| 11. |
- Arnberg, Filip K, 1981-, et al.
(författare)
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Internet-delivered psychological treatments for mood and anxiety disorders : a systematic review of their efficacy, safety, and cost-effectiveness
- 2014
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 9:5, s. e98118-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Greater access to evidence-based psychological treatments is needed. This review aimed to evaluate whether internet-delivered psychological treatments for mood and anxiety disorders are efficacious, noninferior to established treatments, safe, and cost-effective for children, adolescents and adults.METHODS: We searched the literature for studies published until March 2013. Randomized controlled trials (RCTs) were considered for the assessment of short-term efficacy and safety and were pooled in meta-analyses. Other designs were also considered for long-term effect and cost-effectiveness. Comparisons against established treatments were evaluated for noninferiority. Two reviewers independently assessed the relevant studies for risk of bias. The quality of the evidence was graded using an international grading system.RESULTS: A total of 52 relevant RCTs were identified whereof 12 were excluded due to high risk of bias. Five cost-effectiveness studies were identified and three were excluded due to high risk of bias. The included trials mainly evaluated internet-delivered cognitive behavioral therapy (I-CBT) against a waiting list in adult volunteers and 88% were conducted in Sweden or Australia. One trial involved children. For adults, the quality of evidence was graded as moderate for the short-term efficacy of I-CBT vs. waiting list for mild/moderate depression (d = 0.83; 95% CI 0.59, 1.07) and social phobia (d = 0.85; 95% CI 0.66, 1.05), and moderate for no efficacy of internet-delivered attention bias modification vs. sham treatment for social phobia (d = -0.04; 95% CI -0.24, 0.35). The quality of evidence was graded as low/very low for other disorders, interventions, children/adolescents, noninferiority, adverse events, and cost-effectiveness.CONCLUSIONS: I-CBT is a viable treatment option for adults with depression and some anxiety disorders who request this treatment modality. Important questions remain before broad implementation can be supported. Future research would benefit from prioritizing adapting treatments to children/adolescents and using noninferiority designs with established forms of treatment.
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| 12. |
- Arnberg, Filip K, 1981-, et al.
(författare)
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Recent randomized controlled trials of psychological interventions in healthcare : A review of their quantity, scope, and characteristics
- 2013
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Ingår i: Journal of Psychosomatic Research. - : Elsevier BV. - 0022-3999 .- 1879-1360. ; 75:5, s. 401-408
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Forskningsöversikt (refereegranskat)abstract
- Objective: This study aimed to describe the quantity, scope, and fundamental characteristics of recently published randomized controlled trials (RCTs) of psychological interventions.Methods: We queried two major databases (PsycINFO and PubMeD) for primary reports published in 2010 of RCTs of psychological interventions for participants with a medical condition. We collected data on the characteristics of the trials, participants, interventions, outcomes, and reports.Results: Of 3,696 retrieved reports 295 primary publications were included. About half (53%) of trials included participants with a mental disorder and more than half evaluated interventions based on a cognitive behavioral therapy (CBT) framework. A majority of trials recruited participants in North America and Europe (79%). A minority of the trials focused on children and adolescents (17%) or the elderly (8%). The median sample size of the intervention arm was n = 41. Thirty-nine percent of trials reported solely patient-reported outcomes. Only 5% of reports indicated funding from for-profit organizations. The median 2010 impact factor of the journals in which reports were published was 2.96.Conclusion: This snapshot of the research on psychological interventions suggests that the evidence base for psychological interventions is expanding mainly for CBT interventions for adults in high-income countries. Although the restrictive inclusion criteria limit the generalizability of these results, researchers and funding agencies might be advised to strive for greater diversity regarding interventions, geographical/cultural settings and age groups. Regularly updated reviews of this research field, with gradually refined methodology and increased scope, may further inform funders and researchers.
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| 13. |
- Berggren, Steve, et al.
(författare)
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Emotion recognition training in autism spectrum disorder : A systematic review of challenges related to generalizability.
- 2018
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Ingår i: Developmental Neurorehabilitation. - : Informa UK Limited. - 1751-8423 .- 1751-8431. ; 21:3, s. 141-154
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To assess the generalizability of findings from randomized controlled trials (RCTs) evaluating emotion recognition (ER) training for children and adolescents with autism spectrum disorder (ASD).METHODS: We present a systematic review and narrative synthesis of the determinants of external validity in RCTs on ER training. Generalizability of the findings across situations, populations, settings, treatment delivery, and intervention formats was considered.RESULTS: We identified 13 eligible studies. Participants were predominantly boys with ASD in the normative IQ range (IQ > 70), with an age span from 4 to 18 years across studies. Interventions and outcome measures were highly variable. Several studies indicated that training may improve ER, but it is still largely unknown to what extent training effects are translated to daily social life.CONCLUSION: The generalizability of findings from currently available RCTs remains unclear. This underscores the importance of involving children with ASD and their caregivers in informed treatment decisions.
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| 14. |
- Björk, Robert G., 1974, et al.
(författare)
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A Climate Change aspect on root dynamics and nitrogen partitioning in a tundra landscape
- 2005
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Ingår i: Sediment budgets and rates of sediment transfer across cold environments in Europe. 3rd Workshop of the ESF Network SEDIFLUX, Durham, UK, 15 – 19 December 2005..
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The Arctic Climate Impact Assessment (ACIA) recently reported that Arctic is rapidly changing due to Climate Change. Likewise, the mountains of Europe are going to experience large shifts in plant composition and 41-56% of the alpine species might be on the edge of extinction according to the 1st synthesis of the Global Observation Research Initiative in Alpine Environments (GLORIA). Although the tundra ecosystems are subjected to dramatical changes as a result of Climate Change, there is little knowledge of the effect on root dynamics and its implication on the nitrifying and denitrifying microbial community. Here, we compare nitrification enzyme activity (NEA) and denitrification enzyme activity (DEA) rates along an altitudinal gradient with the effects of climatic warming using Open Top Chambers (OTCs) in consideration with root dynamics and architecture. This study was conducted at Latnjajaure Field Station (LFS) located in the midalpine region in northern Sweden. LFS is the Swedish field site for the International Tundra Experiment (ITEX), established in 1993. This gives an opportunity to investigate long-term effects of climatic warming by OTCs and an altitudinal gradient (1000m to 1365m), both within a very small geographical range. The OTCs used at LFS increases the soil surface temperature by approximately 1.5ºC whereas air temperatures normally falls with 0.6ºC with every hundred meter of increased altitude. To analyse the NEA and DEA we used an anaerobic incubation technique, based on acetylene inhibition technique, resulting in N2O as the only end product, which then were analysed by gas chromatography. Soil cores were additionally sampled in the OTCs to study the effects of climatic warming on the root system. The specific root length, root length density and root biomass were determined for the different root fractions. The results from NEA and DEA contradict each other. The gradient study show decreased NEA and DEA rates with falling altitude, whereas the warming experiment show a slight non significant increase due to the temperature enhancement by OTCs. The preliminary results from the root sampling indicate that there is a plant community specific response in root architecture, which has an output on root biomass and particularly in the fraction of fine roots, although, climatic warming did not have any significant affect on the root biomass. The fact that altitudinal temperature decline did not reduce NEA and DEA rates might in part be explained of the variables measured here, although they are not conclusive.
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| 15. |
- Björk, Robert G., 1974, et al.
(författare)
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Long-term warming effects on root morphology, root mass distribution, and microbial activity in two dry tundra plant communities in northern Sweden
- 2007
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Ingår i: New Phytologist. - : Wiley. - 0028-646X .- 1469-8137. ; 176:4, s. 862-873
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Tidskriftsartikel (refereegranskat)abstract
- center dot Effects of warming on root morphology, root mass distribution and microbial activity were studied in organic and mineral soil layers in two alpine ecosystems over > 10 yr, using open-top chambers, in Swedish Lapland. center dot Root mass was estimated using soil cores. Washed roots were scanned and sorted into four diameter classes, for which variables including root mass (g dry matter (g DM) m(-2)), root length density (RLD; cm cm(-3) soil), specific root length (SRL; m g DM-1), specific root area (SRA; m(2) kg DM-1), and number of root tips m(-2) were determined. Nitrification (NEA) and denitrification enzyme activity (DEA) in the top 10 cm of soil were measured. center dot Soil warming shifted the rooting zone towards the upper soil organic layer in both plant communities. In the dry heath, warming increased SRL and SRA of the finest roots in both soil layers, whereas the dry meadow was unaffected. Neither NEA nor DEA exhibited differences attributable to warming. center dot Tundra plants may respond to climate change by altering their root morphology and mass while microbial activity may be unaffected. This suggests that carbon may be incorporated in tundra soils partly as a result of increases in the mass of the finer roots if temperatures rise.
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| 16. |
- Björk, Robert G., 1974, et al.
(författare)
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Nitrification and Denitrification Enzyme Activity: a successful tool in Arctic and Alpine soil ecology
- 2007
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Ingår i: The 14th ITEX workshop, Falls Creek, Victoria, Australia, 2–6 February 2007..
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Nitrogen is consideration to be a limiting factor for plants and microbes in arctic and alpine ecosystems and the rates of mineralization, nitrification, and denitrifi¬cation are known to be generally low. However, Climate Change is expected to alter the nitrogen availability and dynamics and, as a consequence, affect plant community composition and production. The general consensus today is that increased temperature will lead to greater microbial activity and more plant-available nitrogen. Nevertheless, nitrification and denitrification are restricted by a number of environmental factors such as low tem¬perature and low pH. The C/N ratio and the water content of the soils also play an important role in determining the rates of nitrification and denitrification. Since 2002 microbial studies has been undertaken at Latnjajure, and comprise several microbial techniques, e.g. Nitrification Enzyme Activity (NEA), Denitrification Enzyme Activity (DEA), Phospholipid fatty acid analysis (PFLA), and Temperature Gradient Gel Electrophoresis (TGGE). These studies focuses on the interaction between plants and microbes along natural environmental gradients, both within plant communities and within the landscape, but also entails the OTCs used in the ITEX studies at Latnjajaure. Here we present the techniques NEA and DEA and give some brief results from how these have been successfully applied at Latnjajaure. In ecosystems with low nitrification activity, small amounts of NO3-/NO2- will be formed and it is thus difficult to measure low fluxes. However, NO3-/NO2- can be converted to N2O and then analysed by gas chromatography, whereby the detection limit is increased at least 1000 times compared to the spectroscopical technique. These techniques are referred to Nitrification (NEA) and Denitrification Enzyme Activity (DEA) and give a potential measure on the nitrification and denitrification rates, which goes back to the actual populations of nitrifiers and denitrifiers in the soil. For instance, NEA has been proved to better correlate with extractable NH4+ concentration than net nitrification does, and still after twelve weeks show a strong correlation with the initial extractable NH4+ concentration. Therefore, these variables, in particular NEA, have the advantage of being a much more stable variable than, for instance, extractable N concentrations and net nitrification, and NEA and DEA are therefore suitable when working in fringe environments with restricted logistics like the Latnjajaure catchment. NEA is measured using a two-step incubation technique; first by incubate the soil with a nutrient solution for 24 hours in darkness, at room temperature on a rotary shaker. Sub-samples are then withdrawn after a specified time schedule. The second step allows NO3- to be reduced to N2O by adding a modified denitrifying bacterium, Pseudomonas chlororaphis ATCC 43928, together with a carbon source. This strain of bacteria lacks the enzyme to reduce N2O to N2. The samples are then again incubated in darkness, at room temperature for 24 hours, and analysed by gas chromatography. This method was first used by Lensi et al. (1985, 1986), to study nitrification potentials in forest soils. Furthermore, the method has been developed for soils with low pH and small amounts of NO3- and the analysis makes the quantification without interference of organic matter, which makes it suitable for arctic and alpine ecosystems. To analyse DEA an anaerobic incubation technique is used, based on acetylene inhibition of the N2O-reductase resulting in N2O as the only end product. The soil sample is evacuated and flushed with N2. Thereafter acetylene is inserted to a final acetylene concentration of 10%, and the samples are shaken continuously and gas samples are withdrawn after a specified time schedule, which is then analysed by gas chromatography. This provides an estimate of the maximum concentration of functional denitrifying enzymes in the soil. Denitrifiers, in contrast to nitrifiers, are heterotrophs and can switch from using NO3- as an alternative electron acceptor to O2 under aerobic conditions. This makes other factors in the soil important determinants of DEA, e.g. availability of oxygen and C. Hence, the presence of denitrifiers is rarely a limitation for denitrification and they usually make up a reasonably large fraction of the soil bacteria. At Latnjajaure NEA shows a larger differentiation across plant communities than DEA. However, the spatial variability in the landscape, at the meso-scale, was in the same range in both variables and increased with altitude from 1000 to 1365 m a.s.l, particularly in heath plant communities. This result suggests that the decrease in mean annual temperature with altitude (0.6ºC with every one hundred meters) did not reduce nitrification and denitrification rates, as one might have expected. None of the other variable studied could explain the altitudinal increase in all cases, and the factors controlling the nitrification and denitrification rates seem to vary with the vegetation type. Furthermore, neither NEA nor DEA exhibited any changes between the ambient and warmed plots in the warming experiments. However, the warming experiment in the dry heath exhibited a change in root morphology via increased specific root length (SRL; m gDM-1) and specific root area (SRA; m2 kgDM -1). As both heterotrophic microbes and plants out-compete nitrifiers for NH4+, a change in root morphology, as seen in the warming experiment, may also explain the increased activity of nitrifying and denitrifying microbes with altitude.
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| 17. |
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| 18. |
- Bohman, Hannes, 1965-, et al.
(författare)
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Somatic symptoms in adolescence as a predictor of severe mental illness in adulthood : a long-term community-based follow-up study.
- 2018
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Ingår i: Child and Adolescent Psychiatry and Mental Health. - : Springer Science and Business Media LLC. - 1753-2000. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Background: Somatic symptoms are common and costly for society and correlate with suffering and low functioning. Nevertheless, little is known about the long-term implications of somatic symptoms. The objective of this study was to assess if somatic symptoms in adolescents with depression and in their matched controls predict severe mental illness in adulthood by investigating the use of hospital-based care consequent to different mental disorders.Methods: The entire school population of 16-17-year-olds in the city of Uppsala, Sweden, was screened for depression in 1991-1993 (n = 2300). Adolescents with positive screenings (n = 307) and matched non-depressed controls (n = 302) participated in a semi-structured diagnostic interview for mental disorders. In addition, 21 different self-rated somatic symptoms were assessed. The adolescents with depression and the matched non-depressed controls were engaged in follow-up through the National Patient Register 17-19 years after the baseline study (n = 375). The outcome measures covered hospital-based mental health care for different mental disorders according to ICD-10 criteria between the participants' ages of 18 and 35 years.Results: Somatic symptoms were associated with an increased risk of later hospital-based mental health care in general in a dose-response relationship when adjusting for sex, adolescent depression, and adolescent anxiety (1 symptom: OR = 1.63, CI 0.55-4.85; 2-4 symptoms: OR = 2.77, 95% CI 1.04-7.39; ≥ 5 symptoms: OR = 5.75, 95% CI 1.98-16.72). With regards to specific diagnoses, somatic symptoms predicted hospital-based care for mood disorders when adjusting for sex, adolescent depression, and adolescent anxiety (p < 0.05). In adolescents with depression, somatic symptoms predicted later hospital-based mental health care in a dose-response relationship (p < 0.01). In adolescents without depression, reporting at least one somatic symptom predicted later hospital-based mental health care (p < 0.05).Conclusions: Somatic symptoms in adolescence predicted severe adult mental illness as measured by hospital-based care also when controlled for important confounders. The results suggest that adolescents with somatic symptoms need early treatment and extended follow-up to treat these specific symptoms, regardless of co-occurring depression and anxiety.
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| 19. |
- Bohman, Hannes, 1965-, et al.
(författare)
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Thicker carotid intima layer, thinner media layer and higher intima/media ratio in women with recurrent depressive disorders : a pilot study using non-invasive high frequency ultrasound
- 2010
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Ingår i: World Journal of Biological Psychiatry. - : Informa Healthcare. - 1562-2975 .- 1814-1412. ; 11:1, s. 71-75
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Tidskriftsartikel (refereegranskat)abstract
- Background. Growing evidence indicates that depression is an important risk factor for coronary heart disease. Thus, the aim of the present study has been to investigate if young women with adolescent onset and recurrent depressive disorders have signs of carotid intima and media changes already at the age of 30. Methods. Fifteen subjects with adolescent onset recurrent depressive disorders, mean age 31.5 years, were compared to 20 healthy women with a mean age of 39.6 years. The thickness of carotid artery intima and media was assessed, using non-invasive high-frequency ultrasound (25MHz). Results. The subjects with recurrent depressive disorders had significantly thicker carotid intima, significantly thinner carotid media and significantly higher intima/media ratio despite the fact that they were about 10 years younger than the healthy women. Hypertension, obesity or smoking could not explain the results. Conclusion. Already at the age of 30, subjects with recurrent depressive disorders with adolescent onset do have early signs of carotid intima and media changes, indicating a less healthy artery wall, despite otherwise no clinical signs of cardiovascular disease.
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| 20. |
- Bridel, Claire, et al.
(författare)
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Diagnostic Value of Cerebrospinal Fluid Neurofilament Light Protein in Neurology : A Systematic Review and Meta-analysis
- 2019
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Ingår i: JAMA Neurology. - : American Medical Association (AMA). - 2168-6149 .- 2168-6157. ; 76:9, s. 1035-1048
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Forskningsöversikt (refereegranskat)abstract
- Importance Neurofilament light protein (NfL) is elevated in cerebrospinal fluid (CSF) of a number of neurological conditions compared with healthy controls (HC) and is a candidate biomarker for neuroaxonal damage. The influence of age and sex is largely unknown, and levels across neurological disorders have not been compared systematically to date.Objectives To assess the associations of age, sex, and diagnosis with NfL in CSF (cNfL) and to evaluate its potential in discriminating clinically similar conditions.Data Sources PubMed was searched for studies published between January 1, 2006, and January 1, 2016, reporting cNfL levels (using the search terms neurofilament light and cerebrospinal fluid) in neurological or psychiatric conditions and/or in HC.Study Selection Studies reporting NfL levels measured in lumbar CSF using a commercially available immunoassay, as well as age and sex.Data Extraction and Synthesis Individual-level data were requested from study authors. Generalized linear mixed-effects models were used to estimate the fixed effects of age, sex, and diagnosis on log-transformed NfL levels, with cohort of origin modeled as a random intercept.Main Outcome and Measure The cNfL levels adjusted for age and sex across diagnoses.Results Data were collected for 10 059 individuals (mean [SD] age, 59.7 [18.8] years; 54.1% female). Thirty-five diagnoses were identified, including inflammatory diseases of the central nervous system (n = 2795), dementias and predementia stages (n = 4284), parkinsonian disorders (n = 984), and HC (n = 1332). The cNfL was elevated compared with HC in a majority of neurological conditions studied. Highest levels were observed in cognitively impaired HIV-positive individuals (iHIV), amyotrophic lateral sclerosis, frontotemporal dementia (FTD), and Huntington disease. In 33.3% of diagnoses, including HC, multiple sclerosis, Alzheimer disease (AD), and Parkinson disease (PD), cNfL was higher in men than women. The cNfL increased with age in HC and a majority of neurological conditions, although the association was strongest in HC. The cNfL overlapped in most clinically similar diagnoses except for FTD and iHIV, which segregated from other dementias, and PD, which segregated from atypical parkinsonian syndromes.Conclusions and Relevance These data support the use of cNfL as a biomarker of neuroaxonal damage and indicate that age-specific and sex-specific (and in some cases disease-specific) reference values may be needed. The cNfL has potential to assist the differentiation of FTD from AD and PD from atypical parkinsonian syndromes.
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