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- Carlsson, Lena M S, 1957, et al.
(author)
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Life expectancy after bariatric surgery or usual care in patients with or without baseline type 2 diabetes in Swedish Obese Subjects.
- 2023
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In: International journal of obesity (2005). - 1476-5497. ; 47, s. 931-8
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Journal article (peer-reviewed)abstract
- To determine life expectancy and causes of death after bariatric surgery in relation to baseline type 2 diabetes (T2D) in the prospective, Swedish Obese Subjects study.The study included 2010 patients with obesity who underwent bariatric surgery and 2037 matched controls, eligible for surgery. The surgery group underwent gastric bypass (n=265), banding (n=376), or vertical banded gastroplasty (n=1369). The control group (n=2037) received usual obesity care. Causes of death were obtained from the Swedish Cause of Death Register, case sheets and autopsy reports, in patients with baseline T2D (n=392 surgery patients/n=305 controls) or non-T2D (n=1609 surgery patients/n=1726 controls) during a median follow-up 26 years.In T2D and non-T2D subgroups, bariatric surgery was associated with increased life expectancy (2.1, 95% confidence interval (95% CI) 0.2-4.0; and 1.6, 0.5-2.7 years, respectively) and reduced overall mortality (adjusted hazard ratio (adjHR)=0.77, 95% CI: 0.61-0.97; and 0.82, 0.72-0.94, respectively), and the treatment benefit was similar (interaction p=0.615). Bariatric surgery was associated with reduced cardiovascular mortality in both subgroups (adjHR=0.65, 95% CI: 0.46-0.91; and 0.70, 0.55-0.88, respectively (interaction p=0.516)).Bariatric surgery is associated with similar reduction of overall and cardiovascular mortality and increased life expectancy regardless of baseline diabetes status.
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- Carlsson, Lena M S, 1957, et al.
(author)
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Long-term incidence of serious fall-related injuries after bariatric surgery in Swedish obese subjects.
- 2019
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In: International journal of obesity (2005). - : Springer Science and Business Media LLC. - 1476-5497 .- 0307-0565. ; 43:4, s. 933-937
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Journal article (peer-reviewed)abstract
- Obesity increases risk of falling, but the effect of bariatric surgery on fall-related injuries is unknown. The aim of this study was therefore to study the association between bariatric surgery and long-term incidence of fall-related injuries in the prospective, controlled Swedish Obese Subjects study. At inclusion, body mass index was≥34kg/m2 in men and ≥38kg/m2 in women. The surgery per-protocol group (n=2007) underwent gastric bypass (n=266), banding (n=376), or vertical banded gastroplasty (n=1365), and controls (n=2040) received usual care. At the time of analysis (31 December 2013), median follow-up was 19 years (maximal 26 years). Fall-related injuries requiring hospital treatment were captured using data from the Swedish National Patient Register. During follow-up, there were 617 first-time fall-related injuries in the surgery group and 513 in the control group (adjusted hazard ratio 1.21, 95% CI, 1.07-1.36; P=0.002). The incidence differed between treatment groups (P<0.001, log-rank test) and was higher after gastric bypass than after usual care, banding and vertical banded gastroplasty (adjusted hazard ratio 0.50-0.52, P<0.001 for all three comparisons). In conclusion, gastric bypass surgery was associated with increased risk of serious fall-related injury requiring hospital treatment.
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- Ahlin, Sofie, 1985, et al.
(author)
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Fracture risk after three bariatric surgery procedures in Swedish obese subjects : up to 26 years follow-up of a controlled intervention study
- 2020
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In: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 287:5, s. 546-557
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Journal article (peer-reviewed)abstract
- Background: Previous studies have reported an increased fracture risk after bariatric surgery. Objective: To investigate the association between different bariatric surgery procedures and fracture risk. Methods: Incidence rates and hazard ratios for fracture events were analysed in the Swedish Obese Subjects study; an ongoing, nonrandomized, prospective, controlled intervention study. Hazard ratios were adjusted for risk factors for osteoporosis and year of inclusion. Information on fracture events were captured from the Swedish National Patient Register. The current analysis includes 2007 patients treated with bariatric surgery (13.3% gastric bypass, 18.7% gastric banding, and 68.0% vertical banded gastroplasty) and 2040 control patients with obesity matched on group level based on 18 variables. Median follow-up was between 15.1 and 17.9 years for the different treatment groups. Results: During follow-up, the highest incidence rate for first-time fracture was observed in the gastric bypass group (22.9 per 1000 person-years). The corresponding incidence rates were 10.4, 10.7 and 9.3 per 1000 person-years for the vertical banded gastroplasty, gastric banding and control groups, respectively. The risk of fracture was increased in the gastric bypass group compared with the control group (adjusted hazard ratio [adjHR] 2.58; 95% confidence interval [CI] 2.02–3.31; P < 0.001), the gastric banding group (adjHR 1.99; 95%CI 1.41–2.82; P < 0.001), and the vertical banded gastroplasty group (adjHR 2.15; 95% CI 1.66–2.79; P < 0.001). Conclusions: The risk of fracture is increased after gastric bypass surgery. Our findings highlight the need for long-term follow-up of bone health for patients undergoing this treatment.
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- Ahlin, Sofie, 1985, et al.
(author)
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Macrophage Gene Expression in Adipose Tissue is Associated with Insulin Sensitivity and Serum Lipid Levels Independent of Obesity.
- 2013
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In: Obesity (Silver Spring, Md.). - : Wiley. - 1930-739X .- 1930-7381. ; 21:12
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Journal article (peer-reviewed)abstract
- Objective: Obesity is linked to both increased metabolic disturbances and increased adipose tissue macrophage infiltration. However, whether macrophage infiltration directly influences human metabolism is unclear. The aim of this study was to investigate if there are obesity-independent links between adipose tissue macrophages and metabolic disturbances. Design and Methods: Expression of macrophage markers in adipose tissue was analyzed by DNA microarrays in the SOS Sib Pair study and in patients with type 2 diabetes and a BMI-matched healthy control group. Results: The expression of macrophage markers in adipose tissue was increased in obesity and associated with several metabolic and anthropometric measurements. After adjustment for BMI, the expression remained associated with insulin sensitivity, serum levels of insulin, C-peptide, high density lipoprotein cholesterol (HDL-cholesterol) and triglycerides. In addition, the expression of most macrophage markers was significantly increased in patients with type 2 diabetes compared to the control group. Conclusion: Our study shows that infiltration of macrophages in human adipose tissue, estimated by the expression of macrophage markers, is increased in subjects with obesity and diabetes and associated with insulin sensitivity and serum lipid levels independent of BMI. This indicates that adipose tissue macrophages may contribute to the development of insulin resistance and dyslipidemia.
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- Azad, Azadé, et al.
(author)
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“Being a Girl is a Challenge… Maybe That’s Why It’s So Important to Be Proud of It.” Gender Identity and Performances of Femininity in Young Females with Limited Delinquency
- 2024
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In: Women and Criminal Justice. - : ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD. - 0897-4454 .- 1541-0323.
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Journal article (peer-reviewed)abstract
- We seek to expand the knowledge on gender identity and gender roles in young females with limited delinquency. Our thematic analysis of identity-status interviews and narratives from 10 female adolescents (aged 15–18 years) sentenced to youth service showed that they viewed being a girl as important, but also generally inflected by aspects of hardship and violence. We interpreted three types of femininity in the girls’ reasoning about their gender identity in relation to delinquency. These were used to both overcome and sustain gender hegemony. Findings also showed how these young women were both victims and social agents, whose experimentation and defense of self and others were embedded in their rationales for their offenses.
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- Azad, Azadé, 1983-, et al.
(author)
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Identity status and narrative identity processes in female adolescents' stories about committing crimes and being convicted
- 2024
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In: Journal of Adolescence. - 0140-1971 .- 1095-9254. ; 96:1, s. 124-135
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Journal article (peer-reviewed)abstract
- Introduction Adolescent delinquency has been suggested to evolve from a normative motivation to establish independence and identity. However, few studies have examined this in detail, especially in young women. The aim was, therefore, to investigate identity formation in adolescent females with limited delinquency by focusing on identity status and identity processes in narratives about committing crimes and being convicted. Methods Interviews with 10 females, 15-18 years old, sentenced to youth service in three Swedish cities were conducted on Zoom. Results The results showed an equal distribution of all identity statuses within the group. Thematic analysis of their stories about crime and conviction showed that delinquency was described in terms of exploration and commitment, although commitment appeared more clearly. Social relations, in particular peers, played an important role in both committing as well as desisting from delinquency. In terms of narrative processes, the stories contained elements of agency, although diminishing of one's own capability and/or responsibility was common, and meaning making, mostly lesson learning, usually pertained to behaviors, interactional rules, or norms. Conclusion These findings point to the importance of viewing delinquency among young women in a social and developmental context, where delinquency may be a part of the process of identity formation. Interventions focusing on expressing needs of belonging as well as finding oneself in more adaptive ways are warranted, where supporting pro-social relations and contexts is a suggested focus.
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- Azad, Azadé, 1983-, et al.
(author)
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‘When you told us what had happened to you, I started to shiver’ – what children and teenagers immediately express and comprehend after listening to testimonies of Holocaust survivors
- 2024
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In: Holocaust Studies. - : Informa UK Limited. - 1750-4902 .- 2048-4887. ; 30:1, s. 66-83
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Journal article (peer-reviewed)abstract
- We investigated how young people comprehend stories of trauma through their immediate expressions after listening to personal testimonies of Holocaust survivors. The material included 747 drawings and 182 texts by 10–16-year-old Swedish pupils from 14 schools. Qualitative analyses and cross-tabulations showed that the testimonies elicited complex patterns of emotions and cognitive processing. Personal testimonies can thus be a powerful way of teaching about historical trauma, although complex cognitive meaning making might often require additional time and adult-facilitated conversation. Also, as the testimonies aroused strong emotions, they should be used in a well-informed way.
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- Carlsson, Johanna, 1985, et al.
(author)
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A Longitudinal Examination of Identity Status Interview Narratives: How Stable is Stable?
- 2014
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In: Paper presented at the 14th biennial conference of European association for research on adolescence. September 3-6, 2014, Çeşme, Izmir, Turkey..
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Conference paper (other academic/artistic)abstract
- A Longitudinal examination of identity status interview narratives: How stable is stable? The purpose of this research was to investigate how individuals maintain and develop their identities across time, and to identify processes that might prevent identity development. The research aimed to investigate aspects of identity development that are not captured by identity status codings, by focusing on individuals who did not change identity status between measuring points. The identity status interview (Marcia, Waterman, Mattesson, Archer, & Orlofsky, 1993) was performed with 124 Swedes, at age 25 (Frisén & Wängqvist, 2011) and at age 29. Individuals who were stable in committed identity statuses (identity achievement or foreclosure; n=55), and individuals who were stable in uncommitted identity statuses (moratorium or identity diffusion; n= 8), were studied in two separate analyses. Differences and similarities between interview narratives from both interview occasions were summarized, separately for each individual. Inductive thematic analysis (Braun & Clarke, 2006) was applied to these summaries. The analysis of identity narratives from individuals in committed identity statuses resulted in a model that suggests that identity development among these individuals may be understood in terms of the deepening or weakening of three dimensions: approach to changing life conditions, meaning making, and development of personal life direction. Interview narratives from individuals assigned to the same uncommitted identity status at both ages were analyzed in a similar way. A combination of deductive and inductive approaches was used, as this allowed both testing of the model derived from the analysis of individuals in committed identity statuses, and for the model to be expanded beyond this original form. The results from this analysis showed that only the dimension meaning making could be applied to individuals assigned to the same uncommitted identity status. The other two dimensions from the first analysis were revised to fit this new group. In addition to the model, the Interview narratives for individuals with uncommitted identity status included elements of procrastination of exploration and commitment-making, problems integrating different identity domains, elements of dismissing available alternatives without choosing anything, and difficulties with more complex reasoning. The study indicates that continued identity development is one of the key processes through which an established sense of identity can be maintained. Moreover, the study identified processes that might prevent identity development among individuals repeatedly assigned to uncommitted identity statuses. In conclusion, the model that derived from this study captures some aspects of identity development among individuals who are repeatedly assigned to the same identity status.
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