| 1. |
- Ferreira, Daniel, et al.
(författare)
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β-Amyloid and tau biomarkers and clinical phenotype in dementia with Lewy bodies
- 2020
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Ingår i: Neurology. - 1526-632X. ; 95:24, s. 3257-3268
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: In a multicenter cohort of probable dementia with Lewy bodies (DLB), we tested the hypothesis that β-amyloid and tau biomarker positivity increases with age, which is modified by APOE genotype and sex, and that there are isolated and synergistic associations with the clinical phenotype. METHODS: We included 417 patients with DLB (age 45-93 years, 31% women). Positivity on β-amyloid (A+) and tau (T+) biomarkers was determined by CSF β-amyloid1-42 and phosphorylated tau in the European cohort and by Pittsburgh compound B and AV-1451 PET in the Mayo Clinic cohort. Patients were stratified into 4 groups: A-T-, A+T-, A-T+, and A+T+. RESULTS: A-T- was the largest group (39%), followed by A+T- (32%), A+T+ (15%), and A-T+ (13%). The percentage of A-T- decreased with age, and A+ and T+ increased with age in both women and men. A+ increased more in APOE ε4 carriers with age than in noncarriers. A+ was the main predictor of lower cognitive performance when considered together with T+. T+ was associated with a lower frequency of parkinsonism and probable REM sleep behavior disorder. There were no significant interactions between A+ and T+ in relation to the clinical phenotype. CONCLUSIONS: Alzheimer disease pathologic changes are common in DLB and are associated with the clinical phenotype. β-Amyloid is associated with cognitive impairment, and tau pathology is associated with lower frequency of clinical features of DLB. These findings have important implications for diagnosis, prognosis, and disease monitoring, as well as for clinical trials targeting disease-specific proteins in DLB. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that in patients with probable DLB, β-amyloid is associated with lower cognitive performance and tau pathology is associated with lower frequency of clinical features of DLB.
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| 2. |
- Rondung, Elisabet, 1980-, et al.
(författare)
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Feasibility of a randomised trial of Teaching Recovery Techniques (TRT) with refugee youth : results from a pilot of the Swedish UnaccomPanied yOuth Refugee Trial (SUPpORT)
- 2022
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Ingår i: Pilot and Feasibility Studies. - : Springer Science and Business Media LLC. - 2055-5784. ; 8:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Although post-traumatic stress is prevalent among unaccompanied refugee minors (URM), there are few evidence-based psychological interventions for this group. Teaching Recovery Techniques (TRT) is a brief, manualised intervention for trauma-exposed youth, which has shown promising results in exploratory studies. The aim of the present study was to assess the feasibility of conducting a randomised controlled trial (RCT) evaluating the use of TRT among URM by investigating key uncertainties relating to recruitment, randomisation, intervention delivery and data collection. Methods: A 3-month long non-blinded internal randomised pilot trial with a parallel-group design assessed the feasibility of a planned nationwide multi-site RCT. URM with or without granted asylum were eligible if they were 14 to 20 years old, had arrived in Sweden within the last 5 years and had screened positive for symptoms of post-traumatic stress disorder (PTSD). Quantitative data were collected pre- and post-intervention, and 18 weeks after randomisation. On-site individual randomisation (1:1) followed directly after pre-intervention assessment. Participants allocated to the intervention were offered seven weekly group-based TRT sessions. Quantitative pilot outcomes were analysed using descriptive statistics. Qualitative information was gathered through on-site observations and follow-up dialogue with group facilitators. A process for Decision-making after Pilot and feasibility Trials (ADePT) was used to support systematic decision-making in moving forward with the trial. Results: Fifteen URM (mean age 17.73 years) with PTSD symptoms were recruited at two sites. Three of the youths were successfully randomised to either TRT or waitlist control (TRT n = 2, waitlist n = 1). Fourteen participants were offered TRT for ethical reasons, despite not being randomised. Six (43%) attended ≥ 4 of the seven sessions. Seventy-three percent of the participants completed at least two assessments, with a response rate of 53% at both post-intervention and follow-up. Conclusions: The findings demonstrated a need for amendments to the protocol, especially with regard to the procedures for recruitment and randomisation. Upon refinement of the study protocol and strategies, an adequately powered RCT was pursued, with data from this pilot study excluded. Trial registration: ISRCTN47820795, prospectively registered on 20 December 2018
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| 3. |
- Sarkadi, Anna, Professor, 1974-, et al.
(författare)
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Evaluation of the Teaching Recovery Techniques community-based intervention for unaccompanied refugee youth experiencing post-traumatic stress symptoms (Swedish UnaccomPanied yOuth Refugee Trial; SUPpORT) : study protocol for a randomised controlled trial
- 2020
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Ingår i: Trials. - : NLM (Medline). - 1745-6215. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In 2015, 162,877 persons sought asylum in Sweden, 35,369 of whom were unaccompanied refugee minors (URMs). Refugee children, especially URMs, have often experienced traumas and are at significant risk of developing mental health problems, such as symptoms of post-traumatic stress disorder (PTSD), depression and anxiety, which can continue years after resettlement. The Swedish UnaccomPanied yOuth Refugee Trial (SUPpORT) aims to evaluate a community-based intervention, called Teaching Recovery Techniques (TRT), for refugee youth experiencing PTSD symptoms.METHODS/DESIGN: A randomised controlled trial will be conducted in which participants will be randomly allocated to one of two possible arms: the intervention arm (n = 109) will be offered the TRT programme, and the waitlist-control arm (n = 109) will receive services as usual, followed by the TRT programme around 20 weeks later. Outcome data will be collected at three points: pre-intervention (T1), post-intervention (T2; about 8 weeks after randomisation) and follow-up (T3; about 20 weeks after randomisation).DISCUSSION: This study will provide knowledge about the effect and efficiency of a group intervention for URMs reporting symptoms of PTSD in Sweden. TRIAL REGISTRATION: ISRCTN, ISRCTN47820795. Prospectively registered on 20 December 2018.
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| 4. |
- Västhagen, Maja, et al.
(författare)
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Refugee parents’ experiences of coming to Sweden : A qualitative study
- 2022
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Ingår i: International Journal of Intercultural Relations. - : Elsevier. - 0147-1767 .- 1873-7552. ; 91, s. 97-109
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Tidskriftsartikel (refereegranskat)abstract
- Each year, millions of people worldwide are forced to leave their homes. Many of those affected are families. There are already a considerable number of initiatives designed to support refugees who are resettling in new countries and cultures. However, few are promotive interventions aiming to support parents and thereby their children through the extraordinary challenges they face. To develop a culturally adaptive intervention, more knowledge about how refugee parents from different countries perceive and handle these challenges is needed. This study explores refugee parents’ own perspectives on the obstacles, challenges and opportunities they faced during their first years in Sweden to guide the future development of promotive interventions for refugee parents. Interviews were conducted with Arabic, Kurdish, and Somali-speaking refugee parents (n = 28; 19 mothers, 9 fathers). The interviews were examined using content analysis. One overarching theme emerged; “The new language is the key for entering social networks and society, and for helping your child in a new country”. The new language was viewed as a key to integration, and to mastering parenthood in the new context. This theme consisted of four categories; “parents’ motivation and hope as driving forces,” “navigating among past and present culture and values”, “loneliness as a risk factor” and “a new way of being a parent and relating to an acculturation gap”. These findings may help guide the development of parenting interventions for refugees, to promote integration and well-being among parents and their children.
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| 5. |
- Özdemir, Metin, Associate Professor, 1977-, et al.
(författare)
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Preliminary Findings from an ongoing RCT of a Program to Support Adjustment and Development of Recently Arrived Youth
- 2024
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Immigrant and refugee adolescents who migrate to a new country face acculturative challenges in addition to their ongoing developmental challenges. Nevertheless, most preventive interventions for recently arrived youth focus on a small segment of this population who may potentially be at risk for mental health issues related to psychological distress and past trauma. The PIA Youth Program was developed as a 6-week cognitive dissonance-based universal intervention to support newly arrived youth in promoting their adjustment and development in the host society. The program content was informed by the newly arrived youth’s own description of needs and research on the risk and protective factors related to migration and resettlement processes. The program is delivered to 3 to 6 recently arrived youth by trained group leaders in the home language of participants or Swedish. The youth engage in active discussions around potentially challenging acculturative and developmental issues, including learning (and improving) language, exploring the new environment, negotiating cultural differences, social interactions, seeking support, building a sense of belonging, and taking a stance for their future and setting goals. A single-group pre- and post-test pilot study (N = 29) demonstrated the feasibility of the implementation process, relevance of the program content, and appropriateness of the measures. Additionally, the findings from the pilot data suggested trends of improvements in most outcome measures, such as increased internal motivation to learn Swedish (d = .47), increased confidence in achieving academic goals (d = .28), and improved persistence in dealing with school difficulties (d = .22).The pilot test of the PIA Youth Program was followed by a randomized controlled trial with two arms (active intervention and waiting-list control condition) and a pre-, post-, and six-month follow-up design. Twenty-eight schools with students who came to Sweden in 2015 or later were identified based on records from the National Agency for Education and randomized into either the intervention or control condition. Seventh to ninth-grade students who can participate in the program sessions in Arabic, Dari, Kurdish, Somalian, Tigrinya, or Swedish were invited to participate in the study. In Fall 2023, a total of 17 groups (N = 71) were completed with pre- and post-test measures. The trial will continue until Spring 2025 and aims to complete a total of 55 groups. The current presentation (1) focuses on the implementation process of the RCT study and (2) the experiences of the program leaders and participants with the implementation process of the PIA Youth Program, and (3) presents preliminary findings.
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