| 1. |
- Björngrim, Stina, et al.
(författare)
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Comparing Traditional and Digitized Cognitive Tests Used in Standard Clinical Evaluation : A Study of the Digital Application Minnemera
- 2019
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Ingår i: Frontiers in Psychology. - : Frontiers Media SA. - 1664-1078. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to compare a new digitized cognitive test battery, Minnemera, with its correspondent traditional paper-based cognitive tests. Eighty-one healthy adults between the ages of 21 and 85 participated in the study. Participants performed the two different test versions (traditional paper-based and digitized) with an interval of four weeks between the tests. Test presentation (the order of the test versions presented) was counterbalanced in order to control for any possible test learning effects. The digitized tests were constructed so that there were only minor differences when compared to the traditional paper-based tests. Test results from the paper-based and digitized versions of the cognitive screening were compared within individuals by means of a correlation analysis and equivalence tests. The effects of demographic variables (age, gender and level of education) and test presentation were explored for each test measure and each test version through linear regression models. For each test measure, a significant correlation between traditional and digitized version was observed ranging between r = 0.34 and r = 0.67 with a median of r = 0.53 (corresponding to a large effect size). Score equivalence was observed for five out of six tests. In line with previous traditional cognitive studies, age was found to be the most prominent predictor of performance in all digitized tests, with younger participants performing better than older adults. Gender was the second strongest predictor, where women outperformed men in tests measuring verbal memory; men performed better than women in tests with a strong visual component. Finally, the educational level of the test subjects had an effect on executive functions, with a higher educational level linked to a better inhibition response and working memory span. This study suggests that the tests in the Minnemera cognitive screening battery are acceptably comparable to the traditional paper-based counterparts.
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| 2. |
- Hiort, Jenny, et al.
(författare)
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Young pain patients’ experience in primary care : A qualitative study
- 2017
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Ingår i: Nordic Psychology. - : Informa UK Limited. - 1901-2276 .- 1904-0016. ; 69:2, s. 83-99
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Tidskriftsartikel (refereegranskat)abstract
- The purpose was to explore interview data from young adults with long-standing pain about their experience of contacts with caregivers in a primary care setting, in order to synthesize and qualitatively analyse their reports about how they were received. Method: An emergent qualitative design was used. Open thematic research interviews were conducted with 11 young people (1 man, 10 women) (aged 20–31 years) with long-term pain. The interviews were recorded, transcribed verbatim and analysed using inductive thematic content analysis. Result: The analyses resulted in three themes; distrust experienced from care staffs, lonelinessand hopelessness forming the main theme Young adult with long-term pain. The informants described how they struggled with living with the pain, fighting with the care system and to obtain help. They reportedly felt they were not trusted and that they were not given any explanations or information why the pain spread and worsened. This left them feeling abandoned and alone and without hope concerning their pain, their feelings; and with doubts concerning their prospects. Much concern and doubt were expressed about their future work situation; whether they would be able to do work for which they had trained, and whether they would ever get any career opportunities. Conclusion: Living with long-term pain as a young adult and experiencing mistrust when in care might lead to feelings of loneliness, dependence and hopelessness and an existence marked by suffering and dependence. The experienced mistrust confined the young adult instead of allowing growth towards an adult identity and opportunities.
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| 3. |
- Lindau, Maria, et al.
(författare)
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Cross-cultural applicability and reduction of the American seven-subtest short form of the WAIS on a Swedish non-clinical sample
- 2019
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Ingår i: Nordic Psychology. - : Informa UK Limited. - 1901-2276 .- 1904-0016. ; 71:3, s. 148-163
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Tidskriftsartikel (refereegranskat)abstract
- The study aimed at investigating whether the seven-subtest short form based on WAIS-R (Ward 1990) was statistically valid to use on the Swedish version of Wechsler Adult Intelligence Scale, Fourth Edition (WAIS-IV), if this abbreviation was fit to catch the heterogeneity in test performance across age and if this brief measure was possible to abbreviate even more. WAIS-IV data from a non-clinical sample consisting of 261 participants ranging between 18 and 74 in age was analyzed with bivariate and multiple regression analyses, a prorating method for calculation of Full Scale IQ (FSIQ) and its indices as well as paired-samples t-test. The results were contradictory. When the original WAIS-IV was compared to the seven-subtest short form the results showed a good congruence on FSIQ-level between the two sets, but on index level there were several cases of mismatches. In the younger and middle aged sample (<55 years) results on FSIQ as well as index level were in accordance, whereas in the elderly group (∼55 years) they were incongruent. The best reduction of the seven-subtest short form was a four-subtest model, encompassing Block Design, Similarities, Arithmetic and Coding, one subtest from each index, but the t-tests indicated several cases of mismatches between the full WAIS-IV measures and the prorated scores. Applied on the Swedish version of the WAIS-IV the seven-subtest formula appears to be applicable on an FSIQ level, to be suitable for a younger sample, but not for an elderly. Otherwise, this model and the four-subtest model are recommended to be used with caution.
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| 4. |
- Lindau, Maria, et al.
(författare)
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Effects of Stress on Learning and Memory
- 2016
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Ingår i: Stress. - Amsterdam : Academic Press. - 9780128009512 - 9780128011379 ; , s. 153-160
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Stress activates the hypothalamus-pituitary-adrenal axis, which causes the release of glucocorticoids, a class of adrenal steroid hormones. Stress also activates the sympathetic nervous system and thereby, the release of the transmitters adrenaline and noradrenaline. Stress has a memory-modulatory effect in humans as well as in animals. In humans, the hippocampus, prefrontal cortex, and amygdala are rich in cortisol receptors. Acute and tolerable stress may increase memory performance, while excessive levels and chronic stress may have negative effects, thereby mimicking the pattern in animals. Stress in humans seems to have different effects on the various stages of memory (the memory process: encoding, consolidation, and retrieval) and can be enhanced by emotional arousal. Animals learn to associate events in their environment. Studies of the effects of manipulation of corticosterone levels in animals have helped to disentangle the influences of stress on memory and learning, and indicated that low levels enhance spatial learning, whereas higher levels impair performance. © 2016 Elsevier Inc. All rights reserved.
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| 5. |
- Lindau, Maria, et al.
(författare)
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Predictive accuracy of Wechsler Adult Intelligence Scale, forth ed., (WAIS-IV) seven- and four- subtest short form models in estimating full scale IQ (FSIQ) and its indices in a Swedish non-clinical sample
- 2016
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Ingår i: Proceedings of 4th Global Experts Meeting on Neuropharmacology.
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Konferensbidrag (refereegranskat)abstract
- Neurodegenerative disorders usually show characteristic cognitive profiles, determined by the anatomical dispersion of neuronal loss. Short-term/memory decline is a presenting symptom on Alzheimer’s disease, but atypical early signs also occur. The Wechlser Adult Intelligence Scale (WAIS) may be used to differentiate between normal and sub-normal cognitive performance levels, such as pre-dementia stages, AD and related disorders. According to Meyers et al., (2013), a brief measure consisting of a seven-subtest short form (SF) of the WAIS-IV including Block Design (BD), Similarities (SI), Digit Span (DS), Arithmetic (AR), Information (IN) Coding (CD) and Picture Completion (PC) provides a valid means of measuring cognitive level. In order to validate a short form of WAIS-IV on a Swedish non-clinical sample the aim of the present study was to assess the ability of the seven-subtest SF as well as a reduction of the number of subtests in the SF based on standardized β-values, to predict the full scale IQ (FSIQ) and its indices. WAIS-IV scaled score data from 98 healthy individuals (19-90 years M=46 years, SD=23 years, females=48, males=50) were analyzed with linear regression, which showed that the seven predictors explained 92.5% of the variance in FSIQ. When reducing the SF-set the four highest β-values were obtained from the following subtests: CD, β=0.34 (Processing Speed), SI, β=0.31 (Verbal Comprehension), BD, β=0.25 (Perceptual Reasoning), and AR, β=0.23 (Working memory), which showed to be one subtest from each of the four indices. FSIQ prediction rate of these four subtests was 88.1%. Each of the four subtests correlated significantly on p=<0.01 level with its index. To conclude, FSIQ prediction accuracy for the seven-subtest SF is very high, as well as for the four-subtest model. Since the four-subtest model strongly predicts FSIQ, as well as all its indices, it may be a valid, and timesaving, instrument to assess short-term memory (AR, partly CD) deficits typical for different stages of AD, signs on non-amnestic decline in AD, as well as typical clinical manifestations of frontotemporal degeneration, Parkinson’s disease, Lewy body disease, ischemic brain disorders and cognitive dysfunctions associated with depression. In unclear cases additional testing is necessary. Further analyses will reveal possible influences on the norms of age, genus and education.
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| 6. |
- Lindau, Robert, et al.
(författare)
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Interleukin-34 is present at the fetal-maternal interface and induces immunoregulatory macrophages of a decidual phenotype in vitro
- 2018
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Ingår i: Human Reproduction. - : OXFORD UNIV PRESS. - 0268-1161 .- 1460-2350. ; 33:4, s. 588-599
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Tidskriftsartikel (refereegranskat)abstract
- STUDY QUESTION: Is the newly discovered cytokine interleukin (IL)-34 expressed at the human fetal-maternal interface in order to influence polarization of monocytes into macrophages of a decidual immunoregulatory phenotype? SUMMARY ANSWER: IL-34 was found to be present at the fetal-maternal interface, in both fetal placenta and maternal decidua, and it was able to polarize monocytes into macrophages of a decidual phenotype. WHAT IS KNOWN ALREADY: IL-34 was shown to bind to the same receptor as macrophage-colony stimulating factor (M-CSF), which has an important immunomodulatory role at the fetal-maternal interface, for example by polarizing decidual macrophages to an M2-like regulatory phenotype. IL-34 is known to regulate macrophage subsets, such as microglia and Langerhans cells, but its presence at the fetal-maternal interface is unknown. STUDY DESIGN, SIZE, DURATION: The presence of IL-34 at the fetal-maternal interface was evaluated by immunohistochemistry (IHC) and ELISA in placental and decidual tissues as well as in isolated trophoblast cells and decidual stromal cells obtained from first trimester elective surgical terminations of pregnancy (n = 49). IL-34 expression was also assessed in third trimester placental biopsies from women with (n = 21) or without (n = 15) pre-eclampsia. The effect of IL-34 on macrophage polarization was evaluated in an in vitro model of blood monocytes obtained from healthy volunteers (n = 14). In this model, granulocyte macrophage-colony stimulating factor (GM-CSF) serves as a growth factor for M1-like polarization, and M-CSF as a growth factor for M2-like polarization. PARTICIPANTS/MATERIALS, SETTING, METHODS: First trimester placental and decidual tissues were obtained from elective pregnancy terminations. Placental biopsies were obtained from women with pre-eclampsia and matched controls in the delivery ward. Polarization of macrophages in vitro was determined by flow-cytometric phenotyping and secretion of cytokines and chemokines in cell-free supernatants by multiplex bead assay. MAIN RESULTS AND THE ROLE OF CHANCE: Our study shows that IL-34 is produced at the fetal-maternal interface by both placental cyto-and syncytiotrophoblasts and decidual stromal cells. We also show that IL-34, in vitro, is able to polarize blood monocytes into macrophages with a phenotype (CD14(high)CD163(+)CD209(+)) and cytokine secretion pattern similar to that of decidual macrophages. The IL-34-induced phenotype was similar, but not identical to the phenotype induced by M-CSF, and both IL-34-and M-CSF-induced macrophages were significantly different (P amp;lt; 0.05-0.0001 depending on marker) from GM-CSF-polarized M1-like macrophages. Our findings suggest that IL-34 is involved in the establishment of the tolerant milieu found at the fetal-maternal interface by skewing polarization of macrophages into a regulatory phenotype. LIMITATIONS, REASONS FOR CAUTION: Although it is clear that IL-34 is present at the fetal-maternal interface and polarizes macrophages in vitro, its precise role in vivo remains to be established. WIDER IMPLICATIONS OF THE FINDINGS: The recently discovered cytokine IL-34 is present at the fetal-maternal interface and has immunomodulatory properties with regard to induction of decidual macrophages, which are important for a healthy pregnancy. Knowledge of growth factors related to macrophage polarization can potentially be translated to treatment of pregnancy complications involving dysregulation of this process. STUDY FUNDING/COMPETING INTEREST(S): This study was funded by grants from the Medical Research Council (Grant K2013-61X-22310-01-04), the Research Council of South-East Sweden (FORSS), and the County Council of Ostergotland, Sweden. No author has any conflicts of interest to declare.
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| 7. |
- Svensson-Arvelund, Judit, 1982-, et al.
(författare)
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The Human Fetal Placenta Promotes Tolerance against the Semiallogeneic Fetus by Inducing Regulatory T Cells and Homeostatic M2 Macrophages
- 2015
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Ingår i: Journal of Immunology. - : American Association of Immunologists. - 0022-1767 .- 1550-6606. ; 194:4, s. 1534-1544
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Tidskriftsartikel (refereegranskat)abstract
- A successful pregnancy requires that the maternal immune system is instructed to a state of tolerance to avoid rejection of the semiallogeneic fetal-placental unit. Although increasing evidence supports that decidual (uterine) macrophages and regulatory T cells (Tregs) are key regulators of fetal tolerance, it is not known how these tolerogenic leukocytes are induced. In this article, we show that the human fetal placenta itself, mainly through trophoblast cells, is able to induce homeostatic M2 macrophages and Tregs. Placental-derived M-CSF and IL-10 induced macrophages that shared the CD14(+)CD163(+)CD206(+)CD209(+) phenotype of decidual macrophages and produced IL-10 and CCL18 but not IL-12 or IL-23. Placental tissue also induced the expansion of CD25(high)CD127(low)Foxp3(+) Tregs in parallel with increased IL-10 production, whereas production of IFN-gamma (Th1), IL-13 (Th2), and IL-17 (Th17) was not induced. Tregs expressed the suppressive markers CTLA-4 and CD39, were functionally suppressive, and were induced, in part, by IL-10, TGF-beta, and TRAIL. Placental-derived factors also limited excessive Th cell activation, as shown by decreased HLA-DR expression and reduced secretion of Th1-, Th2-, and Th17-associated cytokines. Thus, our data indicate that the fetal placenta has a central role in promoting the homeostatic environment necessary for successful pregnancy. These findings have implications for immune-mediated pregnancy complications, as well as for our general understanding of tissue-induced tolerance.
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