| 211. |
- Kanis, J A, et al.
(författare)
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Previous fracture and subsequent fracture risk: a meta-analysis to update FRAX.
- 2023
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Ingår i: Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. - : Springer Nature. - 1433-2965 .- 0937-941X. ; 34:12, s. 2027-2045
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Tidskriftsartikel (refereegranskat)abstract
- A large international meta-analysis using primary data from 64 cohorts has quantified the increased risk of fracture associated with a previous history of fracture for future use in FRAX.The aim of this study was to quantify the fracture risk associated with a prior fracture on an international basis and to explore the relationship of this risk with age, sex, time since baseline and bone mineral density (BMD).We studied 665,971 men and 1,438,535 women from 64 cohorts in 32 countries followed for a total of 19.5 million person-years. The effect of a prior history of fracture on the risk of any clinical fracture, any osteoporotic fracture, major osteoporotic fracture, and hip fracture alone was examined using an extended Poisson model in each cohort. Covariates examined were age, sex, BMD, and duration of follow-up. The results of the different studies were merged by using the weighted β-coefficients.A previous fracture history, compared with individuals without a prior fracture, was associated with a significantly increased risk of any clinical fracture (hazard ratio, HR = 1.88; 95% CI = 1.72-2.07). The risk ratio was similar for the outcome of osteoporotic fracture (HR = 1.87; 95% CI = 1.69-2.07), major osteoporotic fracture (HR = 1.83; 95% CI = 1.63-2.06), or for hip fracture (HR = 1.82; 95% CI = 1.62-2.06). There was no significant difference in risk ratio between men and women. Subsequent fracture risk was marginally downward adjusted when account was taken of BMD. Low BMD explained a minority of the risk for any clinical fracture (14%), osteoporotic fracture (17%), and for hip fracture (33%). The risk ratio for all fracture outcomes related to prior fracture decreased significantly with adjustment for age and time since baseline examination.A previous history of fracture confers an increased risk of fracture of substantial importance beyond that explained by BMD. The effect is similar in men and women. Its quantitation on an international basis permits the more accurate use of this risk factor in case finding strategies.
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| 212. |
- Karlström, Annika, et al.
(författare)
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Maternal and infant outcome after caesarean section without recorded medical indication: findings from a Swedish casecontrol study
- 2013
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Ingår i: Bjog-an International Journal of Obstetrics and Gynaecology. - : Wiley. - 1470-0328 .- 1471-0528. ; 120:4, s. 479-486
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To compare maternal complications and infant outcomes for women undergoing elective caesarean sections based on a maternal request and without recorded medical indication with those of women who underwent spontaneous onset of labour with the intention to have a vaginal birth. DESIGN: Retrospective register study. SETTING: Sweden; Medical Birth Register used for data collection. METHODS: A case-control study of 5877 birth records of women undergoing caesarean sections without medical indication and a control group of 13 774 women undergoing births through spontaneous onset of labour. The control group was further divided into women who actually had a vaginal birth and women who ended up with an emergency caesarean section. RESULTS: Maternal complications occurred more frequently among women undergoing caesarean section with odds ratios (OR) for bleeding complications of 2.5 (95% CI 2.1-3.0) in the elective caesarean group and 2.0 (95% CI 1.5-2.6) in the emergency caesarean group. The OR for infections was 2.6 in both groups. Breastfeeding complications were most common in women having an elective caesarean section: 6.8 (95% CI 3.2-14.5). Infant outcomes showed a higher incidence of respiratory distress with an OR of 2.7 (95% CI 1.8-3.9) in the elective caesarean section group compared with infants born by emergency caesarean section. The risk of hypoglycaemia was at least twice as high for infants in the caesarean group. CONCLUSIONS: Caesarean sections without medical indication as well as emergency caesarean sections were associated with higher risks for maternal and infant morbidity.
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| 213. |
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| 214. |
- Kivimäki, Mika, et al.
(författare)
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Cognitive stimulation in the workplace, plasma proteins, and risk of dementia : three analyses of population cohort studies
- 2021
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Ingår i: The BMJ. - : BMJ Publishing Group Ltd. - 1756-1833. ; 374
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To examine the association between cognitively stimulating work and subsequent risk of dementia and to identify protein pathways for this association.DESIGN: Multicohort study with three sets of analyses.SETTING: United Kingdom, Europe, and the United States.PARTICIPANTS: Three associations were examined: cognitive stimulation and dementia risk in 107 896 participants from seven population based prospective cohort studies from the IPD-Work consortium (individual participant data meta-analysis in working populations); cognitive stimulation and proteins in a random sample of 2261 participants from one cohort study; and proteins and dementia risk in 13 656 participants from two cohort studies.MAIN OUTCOME MEASURES: Cognitive stimulation was measured at baseline using standard questionnaire instruments on active versus passive jobs and at baseline and over time using a job exposure matrix indicator. 4953 proteins in plasma samples were scanned. Follow-up of incident dementia varied between 13.7 to 30.1 years depending on the cohort. People with dementia were identified through linked electronic health records and repeated clinical examinations.RESULTS: During 1.8 million person years at risk, 1143 people with dementia were recorded. The risk of dementia was found to be lower for participants with high compared with low cognitive stimulation at work (crude incidence of dementia per 10 000 person years 4.8 in the high stimulation group and 7.3 in the low stimulation group, age and sex adjusted hazard ratio 0.77, 95% confidence interval 0.65 to 0.92, heterogeneity in cohort specific estimates I2=0%, P=0.99). This association was robust to additional adjustment for education, risk factors for dementia in adulthood (smoking, heavy alcohol consumption, physical inactivity, job strain, obesity, hypertension, and prevalent diabetes at baseline), and cardiometabolic diseases (diabetes, coronary heart disease, stroke) before dementia diagnosis (fully adjusted hazard ratio 0.82, 95% confidence interval 0.68 to 0.98). The risk of dementia was also observed during the first 10 years of follow-up (hazard ratio 0.60, 95% confidence interval 0.37 to 0.95) and from year 10 onwards (0.79, 0.66 to 0.95) and replicated using a repeated job exposure matrix indicator of cognitive stimulation (hazard ratio per 1 standard deviation increase 0.77, 95% confidence interval 0.69 to 0.86). In analysis controlling for multiple testing, higher cognitive stimulation at work was associated with lower levels of proteins that inhibit central nervous system axonogenesis and synaptogenesis: slit homologue 2 (SLIT2, fully adjusted β -0.34, P<0.001), carbohydrate sulfotransferase 12 (CHSTC, fully adjusted β -0.33, P<0.001), and peptidyl-glycine α-amidating monooxygenase (AMD, fully adjusted β -0.32, P<0.001). These proteins were associated with increased dementia risk, with the fully adjusted hazard ratio per 1 SD being 1.16 (95% confidence interval 1.05 to 1.28) for SLIT2, 1.13 (1.00 to 1.27) for CHSTC, and 1.04 (0.97 to 1.13) for AMD.CONCLUSIONS: The risk of dementia in old age was found to be lower in people with cognitively stimulating jobs than in those with non-stimulating jobs. The findings that cognitive stimulation is associated with lower levels of plasma proteins that potentially inhibit axonogenesis and synaptogenesis and increase the risk of dementia might provide clues to underlying biological mechanisms.
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| 215. |
- Kärrholm, Johan, 1951, et al.
(författare)
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Effects on work resumption of a co-operation project in vocational rehabilitation. Systematic, multi-professional, client-centred and solution-oriented co-operation
- 2006
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Ingår i: Disabil Rehabil. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 28:7, s. 457-67
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The present aim was to evaluate the effect of systematic multi-professional co-ordinated rehabilitation (the Stockholm Co-operation Project) on the number of days' sick leave during the first and second half-years after the rehabilitation co-ordination period, compared to the year before. Another aim was to evaluate the economic effects at national level. METHOD: A matched-pairs design was used. The study group was based on 64 rehabilitees employed by a public employer in Stockholm, who took part in a systematic multi-professional co-operation project. To obtain pairs, the 64 individuals were individually matched with 64 people who received conventionally organised rehabilitation. Thus, there were 128 subjects altogether. RESULTS: The study group had substantially less sick leave days per month than the comparison group during the second half-year after the rehabilitation co-ordination period. The effect was even greater in a subgroup with more previous sick leave. During the first half-year after the intervention the comparison group had relatively more sick leave. No effect was found for a subgroup with less previous sick leave. The economic benefit of the intervention was estimated to 1,278 euros per month and person based on the whole group, and to 2,405 euros per month and person based on those with more sick leave. CONCLUSIONS: People who undergo co-ordinated rehabilitation have more working days after the intervention period than those with conventional rehabilitation. This way for rehabilitation actors to co-operate gives better outcomes for rehabilitation cases with long previous sick leave, but not for cases with less previous sick leave. It also generates economic gains at several levels.
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| 216. |
- Landstedt, Evelina, et al.
(författare)
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Bullying, cyberbullying, and mental health in young people
- 2014
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 42:4, s. 393-399
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the factors associated with exposure to in-real-life (IRL) bullying, cyberbullying, and both IRL and cyberbullying and to explore the relationship between these types of bullying and mental health among 13-16-year-old Swedish boys and girls. Methods: Data was derived from a cross-sectional web-based study of 13-16-year-old students in northern Sweden (n=1214, response rate 81.9%). Results: The combination of IRL- and cyberbullying was the most common type of bullying. A non-supportive school environment and poor body image were related to exposure to bullying for both genders but the relationship was more distinct in girls. All types of bullying were associated with depressive symptoms in both boys and girls and all forms of bullying increased the likelihood of psychosomatic problems in girls. Conclusions: Cyberbullying can be seen as an extension of IRL bullying. A combination of IRL- and cyberbullying seems to be particularly negative for mental health. Interventions should focus on improved school environment and body image as well as anti-violence programmes. Gender aspects of bullying need to be acknowledged.
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| 217. |
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| 218. |
- Larsson, Simon, 1982, et al.
(författare)
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Anarchy in the Game of Thrones
- 2020
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Ingår i: Neohelicon. - : Springer Science and Business Media LLC. - 0324-4652 .- 1588-2810. ; 47:117-129
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Tidskriftsartikel (refereegranskat)abstract
- © 2020, The Author(s). Recent scholarship has come to rethink how the concept of anarchy captures the fragmented plurality of contemporary world politics. This article continues that inquiry through an interpretative reading of the popular TV-series Game of Thrones. The appeal of this show partly derives from its animation of medieval tropes to interpellate with contemporary global politics; it echoes power struggles constitutive of today’s international relations. However, while the fantasy show portrays conflictual relations between different claimants of the Iron Throne in Westeros, it also composes subaltern voices amidst these violent claims to power. This article concludes that such an interpretation diversifies the meanings of anarchy, as both violence and freedom, in the ‘game of thrones’ of contemporary politics.
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| 219. |
- Laven, Daniel, 1973, et al.
(författare)
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From Models to Management: Lessons learned from evaluating U.S. National Heritage Landscapes
- 2011
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Ingår i: 10th Nordic Environmental Social Science Conference, Stockholm 14-16 juni 2011.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- In many parts of the world there is a growing interest in how to manage, protect and develop landscapes as evidenced by the advancement of the European Landscape Convention (ELC) during the last decade. In Sweden, the ELC was recently ratified and decision makers have now turned their attention to implementing the Convention. The ELC underlines the importance of local perspectives and democratic processes to successful and sustainable landscape management. This paper will present experiences from a landscape-scale management and governance program in the United States, and discuss if and how these experiences may inform the ELC process currently underway in Sweden. U.S. National Heritage Areas (NHAs) are one of the oldest and most well-established federal landscape scale programs in the United States. NHAs operate through partnerships with the U.S. National Park Service (NPS), local communities, private and third sector organizations, as well as other governmental agencies and seek to integrate resource conservation with social and economic objectives. Previous research on NHAs reveals the importance of heritage as a discourse tool, inter-sectoral networks and network governance, and entrepreneurial approaches to managing and decision-making. Despite important differences between the NHA environment and the ELC, the NHA experience may be sufficiently similar to the ELC such that thoughtful treatment of these issues will be necessary for successful implementation efforts. We conclude by offering our perspectives on future research.
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| 220. |
- Laven, Daniel, 1973, et al.
(författare)
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Landskap för friluftsliv? En diskussion av forskningserfarenheter från USA och Sverige, i relation till den Europeiska Landskapskonventionen
- 2011
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Ingår i: Friluftsforskning 2011, 9-10 november 2011, Umeå.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Att landskapet är en viktig resurs för friluftslivet är ingen nyhet. Under senare år har dock landskapets betydelse kommit att diskuteras på nya sätt och i nya sammanhang, såväl bland forskare som inom offentlig förvaltning. Den Europeiska Landskapskonventionen, som Sverige i år har anslutit sig till, slår fast att landskap av alla slag har betydelse för människors livskvalitet. Här omfattas både stadens och landsbygdens landskap, allt från erkänt vackra och välvårdade landskap till hårt exploaterade eller skräpiga och bortglömda landskap. Konventionen utgår i hög grad från människors perspektiv och definierar landskap som ”ett område sådant som det uppfattas av människor”. Mot bakgrund av de nya utmaningar som landskapskonventionen erbjuder, diskuterar här två forskare sina erfarenheter av landskapsforskning från skilda vetenskapliga och geografiska utgångspunkter. Daniel Laven har studerat skydd, förvaltning och utveckling av landskapet i ett antal National Heritage Areas i USA, medan Katarina Saltzman belyst människors relationer till natur och landskap i Sverige ur ett etnologiskt perspektiv. Båda har i sin forskning diskuterat landskap som en resurs för många olika intressen och aktiviteter, bland annat för turism och friluftsliv. Denna presentation hålls delvis på svenska, delvis på engelska.
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