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- Odenstad, A, et al.
(författare)
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Does age at adoption and geographic origin matter? A national cohort study of cognitive test performance in adult inter-country adoptees.
- 2008
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Ingår i: Psychol Med. - 0033-2917 .- 1469-8978. ; 38:12, s. 1803-14
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Tidskriftsartikel (refereegranskat)abstract
- Does age at adoption and geographic origin matter? A national cohort study of cognitive test performance in adult inter-country adoptees.Odenstad A, Hjern A, Lindblad F, Rasmussen F, Vinnerljung B, Dalen M.Stress Research Institute, Stockholm University, Sweden.BACKGROUND: Inter-country adoptees run risks of developmental and health-related problems. Cognitive ability is one important indicator of adoptees' development, both as an outcome measure itself and as a potential mediator between early adversities and ill-health. The aim of this study was to analyse relations between proxies for adoption-related circumstances and cognitive development.MethodResults from global and verbal scores of cognitive tests at military conscription (mandatory for all Swedish men during these years) were compared between three groups (born 1968-1976): 746 adoptees born in South Korea, 1548 adoptees born in other non-Western countries and 330 986 non-adopted comparisons in the same birth cohort. Information about age at adoption and parental education was collected from Swedish national registers. RESULTS: South Korean adoptees had higher global and verbal test scores compared to adoptees from other non-European donor countries. Adoptees adopted after age 4 years had lower test scores if they were not of Korean ethnicity, while age did not influence test scores in South Koreans or those adopted from other non-European countries before the age of 4 years. Parental education had minor effects on the test performance of the adoptees - statistically significant only for non-Korean adoptees' verbal test scores - but was prominently influential for non-adoptees. CONCLUSIONS: Negative pre-adoption circumstances may have persistent influences on cognitive development. The prognosis from a cognitive perspective may still be good regardless of age at adoption if the quality of care before adoption has been 'good enough' and the adoption selection mechanisms do not reflect an overrepresentation of risk factors - both requirements probably fulfilled in South Korea.
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| 4. |
- Vinnerljung, Bo, et al.
(författare)
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School performance at age 16 among intercountry adoptees – A Swedish national cohort study.
- 2010
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Ingår i: International Social Work. - : SAGE Publications. - 0020-8728 .- 1461-7234. ; 53:4, s. 510-527
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Tidskriftsartikel (refereegranskat)abstract
- School performance at age 16 for 6448 intercountry adoptees to Sweden was compared with that of siblings and majority population peers. The school performance of Korean-born adoptees was on a par with nonadopted peers, but non-Korean adoptees’ school performance was lower, as was that of adoptees who were older at the time of adoption.
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| 5. |
- Abraham-Nordling, M, et al.
(författare)
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The value of preoperative computed tomography combined with ultrasound in the investigation of small indeterminate liver lesions in patients with colorectal cancer
- 2017
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Ingår i: Acta radiologica (Stockholm, Sweden : 1987). - : SAGE Publications. - 1600-0455 .- 0284-1851. ; 58:11, s. 1288-1293
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Tidskriftsartikel (refereegranskat)abstract
- Computed tomography (CT) is used routinely for the preoperative detection of colorectal cancer (CRC) metastases. When small indeterminate focal liver lesions are detected that are too small to characterize (TSTC) on CT, additional imaging is usually needed, resulting in a potential delay in obtaining a complete diagnostic work-up. Purpose To determine the diagnostic accuracy of ultrasound (US) of the liver performed in direct conjunction to CT in the preoperative investigation among patients with newly diagnosed CRC when indeterminate liver lesions were found on CT. Material and Methods Preoperative investigations with CT and consecutive US where CT had shown at least one focal liver lesion in 74 patients diagnosed with CRC between June 2009 and February 2012 were retrospectively reviewed. Either histopathological findings or a combination of imaging and clinical follow-up one to three years after surgery was used as the reference. Results Liver metastases were diagnosed with CT/US in 13 out of 74 patients (17.6%). In one patient, a liver cyst was preoperatively regarded as liver metastasis by a combined CT/US. The sensitivity and specificity for the CT with consecutive US procedure was 100% (13/13) and 98.4% (60/61). Conclusion US performed in conjunction with CT in patients with indeterminate focal liver lesions on CT is an accurate work-up for detection of liver metastases in patients with newly diagnosed CRC. Although our results are promising, they cannot be considered safely generalizable to all hospitals.
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- Chabok, Abbas, et al.
(författare)
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Randomized clinical trial of antibiotics in acute uncomplicated diverticulitis
- 2012
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Ingår i: British Journal of Surgery. - : Oxford University Press (OUP). - 0007-1323 .- 1365-2168. ; 99:4, s. 532-539
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Tidskriftsartikel (refereegranskat)abstract
- Background: The standard of care for acute uncomplicated diverticulitis today is antibiotic treatment, although there are no controlled studies supporting this management. The aim was to investigate the need for antibiotic treatment in acute uncomplicated diverticulitis, with the endpoint of recovery without complications after 12 months of follow-up. Methods: This multicentre randomized trial involving ten surgical departments in Sweden and one in Iceland recruited 623 patients with computed tomography-verified acute uncomplicated left-sided diverticulitis. Patients were randomized to treatment with (314 patients) or without (309 patients) antibiotics. Results: Age, sex, body mass index, co-morbidities, body temperature, white blood cell count and C-reactive protein level on admission were similar in the two groups. Complications such as perforation or abscess formation were found in six patients (1.9 per cent) who received no antibiotics and in three (1.0 per cent) who were treated with antibiotics (P = 0.302). The median hospital stay was 3 days in both groups. Recurrent diverticulitis necessitating readmission to hospital at the 1-year follow-up was similar in the two groups (16 per cent, P = 0.881). Conclusion: Antibiotic treatment for acute uncomplicated diverticulitis neither accelerates recovery nor prevents complications or recurrence. It should be reserved for the treatment of complicated diverticulitis.
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- Ekeus, C., et al.
(författare)
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Preterm birth, social disadvantage, and cognitive competence in Swedish 18- to 19-year-old men
- 2010
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Ingår i: Pediatrics. - : American Academy of Pediatrics (AAP). - 0031-4005 .- 1098-4275. ; 125:1, s. e67-73
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim was to study the impact of a range of gestationalages (GAs) on cognitive competence in late adolescence and howthis effect is modified by contextual social adversity in childhood. METHODS: This was a register study based on a national cohortof 119664 men born in Sweden from 1973 to 1976. Data on GA andother perinatal factors were obtained from the Medical BirthRegister, and information on cognitive test scores was extractedfrom military conscription at the ages of 18 to 19 years. Testscores were analyzed as z scores on a 9-point stanine scale,whereby each unit is equivalent to 0.5 SD. Socioeconomic indicatorsof the childhood household were obtained from the Populationand Housing Census of 1990. The data were analyzed by multivariatelinear regression. RESULTS: The mean cognitive test scores decreased in a stepwisemanner with GA. In unadjusted analysis, the test scores were0.63 stanine unit lower in men who were born after 24 to 32gestational weeks than in those who were born at term. The differencein global scores between the lowest and highest category ofsocioeconomic status was 1.57. Adjusting the analysis for thechildhood socioeconomic indicators decreased the effect of GAon cognitive test scores by 26% to 33%. There was also a multiplicativeinteraction effect of social adversity and moderately pretermbirth on cognitive test scores. CONCLUSIONS: This study confirms previous claims of an incrementalassociation of cognitive competence with GA. Socioeconomic indicatorsin childhood modified this effect at all levels of preterm birth.
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| 21. |
- Hjern, A, et al.
(författare)
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Migration and atopic disorder in Swedish conscripts
- 1999
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Ingår i: Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology. - : Wiley. - 0905-6157. ; 10:3, s. 209-215
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Tidskriftsartikel (refereegranskat)
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| 24. |
- Hjern, F., et al.
(författare)
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Cohort study of corticosteroid use and risk of hospital admission for diverticular disease
- 2015
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Ingår i: British Journal of Surgery. - : WILEY-BLACKWELL. - 0007-1323 .- 1365-2168. ; 102:1, s. 119-124
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Tidskriftsartikel (refereegranskat)abstract
- Background: Medication has been suggested as a potential risk factor for diverticular disease. The objective of this study was to investigate the association between the intake of corticosteroids, indometacin or aspirin and diverticular disease. Method: This was a prospective population-based cohort study of middle-aged women in the Swedish Mammography Cohort. Use of corticosteroids (oral or inhaled), indometacin or aspirin in 1997 was determined from questionnaires. Cases of diverticular disease were identified from the Swedish national registers until the end of 2010. The relative risk (RR) of diverticular disease requiring hospital admission according to the use of medication was estimated using Cox proportional hazards models, adjusted for age, body mass index, physical activity, fibre intake, diabetes, hypertension, alcohol, smoking and education. Results: A total of 36 586 middle-aged women in the Swedish Mammography Cohort were included, of whom 674 (18 per cent) were hospitalized with diverticular disease at least once. Some 72 per cent of women reported intake of oral corticosteroids and 85 per cent use of inhaled corticosteroids. In multivariable analysis, women who reported oral corticosteroid intake had a 37 per cent (RR 137, 95 per cent c.i. 106 to 178; P=0012) increased risk of diverticular disease compared with those who reported no intake at all. Use of inhaled corticosteroids was associated with an even more pronounced increase in risk of 71 per cent (RR 171, 136 to 214; P<0001). There was a significant dose-response relationship, with the risk increasing with longer duration of inhaled corticosteroids (P for trend<0001). Use of indometacin (25 per cent of women) or aspirin (442 per cent) did not influence the risk. Conclusion: There was a significant relationship between corticosteroids (especially inhaled) and diverticular disease requiring hospital admission.
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- Hjern, F., et al.
(författare)
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Smoking and the risk of diverticular disease in women
- 2011
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Ingår i: British Journal of Surgery. - : WILEY-BLACKWELL. - 0007-1323 .- 1365-2168. ; 98:7, s. 997-1002
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Tidskriftsartikel (refereegranskat)abstract
- Background: The relationship between smoking and the risk of diverticular disease is unclear. An observational cohort study was undertaken to investigate the association between smoking and diverticular disease. Methods: Women in the Swedish Mammography Cohort born between 1914 and 1948 were followed from 1997 to 2008. Information on smoking and other lifestyle factors was collected through questionnaires. Patients with symptomatic diverticular disease were identified from Swedish national registers. Relative risks (RRs) of symptomatic diverticular disease (resulting in hospital admission or death) according to smoking status were estimated using Cox proportional hazards models. Results: Of 35 809 women included in the study, 561 (1.6 per cent) had symptomatic diverticular disease. In multivariable analysis, current smokers had an increased risk of symptomatic diverticular disease compared with non-smokers after adjustment for age, intake of dietary fibre, diabetes, hypertension, use of acetylsalicylic acid, non-steroidal anti-inflammatory drugs or steroid medication, alcohol consumption, body mass index, physical activity and level of education (RR 1.23, 95 per cent confidence interval 0.99 to 1.52). Past smokers also had an increased risk (RR 1.26, 1.02 to 1.56). Smokers had a higher risk of developing a diverticular perforation/abscess than non-smokers (RR 1.89, 1.15 to 3.10). Conclusion: Smoking is associated with symptomatic diverticular disease.
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| 30. |
- Jablonska, B, et al.
(författare)
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Ethnicity, socio-economic status and self-harm in Swedish youth : a national cohort study.
- 2009
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Ingår i: Psychological Medicine. - 0033-2917 .- 1469-8978. ; 39:1, s. 87-94
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Previous studies have shown an elevated risk for self-harm in adolescents from ethnic minorities. However, potential contributions to this risk from socio-economic factors have rarely been addressed. The main aim of this article was to investigate any such effects. METHOD: A national cohort of 1009 157 children born during 1973-1982 was followed prospectively from 1991 to 2002 in Swedish national registers. Multivariate Cox analyses of proportional hazards were used to estimate the relative risk of hospital admission for self-harm. Parental country/region of birth was used as proxy for ethnicity. RESULTS: Youth with two parents born outside Sweden (except those from Southern Europe) had higher age- and gender-adjusted hazard ratios (HRs) of self-harm than the majority population (HR 1.6-2.3). The HRs decreased for all immigrant groups when socio-economic factors were accounted for but remained significantly higher for immigrants from Finland and Western countries and for youth with one Swedish-born and one foreign-born parent. CONCLUSIONS: Socio-economic factors explain much of the variation by parental country of birth of hospital admissions for self-harm in youth in Sweden.
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| 32. |
- Juárez, Sol Pia, et al.
(författare)
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Unintended health consequences of Swedish parental leave policy (ParLeHealth) : Protocol for a quasi-experimental study
- 2021
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 11:6
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Sweden has long been praised for a generous parental leave policy oriented towards facilitating a gender-equitable approach to work and parenting. Yet certain aspects of Swedish parental leave could also be responsible for the maintenance of (or even the increase in) health inequalities. Using a € Health in All Policies' lens, this research project aims to assess the unintended health consequences of various components of Sweden's parental leave policy, including eligibility for and uptake of earnings based benefits. Methods and analysis We will use individual-level data from multiple Swedish registers. Sociodemographic information, including parental leave use, will be retrieved from the total population register, Longitudinal Integration Database for Health Insurance and Labour Market Studies and Social Insurance Agency registers. Health information for parents and children will be retrieved from the patient, prescribed drug, cause of death, medical birth and children's health registers. We will evaluate parents' mental, mothers' reproductive and children's general health outcomes in relation to several policy reforms aiming to protect parental leave benefits in short birth spacing (the speed premium) and to promote father's uptake (the father's quota) and sharing of parental leave days (the double days reform). We will also examine effects of increases in basic parental leave benefit levels. Using quasi-experimental designs, we will compare health outcomes across these reforms and eligibility thresholds with interrupted time series, difference-in-difference and regression discontinuity approaches to reduce the risk of health selection and assess causality in the link between parental leave use and health. Ethics and dissemination This project has been granted all necessary ethical permissions from the Stockholm Regional Ethical Review Board (Dnr 2019-04913) for accessing and analysing deidentified data. The final outputs will primarily be disseminated as scientific articles published in open-access, high-impact peer-reviewed international journals, as well as press releases and policy briefs.
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| 33. |
- Julihn, A., et al.
(författare)
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Socioeconomic Determinants, Maternal Health, and Caries in Young Children
- 2018
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Ingår i: JDR clinical and translational research. - : SAGE Publications. - 2380-0852 .- 2380-0852 .- 2380-0844. ; 3:4, s. 395-404
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Maternal health during pregnancy plays a part in child health, and several conditions have been associated with adverse child outcomes.Objectives: To determine the socioeconomic determinants and maternal health factors associated with dental caries in young children.Methods: This cross-sectional study is part of a register-based cohort study including all children who were born from 2000 to 2003 and were residing in Stockholm County, Sweden, at age 3 y (n = 73,658). The study followed the cohort until individuals were 7 y old. The final study cohort comprised all children examined at 3 and 7 y (n = 65,259). Data on socioeconomic conditions, maternal health, and maternal health behavior were extracted from Swedish national registries. The multivariate analyses used 2 outcomes: caries experience at age 3 and 7 y (deft > 0 [decayed, extracted, and filled teeth]).Results: The results of this study show that socioeconomic and maternal health behaviors during pregnancy are important determinants of oral health in their preschool offspring. When all significant risk factors were present, the cumulative probability of being diagnosed with dental caries at age 7 y was 75%.Conclusion: This study also showed that maternal obesity and smoking during pregnancy were predictors of dental caries in preschool children. Strategies must be developed for increasing maternal motivation and self-efficacy and providing mothers with knowledge and caries-preventive tools.Knowledge Transfer Statement: The results of this study inform clinicians about the importance of including a more detailed history regarding maternal health and maternal health behaviors during pregnancy to assess caries risk in preschool children. Education, income, and other socioeconomic factors are difficult to modify in the short term. Therefore, strategies must be developed to increase parental motivation and self-efficacy to give parents the determination, knowledge, and tools for prevention.
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| 34. |
- Kark, M., et al.
(författare)
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Poor school performance is associated with a larger gain in body mass index during puberty
- 2013
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 103:2, s. 207-213
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Social inequalities in type 2 diabetes and coronary heart disease may be established in formative school years. We investigated whether school performance is associated with adiposity and increase in body mass index (BMI) between 10 and 15 years of age.Methods: A community sample of 2633 school children had height and weight measured in school at the ages of 10 and 15. Percentages of body fat and waist circumference were measured at the age of 15. Mean grades in several school subjects at the age of 15 (ninth school year) were divided into quartiles. A linear regression analysis with BMI as the main outcome took into account parental education and ethnicity, obtained from registers, and children’s living habits, collected by questionnaires.Results: In adjusted models, longitudinal changes in BMI between the ages of 10 and 15 were larger in the lowest quartiles of school grades compared with the highest: for girls, they were b=0.45 (p=0.007) and for boys they wereb=0.45 (p= 0.016). Crosssectional regression analyses, with percentage of body fat and waist circumference as outcomes, showed similar results.Conclusion: Our results suggest that school performance is one pathway to social inequalities in obesity in school children.
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| 38. |
- Lindblad, F, et al.
(författare)
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Maternal and paternal psychopathology increases risk of offspring ADHD equally
- 2011
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Ingår i: Epidemiology and psychiatric sciences. - : Cambridge University Press (CUP). - 2045-7960 .- 2045-7979. ; 20:4, s. 367-372
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Tidskriftsartikel (refereegranskat)abstract
- Parental psychopathology may increase the risk of attention-deficit hyperactivity disorder (ADHD) in the offspring. The aim of this study was to analyze if/how gender influences the association between parental psychiatric/addictive disorders and ADHD medication in the offspring.Methods.Register study in national birth cohorts of 1.1 million 6–19-year-olds. In this population, 7960 individuals with ADHD medication were identified in the Swedish Prescribed Drug Register during 2006. Data on parental psychiatric/addictive disorders and suicide death were obtained through linkages to national registers. Logistic regression was used for analyses with multiple adjustments for socio-economic, regional and demographic confounders.Results.Parental diagnosis related to illicit drugs was associated with the highest odds ratios (ORs) of ADHD medication (OR: ~3.5–4), followed by suicide attempt/death (OR: ~ 3–3.5), alcohol (OR:~2.5–3), affective disorder (OR: ~ 2.5) and psychosis (OR: ~ 2–2.5). The ORs were of similar magnitudes for maternal and paternal psychopathology and did not vary by the gender of the offspring. Adjusting for social characteristics decreased the ORs substantially and in the same way regarding fathers' and mothers' possible influence on the risk of ADHD in children.Conclusions.Neither parental nor offspring gender seems to influence the link between parental addictive/psychiatric disorder and offspring ADHD.
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| 42. |
- Malmborg, Petter, et al.
(författare)
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Effects of Childhood-onset Inflammatory Bowel Disease on School Performance : A Nationwide Population-based Cohort Study Using Swedish Health and Educational Registers
- 2019
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Ingår i: Inflammatory Bowel Diseases. - : Oxford University Press (OUP). - 1078-0998 .- 1536-4844. ; 25:10, s. 1663-1673
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Childhood-onset inflammatory bowel disease (IBD) might negatively impact academic school performance. We conducted a nationwide study to examine the association between childhood-onset IBD and school results. METHODS: Our study population was selected from Swedish health registers. In the National Patient Register (1990 to 2013), we identified 2827 children with IBD: Crohn's disease (CD), n = 1207, and ulcerative colitis (UC), n = 1370. Patients were matched with 10 reference individuals by age, sex, birth year, and place of residence (n = 28,235). Final compulsory school grades (0 to 320 grade points) and qualification for high school (yes or no) were obtained through the National School Register. Regression models controlling for socioeconomic factors were used to analyze the association of IBD with school performance. RESULTS: Children with IBD had a lower final grade point average (adjusted mean grade difference [AMGD] -4.9, 95% confidence interval [CI] -7.1 to -2.6) but not a significantly higher risk to not qualify for high school (odds ratio [OR] 1.14, CI 0.99-1.31). The results were similar in children with UC (AMGD -5.5, CI -8.7 to -2.3) and CD (AMGD -4.7, CI -8.2 to -1.2). Underperformance was more common in subsets of IBD children characterized by markers associated with long-standing active disease (eg, >30 inpatient days [AMGD-18.1, CI -25.8 to -10.4]). CONCLUSION: Most children with IBD achieve comparable results in the final year of compulsory school as their healthy peers. Care should be improved for the subgroup of children for which IBD has a stronger negative impact on school performance.
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| 43. |
- Oistamo, E, et al.
(författare)
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Cancer and diverticulitis of the sigmoid colon. Differentiation with computed tomography versus magnetic resonance imaging: preliminary experiences
- 2013
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Ingår i: Acta radiologica (Stockholm, Sweden : 1987). - : SAGE Publications. - 1600-0455 .- 0284-1851. ; 54:3, s. 237-241
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Tidskriftsartikel (refereegranskat)abstract
- Both colon cancer and diverticular disease are common in the Western world. A challenge when patients present with clinical findings is that both diseases can present with symptoms that may mimic the other. Purpose To determine whether magnetic resonance imaging (MRI) could be helpful to differentiate between diverticulitis and cancer of the sigmoid colon compared to the differentiation offered by evaluation of multidetector computed tomography (CT) in a clinical situation. Material and Methods Thirty patients were consecutively included. Fifteen patients were under work-up for a recently diagnosed sigmoid cancer and 15 patients had recently been treated in hospital due to first-time acute sigmoid diverticulitis. All patients underwent CT, T2-weighted MRI and diffusion-weighted MRI. Anonymized examinations were retrospectively presented in random order to one experienced radiologist. Results With contrast-enhanced CT, the sensitivity and specificity for diagnosis of cancer and diverticulitis were 66.7% (10/15) and 93.3% (14/15), respectively. Using T2-weighted and diffusion-weighted MR images, the sensitivity and specificity for diagnosis of cancer and diverticulitis were 100% (14/14) and 100% (14/14), respectively. Conclusion MRI provides information that may contribute to improve the differentiation between sigmoid cancer and diverticulitis that is offered by CT. These encouraging results need to be confirmed in a larger study.
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| 50. |
- Sköldberg, Filip, et al.
(författare)
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Incidence and lifetime risk of hospitalization and surgery for diverticular disease
- 2019
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Ingår i: British Journal of Surgery. - : Oxford University Press (OUP). - 0007-1323 .- 1365-2168. ; 106:7, s. 930-939
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Tidskriftsartikel (refereegranskat)abstract
- Background: Studies on incidence rates of first-time colonic diverticular disease are few, and population-based estimates of lifetime risk are lacking. In this observational study, the incidence, admission rates and lifetime risks of hospitalization and surgery for diverticular disease were investigated.Methods: Considering the entire Swedish population as an open cohort, incidence and admission rates, and lifetime risk estimates (considering death as a competing risk) of hospitalization and surgery for diverticular disease were calculated using data from cross-linked national registers and population statistics from 1987 to 2010.Results: In total, there were 144 107 hospital admissions for diverticular disease in 95 049 individual patients. Of these, 17 599 were admissions with bowel resection or stoma formation in 16 824 patients. The total number of person-years in the population during the study period was 213 949 897. Age-standardized incidence rates were 47.4 (95 per cent c. i. 47.1 to 47.7) for first-time hospitalization with diverticular disease and 8.4 (8.2 to 8.5) per 100 000 person-years for diverticular disease surgery. The corresponding admission rates (including readmissions) were 70.8 (70.4 to 71.2) and 8.7 (8.6 to 8.9) per 100 000 person-years. Following an increase in 1990-1994, rates stabilized. Based on incidence and mortality rates from 2000 to 2010, the estimated remaining lifetime risk of hospitalization from 30 years of age was 3.1 per cent in men and 5.0 per cent in women. The corresponding risk of surgery was 0.5 per cent in men and 0.8 per cent in women.Conclusion: Diverticular disease is a common reason for hospital admission, particularly in women, but rates are stable and the lifetime risk of surgery is low.
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