| 1. |
- Arvidsson, Daniel, et al.
(författare)
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Vigorous Physical Activity may be Important for the Insulin Sensitivity in Immigrants From the Middle East and Native Swedes
- 2015
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Ingår i: Journal of Physical Activity & Health. - : Human Kinetics. - 1543-3080 .- 1543-5474. ; 12:2, s. 273-281
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To compare physical activity measures and their associations with insulin sensitivity, beta-cell function and body mass index (BMI) between Iraqi immigrants and native Swedes. Methods: A cross-sectional study of 493 Iraqis (58% men) and 469 Swedes (54% men) aged 30 to 75 years living in the city of Malmo, Sweden. Accelerometry was used for physical activity measures (sedentary time, breaks in sedentary time, moderate and vigorous physical activity, total counts). Insulin sensitivity index and oral disposal index were determined from an oral glucose tolerance test and BMI by body weight and height. Results: Iraqi men were less physically active than Swedish men, while the physical activity was more similar in the women. BMI was a strong predictor of insulin sensitivity and beta-cell function and frequently associated with the physical activity measures. BMI modified the associations of insulin sensitivity and beta-cell function with the physical activity measures to such extent that only VPA and total counts show direct associations with insulin sensitivity in addition to the indirect associations via BMI. Iraqi women demonstrated weaker associations compared with Swedish women. Conclusions: Physical activity and performed at vigorous intensity may be important mainly for the insulin sensitivity in Iraqi immigrants and native Swedes.
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| 2. |
- van den Berg, Gerard, et al.
(författare)
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Mortality and the Business Cycle : Evidence from Individual and Aggregated Data
- 2017
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Ingår i: Journal of Health Economics. - : Elsevier BV. - 0167-6296 .- 1879-1646. ; 56, s. 61-70
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- There has been much interest recently in the relationship between economic conditions and mortality, with some studies showing that mortality is pro-cyclical, while others find the opposite. Some suggest that the aggregation level of analysis (e.g. individual vs. regional) matters. We use both individual and aggregated data on a sample of 20-64 year-old Swedish men from 1993 to 2007. Our results show that the association between the business cycle and mortality does not depend on the level of analysis: the sign and magnitude of the parameter estimates are similar at the individual level and the aggregate (county) level; both showing pro-cyclical mortality.
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| 3. |
- Crump, Casey, et al.
(författare)
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Exercise is medicine : Primary care counseling on aerobic fitness and muscle strengthening
- 2019
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Ingår i: Journal of the American Board of Family Medicine. - : American Board of Family Medicine (ABFM). - 1557-2625 .- 1558-7118. ; 32:1, s. 103-107
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Tidskriftsartikel (refereegranskat)abstract
- Patient counseling on physical fitness remains underutilized in primary care, despite its clinical and cost effectiveness. Most counseling interventions have focused on aerobic activity and neglected another vital component of physical fitness, muscle strengthening, which has recently been shown to be independently protective against cardiometabolic diseases and premature mortality. This article reviews the latest scientific evidence and makes recommendations toward a more comprehensive approach for promoting physical fitness in primary care. Given the high prevalence and wide-ranging health impacts of physical inactivity, counseling on physical fitness should be a standard part of wellness promotion and disease prevention and treatment for all patients. Interventions that include muscle strengthening will have a significantly greater impact on health outcomes than those focused on aerobic fitness alone. Counseling to promote both aerobic fitness and muscle strengthening is indicated for all patients, irrespective of body weight, and should begin early in life and continue across the life course.
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| 4. |
- Forsberg, Per Ola, et al.
(författare)
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Neighborhood socioeconomic characteristics and statin medication in patients with myocardial infarction : A Swedish nationwide follow-up study
- 2016
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Ingår i: BMC Cardiovascular Disorders. - : Springer Science and Business Media LLC. - 1471-2261. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Coronary heart disease (CHD) and myocardial infarction (MI) are associated with neighborhood-level socioeconomic status (SES). Statins are important drugs for secondary prevention of MI. However, no study has determined whether neighborhood-level SES is associated with statin medication in MI patients. We aimed to determine whether there is a difference in statin medication rate in MI patients across different levels of neighborhood SES. Methods: All patients in Sweden, diagnosed with incident MI from January 1st, 2000 until December 31st 2010, were followed (n = 116,840). Of these, 89.7 % received statin medication. Data were analyzed by multilevel logistic regression, with individual-level characteristics (age, marital status, family income, educational attainment, country of origin, urban/rural status and comorbidities/chronic conditions related to MI) as covariates. Results: Low neighborhood-level SES was significantly associated with low statin medication rate (Odds Ratio 0.80). In the full model, which took into account individual-level socioeconomic characteristics and MI comorbidities, the odds no longer remained significant. Conclusions: Individual-level approaches may be most important in health care policies regarding statin medication in MI patients.
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| 5. |
- Arvidsson, Daniel, et al.
(författare)
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Physical Activity and Concordance between Objective and Perceived Walkability.
- 2012
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Ingår i: Medicine & Science in Sports & Exercise. - 1530-0315. ; 44, s. 280-287
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE:: To investigate concordance between objective and perceived neighborhood walkability, their associations with self-reported walking and objective physical activity, and sociodemographic characteristics of individuals in neighborhoods with objectively assessed high walkability who misperceive it as low. METHODS:: In 1,925 individuals aged 20-66 years, recruited from administrative areas in the city of Stockholm, Sweden, of both high and low neighborhood walkability, objective neighborhood walkability was assessed within a 1,000m radius of each individual's residential address using Geographic Information Systems (GIS). Perceived walkability was based on the Neighborhood Environment Walkability Scale (NEWS). Walking was assessed using the International Physical Activity Questionnaire (IPAQ), and total physical activity and moderate-to-vigorous physical activity (MVPA) by an accelerometer (ActiGraph). Sociodemographic characteristics were self-reported. RESULTS:: Objective and perceived neighborhood walkability agreed in 67.0% of the individuals, with kappa=0.34 (95% CI: 0.30-0.38). One-third of the individuals in neighborhoods with objectively assessed high walkability misperceived it as low. This non-concordance was more common among older and married/cohabiting individuals. After adjustment for sociodemographic characteristics, high objective neighborhood walkability was associated with 35.0 (95% CI: 14.6-64.6) and 10.5 (95% CI: -5.2-28.5) more minutes/week of walking for transportation and leisure, respectively, and 2.8 (95% CI: 0.9-5.0) more minutes/day of MVPA. High perceived neighborhood walkability was associated with 41.5 (95% CI: 15.8-62.9) and 21.8 (95% CI: 2.8-40.0) more minutes/week of walking for transportation and leisure, respectively, and 1.7 (95% CI: -0.3-3.7) more minutes/day of MVPA. CONCLUSIONS:: Objective and perceived neighborhood walkability both contribute to the amount of walking and objective physical activity. Both measures of neighborhood walkability may be important factors to target in interventions aiming at increasing physical activity.
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| 6. |
- Ohlsson, Henrik, et al.
(författare)
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Performance Evaluations and League Tables: Do They Capture Variation Between Organizational Units? An Analysis of 5 Swedish Pharmacological Performance Indicators.
- 2011
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Ingår i: Medical Care. - 1537-1948. ; 49:3, s. 327-331
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:: The use of league tables during the last decade has frequently been employed to assess quality in health care. However, few studies have attempted to assess quality by quantifying the variability across the organizational units or attempted to investigate whether the units are the correct context that really influences the outcome under study. OBJECTIVES:: To quantify the variation between different organizational units regarding 5 different Swedish national pharmacological performance indicators and to examine whether the organizational units under study are a valid construct of the context that influences the specific outcome. RESEARCH DESIGN:: A multilevel model with patients nested within health care units that in turn were nested within County councils was used. By using measures of variance (intraclass correlation [ICC]), we quantified the extent to which the 5 indicators of health care quality were conditioned by the specified units. RESULTS:: For all 5 studied indicators, the variation between county councils was small (ICC ranged from 2% to 7%), whereas the variation among health care units seemed to be more important (ICC ranged from 20% to 40%). CONCLUSION:: As the variation between county councils was small, using league tables for performance evaluation seems to be inappropriate. If league tables are to be presented, the relative size of the variation at the higher levels and an analysis regarding the possible influence of the context for the specific outcome should be included. This approach provides useful information for identifying relevant contexts to capture health care variation.
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| 7. |
- Oudin Åström, Daniel, et al.
(författare)
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Heat wave-related mortality in Sweden : a case-crossover study investigating effect modification by neighbourhood deprivation
- 2020
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Ingår i: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 48:4, s. 428-435
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: The present study aimed to investigate if set thresholds in the Swedish heat-wave warning system are valid for all parts of Sweden and if the heat-wave warning system captures a potential increase in all-cause mortality and coronary heart disease (CHD) mortality. An additional aim was to investigate whether neighbourhood deprivation modifies the relationship between heat waves and mortality.METHODS: From 1990 until 2014, in 14 municipalities in Sweden, we collected data on daily maximum temperatures and mortality for the five warmest months. Heat waves were defined according to the categories used in the current Swedish heat-wave warning system. Using a case-crossover approach, we investigated the association between heat waves and mortality in Sweden, as well as a modifying effect of neighbourhood deprivation.RESULTS: On a national as well as a regional level, heat waves significantly increased both all-cause mortality and CHD mortality by approximately 10% and 15%, respectively. While neighbourhood deprivation did not seem to modify heat wave-related all-cause mortality, CHD mortality did seem to modify the risk.CONCLUSIONS: It may not be appropriate to assume that heat waves in Sweden will have the same impact in a northern setting as in a southern, or that the impact of heat waves will be the same in affluent and deprived neighbourhoods. When designing and implementing heat-wave warning systems, neighbourhood, regional and national information should be incorporated.
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| 8. |
- Crump, Casey, et al.
(författare)
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Interactive Effects of Aerobic Fitness, Strength, and Obesity on Mortality in Men
- 2017
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Ingår i: American Journal of Preventive Medicine. - : Elsevier BV. - 0749-3797. ; 52:3, s. 353-361
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Low aerobic fitness, low muscular strength, and obesity have been associated with premature mortality, but their interactive effects are unknown. This study examined interactions among these common, modifiable factors, to help inform more-effective preventive interventions. Methods: This national cohort study included all 1,547,478 military conscripts in Sweden during 1969-1997 (97%-98% of all men aged 18 years each year). Aerobic fitness, muscular strength, and BMI measurements were examined in relation to all-cause and cardiovascular mortality through 2012 (maximum age, 62 years). Data were collected/analyzed in 2015-2016. Results: Low aerobic fitness, low muscular strength, and obesity at age 18 years were independently associated with higher all-cause and cardiovascular mortality in adulthood. The combination of low aerobic fitness and muscular strength (lowest versus highest tertiles) was associated with twofold all-cause mortality (adjusted hazard ratio=2.01; 95% CI=1.93, 2.08;. p<0.001; mortality rates per 100,000 person years, 247.2 vs 73.8), and 2.6-fold cardiovascular mortality (2.63; 95% CI=2.38, 2.91;. p<0.001; 43.9 vs 8.3). These factors also had positive additive and multiplicative interactions in relation to all-cause mortality (their combined effect exceeded the sum or product of their separate effects;. p<0.001), and were associated with higher mortality even among men with normal BMI. Conclusions: Low aerobic fitness, low muscular strength, and obesity at age 18 years were associated with increased mortality in adulthood, with interactive effects between aerobic fitness and muscular strength. Preventive interventions should begin early in life and include both aerobic fitness and muscular strength, even among those with normal BMI.
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| 9. |
- Kendler, Kenneth S., et al.
(författare)
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Parent-offspring transmission of drug abuse and alcohol use disorder : Application of the multiple parenting relationships design
- 2019
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Ingår i: American Journal of Medical Genetics, Part B: Neuropsychiatric Genetics. - : Wiley. - 1552-4841 .- 1552-485X. ; 180:4, s. 249-257
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Tidskriftsartikel (refereegranskat)abstract
- With complete genealogical and cohabitation information, new genetic-epidemiological designs can be developed to clarify causes of parent-offspring transmission. We propose the Multiple Parenting Relationships (MPR) Design and apply it to drug abuse (DA) and alcohol use disorder (AUD). Using national Swedish registries, we identified four kinds of informative parents with multiple children with whom they had different genetic and/or rearing relationships. These types had children for whom they provided: (a) genes (G) plus rearing (R), G only and R only; (b) G + R and G only; (c) G only and R only; and (d) G + R and R only. We identified DA and AUD cases from national registries in over 475,000 informative parent-offspring pairs. Controlling for parental resemblance for DA or AUD, all estimates were statistically homogeneous across family types. The weighted average tetrachoric correlation (SE) for DA for G + R, R only and G only relationships were, respectively, +0.21 (0.01), +0.10 (0.02), and +0.16 (0.02). Parallel results for AUD were +0.16 (0.01), +0.04 (0.02), and +0.14 (0.01). Analyses within families with affected parents showed significantly higher disorder risks in offspring with a G + R versus an R only relationship. The MPR design is complementary to other methods, especially adoption and triparental designs, in clarifying the sources of cross-generational transmission. Consistent with results from these other designs applied to the Swedish population, we find that for DA and AUD, parent-offspring resemblance was strongest for G + R relationships, intermediate for G only relationships and weakest but significant for R only relationships.
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| 10. |
- Kerstis, Birgitta, 1963-, et al.
(författare)
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The association between perceived relationship discord at childbirth and parental postpartum depressive symptoms: a comparison of mothers and fathers in Sweden
- 2012
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Ingår i: Uppsala Journal of Medical Sciences. - : Uppsala Medical Society. - 0300-9734 .- 2000-1967 .- 0300-9726. ; 117:4, s. 430-438
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Tidskriftsartikel (refereegranskat)abstract
- Aim. To examine whether mothers' and fathers' levels of perceived relationship discord at childbirth were associated with postpartum depressive symptoms when the child was 3 months old. Another aim was to examine parents' levels of self-reported depressive symptoms. The hypothesis was that parents with high levels of perceived relationship discord have higher levels of postpartum depressive symptoms than parents with low levels of perceived relationship discord. Method. One week after childbirth, 305 couples' perceived level of relationship discord was measured using the Dyadic Consensus Subscale (DCS) of the Dyadic Adjustment Scale (DAS). At 3 months postpartum, the same couples answered the Edinburgh Postnatal Depression Scale (EPDS) questionnaire. The relations between perceived level of relationship discord and postpartum depressive symptoms were analysed using standard non-parametric statistical methods. Results. The mothers and fathers partly differed regarding which areas of their relationship they perceived that they disagreed with their partners about. Furthermore, 16.5% of the mothers and 8.7% of the fathers reported postpartum depressive symptoms, and there was a moderate level of correlation between the DCS and EPDS scores. Conclusion. These results may be useful for professionals in antenatal care and child health centres as well as for family caregivers who need to be aware that mothers and fathers may have different views on relationship discord and of the high level of depressive symptoms in recent parents. Further research is needed to examine perceived relationship discord and the development of depressive symptoms postpartum over a longer term.
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