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1.
  • Månsson, Nils-Ove, et al. (författare)
  • Alcohol consumption and disability pension among middle-aged men
  • 1999
  • Ingår i: Annals of Epidemiology. - 1047-2797. ; 9:6, s. 341-348
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: To analyze the relation between alcohol consumption and the risk of disability pension among middle-aged men. METHODS: In the mid-seventies, complete birth-year cohorts of middle-aged male residents in Malmo, Sweden, were invited to participate in a general health survey. The 3751 men with complete data who constituted the cohort in this study were followed for 11 years. Alcohol consumption was estimated from the scores obtained from a test designed to identify subjects with alcohol related problems. RESULTS: Of the 498 men granted disability pension during follow-up, 48 stated to be teetotalers. The cumulative incidence of disability pension among teetotalers was 19%, whereas, it was 12% and 16%, respectively, among men with low and high alcohol consumption. The adjusted relative risk (RR) for acquiring a disability pension (using the group with low alcohol consumption as reference) was 1.8 among abstainers and 1.3 among men with high alcohol consumption. CONCLUSIONS: Alcohol overconsumption, as well as teetotalism, showed a positive relation to disability pension, and a moderate alcohol intake was found to be beneficial with respect to the risk of future disability pension.
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  • Michels, Karin B., et al. (författare)
  • Coffee, tea, and caffeine consumption and breast cancer incidence in a cohort of Swedish women
  • 2002
  • Ingår i: Annals of Epidemiology. - 1047-2797 .- 1873-2585. ; 12:1, s. 21-6
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: Coffee, caffeinated tea, and caffeine have been suggested to play a role in breast carcinogenesis or in the promotion or inhibition of tumor growth. Prior epidemiologic evidence has not supported an overall association between consumption of caffeinated beverages and risk of breast cancer, but consumption in some studies was low. METHODS: We studied this relation in the Swedish Mammography Screening Cohort, a large population-based prospective cohort study in Sweden comprising 59,036 women aged 40-76 years. Sweden has the highest coffee consumption per capita in the world. RESULTS: During 508,267 person-years of follow-up, 1271 cases of invasive breast cancer were diagnosed. Women who reported drinking 4 or more cups of coffee per day had a covariate-adjusted hazard ratio of breast cancer of 0.94 [95% confidence interval (CI) 0.75-1.28] compared to women who reported drinking 1 cup a week or less. The corresponding hazard ratio for tea consumption was 1.13 (95% CI 0.91-1.40). Similarly, women in the highest quintile of self-reported caffeine intake had a hazard ratio of beast cancer of 1.04 (95% CI 0.87-1.24) compared to women in the lowest quintile. CONCLUSIONS: In this large cohort of Swedish women, consumption of coffee, tea, and caffeine was not associated with breast cancer incidence.
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  • Bean, Christopher, 1990-, et al. (författare)
  • Poor peer relations in adolescence, social support in early adulthood, and depressive symptoms in later adulthood : evaluating mediation and interaction using four-way decomposition analysis
  • 2019
  • Ingår i: Annals of Epidemiology. - : Elsevier BV. - 1047-2797 .- 1873-2585. ; 29, s. 52-59
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: Supportive social relations are associated with good mental health, yet few studies have considered the prospective importance of adolescent peer relations for adult mental health and the potential mechanisms involved.Methods: Participants (n=941) were sourced from the Northern Swedish Cohort, a prospective study comprising school students aged 16 in 1981. Integrating life course epidemiology with four-way decomposition analysis, this paper considers the controlled direct effect of poor peer relations at age 16 on depressive symptoms at age 43, the pure indirect effect mediated by the availability of social support at age 30, and potential interactions between the exposure and the mediator.Results: After controlling for gender, baseline depressive symptoms and parental socioeconomic position, poor peer relations at age 16 were associated with depressive symptoms at age 43, largely irrespective of social support at age 30. Nonetheless, poor peer relations in adolescence were associated with poorer social support at age 30, and mediation accounted for a modest proportion (pure indirect effect 10%) of the association between poor peer relations and depressive symptoms at age 43.Conclusions: Policies to foster constructive peer relations for adolescents at school are encouraged; such policies may promote both the availability of social support and better mental health across the life course.
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  • Bellavia, Andrea, et al. (författare)
  • Alcohol consumption and mortality : a dose-response analysis in terms of time
  • 2014
  • Ingår i: Annals of Epidemiology. - : ELSEVIER SCIENCE INC. - 1047-2797 .- 1873-2585. ; 24:4, s. 291-296
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: Low-to-moderate alcohol consumption is associated with decreased mortality. However, many aspects of this association are still debated. Our aim was to complement available information by conducting a dose-response analysis of the association between alcohol consumption and survival time. Methods: In a Swedish population-based cohort of 67,706 middle-aged and elderly men and women, frequency and amount of drinking were assessed through a self-administrated questionnaire. During 15 years of follow-up, 13,323 participants died. Differences in survival (10th percentile differences, PDs) according to levels of alcohol consumption were estimated using Laplace regression. Results: We found evidence of nonlinearity between alcohol consumption and survival. Among women, we observed a rapid increase in survival up to 6 g/d of alcohol consumption (0.5 drinks/d) where survival was 17 months longer (PD = 17 months, 95% confidence interval, 10 to 24). After this peak, higher alcohol consumption was progressively associated with shorter survival. Among men, survival improved up to 15 g/d (1.5 drinks/d) where we observed a PD of 15 months (95% confidence interval, 8 to 22). Conclusions: Low alcohol consumption was associated with improved survival up to 1.5 years for women with an average consumption of 0.5 drinks per day and to 13 years for men with an average consumption of 1.5 drinks per day. (C) 2014 Elsevier Inc. All rights reserved.
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  • Bruckner, Tim .A., et al. (författare)
  • Cold ambient temperature in utero and birth outcomes in Uppsala, Sweden, 1915 to 1929
  • 2014
  • Ingår i: Annals of Epidemiology. - : Elsevier BV. - 1047-2797 .- 1873-2585. ; 24:2, s. 116-121
  • Tidskriftsartikel (refereegranskat)abstract
    • PurposeAlthough the literature reports adverse birth outcomes following ambient heat, less work focuses on cold. We, moreover, know of no studies of cold that examine stillbirth. We tested the relation between cold ambient temperature during pregnancy in Sweden and four outcomes: stillbirth, preterm, birth weight for gestational age, and birth length. We examined births from 1915 to 1929 in Uppsala, Sweden, which—unlike most societies today—experienced substandard indoor-heating and fewer amenities to provide shelter from cold.MethodsWe retrieved data on almost 14,000 deliveries from the Uppsala Birth Cohort Study. We linked a validated, daily ambient temperature series to all pregnancies and applied Cox proportional hazards (stillbirth and preterm) and linear regression models (birth weight and length). We tested for nonlinearity using quadratic splines.ResultsThe risk of stillbirth rose as ambient temperature during pregnancy fell (hazard ratio for a 1°C decrease in temperature, 1.08; 95% confidence interval, 1.00 to 1.17). Cold extremes adversely affected preterm and birth length, whereas warm extremes increased preterm risk. We observed no relation between cold and birth weight for gestational age.ConclusionIn historical Sweden, cold temperatures during pregnancy increased stillbirth and preterm risk and reduced birth length among live births.
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  • Cameron, Raquel, et al. (författare)
  • Mortality risk increased in colonic diverticular disease : a nationwide cohort study
  • 2022
  • Ingår i: Annals of Epidemiology. - : Elsevier. - 1047-2797 .- 1873-2585. ; 76, s. 39-49
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: There are limited population cohort data on overall and cause-specific mortality in colonic diverticular disease.Objective: To measure overall and cause-specific mortality in colonic diverticular disease, compared to matched reference individuals and siblings.Methods: Population-based cohort study ("the ESPRESSO study") in Sweden. There were 97,850 cases with a medical diagnosis of diverticular disease (defined by international classification of disease codes) and colorectal histology identified in 1987-2017 from histopathology reports. The mortality risk between individuals with colonic diverticular disease and matched reference individuals ( n = 453/634) from the general population was determined. Cox regression models adjusted for comorbidity estimated hazard ratios (HRs) for all-cause mortality.
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  • Crump, Casey, et al. (författare)
  • Gestational Age at Birth and Risk of Gastric Acid-Related Disorders in Young Adulthood
  • 2012
  • Ingår i: Annals of Epidemiology. - : Elsevier BV. - 1047-2797. ; 22:4, s. 233-238
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: Preterm birth is associated with gastric acid-related disorders in infancy, but no investigators have examined this association beyond early childhood. We used antisecretory medication data to explore whether preterm birth is associated with gastric acid-related disorders in young adulthood. METHODS: We conducted a national cohort study of 626,811 individuals born in Sweden in 1973 to 1979, followed up for antisecretory (proton pump inhibitor and H2-receptor antagonist) medication prescriptions from all outpatient and inpatient pharmacies nationwide from 2005 to 2009 (ages 25.5-37.0 years). We excluded individuals with congenital anomalies, and examined potential confounding by other comorbidities identified on the basis of oral anti-inflammatory or corticosteroid medication prescription. RESULTS: Gestational age at birth was inversely associated with antisecretory medication prescription in young adulthood. Adjusted odds ratios for >= 1 antisecretory medication prescription/year were 3.38 (95% confidence interval [95% CI], 1.73-6.62) for individuals born at 22-27 weeks, 1.38 (95% CI, 1.19-1.60) for those born at 28-34 weeks, and 1.19 (95% CI, 1.06-1.32) for those born at 35-36 weeks, relative to those born full-term (37-42 weeks). Exclusion of individuals who were prescribed oral anti-inflammatory or corticosteroid medications (>= 1/year) had little effect on these results. CONCLUSIONS: These findings suggest that low gestational age at birth may be independently associated with an increased risk of gastric acid-related disorders in young adulthood. Ann Epidemiol 2012;22:233-238. (C) 2012 Elsevier Inc. All rights reserved.
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  • Crump, Casey, et al. (författare)
  • Neighborhood Deprivation and Psychiatric Medication Prescription: A Swedish National Multilevel Study
  • 2011
  • Ingår i: Annals of Epidemiology. - : Elsevier BV. - 1047-2797. ; 21:4, s. 231-237
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: Previous studies of neighborhood deprivation and mental disorders have yielded mixed results, possibly because they were based on different substrata of the population. We conducted a national multilevel study to determine whether neighborhood deprivation is independently associated with psychiatric medication prescription in a national population. METHODS: Nationwide outpatient and inpatient psychiatric medication data were analyzed for all Swedish adults (N = 6,998,075) after 2.5 years of follow-up. Multilevel logistic regression was used to estimate the association between neighborhood deprivation (index of education, income, unemployment, and welfare assistance) and prescription of psychiatric medications (antipsychotics, antidepressants, anxiolytics, or hypnotics/sedatives), after adjusting for broadly measured individual-level sociodemographic characteristics. RESULTS: For each psychiatric medication class, a monotonic trend of increasing prescription was observed by increasing level of neighborhood deprivation. The strongest associations were found for antipsychotics and anxiolytics, with adjusted odds ratios of 1.40 (95% confidence interval [CI], 1.36-1.44) and 1.24 (95% CI, 1.22-1.27), respectively, comparing the highest-to the lowest-deprivation neighborhood quintiles. CONCLUSIONS: These findings suggest that neighborhood deprivation is associated with psychiatric medication prescription independent of individual-level sociodemographic characteristics. Further research is needed to elucidate the mechanisms by which neighborhood deprivation may affect mental health and to identify the most susceptible groups in the population. Ann Epidemiol 2011;21:231-237. (C) 2011 Elsevier Inc. All rights reserved.
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  • Crump, Casey, et al. (författare)
  • Preterm or early term birth and risk of attention-deficit/hyperactivity disorder : a national cohort and co-sibling study
  • 2023
  • Ingår i: Annals of Epidemiology. - 1047-2797. ; 86, s. 4-125
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: To examine risks of attention-deficit/hyperactivity disorder (ADHD) in preterm and early term birth survivors, and potential sex-specific differences. Methods: A national cohort study was conducted of all 4061,795 singletons born in Sweden in 1973–2013 who survived infancy, followed up for ADHD identified from nationwide diagnoses and medications through 2018. Poisson regression was used to compute prevalence ratios (PRs), adjusting for sociodemographic and perinatal factors. Co-sibling analyses assessed for confounding by unmeasured shared familial (genetic or environmental) factors. Results: ADHD prevalences by gestational age at birth were 12.1% for extremely preterm (22–27 weeks), 7.0% for moderately preterm (28–33 weeks), 5.7% for late preterm (34–36 weeks), 6.1% for all preterm (<37 weeks), 5.2% for early term (37–38 weeks), and 4.5% for full-term (39–41 weeks). Adjusted PRs comparing extremely preterm, all preterm, or early term versus full-term, respectively, were 2.35 (95% CI, 2.15–2.57), 1.28 (1.25–1.31), and 1.12 (1.10–1.13) among males, and 2.46 (2.17–2.78), 1.24 (1.20–1.28), and 1.08 (1.06–1.10) among females (P < .001 for each). These associations were virtually unchanged after controlling for shared familial factors. Both spontaneous and medically indicated preterm birth were associated with ADHD (adjusted PRs, 1.21; 95% CI, 1.18–1.24; and 1.39; 1.34–1.43, respectively). Conclusions: In this large cohort, preterm and early term birth were associated with increased risks of ADHD in males and females, independently of covariates and shared familial factors.
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  • Engström, Gunnar, et al. (författare)
  • Long-term change in cholesterol in relation to inflammation-sensitive plasma proteins: a longitudinal study.
  • 2007
  • Ingår i: Annals of Epidemiology. - : Elsevier BV. - 1047-2797. ; 17:1, s. 57-63
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: The nature of the relationship between inflammation and elevated serum lipid levels is incompletely understood. This longitudinal study explores whether elevated levels of inflammation-sensitive plasma proteins (ISPs) are a risk factor for developing increased cholesterol and triglyceride levels. METHODS: Five ISPs (fibrinogen, orosomucoid, alpha(1)-antitrypsin, haptoglobin, and ceruloplasmin) were measured in a population-based cohort of nondiabetic healthy men aged 38 to 50 years at baseline. Subjects were reexamined after a mean of 6.2 years. The development of hypercholesterolemia (cholesterol >= 6.5 mmol/L [>= 251 mg/dL]) and hypertriglyceridemia (triglycerides >= 2.3 mmol/L [>= 204 mg/dL]) during follow-up was studied in relation to the number of elevated levels of ISPs (i.e., in the top quartile). RESULTS: Of men with initially normal cholesterol levels (< 6.5 mmol/L; n = 2224), proportions of men with no, one, two, and three or more elevated ISP levels at baseline who developed hypercholesterolemia were 12%, 13%, 16%, and 20%, respectively (p for trend = 0.0002). This relationship remained significant after adjustments for cholesterol level at baseline and other confounding factors. The relationship between ISP levels and future hypertriglyceridemia was attenuated and nonsignificant after adjustments for confounding factors. CONCLUSION: In apparently healthy men with initially normal cholesterol levels, elevated ISP levels are a risk factor for development of hypercholesterolemia.
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  • Fedirko, Veronika, et al. (författare)
  • Alcohol drinking and endometrial cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study
  • 2013
  • Ingår i: Annals of Epidemiology. - : Elsevier BV. - 1047-2797 .- 1873-2585. ; 23:2, s. 93-98
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: Alcohol intake may adversely affect the concentrations of endogenous sex hormones, and thus increase the risk of endometrial cancer. However, epidemiologic studies have provided conflicting results. Therefore, we investigated the association between alcohol intake and endometrial cancer risk a large, multicenter, prospective study. Methods: From 1992 through 2010, 301,051 women in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort were followed for incident endometrial cancer (n = 1382). Baseline alcohol consumption was assessed by country-specific, validated dietary questionnaires. Information on past alcohol consumption was collected by lifestyle questionnaires. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated from Cox proportional hazard models. Results: The multivariable HRs (and 95% CIs) compared with light drinkers (0.1-6 g/d) were 1.03(0.88-1.20) for 0 g of alcohol per day at baseline, 1.01 (0.86-1.17) for 6.1-12 g/d, 1.03 (0.87-1.22) for 12.1-24 g/d, 1.07(0.87-1.38) for 241-36 g/d, and 0.85(0.61-1.18) for more than 36 g/d (p(trend) = 0.77). No association was observed among former drinkers (OR, 1.28; 95% CI, 0.98-1.68 compared with light drinkers). Null associations were also found between alcohol consumption at age 20 years, lifetime pattern of alcohol drinking, and baseline alcohol intake from specific alcoholic beverages and endometrial cancer risk. Conclusions: Our findings suggest no association between alcohol intake and endometrial cancer risk.
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  • Gustafsson, Per E, et al. (författare)
  • Life course origins of the metabolic syndrome in middle-aged women and men : the role of socioeconomic status and metabolic risk factors in adolescence and early adulthood
  • 2011
  • Ingår i: Annals of Epidemiology. - : Elsevier BV. - 1047-2797 .- 1873-2585. ; 21:2, s. 103-110
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: To assess whether body mass index (BMI), blood pressure, and socioeconomic status in adolescence and early adulthood are independently related to the metabolic syndrome in adult women and men. METHODS: We based our work on a Swedish prospective cohort study that recruited participants at 16 years of age (N = 1083 at age 16; 403 women and 429 men at age 43, 78% of those still alive [N = 1071]). Blood pressure (BP) and BMI were assessed when participants were 16 and 21 years of age. At age 43, the metabolic syndrome was defined according to the International Diabetes Federation guidelines. Socioeconomic status (SES) was operationalized by the participant (age 21 and 43) or parent's (age 16) occupational status. Information on smoking, snuff, alcohol, and inactivity was collected at age 43. RESULTS: In women, SES at age 16 was independently related to the risk of metabolic syndrome. In women and men, BMI at age 16 was related to metabolic syndrome but was attenuated by BMI at age 21, which was significant in the final model; in women systolic BP displayed similar patterns. CONCLUSIONS: Our data seem to suggest two independent life course pathways for metabolic syndrome: one metabolic pathway for both women and men operating through BMI (for women also systolic BP) in adolescence and early adulthood, and for women, an apparently independent pathway through adolescent socioeconomic disadvantage. Ann Epidemiol 2011;21:103-110. (C) 2011 Elsevier Inc. All rights reserved.
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  • Hemminki, Kari, et al. (författare)
  • Subsequent Autoimmune or Related Disease in Asthma Patients: Clustering of Diseases or Medical Care?
  • 2010
  • Ingår i: Annals of Epidemiology. - : Elsevier BV. - 1047-2797 .- 1873-2585. ; 20, s. 217-222
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: Asthma includes immunological components that may share mechanisms with autoimmune diseases. We analyzed the subsequent occurrence of any of 22 autoimmune and related conditions in hospitalized asthma patients. METHODS: A nationwide study was conducted in Sweden on subsequent diseases of asthma patients on the basis of the Hospital Discharge Register. Standardized incidence ratios (SIRs) were calculated for subsequent autoimmune diseases. RESULTS: A total of 4006 patients were hospitalized for an autoimmune condition after last hospitalization for asthma. The SIRs were increased for 11 subsequent autoimmune conditions, diagnosed at least 5 years after asthma. The highest SIRs were noted for polyarteritis nodosa (4.29) and Addison disease (3.62). SIRs for these diseases and others, including the most common autoimmune disease rheumatoid arthritis, were increased even when the follow-up was started 5 years after the last asthma hospitalization. Addison disease and Crohn disease were increased in asthma patients hospitalized at various ages, whereas young asthma patients presented with celiac disease and immune thrombocytopenic purpura. CONCLUSIONS: Hospitalized asthma patients presented with a number of subsequent autoimmune and related diseases. Although we were unable to exclude the effects of environmental factors, the data suggest that shared genetic factors or gene-environment interactions may explain coexistence of some of these diseases.
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  • Johansson, AnnaKarin, et al. (författare)
  • Assessment of Smoking Behaviors in the Home and Their Influence on Children's Passive Smoking: Development of a Questionnaire
  • 2005
  • Ingår i: Annals of Epidemiology. - : Elsevier BV. - 1047-2797. ; 15:6, s. 453-459
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose To construct and validate a questionnaire aiming to measure children's exposure to environmental tobacco smoke (ETS) in the home. Methods The development of the instrument included epidemiological studies, qualitative interviews, pilot studies, and validation with biomarkers and is described in seven consecutive steps. Parents of preschool children, from different population-based samples in south-east Sweden, have participated in the studies. Results Content and face validity was tested by an expert panel and core elements for the purpose of the instrument identified. Reliability was shown with test-retest of the first version. The validation with biomarkers indicated that the sensitivity of the instrument was high enough to discriminate between children's ETS exposure levels. Cotinine/creatinine levels were related to parents' described smoking behaviors. Differences were shown between children from non-smoking homes, and all groups with smoking parents, independent of their smoking behavior (p < 0.01), as well as between parents smoking strictly outdoors and parents reporting indoor smoking (p < 0.001). Conclusion The results indicate that the presented instrument can be used to discriminate between different levels of ETS exposure and when children's level of tobacco smoke exposure is to be assessed.
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  • Larsson, Susanna C., et al. (författare)
  • Black tea consumption and risk of stroke in women and men
  • 2013
  • Ingår i: Annals of Epidemiology. - : ELSEVIER SCIENCE INC. - 1047-2797 .- 1873-2585. ; 23:3, s. 157-160
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: Our aim was examine the association between black tea consumption and risk of total stroke and stroke types in a prospective study. Methods: A total of 74,961 Swedish women and men who were free of cardiovascular disease and cancer at baseline in 1997 were followed up through December 2008. Tea consumption was assessed with a questionnaire at baseline. Stroke cases were ascertained from the Swedish Hospital Discharge Registry. Results: During a mean follow-up of 10.2 years, we ascertained 4089 cases of first stroke, including 3159 cerebral infarctions, 435 intracerebral hemorrhages, 148 subarachnoid hemorrhages, and 347 unspecified strokes. After adjustment for other risk factors, high tea consumption was associated with a significantly lower risk of total stroke; however, there was no dose response relation (P for trend = .36). Compared with no tea consumption, the multivariable relative risk for four or more cups per day (median, 5) was 0.79 (95% confidence interval [CI], 0.62-0.998). The corresponding relative risks were 0.80 (95% CI, 0.61-1.04) for cerebral infarction and 0.68 (95% Cl, 0.35-1.30) for hemorrhagic stroke. Conclusions: These findings suggest that daily consumption of four or more cups of black tea is inversely associated with risk of stroke. (C) 2013 Elsevier Inc. All rights reserved.
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  • Martinengo, Laura, et al. (författare)
  • Prevalence of chronic wounds in the general population : systematic review and meta-analysis of observational studies
  • 2019
  • Ingår i: Annals of Epidemiology. - : Elsevier BV. - 1047-2797. ; 29, s. 8-15
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: Chronic wounds are a major public health challenge, but little is known about the true burden with studies reporting different estimates because of disparities in study designs and measurement methods. This hampers efficient resource allocation, planning, and improvement of wound care. Methods: Our study aimed to pool prevalence estimates from a global perspective by systematically carrying out searches in MEDLINE, EMBASE, Cochrane, CINAHL, Global Health, and PsycINFO databases for articles reporting the prevalence of chronic wounds in adults, from January 2000 to June 2018. The included publications had to define wound chronicity by duration (≥3 weeks), and/or labeling the wounds as chronic, complex, or hard-to-heal. Results: Seventeen studies met the inclusion criteria, and 11 studies analyzing chronic wounds in the general population were included in random effects meta-analyses to calculate pooled prevalence. Chronic wounds of mixed etiologies (n = 3) showed a pooled prevalence of 2.21 per 1000 population, and for chronic leg ulcers (n = 9), the prevalence was estimated at 1.51 per 1000 population. Conclusions: Our findings, aligned to previous studies reporting point prevalence of chronic wounds identified within the healthcare system, showed that the vast majority of chronic wounds in epidemiological studies are made up by chronic leg ulcers.
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  • Mboya, Innocent B, et al. (författare)
  • Time trends of the association of body mass index with mortality in 3.5 million young Swedish adults
  • Ingår i: Annals of Epidemiology. - 1047-2797. ; 97, s. 23-32
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: We investigated time trends of the obesity-mortality association, accounting for age, sex, and cause-specific deaths.METHODS: We analysed pooled nationwide data in Sweden for 3,472,310 individuals aged 17-39 years at baseline in 1963-2016. Cox regression and flexible parametric survival models investigated BMI-mortality associations in sub-groups of sex and baseline calendar years (men: <1975, 1975-1985, ≥1985 and women: <1985, 1985-1994, ≥1995).RESULTS: Comparing men with obesity vs. normal weight, all-cause and "other-cause" mortality associations decreased over periods; HR (95% CI) 1.92 (1.83-2.01) and 1.70 (1.58-1.82) for all-cause and 1.72 (1.58-1.87) and 1.40 (1.28-1.53) for "other-cause" mortality in <1975 and ≥1985, but increased for CVD mortality; HR 2.71 (2.51-2.94) and 3.91 (3.37-4.53). Higher age at death before 1975 coincided with more obesity-related deaths at higher ages. Furthermore, the all-cause mortality association for different ages in men showed no clear differences between periods (p-interaction=0.09), suggesting no calendar effect after accounting for attained age. Similar, but less pronounced, results were observed in women. Associations with cancer mortality showed no clear trends in men or in women.CONCLUSIONS: Accounting for differences in age and death causes between calendar periods when investigating BMI-mortality time trends may avoid misinterpreting the risks associated with obesity over time.
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  • Mboya, Innocent B, et al. (författare)
  • Time trends of the association of body mass index with mortality in 3.5 million young Swedish adults
  • 2024
  • Ingår i: Annals of Epidemiology. - : Elsevier. - 1047-2797 .- 1873-2585. ; 97, s. 23-32
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: We investigated time trends of the obesity-mortality association, accounting for age, sex, and cause-specific deaths.Methods: We analysed pooled nationwide data in Sweden for 3,472,310 individuals aged 17–39 years at baseline in 1963–2016. Cox regression and flexible parametric survival models investigated BMI-mortality associations in sub-groups of sex and baseline calendar years (men: <1975, 1975–1985, ≥1985 and women: <1985, 1985–1994, ≥1995).Results: Comparing men with obesity vs. normal weight, all-cause and “other-cause” mortality associations decreased over periods; HR (95% CI) 1.92 (1.83–2.01) and 1.70 (1.58–1.82) for all-cause and 1.72 (1.58–1.87) and 1.40 (1.28–1.53) for “other-cause” mortality in <1975 and ≥1985, but increased for CVD mortality; HR 2.71 (2.51–2.94) and 3.91 (3.37–4.53). Higher age at death before 1975 coincided with more obesity-related deaths at higher ages. Furthermore, the all-cause mortality association for different ages in men showed no clear differences between periods (p-interaction=0.09), suggesting no calendar effect after accounting for attained age. Similar, but less pronounced, results were observed in women. Associations with cancer mortality showed no clear trends in men or in women.Conclusions: Accounting for differences in age and death causes between calendar periods when investigating BMI-mortality time trends may avoid misinterpreting the risks associated with obesity over time.
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  • McCoy, Brittany M., et al. (författare)
  • Mediators of the association between parental severe mental illness and offspring neurodevelopmental problems
  • 2014
  • Ingår i: Annals of Epidemiology. - New York, USA : Elsevier. - 1047-2797 .- 1873-2585. ; 24:9, s. 629-634.e1
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: Parental severe mental illness (SMI) is associated with an increased risk of offspring autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). We conducted a study to examine the extent to which risk of preterm birth, low birth weight, and small for gestational age mediated this association.Methods: We obtained data on offspring born 1992-2001 in Sweden (n = 870,017) through the linkage of multiple population-based registers. We used logistic and Cox regression to assess the associations between parental SMI, adverse pregnancy outcomes, and offspring ASD and ADHD, as well as tested whether adverse pregnancy outcomes served as mediators.Results: After controlling for measured covariates, maternal and paternal SMI were associated with an increased risk for preterm birth, low birth weight, and gestational age, and for offspring ASD and ADHD. These pregnancy outcomes were also associated with an increased risk of ASD and ADHD. We found that pregnancy outcomes did not mediate the association between parental SMI and offspring ASD and ADHD, as there was no substantial change in magnitude of the risk estimates after controlling for pregnancy outcomes.Conclusions: Parental SMI and adverse pregnancy outcomes appear to be independent risk factors for offspring ASD and ADHD.
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  • Mo, Minjia, et al. (författare)
  • The joint effect between fetal growth and health behaviors on the risk of cardiovascular diseases in young adulthood
  • 2023
  • Ingår i: Annals of Epidemiology. - : Elsevier. - 1047-2797 .- 1873-2585. ; 78, s. 54-60
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: To investigate the individual and the joint effect of impaired fetal growth and adult health behaviors on the risk of cardiovascular diseases (CVDs).Methods: A total of 15,618 individuals were included from three sub-cohorts of the Stockholm Public Health Cohort. Data on participants' birthweight and gestational age were retrieved from the Medical Birth Register. Data on the diagnoses of CVDs were extracted from the Swedish National Patient Register and the Cause of Death Register. Data on health behaviors were identified from self-reported questionnaires, and health behavioral profile was defined based on the recommendations of the American Health Association. The associations of fetal growth and health behaviors with the risk of CVDs were analyzed using Cox proportional hazard model.Results: Individuals born small for gestational age (SGA) had a higher risk of CVDs than those born appropriate for gestational age (AGA), and the adjusted hazard ratio (HR) and 95% confidence interval (CI) was 1.88 (1.44, 2.47). Participants born SGA and having poor health behavioral profile in adulthood had a higher risk of CVDs than those born AGA and having ideal health behaviors with adjusted HR (95% CI) being 3.58 (1.95, 6.56).Conclusions: Impaired fetal growth was associated with an increased risk of CVDs in adulthood, and the risk was highest in individuals with both impaired fetal growth and poor health behaviors in adulthood.
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41.
  • Pazzagli, Laura, et al. (författare)
  • Marginal structural model to evaluate the joint effect of socioeconomic exposures on the risk of developing end-stage renal disease in patients with type 1 diabetes : a longitudinal study based on data from the Swedish Childhood Diabetes Study Group
  • 2017
  • Ingår i: Annals of Epidemiology. - New York : Elsevier. - 1047-2797 .- 1873-2585. ; 27:8, s. 479-484
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: Diabetic nephropathy is a severe complication of type 1 diabetes (T1D) that may lead to renal failure and end-stage renal disease (ESRD) demanding dialysis and transplantation. The aetiology of diabetic nephropathy is multifactorial and both genes and environmental and life style related factors are involved. In this study we investigate the effect of the socioeconomic exposures unemployment and receiving income support on the development of ESRD in T1D patients, using a marginal structural model in comparison with standard logistic regression models.Methods: The study is based on the Swedish Childhood Diabetes Register which in 1977 started to register patients developing T1D before 15 years of age. In the analyses we include patients born between 1965 and 1979, developing diabetes between 1977 and 1994, followed until 2013 (n=4034). A marginal structural model (MSM) was fitted to adjust for both baseline and time-varying confounders.Results: The main results of the analysis indicate that being unemployed for more than one year and receiving income support are risk factors for the development of ESRD. Multiple exposure over time to these risk factors increases the risk associated with the disease.Conclusions: Using a MSM is an advanced method well suited to investigate the effect of exposures on the risk of complications of a chronic disease with longitudinal data. The results show that socioeconomic disadvantage increases the risk of developing ESRD in patients with type 1 diabetes.
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42.
  • Pham, T. M., et al. (författare)
  • Average lifespan shortened due to cancer in selected countries of North America, Europe, Asia and Oceania, 2006 and 2016
  • 2023
  • Ingår i: Annals of Epidemiology. - : Elsevier BV. - 1047-2797. ; 80, s. 76-85
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: We applied a novel measure of average lifespan shortened (ALSS) to examine changes in lifespan among patients who died of cancer over a 10-year period from 2006 to 2016 in 20 selected high-income countries from North America, Europe, Asia, and Oceania. Methods: We retrieved cancer deaths in each country from the World Health Organization mortality database. We calculated ALSS as a ratio of years of life lost to the expected lifespan among patients who died from cancer.Results: Between 2006 and 2016, we observed modest changes in ALSS for overall cancer deaths over the study in many countries. The changes in the ALSS over time due to any cancer ranged between-1.7 and + 0.4 percentage points (pps) among men and between-1.9 and + 0.6 pps among women. Across countries, overall cancer deaths led to an average loss between 16% and 22% of their lifespan in men, and between 18% and 24% in women. Across cancer sites, patients who died of central nervous system cancers, for instance, lost a large proportion of their lifespan.Conclusions: In this study, we demonstrated the use of ALSS across selected high-income countries, which enables population-level assessment of premature mortality among cancer patients over time. (c) 2023 Published by Elsevier Inc.
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44.
  • Robbins, Hilary A., et al. (författare)
  • Design and methodological considerations for biomarker discovery and validation in the Integrative Analysis of Lung Cancer Etiology and Risk (INTEGRAL) Program
  • 2023
  • Ingår i: Annals of Epidemiology. - : Elsevier. - 1047-2797 .- 1873-2585. ; 77, s. 1-12
  • Tidskriftsartikel (refereegranskat)abstract
    • The Integrative Analysis of Lung Cancer Etiology and Risk (INTEGRAL) program is an NCI-funded initiative with an objective to develop tools to optimize low-dose CT (LDCT) lung cancer screening. Here, we describe the rationale and design for the Risk Biomarker and Nodule Malignancy projects within INTEGRAL. The overarching goal of these projects is to systematically investigate circulating protein markers to include on a panel for use (i) pre-LDCT, to identify people likely to benefit from screening, and (ii) post-LDCT, to differentiate benign versus malignant nodules. To identify informative proteins, the Risk Biomarker project measured 1161 proteins in a nested-case control study within 2 prospective cohorts (n = 252 lung cancer cases and 252 controls) and replicated associations for a subset of proteins in 4 cohorts (n = 479 cases and 479 controls). Eligible participants had a current or former history of smoking and cases were diagnosed up to 3 years following blood draw. The Nodule Malignancy project measured 1078 proteins among participants with a heavy smoking history within four LDCT screening studies (n = 425 cases diagnosed up to 5 years following blood draw, 430 benign-nodule controls, and 398 nodule-free controls). The INTEGRAL panel will enable absolute quantification of 21 proteins. We will evaluate its performance in the Risk Biomarker project using a case-cohort study including 14 cohorts (n = 1696 cases and 2926 subcohort representatives), and in the Nodule Malignancy project within five LDCT screening studies (n = 675 cases, 680 benign-nodule controls, and 648 nodule-free controls). Future progress to advance lung cancer early detection biomarkers will require carefully designed validation, translational, and comparative studies.
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46.
  • Timpka, Toomas, et al. (författare)
  • Face mask use during the COVID-19 pandemic-the significance of culture and the symbolic meaning of behavior
  • 2021
  • Ingår i: Annals of Epidemiology. - : ELSEVIER SCIENCE INC. - 1047-2797 .- 1873-2585. ; 59
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
    • During public emergencies, a door can open on the fundamental elements upon which a societys social order is built. The Covid-19 pandemic has opened such a door in societies worldwide. We outline in this commentary some of these social elements and how they may have influenced face mask use during the early stages of the pandemic. The purpose is to expand the perspective on mechanisms that are relevant to consider in pandemic response planning. Our look at these fundamental elements showed that latent aspects of the dominant culture and various symbolic meanings of behaviors can reduce adherence with public health recommendations if they are overlooked in the strategic health plans. We conclude that when policymakers decide non-pharmacological interventions during pandemics, they should take into account fundamental attitudes and beliefs that may influence population behavior. This will require paying attention to variations in things like culture and symbolic meanings of behavior. (C) 2021 Elsevier Inc. All rights reserved.
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47.
  • Tverdal, A., et al. (författare)
  • Coffee and wine consumption is associated with reduced mortality from alcoholic liver disease: follow-up of 219,279 Norwegian men and women aged 30-67 years
  • 2018
  • Ingår i: Annals of Epidemiology. - : Elsevier BV. - 1047-2797. ; 28:11, s. 753-758
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: To study the association between coffee and alcoholic beverage consumption and alcoholic liver disease mortality. Methods: In total, 219,279 men and women aged 30-67 years attended cardiovascular screening in Norway from 1994 to 2003. Linkage to the Cause of Death Registry identified 93 deaths from alcoholic liver disease. Coffee consumption was categorized into four levels: 0, 1-4, 5-8, and greater than or equal to 9 cups/d and alcohol consumption as 0, greater than 0 to less than 1.0, 1.0 to less than 2.0, and greater than or equal to 2.0 units/d, for beer, wine, liquor, and total alcohol consumption. Results: The hazard ratios per one category of consumption were 2.06 (95% confidence interval 1.62-2.61), 0.68 (0.46-1.00), and 2.54 (1.92-3.36) for beer, wine, and liquor, respectively. Stratification at 5 cups/d (the mean) revealed a stronger association between alcohol consumption and alcoholic liver disease at less than 5 versus 5 or more cups/d. With less than 5 cups/d, 0 alcohol units/d as reference, the hazard ratio reached to 25.5 (9.2-70.5) for greater than or equal to 2 units/d, whereas with greater than or equal to 5 cups/d, it reached 5.8 (1.9-17.9) for greater than or equal to 2 units/d. A test for interaction was significant (P = .01). Conclusions: Coffee and wine consumption were inversely associated with alcoholic liver disease death. Total alcohol consumption was adversely associated with alcoholic liver disease mortality and the strength of the association varied with the level of coffee consumption. (C) 2018 Elsevier Inc. All rights reserved.
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  • Ytterberg, Karin, et al. (författare)
  • Exploring the association of parity and its interaction with history of preterm delivery on gestational duration.
  • 2023
  • Ingår i: Annals of epidemiology. - 1047-2797 .- 1873-2585. ; 87
  • Tidskriftsartikel (refereegranskat)abstract
    • Preterm delivery is a major cause of child mortality. While the relationship between parity and preterm delivery is known, its association with gestational duration and variability remains underexplored. Differences in variance may suggest interaction with other well-established risk factors.With 1.1 million spontaneous deliveries (1990-2012) from the Swedish Medical Birth Register, we assessed while accounting for potential confounders the effects of parity on the mean and variance of gestational duration, and its possible interactions with history of preterm delivery. Pedigrees allowed to account for nonobserved, shared confounders using linear mixed models.Parity has a modest association with mean gestational duration, but a large effect on its variance. For example, the first pregnancy had the shortest mean gestational duration, 0.29days shorter (95% CI: -0.33, -0.25) than the second, and the largest variance (σ2 =135days2). Accounting for shared unobserved confounders highlighted a group effect bias, likely linked to the mothers' total number of offspring. Parity interacts with other risk factors, including previous preterm delivery where the magnitude of its effect increases with parity (up to 4.6days effect difference).Nonshared factors across a mother's pregnancies highlight parity's importance to gain insight into the mechanisms governing the timing of delivery.
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