| 1. |
- Hudson, Lawrence N, et al.
(författare)
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The database of the PREDICTS (Projecting Responses of Ecological Diversity In Changing Terrestrial Systems) project
- 2017
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Ingår i: Ecology and Evolution. - : John Wiley & Sons. - 2045-7758. ; 7:1, s. 145-188
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Tidskriftsartikel (refereegranskat)abstract
- The PREDICTS project-Projecting Responses of Ecological Diversity In Changing Terrestrial Systems (www.predicts.org.uk)-has collated from published studies a large, reasonably representative database of comparable samples of biodiversity from multiple sites that differ in the nature or intensity of human impacts relating to land use. We have used this evidence base to develop global and regional statistical models of how local biodiversity responds to these measures. We describe and make freely available this 2016 release of the database, containing more than 3.2 million records sampled at over 26,000 locations and representing over 47,000 species. We outline how the database can help in answering a range of questions in ecology and conservation biology. To our knowledge, this is the largest and most geographically and taxonomically representative database of spatial comparisons of biodiversity that has been collated to date; it will be useful to researchers and international efforts wishing to model and understand the global status of biodiversity.
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| 2. |
- Backé, Eva-Maria, et al.
(författare)
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The role of psychosocial stress at work for the development of cardiovascular diseases : a systematic review.
- 2012
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Ingår i: International Archives of Occupational and Environmental Health. - Berlin : Springer Berlin/Heidelberg. - 0340-0131 .- 1432-1246. ; 85:1, s. 67-79
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: A systematic review was carried out to assess evidence for the association between different models of stress at work, and cardiovascular morbidity and mortality. METHODS: A literature search was conducted using five databases (MEDLINE, Cochrane Library, EMBASE, PSYNDEX and PsycINFO). Inclusion criteria for studies were the following: self-reported stress for individual workplaces, prospective study design and incident disease (myocardial infarction, stroke, angina pectoris, high blood pressure). Evaluation, according to the criteria of the Scottish Intercollegiate Guidelines Network, was done by two readers. In case of disagreement, a third reader was involved. RESULTS: Twenty-six publications were included, describing 40 analyses out of 20 cohorts. The risk estimates for work stress were associated with a statistically significant increased risk of cardiovascular disease in 13 out of the 20 cohorts. Associations were significant for 7 out of 13 cohorts applying the demand-control model, all three cohorts using the effort-reward model and 3 out of 6 cohorts investigating other models. Most significant results came from analyses considering only men. Results for the association between job stress and cardiovascular diseases in women were not clear. Associations were weaker in participants above the age of 55. CONCLUSIONS: In accordance with other systematic reviews, this review stresses the importance of psychosocial factors at work in the aetiology of cardiovascular diseases. Besides individual measures to manage stress and to cope with demanding work situations, organisational changes at the workplace need to be considered to find options to reduce occupational risk factors for cardiovascular diseases.
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| 3. |
- Bashir, Fatima, et al.
(författare)
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The realities of HIV prevention. A closer look at facilitators and challenges faced by HIV prevention programmes in Sudan and Yemen
- 2019
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Ingår i: Global Health Action. - : Taylor & Francis. - 1654-9716 .- 1654-9880. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: HIV/AIDS prevention has historically encountered many obstacles. Understanding the factors affecting HIV/AIDS prevention is central to designing and implementing suitable context-specific interventions. Research relating to HIV prevention in the Middle East and North African region is required to address the gradually increasing HIV epidemic.Objective: This study aimed to explore the perspectives of employees/health care professionals who are working or have worked within HIV prevention in Sudan and Yemen on the challenges and facilitating factors facing HIV prevention.Methods: A qualitative approach was employed using an open-ended questionnaire. Sixteen stakeholders from governmental and non-governmental agencies participated in the study. The questionnaire focused on the various challenges and facilitating factors facing HIV prevention as well as proposed possible solutions from the perspectives of the participants. The data were analysed using thematic analysis.Results: The study illustrated the similarities in context and HIV prevention systems between Sudan and Yemen. Thematic analysis resulted in three main themes: I) much is achieved despite difficulties; II) a programme left to be paralysed; this theme addressed the main obstacles facing HIV prevention in Sudan and Yemen generating a total of six sub-themes; III) comprehensive change is needed. The participants drew focus and attention to vital changes required to improve the delivery of HIV prevention services. Conclusion: Increased financial support for HIV prevention in Sudan and Yemen is urgently needed. De-stigmatisation and increased political support, advocacy and improved legislation for people living with HIV (PLHIV) are required for the sustainability and effectiveness of HIV prevention programmes in Sudan and Yemen. Civil society organisations must be aided and supported in their role in engaging key populations.
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| 4. |
- Benebo, Faith Owunari, et al.
(författare)
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Intimate partner violence against women in Nigeria : a multilevel study investigating the effect of women's status and community norms
- 2018
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Ingår i: BMC Women's Health. - : BioMed Central. - 1472-6874. ; 18
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Intimate partner violence (IPV) against women has been recognised as a public health problem with far-reaching consequences for the physical, reproductive, and mental health of women. The ecological framework portrays intimate partner violence as a multifaceted phenomenon, demonstrating the interplay of factors at different levels: individual, community, and the larger society. The present study examined the effect of individual- and community-level factors on IPV in Nigeria, with a focus on women's status and community-level norms among men.METHODS: A cross-sectional study based on the latest Nigerian Demographic Health Survey (2013) was conducted involving 20,802 ever-partnered women aged 15-49 years. Several multilevel logistic regression models were calibrated to assess the association of individual- and community-level factors with IPV. Both measures of association (fixed effect) and measures of variations (random effect) were reported.RESULTS: Almost one in four women in Nigeria reported having ever experienced intimate partner violence. Having adjusted for other relevant covariates, higher women's status reduced the odds of IPV (OR = 0.47; 95% CI = 0.32-0.71). However, community norms among men that justified IPV against women modified the observed protective effect of higher women's status against IPV and reversed the odds (OR = 1.89; 95% CI = 1.26-2.83).CONCLUSIONS: Besides women's status, community norms towards IPV are an important factor for the occurrence of IPV. Thus, addressing intimate partner violence against women calls for community-wide approaches aimed at changing norms among men alongside improving women's status.
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| 5. |
- Bergmann, Annekatrin, et al.
(författare)
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Do occupational risks for low back pain differ from risks for specific lumbar disc diseases? : Results of the German Lumbar Spine Study (EPILIFT)
- 2017
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Ingår i: Spine. - 0362-2436 .- 1528-1159. ; 42:20, s. E1204-E1211
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Tidskriftsartikel (refereegranskat)abstract
- Study design: A multicenter, population based, case-control study.Objective: The aim of the present analysis is to clarify potential differences in the "occupational risk profiles" of structural lumbar disc diseases on the one hand, and low back pain (LBP) on the other hand.Summary of background data: Physical workplace factors seem to play an important etiological role.Methods: We recruited 901 patients with structural lumbar disc diseases (disc herniation or severe disc space narrowing) and 233 control subjects with "low-back-pain." Both groups were compared with 422 "low-back pain free" control subjects. Case history, pain data, neurological deficits, and movement restrictions were documented. LBP was recorded by the Nordic questionnaire on musculoskeletal symptoms. All magnetic resonance imaging, computed tomography, and X-rays were inspected by an independent study radiologist. The calculation of cumulative physical workload was based on a computer-assisted interview and a biomechanical analysis by 3-D-dynamic simulation tool. Occupational exposures were documented for the whole working life.Results: We found a positive dose-response relationship between cumulative lumbar load and LBP among men, but not among women. Physical occupational risks for structural lumbar disc diseases [odds ratio (OR) 3.7; 95% confidence interval (95% CI) 2.3-6.0] are higher than for LBP (OR 1.9; 95% CI 1.0-3.5).Conclusion: Our finding points to potentially different etiological pathways in the heterogeneous disease group of LBP. Results suggest that not all of the structural disc damage arising from physical workload leads to LBP.
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| 6. |
- Daca, Chanvo Salvador Lucas, 1976-
(författare)
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Making the connections : understanding inequalities in reproductive and child health in Mozambique
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: In Mozambique, despite significant socio-economic and health system challenges, there has been progress in reproductive and child health in recent years. However, there is still a lack of comprehensive studies that thoroughly unravel the socio-economic determinants of health and health inequalities in the country.The overall aim of this thesis was to understand the socio-economic and geographic inequalities in reproductive and child health with the intention of informing and optimizing the implementation of targeted health programmes in Mozambique.Methods: This thesis is based on three sub-studies that used data obtained from population-based health surveys. In sub-study I, prevalence ratios (PRs) with 95% confidence intervals (95% CI) were calculated by log binomial regression to assess the relationship of socio-economic, demographic, and geographic characteristics with three outcomes of interest: insecticide-treated bed nets (ITNs), child immunization coverage and modern contraceptive use. Sub-study II used the concentration index (Cindex) and decomposition analysis to assess the socio-economic and regional contributions to the wealth inequality in health preventive care. Sub-study III estimated absolute risk differences and the slope index of inequality (SII) as the measures of association between the socio-economic variables and the outcomes (ITN use, fever treatment and Fansidar prophylaxis) for the 2015 and 2018 surveys, as well as for the differences between the two time points.Results: The proportion of mothers with at least one child aged under five years that did not use an ITN was 51.01%, while 46.25% of women had children aged one to four years who were not fully immunized and 74.28% of women did not use modern contraceptives. Non-educated mothers and residents of the southern region were more likely to report not using an ITN (PR = 1.36; 95% CI: 1.17–1.59), while those in the lowest wealth quintile had a higher chance of having children who were not fully immunized (PR = 1.34; 95% CI: 1.04–1.71). Similarly, non-educated mothers (PR = 1.17; 95% CI: 1.10–1.25), non-working women (PR = 1.09; 95% CI: 1.04–1.16) and those in the poorest wealth quintile (PR = 1.13; 95% CI: 1.04–1.24) were more likely to not use modern contraception (sub-study I). Sub-study II found a Cindex of -0.081 for non-ITN, -0.189 for a lack of vaccination coverage and -0.284 for non-contraceptive use, showing a worse health outcome among the poorest population. The study revealed that 88.41% of the wealth gap for ITNs was explained by socio-economic factors, with education and wealth playing the largest roles. With regard to the lack of full vaccination, socio-economic factors (47.74%), particularly the wealth quintile (35.79%), emerged as the predominant contributor to the inequality. Similarly, socio-economic factors (39.39%) were also the main explanatory factors for the lack of contraceptive use, but to a lesser degree than for the other two outcomes (sub-study II). Access to health preventive activities increased in all of the three studied outcomes between 2015 and 2018. Significant reductions in ITN inequality were observed for all socio-economic variables, but no decrease of inequalities in fever treatment and Fansidar prophylaxis was found over time (sub-study III).Conclusion: This thesis revealed that bed net use and immunization coverage among children, and modern contraceptive use among women, were notably low. There was inequality, concentrated among the poor, in reproductive and child preventive measures. The greater part of this inequality could be attributed to low wealth and education, as well as to residence in rural areas. Reductions in socio-economic inequalities between 2015 and 2018 were observed for ITN use but not for fever treatment or malaria prophylaxis. Based on these findings, achieving universal health coverage in Mozambique will require an equitable resource distribution among rural regions, increased community education on health preventative measures and health service expansion to socio-economically disadvantaged households.
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| 7. |
- Daca, Chanvo S. L., et al.
(författare)
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Socioeconomic and geographical inequalities in health care coverage in Mozambique : a repeated cross-sectional study of the 2015 and 2018 national surveys
- 2023
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Ingår i: BMC Public Health. - : BioMed Central (BMC). - 1471-2458. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundOver the past years, Mozambique has implemented several initiatives to ensure equitable coverage to health care services. While there have been some achievements in health care coverage at the population level, the effects of these initiatives on social inequalities have not been analysed.ObjectiveThe present study aimed to assess changes in socioeconomic and geographical inequalities (education, wealth, region, place of residence) in health care coverage between 2015 and 2018 in Mozambique.MethodsThe study was based on repeated cross-sectional surveys from nationally representative samples: the Survey of Indicators on Immunisation, Malaria and HIV/AIDS in Mozambique (IMASIDA) 2015 and the 2018 Malaria Indicator survey. Data from women of reproductive age (15 to 49 years) were analysed to evaluate health care coverage of three indicators: insecticide-treated net use, fever treatment of children, and use of Fansidar malaria prophylaxis for pregnant women. Absolute risk differences and the slope index of inequality (SII) were calculated for the 2015 survey period and the 2018 survey period, respectively. An interaction term between the socioeconomic and geographical variables and the period was included to assess inequality changes between 2015 and 2018.ResultsThe non-use of insecticide-treated nets dropped, whereas the proportion of women with children who were not treated for fever and the prevalence of women who did not take the full Fansidar dose during pregnancy decreased between 2015 and 2018. Significant reductions in the inequality related to insecticide-treated net use were observed for all socioeconomic variables. Concerning fever treatment, some reductions in socioeconomic inequalities were observed, though not statistically significant. For malaria prophylaxis, the SII was significant for education, wealth, and residence in both periods, but no significant inequality reductions were observed in any of these variables over time.ConclusionsWe observed significant reductions of socioeconomic inequalities in insecticide-treated net use, but not in fever treatment of children and Fansidar prophylaxis for pregnant women. Decision-makers should target underserved populations, specifically the non-educated, poor, and rural women, to address inequalities in health care coverage.
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| 8. |
- Daca, Chanvo, et al.
(författare)
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Socio-economic and demographic factors associated with reproductive and child health preventive care in Mozambique : a cross-sectional study
- 2020
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Ingår i: International Journal for Equity in Health. - : BioMed Central. - 1475-9276. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Reproductive and child health interventions are essential to improving population health in Africa. In Mozambique, although some progress on reproductive and child health has been made, knowledge of social inequalities in health and health care is lacking.OBJECTIVE: To investigate socio-economic and demographic inequalities in reproductive and child preventive health care as a way to monitor progress towards universal health coverage.METHODS: A cross-sectional study was conducted, using data collected from the 2015 Immunization, AIDS and Malaria Indicators Survey (IMASIDA) in Mozambique. The sample included 6946 women aged 15 to 49 years. Outcomes variables were the use of insecticide treated nets (ITN) for children under 5 years, full child immunization and modern contraception use, while independent variables included age, marital status, place of residence, region, education, occupation, and household wealth index. Prevalence ratios (PR) with 95% confidence intervals (95% CI) were calculated by log binomial regression to assess the relationship between the socio-economic and demographic characteristics and the three outcomes of interest.RESULTS: The percentage of mothers with at least one child under 5 years that did not use ITN was 51.01, 46.25% of women had children aged 1 to 4 years who were not fully immunized, and 74.28% of women were not using modern contraceptives. Non-educated mothers (PR = 1.33; 95% CI: 1.16-1.51) and those living in the Southern region (PR = 1.36; 95% CI: 1.17-1.59) had higher risk of not using ITN, while the poorest quintile (PR = 1.34; 95% CI: 1.04-1.71) was more likely to have children who were not fully immunized. Similarly, non-educated women (PR = 1.17; 95% CI: 1.10-1.25), non-working women (PR = 1.09; 95% CI: 1.04-1.16), and those in the poorest quintile (PR = 1.13; 95% CI: 1.04-1.24) had a higher risk of not using modern contraceptives.CONCLUSION: Our study showed a low rate of ITN utilization, immunization coverage of children, and modern contraceptive use among women of reproductive age. Several socio-economic and demographics factors (region, education, occupation, and wealth) were associated with these preventive measures. We recommend an equity-oriented resource allocation across regions, knowledge dissemination on the importance of ITN and contraceptives use, and an expansion of immunization services to reach socio-economically disadvantaged families in order to achieve universal health coverage in Mozambique.
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| 9. |
- Daca, Chanvo, et al.
(författare)
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Wealth inequalities in reproductive and child health preventive care in Mozambique : a decomposition analysis
- 2022
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Ingår i: Global Health Action. - : Taylor & Francis Group. - 1654-9716 .- 1654-9880. ; 15:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Assessing the gap between rich and poor is important to monitor inequalities in health. Identifying the contribution to that gap can help policymakers to develop interventions towards decreasing that difference.Objective: To quantify the wealth inequalities in health preventive measures (bed net use, vaccination, and contraceptive use) to determine the demographic and socioeconomic contribution factors to that inequality using a decomposition analysis.Methods: Data from the 2015 Immunisation, Malaria and AIDs Indicators Survey were used. The total sample included 6946 women aged 15–49 years. Outcomes were use of insecticide-treated nets (ITN), child vaccination, and modern contraception use. Wealth Index was the exposure variable and age, marital status, place of residence, region, education, occupation, and household wealth index were the explanatory variables. Wealth inequalities were assessed using concentration indexes (Cindex). Wagstaff-decomposition analysis was conducted to assess the determinants of the wealth inequality.Results: The Cindex was −0.081 for non-ITN, −0.189 for lack of vaccination coverage and −0.284 for non-contraceptive use, indicating a pro-poor inequality. The results revealed that 88.41% of wealth gap for ITN was explained by socioeconomic factors, with education and wealth playing the largest roles. Lack of full vaccination, socioeconomic factors made the largest contribution, through the wealth variable, whereas geographic factors came next. Finally, the lack of contraceptive use, socioeconomic factors were the main explanatory factors, but to a lesser degree than the other two outcomes, with wealth and education contributing most to explaining the gap.Conclusion: There was a pro-poor inequality in reproductive and child preventive measures in Mozambique. The greater part of this inequality could be attributed to wealth, education, and residence in rural areas. Resources should be channeled into poor and non-educated rural communities to tackle these persistent inequities in preventive care.
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| 10. |
- Dima, Danai, et al.
(författare)
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Subcortical volumes across the lifespan : Data from 18,605 healthy individuals aged 3-90 years.
- 2022
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Ingår i: Human Brain Mapping. - : Wiley. - 1065-9471 .- 1097-0193. ; 43:1, s. 452-469
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Tidskriftsartikel (refereegranskat)abstract
- Age has a major effect on brain volume. However, the normative studies available are constrained by small sample sizes, restricted age coverage and significant methodological variability. These limitations introduce inconsistencies and may obscure or distort the lifespan trajectories of brain morphometry. In response, we capitalized on the resources of the Enhancing Neuroimaging Genetics through Meta-Analysis (ENIGMA) Consortium to examine age-related trajectories inferred from cross-sectional measures of the ventricles, the basal ganglia (caudate, putamen, pallidum, and nucleus accumbens), the thalamus, hippocampus and amygdala using magnetic resonance imaging data obtained from 18,605 individuals aged 3-90 years. All subcortical structure volumes were at their maximum value early in life. The volume of the basal ganglia showed a monotonic negative association with age thereafter; there was no significant association between age and the volumes of the thalamus, amygdala and the hippocampus (with some degree of decline in thalamus) until the sixth decade of life after which they also showed a steep negative association with age. The lateral ventricles showed continuous enlargement throughout the lifespan. Age was positively associated with inter-individual variability in the hippocampus and amygdala and the lateral ventricles. These results were robust to potential confounders and could be used to examine the functional significance of deviations from typical age-related morphometric patterns.
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| 11. |
- Fonseca Rodriguez, Osvaldo, et al.
(författare)
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Association between Weather Types based on the Spatial Synoptic Classification and All-Cause Mortality in Sweden, 1991⁻2014
- 2019
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 16:10
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Tidskriftsartikel (refereegranskat)abstract
- Much is known about the adverse health impact of high and low temperatures. The Spatial Synoptic Classification is a useful tool for assessing weather effects on health because it considers the combined effect of meteorological factors rather than temperature only. The aim of this study was to assess the association between oppressive weather types and daily total mortality in Sweden. Time-series Poisson regression with distributed lags was used to assess the relationship between oppressive weather (Dry Polar, Dry Tropical, Moist Polar, and Moist Tropical) and daily deaths over 14 days in the extended summer (May to September), and 28 days during the extended winter (November to March), from 1991 to 2014. Days not classified as oppressive weather served as the reference category. We computed relative risks with 95% confidence intervals, adjusting for trends and seasonality. Results of the southern (Skåne and Stockholm) and northern (Jämtland and Västerbotten) locations were pooled using meta-analysis for regional-level estimates. Analyses were performed using the dlnm and mvmeta packages in R. During summer, in the South, the Moist Tropical and Dry Tropical weather types increased the mortality at lag 0 through lag 3 and lag 6, respectively. Moist Polar weather was associated with mortality at longer lags. In the North, Dry Tropical weather increased the mortality at shorter lags. During winter, in the South, Dry Polar and Moist Polar weather increased mortality from lag 6 to lag 10 and from lag 19 to lag 26, respectively. No effect of oppressive weather was found in the North. The effect of oppressive weather types in Sweden varies across seasons and regions. In the North, a small study sample reduces precision of estimates, while in the South, the effect of oppressive weather types is more evident in both seasons.
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| 12. |
- Fonseca Rodriguez, Osvaldo, PhD, 1982-, et al.
(författare)
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Effect of extreme hot and cold weather on cause-specific hospitalizations in Sweden : A time series analysis
- 2021
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Ingår i: Environmental Research. - : Elsevier. - 0013-9351 .- 1096-0953. ; 193
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Tidskriftsartikel (refereegranskat)abstract
- Considering that several meteorological variables can contribute to weather vulnerability, the estimation of their synergetic effects on health is particularly useful. The spatial synoptic classification (SSC) has been used in biometeorological applications to estimate the effect of the entire suite of weather conditions on human morbidity and mortality. In this study, we assessed the relationships between extremely hot and dry (dry tropical plus, DT+) and hot and moist (moist tropical plus, MT+) weather types in summer and extremely cold and dry (dry polar plus, DP+) and cold and moist (moist polar, MP+) weather types in winter and cardiovascular and respiratory hospitalizations by age and sex. Time-series quasi-Poisson regression with distributed lags was used to assess the relationship between oppressive weather types and daily hospitalizations over 14 subsequent days in the extended summer (May to August) and 28 subsequent days during the extended winter (November to March) over 24 years in 4 Swedish locations from 1991 to 2014. In summer, exposure to hot weather types appeared to reduce cardiovascular hospitalizations while increased the risk of hospitalizations for respiratory diseases, mainly related to MT+. In winter, the effect of cold weather on both cause-specific hospitalizations was small; however, MP+ was related to a delayed increase in cardiovascular hospitalizations, whilst MP+ and DP + increased the risk of hospitalizations due to respiratory diseases. This study provides useful information for the staff of hospitals and elderly care centers who can help to implement protective measures for patients and residents. Also, our results could be helpful for vulnerable people who can adopt protective measures to reduce health risks.
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| 13. |
- Fonseca Rodriguez, Osvaldo, PhD, 1982-, et al.
(författare)
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Hot and cold weather based on the spatial synoptic classification and cause-specific mortality in Sweden : a time-stratified case-crossover study
- 2020
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Ingår i: International journal of biometeorology. - : Springer. - 0020-7128 .- 1432-1254. ; 64:9, s. 1435-1449
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Tidskriftsartikel (refereegranskat)abstract
- The spatial synoptic classification (SSC) is a holistic categorical assessment of the daily weather conditions at specific locations; it is a useful tool for assessing weather effects on health. In this study, we assessed (a) the effect of hot weather types and the duration of heat events on cardiovascular and respiratory mortality in summer and (b) the effect of cold weather types and the duration of cold events on cardiovascular and respiratory mortality in winter. A time-stratified case-crossover design combined with a distributed lag nonlinear model was carried out to investigate the association of weather types with cause-specific mortality in two southern (Skåne and Stockholm) and two northern (Jämtland and Västerbotten) locations in Sweden. During summer, in the southern locations, the Moist Tropical (MT) and Dry Tropical (DT) weather types increased cardiovascular and respiratory mortality at shorter lags; both hot weather types substantially increased respiratory mortality mainly in Skåne. The impact of heat events on mortality by cardiovascular and respiratory diseases was more important in the southern than in the northern locations at lag 0. The cumulative effect of MT, DT and heat events lagged over 14 days was particularly high for respiratory mortality in all locations except in Jämtland, though these did not show a clear effect on cardiovascular mortality. During winter, the dry polar and moist polar weather types and cold events showed a negligible effect on cardiovascular and respiratory mortality. This study provides valuable information about the relationship between hot oppressive weather types with cause-specific mortality; however, the cold weather types may not capture sufficiently effects on cause-specific mortality in this sub-Arctic region.
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| 14. |
- Fonseca-Rodriguez, Osvaldo, PhD, 1982-, et al.
(författare)
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Projection of extreme heat- and cold-related mortality in Sweden based on the spatial synoptic classification
- 2023
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Ingår i: Environmental Research. - : Elsevier. - 0013-9351 .- 1096-0953. ; 239
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Tidskriftsartikel (refereegranskat)abstract
- Background: Climate change is projected to result in increased heat events and decreased cold events. This will substantially impact human health, particularly when compounded with demographic change. This study employed the Spatial Synoptic Classification (SSC) to categorize daily weather into one of seven types. Here we estimated future mortality due to extremely hot and cold weather types under different climate change scenarios for one southern (Stockholm) and one northern (Ja center dot mtland) Swedish region. Methods: Time-series Poisson regression with distributed lags was used to assess the relationship between extremely hot and cold weather events and daily deaths in the population above 65 years, with cumulative effects (6 days in summer, 28 days in winter), 1991 to 2014. A global climate model (MPI-M-MPI-ESM-LR) and two climate change scenarios (RCP 4.5 and 8.5) were used to project the occurrence of hot and cold days from 2031 to 2070. Place-specific projected mortality was calculated to derive attributable numbers and attributable fractions (AF) of heat- and cold-related deaths. Results: In Stockholm, for the RCP 4.5 scenario, the mean number of annual deaths attributed to heat increased from 48.7 (CI 32.2-64.2; AF = 0.68%) in 2031-2040 to 90.2 (56.7-120.5; AF = 0.97%) in 2061-2070, respectively. For RCP 8.5, heat-related deaths increased more drastically from 52.1 (33.6-69.7; AF = 0.72%) to 126.4 (68.7-175.8; AF = 1.36%) between the first and the last decade. Cold-related deaths slightly increased over the projected period in both scenarios. In Ja center dot mtland, projections showed a small decrease in cold-related deaths but no change in heat-related mortality.Conclusions: In rural northern region of Sweden, a decrease of cold-related deaths represents the dominant trend. In urban southern locations, on the other hand, an increase of heat-related mortality is to be expected. With an increasing elderly population, heat-related mortality will outweigh cold-related mortality at least under the RCP 8.5 scenario, requiring societal adaptation measures.
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| 15. |
- Frangou, Sophia, et al.
(författare)
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Cortical thickness across the lifespan : Data from 17,075 healthy individuals aged 3-90 years
- 2022
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Ingår i: Human Brain Mapping. - : John Wiley & Sons. - 1065-9471 .- 1097-0193. ; 43:1, s. 431-451
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Tidskriftsartikel (refereegranskat)abstract
- Delineating the association of age and cortical thickness in healthy individuals is critical given the association of cortical thickness with cognition and behavior. Previous research has shown that robust estimates of the association between age and brain morphometry require large-scale studies. In response, we used cross-sectional data from 17,075 individuals aged 3-90 years from the Enhancing Neuroimaging Genetics through Meta-Analysis (ENIGMA) Consortium to infer age-related changes in cortical thickness. We used fractional polynomial (FP) regression to quantify the association between age and cortical thickness, and we computed normalized growth centiles using the parametric Lambda, Mu, and Sigma method. Interindividual variability was estimated using meta-analysis and one-way analysis of variance. For most regions, their highest cortical thickness value was observed in childhood. Age and cortical thickness showed a negative association; the slope was steeper up to the third decade of life and more gradual thereafter; notable exceptions to this general pattern were entorhinal, temporopolar, and anterior cingulate cortices. Interindividual variability was largest in temporal and frontal regions across the lifespan. Age and its FP combinations explained up to 59% variance in cortical thickness. These results may form the basis of further investigation on normative deviation in cortical thickness and its significance for behavioral and cognitive outcomes.
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| 16. |
- Furberg, Maria, 1970-, et al.
(författare)
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Post-infectious fatigue following Puumala virus infection
- 2019
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Ingår i: Infectious Diseases. - : Taylor & Francis. - 2374-4235 .- 2374-4243. ; 51:7, s. 519-526
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Puumala virus infection or nephropathia epidemica (NE) is common in northern Sweden. NE causes haemorrhagic fever with renal syndrome. Most patients make a full recovery, but a convalescent phase with fatigue has been reported. Although post-infectious fatigue has been demonstrated for other viral infections, it is not well studied in relation to NE. This study assessed recovery time and levels of fatigue in former NE patients, as compared to the general population.METHODS: NE patients diagnosed in northern Sweden between 2007 and 2011, together with a comparison sample from the general population, answered a questionnaire on demographic and health-related factors, including the Fatigue Severity Scale (FSS), and characteristics of NE infection. Self-reported recovery time was assessed, and fatigue levels were compared across the two groups by multiple linear regression, stratified by gender.RESULTS: In total, 1132 NE patients and 915 comparison group subjects participated. Time to complete recovery was reported to exceed 3 months for 47% and 6 months for 32% of the NE patients. Recovery time differed by gender and age. NE patients had significantly higher FSS scores than the comparison group. Differences were greater among women than men, and adjustments for current illness, body mass index, smoking and current residence only slightly modified the estimates.CONCLUSIONS: Individuals with previous NE infection show higher fatigue scores than non-infected individuals, even 5 years following the infection. Full recovery takes half a year or longer for a substantial proportion of former NE patients.
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| 17. |
- Greiser, K. H., et al.
(författare)
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Association of neighbourhood socioeconomic status and individual socioeconomic status with cardiovascular risk factors in an Eastern German population : the CARLA Study 2002–2006
- 2011
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Ingår i: IEA World Congress of Epidemiology, 7–11 August 2011, Edinburgh International Conference Centre, Edinburgh, Scotland Programme and abstracts. - : BMJ. ; , s. A249-
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Konferensbidrag (refereegranskat)abstract
- Introduction/objectives: Individual socioeconomic status (SES) is a determinant of cardiovascular risk factors (RF). Recent studies suggest an independent association of neighbourhood SES with cardiovascular RF, but the mechanisms have not fully been understood. Our aim was to assess the association of neighbourhood and individual SES with cardiovascular RF in an Eastern German population. Methods: We used cross-sectional data of 1779 participants aged 45–83 years of the population-based CARLA study. We calculated linear mixed models to assess the age-adjusted influence of neighbourhood-specific unemployment rates and individual SES on smoking, systolic blood pressure (SBP), and body mass index (BMI). Spatial dependencies within and between neighbourhoods were adjusted for by using ICAR models. Results: Neighbourhood-specific unemployment rates varied between 6.3 and 35.3%. Per 1% increase in the neighbourhood's unemployment rate, the number of cigarettes smoked/day increased by 0.11 in men (95% CI 0.09 to 0.12) and 0.05, (CI 0.04 to 0.07) in women. In women, SBP increased by 0.04 mm Hg with unemployment rate (CI 0.03 to 0.06), while there was no statistically significant association of SBP with SES in men. BMI was only in women significantly associated with unemployment (increase in BMI per 1% increase in unemployment rate 0.04 (CI 0.02 to 0.05)). Associations of RF with individual SES were stronger than with neighbourhood SES in multiple models. Conclusions: Our findings confirm the previously described association of neighbourhood SES with smoking independent of individual SES, while we found inconsistent associations with SBP and BMI. The neighbourhood environment may be more relevant for behavioural than for biomedical risk factors.
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| 18. |
- Hedlund, Christina, et al.
(författare)
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Association of climatic factors with infectious diseases in the Arctic and subarctic region : a systematic review
- 2014
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Ingår i: Global Health Action. - : Global Health Action. - 1654-9716 .- 1654-9880. ; 7, s. 1-16
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Forskningsöversikt (refereegranskat)abstract
- Background:The Arctic and subarctic area are likely to be highly affected by climate change, with possible impacts on human health due to effects on food security and infectious diseases.Objectives:To investigate the evidence for an association between climatic factors and infectious diseases, and to identify the most climate-sensitive diseases and vulnerable populations in the Arctic and subarctic region.Methods:A systematic review was conducted. A search was made in PubMed, with the last update in May 2013. Inclusion criteria included human cases of infectious disease as outcome, climate or weather factor as exposure, and Arctic or subarctic areas as study origin. Narrative reviews, case reports, and projection studies were excluded. Abstracts and selected full texts were read and evaluated by two independent readers. A data collection sheet and an adjusted version of the SIGN methodology checklist were used to assess the quality grade of each article.Results:In total, 1953 abstracts were initially found, of which finally 29 articles were included. Almost half of the studies were carried out in Canada (n = 14), the rest from Sweden (n = 6), Finland (n = 4), Norway (n = 2), Russia (n = 2), and Alaska, US (n = 1). Articles were analyzed by disease group: food-and waterborne diseases, vector-borne diseases, airborne viral-and airborne bacterial diseases. Strong evidence was found in our review for an association between climatic factors and food-and waterborne diseases. The scientific evidence for a link between climate and specific vector-and rodent-borne diseases was weak due to that only a few diseases being addressed in more than one publication, although several articles were of very high quality. Air temperature and humidity seem to be important climatic factors to investigate further for viral-and bacterial airborne diseases, but from our results no conclusion about a causal relationship could be drawn.Conclusions:More studies of high quality are needed to investigate the adverse health impacts of weather and climatic factors in the Arctic and subarctic region. No studies from Greenland or Iceland were found, and only a few from Siberia and Alaska. Disease and syndromic surveillance should be part of climate change adaptation measures in the Arctic and subarctic regions, with monitoring of extreme weather events known to pose a risk for certain infectious diseases implemented at the community level.
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| 19. |
- Hibar, Derrek P., et al.
(författare)
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Novel genetic loci associated with hippocampal volume
- 2017
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Ingår i: Nature Communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- The hippocampal formation is a brain structure integrally involved in episodic memory, spatial navigation, cognition and stress responsiveness. Structural abnormalities in hippocampal volume and shape are found in several common neuropsychiatric disorders. To identify the genetic underpinnings of hippocampal structure here we perform a genome-wide association study (GWAS) of 33,536 individuals and discover six independent loci significantly associated with hippocampal volume, four of them novel. Of the novel loci, three lie within genes (ASTN2, DPP4 and MAST4) and one is found 200 kb upstream of SHH. A hippocampal subfield analysis shows that a locus within the MSRB3 gene shows evidence of a localized effect along the dentate gyrus, subiculum, CA1 and fissure. Further, we show that genetic variants associated with decreased hippocampal volume are also associated with increased risk for Alzheimer's disease (r(g) = -0.155). Our findings suggest novel biological pathways through which human genetic variation influences hippocampal volume and risk for neuropsychiatric illness.
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| 20. |
- Ingole, Vijendra, et al.
(författare)
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Impact of Heat and Cold on Total and Cause-Specific Mortality in Vadu HDSS : A Rural Setting in Western India
- 2015
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Ingår i: International Journal of Environmental Research and Public Health. - : Modern Scientific Press. - 1661-7827 .- 1660-4601. ; 12:12, s. 15298-15308
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Tidskriftsartikel (refereegranskat)abstract
- Many diseases are affected by changes in weather. There have been limited studies, however, which have examined the relationship between heat and cold and cause-specific mortality in low and middle-income countries. In this study, we aimed to estimate the effects of heat and cold days on total and cause-specific mortality in the Vadu Health and Demographic Surveillance System (HDSS) area in western India. We used a quasi-Poisson regression model allowing for over-dispersion to examine the association of total and cause-specific mortality with extreme high (98th percentile, >39 °C) and low temperature (2nd percentile, <25 °C) over the period January 2003 to December 2012. Delays of 0 and 0-4 days were considered and relative risks (RR) with 95% confidence intervals (CI) were calculated. Heat was significantly associated with daily deaths by non-infectious diseases (RR = 1.57; CI: 1.18-2.10). There was an increase in the risk of total mortality in the age group 12-59 years on lag 0 day (RR = 1.43; CI: 1.02-1.99). A high increase in total mortality was observed among men at lag 0 day (RR = 1.38; CI: 1.05-1.83). We did not find any short-term association between total and cause-specific mortality and cold days. Deaths from neither infectious nor external causes were associated with heat or cold. Our results showed a strong and rather immediate relationship between high temperatures and non-infectious disease mortality in a rural population located in western India, during 2003-2012. This study may be used to develop targeted interventions such as Heat Early Warning Systems in the area to reduce mortality from extreme temperatures.
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| 21. |
- Ingole, Vijendra, et al.
(författare)
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Socioenvironmental factors associated with heat and cold-related mortality in Vadu HDSS, western India : a population-based case-crossover study
- 2017
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Ingår i: International journal of biometeorology. - : Springer. - 0020-7128 .- 1432-1254. ; 61:10, s. 1797-1804
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Tidskriftsartikel (refereegranskat)abstract
- Ambient temperatures (heat and cold) are associated with mortality, but limited research is available about groups most vulnerable to these effects in rural populations. We estimated the effects of heat and cold on daily mortality among different sociodemographic groups in the Vadu HDSS area, western India. We studied all deaths in the Vadu HDSS area during 2004-2013. A conditional logistic regression model in a case-crossover design was used. Separate analyses were carried out for summer and winter season. Odds ratios (OR) and 95% confidence intervals (CI) were estimated for total mortality and population subgroups. Temperature above a threshold of 31 A degrees C was associated with total mortality (OR 1.48, CI = 1.05-2.09) per 1 A degrees C increase in daily mean temperature. Odds ratios were higher among females (OR 1.93; CI = 1.07-3.47), those with low education (OR 1.65; CI = 1.00-2.75), those owing larger agricultural land (OR 2.18; CI = 0.99-4.79), and farmers (OR 1.70; CI = 1.02-2.81). In winter, per 1 A degrees C decrease in mean temperature, OR for total mortality was 1.06 (CI = 1.00-1.12) in lag 0-13 days. High risk of cold-related mortality was observed among people occupied in housework (OR = 1.09; CI = 1.00-1.19). Our study suggests that both heat and cold have an impact on mortality particularly heat, but also, to a smaller degree, cold have an impact. The effects may differ partly by sex, education, and occupation. These findings might have important policy implications in preventing heat and cold effects on particularly vulnerable groups of the rural populations in low and middle-income countries with hot semi-arid climate.
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| 22. |
- Ingole, Vijendra, 1984-
(författare)
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Too Hot! : an Epidemiological Investigation of Weather-Related Mortality in Rural India
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- BackgroundMost environmental epidemiological studies are conducted in high income settings. The association between ambient temperature and mortality has been studied worldwide, especially in developed countries. However, more research on the topic is necessary, particularly in India, given the limited evidence on the relationship between temperature and health in this country. The average global temperature is increasing, and it is estimated that it will go up further. The factors affecting vulnerability to heat-related mortality are not well studied. Therefore, identifying high-risk population subgroups is of particular importance given the rising temperature in India.ObjectivesThis research aimed to investigate the association of daily mean temperature and rainfall with daily deaths (Paper I), examine the relationship of hot and cold days with total and cause-specific mortality (Paper II), assess the effects of heat and cold on daily mortality among different socio-demographic groups (Paper III) and estimate the effect of maximum temperature on years of life lost (Paper IV).MethodsThe Vadu Health and Demographic Surveillance System (HDSS) monitors daily deaths, births, in-out migration and other demographic trends in 22 villages from two administrative blocks in the rural Pune district of Maharashtra state, in western India. Daily deaths from Vadu HDSS and daily weather data (temperature and rainfall) from the Indian Meteorological Department were collected from 2003 through 2013. Verbal autopsy data were used to define causes of death and classified into four groups: non-infectious diseases, infectious diseases, external causes and unspecified causes of death. Socio-demographic groups were based on education, occupation, house type and land ownership. In all papers, time series regression models were applied as the basic approach; additionally, in Paper III, a case-crossover design and, in Paper IV, a distributed lag non-linear model (DLNM) were used.ResultsThere was a significant association between daily temperature and mortality. Younger age groups (0-4 years) reported higher risk of mortality due to high and low temperature and heavy rainfall. In the working age group (20-59 years), mortality was significantly associated only with high temperature. Mortality due to non-infectious diseases was higher on hot days (>39°C), while mortality from infectious diseases and from external causes were not associated with hot or cold days. A higher heat-related total mortality was observed among men than in women. Mortality among residents with low education and those whose occupation was farming was associated with high temperature. We found a significant impact of high temperature on years of life lost, which confirms our results from the previous research (Papers I-III).ConclusionThe study findings broadened our knowledge of the health impacts of environmental exposure by providing evidence on the risks related to ambient temperature in a rural population in India. More specifically, the study identified vulnerable population groups (working age groups, those of low education and farmers) in relation to high temperature. The adverse effect of heat on population is preventable if local human and technical capacities for risk communication and promoting adaptive behavior are built. Furthermore, it is necessary to increase residents’ awareness and prevention measures to tackle this public health challenge in rural populations.
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| 23. |
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| 24. |
- Junkka, Johan, 1981-, et al.
(författare)
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Climate vulnerability of Swedish newborns : Gender differences and time trends of temperature-related neonatal mortality, 1880–1950
- 2021
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Ingår i: Environmental Research. - : Elsevier. - 0013-9351 .- 1096-0953. ; 192
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Tidskriftsartikel (refereegranskat)abstract
- Background: In resource-poor societies, neonatal mortality (death in the first 28 days of life) is usually very high.Young infants are particularly vulnerable to environmental health risks, which are modified by socioeconomicfactors that change over time. We investigated the association between ambient temperature and neonatalmortality in northern Sweden during the demographic transition.Methods: Parish register data and temperature data in coastal Vasterbotten, ¨ Sweden, between 1880 and 1950were used. Total and sex-specific neonatal mortality was modelled as a function of mean temperature, adjustingfor age, seasonality and calendar time, using discrete-time survival analysis. A linear threshold function wasapplied with a cut point at 14.5 ◦C (the minimum mortality temperature). Odds ratios (ORs) with 95% confidence intervals (CIs) were computed. Further analyses were stratified by study period (1800–1899, 1900–1929,and 1930–1950).Results: Neonatal mortality was 32.1 deaths/1000 live births, higher in boys than in girls, and decreased between1880 and 1950, with high inter-annual variability. Mean daily temperature was +2.5 ◦C, ranging from − 40.9 ◦Cto +28.8 ◦C. At − 20 ◦C, the OR of neonatal death was 1.56 (CI 1.30–1.87) compared to the reference at +14.5 ◦C.Among girls, the OR of mortality at − 20 ◦C was 1.17 (0.88–1.54), and among boys, it was 1.94 (1.53–2.45). Atemperature increase from +14.5 to +20 ◦C was associated with a 25% increase of neonatal mortality (OR 1.25,CI 1.04–1.50). Heat- and cold-related risks were lowest between 1900 and 1929.Conclusions: In this remote sub-Arctic region undergoing socio-economic changes, we found an increased mortality risk in neonates related to low but also to high temperature. Climate vulnerability varied across time andwas particularly high among boys. This demonstrates that environmental impacts on human health are complexand highly dependent on the specific local context, with many, often unknown, contributing determinants ofvulnerability.
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| 25. |
- Karlsson, Lena, 1973-, et al.
(författare)
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Ambient temperature and stillbirth risks in northern Sweden, 1880–1950
- 2021
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Ingår i: Environmental Epidemiology. - : Wolters Kluwer. - 2474-7882. ; 5:6
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Tidskriftsartikel (refereegranskat)abstract
- Background: Climate vulnerability of the unborn can contribute to adverse birth outcomes, in particular, but it is still not well under-stood. We investigated the association between ambient temperature and stillbirth risk among a historical population in northern Sweden (1880–1950).Methods: We used digitized parish records and daily temperature data from the study region covering coastal and inland communi-ties some 600 km north of Stockholm, Sweden. The data included 141,880 births, and 3,217 stillbirths, corresponding to a stillbirth rate of 22.7 (1880–1950). The association between lagged temperature (0–7 days before birth) and stillbirths was estimated using a time-stratified case-crossover design. Incidence risk ratios (IRR) with 95% confidence intervals were computed, and stratified by season and sex.Results: We observed that the stillbirth risk increased both at low and high temperatures during the extended summer season (April to September), at −10°C, and the IRR was 2.3 (CI 1.28, 4.00) compared to the minimum mortality temperature of +15°C. No clear effect of temperature during the extended winter season (October to March) was found. Climate vulnerability was greater among the male fetus compared to the female counterparts.Conclusion: In this subarctic setting before and during industrialization, both heat and cold during the warmer season increased the stillbirth risk. Urbanization and socio-economic development might have contributed to an uneven decline in climate vulnerability of the unborn.
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