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- Mishra, A, et al.
(författare)
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Diminishing benefits of urban living for children and adolescents' growth and development
- 2023
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Ingår i: Nature. - : Springer Science and Business Media LLC. - 1476-4687 .- 0028-0836. ; 615:7954, s. 874-883
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Tidskriftsartikel (refereegranskat)abstract
- Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified.
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- Djukanovic, Ingrid
(författare)
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Depression in late life-prevalence and preventive intervention
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- BackgroundDepression in older people often goes undetected but has severe consequences on physical health, functioning and quality of life. As the aging population is growing, mental ill-health already is and will continue to be an important public health problem. There is a need for adequate strategies to meet this challenge.Aims(1) To investigate the prevalence of and the association between depressive symptoms and loneliness in relation to age and sex in a random Swedish sample in the age group 65-80 years, and to investigate to what extent those scoring ≥ 8 in the depression dimension of the Hospital Anxiety and Depression Scale (HAD) had visited health care professionals and/ or used antidepressive medication.(2) To evaluate the effect of group discussions, in which structured reminiscence and a Problem Based Method (PBM) were used, on depressive symptoms, Quality of Life (QoL) and Self-Rated Health (SRH) among older people.(3) To describe the individual´s experiences of the year before and the time after retirement.(4) To evaluate the factorial structure of the HAD in a general older population 65-80 years and to examine the possible presence of differential item functioning (DIF) related to sex.ResultMore men than women reported depressive symptoms, few were offered psychological treatment and a quarter used antidepressant medication. Depressive symptoms were associated with loneliness and this association decreased with increasing age. Participation in group discussions resulted in a decrease in depressive symptoms and an increase in QoL and SRH. Both expectations and fears were experienced the year before and the time after retirement.The psychometric evaluation of the HAD showed a two-factorial structure and invariance regarding sex.ConclusionThe result highlights the importance of detecting depressive symptoms and loneliness in older people and offer adequate treatment. Transition into retirement should receive more attention both from a health care and organizational perspective. Group discussions with structured reminiscence and PBM as a nursing intervention, seem to be a promising method to prevent depressive symptoms in older people, but further research is needed. The HAD can be recommended to assess anxiety and depression among a general population 65-80 years old.
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- Emilsson, Louise, 1982-
(författare)
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Cardiac complications in celiac disease
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Celiac disease (CD) is an immune-mediated enteropathy induced by dietary gluten that affects about 1% of western populations. CD has been associated to an increased risk of cardiovascular mortality in some studies; however associations to cardiovascular diseases have not been broadly researched.Aim: The aim of this thesis was to examine the associations between CD and some cardiovascular diseases, namely; atrial fibrialltion, dilated cardiomyopathy and risk factors of ischemic heart disease.Methods: We used computerized data on all Swedish patients with biopsy-verified CD equal to villous atrophy from 1969 to 31st of December 2008. All CD patients were matched on age, sex, county and calendar year with up to five reference individuals. Altogether we had data on 29,096 CD patients and 144,522 reference individuals. Data were linked to different Swedish national registries and the Swedish quality and cardiac care registry SWEDEHEART. Main outcomes in the studies were: I: atrial fibrillation registered in the national patient registry or the cause of death registry, II: chart validated idiopathic dilated cardiomyopathy, III: different risk factors, clinical presentation and parameters in patients with first myocardial infarction (MI) registered in SWEDEHEART and IV: follow-up parameters, 6-10 weeks and one year after MI, registered in SWEDEHEART.Result: We showed a 34% increased risk of atrial fibrillation in CD and a 73% increased risk of dilated cardiomyopathy, the latter only of borderline significance, p=0.052. In the third study we showed that CD patients with MI had a more beneficial cardiovascular risk factor profile, better left ventricular ejection fraction and fewer stenoses on coronary angiography compared to reference individuals with MI. The fourth study showed that follow-up after MI does not differ from follow-up in reference individuals.Conclusion: This thesis supports an association of cardiovascular diseases in CD. Potential mechanisms include shared risk factors and chronic in-flammation.
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