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1.
  • Ahlbom, A, et al. (författare)
  • Interaction: A word with two meanings creates confusion
  • 2005
  • Ingår i: European journal of epidemiology. - : Springer Science and Business Media LLC. - 0393-2990 .- 1573-7284. ; 20:7, s. 563-564
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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  • Ahlgren, Cecilia, 1946, et al. (författare)
  • A population-based case-control study on viral infections and vaccinations and subsequent multiple sclerosis risk.
  • 2009
  • Ingår i: European Journal of Epidemiology. - : Springer Science and Business Media LLC. - 1573-7284 .- 0393-2990. ; 24:9, s. 541-52
  • Tidskriftsartikel (refereegranskat)abstract
    • Viral infections are probably involved in the pathogenesis of multiple sclerosis (MS). A recent cohort study in the Gothenburg population revealed no change in MS incidence associated with the introduction of the Swedish measles, mumps and rubella vaccination programmes. The aim of the present study was to clarify whether these infections or vaccinations, and two other infections, varicella and infectious mononucleosis, influence MS risk. We performed a population-based case-control study in Gothenburg that included 509 MS cases and 2,067 controls, born 1959-1986. Data on infections and vaccinations were obtained from questionnaires and from child health and school health records. We found no significant associations between measles, mumps, rubella or varicella and MS risk. These results were consistent between the two source materials. Infectious mononucleosis was associated with significantly higher MS risk (odds ratio 2.03, 95% CI 1.52-2.73). Overall, there was no significant association between measles-mumps-rubella (MMR) vaccination and MS risk, while those MMR vaccinated before age ten only were at significantly higher MS risk (odds ratio 4.92, 95% CI 1.97-12.20). Those MMR vaccinated both before and after age ten had intermediate MS risk. Infection with measles, mumps, rubella and varicella did not influence MS risk in contrast to infectious mononucleosis which conferred doubled MS risk. The association with 'early' MMR vaccination only was an isolated finding, limited by a small number of subjects and multiple testing. Most likely this was a chance finding. Future studies could investigate it on an a priori basis.
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  • Andersson, T, et al. (författare)
  • Calculating measures of biological interaction
  • 2005
  • Ingår i: European journal of epidemiology. - : Springer Science and Business Media LLC. - 0393-2990 .- 1573-7284. ; 20:7, s. 575-579
  • Tidskriftsartikel (refereegranskat)
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  • Blomgren, K. J., et al. (författare)
  • Interviewer variability - quality aspects in a case-control study
  • 2006
  • Ingår i: Eur J Epidemiol. - : Springer Science and Business Media LLC. - 0393-2990 .- 1573-7284. ; 21:4, s. 267-77
  • Tidskriftsartikel (refereegranskat)abstract
    • Quality assurance and quality control are important for the reliability of case-control studies. Here we describe the procedures used in a previously published study, with emphasis on interviewer variability. To evaluate risk factors for acute pancreatitis, information including previous diagnoses and medication was collected from medical records and by telephone interviews from 462 cases and 1781 controls. Quality assurance procedures included education and training of interviewers and data validity checks. Quality control included a classification test, annual test interviews, expert case validation, and database validation. We found pronounced variations between interviewers. The maximal number of interviews per day varied from 3 to 9. The adjusted average (95% CI) number of diagnoses captured per interview of cases was 4.1 (3.8-4.3) and of controls 3.5 (3.4-3.7) (excluding one deviating interviewer). For drugs, the average (95% CI) number per interview was 3.9 (3.7-4.1) for cases and 3.3 (3.2-3.4) for controls (excluding one deviating interviewer). One of the fourteen interviewers deviated significantly from the others, and more so for controls than for cases. This interviewer's data ;were excluded. Nonetheless, data concerning controls more frequently needed correction and supplementation than for cases. Erroneous coding of diagnoses and medication was also more frequent among controls. Thus, a system for quality control of coding practices is crucial. Variability in interviewers' ability to ascertain information is a possible source of bias in interview-based case-control studies when "blinding" cannot be achieved.
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  • Bälter, Olle, 1962-, et al. (författare)
  • Demands on web survey tools for epidemiological research
  • 2005
  • Ingår i: European Journal of Epidemiology. - Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden. : Springer Science and Business Media LLC. - 0393-2990 .- 1573-7284. ; 20:2, s. 137-139
  • Tidskriftsartikel (refereegranskat)abstract
    • In countries where the Internet access is high, a web-based questionnaire could save time and money compared to printed questionnaires, mainly by eliminating the two steps of transferring answers from printed to a digital data set and manually completing missing and impossible answers. However, many of the features wanted for conducting large epidemiological studies are not available in many web survey systems. Here we describe design issues the investigator needs to be aware of when using web-based questionnaires in epidemiological research.
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  • Cabrera-Moksnes, Claudia, 1966, et al. (författare)
  • Can the relation between tooth loss and chronic disease be explained by socio-economic status? A 24-year follow-up from the population study of women in Gothenburg, Sweden.
  • 2005
  • Ingår i: European journal of epidemiology. - : Springer Science and Business Media LLC. - 0393-2990 .- 1573-7284. ; 20:3, s. 229-36
  • Tidskriftsartikel (refereegranskat)abstract
    • The objective of this study was to evaluate the association between number of missing teeth and all cause, cardiovascular, and cancer mortality as well as morbidity and to explore whether socio-economic factors mediate this association. An ongoing prospective cohort study of 1462 Swedish women included a dental survey in 1968/69 with follow-up until 1992/93. The dental examination included a panoramic radiographic survey and a questionnaire. Number of missing teeth at baseline was analysed in a Cox proportional hazards model to estimate time to mortality and morbidity. Number of missing teeth, independently of socio-economic status variables (the husband's occupational category, combined income, and education) was associated with increased all cause mortality and cardiovascular disease mortality respectively (relative risk (RR): 1.36; 95% confidence interval (95% CI): 1.18-1.58) and (RR: 1.46; 95% CI: 1.15-1.85 per 10 missing teeth), but no associations were found for cancer mortality (RR: 1.18; 95% CI: 0.91-1.52). The relation between poor oral health and future cardiovascular disease could not be explained by measures of socio-economic status in this study.
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  • Ekberg, Marie, et al. (författare)
  • Mortality risks among heavy-smokers with special reference to women: a long-term follow-up of an urban population
  • 2007
  • Ingår i: European Journal of Epidemiology. - : Springer Science and Business Media LLC. - 1573-7284 .- 0393-2990. ; 22:5, s. 301-309
  • Tidskriftsartikel (refereegranskat)abstract
    • Increased mortality risks associated with smoking are well established among men. There are very few population-based studies comprising a sufficient number of heavily smoking women, measuring the direct effect of smoking on mortality risks. Between 1974 and 1992, 8,499 women and 13,888 men attended a health screening programme including reporting of smoking habits. Individuals were followed for total mortality until 2005. All-cause, cancer, cardiovascular, lung cancer and respiratory mortality were calculated in smoking categories < 10 g per day, 10-19 g per day, and >= 20 g per day with never-smokers as a reference group and with adjustments for co-morbidities, socio-economic and marital status. For respiratory mortality and lung cancer adjustments for FEV1, socio-economic and marital status were performed. Smoking was associated with a two to almost threefold increased mortality risk among women and men. The relative risk (RR) with 95% confidence interval, (CI) for women who smoked 10-19 g per day was 2.44 (2.07-2.87), and for those who smoked 20 g per day or more the RR (95% CI) was 2.42 (2.00-2.92). Smoking was a strong risk factor for cardiovascular mortality among women, the RR (95% CI) for women who smoked 10-19 g per day was 4.52 (3.07-6.64). Ex-smoking women showed increased risks of all-cause mortality; RR (95% CI) 1.26 (1.04-1.52) cancer (excluding lung cancer); RR (95% CI) 1.42 (1.07-1.88) and lung cancer RR (95% CI) 2.71 (1.02-7.23) mortality. However, the cardiovascular; RR (95% CI) 1.18 (0.69-2.00) and respiratory; RR (95% CI) 0.79 (0.16-3.84) mortality risks were not statistically significant. This study confirms that as for men, middle-aged heavily smoking women have a two to threefold increased mortality risk. Adjustments for co-morbidity, socio-economic and marital status did not change these results.
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  • Ekman, A, et al. (författare)
  • New times, new needs; e-epidemiology
  • 2007
  • Ingår i: European journal of epidemiology. - : Springer Science and Business Media LLC. - 0393-2990 .- 1573-7284. ; 22:5, s. 285-292
  • Tidskriftsartikel (refereegranskat)
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  • Galanti, Maria Rosaria, et al. (författare)
  • Smoking and environmental iodine as risk factors for thyroiditis among parous women
  • 2007
  • Ingår i: European Journal of Epidemiology. - : Springer Science and Business Media LLC. - 0393-2990 .- 1573-7284. ; 22:7, s. 467-472
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective To elucidate whether exposure to some environmental factors, i.e. cigarette smoking and iodine deficiency influence the risk of thyroiditis. Methods We identified a cohort of 874, 507 parous women with self-reported information on smoking during pregnancy registered in the Swedish Medical Birth Registry from September 1983 through December 1997. Hospital diagnoses of thyroiditis (n = 286) and hypothyroidism (n = 690) following entry into the cohort were identified by record-linkage with the national Inpatient Registry. The hazard ratio (HR) of smokers compared to non-smokers and the corresponding 95% confidence limits (CL) were estimated by Cox regression. Results Smoking was inversely associated with risk of overt thyroiditis (adjusted HR = 0.72; CL = 0.54-0.95), even when diagnoses of primary hypothyroidism were included. However, a diagnosis of thyroiditis within 6 months from a childbirth was positively associated with smoking (adjusted HR = 1.88; CL = 0.94-3.76). Being born in areas of endemic goiter was not associated to hospital admission for thyroiditis. Thyroiditis patients who were smokers had more often than non-smokers a co-morbidity with other autoimmune disorders. Conclusions Smoking may increase the risk of thyroiditis occurring in the post-partum period and influence the clinical expression of other thyroiditis, especially when occurring as part of a polymorphic autoimmune disease.
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  • Grotmol, T, et al. (författare)
  • Conditions in utero and cancer risk
  • 2006
  • Ingår i: European journal of epidemiology. - : Springer Science and Business Media LLC. - 0393-2990 .- 1573-7284. ; 21:8, s. 561-70
  • Tidskriftsartikel (refereegranskat)
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  • Hedlund, Ebba, et al. (författare)
  • Country of birth and survival after first myocardial infarction in Stockholm, Sweden
  • 2008
  • Ingår i: European Journal of Epidemiology. - : Springer Science and Business Media LLC. - 0393-2990 .- 1573-7284. ; 23:5, s. 341-347
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim To analyse survival after a first myocardial infarction among immigrants in Stockholm, Sweden. Methods All cases of first myocardial infarction among persons 30–74 years of age during 1985–1996 in Stockholm, Sweden were identified using registers of hospital discharges and deaths. Cases surviving 28 days were followed with regard to mortality during one year. Information on country of birth was obtained from national censuses and from a register on immigration. Early mortality was analysed by odds ratios (OR) through logistic regression and 1 year mortality by hazard ratios (HR) through cox proportional hazards regression. Results Male immigrants had a lower mortality within 28 days after a first myocardial infarction compared to Sweden-born after adjustment for socioeconomic status (OR 0.84; 95% CI 0.76–0.94). Among women there was a weak similar tendency (OR 0.92; 95% CI 0.76–1.10). There were essentially no differences overall between foreign-born and Sweden-born in 1-year-mortality after adjustment for socioeconomic status (men HR 1.13; 95% CI 0.91–1.41; women HR 0.90; 95% CI 0.61–1.34). Conclusion Immigrants in Sweden in general do not seem to have a higher mortality after a first myocardial infarction than Sweden-born, in particular when differences in socioeconomic status are accounted for. A higher CHD mortality in immigrants appears to be primarily due to an elevated disease incidence.
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  • Koupil, Ilona, et al. (författare)
  • Blood pressure, hypertension and mortality from circulatory disease in men and women who survived the siege of Leningrad
  • 2007
  • Ingår i: European Journal of Epidemiology. - : Springer Science and Business Media LLC. - 0393-2990 .- 1573-7284. ; 22:4, s. 223-234
  • Tidskriftsartikel (refereegranskat)abstract
    • The population of Leningrad suffered from severe starvation, cold and psychological stress during the siege in 1941–1944. We investigated long-term effects of the siege on cardiovascular risk factors and mortality in surviving men and women. 3905 men born 1916–1935 and 1729 women born 1910–1940, resident in St Petersburg (formerly Leningrad) between 1975 and 1982, of whom a third experienced the siege as children, adolescents or young adults,were examined for cardiovascular risk factors in 1975–1977 and 1980–1982 respectively and followed till end 2005. Effects of siege exposure on bloodpressure, lipids, body size, and mortality were studied in multivariate analysis stratified by gender and period of birth, adjusted for age, smoking, alcohol and social characteristics. Women who were 6–8 years old and men who were 9–15 years-old at the peak of starvation had higher systolic blood pressure compared to unexposed subjects born during the same period of birth (fully adjusted difference 8.8, 95% CI:0.1–17.5 mm Hg in women and 2.9, 95% CI: 0.7–5.0 mm Hg in men). Mean height of women who were exposed to siege as children appeared to be greater than that of unexposed women. Higher mortality from ischaemic heart disease and cerebrovascular disease was noted in men exposed at age 6–8 and 9–15, respectively. The experience of severe stress and starvation in childhood and puberty may have long-term effects on systolic blood pressure and circulatory disease in surviving men and women with potential gender differences in the effect of siege experienced at pre-pubertal age.
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  • Lagerros, Y. T., et al. (författare)
  • Validity and reliability of self-reported total energy expenditure using a novel instrument
  • 2006
  • Ingår i: European Journal of Epidemiology. - Karolinska Inst, Dept Med Epidemiol & Biostat, SE-17177 Stockholm, Sweden. Harvard Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA 02115 USA. Univ Milano Bicocca, Dept Stat, Milan, Italy. Royal Inst Technol, Sch Comp Sci & Commun, Stockholm, Sweden. : Springer Science and Business Media LLC. - 0393-2990 .- 1573-7284. ; 21:3, s. 227-236
  • Tidskriftsartikel (refereegranskat)abstract
    • Improved methods for quantitative self-reports of total physical activity in epidemiological studies are needed. We evaluated randomly selected individuals' ability to integrate their perception of physical activity over time to produce an estimate of the usual level, using a novel instrument for self-quantification of energy expenditure. A population-based sample of 418 Swedish men and women, age 20-59, completed a questionnaire containing the new instrument. For validation, three 24 hour recalls by phone served as gold standard. Reproducibility was assessed through administering the instrument another three times. The validation involved 133 subjects and another 160 completed the reproducibility evaluation. Pearson correlation between usual daily energy expenditure measured by the instrument and the mean of the 24 hour recalls was 0.73. After subdividing the self-reported daily energy expenditure and the mean of the 24 hour recalls into quintiles, 83.5% of the participants remained in the same quintile, or one quintile apart. There was a tendency towards overestimation of usual daily physical activity. This was significantly associated with low education. Reproducibility showed an intraclass correlation of 0.55. Although integrated reports of usual daily energy expenditure over longer periods seem to be afflicted with a tendency of overestimation, total energy expenditure can be estimated with reasonable validity and reproducibility using our instrument.
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  • Lagiou, P, et al. (författare)
  • Causality in cancer epidemiology
  • 2005
  • Ingår i: European journal of epidemiology. - : Springer Science and Business Media LLC. - 0393-2990 .- 1573-7284. ; 20:7, s. 565-574
  • Tidskriftsartikel (refereegranskat)
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  • Lobacheva, Tatiana, et al. (författare)
  • Risk factors for developing tuberculosis in remand prisons in St. Petersburg, Russia : a case-control study
  • 2007
  • Ingår i: European Journal of Epidemiology. - : Springer Science and Business Media LLC. - 0393-2990 .- 1573-7284. ; 22:2, s. 121-127
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Detainees have a substantial risk to develop tuberculosis ( TB) due to a higher incidence of TB in remand prison compared to the civil community. They develop TB during incarceration not only due to poor living conditions in remand prison, but also due to some factors affecting their life before imprisonment. Prevention measures against TB spread from penitentiary institutions to society include study of factors, which contribute to TB development. Current study aims at identification of important risk factors of TB development in remand prison in St. Petersburg, Russia. Methods: A retrospective matched case-control study was performed from May 2002 to May 2003 in two remand prisons in St. Petersburg. One hundred and fourteen prisoners ( 57 cases, 57 controls) were interviewed by using standardised questionnaire. Logistic regression analysis was performed to identify risk factors. Results: Six factors were significantly linked to the risk of developing TB: narcotic drug use ( odds ratio ( OR): 2.6, 95% confidence interval (CI): 1.0-6.9), low income ( OR: 3.2, CI: 1.2-8.6), high ratio of prisoners per available bed ( OR: 4.0, CI: 1.1-15.0), not having own bed clothes ( OR: 13.0, CI: 2.7-61.6), and little time outdoors ( OR: 3.3,CI: 1.3-8.5). However, good housing before imprisonment ( OR: 4.2, CI: 1.1-15.7) was a separate risk factor for TB. Conclusions: Three of the risk factors ( high number of prisoners per bed, not having own bed clothes, and little time outdoors) are certainly possible to approach by improvement of conditions in remand prisons. The remaining three factors ( narcotic drug use, good housing before imprisonment, and low income) provide knowledge about study population, but cannot be intervened by prison's medical staff.
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  • Manjer, Jonas, et al. (författare)
  • Smoking as a determinant for plasma levels of testosterone, androstenedione, and DHEAs in postmenopausal women
  • 2005
  • Ingår i: European Journal of Epidemiology. - : Springer Science and Business Media LLC. - 1573-7284 .- 0393-2990. ; 20:4, s. 331-337
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of the present study was to investigate whether current smoking, ex-smoking, or amount of current smoking among postmenopausal women was associated with plasma levels of testosterone, and rostenedione, and DHEAs. About 65,000 women in Sweden have participated in two population-based prospective cohort studies where blood samples were collected at baseline, and information on life-style, reproductive history and anthropometrical measurements were available. The present study was based on 407 control subjects from a previous nested case-control study on the relation between steroid hormone levels and risk of breast cancer. A multivariate logistic regression analysis, adjusted for potential confounders, was used in order to obtain odds ratios (OR) with 95 confidence intervals. There was a high risk of high testosterone levels (above the median) in current vs. never smokers, OR1.85 (1.06-3.23). Risk of high testosterone levels increased by amount of daily smoking (increments of 10 cigarettes/day), OR 1.55 (1.02-2.37). Ex-smoking was associated with high testosterone levels, OR: 1.56 (0.98-2.47). Current smoking and increasing amount of current smoking were weakly associated with high androstenedione levels. However, these associations did not reach statistical significance. No association was seen between smoking habits and DHEAs levels. We conclude that current smoking, and increasing amount of daily smoking, is associated with high testosterone levels.
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  • Nafziger, AN, et al. (författare)
  • High obesity incidence in northern Sweden: how will Sweden look by 2009?
  • 2006
  • Ingår i: European Journal of Epidemiology. - : Springer Science and Business Media LLC. - 0393-2990 .- 1573-7284. ; 21:5, s. 377-382
  • Tidskriftsartikel (refereegranskat)abstract
    • The study objective was to evaluate the incidence of overweight and obesity in two rural areas of Sweden and the U.S. Previously collected data were used from 1990 to 1999 Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) studies in northern Sweden. Health censuses of adults in Otsego County, New York were collected in 1989 and 1999. Adults aged 25-64 year in 1989 with reports from both surveys were included. The 10-year change in body mass index (BMI), overweight (BMI 25-29.9 kg/m2) and obesity (BMI>or=30) were obtained from panel studies. Incidences of overweight and obesity were calculated and compared between countries. The 10-year incidence of obesity was 120/1000 in Sweden and 173/1000 in the U.S. (p<0.001 for difference between countries). In 1999, prevalence of obesity rose to 18.4% (Sweden) and 32.3% (U.S.). Cumulative distribution curves show that the BMI distribution in Sweden during 1999 is nearly identical to the U.S. during 1989. The obese proportions of these rural populations increased from 1989 to 1999. Sweden's obesity epidemic has a progression similar to that of the U.S., implying that by 2009, the prevalence of obesity in rural northern Sweden may mimic that present in rural New York during 1999. Attention should be paid to the increased obesity rates in rural areas.
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  • Orsini, Nicola, et al. (författare)
  • Reproducibility of the past year and historical self-administered total physical activity questionnaire among older women.
  • 2007
  • Ingår i: European Journal of Epidemiology. - : Springer Science and Business Media LLC. - 0393-2990 .- 1573-7284. ; 22:6, s. 363-8
  • Tidskriftsartikel (refereegranskat)abstract
    • Few studies have evaluated the reliability of a self-administered current and historical physical activity questionnaire (PAQ) among middle-aged and elderly women. We evaluated the reliability of a self-administered PAQ designed to assess total (24 h) current and historical physical activity at age 15, 30, and 50 years, which was completed by a subgroup of 303 women aged 56-75 years from the Swedish Mammography Cohort (SMC). Total physical activity covered occupational and household activity as well as walking/bicycling, exercise, and inactivity (sitting watching TV/reading). Reliabilities (1-year test-retest) of continuous activity measures in metabolic equivalents were evaluated using an intraclass correlation coefficient (ICC); classification consistency was evaluated using sensitivity and specificity statistics. The ICC for total current physical activity was 0.69; for specific types of activities the ICC ranged from 0.49 to 0.59; for historical physical activity, the reliabilities for total activity ranged from 0.75 for age 50 to 0.81 for age 30 years, being substantial for occupational activities (ICC = 0.73-0.75), and fair to moderate for inactivity (ICC = 0.31-0.60). These data indicate that the PAQ used in the SMC is a satisfactory and reproducible measure of current and historical physical activity, for total as well as for different types of activities.
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  • Orsini, Nicola, et al. (författare)
  • Validity of self-reported total physical activity questionnaire among older women
  • 2008
  • Ingår i: European Journal of Epidemiology. - : SPRINGER. - 0393-2990 .- 1573-7284. ; 23:10, s. 661-667
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim of this study was to assess the validity of a short self-administered physical activity questionnaire, intended to measure past year total daily physical activity, by comparison with activity records and accelerometers. Over a 1-year period, data from a questionnaire, 7-day activity records and accelerometers were obtained from a subset of 116 women between the ages of 56 and 75 years from the population-based Swedish Mammography Cohort. We estimated concordance correlations as measure of validity, deattenuated for intraindividual variation in the reference method. Deattenuated concordance correlations comparing total daily activity measured by the questionnaire with the accelerometers and the records were 0.38 (95% CI: 0.22-0.54) and 0.64 (95% CI: 0.45-0.83), respectively. Validity of leisure-time activity (walking/bicycling and exercise) and inactivity (watching TV/reading) estimates comparing the records with the questionnaire were 0.42 (95% CI: 0.22-0.62) and 0.52 (95% CI: 0.36-0.69), respectively. These data indicate that the average past year total physical activity, leisure-time activity and inactivity can be estimated with a reasonable validity using our short self-administered questionnaire.
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