for education to increase diagnostic accuracy and that the choice of cut-off score should be considered based on the clinical context and expected base rate of dementia.
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| 10. |
- Plejert, Charlotta, et al.
(författare)
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'There is a letter called ef': on challanges and repair in interpreter-mediated tests of cognitive functioning in dementia.
- 2015
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Ingår i: Journal of Cross-Cultural Gerontology. - : Springer Science and Business Media LLC. - 0169-3816 .- 1573-0719. ; 30:2, s. 163-187
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Tidskriftsartikel (refereegranskat)abstract
- In the Scandinavian countries Sweden, Denmark, Norway, and Finland, the number of first generation migrants reaching an old age, who will be in need of age-related health-care, is rapidly increasing. This situation poses new demands on health-care facilities, such as memory clinics, where patients with memory problems and other dementia symptoms are referred for examination and evaluation. Very many elderly people with a foreign background require the assistance of an interpreter in their encounter with health-care facilities. The use of, and work by an interpreter is crucial in facilitating a smooth assessment. However, interpreters, clinicians, as well as patients and their companions, may be faced with many challenges during the evaluation procedure. The aim of this case-study is to highlight some of the challenges that occur in relation to a specific activity within the dementia evaluation, namely the test of cognitive functioning. Special attention will be paid to the phenomenon 'repair', i.e., participants' joint attempts to solve upcoming difficulties during the course of interaction. Results show that sources of trouble may be related to the lack of cultural, linguistic, and educational adaptation of the test to the patient, and to interpreter and clinician practises. Findings will be discussed in terms of test-validity, clinician and interpreter training, and the institutional goals and constraints of the dementia evaluation. The methodology Conversation Analysis has been used to conduct a highly detailed analysis of participants' practices and actions during the administration of the test.
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