| 1. |
- Newby, P K, et al.
(författare)
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Early anthropometric measures and reproductive factors as predictors of body mass index and obesity among older women
- 2005
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Ingår i: International Journal of Obesity. - Tufts Univ, Jean Mayer United State Dept Agr, Human Nutr Res Ctr, Boston, MA 02111 USA. Karolinska Inst, Dept Med Epidemiol, Stockholm, Sweden. Karolinska Inst, Dept Environm Med, Div Nutr Epidemiol, Stockholm, Sweden. : NATURE PUBLISHING GROUP. - 0307-0565 .- 1476-5497. ; 29:9, s. 1084-1092
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To examine whether early anthropometric measures and reproductive factors were associated with body mass index (BMI), overweight, and obesity. DESIGN: Cross-sectional, observational study. SUBJECTS: In all, 18 109 healthy women who participated in the Swedish Mammography Cohort aged 49-83 y. MEASUREMENTS: Early anthropometric (birthweight and body shape at age 10 y) and reproductive ( age at menarche, age at the birth of the first child, and parity) variables were our predictors and current BMI, overweight ( BMI 25-29.99 kg/m(2)), and obesity (BMI >= 30 kg/m(2)) were our outcomes. RESULTS: In multivariate-adjusted polytomous logistic regression analysis, risk of overweight and obesity increased with increasing body shape at age 10 y and decreased with increasing age at menarche and age at first birth (P for trend < 0.0001). A U-shaped relation with birthweight was observed. In our tests for effect modification of the relation with overweight/obesity (ow/ob; BMI >= 25 kg/m(2)), we detected significant interactions between body shape at 10 y and age ( P < 0.0001); body shape at 10 y and physical activity ( P < 0.0001); age at first birth and smoking (P = 0.02); and parity and physical activity (P = 0.004). The increased risk of ow/ob among women who reported a larger childhood body shape was reduced as women moved from the lowest to highest quartile of physical activity in adulthood. Likewise, the increasing risk of ow/ob among women with greater parity was reduced with increased physical activity. CONCLUSION: Early anthropometric measures and reproductive factors are significantly associated with BMI, overweight, and obesity among older women. The effects of childhood body weight, age at first birth, and parity may be modified by adult lifestyle choices, as well as age.
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| 2. |
- Surkan, P. J., et al.
(författare)
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Events after stillbirth in relation to maternal depressive symptoms: a brief report.
- 2008
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Ingår i: Birth. - 1523-536X. ; 35:2, s. 153-157
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT: Background: Actions taken after a stillbirth can affect long-term psychological morbidity. Our objective was to study how infant bonding and maternal actions after stillbirth are associated with ensuing depressive symptoms. Methods: Using the population-based Swedish Medical Birth Register, we identified all 380 Swedish-speaking women who gave birth to singleton stillborn infants in Sweden in 1991. Of these, 314 (83%) completed a postal questionnaire 3 years after the stillbirth. Items included actions taken to bond with the baby and demographics. The association between care-related factors and later maternal depressive symptoms was quantified using relative risks estimated using multivariable regression. Results: We observed an almost sevenfold increased risk of depressive symptoms for mothers who reported not being with their babies as long as they wished (adjusted risk ratio [RR] 6.9, 95% CI 2.4–19.8). Compared with women who became pregnant again within 6 months, those with no later pregnancy were at higher risk of depressive symptoms (adjusted RR 2.8, 95% CI 0.9–8.4). In addition, compared with women who experienced a stillbirth in their first pregnancy, stillbirth occurring with an infant who was third in the birth order was related to a twofold risk of elevated depressive symptoms (adjusted RR 2.2, 95% CI 0.8–6.4). Furthermore, stillbirth occurring in a fourth or later pregnancy was associated with an almost sevenfold risk of depressive symptomatology (adjusted RR 6.7, 95% CI 2.2–20.5). No evidence of an association was found between other care-related actions and subsequent maternal depressive symptoms. Conclusions: Our results suggest that a mother being with the stillborn baby for as long as desired and the birth order of the stillbirth may influence her later depressive symptomatology. Compared with mothers who became pregnant again within 6 months, those who did not have a subsequent pregnancy were at higher risk of depressive symptoms at 3 years’ follow-up
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| 3. |
- Surkan, P. J., et al.
(författare)
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Home care of a child dying of a malignancy and parental awareness of a child's impending death
- 2006
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Ingår i: Palliative Medicine. - : SAGE Publications. - 0269-2163 .- 1477-030X. ; 20:3, s. 161-9
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Tidskriftsartikel (refereegranskat)abstract
- In this population-based study, we found that parents who are aware that their child will die from a malignancy are more likely to care for their child at home during the child's last month of life compared to parents who are not aware. End-of-life home care was comparable to hospital care for satisfactory pain relief, access to pain relief and access to medications for other physical symptoms. Using an anonymous postal questionnaire, we obtained information from 449 parents in Sweden who had lost a child due to a malignancy between 1992 and 1997, 4 to 9 years before participating in our study. The prevalence of dying at home and being cared for at home during the last month of life was 23.7% when parents realized intellectually more than 1 month in advance that the child would die (versus 12% who did not), 28.7% for parents who sensed that the child was aware of his or her imminent death (versus 7.8% who did not sense this) and 21.9% for those who received information that the child's illness was incurable (versus 9.4% who did not receive the information). Prevalence of children's unrelieved pain was 11.6% for those receiving home care and 15.3% for those receiving care outside the home.
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| 4. |
- Surkan, P. J., et al.
(författare)
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Perceptions of inadequate health care and feelings of guilt in parents after the death of a child to a malignancy: a population-based long-term follow-up
- 2006
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Ingår i: J Palliat Med. - : Mary Ann Liebert Inc. - 1096-6218 .- 1557-7740. ; 9:2, s. 317-31
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Parental feelings of guilt can be a serious problem after the death of a child to a malignancy. This study identified predictors of feelings of guilt in parents during the year after a child's death. METHODS: The Swedish Cause of Death Register and Swedish Cancer Register were used to identify all parents in Sweden who had a child who died of a malignancy between 1992-1997. RESULTS: Among parents not reporting recent depression, those who were not confident that their child would immediately receive help from the staff in the hospital while he or she was sick with a malignancy (compared to those who felt partly or entirely sure, relative risk [RR] 4.0; 95% confidence interval [CI] 2.1-7.6), were at increased risk for reporting daily or weekly feelings of guilt in the year after the child's death. Parents who perceived that the staff in the pediatric cancer ward were incompetent were at increased risk (compared to parents reporting partial or total competence, RR 3.7; 95% CI 1.6-8.6). Compared to parents reporting that their children had moderate or much access, those who felt their children had little or no access to pain relief, dietary advice, anxiety relief, and relief of other psychological symptoms beside anxiety were at more than two times greater risk for reporting feelings of guilt. CONCLUSIONS: Bereaved parents' perceptions of inadequate health care were associated with subsequent feelings of guilt during the year following their child's death due to a malignancy.
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| 5. |
- Bergmark, K., et al.
(författare)
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Lymphedema and bladder-emptying difficulties after radical hysterectomy for early cervical cancer and among population controls
- 2006
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Ingår i: Int J Gynecol Cancer. - : Lippincott Williams & Wilkins. - 1048-891X .- 1525-1438. ; 16:3, s. 1130-9
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to acquire knowledge that can be used to refine radical hysterectomy to improve quality-of-life outcome. Data were collected in 1996-1997 by means of an anonymous postal questionnaire in a follow-up study of two cohorts (patients and population controls). We attempted to enroll all 332 patients with stage IB-IIA cervical cancer registered in 1991-1992 at the seven departments of gynecological oncology in Sweden and 489 population controls. Ninety three (37%) of the 256 women with a history of cervical cancer who answered the questionnaire (77%) were treated with surgery alone. Three-hundred fifty population controls answered the questionnaire (72%). Women treated with radical hysterectomy, as compared with controls, had an 8-fold increase in symptoms indicating lymphedema (25% reported distress due to lymphedema), a nearly 9-fold increase in difficult emptying of the bladder, and a 22-fold increase in the need to strain to initiate bladder evacuation. Ninety percent of the patients were not willing to trade off survival for freedom from symptoms. Avoiding to induce long-term lymphedema or bladder-emptying difficulties would probably improve quality of life after radical hysterectomy (to cure cervical cancer). Few women want to compromise survival to avoid long-term symptoms.
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| 6. |
- Bergmark, K., et al.
(författare)
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Synergy between sexual abuse and cervical cancer in causing sexual dysfunction
- 2005
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Ingår i: J Sex Marital Ther. - : Routledge. - 0092-623X .- 1521-0715. ; 31:5, s. 361-83
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Tidskriftsartikel (refereegranskat)abstract
- Experiencing a sexual abuse creates a life-long traumatic memory. The life-long effect of such abuse on sexuality, well-being, the risk of contracting cervical cancer, or problems after treatment for cervical cancer is not known. A population-based follow-up study in 1996-97 that used an anonymous postal questionnaire for data collection, 256 women with stage IB-IIA cervical cancer registered in 1991-92 in Sweden, and 350 women without cervical cancer frequency matched for age and region of residence, provided information. Among the women with a history of cervical cancer and the control women, 46 (18%) and 50 (15%), respectively, reported a history of sexual abuse. The follow-up was 1-70 years after the sexual abuse. The relative risk (with 95% confidence interval) of decreased well-being was 2.4 (1.1-5.2) among controls and 2.7 (1.1-6.4) among former cervical cancer patients. A history of both sexual abuse and cervical cancer gave a relative risk of 30.0 (7.0-129.0) for superficial dyspareunia. Sexual abuse increased the risk of sexual problems after treatment. The sexually abused cervical cancer patients were generally less willing than other patients to trade off possible maximal survival and forgo parts of the treatment. A history of sexual abuse and cervical cancer are both independent risk factors for sexual dysfunction and decreased well-being, and there may be a large synergy when both factors are combined. Diagnosis and treatment of cervical cancer may be improved by recognition of a sexual abuse history.
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| 7. |
- Brooks, D. R., et al.
(författare)
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Temporal trends in non-small cell lung cancer survival in Sweden
- 2007
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Ingår i: British Journal of Cancer. - : Springer Science and Business Media LLC. - 0007-0920 .- 1532-1827. ; 96:3, s. 519-522
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Tidskriftsartikel (refereegranskat)abstract
- We modeled temporal trends in the 1- and 5-year survival of 32 499 patients with adenocarcinoma and squamous cell carcinoma of the lung in the Swedish Cancer Register between 1961 and 2000. The 1-year relative survival for adenocarcinoma improved from 37% for patients diagnosed 1961–1965 to 45% for those diagnosed 1996–2000 and from 39 to 45% for squamous cell carcinoma. The adjusted excess mortality ratios for the period 1996–2000 compared with 1961–1965 were 0.80 for adenocarcinoma and 0.81 for squamous cell carcinoma. Thus, a previous report in a Dutch study of a relatively worsening prognosis for adenocarcinoma over time could not be confirmed.
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| 8. |
- Halthur, C., et al.
(författare)
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Serum calcium and the risk of prostate cancer
- 2009
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Ingår i: Cancer Causes and Control. - : Springer Science and Business Media LLC. - 1573-7225 .- 0957-5243. ; 20:7, s. 1205-1214
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Tidskriftsartikel (refereegranskat)abstract
- Recent studies have suggested an association between high dietary intake of calcium and the risk of prostate cancer. Calcium-rich diet has been suggested to affect the serum levels of Vitamin D, and thereby promote cancer. We conducted the largest study of the association between prediagnostic serum levels of calcium and the risk of prostate cancer. We examined the incidence of prostate cancer in relation to prediagnostic serum calcium levels in a prospective cohort study of 22,391 healthy Swedish men, of which 1,539 incident cases of prostate cancer were diagnosed during the 30 years of follow-up until December 2006. Serum levels of calcium were measured at baseline, and categorized into quartiles. Cox regression was used to estimate the adjusted hazard ratios (HR) with 95% confidence intervals (CI). We found no evidence of an association between prediagnostic serum levels of calcium and risk of prostate cancer (HR for trend = 0.99 [95% CI;0.94-1.03]). However, a moderate significant negative association was seen in men with a BMI above 25 and aged below 45 years at baseline (Highest vs. lowest quartile, HR = 0.63 [95% CI;0.40-0.99]). These data do not support the hypothesis that high serum calcium levels is a risk factor for prostate cancer. On the contrary, the data suggest that high serum levels of calcium in young overweight men may be a marker for a decreased risk of developing prostate cancer.
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| 9. |
- Ylitalo, Nathalie, et al.
(författare)
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Guilt after the loss of a husband to cancer: is there a relation with the health care provided?
- 2008
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Ingår i: Acta Oncology. - : Informa UK Limited. - 0284-186X .- 1651-226X. ; 47:5, s. 870-878
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Tidskriftsartikel (refereegranskat)abstract
- Background. Feelings of guilt are common after bereavement. We investigated whether feelings of guilt after the loss of a husband to cancer are associated with the health care provided at the time close to and at the moment of death. Materials and methods. The study population consisted of 506 widows of men who died of prostate cancer in 1995 or of urinary bladder cancer in 1995 or 1996 at the ages 45–74 years. We collected information on the received health care at the time of the husband's death from the widows, through a postal questionnaire. Results. Widows who perceived that their husbands did not get enough pain relief had an increased relative risk of 1.7 (95% CI 1.1–2.8), for guilt feelings, compared to widows who felt that their husbands had adequate pain relief. If a widow considered her husband being exposed to less satisfactory care or treatment, she had an almost two-fold increased relative risk, 1.9 (95% CI 1.2–3.1), for guilt feelings after the husband's death, compared to a widow who thought that satisfactory care or treatment was provided. Discussion. Feelings of guilt after bereavement may occur in response to the perception of inadequate health care during the last months and at the actual moment of death of the significant other.
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| 10. |
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