| 1. |
- Alfven, T., et al.
(författare)
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Placing children and adolescents at the centre of the Sustainable Development Goals will deliver for current and future generations
- 2019
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Ingår i: Global health action. - : Informa UK Limited. - 1654-9880 .- 1654-9880 .- 1654-9716. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- Child health is taking the back seat in development strategies. In summarising a newly released collaborative report, this paper calls for a novel conceptual model where child health takes centre stage in relation to the 2030 Agenda and the Sustainable Development Goals. It lays out five principles by which renewed effort and focus would yield the most benefit for children and adolescents. These include: re-defining global child health in the post-2015 era by placing children and adolescents at the centre of the Sustainable Development Goals; striving for equity; realising the rights of the child to thrive throughout the life-course; facilitating evidence informed policy-making and implementation; and capitalising on interlinkages within the SDGs to galvanise multisectoral action. These five principles offer models that together have the potential of improving design, return and quality of global child health programs while re-energising the 2030 Agenda and the Sustainable Development Goals.
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| 2. |
- Bungum, Ane Berger, et al.
(författare)
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Risk of metabolic disorders in childless men : A population-based cohort study
- 2018
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 8:8
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Tidskriftsartikel (refereegranskat)abstract
- Objective To study whether male childlessness is associated with an increased risk of metabolic disorders such as metabolic syndrome (MetS) and diabetes. Design A population-based cohort study. Setting Not applicable. Participants 2572 men from the population-based Malmö Diet and Cancer Cardiovascular Cohort. Interventions None. Main outcome measures From cross-sectional analyses, main outcome measures were ORs and 95% CIs for MetS and diabetes among childless men. In prospective analyses, HRs and 95% CI for diabetes among childless men. Results At baseline, in men with a mean age of 57 years, the prevalence of MetS was 26% and 22% among childless men and fathers, respectively. Similarly, we observed a higher prevalence of diabetes of 11% among childless men compared with 5% among fathers. In the cross-sectional adjusted analyses, childless men had a higher risk of MetS and diabetes, with ORs of 1.22 (95% CI 0.87 to 1.72) and 2.12 (95% CI 1.34 to 3.36) compared with fathers. In the prospective analysis, during a mean follow-up of 18.3 years, we did not see any increase in diabetes risk among childless men (HR 1.02 (0.76 to 1.37)). Conclusion This study provides evidence of an association between male childlessness and a higher risk of MetS and diabetes. However, as these associations were found in cross-sectional analyses, reverse causation cannot be excluded.
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| 3. |
- Glazer, Clara Helene, et al.
(författare)
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Male factor infertility and risk of death : a nationwide record-linkage study
- 2019
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Ingår i: Human Reproduction. - : Oxford University Press (OUP). - 0268-1161 .- 1460-2350. ; 34:11, s. 2266-2273
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Tidskriftsartikel (refereegranskat)abstract
- STUDY QUESTION: What is the risk of death among men with oligospermia, unspecified male factor and azoospermia in the years following fertility treatment? SUMMARY ANSWER: No significantly elevated risk was observed among men with oligospermia and unspecified male factor, while an increased risk was found among men with azoospermia. WHAT IS KNOWN ALREADY: Previous studies have shown associations between male factor infertility and risk of death, but these studies have relied on internal reference groups and the risk of death according to type of male infertility is not well characterized. STUDY DESIGN, SIZE, DURATION: In this prospective record-linkage cohort study, we identified men who had undergone medically assisted reproduction (MAR) between 1994 and 2015. Data was linked to the Danish causes of death register and sociodemographic registers through personal identification numbers assigned to all Danish citizens at birth. PARTICIPANTS/MATERIALS, SETTING, METHODS: Men that had undergone MAR in Denmark (MAR Cohort; n = 64 563) were identified from the Danish IVF register, which includes data on whether infertility was due to male factor. For each man in the MAR cohort, five age-matched men who became fathers without fertility treatment were selected from the general population (non-MAR fathers; n = 322 108). Men that could not adequately be tracked in the Danish CPR register (n = 1259) and those that were censored prior to study entry (n = 993) were excluded, leaving a final population of 384 419 men. Risk of death was calculated by Cox regression analysis with age as an underlying timeline and adjustments for educational attainment, civil status and year of study entry. The risk of death was compared among men with and without male factor infertility identified from the IVF register (internal comparisons) as well as to the non-MAR fathers (external comparison). MAIN RESULTS AND THE ROLE OF CHANCE: The risk of death between the MAR cohort (all men, regardless of infertility) and the non-MAR fathers was comparable [hazard ratio (HR), 1.07; 95% CI, 0.98-1.15]. When the MAR cohort was limited to infertile men, these men were at increased risk of death [HR, 1.27; 95% CI, 1.12-1.44]. However, when stratified by type of male factor infertility, men with azoospermia had the highest risk of death, which persisted when in both the internal [HR, 2.30; 95% CI, 1.54-3.41] and external comparison [HR, 3.32; 95% CI, 2.02-5.40]. No significantly elevated risk of death was observed among men with oligospermia [HR, 1.14; 95% CI, 0.87-1.50] and unspecified male factor [HR, 1.10; 95% CI, 0.75-1.61] compared with the non-MAR fathers. The same trends were observed for the internal comparison. LIMITATIONS, REASONS FOR CAUTION: Duration of the follow-up was limited and there is limited generalizability to infertile men who do not seek fertility treatment. WIDER IMPLICATIONS OF THE FINDINGS: Using national health registers, we found an increased risk of death among azoospermic men while no increased risk was found among men with other types of infertility. For the azoospermic men, further insight into causal pathways is needed to identify options for monitoring and prevention.
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| 4. |
- Glazer, Clara Helene, et al.
(författare)
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Male factor infertility and risk of multiple sclerosis : A register-based cohort study
- 2018
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Ingår i: Multiple Sclerosis Journal. - : SAGE Publications. - 1352-4585 .- 1477-0970. ; 24:14, s. 1835-1842
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Tidskriftsartikel (refereegranskat)abstract
- Background: Gender, possibly due to the influence of gonadal hormones, is presumed to play a role in the pathogenesis of multiple sclerosis (MS), but no studies have evaluated whether male infertility is associated with MS. Objective: To study the association between male factor infertility and prevalent as well as incident MS. Method: Our cohort was established by linkage of the Danish National in vitro fertilization (IVF) registry to The Danish Multiple Sclerosis Registry and consisted of 51,063 men whose partners had undergone fertility treatment in all public and private fertility clinics in Denmark between 1994 and 2015. Results: With a median age of 34 years at baseline, 24,011 men were diagnosed with male factor infertility and 27,052 did not have male factor infertility and made up the reference group. Men diagnosed with male factor infertility had a higher risk of prevalent (odds ratio (OR) = 1.61, 95% confidence interval (95% CI) 1.04–2.51) and incident MS (hazard ratio (HR) = 1.28, 95% CI 0.76–2.17) when compared to the reference group. Conclusion: This nationwide cohort study has shown, for the first time, an association between male infertility and MS which may be due to underlying common etiologies such as hypogonadism, shared genetics, or a joint autoimmune component.
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| 5. |
- Hallman, David, et al.
(författare)
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Effect of an aerobic exercise intervention on cardiac autonomic regulation : A worksite RCT among cleaners
- 2017
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Ingår i: Physiology and Behavior. - : Elsevier BV. - 0031-9384 .- 1873-507X. ; 169, s. 90-97
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveThe aim of this randomized controlled trial (RCT) was to determine whether aerobic exercise during work hours affects cardiac autonomic regulation in cleaners characterized by high levels of occupational physical activity and poor cardiorespiratory fitness.MethodEligible cleaners (n=116) were randomized to an aerobic exercise group (n=59) or a reference group (n=57) with lectures. The intervention group received two 30-min sessions per week of supervised aerobic exercise over 4 months. Diurnal measurements of heart rate variability (HRV) and physical activity (accelerometry) were obtained at baseline and at 4-month follow-up. Time and frequency domain indices of HRV were derived during work, leisure time and sleep to evaluate cardiac autonomic regulation. Linear mixed models were used to determine the effect of the intervention on HRV indices, with adjustment for age, gender and daily use of antihypertensive and/or heart medication.ResultsCompared with the reference group, the exercise group increased all HRV indices apart from a reduction in LF/HF ratio from baseline to follow-up both during work (p<0.05) and leisure (p<0.05). In contrast, during sleep, the HRV indices tended to decrease in the exercise group compared with the reference group from baseline to follow-up, being significant for the HF spectral component (p=0.03).ConclusionAmong cleaners, a worksite aerobic exercise intervention improved cardiac autonomic regulation during work and leisure, but not during sleep. The health effect of this contrasting change in autonomic regulation needs further investigation.
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| 6. |
- Høyer, Birgit Bjerre, et al.
(författare)
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Exposure to perfluoroalkyl substances during pregnancy and child behaviour at 5 to 9 years of age
- 2018
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Ingår i: Hormones and Behavior. - : Elsevier BV. - 0018-506X. ; 101, s. 105-112
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Tidskriftsartikel (refereegranskat)abstract
- We examined associations between prenatal exposure to perfluorohexane sulfonic acid (PFHxS), perfluoroheptanoic acid (PFHpA), perfluorononanoic acid (PFNA), and perfluorodecanic acid (PFDA) - and child behaviour (SDQ-total) and hyperactivity (sub-scale) at 5–9 years of age in birth cohorts from Greenland and Ukraine. Pregnancy serum samples (N = 1023) were analysed for perfluoroalkyl substances (PFASs) and categorised into tertiles and also used as continuous exposure variables. Problem behaviour and hyperactivity were assessed, using the Strength and Difficulties Questionnaire (SDQ) and categorised as normal/borderline and abnormal. Associations were analysed using multiple logistic and linear regression. High compared to low prenatal PFHxS exposure was associated with 1.16 (95% confidence interval (CI): 0.08; 2.25) point higher SDQ-total (more problem behaviour) in Greenland and 0.80 (CI: 0.06; 1.54) point higher SDQ-total in the combined analyses, whereas no association was present in Ukraine alone. One natural log-unit increase in prenatal PFNA exposure was associated with 0.90 (CI: 0.10; 1.71) points higher SDQ-total in Greenland and 0.72 (CI: 0.13; 1.31) points higher in the combined analysis and no association in Ukraine. Prenatal PFAS exposure was unrelated to problem behaviour (abnormal SDQ-total). In the combined analysis, odds ratio (OR) (CI) for hyperactivity was 1.8 (1.0; 3.2) for one natural log-unit increase in prenatal PFNA and 1.7 (1.0; 3.1) for one natural log-unit increase in prenatal PFDA exposure. Findings are compatible with weak effects on child behaviour of prenatal exposure to some PFASs although spurious results are not entirely unlikely. The associations were strongest in Greenland.
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| 7. |
- Lherrnie, Guillaume, et al.
(författare)
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Tradeoffs between resistance to antimicrobials in public health and their use in agriculture : Moving towards sustainability assessment
- 2019
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Ingår i: Ecological Economics. - : Elsevier BV. - 0921-8009 .- 1873-6106. ; 166
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Tidskriftsartikel (refereegranskat)abstract
- Antimicrobial use (AMU) in animal agriculture contributes to select resistant bacteria potentially transferred to humans directly or indirectly via the food chain, representing a public health hazard. Yet, a major difference triggering AMU in food animal production is that in addition to therapeutic cure, farmers use antimicrobials to keep their herds healthy and highly productive, while ensuring animal welfare and food safety objectives. As a society, we consequently face difficult tradeoffs, between massive restrictions of AMU, and maintenance of current and potentially non-sustainable consumption levels. Here, we present the different components to be addressed for assessing the sustainability of AMU in animal agriculture. At first, we describe the interests and limits of existing models identified by reviewing the literature, which could potentially be used to assess AMU sustainability, while allowing the reader to capture in a simple and visual manner the complexity of the issue. We address in the following sections the boundaries of the social-ecological system and the indicators that are required for assessment of AMU sustainability. We introduce analytic methods that could be used for assessing the sustainability of antimicrobial use.
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| 8. |
- Lim, Michelle M. L., et al.
(författare)
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Reframing the sustainable development goals to achieve sustainable development in the Anthropocene-a systems approach
- 2018
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Ingår i: Ecology and Society. - 1708-3087. ; 23:3
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Tidskriftsartikel (refereegranskat)abstract
- Griggs et al. (2013) redefine sustainable development as development that meets the needs of the present while safeguarding Earth's life-support system, on which the welfare of current and future generations depend. We recommend this as the end goal that the United Nations sustainable development goals (SDGs) should strive to achieve. Integration across the SDGs is less than what is required from a science perspective. Effective implementation of the SDGs will require States to attend to trade-offs and overlaps. We argue that continuous failure to address integration within the SDGs will jeopardize realization of this ultimate end goal. Therefore, we adopt a systems approach to identify gaps and connections across the goals and targets of the SDGs as well as leverage points for effective intervention. We triangulate across methods of critical analysis, conceptual modeling, and keyword network analysis to draw out seven overarching directions that could provide a prioritization framework to enhance efficient implementation of the SDGs. Our results identify main gaps as exclusion of key actors (e.g., corporations) and issues (e.g., intergenerational equity and population); inadequate reconciliation of economic growth with maintaining the Earth system; and deficient consideration of the relationship with international law. Conceptual mapping identifies education and innovation; governance and implementation; sustainable consumption and production; and addressing the key drivers of climate change as key leverage points. The keyword analysis highlights greater integration within the SDGs than what appears at face value. Keywords access, women, resources,and finance feature across the SDGs and provide further leverage points. Targeting these issues will facilitate realization of a high proportion of SDGs and correspondingly could have a disproportional impact on effective SDG implementation. We conclude that the success of the SDGs needs to be evaluated by the extent to which it contributes to human development while advancing protection of planetary must-haves for current and future generations.
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| 9. |
- Nyström, Magnus, et al.
(författare)
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Anatomy and resilience of the global production ecosystem
- 2019
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Ingår i: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 575, s. 98-108
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Tidskriftsartikel (refereegranskat)abstract
- Much of the Earth's biosphere has been appropriated for the production of harvestable biomass in the form of food, fuel and fibre. Here we show that the simplification and intensification of these systems and their growing connection to international markets has yielded a global production ecosystem that is homogenous, highly connected and characterized by weakened internal feedbacks. We argue that these features converge to yield high and predictable supplies of biomass in the short term, but create conditions for novel and pervasive risks to emerge and interact in the longer term. Steering the global production ecosystem towards a sustainable trajectory will require the redirection of finance, increased transparency and traceability in supply chains, and the participation of a multitude of players, including integrated 'keystone actors' such as multinational corporations.
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| 10. |
- Semb, Gunvor, et al.
(författare)
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A Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 1. Planning and management.
- 2017
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Ingår i: Journal of Plastic Surgery and Hand Surgery. - : Taylor & Francis. - 2000-656X .- 2000-6764. ; 51:1, s. 2-13
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: Longstanding uncertainty surrounds the selection of surgical protocols for the closure of unilateral cleft lip and palate, and randomised trials have only rarely been performed. This paper is an introduction to three randomised trials of primary surgery for children born with complete unilateral cleft lip and palate (UCLP). It presents the protocol developed for the trials in CONSORT format, and describes the management structure that was developed to achieve the long-term engagement and commitment required to complete the project.METHOD: Ten established national or regional cleft centres participated. Lip and soft palate closure at 3-4 months, and hard palate closure at 12 months served as a common method in each trial. Trial 1 compared this with hard palate closure at 36 months. Trial 2 compared it with lip closure at 3-4 months and hard and soft palate closure at 12 months. Trial 3 compared it with lip and hard palate closure at 3-4 months and soft palate closure at 12 months. The primary outcomes were speech and dentofacial development, with a series of perioperative and longer-term secondary outcomes.RESULTS: Recruitment of 448 infants took place over a 9-year period, with 99.8% subsequent retention at 5 years.CONCLUSION: The series of reports that follow this introductory paper include comparisons at age 5 of surgical outcomes, speech outcomes, measures of dentofacial development and appearance, and parental satisfaction. The outcomes recorded and the numbers analysed for each outcome and time point are described in the series.TRIAL REGISTRATION: ISRCTN29932826.
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| 11. |
- Storkås, Hanne Stavø, et al.
(författare)
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Left axis deviation in patients with left bundle branch block is a marker of myocardial disease associated with poor response to cardiac resynchronization therapy
- 2019
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Ingår i: Journal of Electrocardiology. - : Elsevier BV. - 0022-0736.
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Patients with left axis deviation (LAD) and left bundle branch block (LBBB) show less benefit from cardiac resynchronization therapy (CRT) compared to other LBBB-patients. This study investigates the reasons for this. Methods: Sixty-eight patients eligible for CRT were included. Patients were divided into groups according to QRS-axis; normal axis (NA), left axis deviation (LAD) and right axis deviation (RAD). Before CRT implantation CMR imaging was performed to evaluate scar tissue. Echocardiography was performed before and after implantation. The electrical substrate was assessed by measuring interlead electrical delays. Response was evaluated after 8 months by left ventricular (LV) remodelling and clinical response. Results: Forty-four (65%) patients were responders in terms of LV remodelling. The presence of LAD was found to be independently associated with a poor LV remodelling non-response OR 0.21 [95% CI 0.06–0.77] (p = 0.02). Patients with axis deviation had more myocardial scar tissue (1.3 ± 0.6 vs. 0.9 ± 0.6, P = 0.04), more severe LV hypertrophy (14 (64%) and 6 (60%) vs. 7 (29%), P = 0.05) and tended to have a shorter interlead electrical delay than patients with NA (79 ± 40 ms vs. 92 ± 48 ms, P = 0.07). A high scar tissue burden was more pronounced in non-responders (1.4 ± 0.6 vs. 1.0 ± 0.5, P = 0.01). Conclusions: LAD in the presence of LBBB is a predictor of poor outcome after CRT. Patients with LBBB and LAD have more scar tissue, hypertrophy and less activation delay.
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| 12. |
- Søgaard Jørgensen, Peter, et al.
(författare)
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Antibiotic and pesticide susceptibility and the Anthropocene operating space
- 2018
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Ingår i: Nature Sustainability. - : Springer Science and Business Media LLC. - 2398-9629. ; 1:11, s. 632-641
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Forskningsöversikt (refereegranskat)abstract
- Rising levels of antimicrobial and pesticide resistance increasingly undermine human health and systems for biomass production, and emphasize the sustainability challenge of preserving organisms susceptible to these biocides. In this Review, we introduce key concepts and examine dynamics of biocide susceptibility that must be governed to address this challenge. We focus on the impact of biocides on the capacity of susceptible organisms to prevent spread of resistance, and we then review how biocide use affects a broader suite of ecosystem services. Finally, we introduce and assess the state of what we term the Anthropocene operating space of biocide susceptibility, a framework for assessing the potential of antibiotic and pesticide resistance to undermine key functions of human society. Based on current trends in antibiotic, insecticide and herbicide resistance, we conclude that the states of all six assessed variables are beyond safe zones, with three variables surpassed regionally or globally.
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| 13. |
- Søgaard Jørgensen, Peter, et al.
(författare)
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Building urgent intergenerational bridges : assessing early career researcher integration in global sustainability initiatives
- 2019
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Ingår i: Current Opinion in Environmental Sustainability. - : Elsevier BV. - 1877-3435 .- 1877-3443. ; 39, s. 153-159
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Forskningsöversikt (refereegranskat)abstract
- A double intergenerational conundrum abounds in sustainability science as young generations of researchers have relatively little influence on current strategic decisions, but inherit their potential future consequences as professionals as well as human-beings. Collaborating with early career researchers (ECRs) in global sustainability initiatives can help address this conundrum. Guided by a model for how enhanced collaboration with ECRs can emerge, we assess the current state of integration of ECRs in five major global sustainability initiatives. Highlighting the increasingly organized state of ECR networks,we find that initiatives increasingly collaborate with ECRs and that some initiatives integrate them at strategic decision-making levels. Yet, current forms of collaboration are often institutionally fragile and can be strengthened in this respect.
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| 14. |
- Søgaard Jørgensen, Peter, et al.
(författare)
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Changing antibiotic resistance : sustainability transformation to a pro-microbial planet
- 2017
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Ingår i: Current Opinion in Environmental Sustainability. - : Elsevier BV. - 1877-3435 .- 1877-3443. ; 25, s. 66-76
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Forskningsöversikt (refereegranskat)abstract
- Decades of overuse, misuse, and environmental antibiotic pollution has increased the global pool of resistant bacteria. With estimates of hundreds of thousands of annual human deaths and a lack of new drugs to replace old ones, antimicrobial resistance probably constitutes one of the greatest human health and sustainability challenges of the 21st century. To safeguard treatable infections, a deliberate social-ecological transformation is needed toward stewardship of the global microbiome and long-term sustainable use of antibiotics. We review the foundation for such a transformation using recent insights from sustainability science, evolutionary biology and health, and the understanding of human interactions with microbes as two intertwined complex adaptive systems. A coherent strategy should acknowledge humans as the source of the world's strongest evolutionary force, reflect that antibiotics are building blocks of modern health systems, and strive to build social-ecological resilience to minimize levels of resistance and avoid over dependency on innovation of new drugs. Bottom up opportunities for seeding the transformation include participatory monitoring and stewardship of our personal and environmental microbiomes, as well as collective consumer action. Top down priorities include regular international institutions to coordinate multi-level action.
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| 15. |
- Søgaard Jørgensen, Peter, et al.
(författare)
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Evolution in the Anthropocene : Informing Governance and Policy
- 2019
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Ingår i: Annual Review of Ecology, Evolution and Systematics. - : Annual Reviews. - 1543-592X .- 1545-2069. ; 50, s. 527-546
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Forskningsöversikt (refereegranskat)abstract
- The Anthropocene biosphere constitutes an unprecedented phase in the evolution of life on Earth with one species, humans, exerting extensive control. The increasing intensity of anthropogenic forces in the twenty-first century has widespread implications for attempts to govern both human-dominated ecosystems and the last remaining wild ecosystems. Here, we review how evolutionary biology can inform governance and policies in the Anthropocene, focusing on five governance challenges that span biodiversity, environmental management, food and other biomass production, and human health. The five challenges are: (a) evolutionary feedbacks, (b) maintaining resilience, (c) alleviating constraints, (d) coevolutionary disruption, and (e) biotechnology. Strategies for governing these dynamics will themselves have to be coevolutionary, as eco-evolutionary and social dynamics change in response to each other.
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