| 1. |
- Berman, Anne H., et al.
(author)
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Children's Quality of Life Based on the KIDSCREEN-27 : Child Self-Report, Parent Ratings and Child-Parent Agreement in a Swedish Random Population Sample
- 2016
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In: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 11:3
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Journal article (peer-reviewed)abstract
- Background The KIDSCREEN-27 is a measure of child and adolescent quality of life (QoL), with excellent psychometric properties, available in child-report and parent-rating versions in 38 languages. This study provides child-reported and parent-rated norms for the KIDSCREEN-27 among Swedish 11-16 year-olds, as well as child-parent agreement. Sociodemographic correlates of self-reported wellbeing and parent-rated wellbeing were also measured. Methods A random population sample consisting of 600 children aged 11-16, 100 per age group and one of their parents (N = 1200), were approached for response to self-reported and parentrated versions of the KIDSCREEN-27. Parents were also asked about their education, employment status and their own QoL based on the 26-item WHOQOL-Bref. Based on the final sampling pool of 1158 persons, a 34.8% response rate of 403 individuals was obtained, including 175 child-parent pairs, 27 child singleton responders and 26 parent singletons. Gender and age differences for parent ratings and child-reported data were analyzed using t-tests and the Mann-Whitney U-test. Post-hoc Dunn tests were conducted for pairwise comparisons when the p-value for specific subscales was 0.05 or lower. Child-parent agreement was tested item-by-item, using the Prevalence-and Bias-Adjusted Kappa (PABAK) coefficient for ordinal data (PABAK-OS); dimensional and total score agreement was evaluated based on dichotomous cut-offs for lower well-being, using the PABAK and total, continuous scores were evaluated using Bland-Altman plots. Results Compared to European norms, Swedish children in this sample scored lower on Physical wellbeing (48.8 SE/49.94 EU) but higher on the other KIDSCREEN-27 dimensions: Psychological wellbeing (53.4/49.77), Parent relations and autonomy (55.1/49.99), Social Support and peers (54.1/49.94) and School (55.8/50.01). Older children self-reported lower wellbeing than younger children. No significant self-reported gender differences occurred and parent ratings showed no gender or age differences. Item-by-item child-parent agreement was slight for 14 items (51.9%), fair for 12 items (44.4%), and less than chance for one item (3.7%), but agreement on all dimensions as well as the total score was substantial according to the PABAK-OS. Visual interpretation of the Bland-Altman plot suggested that when children's average wellbeing score was lower parents seemed to rate their children as having relatively higher total wellbeing, but as children's average wellbeing score increased, parents tended to rate their children as having relatively lower total wellbeing. Children living with both parents had higher wellbeing than those who lived with only one parent. Conclusions Results agreed with European findings that adolescent wellbeing decreases with age but contrasted with some prior Swedish research identifying better wellbeing for boys on all dimensions but Social support and peers. The study suggests the importance of considering children's own reports and not only parental or other informant ratings. Future research should be conducted at regular intervals and encompass larger samples.
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| 2. |
- Berman, Anne H., et al.
(author)
-
Children’s Quality of Life Based on the KIDSCREEN-27
- 2016
-
In: PLoS ONE. ; 11:3
-
Journal article (peer-reviewed)abstract
- Background: The KIDSCREEN-27 is a measure of child and adolescent quality of life (QoL), with excellent psychometric properties, available in child-report and parent-rating versions in 38 languages. This study provides child-reported and parent-rated norms for the KIDSCREEN-27 among Swedish 11-16 year-olds, as well as child-parent agreement. Sociodemographic correlates of self-reported wellbeing and parent-rated wellbeing were also measured. Methods: A random population sample consisting of 600 children aged 11-16, 100 per age group and one of their parents (N = 1200), were approached for response to self-reported and parent-rated versions of the KIDSCREEN-27. Parents were also asked about their education, employment status and their own QoL based on the 26-item WHOQOL-Bref. Based on the final sampling pool of 1158 persons, a 34.8% response rate of 403 individuals was obtained, including 175 child-parent pairs, 27 child singleton responders and 26 parent singletons. Gender and age differences for parent ratings and child-reported data were analyzed using t-tests and the Mann-Whitney U-test. Post-hoc Dunn tests were conducted for pairwise comparisons when the p-value for specific subscales was 0.05 or lower. Child-parent agreement was tested item-by-item, using the Prevalence- and Bias-Adjusted Kappa (PABAK) coefficient for ordinal data (PABAK-OS); dimensional and total score agreement was evaluated based on dichotomous cut-offs for lower well-being, using the PABAK and total, continuous scores were evaluated using Bland-Altman plots. Results: Compared to European norms, Swedish children in this sample scored lower on Physical wellbeing (48.8 SE/49.94 EU) but higher on the other KIDSCREEN-27 dimensions: Psychological wellbeing (53.4/49.77), Parent relations and autonomy (55.1/49.99), Social Support and peers (54.1/49.94) and School (55.8/50.01). Older children self-reported lower wellbeing than younger children. No significant self-reported gender differences occurred and parent ratings showed no gender or age differences. Item-by-item child-parent agreement was slight for 14 items (51.9%), fair for 12 items (44.4%), and less than chance for one item (3.7%), but agreement on all dimensions as well as the total score was substantial according to the PABAK-OS. Visual interpretation of the Bland-Altman plot suggested that when children's average wellbeing score was lower parents seemed to rate their children as having relatively higher total wellbeing, but as children's average wellbeing score increased, parents tended to rate their children as having relatively lower total wellbeing. Children living with both parents had higher wellbeing than those who lived with only one parent. Conclusions: Results agreed with European findings that adolescent wellbeing decreases with age but contrasted with some prior Swedish research identifying better wellbeing for boys on all dimensions but Social support and peers. The study suggests the importance of considering children's own reports and not only parental or other informant ratings. Future research should be conducted at regular intervals and encompass larger samples.
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| 3. |
- Liu, Bojing, et al.
(author)
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Child self-report and parent ratings for the Strengths and Difficulties Questionnaire : Norms and agreement in a Swedish random population sample
- 2017
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In: Scandinavian Journal of Child and Adolescent Psychiatry and Psychology. - : Walter de Gruyter GmbH. - 2245-8875. ; 5:1, s. 13-27
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Journal article (peer-reviewed)abstract
- Background: The Strengths and Difficulties Questionnaire (SDQ) measures behavioral problems among children and adolescents. Prior research in Sweden has included child self-report or parent ratings from community or population data. Objective: To provide child-reported and parent-rated SDQ norms for 11- to 16-year-olds, as well as data on child-parent agreement and parental sociodemographic correlates: education, employment status, and quality of life. Method: A random population sample with 600 children aged 11 to 16 years, 100 per age group, and one of their parents (N=1200) yielded a sampling pool of 1158 participants and a 34.8 % response rate, including 175 child-parent pairs and 27 and 26 child/parent singletons. Responses to child and parent versions of the extended SDQ were analyzed by child gender and age. Child-parent agreement was evaluated using the Prevalence- and Bias-Adjusted Kappa and Bland-Altman plots. Results: Older children reported greater difficulties compared with younger children, while girls reported a higher negative impact of difficulties on daily life in comparison to boys. Child-parent item-by-item agreement was fair to slight on 15 of the 25 SDQ items, perfect to moderate on 9 items, and less than chance on 1 item, but generally high regarding dichotomous assignment to the "raised difficulties" or "normal" groups, based on subscales and the total SDQ score. Greater difficulties for children were reported by parents born outside Sweden, parents of children born outside Sweden, parents lacking regular employment, and parents with lower education or lower quality of life. In relation to other child-parent pairs, parents born outside Sweden perceived greater difficulties for their children compared with the children's own ratings. Parents with better physical health and social relationships rated their children as having fewer difficulties compared with the rates reported by children. Conclusions: Gender differences contrasted with prior Swedish studies showing higher ratings for boys on hyperactivity and total difficulties and for girls on emotional symptoms. However, findings on increased difficulties with age concurred with prior studies. Research on children's mental health should be widely and systematically conducted at regular intervals and encompasses large, representative samples in order to inform national public health and health-care policy regarding measures to support children and enhance their mental health.
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| 4. |
- Liu, Bojing, et al.
(author)
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Child self-report and parent ratings for the Strengths and Difficulties Questionnaire
- 2017
-
In: Scandinavian Journal of Child and Adolescent Psychiatry and Psychology. - : Walter de Gruyter GmbH. - 2245-8875. ; 5:1
-
Journal article (peer-reviewed)abstract
- Background:The Strengths and Difficulties Questionnaire (SDQ) measures behavioral problems among children and adolescents. Prior research in Sweden has included child self-report or parent ratings from community or population data.Objective:To provide child-reported and parent-rated SDQ norms for 11- to 16-year-olds, as well as data on child–parent agreement and parental sociodemographic correlates: education, employment status, and quality of life.Method:A random population sample with 600 children aged 11 to 16 years, 100 per age group, and one of their parents (N=1200) yielded a sampling pool of 1158 participants and a 34.8% response rate, including 175 child–parent pairs and 27 and 26 child/parent singletons. Responses to child and parent versions of the extended SDQ were analyzed by child gender and age. Child–parent agreement was evaluated using the Prevalence- and Bias-Adjusted Kappa and Bland–Altman plots.Results:Older children reported greater difficulties compared with younger children, while girls reported a higher negative impact of difficulties on daily life in comparison to boys. Child–parent item-by-item agreement was fair to slight on 15 of the 25 SDQ items, perfect to moderate on 9 items, and less than chance on 1 item, but generally high regarding dichotomous assignment to the “raised difficulties” or “normal” groups, based on subscales and the total SDQ score. Greater difficulties for children were reported by parents born outside Sweden, parents of children born outside Sweden, parents lacking regular employment, and parents with lower education or lower quality of life. In relation to other child–parent pairs, parents born outside Sweden perceived greater difficulties for their children compared with the children’s own ratings. Parents with better physical health and social relationships rated their children as having fewer difficulties compared with the rates reported by children.Conclusions:Gender differences contrasted with prior Swedish studies showing higher ratings for boys on hyperactivity and total difficulties and for girls on emotional symptoms. However, findings on increased difficulties with age concurred with prior studies. Research on children’s mental health should be widely and systematically conducted at regular intervals and encompasses large, representative samples in order to inform national public health and health-care policy regarding measures to support children and enhance their mental health.Graphical ABSTRACT
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| 5. |
- Liu, Bojing, et al.
(author)
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Irritable bowel syndrome and Parkinson's disease risk : register-based studies
- 2021
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In: NPJ Parkinson's Disease. - : Nature Publishing Group. - 2373-8057. ; 7:1
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Journal article (peer-reviewed)abstract
- To examine whether irritable bowel syndrome (IBS) was related to the future risk of Parkinson's disease (PD), we conducted a nested case-control study in the Swedish total population including 56,564 PD cases identified from the Swedish Patient Register and 30 controls per case individually matched by sex and year of birth. Odds ratios (ORs) with 95% confidence intervals (CIs) for having a prior diagnosis of IBS were estimated using conditional logistic regression. We furthermore conducted a cohort study using the Swedish Twin Registry following 3046 IBS patients identified by self-reported abdominal symptoms and 41,179 non-IBS individuals. Through Cox proportional hazard models, we estimated hazard ratios (HRs) and 95% CIs for PD risk. In the nested case-control study, 253 (0.4%) PD cases and 5204 (0.3%) controls had a previous IBS diagnosis. IBS diagnosis was associated with a 44% higher risk of PD (OR = 1.44, 95% CI 1.27-1.63). Temporal relationship analyses showed 53% and 38% increased risk of PD more than 5 and 10 years after IBS diagnosis, respectively. In the cohort analysis based on the Swedish Twin Registry, there was no statistically significantly increased risk of PD related to IBS (HR = 1.25, 95% CI = 0.87-1.81). Our results suggest a higher risk of PD diagnosis after IBS. These results provide additional evidence supporting the importance of the gut-brain axis in PD.
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| 6. |
- Liu, Bojing
(author)
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Parkinson’s disease etiology : beyond the brain and late adulthood
- 2018
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Doctoral thesis (other academic/artistic)abstract
- Despite much effort investigating the etiology of Parkinson’s disease (PD), the causes and the exact mechanisms underlying the disease remain elusive. Braak’s hypothesis suggests that PD pathology may start in the enteric nervous system and later spread to the brain via the vagus nerve. This hypothesis is further extended to the dual-hit hypothesis suggesting that environmental neurotropic pathogens may contribute to PD development through nasal and gut gateways that are in direct connection with each other via inhalation and ingestion. Mounting evidence also suggests the importance of neuroinflammation in the pathogenesis of PD. In this thesis, I aimed to explore the etiology of PD focusing on developmental origins related to early infection and inflammation, gastrointestinal aspects, and olfactory function using various register and population based datasets. In Study I, we conducted a cohort study to examine developmental aspects of PD regarding early life infection, parental age at birth, multiple birth. We considered birth order, sibship size, birth seasonality, and flu activity in the year of birth as surrogates for early infection and inflammation. Overall, we found that early life characteristics were not associated with future risk of PD, indicating little support for the importance of early life aspects in PD etiology. In Study II, we evaluated vagotomy and its subtypes (truncal and selective vagotomies) in relation to PD risk in a matched cohort. We found that truncal vagotomy, with the nerve trunk fully resected, appeared to be associated with a decreased risk of PD more than five years after the surgery, while selective vagotomy was not associated with the risk of PD. The results provide preliminary evidence supporting Braak’s hypothesis. In Study III, we conducted a nested case-control study in the Swedish total population and a cohort study in Swedish twins to investigate irritable bowel syndrome (IBS) diagnosis as well as IBS based on self-reported symptoms in relation to the risk of PD. The results demonstrated that IBS was linked to an elevated risk of PD. The findings add additional evidence suggesting the importance of gut-brain-axis in PD development. In Study IV, we examined whether poor olfaction is associated with long-term mortality and potential explanations for such association among older adults in a community-based cohort. We found that poor olfaction was associated with higher long-term mortality and that part of the association was explained by neurodegenerative diseases, in particular, PD and dementia, and body weight loss. In summary, by taking advantage of Swedish nationwide registers, we provide some evidence supporting Braak’s hypothesis and the importance of the gut-to-brain axis in PD development. Our data, however, do not support the importance of developmental origins of PD. Additionally, we confirmed the association between poor olfaction and mortality in healthy older adults from the Health, Aging and Body Composition study and identified PD or dementia and body weight loss as part of the potential mechanisms underlying the association.
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| 7. |
- Liu, Bojing, et al.
(author)
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Vagotomy and Parkinson disease : A Swedish register-based matched-cohort study
- 2017
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In: Neurology. - : Lippincott Williams & Wilkins. - 0028-3878 .- 1526-632X. ; 88:21, s. 1996-2002
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Journal article (peer-reviewed)abstract
- Objective: To examine whether vagotomy decreases the risk of Parkinson disease (PD).Methods: Using data from nationwide Swedish registers, we conducted a matched-cohort study of 9,430 vagotomized patients (3,445 truncal and 5,978 selective) identified between 1970 and 2010 and 377,200 reference individuals from the general population individually matched to vagotomized patients by sex and year of birth with a 40: 1 ratio. Participants were followed up from the date of vagotomy until PD diagnosis, death, emigration out of Sweden, or December 31, 2010, whichever occurred first. Vagotomy and PD were identified from the Swedish Patient Register. We estimated hazard ratios (HRs) with 95% confidence intervals (CIs) using Cox models stratified by matching variables, adjusting for country of birth, chronic obstructive pulmonary disease, diabetes mellitus, vascular diseases, rheumatologic disease, osteoarthritis, and comorbidity index.Results: A total of 4,930 cases of incident PD were identified during 7.3 million person-years of follow-up. PD incidence (per 100,000 person-years) was 61.8 among vagotomized patients (80.4 for truncal and 55.1 for selective) and 67.5 among reference individuals. Overall, vagotomy was not associated with PD risk (HR 0.96, 95% CI 0.78-1.17). However, there was a suggestion of lower risk among patients with truncal vagotomy (HR 0.78, 95% CI 0.55-1.09), which may be driven by truncal vagotomy at least 5 years before PD diagnosis (HR 0.59, 95% CI 0.37-0.93). Selective vagotomy was not related to PD risk in any analyses.Conclusions: Although overall vagotomy was not associated the risk of PD, we found suggestive evidence for a potential protective effect of truncal, but not selective, vagotomy against PD development.
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| 8. |
- Liu, Bojing, et al.
(author)
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Vagotomy and subsequent risk of inflammatory bowel disease : a nationwide register-based matched cohort study
- 2020
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In: Alimentary Pharmacology and Therapeutics. - : John Wiley & Sons. - 0269-2813 .- 1365-2036. ; 51:11, s. 1022-1030
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Journal article (peer-reviewed)abstract
- Background: The vagus nerve provides essential parasympathetic innervation to the gastrointestinal system and is known to have anti-inflammatory properties.Aims: To explore the relationship between vagotomy and the risk of inflammatory bowel disease (IBD) and its major categories: Crohn's disease (CD) and ulcerative colitis (UC).Methods: A matched cohort comprising 15 637 patients undergoing vagotomy was identified through the Swedish Patient Register from 1964 to 2010. Each vagotomised patient was matched for birth year and gender with 40 nonvagotomised individuals on the date of vagotomy. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for IBD using flexible parametric models adjusted for matching variables, year of vagotomy, birth country, chronic obstructive pulmonary disease and comorbidity index.Results: We observed 119 (0.8%) patients with vagotomy developed IBD compared to 3377 (0.5%) IBD cases in nonvagotomised individuals. The crude incidence of IBD (per 1000 person-years) was 0.38 for vagotomised patients and 0.25 for nonvagotomised individuals. We observed a time-dependent elevated risk of IBD associated with vagotomy, for instance, the HR (95% CI) was 1.80 (1.40-2.31) at year 5 and 1.49 (1.14-1.96) at year 10 post-vagotomy. The association appeared to be stronger for truncal than selective vagotomy and limited to CD (HR was 3.63 [1.94-6.80] for truncal and 2.06 [1.49-2.84] for selective vagotomy) but not UC (1.36 [0.71-2.62] for truncal and 1.25 [0.95-1.63] for selective vagotomy).Conclusions: We found a positive association between vagotomy and later IBD, particularly for CD. The finding indirectly underlines the beneficial role of the vagal tone in IBD.
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| 9. |
- Liu, Bojing, et al.
(author)
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Working conditions, serotonin transporter gene polymorphism (5-HTTLPR) and anxiety disorders : a prospective cohort study
- 2013
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In: Journal of Affective Disorders. - : Elsevier BV. - 0165-0327 .- 1573-2517. ; 151:2, s. 652-659
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Journal article (peer-reviewed)abstract
- BACKGROUND: The etiology and pathology of anxiety disorders involve both genetic and environmental influences. Adverse working conditions may contribute to the development of anxiety. The serotonin transporter-linked polymorphic region (5-HTTLPR) has been implicated in stress sensitivity. Therefore, we investigated the potential interplay between 5-HTTLPR and job-related risk factors in the prediction of the occurrence of anxiety.METHODS: We conducted a prospective study using the first two waves of a Swedish population-based cohort. At Wave I, 1585 individuals without anxiety, depression or dysthymia who were active in the labor market during both waves were included. Information on job demands, skill discretion, decision authority and social climate was collected at Wave I. After a three year interval, the presence of anxiety disorders was determined at Wave II. All 1585 participants were genotyped for 5-HTTLPR. Both additive and multiplicative models were considered in examining the potential interaction between 5-HTTLPR and adverse working conditions on the development of anxiety.RESULTS: Anxiety was associated with high job demands but not with 5-HTTLPR. An interaction was observed between 5-HTTLPR and high job demands among females. Individuals with 5-HTTLPR high expression genotype (LL) developed anxiety disorders more frequently when exposed to high job demands compared to 'LS/SS' carriers.LIMITATIONS: A limited number of participants developed anxiety.CONCLUSIONS: High job demands predict the development of anxiety. The 5-HTT polymorphism has a moderating effect on the relationship between high job demands and anxiety among females.
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| 10. |
- Liu, Bojing, et al.
(author)
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β2-adrenoreceptor agonists, montelukast, and Parkinson's disease risk
- 2023
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In: Annals of Neurology. - : John Wiley & Sons. - 0364-5134 .- 1531-8249. ; 93:5, s. 1023-1028
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Journal article (peer-reviewed)abstract
- Objective: This study was undertaken to examine the association between montelukast use, beta 2-adrenoreceptor (beta 2AR) agonist use, and later Parkinson disease (PD).Methods: We ascertained use of beta 2AR agonists (430,885 individuals) and montelukast (23,315 individuals) from July 1, 2005 to June 30, 2007, and followed 5,186,886 PD-free individuals from July 1, 2007 to December 31, 2013 for incident PD diagnosis. We estimated hazard ratios and 95% confidence intervals using Cox regressions.Results: We observed 16,383 PD cases during on average 6.1 years of follow-up. Overall, use of beta 2AR agonists and montelukast were not related to PD incidence. A 38% lower PD incidence was noted among high-dose montelukast users when restricted to PD registered as the primary diagnosis.Interpretation: Overall, our data do not support inverse associations between beta 2AR agonists, montelukast, and PD. The prospect of lower PD incidence with high-dose montelukast exposure warrants further investigation, especially with adjustment for high-quality data on smoking. ANN NEUROL 2023
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