| 1. |
- Bluhm, Gösta, et al.
(author)
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Buller.
- 2006
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In: Barns hälsa och miljö i Stockholms län 2006. - : Stockholms läns landsting, Stockholm. - 9163190230 ; , s. 113-126
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Book chapter (other academic/artistic)abstract
- Noise is an environmental problem that affects children both at school and home. This chapter summarizes the results on noise disturbances from the “Children’s environment and health survey” conducted in Stockholm County in year 2003. It was found that children were most disturbed by noise at school. Thirty per cent of all 8- and 12 year old children in Stockholm County were annoyed by noise at school, mainly noise from other children. Children in Stockholm County were exposed to more noise in their homes than children in other parts of Sweden. Almost 50 % of children in inner city Stockholm and 20 % in the rest of the County were living in apartments with windows facing a major road, railway or industry. Eighteen per cent of all 8- and 12-year olds were disturbed by noise in their homes. Slightly less than 6 % reports that noise disturbed school homework or speech communication, whereas 4 % reported difficulties in falling asleep due to noise in the home. Approximately three per cent of parents to all 4-, 8- and 12-year old children reported that their children have reduced hearing, and three per cent of 8- and 12-year old children reported that they have tinnitus. It is concluded that noise in dwellings and schools should be reduced in order to provide good and healthy sound environments for children. Furthermore, the sound environment should be considered already at the planning stage, in order to minimize indoor and outdoor noise exposure in future dwellings and schools.
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| 2. |
- Selander, Jenny, et al.
(author)
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Long-Term Exposure to Road Traffic Noise and Myocardial Infarction
- 2009
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In: Epidemiology. - : Lippincott Williams & Wilkins, Inc. - 1044-3983 .- 1531-5487. ; 20:2, s. 272-279
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Journal article (peer-reviewed)abstract
- Background: An association has been reported between long-term exposure to road traffic noise and the risk of myocardial infarction (MI), but the evidence is limited and inconclusive. No previous study has simultaneously analyzed the role of exposure to noise and air pollution from road traffic in the risk of MI. Methods: A population-based case-control study on MI was conducted 1992-1994 in Stockholm County. Participants answered a questionnaire and underwent a physical examination. Residential exposure to noise and air pollution from road traffic between 1970 and 1992-1994 was assessed for 3666 participants (1571 cases of MI and 2095 controls), based on residential history combined with information on traffic intensity and distance to nearby roads. Information was also obtained on factors potentially affecting the relationship between noise exposure and MI, such as noise annoyance. Results: The correlation between long-term individual exposure to noise and air pollution from traffic was high (r = 0.6). The adjusted odds ratio for MI associated with long-term road traffic noise exposure of 50 dBA or higher was 1.12 (95% confidence interval = 0.95-1.33). In a subsample, defined by excluding persons with hearing loss or exposure to noise from other sources, the corresponding odds ratio was 1.38 (1.11-1.71), with a positive exposure-response trend. No strong effect modification was apparent by sex or cardiovascular risk factors, including air pollution from road traffic. Conclusions: The results lend some support to the hypothesis that long-term exposure to road traffic noise increases the risk for MI.
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| 3. |
- Caccamisi, Andrea, et al.
(author)
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Natural language processing and machine learning to enable automatic extraction and classification of patients' smoking status from electronic medical records
- 2020
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In: Upsala Journal of Medical Sciences. - : Uppsala Medical Society. - 0300-9734 .- 2000-1967. ; 125:4, s. 316-324
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Journal article (peer-reviewed)abstract
- Background: The electronic medical record (EMR) offers unique possibilities for clinical research, but some important patient attributes are not readily available due to its unstructured properties. We applied text mining using machine learning to enable automatic classification of unstructured information on smoking status from Swedish EMR data.Methods: Data on patients' smoking status from EMRs were used to develop 32 different predictive models that were trained using Weka, changing sentence frequency, classifier type, tokenization, and attribute selection in a database of 85,000 classified sentences. The models were evaluated using F-score and accuracy based on out-of-sample test data including 8500 sentences. The error weight matrix was used to select the best model, assigning a weight to each type of misclassification and applying it to the model confusion matrices. The best performing model was then compared to a rule-based method.Results: The best performing model was based on the Support Vector Machine (SVM) Sequential Minimal Optimization (SMO) classifier using a combination of unigrams and bigrams as tokens. Sentence frequency and attributes selection did not improve model performance. SMO achieved 98.14% accuracy and 0.981 F-score versus 79.32% and 0.756 for the rule-based model.Conclusion: A model using machine-learning algorithms to automatically classify patients' smoking status was successfully developed. Such algorithms may enable automatic assessment of smoking status and other unstructured data directly from EMRs without manual classification of complete case notes.
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| 4. |
- Caccamisi, Andrea, et al.
(author)
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PRM92 - Automatic Extraction and Classification of Patients’ Smoking Status from Free Text Using Natural Language Processing
- 2016
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In: Value in Health. - : Elsevier BV. - 1098-3015 .- 1524-4733. ; 19:7
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Journal article (peer-reviewed)abstract
- ObjectivesTo develop a machine learning algorithm for automatic classification of smoking status (smoker, ex-smoker, non-smoker and unknown status) in EMRs, and validate the predictive accuracy compared to a rule-based method. Smoking is a leading cause of death worldwide and may introduce confounding in research based on real world data (RWD). Information on smoking is often documented in free text fields in Electronic Medical Records (EMRs), but structured RWD on smoking is sparse.Methods32 predictive models were trained with the Weka machine learning suite, tweaking sentence frequency, classifier type, tokenization and attribute selection using a database of 85,000 classified sentences. The models were evaluated using F-Score and Accuracy based on out-of-sample test data including 8,500 sentences. The error weight matrix was used to select the best model, assigning a weight to each type of misclassification and applying it to the models confusion matrices.ResultsThe best performing model was based on the Support Vector Machine (SVM) Sequential Minimal Optimization (SMO) classifier using a polynomial kernel with parameter C equal to 6 and a combination of unigrams and bigrams as tokens. Sentence frequency and attributes selection did not improve model performance. SMO achieved 98.25% accuracy and 0.982 F-Score versus 79.32% and 0.756, respectively, for the rule-based model.ConclusionsA model using machine learning algorithms to automatically classify patients smoking status was successfully developed. This algorithm would enable automatic assessment of smoking status directly from EMRs, obviating the need to extract complete case notes and manual classification.
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| 5. |
- Castelo-Branco, Anna, et al.
(author)
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Infections in patients with multiple sclerosis : A national cohort study in Sweden
- 2020
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In: Multiple Sclerosis and Related Disorders. - : Elsevier. - 2211-0348 .- 2211-0356. ; 45
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Journal article (peer-reviewed)abstract
- BACKGROUND: Multiple sclerosis (MS) patients have an increased risk of infections, but few population-based studies have reported infections occurring in MS in the years immediately after diagnosis.OBJECTIVE: To explore incident infections in MS, stratified by age and sex.METHODS: In a Swedish population-based cohort study 6602 incident MS patients (aged ≥18 years), matched at diagnosis with 61,828 matched MS-free individuals were identified between 1st January 2008 and 31st December 2016, using national registers. Incidence rates (IR) and incidence rate ratios (IRR) with 95% CI were calculated for each outcome.RESULTS: The IRRs were 2.54 (95% CI 2.28-2.83) for first serious infection and 1.61 (1.52-1.71) for first non-serious infection. Compared with MS-free individuals, MS patients had higher IRs for skin, respiratory/throat infections, pneumonia/influenza, bacterial, viral, and fungal infections, with the highest IRR observed for urinary tract/kidney infections (2.44; 2.24-2.66). The cumulative incidence for most of these infections was higher among MS patients than MS-free individuals, both 0 to <5 and 5 to <9 years after index date.CONCLUSION: The burden of infections around the time of MS diagnosis and subsequent infection risk, underscore the need for careful considerations regarding the risk-benefit across different disease-modifying therapies.
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| 6. |
- Castelo-Branco, Anna, et al.
(author)
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Non-infectious comorbidity in patients with multiple sclerosis : A national cohort study in Sweden
- 2020
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In: Multiple Sclerosis Journal, Experimental, Translational and Clinical. - California, USA : Sage Publications. - 2055-2173. ; , s. 1-10
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Journal article (peer-reviewed)abstract
- Background: Comorbidity is of significant concern in multiple sclerosis (MS). Few population-based studies have reported conditions occurring in MS after diagnosis, especially in contemporary cohorts.Objective: To explore incident comorbidity, mortality and hospitalizations in MS, stratified by age and sex.Methods: In a Swedish population-based cohort study 6602 incident MS patients (aged ≥18 years) and 61,828 matched MS-free individuals were identified between 1 January 2008 and 31 December 2016, using national registers. Incidence rates (IRs) and incidence rate ratios (IRRs) with 95% CI were calculated for each outcome.Results: IRs of cardiovascular disease (CVD) were higher among MS patients than MS-free individuals, (major adverse CVD: IRR 1.42; 95% CI 1.12-1.82; hemorrhagic/ischemic stroke: 1.46; 1.05-2.02; transient ischemic attack: 1.65; 1.09-2.50; heart failure: 1.55; 1.15-2.10); venous thromboembolism: 1.42; 1.14-1.77). MS patients also had higher risks of several non-CVDs such as autoimmune conditions (IRR 3.83; 3.01-4.87), bowel dysfunction (2.16; 1.86-2.50), depression (2.38; 2.11-2.68), and fractures (1.32; 1.19-1.47), as well as being hospitalized and to suffer from CVD-related deaths ((1.91; 1.00-3.65), particularly in females (3.57; 1.58-8.06)).Conclusion: MS-patients experience a notable comorbidity burden which emphasizes the need for integrated disease management in order to improve patient care and long-term outcomes of MS.
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| 7. |
- Holl, Katsiaryna, et al.
(author)
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The Impact of Childhood Acute Otitis Media on Parental Quality of Life in a Prospective Observational Cohort Study
- 2015
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In: Clinical drug investigation. - : Springer Science and Business Media LLC. - 1173-2563 .- 1179-1918. ; 35:10, s. 613-624
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Journal article (peer-reviewed)abstract
- Acute otitis media (AOM) not only affects childhood quality of life (QoL), but can also affect parental QoL. We adapted a previously published questionnaire on the effect of childhood recurrent ear, nose and throat infections on parental QoL for use with AOM and used it in an observational, multicentre, prospective study of children with AOM. The AOM-specific parental QoL questionnaire grouped 15 items into emotional, daily disturbance, total and overall parental QoL impact scores. The questionnaire was assessed using item-convergent and item-discriminant validity criteria and internal consistency reliability; and then used with parents of children aged < 6 years diagnosed with AOM at 73 practices in Germany, Italy, Spain, Sweden and the UK. Bivariate analyses explored the differences in mean parental QoL impact scores by various characteristics. The questionnaire demonstrated good to excellent internal consistency reliability for the various components (Cronbach's alpha 0.82-0.97). There were 1419 AOM episodes among 5882 healthy children over 1 year, of which 1063 episodes (74.9 %) among 852 children had a questionnaire. Parents reported interrupted sleep (68.4 %), worry (51.0 %), altered daily schedule (44.6 %) and less leisure time (41.5 %) with a score a parts per thousand yen3 (1 = least to 5 = most impact). Factors that adversely affected parental QoL included: increased parental perception of AOM severity, younger child age and multiple AOM episodes. The AOM-specific parental QoL questionnaire demonstrated good performance across five European countries. Parental QoL was affected by childhood AOM proportionally to severity, number of episodes and younger child age.
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| 8. |
- Rosenlund, Joacim, 1985-
(author)
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Environmental research collaboration : Cross-sector knowledge production in environmental science
- 2017
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Doctoral thesis (other academic/artistic)abstract
- Increased interaction between science and society is recognised as one of the characteristics of contemporary science. Solving the complex environmental problems of our day also necessitate such interactions. In this thesis, theories of knowledge production and innovation, including the triple helix and Mode 2, were used to analyse and assess environmental science critically. The triple helix model claims that interaction between university, industry, and government, is essential for innovation development. The Mode 2 of science emphasises the social embeddedness of science. These theories of knowledge production are situated on a macro level. Most studies carried out about this have disregarded the interactions in practice between science and society. The aim of the thesis was to explore how these theories manifest themselves in practice. Further, the aim was to contribute to knowledge about cross-sector interactions in environmental research collaboration. Interactive research was conducted in three environmental research projects. One survey was also conducted on a national level. Results are distributed in five research papers. Firstly, the results showed that the triple helix became somethings else on a project level. Further, when working in a triple helix-based collaboration participants encountered boundaries and which could be crossed using boundary-spanning means. The use of dialogue arenas in interactive research, meaning research oriented workshops and seminars, aided both participants and the researcher to cross disciplinary and cross-sector boundaries. Solving environmental problems, using cross-sector research collaboration, necessitated the recognition of the collaborative process itself. An abstract environmental idea such as the circular economy was also found to contribute to bridging the gaps between research and society. Lastly, the research showed that environmental scientists reflect upon the relevance of their research. The scientists felt the need to provide society with relevant research and adjust their research choices due to this. This thesis ends up with a discussion about a Mode 3 of knowledge production where the democratisation of research is crucial. Here a fourth helix represents the further inclusion of society in general. A fifth helix includes the natural environment as a driver for collaboration, forming a quintuple helix which incorporates the environmental relevance into collaboration. This thesis contributes to knowledge about theories of knowledge production, cross-sector research collaboration and the role of environmental science in society.
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| 9. |
- Rosenlund, Mats, et al.
(author)
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Daily intake of magnesium and calcium from drinking water in relation to myocardial infarction
- 2005
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In: Epidemiology. - : Ovid Technologies (Wolters Kluwer Health). - 1044-3983 .- 1531-5487. ; 16:4, s. 570-576
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Journal article (peer-reviewed)abstract
- BACKGROUND:A decreased risk for cardiovascular disease has been related to the hardness of drinking water, particularly high levels of magnesium. However, the evidence is still uncertain, especially in relation to individual intake from water.METHODS:We used data from the Stockholm Heart Epidemiology Program, a population-based case-control study conducted during 1992-1994, to study the association between myocardial infarction and the daily intake of drinking water magnesium and calcium. Our analyses are based on 497 cases age 45-70 years, and 677 controls matched on age, sex, and hospital catchment area. Individual data on magnesium, calcium, and hardness of the domestic drinking water were assessed from waterwork registers or analyses of well water.RESULTS:After adjustment for the matching variables and smoking, hypertension, socioeconomic status, job strain, body mass index, diabetes, and physical inactivity, the odds ratio for myocardial infarction was 1.09 (95% confidence interval = 0.81-1.46) associated with a tap water hardness above the median (>4.4 German hardness degrees) and 0.88 (0.67-1.15) associated with a water magnesium intake above the median (>1.86 mg/d). There was no apparent sign of any exposure-response pattern related to water intake of magnesium or calcium.CONCLUSIONS:This study does not support previous reports of a protective effect on myocardial infarction associated with consumption of drinking water with higher levels of hardness, magnesium, or calcium.
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| 10. |
- Rosenlund, Mats
(author)
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Environmental factors in cardiovascular disease
- 2005
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Doctoral thesis (other academic/artistic)abstract
- Cardiovascular disease is the main cause of death in Sweden and other developed countries. The purpose of this thesis is to assess the role of certain environmental factors in the etiology of cardiovascular disease, expressed as hypertension and myocardial infarction, focusing on aircraft noise, environmental tobacco smoke, drinking water hardness, and ambient air pollution. The thesis is based on two epidemiological materials, i.e. an Environmental Health Survey (EH survey) in Stockholm county during 1997 and the Stockholm Heart Epidemiology Program (SHEEP), which is a county-wide case-control study of myocardial infarction 19921994. Aircraft noise exposure was assessed for 266 residents in the vicinity of Arlanda airport and 2693 inhabitants in other parts or the county who answered the EH-survey. The SHEEP study, comprising 2246 cases of myocardial infarction and 3206 population controls, was used to investigate the importance of exposure to environmental tobacco smoke, intake of drinking water magnesium and calcium, and exposure to source-specific residential air pollution. Exposure to energy-averaged aircraft noise above 55 dBA was associated with an adjusted odds ratio for hypertension of 1.59 (95% Cl 1.00-2.53), and maximum aircraft noise above 72 dBA was associated with an adjusted odds ratio of 1.76 (95% Cl 1. 12-2.77). A dose-response relation between aircraft noise and hypertension prevalence was suggested. Exposure to environmental tobacco smoke at home and work was associated with an increased risk of nonfatal myocardial infarction among never-smokers, both with regard to intensity, duration, time since last exposure, and cumulative dose. For example, spousal exposure of 20 cigarettes per day or more was associated with an adjusted odds ratio of 1.58 (95% Cl 0.97-2.56), and cumulative combined exposure at home and work was associated with an adjusted odds ratio of 1.55 (95% Cl 1.022.34) in the top decile of exposure. An inter-quartile range increase in the daily intake of drinking water magnesium was associated with an adjusted odds ratio for myocardial infarction of 1.01 (95% Cl 0.87-1.17). There was no indication of dose-response for any of the drinking water parameters. An increased risk of fatal myocardial infarction was suggested in relation to long-term air pollution exposure, but not for incidence or nonfatal myocardial infarction. A difference in the 30-year average exposure to traffic-generated N02 of 30 µg/M3 was associated with an adjusted odds ratio for fatal myocardial infarction of 1.51 (95% Cl 0.96-2.16) and 2.17 (95 Cl 1.05-4.5 1) for out-of hospital death. In conclusion, the results suggest that exposure to aircraft noise may be associated with an increased prevalence of hypertension, indicate that exposure to environmental tobacco smoke increases the risk of nonfatal myocardial infarction, do not support the hypothesis that drinking water hardness would protect against myocardial infarction, and point to long-term air pollution exposure as a risk factor for fatal myocardial infarction.
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