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- de Rojas, I., et al.
(författare)
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Common variants in Alzheimer’s disease and risk stratification by polygenic risk scores
- 2021
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Ingår i: Nature Communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- Genetic discoveries of Alzheimer’s disease are the drivers of our understanding, and together with polygenetic risk stratification can contribute towards planning of feasible and efficient preventive and curative clinical trials. We first perform a large genetic association study by merging all available case-control datasets and by-proxy study results (discovery n = 409,435 and validation size n = 58,190). Here, we add six variants associated with Alzheimer’s disease risk (near APP, CHRNE, PRKD3/NDUFAF7, PLCG2 and two exonic variants in the SHARPIN gene). Assessment of the polygenic risk score and stratifying by APOE reveal a 4 to 5.5 years difference in median age at onset of Alzheimer’s disease patients in APOE ɛ4 carriers. Because of this study, the underlying mechanisms of APP can be studied to refine the amyloid cascade and the polygenic risk score provides a tool to select individuals at high risk of Alzheimer’s disease. © 2021, The Author(s).
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- Mock, P. C., et al.
(författare)
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Status and capabilities of AMANDA-94
- 1995
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Ingår i: Proceedings, 24th International Conference, Rome, Italy, August 28-September 8, 1995.
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Konferensbidrag (refereegranskat)
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| 8. |
- Neher, M. S., et al.
(författare)
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Exploring implementation issues when introducing a novel internet-based intervention to treat cardiovascular disease-associated mental health issues- the Implement-IT project.
- 2017
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Ingår i: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 16:Suppl. 1, s. S52-S53
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Tidskriftsartikel (refereegranskat)abstract
- Background: Mental health (MH) problems such as depression and insomnia are prominent among patients with cardiovascular disease (CVD). They are associated with a negative impact on quality of life, higher health care costs and a poorer prognosis. Despite this most patients with CVD will not receive support or treatment for their MH problems. Studies in other patient groups have described internet based cognitive behavioral treatment (I-CBT) as a promising intervention, but I-CBT has not been tested in CVD patients. The I-CBT HEART research project aims specifically to develop and evaluate I-CBT programs for CVD patients with psychological distress. The programs, both of which are in early stages of clinical evaluation, respectively target patients with depressive symptoms and patients with insomnia. Two randomized controlled trials will be carried out, I-CBT for insomnia (HiT-IT) and I-CBT for depression (DOHART). Implementation research has shown overwhelming evidence of the difficulties that are often encountered in the diffusion and dissemination of novel treatments, such as I-CBT for CVD. To smooth the way for future use of a successful intervention in clinical practice, a better knowledge is needed of the factors that may hinder or support implementation in practice.Purpose: The overall aim of the IMPLEMENT-IT study, a part of the I-CBT HEART project, is to achieve a better understanding of potential future implementation issues by exploring barriers and facilitators from different stakeholder perspectives that may be of importance in future implementation.Methods: Both qualitative and quantitative data will be collected in conjunction with the RCT studies HiT-IT and DOHART. Interviews with stakeholders at different levels focusing on perceptions of the role of eHealth in traditional healthcare in general, and of the I-CBT HEART intervention in particular. Informants are recruited in groups of healthcare-tasked representatives of political parties at the regional level, local decision-makers in higher healthcare administration, clinical decision-makers, healthcare profe ssionals (providers), as well as patients. Our intention is to measure implementation leadership,empowerment and implementation climate in the clinical contexts, but also to develop valid and reliable instruments to be used in future studies.Conclusion: Studying factors that may potentially influence the implementation of a novel I-CBT program for treatment of MH problems in CVD patients through a mixed methods approach may assist the design of future implementation strategies in clinical cardiac care.
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| 9. |
- Siebmanns, Sandra, et al.
(författare)
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Insomnia in patients with cardiovascular disease - a review of causes, consequences and nursing interventions
- 2017
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Ingår i: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 16:Suppl. 1, s. S31-S31
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Insomnia is defined as a subjective complaint of difficulty to initiate sleep, difficulty to maintain sleep, and early morning awakenings that occur at a minimum of 3 nights per week for 3 months. The prevalence of insomnia in the general adult population is estimated to 12–20%. The prevalence is even higher among those with cardiovascular disease (CVD). Insomnia has a significant impact on the individual’s health and quality of life.Aim: To examine causes, consequences and nursing interventions for insomnia in patients with CVD.Design: Literature review.Method: Electronic search through PubMed and Cinahl for studies published 2001-2016. Insomnia, CVD, causes, consequences, interventions and nurse-led intervention were used as keywords. Detected duplicates, irrelevant studies and others (i.e., editorials, letters) were removed. “Insomnia and CVD” resulted in 214 hits, “insomnia and CVD and causes” in 394 hits, “insomnia and CVD and consequences” in 35 hits, and “insomnia and CVD and interventions” resulted in 51 hits.Results: Insomnia causes impaired daytime functioning, poorer cognitive function and a feeling of isolation. The pathophysiological consequences of insomnia are associated with increased risk for arteriosclerosis and CVD (i.e., caused by an increased inflammatory processes). Pharmacological treatment for insomnia have been used for some time (i.e., sedative, hypnotics and antidepressant), but there are concerns about tolerance and dependence, as well as other side effects (i.e., falls, cognitive changes and unusual sleep behaviours) which requires a thorough risk and benefit analysis before prescription. Non-pharmacological treatments such as Cognitive behavioural therapy (CBT) and internet-based CBT (I-CBT) for insomnia, led by therapists, is a less expensive intervention used in previous studies for othe rpatient groups. Despite positive results for both CBT andI-CBT (i.e., improved performance, increased quality of life and reduced symptom burden) in these studies no nurse-led interventions (i.e., of any type) intended for patients with CVD and insomnia were found.Conclusion: I-CBT for insomnia seems to be an accessible and effective treatment for other patient groups. The lack of nurse-led interventions, highlights the need for future studies in patients with CVD and insomnia.
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- Siebmanns, Sandra, 1974-, et al.
(författare)
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Internet-based CBT for insomnia in the general population - a description of design, measurements and interventions in recent RCT studies
- 2018
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Ingår i: Journal of Sleep Research. - : John Wiley & Sons. - 0962-1105 .- 1365-2869. ; 27:1, SI, s. 290-291
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Tidskriftsartikel (refereegranskat)abstract
- Objectives/Introduction: Internet-based cognitive behavioural therapy for insomnia (ICBTi) has been proposed as an effective, accessible, non-pharmacologic treatment for insomnia disorder. The objective was to perform a literature review of published randomized controlled trials (RCT).Methods: Literature review. PubMed was used to identify RCTs ofICBTi published since 2013. Keywords were insomnia, ICBT and RCT. The search resulted in 40 hits. Papers with study designs and methods not relevant to the objective were removed (n = 29). Reasons for exclusion were: only study protocol, not internet-based, and results based on old data.Results: Design: Recruitment were done via e-mail, from websites, online ads, and advertisements in local newspapers.Inclusion criteria: Six studies based their inclusion only on ISI score (from >7to>=15). 3 studies used a combination of ISI and DSM-IV. Two studies used DSM-IV only.Sample sizes: 4 studies had less than 100 participants, and 2 studies over 200, the mean number was 139 participants (48-303). The mean age varied from 15 to 52 years. Significantly more female participants in all studies.Data collection: ISI combined with sleep diary was the most commonly used primary or secondary outcome measurements (n =7), 2 used ISI only, and 2 used sleep diary only. Other common instruments were, PSQI, HADS, DBAS-16 and CES-D. All studies had pre- and post-treatment measurements, but none during the intervention. The follow-up-period varied between 8 weeks and 3 years. The most common follow-up time was 6 months (n = 4), with a range from 4 weeks3years.Intervention: Most of the studies (n = 10) used traditional ICBTi-treatments (i.e., stimulus control, sleep restriction, relaxation, sleep hygiene). One study did not include stimulus control. The treatment duration were six weeks (n = 8), eight weeks (n = 2) and nine weeks (n = 1). All except one used therapist guided support.Results: All studies showed significant post treatment improvements on sleep outcomes.Conclusions: All studies showed significant improvement with regard to sleep. The total number of participants in the studies was relatively low. Most studies are not based on clinical samples, which may affect the generalizability of the findings.Disclosure: Nothing to disclose
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