| 1. |
- Bergh, Cecilia, 1972-, et al.
(författare)
-
Shared unmeasured characteristics among siblings confound the association of Apgar score with stress resilience in adolescence
- 2019
-
Ingår i: Acta Paediatrica. - : Wiley-Blackwell Publishing Inc.. - 0803-5253 .- 1651-2227. ; 108:11, s. 2001-2007
-
Tidskriftsartikel (refereegranskat)abstract
- AIM: We investigated the association between low Apgar score, other perinatal characteristics and low stress resilience in adolescence. A within-siblings analysis was used to tackle unmeasured shared familial confounding.METHODS: We used a national cohort of 527,763 males born in Sweden between 1973 and 1992 who undertook military conscription assessments at mean age 18 years (17-20). Conscription examinations included a measure of stress resilience. Information on Apgar score and other perinatal characteristics was obtained through linkage with the Medical Birth Register. Analyses were conducted using ordinary least squares and fixed-effects linear regression models adjusted for potential confounding factors.RESULTS: Infants with a prolonged low Apgar score at five minutes had an increased risk of low stress resilience in adolescence compared to those with highest scores at one minute, with an adjusted coefficient and 95% confidence interval of -0.26 (-0.39, -0.13). The associations were no longer statistically significant when using within-siblings models. However, the associations with stress resilience and birthweight remained statistically significant in all analyses.CONCLUSION: The association with low Apgar score seems to be explained by confounding due to shared childhood circumstances among siblings from the same family, while low birthweight is independently associated with low stress resilience.
|
|
| 2. |
- Han, Hedong, et al.
(författare)
-
Dose-response relationship between dietary magnesium intake, serum magnesium concentration and risk of hypertension : a systematic review and meta-analysis of prospective cohort studies
- 2017
-
Ingår i: Nutrition Journal. - : BioMed Central. - 1475-2891. ; 16
-
Forskningsöversikt (refereegranskat)abstract
- Background: The findings of prospective cohort studies are inconsistent regarding the association between dietary magnesium intake and serum magnesium concentration and the risk of hypertension. We aimed to review the evidence from prospective cohort studies and perform a dose-response meta-analysis to investigate the relationship between dietary magnesium intake and serum magnesium concentrations and the risk of hypertension.Methods: We searched systematically PubMed, EMBASE and the Cochrane Library databases from October 1951 through June 2016. Prospective cohort studies reporting effect estimates with 95% confidence intervals (CIs) for hypertension in more than two categories of dietary magnesium intake and/or serum magnesium concentrations were included. Random-effects models were used to combine the estimated effects.Results: Nine articles (six on dietary magnesium intake, two on serum magnesium concentration and one on both) of ten cohort studies, including 20,119 cases of hypertension and 180,566 participates, were eligible for inclusion in the meta-analysis. We found an inverse association between dietary magnesium intake and the risk of hypertension [relative risk (RR) = 0.92; 95% CI: 0.86, 0.98] comparing the highest intake group with the lowest. A 100 mg/day increment in magnesium intake was associated with a 5% reduction in the risk of hypertension (RR = 0.95; 95% CI: 0.90, 1.00). The association of serum magnesium concentration with the risk of hypertension was marginally significant (RR = 0.91; 95% CI: 0.80, 1.02).Conclusions: Current evidence supports the inverse dose-response relationship between dietary magnesium intake and the risk of hypertension. However, the evidence about the relationship between serum magnesium concentration and hypertension is limited.
|
|
| 3. |
- Hiyoshi, Ayako, 1972-, et al.
(författare)
-
Comorbidity trajectories in working age cancer survivors : A national study of Swedish men
- 2017
-
Ingår i: Cancer Epidemiology. - : Elsevier. - 1877-7821 .- 1877-783X. ; 48, s. 48-55
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A large proportion of cancer survivors are of working age, and maintaining health is of interest both for their working and private life. However, patterns and determinants of comorbidity over time among adult cancer survivors are incompletely described. We aimed to identify distinct comorbidity trajectories and their potential determinants.METHODS: In a cohort study of Swedish men born between 1952 and 1956, men diagnosed with cancer between 2000 and 2003 (n=878) were matched with cancer-free men (n=4340) and followed over five years after their first year of survival. Comorbid diseases were identified using hospital diagnoses and included in the analysis using group-based trajectory modelling. The association of socioeconomic and developmental characteristics were assessed using multinomial logit models.RESULTS: Four distinct comorbidity trajectories were identified. As many as 84% of cancer survivors remained at very low levels of comorbidity, and the distribution of trajectories was similar among the cancer survivors and the cancer-free men. Increases in comorbidity were seen among those who had comorbid disease at baseline and among those with poor summary disease scores in adolescence. Socioeconomic characteristics and physical, cognitive and psychological function were associated with types of trajectory in unadjusted models but did not retain independent relationships with them after simultaneous adjustment.CONCLUSIONS: Among working-age male cancer survivors, the majority remained free or had very low levels of comorbidity. Those with poorer health in adolescence and pre-existing comorbid diseases at cancer diagnosis may, however, benefit from follow-up to prevent further increases in comorbidity.
|
|
| 4. |
- Leepe, Khadija Akter, et al.
(författare)
-
Acute effect of daily fine particulate matter pollution on cerebrovascular mortality in Shanghai, China : a population-based time series study
- 2019
-
Ingår i: Environmental Science and Pollution Research. - : Springer. - 0944-1344 .- 1614-7499. ; 26:25, s. 25491-25499
-
Tidskriftsartikel (refereegranskat)abstract
- Numerous studies have investigated the impacts of ambient fine particulate matter (PM2.5) on human health. In this study, we examined the association of daily PM2.5 concentrations with the number of deaths for the cerebrovascular disease on the same day, using the generalized additive model (GAM) controlling for temporal trend and meteorological variables. We used the data between 2012 and 2014 from Shanghai, China, where the adverse health effects of PM2.5 have been of particular concern. Three different approaches (principal component analysis, shrinkage smoothers, and the least absolute shrinkage and selection operator regularization) were used in GAM to handle multicollinear meteorological variables. Our results indicate that the average daily concentration of PM2.5 in Shanghai was high, 55 μg/m3, with an average daily death for cerebrovascular disease (CVD) of 62. There was 1.7% raised cerebrovascular disease deaths per 10 μg/m3 increase in PM2.5 concentration in the unadjusted model. However, PM2.5 concentration was no longer associated with CVD deaths after controlling for meteorological variables. The results were consistent in the three modelling techniques that we used. As a large number of people are exposed to air pollution, further investigation with longer time period including individual-level information is needed to examine the association.
|
|
| 5. |
|
|
| 6. |
- Montgomery, Scott, 1961-, et al.
(författare)
-
Sex of older siblings and cognitive function
- 2017
-
Konferensbidrag (refereegranskat)abstract
- Background : Number of older siblings is associated with lower cognitive function, possibly as marker of material disadvantage. Sex differences may signal an influence of inter-sibling interactions.Methods: The study used a national Swedish register-based cohort of men (n=644,603), born between 1970 and 1992 who undertook military conscription assessments in adolescence that included cognitive function measured on a normally-distributed scale of 1-9. Associations with siblings were investigated using linear regression.Results: After adjustment for numbers of younger siblings, year of conscription assessment, age/year of birth, sex, European socioeconomic classification for parents and maternal age at delivery; the regression coefficients (and 95% confidence intervals) for cognitive function are -0.26 (-0.27, -0.25), -0.42 (-0.44, -0.40), and -0.72 (-0.76, -0.67) for one, two and three or more male older siblings, respectively, compared with none; and -0.22 (-0.23, -0.21), -0.39 (-.41, -0.37), -0.62 (-0.67, -0.58) for one two and three or more female older siblings, respectively, compared with none. A larger number of younger siblings is not associated with lower cognitive function in the adjusted model.Conclusions: Family size is associated with cognitive function: older male siblings may have greater implications than females due to their demands on familial resources or through inter-sibling interactions.
|
|
| 7. |
|
|
| 8. |
- Montgomery, Scott, 1961-, et al.
(författare)
-
Sex of older siblings and stress resilience
- 2018
-
Ingår i: Longitudinal and Life Course Studies. - : Society for Longitudinal and Life Course Studies. - 1757-9597. ; 9:4, s. 447-455
-
Tidskriftsartikel (refereegranskat)abstract
- The aim was to investigate whether older siblings are associated with development of stress resilience in adolescence and if there are differences by sex of siblings. The study used a Swedish register-based cohort of men (n=664 603) born between 1970 and 1992 who undertook military conscription assessments in adolescence that included a measure of stress resilience: associations were assessed using multinomial logistic regression. Adjusted relative risk ratios (95% confidence intervals) for low stress resilience (n=136 746) compared with high (n=142 581) are 1.33 (1.30, 1.35), 1.65 (1.59, 1.71) and 2.36 (2.18, 2.54) for one, two and three or more male older siblings, compared with none. Equivalent values for female older siblings do not have overlapping confidence intervals with males and are 1.19 (1.17, 1.21), 1.46 (1.40, 1.51) and 1.87 (1.73, 2.03). When the individual male and female siblings are compared directly (one male sibling compared with one female sibling, etc.) and after adjustment, including for cognitive function, there is a statistically significant (p<0.005) greater risk for low stress resilience associated with male siblings. Older male siblings may have greater adverse implications for psychological development, perhaps due to greater demands on familial resources or inter-sibling interactions.
|
|
| 9. |
- Cable, N., et al.
(författare)
-
Identifying Frail-Related Biomarkers among Community-Dwelling Older Adults in Japan : A Research Example from the Japanese Gerontological Evaluation Study
- 2018
-
Ingår i: BioMed Research International. - : Hindawi Publishing Corporation. - 2314-6133 .- 2314-6141.
-
Tidskriftsartikel (refereegranskat)abstract
- We examined correlating clinical biomarkers for the physical aspect of frailty among community-dwelling older adults in Japan, using Japanese Gerontological Evaluation Study (JAGES). We used information from the JAGES participants (N = 3,128) who also participated in the community health screening in 2010. We grouped participants' response to the Study of Osteoporotic Fracture (SOF) Frailty Index into robust (=0), intermediate frail (=1), and frail (=2+) ones to indicate physical aspect of frailty. Independent of sex and age, results from multinomial logistic regression showed above normal albumin and below normal HDL and haemoglobin levels were positively associated with intermediate frail (RRR = 1.99, 95% CI = 1.22-3.23; RRR = 1.36, 95% CI = 1.33-1.39; RRR = 1.36, 95% CI = 1.23-1.51, resp.) and frail cases (RRR = 2.27, 95% CI = 1.91-2.70; RRR = 1.59, 95% CI = 1.51-1.68; RRR = 1.40, 95% CI = 1.28-1.52, resp.). Limited to women, above normal Hb1Ac level was similarly associated with intermediate frail and frail cases (RRR = 1.18, 95% CI = 1.02, 1.38; RRR = 2.56, 95% CI = 2.23-2.95, resp.). Use of relevant clinical biomarkers can help in assessment of older adults' physical aspect of frailty.
|
|
| 10. |
- Hiyoshi, Ayako, 1972-, et al.
(författare)
-
Increasing income-based inequality in suicide mortality among working-age women and men, Sweden, 1990-2007 : is there a point of trend change?
- 2018
-
Ingår i: Journal of Epidemiology and Community Health. - : BMJ Publishing Group Ltd. - 0143-005X .- 1470-2738. ; 72:11, s. 1009-1015
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Income inequalities have risen from the 1990s to 2000s, following the economic recession in 1994, but little research has investigated socioeconomic inequalities in suicide mortality for working-age men and women (aged between 30 and 64 years) over the time using longitudinal data in Sweden.METHODS: Using Swedish national register data between 1990 and 2007 as a series of repeated cohort studies with a 3-year follow-up (sample sizes were approximately 3.7 to 4.0 million in each year), relative and slope indices of inequality (RII and SII respectively) based on quintiles of individual disposable income were calculated and tested for temporal trends.RESULTS: SII for the risk of suicide mortality ranged from 27.6 (95% CI 19.5 to 35.8) to 44.5 (36.3 to 52.6) in men and 5.2 (0.2 to 10.4) to 16.6 (10.7 to 22.4) in women (per 100 000 population). In men, temporal trends in suicide inequalities were stable in SII but increasing in RII by 3% each year (p=0.002). In women, inequalities tended to increase in both RII and SII, especially after the late-1990s, with 10% increment in RII per year (p<0.001).CONCLUSIONS: Despite universal social security and generous welfare provision, income inequalities in suicide were considerable and have widened, especially in women. The steeper rise in women may be partially related to higher job insecurity and poorer working conditions in the female dominated public sector after the recession. To reduce health consequences following an economic crisis and widened income inequalities, additional measures may be necessary in proportion to the levels of financial vulnerability.
|
|
| 11. |
- Hiyoshi, Ayako, 1972-, et al.
(författare)
-
Precursors in adolescence of adult-onset bipolar disorder
- 2017
-
Ingår i: Journal of Affective Disorders. - : Elsevier. - 0165-0327 .- 1573-2517. ; 218, s. 353-358
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Although the estimated contribution of genetic factors is high in bipolar disorder, environmental factors may also play a role. This Swedish register-based cohort study of men examined if physical and psychological characteristics in late adolescence, including factors previously linked with bipolar disorder (body mass index, asthma and allergy), are associated with subsequent bipolar disorder in adulthood. Unipolar depression and anxiety are analysed as additional outcomes to identify bipolar disorder-specific associations.Methods: A total of 213,693 men born between 1952 and 1956, who participated in compulsory military conscription assessments in late adolescence were followed up to 2009, excluding men with any psychiatric diagnoses at baseline. Cox regression estimated risk of bipolar disorder, depression and anxiety in adulthood associated with body mass index, asthma, allergy, muscular strength stress resilience and cognitive function in adolescence.Results: BMI, asthma and allergy were not associated with bipolar disorder. Higher grip strength, cognitive function and stress resilience were associated with a reduced risk of bipolar disorder and the other disease outcomes.Limitations: The sample consisted only of men; even though the characteristics in adolescence pre-dated disease onset, they may have been the consequence of prodromal disease.Conclusions: Associations with body mass index and asthma found by previous studies may be consequences of bipolar disorder or its treatment rather than risk factors. Inverse associations with all the outcome diagnoses for stress resilience, muscular strength and cognitive function may reflect general risks for these psychiatric disorders or intermediary factors.
|
|
| 12. |
- Hiyoshi, Ayako, 1972-, et al.
(författare)
-
Remarriage after divorce and depression risk
- 2015
-
Ingår i: Social Science and Medicine. - : Elsevier BV. - 0277-9536 .- 1873-5347. ; 141, s. 109-114
-
Tidskriftsartikel (refereegranskat)abstract
- As marriage is associated with lower depression rates compared with being single in men, we aimed to examine if remarriage compared with remaining divorced is also associated with a reduced depression risk. Swedish register data were used to define a cohort of men who were born between 1952 and 1956 and underwent a compulsory military conscription assessment in adolescence. This study population comprised men who were divorced in 1985 (n = 72,246). The risk of pharmaceutically treated depression from 2005 to 2009 was compared for those who remarried or remained divorced between 1986 and 2004. Cox proportional hazards analysis was used to estimate hazard ratios for the risk of depression identified by pharmaceutical treatment, with adjustment for a range of potential confounding factors including childhood and adulthood socioeconomic circumstances, cognitive, physical, psychological and medical characteristics at the conscription assessment. The results showed that, even though divorced men who remarried had markers of lower depression risk in earlier life such as higher cognitive and physical function, higher stress resilience and socioeconomic advantages than men who remained divorced, remarriage was associated with a statistically significant elevated risk of depression with an adjusted hazard ratio (and 95% confidence interval) of 1.27(1.03 1.55), compared with men who remained divorced. Remarriage following divorce is not associated with a reduced risk of depression identified by pharmaceutical treatment, compared with remaining divorced. Interpersonal or financial difficulties resulting from remarriage may outweigh the benefits of marriage in terms of depression risk.
|
|
| 13. |
- Hiyoshi, Ayako, 1972-, et al.
(författare)
-
Stress resilience in adolescence and subsequent antidepressant and anxiolytic medication in middle aged men : Swedish cohort study
- 2015
-
Ingår i: Social Science and Medicine. - Oxford, United Kingdom : Pergamon-Elsevier. - 0277-9536 .- 1873-5347. ; 134, s. 43-49
-
Tidskriftsartikel (refereegranskat)abstract
- It is unclear whether psychological resilience to stress in adolescence represents a persistent characteristic relevant to the subsequent risk for depression and anxiety in later adulthood. We aimed to test whether low psychological stress resilience assessed in adolescence is associated with an increased risk of receiving medication for depression and anxiety in middle age. We utilized Swedish register-based cohort study. Men born between 1952 and 1956 (n = 175,699), who underwent compulsory assessment for military conscription in late adolescence were followed to examine subsequent risk of pharmaceutically-treated depression and anxiety in middle age, from 2006 to 2009 corresponding to ages between 50 and 58 years, using Cox regression. The associations of stress resilience with prescription of antidepressant and anxiolytics medication through potential mediating factors cognitive and physical function and adult socioeconomic factors were calculated. Low stress resilience was associated with elevated risks for antidepressant (hazard ratio (HR):1.5 (95% CI 1.4 1.6)) and anxiolytics (HR:2.4 (CI 2.0 2.7)) medication. Adjustment for measures of childhood living circumstances attenuated the associations somewhat. Around a third of association with low stress resilience, and a half of that with moderate resilience, was mediated through cognitive and physical function in adolescence and adult socioeconomic factors. The magnitude of the inverse association of higher cognitive function with antidepressant medication was eliminated among those with low stress resilience. These results indicate that low stress resilience in adolescence is associated with an increased risk for antidepressant and anxiolytics medication over 30 years later, in part mediated through developmental factors in adolescence and socioeconomic circumstances in adulthood, and low stress resilience can diminish or eliminate the inverse association of higher cognitive function with antidepressant medication.
|
|
| 14. |
- Hiyoshi, Ayako, 1972-, et al.
(författare)
-
Trajectories of Income and Social Benefits for Mothers and Fathers of Children With Cancer : A National Cohort Study in Sweden
- 2018
-
Ingår i: Cancer. - : John Wiley & Sons. - 0008-543X .- 1097-0142. ; 124:7, s. 1492-1500
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The contribution of different income sources from work and social benefits to trajectories of income for the parents of children with cancer has not been empirically investigated.METHODS: Using Swedish registers, parents of children with an incidence cancer diagnosis between 2004 and 2009 were identified and matched with parents of children without cancer (reference parents). A total of 20,091 families were followed from the year before the diagnosis to a maximum of 8 years. Generalized linear models estimated the ratios of mean incomes from work and social benefits and of its total.RESULTS: Around the time of the child's cancer diagnosis, the total income was on average up to 6% higher among the mothers of children with cancer compared with reference mothers, but no differences were noted among fathers. Income from work dropped to the lowest level around the time of a cancer diagnosis, with swift recovery noted for fathers but not for mothers. Sickness and childcare-related benefits were up to 6 times larger for the parents of children with cancer than reference parents. As social benefits diminished after approximately 3 years, the total income of mothers of children with cancer became lower than that of reference mothers, and the gap widened over time.CONCLUSIONS: Social benefits appeared to ease the financial burden during the years around a cancer diagnosis. However, mothers experienced persistently lower income after benefits diminished. Experiences differed by single-parent versus dual-parent households, the survival of the child with cancer, and other relevant characteristics. Further investigation is needed for potential long-term consequences for mothers, including their career and future pension in retirement.
|
|
| 15. |
- Lindner, Helen, 1967-, et al.
(författare)
-
Risk of depression following traumatic limb amputation : a general population-based cohort study
- 2018
-
Ingår i: Book of Abstracts. - Ljubjana, Slovenia : ISPO Slovena. - 9789612887346 ; , s. 9-9
-
Konferensbidrag (refereegranskat)abstract
- INTRODUCTION: Traumatic limb amputation (TLA) is a sudden event that accompanies life changes in physical functioning, body image and challenges in daily lives. Amputees may experience significant levels of distress and be at risk of depression may be at risk of depression. However, evidence for depression risk after TLA has been limited because of the use of cross-sectional study design of a small or selected sample and the lack of a comparison with non-amputees. Confounding from pre-amputated occupational and individual characteristics was possible but no study has controlled for these. AIMS: We aimed to examine whether amputation may be associated with an increased risk of depression required inpatient and outpatient hospital treatment. METHODS: Our study population was drawn from a cohort of men (n=284,257) who underwent a compulsory conscription assessment for between 1969 and 1976. Complete data were available for 189,220 men. We followed these men from 1st January 1985, when these men were between age 29 and 34 years until the date of depression. We used the ICD codes in Swedish patient register to identify TLA (primary and secondary diagnosis) and depression after TLA (primary diagnosis). Cox regression was used to calculate hazard ratios and 95% confidence intervals [CI] for the association of amputation with depression. Age was used as the underlying time scale, and the diagnosis of amputation was included as a time-dependent exposure status, with the value zero before amputation and one after the date of amputation. Birth year, region, occupation, cognitive and physical function and stress resilience in adolescence were considered as potential confounding factors and adjusted for in the analysis. RESULTS: In total 401 men experienced amputation between 1985 and 2009, with the mean age of amputation was age 42.5 years (SD 7.4). Those who experience amputation were more likely to have low stress resilience and cognitive function in adolescence and engaged in farming and manual work in 1985. Cox regression produced unadjusted hazard ratio 2.61 (CI 1.62-4.21, p<0.001), i.e. 2.61 times risk of subsequent depression diagnosis for risk of subsequent depression compared with amputation-free individuals. Moderate and low cognitive function, physical fitness and stress resilience were associated with elevated risk of depression. Working for farms and manual work was also associated with higher depression risk. When the analysis was adjusted for these factors, the risk of depression after amputation changed little, 2.53 (CI 1.57-4.08, p <0.001) times risk of depression remained compared with amputation-free individuals.CONCLUSIONS: As we hypothesized, TLA was associated with an increased risk of depression over more than two decades of follow-up of men from age 29 to 57 years. Higher levels of depressive symptoms were noted among working age amputees and our study group also comprised of working age amputees. Future research may benefit from investigating potential influence of different amputation sites, degree, and prosthesis use involved in order to set intervention target.
|
|
| 16. |
|
|
| 17. |
- Lindner, Helen Y, 1967-, et al.
(författare)
-
Relation between capacity and performance in paediatric upper limb prosthesis users
- 2018
-
Ingår i: Prosthetics and Orthotics International. - : Sage Publications. - 0309-3646 .- 1746-1553. ; 42:1, s. 14-20
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The International Classification of functioning, disability and health refers capacity to what an individual can do in a standardised environment and describes performance as what an individual really does and whether the individual encounters any difficulty in the real-life environment. Measures of capacity and performance can help to determine if there is any gap between them that may restrict participation. The aim of this study was to explore the relationship between capacity scores obtained in a standardised clinical setting and proportional ease of performance obtained from a real-life environment.METHODS: The Assessment of Capacity for Myoelectric Control and the Prosthetic Upper Extremity Functional Index were used to assess capacity and performance in 62 prosthetic users (age 3-17). Spearman coefficient and generalised linear model were used to examine the association between these measures.RESULTS: A strong correlation (Spearman = 0.75) was found between the capacity scores and the ease of performance. In both unadjusted and adjusted models, capacity was significantly associated with proportional ease of performance. The adjusted model showed that, by 1 unit increase in the Assessment of Capacity for Myoelectric Control score, the ratio of proportional ease of performance increases by 45%.CONCLUSION: This implies that Assessment of Capacity for Myoelectric Control can be a predictor for ease of performance in real-life environment.Clinical relevance: The ACMC scores may serve as an indicator to predict the difficulties that the children may encounter in their home environment. This prediction can help the clinician to make decisions, such that if the child requires more control training or is ready to move on to learn more complex tasks.
|
|
| 18. |
|
|
| 19. |
- Melinder, Carren, 1975-, et al.
(författare)
-
Decreased stress resilience in young men significantly increases the risk of subsequent peptic ulcer disease : a prospective study of 233 093 men in Sweden
- 2015
-
Ingår i: Alimentary Pharmacology and Therapeutics. - : Wiley. - 0269-2813 .- 1365-2036. ; 41:10, s. 1005-1015
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Psychosocial stress may influence peptic ulcer disease (PUD) risk, but it can be difficult to identify reliably whether stressful exposures pre-dated disease. The association of stress resilience (susceptibility to stress) with subsequent PUD risk has been incompletely investigated.AIM: To assess if stress resilience in adolescence is associated with subsequent PUD risk.METHODS: The participants comprised of 233 093 men resident in Sweden, born 1952-1956 and assessed for compulsory military conscription during 1969-1976, with data provided by national Swedish registers. Stress resilience was evaluated through semi-structured interviews by a certified psychologist. Cox regression assessed the association between stress resilience in adolescence and the risk of PUD from 1985 to 2009, between ages 28 and 57 years, with adjustment for parental socioeconomic index, household crowding and number of siblings in childhood, as well as cognitive function and erythrocyte sedimentation rate in adolescence.RESULTS: In total, 2259 first PUD diagnoses were identified. Lower stress resilience in adolescence is associated with a higher risk of PUD in subsequent adulthood: compared with high resilience, the adjusted hazard ratios (and 95% CI) are 1.84 (1.61-2.10) and 1.23 (1.09-1.38) for low and moderate stress resilience, respectively.CONCLUSION: Stress may be implicated in the aetiology of PUD and low stress resilience is a marker of risk.
|
|
| 20. |
- Melinder, Carren, 1975-, et al.
(författare)
-
Physical Fitness in Adolescence and Subsequent Inflammatory Bowel Disease Risk
- 2015
-
Ingår i: Clinical and Translational Gastroenterology. - New York, USA : Nature Publishing Group. - 2155-384X. ; 6
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: Physical fitness may reduce systemic inflammation levels relevant to the risk of symptomatic Crohn's disease (CD) and ulcerative colitis (UC); we assessed if fitness in adolescence is associated with subsequent inflammatory bowel disease (IBD) risk, independent of markers of risk and prodromal disease activity.Methods: Swedish registers provided information on a cohort of 240,984 men (after exclusions) who underwent military conscription assessments in late adolescence (1969-1976). Follow-up started at least 4 years after the conscription assessment until 31 December 2009 (up to age 57 years). Cox's regression assessed the association of physical fitness with CD (n=986) and UC (n=1,878) in separate models, with adjustment including: socioeconomic conditions in childhood; physical fitness, height, body mass index, and erythrocyte sedimentation rate (ESR) in adolescence; and subsequent diagnoses of IBD.Results: Low fitness was associated with a raised risk of IBD, with unadjusted hazard ratios (and 95% confidence intervals) of 1.62 (1.31-2.00) for CD and 1.36 (1.17-1.59) for UC. The results were attenuated by adjustment, particularly for markers of prodromal disease activity to 1.32 (1.05-1.66) and 1.25 (1.06-1.48), respectively. Raised ESR in adolescence was associated with increased risks for subsequent CD (5.95 (4.47-7.92)) and UC (1.92 (1.46-2.52)).Conclusions: The inverse association of physical fitness with IBD risk is consistent with a protective role for exercise. However, evidence of disease activity before diagnosis was already present in adolescence, suggesting that some or all of the association between fitness and IBD may be due to prodromal disease activity reducing exercise capacity and therefore fitness.
|
|
| 21. |
- Melinder, Carren, 1975-, et al.
(författare)
-
Resilience to stress and risk of gastrointestinal infections
- 2018
-
Ingår i: European Journal of Public Health. - Oxford, United Kingdom : Oxford University Press. - 1101-1262 .- 1464-360X. ; 28:2, s. 364-369
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Exposure to psychological stress can elicit a physiological response that may influence characteristics of the gastrointestinal mucosa, including increased intestinal permeability, in turn possibly increasing susceptibility to gastrointestinal infections. We investigated whether low stress resilience in adolescence is associated with an 'increased' risk of gastrointestinal infections in subsequent adulthood.Methods: Data were provided by Swedish registers for a cohort of 237 577 men who underwent military conscription assessment in late adolescence (1969-76). As part of the assessment procedure, certified psychologists evaluated stress resilience through semi-structured interviews. The cohort was followed from conscription assessment until 31 December 2009 (up to age 57 years). Cox regression assessed the association of stress resilience with gastrointestinal infections (n = 5532), with adjustment for family background measures in childhood and characteristics in adolescence. Peptic ulcer disease (PUD) in adulthood was modelled as a time-dependent covariate.Results: Compared with high stress resilience, lower stress resilience was associated with a 'reduced' risk of gastrointestinal infections after adjustment for family background in childhood, characteristics in adolescence and PUD in adulthood, with hazard ratios (and 95% confidence intervals) of 0.88 (0.81-0.97) and 0.83 (0.77-0.88) for low and moderate stress resilience, respectively.Conclusion: Lower stress resilience in adolescence is associated with reduced risk of gastrointestinal infections in adulthood, rather than the hypothesized increased risk.
|
|
| 22. |
- Melinder, Carren, 1975-, et al.
(författare)
-
Stress resilience and the risk of inflammatory bowel disease : a cohort study of men living in Sweden
- 2017
-
Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 7:1
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To determine if low psychosocial stress resilience in adolescence (increasing chronic stress arousal throughout life) is associated with an increased inflammatory bowel disease (IBD) risk in adulthood. Subclinical Crohn's disease (CD) and ulcerative colitis (UC) can exist over many years and we hypothesise that psychosocial stress may result in conversion to symptomatic disease through its proinflammatory or barrier function effects.DESIGN: National register-based cohort study of men followed from late adolescence to middle age.SETTING: A general population cohort of men in Sweden.PARTICIPANTS: Swedish population-based registers provided information on all men born between 1952 and 1956 who underwent mandatory Swedish military conscription assessment (n=239 591). Men with any gastrointestinal diagnoses (except appendicitis) prior to follow-up were excluded.PRIMARY OUTCOME MEASURES: An inpatient or outpatient diagnosis of CD or UC recorded in the Swedish Patient Register (1970-2009).RESULTS: A total of 938 men received a diagnosis of CD and 1799 UC. Lower stress resilience in adolescence was associated with increased IBD risk, with unadjusted HRs (95% CIs) of 1.54 (1.26 to 1.88) and 1.24 (1.08 to 1.42), for CD and UC, respectively. After adjustment for potential confounding factors, including markers of subclinical disease activity in adolescence, they are 1.39 (1.13 to 1.71) and 1.19 (1.03 to 1.37).CONCLUSIONS: Lower stress resilience may increase the risk of diagnosis of IBD in adulthood, possibly through an influence on inflammation or barrier function.
|
|
| 23. |
- Melinder, Carren, 1975-, et al.
(författare)
-
Stress resilience in adolescence and subsequent inflammatory bowel disease risk in adulthood
- 2015
-
Ingår i: Psychoneuroendocrinology. - : Elsevier BV. - 0306-4530 .- 1873-3360. ; 61, s. 27-27
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Objective: Psychosocial stress may increase the risk of systemic inflammation. As subclinical inflammatory bowel disease (IBD) – Crohn's disease (CD) and ulcerative colitis (UC) – can exist over many years, stress may result in conversion to symptomatic disease through its inflammatory influence. Low stress resilience may result in a greater risk of chronic stress arousal due to the normal stresses of everyday life. We investigated the association of stress resilience in adolescence with subsequent risk of IBD, independent of other risks.Design: Swedish registers provided information on 242,999 men who underwent military conscription assessments in late adolescence (1969 – 1976) with follow-up until 2009 (up to age 57 years). Stress resilience was evaluated through semi-structured interviews. Cox regression assessed the association of stress resilience with CD (n = 1,082) and UC (1,922) in separate models. The models included adjustment for socioeconomic characteristics in childhood and height, BMI and erythrocyte sedimentation rate (indicating inflammation) as indicators of subclinical disease activity in adolescence.Results: Low stress resilience in adolescence was associated with increased risk of IBD after adjustment for potential confounding factors, with hazard ratios (95% confidence intervals) of 1.50 (1.24-1.81) and 1.21 (1.06-1.39), for CD and UC respectively. The associations attenuated somewhat by further adjustment for markers of subclinical disease to 1.38 (1.14-1.67) and 1.19 (1.04-1.36).Conclusions: low stress resilience is associated with an elevated subsequent IBD risk. Stress may increase the risk of symptomatic IBD, although there is also evidence of a potentially modest effect of subclinical disease activity on stress resilience.
|
|
| 24. |
- Montgomery, Scott, 1961-, et al.
(författare)
-
Childhood exposures among mothers and Hodgkin's lymphoma in offspring
- 2015
-
Ingår i: Cancer Epidemiology. - : Elsevier. - 1877-7821 .- 1877-783X. ; 39:6, s. 1006-1009
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Childhood exposures in mothers, signaled by number of older and younger siblings, have lifelong consequences for aspects of immune function. We hypothesized that these may influence young adult-onset Hodgkin's lymphoma (HL) risk in offspring.Materials and methods: Swedish registers identified 2028 cases of young adult onset HL (diagnosed between ages 15-39 years) up to 2012 among those born since 1958; and 18,374 matched controls. Conditional logistic regression was used to assess HL risk associated with number of older and younger siblings of mothers.Results: Having a mother with more than two older siblings is associated with lower HL risk, and the association is statistically significant for mothers with three or more siblings, compared with none. The adjusted odds ratios (and 95% confidence intervals) are 1.04 (0.93-1.16); 0.95 (0.81-1.10); and 0.81 (0.66-0.98) for one, two, and three or more older siblings, respectively. There is no association between number of mothers' younger siblings and HL risk.Conclusions: Exposures during the childhood of mothers may influence young onset adult HL risk in offspring, perhaps through vertical transmission of infectious agents, or through other long-term influences on maternal immune function.
|
|
| 25. |
- Montgomery, Scott, 1961-, et al.
(författare)
-
Concussion in adolescence and risk of multiple sclerosis
- 2017
-
Ingår i: Annals of Neurology. - : John Wiley & Sons. - 0364-5134 .- 1531-8249. ; 82:4, s. 554-561
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To assess whether concussion in childhood or adolescence is associated with subsequent multiple sclerosis (MS) risk. Previous research suggests an association, but methodological limitations included retrospective data collection and small study populations.Methods: The national Swedish Patient Register (hospital diagnoses) and MS Register were used to identify all MS diagnoses up to 2012 among people born since 1964, when the Patient Register was established. The 7,292 patients with MS were matched individually with 10 people without MS by sex, year of birth, age/vital status at MS diagnosis, and region of residence (county), resulting in a study population of 80,212. Diagnoses of concussion and control diagnoses of broken limb bones were identified using the Patient Register from birth to age 10 years or from age 11 to 20 years. Conditional logistic regression was used to examine associations with MS.Results: Concussion in adolescence was associated with a raised risk of MS, producing adjusted odds ratios (95% confidence intervals) of 1.22 (1.05-1.42, p=0.008) and 2.33 (1.35-4.04, p=0.002) for 1 diagnosis of concussion and >1 diagnosis of concussion, respectively, compared with none. No notable association with MS was observed for concussion in childhood, or broken limb bones in childhood and adolescence.Interpretation: Head trauma in adolescence, particularly if repeated, is associated with a raised risk of future MS, possibly due to initiation of an autoimmune process in the central nervous system. This further emphasizes the importance of protecting young people from head injuries. Ann Neurol 2017;82:554-561
|
|
