| 1. |
- Chen, Yun, 1966, et al.
(författare)
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Hair glucocorticoid concentration, self-perceived stress and their associations with cardiometabolic risk markers in Swedish adolescents
- 2022
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Ingår i: Psychoneuroendocrinology. - : Elsevier BV. - 0306-4530. ; 146
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Tidskriftsartikel (refereegranskat)abstract
- Background: While hair cortisol is proposed as a biomarker for chronic stress and a possible mediator linking chronic stress and cardiovascular risk in adults, studies in adolescents are scarce. We explored the associations between self-perceived stress, hair cortisol (HairF) and cortisone (HairE), and cardiometabolic risk markers in adolescents. Further, we examined whether association between self-perceived stress and HairF may depend on the use of the coping strategies "shift-persist ". Methods: Participants were 7th grade pupils recruited to the STudy of Adolescence Resilience and Stress (STARS) and data from the baseline examinations were used. Adolescents (n = 1553, 26 % boys, Mage=13.6, SD = 0.4) completed questionnaires assessing perceived stress and coping strategies "shift-persist ", provided hair sample, and examined for cardiometabolic risk factors including waist circumference (WC), body mass index (BMI) z -score, blood pressure, and white blood cell counts (WBC). HairF and HairE were analysed using liquid chro-matography with tandem mass spectrometry. We conducted descriptive analyses (Student's t-test, Wilcoxon Signed Ranks test, Chi-square test) and linear regression analyses. Results: Perceived stress was not associated with HairF, neither had the use of coping strategies "shift-persist " any influence on this association. Both HairF and HairE were positively associated with BMI z-score (beta coefficients (8): 0.178 (p < 0.001) and 0.119 (p < 0.001) for boys; 0.123 (p < 0.001) and 0.089 (p < 0.01) for girls) and WC (8: 0.089 (p > 0.05) and 0.098 (p < 0.05) for boys; 0.103 (p < 0.01) and 0.076 (p < 0.05) for girls). Perceived stress was also positively associated with BMI z-score and WC. Perceived stress, but not HairF, remained asso-ciated with WC in boys (8 = 0.200, p < 0.001) in the models with HairF and perceived stress presented simultaneously. Modest association between HairE and WBC was found in boys (8 = 0.149, p < 0.01). Conclusions: The study supports the association between chronic stress and overweight/obesity in adolescents. Hair cortisol and self-perceived stress capture different aspects of how chronic stress is related to overweight/ obesity in adolescents.
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| 2. |
- Corell, Maria, et al.
(författare)
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Does the family affluence scale reflect actual parental earned income, level of education and occupational status? A validation study using register data in Sweden
- 2021
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Ingår i: Bmc Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Aim To examine the external validity of the Family Affluence Scale (FAS) among adolescents in Sweden by using register data for parental earned income, level of education and occupational status. Methods Data from the baseline (2015-2019) of the Study of Adolescence Resilience and Stress (STARS), comprising 2283 13-year-olds in the region of Vastra Gotaland, were used. The FAS III consists of six items: unshared bedroom, car ownership, computer/tablet ownership, dishwasher, number of bathrooms and number of holidays abroad. Register data regarding earned income, educational level and occupational status from Statistics Sweden (2014-2018) were linked to adolescents. In total, survey data were available for 2280 adolescents, and register data were available for 2258 mothers and 2204 fathers. Results Total parental earned income was moderately correlated with adolescents' scoring on FAS (0.31 r < 0.48, p < 0.001), depending on examination year. The low FAS group mainly comprised low-income households, and the high FAS group mainly comprised high-income households. Correlations between mothers' and fathers' educational level and adolescents' scoring on FAS were low (r = 0.19 and r = 0.21, respectively, p < 0.001). FAS was higher among adolescents whose parents were working, but the correlation between parents' occupational status and FAS was low (r = 0.22, p < 0.001). Conclusions The FAS can mainly identify low- and high-income households in Sweden. It may be used as an alternative measure of parental earned income in studies using self-reported socioeconomic status among adolescents.
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| 3. |
- Corell, Maria, et al.
(författare)
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Socioeconomic inequalities in adolescent mental health in the Nordic countries in the 2000s-A study using cross-sectional data from the Health Behaviour in School-aged Children study
- 2024
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Ingår i: ARCHIVES OF PUBLIC HEALTH. - 0778-7367 .- 2049-3258. ; 82:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundAdolescents in Sweden experience more mental health problems and lower mental well-being than adolescents in other Nordic countries. According to the literature, one possible explanation may be differences in income inequality. The at-risk-of-poverty rate varies significantly across the Nordic countries, and the highest rate is found in Sweden. The aims of the study were to examine socioeconomic inequalities in subjective health complaints and life satisfaction among adolescents in the Nordic countries during 2002 - 2018 and to explore whether subjective health complaints and life satisfaction were related to income inequality in terms of the at-risk-of-poverty rate at the country level.MethodsData regarding 15-year-olds from the Health Behaviour in School-aged Children study from five survey rounds (2002 - 2018) were used (n = 41,148). The HBSC Symptoms Checklist and Cantril's ladder were used as measures of subjective health complaints and life satisfaction, respectively. The Family Affluence Scale, the Perceived Family Wealth item and the at-risk-of-poverty rate in each country were used as measures of individual-level socioeconomic conditions and country-level income inequality. Statistical methods involved ANOVA, multiple linear regressions and multilevel regression analyses.ResultsAbsolute and relative socioeconomic inequalities in both subjective health complaints and life satisfaction were found in all countries. Sweden showed average socioeconomic inequalities, Iceland the largest and Denmark the smallest. Country-level income inequality in terms of the at-risk-of-poverty rate was associated with a higher prevalence of subjective health complaints and lower levels of life satisfaction in all countries.ConclusionSocioeconomic inequalities in adolescent mental health and well-being persisted in Nordic countries in the 2000s. Increasing income inequality may have contributed to higher levels of SHC and lower LS in Sweden compared to the other Nordic countries. Policies improving families' socioeconomic conditions and reducing income inequality at the country level are needed to improve and reduce inequalities in mental health and well-being among adolescents.
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| 4. |
- Corell, Maria, et al.
(författare)
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Subjective health complaints in early adolescence reflect stress: A study among adolescents in Western Sweden
- 2022
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 50:4, s. 516-523
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Mental health problems are common among Swedish adolescents and are sometimes referred to as 'stress-related'. The overall aim of this study is to do an analysis of subjective health complaints (SHCs) and perceived general stress among adolescents in Sweden, both their prevalence and association, by gender, migration background, family structure and socioeconomic conditions. Methods: Data from the baseline (comprising 2283 adolescents aged 13) of the STudy of Adolescence Resilience and Stress (STARS) study in Vastra Gotaland in Sweden were used. SHCs were measured by the Psychosomatic Problems Scale (PSP-scale) and self-reported stress was measured by Cohen's Perceived Stress Scale (PSS-10). Socioeconomic conditions were measured with the Family Affluence Scale (FAS) and the MacArthur Scale of Subjective Social Status (SSS). Statistical analyses included Student's t-tests and ANOVAs of means, linear and logistic regression analyses and Pearson's correlations. Results: Social inequalities in both SHCs and self-reported stress were found; levels were higher among girls, adolescents living with one parent or in families with less favourable socioeconomic conditions. Self-reported stress and SHCs were found to be strongly correlated (r=0.70). Correlations with self-reported stress were stronger for psychological complaints (r=0.71) than for somatic complaints (r=0.52). Correlations did not vary with socioeconomic conditions of the family. Conclusions: SHCs do reflect general stress among adolescents, and it is appropriate to address the complaints as 'stress-related'. Measures to improve adolescents' mental health by reducing levels of SHCs should pay special attention to stressors in adolescents' daily lives and strengthening adolescent's coping resources and strategies.
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| 5. |
- Munkvold, Bodil Karoline Ravn, et al.
(författare)
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Variations in the management of diffuse low-grade gliomas : A Scandinavian multicenter study
- 2021
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Ingår i: Neuro-Oncology Practice. - : Oxford University Press. - 2054-2577 .- 2054-2585. ; 8:6, s. 706-717
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Tidskriftsartikel (refereegranskat)abstract
- Background. Early extensive surgery is a cornerstone in treatment of diffuse low-grade gliomas (DLGGs), and an additional survival benefit has been demonstrated from early radiochemotherapy in selected "high-risk" patients. Still, there are a number of controversies related to DLGG management. The objective of this multicenter population-based cohort study was to explore potential variations in diagnostic work-up and treatment between treating centers in 2 Scandinavian countries with similar public health care systems.Methods. Patients screened for inclusion underwent primary surgery of a histopathologically verified diffuse WHO grade II glioma in the time period 2012 through 2017. Clinical and radiological data were collected from medical records and locally conducted research projects, whereupon differences between countries and inter-hospital variations were explored.Results. A total of 642 patients were included (male:female ratio 1:4), and annual age-standardized incidence rates were 0.9 and 0.8 per 100 000 in Norway and Sweden, respectively. Considerable inter-hospital variations were observed in preoperative work-up, tumor diagnostics, surgical strategies, techniques for intraoperative guidance, as well as choice and timing of adjuvant therapy.Conclusions. Despite geographical population-based case selection, similar health care organizations, and existing guidelines, there were considerable variations in DLGG management. While some can be attributed to differences in clinical implementation of current scientific knowledge, some of the observed inter-hospital variations reflect controversies related to diagnostics and treatment. Quantification of these disparities renders possible identification of treatment patterns associated with better or worse outcomes and may thus represent a step toward more uniform evidence-based care.
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| 6. |
- Russell Jonsson, Kenisha, 1980, et al.
(författare)
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The clustering of multiple health and lifestyle behaviors among Swedish adolescents: a person-oriented analysis
- 2023
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Ingår i: Frontiers In Public Health. - 2296-2565. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundKnowledge of the distribution, prevalence, and clustering of multiple health and lifestyle related behaviors (HLBs) among adolescents can inform the development of effective health-promoting policies and interventions. We assessed the clustering of multiple HLBs among 11, 13 and 15-year-old Swedish adolescents and examined the socioeconomic and demographic correlates for the identified clusters. MethodsWe used data from the 2017/2018 Swedish Health Behaviour in School-aged children (HBSC) study to conduct sex and age-stratified latent class analysis (LCA). The LCA was based on five HLBs: eating behavior and habits (EBH), physical activity (PA), tobacco usage (TU), alcohol consumption (AC) and sleeping habits and patterns (SHPs). Multinomial logistic regression models were used to assess the associations between the identified clusters and the socioeconomic and demographic characteristics of adolescents and their parents. ResultsHealth behaviors varied by sex and age. Four distinct clusters were identified based on sex: cluster 1 (Mixed eating behaviors and habits, physical activity and low alcohol consumption), cluster 2 (Healthy lifestyle behaviors), cluster 3 (Unhealthy lifestyle behaviors), and cluster 4 (Breakfast, low alcohol consumption and tobacco usage). In the age-stratified analyzes, three clusters were identified: cluster 1 (Unhealthy lifestyle behaviors), cluster 2 (Moderately healthy lifestyle behaviors) and cluster 3 (Healthy lifestyle behaviors). The multinomial analysis showed that sex, age, family situation and perceived family wealth were strong predictors of health behaviors. Unhealthy behaviors were most commonly associated with socioeconomic disadvantage, having a migrant background, and living in reconstructed families or single-parent households. ConclusionHealth behaviors vary significantly based on socioeconomic and demographic circumstances. Targeted policies and intervention programs are necessary to improve HLBs among vulnerable and at-risk adolescents.
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| 7. |
- Samdal, Oddrun, et al.
(författare)
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Encouraging greater empowerment for adolescents in consent procedures in social science research and policy projects.
- 2023
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Ingår i: Obesity reviews : an official journal of the International Association for the Study of Obesity. - 1467-789X. ; 24 Suppl 2
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Tidskriftsartikel (refereegranskat)abstract
- The United Nations Convention on the Rights of the Child emphasizes the importance of allowing children and adolescents to influence decisions that are important to them following their age and maturity. This paper explores the principles, practices, and implications around using parental versus child/adolescent consent when participating in social science research and policy development. Experiences from two studies are presented: The Confronting Obesity: Co-creating policy with youth (CO-CREATE) and the Health Behaviour in School-aged Children (HBSC) study, a World Health Organization (WHO) Collaborative Cross-National study. Although parental consent may be an important gatekeeper for protecting children and adolescents from potentially harmful research participation, it may also be considered an obstacle to the empowerment of children and adolescents in case they want to share their views and experiences directly. This paper argues that evaluation of possible harm should be left to ethics committees and that, if no harm related to the research participation processes is identified and the project has a clear perspective on collaborating with the target group, adolescents from the age of 12years should be granted the legal capacity to give consent to participate in the research project. Collaboration with adolescents in the development of the research project is encouraged.
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| 8. |
- Schnohr, Christina W., et al.
(författare)
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Semantics bias in cross-national comparative analyses : Is it good or bad to have "fair" health?
- 2016
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Ingår i: Health and Quality of Life Outcomes. - : Springer Science and Business Media LLC. - 1477-7525. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- The Health Behavior in School-aged Children is a cross-national study collecting data on social and health indicators on adolescents in 43 countries. The study provides comparable data on health behaviors and health outcomes through the use of a common protocol, which have been a back bone of the study sine its initiation in 1983. Recent years, researchers within the study have noticed a questionable comparability on the widely used item on self-rated health. One of the four response categories to the item "Would you say your health is....?" showed particular variation, as the response category "Fair" varied from 20 % in Latvia and Moldova to 3-4 % in Bulgaria and Macedonia. A qualitative mini-survey of the back-translations showed that the response category "Fair" had a negative slant in 25 countries, a positive slant in 10 countries and was considered neutral in 9 countries. This finding indicates that there are what may be called semantic issues affecting comparability in international studies, since the same original word (in an English original) is interpreted differently across countries and cultures. The paper test and discuss a few possible explanations to this, however, only leaving to future studies to hold a cautious approach to international comparisons if working with the self-rated health item with four response categories.
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| 9. |
- Svenningsen, Åsa Fex, et al.
(författare)
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Effects on DHEA levels by estrogen in rat astrocytes and CNS co-cultures via the regulation of CYP7B1-mediated metabolism
- 2011
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Ingår i: Neurochemistry International. - : Elsevier BV. - 0197-0186 .- 1872-9754. ; 58:6, s. 620-624
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Tidskriftsartikel (refereegranskat)abstract
- The neurosteroid dehydroepiandrosterone (DHEA) is formed locally in the CNS and has been implicated in several processes essential for CNS function, including control of neuronal survival. An important metabolic pathway for DHEA in the CNS involves the steroid hydroxylase CYP7B1. In previous studies, CYP7B1 was identified as a target for estrogen regulation in cells of kidney and liver. In the current study, we examined effects of estrogens on CYP7B1-mediated metabolism of DHEA in primary cultures of rat astrocytes and co-cultures of rat CNS cells. Astrocytes, which interact with neurons in several ways, are important for brain neurosteroidogenesis. We found that estradiol significantly suppressed CYP7B1-mediated DHEA hydroxylation in primary mixed CNS cultures from fetal and newborn rats. Also, CYP7B1-mediated DHEA hydroxylation and CYP7B1 mRNA were markedly suppressed by estrogen in primary cultures of rat astrocytes. Interestingly, diarylpropionitrile, a well-known agonist of estrogen receptor β, also suppressed CYP7B1-mediated hydroxylation of DHEA. Several previous studies have reported neuroprotective effects of estrogens. The current data indicate that one of the mechanisms whereby estrogen can exert protective effects in the CNS may involve increase of the levels of DHEA by suppression of its metabolism.
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