| 1. |
- Brew, Bronwyn K., et al.
(författare)
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Using fathers as a negative control exposure to test the Developmental Origins of Health and Disease Hypothesis : A case study on maternal distress and offspring asthma using Swedish register data
- 2017
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Ingår i: Scandinavian Journal of Public Health. - Stockholm : Sage Publications. - 1403-4948 .- 1651-1905. ; 45:17, s. 36-40
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Tidskriftsartikel (refereegranskat)abstract
- Background: Developmental Origins of Health and Disease Hypothesis (DOHaD) studies are often observational in nature and are therefore prone to biases from loss to follow-up and unmeasured confounding. Register-based studies can reduce these issues since they allow almost complete follow-up and provide information on fathers that can be used in a negative control analysis to assess the impact of unmeasured confounding.Aim: The aim of this study was to propose a causal model for testing DOHaD using paternal exposure as a negative control, and its application to maternal distress in pregnancy and offspring asthma.Methods: A causal diagram including shared and parent-specific measured and unmeasured confounders for maternal (fetal) and paternal exposures is proposed. The case study consisted of all children born in Sweden from July 2006 to December 2008 (n=254,150). Information about childhood asthma, parental distress and covariates was obtained from the Swedish national health registers. Associations between maternal and paternal distress during pregnancy and offspring asthma at age five years were assessed separately and with mutual adjustment for the other parent's distress measure, as well as for shared confounders.Results: Maternal distress during pregnancy was associated with offspring asthma risk; mutually adjusted odds ratio (OR) (OR 1.32, 95% CI 1.23, 1.43). The mutually adjusted paternal distress-offspring asthma analysis (OR 1.05, 95% CI 0.97, 1.13) indicated no evidence for unmeasured confounding shared by the mother and father.Conclusions: Using paternal exposure in a negative control model to test the robustness of fetal programming hypotheses can be a relatively simple extension of conventional observational studies but limitations need to be considered.
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| 2. |
- Maret-Ouda, John, et al.
(författare)
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Nordic registry-based cohort studies : possibilities and pitfalls when combining Nordic registry data
- 2017
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Ingår i: Scandinavian Journal of Public Health. - Stockholm : Karolinska Institutet, Dept of Molecular Medicine and Surgery. - 1403-4948 .- 1651-1905.
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Tidskriftsartikel (refereegranskat)abstract
- Aims: All five Nordic countries (Denmark, Finland, Iceland, Norway, and Sweden) have nationwide registries with similar data structure and validity, as well as personal identity numbers enabling linkage between registries. These resources provide opportunities for medical research that is based on large registry-based cohort studies with long and complete follow-up. This review describes practical aspects, opportunities, and challenges encountered when setting up all-Nordic registry-based cohort studies. Methods: Relevant articles describing registries often used for medical research in the Nordic countries were retrieved. Further, our experiences of conducting this type of study, including planning, acquiring permissions, data retrieval, and data cleaning and handling, and the possibilities and challenges we have encountered, are described. Results: Combining data from the Nordic countries makes it possible to create large and powerful cohorts. The main challenges include obtaining all permissions within each country, usually in the local language, and to retrieve the data. These challenges emphasise the importance of having experienced collaborators within each country. Following the acquisition of data, data management requires the understanding of differences between the variables to be used in the various countries. A concern is the long time required between initiation and completion. Conclusions: Nationwide Nordic registries can be combined into cohorts with high validity and statistical power, but the considerable expertise, workload, and time required to complete such cohorts should not be underestimated.
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| 3. |
- Aili, Katarina, 1980-, et al.
(författare)
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Sleep disturbances predict future sickness absence among individuals with lower back or neck-shoulder pain : A 5-year prospective study
- 2015
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Ingår i: Scandinavian Journal of Public Health. - London : SAGE Publications. - 1403-4948 .- 1651-1905. ; 43:3, s. 315-323
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Tidskriftsartikel (refereegranskat)abstract
- Background: Musculoskeletal pain is one of the most common causes of sickness absence. Sleep disturbances are often co-occurring with pain, but the relationship between sleep and pain is complex. Little is known about the importance of self-reported sleep, when predicting sickness absence among persons with musculoskeletal pain. This study aims to study the association between self-reported sleep quality and sickness absence 5 years later, among individuals stratified by presence of lower back pain (LBP) and neck and shoulder pain (NSP). Methods: The cohort (n = 2286) in this 5-year prospective study (using data from the MUSIC-Norrtalje study) was stratified by self-reported pain into three groups: no LBP or NSP, solely LBP or NSP, and oncurrent LBP and NSP. Odds ratios (ORs) for the effect of self-reported sleep disturbances at baseline on sickness absence (> 14 consecutive days), 5 years later, were calculated. Results: Within all three pain strata, individuals reporting the most sleep problems showed a significantly higher OR for all-cause sickness absence, 5 years later. The group with the most pronounced sleep problems within the concurrent LBP and NSP stratum had a significantly higher OR (OR 2.00; CI 1.09-3.67) also for long-term sickness absence (> 90days) 5 years later, compared to the group with the best sleep. Conclusions: Sleep disturbances predict sickness absence among individuals regardless of co-existing features of LBP and/or NSP. The clinical evaluation of patients should take possible sleep disturbances into account in the planning of treatments.
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| 4. |
- Albrecht, Sophie, et al.
(författare)
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Investigating the factorial structure and availability of work time control in a representative sample of the Swedish working population
- 2016
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 44:3, s. 320-328
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Past research has often neglected the sub-dimensions of work time control (WTC). Moreover, differences in levels of WTC with respect to work and demographic characteristics have not yet been examined in a representative sample. We investigated these matters in a recent sample of the Swedish working population. Methods: The study was based on the 2014 data collection of the Swedish Longitudinal Occupational Survey of Health. We assessed the structure of the WTC measure using exploratory and confirmatory factor analysis. Differences in WTC by work and demographic characteristics were examined with independent sample t-tests, one-way ANOVAs and gender-stratified logistic regressions. Results: Best model fit was found for a two-factor structure that distinguished between control over daily hours and control over time off (root mean square error of approximation = 0.06; 95% CI 0.04 to 0.09; Comparative Fit Index (CFI) = 0.99). Women, shift and public-sector workers reported lower control in relation to both factors. Age showed small associations with WTC, while a stronger link was suggested for civil status and family situation. Night, roster and rotating shift work seemed to be the most influential factors on reporting low control over daily hours and time off. Conclusions: Our data confirm the two-dimensional structure underlying WTC, namely the components 'control over daily hours' and 'control over time off'. Women, public-sector and shift workers reported lower levels of control. Future research should examine the public health implications of WTC, in particular whether increased control over daily hours and time off can reduce health problems associated with difficult working-time arrangements.
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| 5. |
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| 6. |
- Andersen, Lars L, et al.
(författare)
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Effect of physical exercise on workplace social capital: cluster randomized controlled trial
- 2015
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 43:8, s. 810-818
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Tidskriftsartikel (refereegranskat)abstract
- While workplace health promotion with group-based physical exercise can improve workers' physical health, less is known about potential carry-over effects to psychosocial factors. This study investigates the effect of physical exercise on social capital at work.
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| 7. |
- Andersén, Åsa, 1975-, et al.
(författare)
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The relationship between self-efficacy and transition to work or studies in young adults with disabilities
- 2018
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Ingår i: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 46:2, s. 272-278
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To investigate perceived self-efficacy in unemployed young adults with disabilities and the association between self-efficacy and transition to work or studies. Methods: This prospective cohort study collected data through self-report questionnaires and registry data from a vocational rehabilitation project with young adults, aged 19-29 years. The Swedish Social Insurance Agency, the Swedish Public Employment Service and the participating municipalities identified potential participants to the study. A total of 531 participants were included in the study, of which 249 (47%) were available for analysis. Multinomial logistic regression models were carried out to estimate the associations between self-efficacy, demographic, health and employment status. The latter was coded as: “no transition to work or studies”, “transition to studies”, and “transition to work”.Results: A higher level of self-efficacy was associated with increased odds for “transition to work” (OR=2.37, p<0.05). This finding remained consistent when adjusting for possible confounders. The mean value of self-efficacy was low, and participants with lower self-efficacy reported worse self-rated health (p<0.001) compared with participants with higher self-efficacy.Conclusions: The results from this study suggest that self-efficacy should be addressed in vocational rehabilitation of young adults with disabilities in order to support their transition and integration into the labour market.
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| 8. |
- Andersson, Helen, et al.
(författare)
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The outcome of two-step blood pressure screening in dental healthcare
- 2018
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 46:6, s. 623-629
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The purpose of this study was to evaluate a two-step screening method for hypertension in dentistry regarding the number needed to screen (NNS) and positive predictive value (PPV) and to risk-classify those with newly diagnosed hypertension. Methods: In connection with their regular dental care check-up, 2025 subjects aged 40-75 years were screened for high blood pressure. Via a health questionnaire, data were collected concerning risk factors. Blood pressure was screened comprehensively in two steps, which included screening in a dental clinic and home measurements for one week. Recently discovered hypertensive participants were assessed for 10-year risk of cardiovascular mortality according to the guidelines of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC). Results: A total of 170 new hypertensive participants were found (NNS = 12; 95% confidence interval (CI): 11-13). The method yielded a PPV of 0.73 (95% CI: 0.68-0.78) and eliminated 84.8% of the false-positive participants. The results also showed that based on ESH/ESC risk estimation, 76.5% of those newly diagnosed hypertensive participants had a moderate or high risk of cardiovascular mortality within 10 years. Conclusions: The study shows that a two-step method for blood pressure screening in a dental setting including home measurement resulted in a high PPV and eliminated most of those with a false high blood pressure reading. The findings also show that two-step screening for hypertension is feasible in a larger population with more screening providers involved.
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| 9. |
- Araghi, Marzieh, et al.
(författare)
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Smokeless tobacco (snus) use and colorectal cancer incidence and survival : Results from nine pooled cohorts
- 2017
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 45:8, s. 741-748
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: Although smoking is considered to be an established risk factor for colorectal cancer, the current evidence on the association between smokeless tobacco and colorectal cancer is scant and inconclusive. We used pooled individual data from the Swedish Collaboration on Health Effects of Snus Use to assess this association.METHODS: A total of 417,872 male participants from nine cohort studies across Sweden were followed up for incidence of colorectal cancer and death. Outcomes were ascertained through linkage to health registers. We used shared frailty models with random effects at the study level to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).RESULTS: During 7,135,504 person-years of observation, 4170 men developed colorectal cancer. There was no clear association between snus use and colorectal cancer overall. Exclusive current snus users, however, had an increased risk of rectal cancer (HR 1.40: 95% CI 1.09, 1.79). There were no statistically significant associations between snus use and either all-cause or colorectal cancer-specific mortality after colorectal cancer diagnosis.CONCLUSIONS: Our findings, from a large sample, do not support any strong relationships between snus use and colorectal cancer risk and survival among men. However, the observed increased risk of rectal cancer is noteworthy, and in merit of further attention.
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| 10. |
- Aronsson, Mattias, et al.
(författare)
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Differences between hypothetical and experience-based value sets for EQ-5D used in Sweden: Implications for decision makers
- 2015
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Ingår i: Scandinavian Journal of Public Health. - : SAGE PUBLICATIONS LTD. - 1403-4948 .- 1651-1905. ; 43:8, s. 848-854
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Tidskriftsartikel (refereegranskat)abstract
- Aims: A number of value sets are available today for converting EQ-5D questionnaire responses to quality-adjusted life year-weights used in health economic evaluations. The aim of this study is to analyse the differences between the commonly used hypothetical UK value set and the newly introduced Swedish experience-based value set and to evaluate health economic implications of such differences on policy decisions. Methods: Differences between the two value sets were studied using two methods: a comparison of health states and improvements as well as an empirical comparison. In the comparison of health states and improvements, the valuations of all EQ-5D states and all pure improvements were compared. In the empirical study, a database of 23,925 individuals was used to identify patient groups that could be affected by the implementation of the Swedish experience-based value set. Results: The comparison of health states and possible improvements showed that only three health states were assigned a lower quality-adjusted life year-weight and most improvements were given smaller absolute values if the experience-based value set was used. The empirical comparison showed that severe conditions were assigned higher values when using the experience-based value set. Conclusions: The Swedish experience-based value set seems to render a higher estimated level of health-related quality of life in virtually all health conditions compared to the hypothetical UK value set. In extension, health-related quality of life enhancing interventions are likely to be given higher priority in decision-making situations where hypothetical values are used to construct quality-adjusted life year-weights. In situations where experience-based quality-adjusted life year-weights are used, life-prolonging interventions would be prioritised.
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