| 1. |
- Eloff, Emma, et al.
(författare)
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Autoantibodies are major predictors of arthritis development in patients with anti-citrullinated protein antibodies and musculoskeletal pain
- 2021
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Ingår i: Scandinavian Journal of Rheumatology. - : Taylor & Francis Group. - 0300-9742 .- 1502-7732. ; 50:3, s. 189-197
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Predictors of arthritis development are highly warranted among patients with anti-citrullinated protein antibodies (ACPAs) and musculoskeletal symptoms to optimize clinical management. We aimed to identify clinical and laboratory predictors of arthritis development, including biochemically assessed alcohol consumption, among ACPA-positive patients with musculoskeletal pain.Method: 82 ACPA-positive individuals with musculoskeletal pain but no clinical arthritis were followed for a median of 72 months (interquartile range 57–81 months). We evaluated the prognostic value of baseline clinical and laboratory factors including smoking, symptom duration, age, gender, shared epitope, rheumatoid factor (RF), anti-carbamylated protein antibodies, ACPA levels, erythrocyte sedimentation rate, C-reactive protein levels, tender joint count, patient-reported general well-being, 28-joint Disease Activity Score, and alcohol consumption as measured by phosphatidyl ethanol (PEth) levels in whole blood.Results: During follow-up, 48% developed at least one arthritis. Multivariable analysis revealed an increased risk of arthritis development with RF positivity [hazard ratio (HR) = 2.3, 95% confidence interval (CI) 1.1–4.8, p = 0.028] and higher ACPA levels (HR = 1.0, 95% CI 1.000–1.001, p = 0.002). High levels of RF (HR = 4.4, 95% CI 1.7–11) entailed the highest HR in this ACPA-positive population. Neither clinical characteristics nor alcohol consumption measured by PEth conferred significant prognostic value.Conclusions: ACPA levels and concurrent presence of RF are independent predictors of arthritis development among ACPA-positive patients with musculoskeletal pain. The results are compatible with a dose–response relationship between RA-related autoantibodies and risk of arthritis development.
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| 2. |
- Kastbom, Åsa A., et al.
(författare)
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Parents? : Observations and Reports on the Sexual Behaviour of 7 to 13 Years Old Children
- 2012
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Ingår i: Reproductive System & Sexual Disorders. - : OMICS International. - 2161-038X. ; 1:2, s. 2-7
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To investigate sexual behaviours, types and frequencies, among Swedish children in the age group of 7-13 years, as observed and reported by their parents and to give professionals in different areas a greater knowledge of sexual behaviour among younger school children.Methods: The parents of 418 children answered questionnaires about their child's behaviour, both general and sexual, and about their own attitudes.Results: We found that most sexual behaviours we asked about were reported by the parents as common, and are in part related to, or vary with, age and gender. A small number of sexual behaviours often referred to as problematic behaviour were found to be very unusual in this normative group of Swedish children.Conclusion: Behaviours usually referred to as sexualized and problematic were rare in this normative sample of children at 7-13 years of age. The results are of importance for clinicians' evaluation of sexual behaviours reported by parents.
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| 3. |
- Kastbom, Åsa A., 1971-
(författare)
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Sexual behaviour, debut and identity among Swedish Schoolchildren
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Sexual behaviour among schoolchildren and adolescents is a sparsely researched area and there are delicate methodological obstacles and ethical concerns when conducting such research. Still it is a subject that engages both parents and professionals. A sexualized behaviour or an early sexual debut (younger than 14 years) can be a sign of sexual abuse. It is therefore of importance to describe what is common and what is uncommon sexual behaviour among children and what the consequences of an early or a late sexual debut may be for the individual upon reaching late adolescence. Adolescents who identify themselves as lesbian, gay or bisexual (LGB) are also a group that needs further attention and research since they are often described as having a lower quality of life and more often experience child abuse than heterosexual teens.Aims: The research leading to this thesis had four goals: 1) to elucidate the sexual behaviour of children between the ages of 7 and 13 as observed by their parents, 2) to investigate the relationship between an early sexual debut (before 14 years of age) and socio-demographic data, sexual experience, health, experience of child abuse and behaviour at 18-years-of-age, 3) to explore associations with no sexual debut (no oral, vaginal or anal sex) at the age of 18, and 4) to describe the relationship between sexual identification and socio-demographic background data, sexual behaviour, health and health behaviour, experiences of child sexual and/or physical abuse and present behaviour among Swedish adolescents.Methods: The parents of 418 children answered questionnaires about their child’s behaviour, both general and sexual, and a sample of 3432 Swedish high school students completed a survey about sexuality, health and abuse at the age of 18. In addition, 362 members of the Swedish Federation for Lesbian, Gay, Bisexual and Transgender Rights (RFSL) completed the same survey at a mean age of 21.4 years.Results: Most of the sexual behaviours among the schoolchildren were common, and in part related to, or varied with, age and gender. A small number of sexual behaviours often referred to as sexualised or problematic behaviours (for example, kissing adults with the tongue, imitating intercourse, masturbating in public, and touching other children’s genitals with the mouth) were found to be very unusual or not reported by any parent in this normative group of Swedish children. Among the adolescents, an early debut (younger than 14 years of age) correlated positively with number of partners, experience of oral and anal sex, smoking, drug and alcohol use and antisocial behaviour, such as being violent, lying, stealing and running away from home. Girls with an early sexual debut had significantly more experience of sexual abuse while boys with an early sexual debut were more likely to have a weak sense of coherence, low self-esteem and poor mental health, together with experience of sexual abuse, selling sex and physical abuse. A multiple logistic regression model showed that a number of antisocial acts and health behaviours remained significant, but early sexual debut did not increase the risk of psychiatric symptoms, low self-esteem or low sense of coherence at 18-years-of-age. Just under a quarter (24.6%) of the 3,380 adolescents had not had their sexual debut (no oral, anal or vaginal sex by the age of 18). There was a positive correlation between not debuting sexually at age 18 and a number of factors such as: being more likely to have caring fathers; parents born outside Europe; low sexual desire; lower pornography consumption; lower alcohol and tobacco consumption; less antisocial behavior and fewer experiences of sexual abuse than 18 year olds who had already made their sexua debut. Adolescents with a minority sexual identity more often described their relationship with their parents as based on low care and high overprotection than did their heterosexual peers. The minority adolescents used alcohol and drugs to a significantly higher degree than the heterosexual adolescents. Multivariate analysis showed a positive correlation between a minority sexual identity and experience of anal sex, higher sexual lust, experience of sexual abuse, physical abuse and sexual exploitation. It was more than twice as common to have experience of penetrating sexual abuse and physical abuse with a sexual minority identity.Conclusions: Behaviours usually referred to as sexualised and problematic are uncommon among children at 7-13 years of age. Professionals and should give a child showing a sexualised behaviour special attention and investigate the reasons for the behaviour. Early sexual debut seems to be associated with problematic behaviours during later adolescence, indicating the fact that the early debut for some children is associated with an increased vulnerability, which has to be addressed. Family socio-demographics such as family stability and/or cultural status matter when it comes to time of sexual debut. Personality also seems to matter and further studies are needed to investigate if there is any correlation between personality traits and late sexual debut. Adolescents with no sexual debut at 18 years of age reported fewer antisocial acts, were less likely to smoke and drink alcohol, had less sexual desire and less experience of sexual abuse. Young people with a sexual minority identity (homo- and bisexual) could be seen to have a lower quality of life compared to heterosexual peers and studies need to be done to further explore possible reasons. They have a higher risk of having experience of sexual and physical abuse compared to heterosexual adolescents. Professionals need to be more aware of this group’s additional vulnerability including the increased risk of child abuse and offer different forms of support.
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| 4. |
- Kastbom, Åsa, et al.
(författare)
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Comparing quality of life between Swedish adolescents and young adults from sexual minorities and heterosexual groups
- 2015
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Objectives: To investigate the relationship between sexual identity and socio- demographics, sexual experience, health, experience of child abuse, sexual exploitation and present behavior among Swedish adolescents and young adults.Methods: A cross-sectional survey with 3,503 adolescents completing a survey about their sexuality, health and abuse at a mean age of 18.3 years. In addition, 362 members of the Swedish Federation for Lesbian, Gay, Bisexual and Transgender Rights completed the same survey at a mean age of 21.4 years.Results: Sexual minority respondents were more likely to say that their parental relationship was based on low care and high overprotection and they used alcohol and other drugs to a significantly higher extent than their heterosexual peers. Multivariate analysis showed a positive correlation between sexual minority and low self-esteem, poor mental health and experience of sexual abuse, physical abuse and sexual exploitation.Conclusion: The sexual minority group had a lower quality of life than their heterosexual peers and professionals need to be more aware that they are more vulnerable in a number of respects, including an increased risk of having experienced child abuse, and offer them different forms of support.
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| 5. |
- Kastbom, Åsa, et al.
(författare)
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Differences in sexual behavior, health, and history of child abuse among school students who had and had not engaged in sexual activity by the age of 18 years : a cross-sectional study
- 2016
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Ingår i: Adolescent Health, Medicine and Therapeutics. - : DOVE MEDICAL PRESS LTD. - 1179-318X. ; 7, s. 1-11
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Tidskriftsartikel (refereegranskat)abstract
- Background: Empirical research about late sexual debut and its consequences is limited, and further research is needed. Objective: To explore how students who had not had intercourse by the age of 18 years differed in terms of sociodemographic factors, physical and psychological health, sexual behavior, and history of sexual abuse from those who had. Materials and methods: This is a cross-sectional survey involving 3,380 Swedish 18-year-olds. Descriptive analyses were used to investigate different types of sexual behavior. Ordinal data concerning alcohol consumption, self-esteem, sexual and physical abuse, parental relationships, sense of coherence, and health were analyzed, and multiple regression was carried out to identify the most important factors associated with no sexual debut. Results: Just under a quarter of the adolescents had not had oral, anal, or vaginal sex by the age of 18 years, and they comprised the index group. They were characterized by being more likely to have caring fathers, parents born outside Europe, lower pornography consumption, lower alcohol and tobacco consumption, less antisocial behavior, and above all lower sexual desire (sometimes, adjusted odds ratio [aOR] 3.8; never/seldom, aOR 13.3) and fewer experiences of sexual abuse (aOR 25.5). Family structure and culture matters when it comes to the age of sexual debut. Conclusion: Adolescents with no sexual debut at 18 years of age seemed to live a more stable and cautious life than more sexual experienced peers, exemplified by fewer antisocial acts, less smoking and alcohol/drug consumption, less sexual desire, and less experience of sexual abuse.
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| 6. |
- Kastbom, Åsa
(författare)
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Parents' reports on 7-12-years old childrens sexual behavior
- 2011
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Ingår i: Journal of Sexual Medicine. - Malden , MA, USA : Blackwell Publishing. - 1743-6095 .- 1743-6109. ; 8:Suppl. 3, s. 270-270
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Aim: To understand if a sexual behaviour in a child is a sign of sexual abuse or neglect we need to investigate sexual behaviours among chil-dren. In the present study we investigated Swedish children age 7–12 to determine what constitutes usual and unusual sexual behaviours.Methods: Parents of 418 children answered questionnaires about their child’s behaviour, both general and sexual, and about their own attitudes.Results: We found that most sexual behaviours we asked about are common, and are in part related to or vary with age and gender. A small number of sexual behaviours were found to be very unusual in this normative group of children.Conclusion: Behaviours usually referred to as sexualized and problematic and perhaps a sign of sexual abuse or neglect were very rare in this normative sample of children 7–12 years of age.
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| 7. |
- Kastbom, Åsa, et al.
(författare)
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Sexual debut before the age of 14 leads to poorer psychosocial health and risky behaviour in later life
- 2015
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Ingår i: Acta Paediatrica. - : Wiley-Blackwell. - 0803-5253 .- 1651-2227. ; 104:1, s. 91-100
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Tidskriftsartikel (refereegranskat)abstract
- Aim: This study investigated the relationship between sexual debut before 14 years of age and socio-demographics, sexual experience, health, experience of child abuse and behaviour at 18 years of age. Methods: A sample of 3432 Swedish high school seniors completed a survey about sexuality, health and abuse at the age of 18. Results: Early debut was positively correlated with risky behaviours, such as the number of partners, experience of oral and anal sex, health behaviours, such as smoking, drug and alcohol use, and antisocial behaviour, such as being violent, lying, stealing and running away from home. Girls with an early sexual debut had significantly more experience of sexual abuse. Boys with an early sexual debut were more likely to have a weak sense of coherence, low self-esteem and poor mental health, together with experience of sexual abuse, selling sex and physical abuse. A multiple logistic regression model showed that a number of antisocial acts and health behaviours remained significant, but early sexual debut did not increase the risk of psychiatric symptoms, low self-esteem or low sense of coherence at 18 years of age. Conclusion: Early sexual debut was associated with problematic behaviours during later adolescence, and this vulnerability requires attention from parents and healthcare providers.
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| 8. |
- Martinsson, Klara, et al.
(författare)
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Elevated free secretory component in early rheumatoid arthritis and prior to arthritis development in patients at increased risk
- 2020
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Ingår i: Rheumatology. - : Oxford University Press. - 1462-0324 .- 1462-0332. ; 59:5, s. 979-987
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. Considering growing evidence of mucosal involvement in RA induction, this study investigated circulating free secretory component (SC) in patients with either recent-onset RA or with ACPA and musculoskeletal pain. Methods. Two prospective cohorts were studied: TIRA-2 comprising 452 recent-onset RA patients with 3 years of clinical and radiological follow-up, and TIRx patients (n = 104) with ACPA IgG and musculoskeletal pain followed for 290 weeks (median). Blood donors and three different chronic inflammatory diseases served as controls. Free SC was analysed by sandwich ELISA. Results. Serum levels of free SC were significantly higher in TIRA-2 patients compared with TIRx and all control groups (P < 0.01). Among TIRx patients who subsequently developed arthritis, free SC levels were higher compared with all control groups (P < 0.05) except ankylosing spondylitis (P = 0.74). In TIRA-2, patients with ACPA had higher baseline levels of free SC compared with ACPA negative patients (P < 0.001). Free SC status at baseline did not predict radiographic joint damage or disease activity over time. In TIRx, elevated free SC at baseline trendwise associated with arthritis development during follow-up (P = 0.066) but this disappeared when adjusting for confounders (P = 0.72). Cigarette smoking was associated with higher levels of free SC in both cohorts. Conclusion. Serum free SC levels are increased in recent-onset RA compared with other inflammatory diseases, and associate with ACPA and smoking. Free SC is elevated before arthritis development among ACPA positive patients with musculoskeletal pain, but does not predict arthritis development. These findings support mucosal engagement in RA development.
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| 9. |
- Mathioudaki, Argyri, Ph.D student, 1986-, et al.
(författare)
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Replication and fine mapping of ankylosing spondylitis replicated loci in the Swedish population reveal different CCHCR1 protective haplotypes
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Background: The genetics of ankylosing spondylitis (AS) derives mainly from studies performed in large cohorts of British origin. However, within Europe, disease prevalence is higher in Sweden, and so we investigated the reproducibility of known AS susceptibility patterns in a homogeneous Swedish cohort.Methods: The replication power of the Swedish cohort was examined and a set of published SNP associations intersected with genotypes from an existing targeted sequencing study using these individuals (381 controls; 310 AS cases). To elucidate whether replication patterns derived from population subsampling or genetic similarity, allele frequency data from additional British and Swedish control populations were examined for genetic differentiation (FST). Replicated loci were fine mapped to investigate associations in more detail, and signals were dissected with haplotype analysis and functional annotation.Results: The study had 80% power to find variants of strong effect (Odds ratio, OR>2) given a wide range of risk allele frequencies (0.2-3), tagging HLA-B,CCHCR1and IL23R. The replication pattern was not due to European population genetic distance and fine mapping revealed genome-wide repositioned associations in HLA-Band CCHCR1, independent from the published associations (p-value < 2 x10-8, r2 < 0.3). The CCHCR1 locus showed two protective haplotype blocks (B1-1 and B2-1), independent from HLA-B signals (B1-1: r2 = 0.39, B2-2:r2=0.07), where 74% of controls were carrying 2 copies of the protective haplotypes (B1-1 and B2-1: OR=0.3, p-value = 1.2 x 10-45). Interestingly, while both haplotypes span CCHCR1, the effect of each haplotype is likely in cis, with eQTL evidence pointing to the regulation of TCF19(B1-1) and POU5F1(B1-2).Conclusions: Both European populations share key disease loci, but the Swedish cohort revealed fine-scale genetic differences, that may point to gene regulation. This study utilized a different variant resolution, and by doing so demonstrated that smaller populations have the potential to reveal new AS pathogenesis mechanisms and that further study of the Swedish population is warranted.
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| 10. |
- Mathioudaki, Argyri, Ph.D student, 1986-, et al.
(författare)
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The sex-stratified genetic architecture of ankylosing spondylitis
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Sexual dimorphism is an emerging feature of ankylosing spondylitis (AS), a chronic rheumatic condition affecting upto three times more men than women. Using 691 individuals from a Swedish case-control cohort, we revealed thatsex biases are also a hallmark of AS genetic predisposition, and that this multifactorial disease is in part driven byboth rare and common variants. We identified SNPs via the targeted re-sequencing of 7 270 coding and non-codingloci, and assessed novel patterns of association with both single marker and aggregate loci SKAT tests. The malespecific RUNX3 locus (including rs7414934, OR=2.58, p=1.7x10-5) and female specific MICB SKAT locus (27variants, p=1.2x10-6; rs3828903, OR=4.62, p=6.2x10-13) exceeded discovery thresholds. Multiple risk variants fromeach locus were shown to be functionally active in immune (Jurkat), skin (HaCat) and bone (SaOS-2) cell lines.Differential patterns of genetic predisposition may point to alternative disease mechanisms in male and femalepatients. Genetic and functional analyses demonstrated that risk alleles should not be considered in isolation and thatassociated variants would likely affect gene regulation across multiple tissues. This work illustrates the need toconsider the contribution of sex to the genetics of AS and the duality that individual loci may play in the key clinical outcomes of disease.
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