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1.
  • Fridh, Maria, et al. (author)
  • Associations between self-injury and involvement in cyberbullying among mentally distressed adolescents in Scania, Sweden
  • 2019
  • In: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 47:2, s. 190-198
  • Journal article (peer-reviewed)abstract
    • Aims: To investigate associations between self-injury and involvement in cyberbullying as a bully, victim or bully-victim among mentally distressed adolescents. Methods: Data from the public health survey of children and adolescents in Scania, Sweden 2016 were used. A questionnaire was answered anonymously in school by 9143 students in 9th grade compulsory school (response rate 77%) and 7949 students in 2nd grade of upper secondary school (response rate 73%). Students with past year (broadly defined) mental distress at least 2 weeks in a row (33% of boys and 63% of girls) were asked if they had performed self-injury (i.e. cut, superficially cut or otherwise injured themselves) past year, and those with data on self-injury and cyberbullying were included in the present study (n=6841). Associations between self-injury and cyberbullying were investigated by multiadjusted logistic regression analysis. Results: Among mentally distressed students, self-injury was reported by 11.7% of boys and 25.9% of girls. Age-adjusted analysis showed increasingly higher odds of self-injury among cyberbullies, cybervictims and cyberbully-victims, using non-involved as reference group (OR boys: 1.8, 2.3, 3.0; girls: 2.1, 3.2, 4.8). Associations weakened after adjustment for several potential confounders but remained significant for all cyberbullying groups except male cyberbullies, among whom significance was lost after adjustment for smoking, alcohol and narcotics. Conclusions: Peer victimization in cyber space is associated with self-injury, especially among victims and bully-victims. Decreasing peer victimization is a priority, and school and health professionals need to be aware of the associations between cyberbullying and self-injury among mentally distressed adolescents.
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4.
  • Fridh, Maria, et al. (author)
  • Poor psychological health and 5-year suicide mortality : A population-based prospective cohort study
  • 2020
  • In: Social Science and Medicine. - : Elsevier BV. - 0277-9536. ; 258
  • Journal article (peer-reviewed)abstract
    • Objective: The objective was to investigate associations between the General Health Questionnaire with twelve sub-items (GHQ-12) and prospective five-year suicide mortality. The two commonly used GHQ-12 cut-offs (2/3 and 3/4) were analyzed. Method: The 2008 public health survey, which was conducted in the autumn of 2008 in Scania, southern Sweden, is based on a postal questionnaire answered by 28,198 participants, aged 18 to 80. GHQ-12 was assessed from the baseline questionnaire, and five-year prospective register data on causes of death were connected to the baseline survey. In total, 21 persons died from intentional self-inflicted injuries, and twenty of them had complete answers regarding GHQ-12. Hazard rate ratios (HRR) were analyzed in survival (Cox-) regression analyses, adjusted for age, sex, marital status and socioeconomic status (SES). Results: The prevalence of poor psychological health according to GHQ-12 with the 2/3 cut-off was 14% among men and 18% among women, and with the 3/4 cut-off it was 11% among men and 15% among women. The 2/3 cut-off yielded a HRR of 3.02 (1.14–7.98, 95% CI) which decreased to 2.44 (0.92–6.49) when adjusted for marital status and SES, and a 3/4 cut-off HRR of 3.97 (1.51–10.47) which decreased to 3.23 (1.22-1.22-8.56) when adjusted for marital status and SES. Conclusion: The results indicate high effect measures (HRRs) between GHQ12 with both cut offs and five-year suicide mortality.
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5.
  • Fridh, Maria, et al. (author)
  • Poor psychological health and 8-year mortality: a population-based prospective cohort study stratified by gender in Scania, Sweden
  • 2022
  • In: Bmj Open. - : BMJ. - 2044-6055. ; 12:11
  • Journal article (peer-reviewed)abstract
    • OBJECTIVES: We investigated gender differences in the association between mortality and general psychological distress (measured by 12-item General Health Questionnaire, GHQ-12), as an increased mortality risk has been shown in community studies, but gender differences are largely unknown. SETTING: We used data from a cross-sectional population-based public health survey conducted in 2008 in the Swedish region of Skåne (Scania) of people 18-80 years old (response rate 54.1 %). The relationship between psychological distress and subsequent all-cause and cause-specific mortality was examined by logistic regression models for the total study population and stratified by gender, adjusting for age, socioeconomic status, lifestyle (physical activity, smoking, alcohol consumption), and chronic disease. PARTICIPANTS: Of 28 198 respondents, 25 503 were included in analysis by restrictive criteria. OUTCOME MEASURES: Overall and cause-specific mortality by 31 December 2016. RESULTS: More women (20.2 %) than men (15.7 %) reported psychological distress at baseline (GHQ ≥3). During a mean follow-up of 8.1 years, 1389 participants died: 425 (30.6%) from cardiovascular diseases, 539 (38.8%) from cancer, and 425 (30.6%) from other causes. The overall association between psychological distress and mortality risk held for all mortality end-points except cancer after multiple adjustments (eg, all-cause mortality OR 1.8 (95 % CI 1.4 to 2.2) for men and women combined. However, stratification revealed a clear gender difference as the association between GHQ-12 and mortality was consistently stronger and more robust among men than women. CONCLUSION: More women than men reported psychological distress while mortality was higher among men (ie, the morbidity-mortality gender paradox). GHQ-12 could potentially be used as one of several predictors of mortality, especially for men. In the future, screening tools for psychological distress should be validated for both men and women. Further research regarding the underlying mechanisms of the gender paradox is warranted.
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6.
  • Fridh, Maria, et al. (author)
  • Subjective health complaints and exposure to peer victimization among disabled and non-disabled adolescents: A population-based study in Sweden.
  • 2018
  • In: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 46:2
  • Journal article (peer-reviewed)abstract
    • To investigate subjective health complaints (SHCs) (psychological and somatic, respectively) among disabled and non-disabled adolescents, focusing on the impact of traditional bullying and cyber harassment, and furthermore to report psychological and somatic SHCs across different types of disability.Data from the public health survey of children and adolescents in Scania, Sweden, 2012 was used. A questionnaire was answered anonymously in school by 9791 students in the 9th grade (response rate 83%), and 7533 of these with valid answers on key questions were included in this study. Associations with daily SHCs were investigated by multi-adjusted logistic regression analyses.Any disability was reported by 24.1% of boys and 22.0% of girls. Disabled students were more exposed to cyber harassment (boys: 20.0%; girls: 28.2%) than non-disabled peers (boys: 11.8%; girls: 18.1%). Exposure to traditional bullying showed the same pattern but with a lower prevalence. Disabled students had around doubled odds of both daily psychological SHCs and daily somatic SHCs in the fully adjusted models. In general, the odds increased with exposure to cyber harassment or traditional bullying and the highest odds were seen among disabled students exposed to both cyber harassment and traditional bullying. Students with ADHD/ADD had the highest odds of daily psychological SHCs as well as exposure to traditional bullying across six disability types.Disabled adolescents report poorer health and are more exposed to both traditional bullying and cyber harassment. This public health issue needs more attention in schools and in society in general.
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7.
  • Fridh, Maria, et al. (author)
  • Subjective health complaints in adolescent victims of cyber harassment: moderation through support from parents/friends - a Swedish population-based study.
  • 2015
  • In: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 15:1
  • Journal article (peer-reviewed)abstract
    • Victimization in cyberspace has emerged as a new public health issue among the young. The main purpose of this study was to analyze associations between cyber victimization defined as cyber harassment (CH) (a somewhat broader concept than cyberbullying) and subjective health complaints (SHC), to study whether these associations were modified by parental/friend support (measured as communication), and to explore the influence of traditional bullying victimization (TBV) on the association between CH and SHC.
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8.
  • Köhler, Marie, et al. (author)
  • "All is well": professionals' documentation of social determinants of health in Swedish Child Health Services health records concerning maltreated children - a mixed method approach
  • 2016
  • In: Bmc Pediatrics. - : Springer Science and Business Media LLC. - 1471-2431. ; 16
  • Journal article (peer-reviewed)abstract
    • Background: Knowledge about social determinants of health has influenced global health strategies, including early childhood interventions. Some psychosocial circumstances - such as poverty, parental mental health problems, abuse and partner violence - increase the risk of child maltreatment and neglect. Healthcare professionals' awareness of psychosocial issues is of special interest, since they both have the possibility and the obligation to identify vulnerable children. Methods: Child Health Services health records of 100 children in Malmo, Sweden, who had been placed in, or were to be placed in family foster care, were compared with health records of a matched comparison group of 100 children who were not placed in care. A mixed-method approach integrating quantitative and qualitative analysis was applied. Results: The documentation about the foster care group was more voluminous than for the comparison group. The content was problem-oriented and dominated by severe parental health and social problems, while the child's own experiences were neglected. The professionals documented interaction with healthcare and social functions, but very few reports to the Social Services were noted. For both groups, notes about social structures were almost absent. Conclusions: Child Health Service professionals facing vulnerable children document parental health issues and interaction with healthcare, but they fail to document living conditions thereby making social structures invisible in the health records. The child perspective is insufficiently integrated in the documentation and serious child protection needs remain unmet, if professionals avoid reporting to Social Services.
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  • Köhler, Marie, et al. (author)
  • Children in family foster care have greater health risks and less involvement in Child Health Services
  • 2015
  • In: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 104:5, s. 508-513
  • Journal article (peer-reviewed)abstract
    • AimThis study investigated the impact of being in family foster care on selected health determinants and participation in Child Health Services (CHS).MethodsTwo groups of 100 children, born between 1992 and 2008, were studied using data from Swedish Child Health Services for the preschool period up to the age of six. The first group had been in family foster care, and the controls, matched for age, sex and geographic location, had not. Descriptive statistics were used to describe differences in health determinants and participation in Child Health Services between the two groups.ResultsThe foster care group had higher health risks, with lower rates of breastfeeding and higher levels of parental smoking. They were less likely to have received immunisations and attended key nurse or physician visits and speech and vision screening. Missing data for the phenylketonuria test were more common in children in family foster care.ConclusionChildren in family foster care were exposed to more health risks than the control children and had lower participation in the universal child health programme during the preschool period. These results call for secure access to high‐quality preventive health care for this particularly vulnerable group of children.
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10.
  • Köhler, Marie, et al. (author)
  • Parental health and psychosomatic symptoms in preschool children : A cross-sectional study in Scania, Sweden
  • 2017
  • In: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 45:8, s. 846-853
  • Journal article (peer-reviewed)abstract
    • Aim: The aim of the study was to assess the association between parental self-rated health and recurrent abdominal pain (RAP) in preschool children. Methods: A questionnaire, including questions about sociodemographic and psychosocial factors, lifestyle, parental and child health, was sent to parents of all 4-year-old children in Scania, Sweden. The response rate was 43.6%. The outcome was RAP and the main exposure was parental self-rated health (SRH). Covariates included sociodemographic, lifestyle and psychosocial factors. Logistic regression analyses were used in a five-step model to estimate the odds ratio (OR) and 95% confidence interval (CI) of parental SRH in relation to child RAP. Results: Logistic regression analysis showed higher odds of RAP among children whose parents reported domestic violence, economic worries and poor SRH (mothers OR = 2.1 (95% CI: 1.6, 2.7) and fathers OR = 1.5 (95% CI: 1.1, 2.0)). Adjustment for sociodemographic, lifestyle and psychosocial factors reduced the OR for RAP in the children of mothers with poor SRH (OR = 1.6 (95% CI: 1.2, 2.2)) and fathers with poor SRH (OR = 1.2 (CI 95%: 0.8, 1.7)). Poor SRH was associated with less reading to the child as well as parental perceptions of insufficiency in the interaction with the child. Conclusions: Health professionals have a key position to prevent psychosomatic symptoms in childhood by identifying the living conditions of children with RAP and particularly, to pay attention to parental poor health to identify if support to the family and/or child protection interventions are needed. Health professionals meeting adult patients with poor health should identify whether they are parents and have children who might need information, support and/or protection.
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  • Lindström, Martin, et al. (author)
  • Economic stress in childhood and adulthood, and poor psychological health: Three life course hypotheses.
  • 2014
  • In: Psychiatry Research. - : Elsevier BV. - 1872-7123 .- 0165-1781. ; 215:2, s. 386-393
  • Journal article (peer-reviewed)abstract
    • Investigations of mental health in a life course perspective are scarce. The aim is to investigate associations between economic stress in childhood and adulthood, and poor psychological health in adulthood with reference to the accumulation, critical period and social mobility hypotheses in life course epidemiology. The 2008 public health survey in Skåne is a cross-sectional postal questionnaire study. A random sample was invited which yielded 28,198 respondents aged 18-80 (55% participation). Psychological health was assessed with the GHQ12 instrument. Logistic regression models were used to investigate the associations adjusting for age, country of birth, socioeconomic status, emotional support, instrumental support and trust, and stratifying by sex. The accumulation hypothesis was confirmed because combined childhood and adulthood exposures to economic stress were associated with poor psychological health in a graded manner. The social mobility hypothesis was also confirmed. The critical period hypothesis was not confirmed because both childhood and adulthood economic stress remained significantly associated with poor psychological health in adulthood. Economic stress in childhood is associated with mental health in adulthood.
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  • Lindström, Martin, et al. (author)
  • Health locus of control and all-cause, cardiovascular, cancer and other cause mortality: A population-based prospective cohort study in southern Sweden
  • 2022
  • In: Preventive Medicine. - : Elsevier BV. - 0091-7435. ; 161
  • Journal article (peer-reviewed)abstract
    • The aim was to investigate associations between health locus of control (HLC) and all-cause, cardiovascular (CVD), cancer and other cause mortality. A public health postal questionnaire was distributed in the autumn of 2008 to a stratified random sample of the 18-80 year old adult population in Scania in southernmost Sweden. The participation rate was 54.1%, and 25,517 participants were included in the present study. Baseline 2008 survey data was linked to cause of death register data to create a prospective cohort with 8.3-year follow-up. Associations between health locus of control and mortality were investigated in survival (Cox) regression models. Prevalence of internal HLC was 69.0% and external HLC 31.0% among women. Internal HLC was 67.6% and external HLC 32.4% among men. In the models with women and men combined, external HLC had significantly higher all-cause, CVD, cancer and other cause mortality even after adjustments for sociodemographic factors and chronic disease at baseline, but after the introduction of health-related behaviors, external HLC only displayed higher cancer mortality compared to internal HLC. External HLC displayed higher all-cause, cancer and other cause mortality for men in the final model adjusted for health-related behaviors, but not for women. Other pathways than health-related behaviors may exist for the association between external HLC and cancer mortality, particularly among men.
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  • Lindström, Martin, et al. (author)
  • Marital status and cause-specific mortality: A population-based prospective cohort study in southern Sweden
  • 2024
  • In: Preventive Medicine Reports. - 2211-3355. ; 37
  • Journal article (peer-reviewed)abstract
    • The aim was to investigate associations between marital status and mortality with a prospective cohort study design. A public health survey including adults aged 18–80 was conducted with a postal questionnaire in southern Sweden in 2008 (54.1% participation). The survey formed a baseline that was linked to 8.3-year follow-up all-cause, cardiovascular (CVD), cancer and other cause mortality. The present investigation entails 14,750 participants aged 45–80. Associations between marital status and mortality were investigated with multiple Cox-regression analyses. A 72.8% prevalence of respondents were married/cohabitating, 9.1% never married, 12.2% divorced and 5.9% widows/widowers. Marital status was associated with age, sex, socioeconomic status (SES) by occupation, country of birth, chronic disease, Body Mass Index (BMI), health-related behaviors and generalized trust covariates. Never married/single, divorced, and widowed men had significantly higher hazard rate ratios (HRRs) of all-cause mortality than the reference category married/cohabitating men throughout the multiple analyses. For men, CVD and other cause mortality showed similar significant results, but not cancer. No significant associations were displayed for women in the multiple analyses. Associations between marital status and mortality are stronger among men than women. Associations between marital status and cancer mortality are not statistically significant with low effect measures throughout the multiple analyses among both men and women.
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  • Rohrmann, S., et al. (author)
  • The association of education with long-term weight change in the EPIC-PANACEA cohort
  • 2012
  • In: European Journal of Clinical Nutrition. - : Springer Science and Business Media LLC. - 0954-3007 .- 1476-5640. ; 66:8, s. 957-963
  • Journal article (peer-reviewed)abstract
    • BACKGROUND/OBJECTIVES: Cross-sectionally, educational attainment is strongly associated with the prevalence of obesity, but this association is less clear for weight change during adult life. The objective of this study is to examine the association between educational attainment and weight change during adult life in the European Prospective Investigation into Cancer and Nutrition (EPIC). SUBJECTS/METHODS: EPIC is a cohort study with 361 467 participants and up to 10 years of follow-up. Educational attainment was categorized according to the highest obtained school level (primary school or less, vocational secondary training, other secondary education and university). Multivariate mixed-effects linear regression models were used to study education in relation to weight at age 20 years (self-reported), to annual change in weight between age 20 years and measured weight at recruitment, and to annual change in weight during follow-up time. RESULTS: Higher educational attainment was associated with on average a lower body mass index (BMI) at age 20 years and a lower increase in weight up to recruitment (highest vs lowest educational attainment in men: -60 g per year (95% confidence interval (CI) -80; -40), women -110 g per year (95% CI -130; -80)). Although during follow-up after recruitment an increase in body weight was observed in all educational levels, gain was lowest in men and women with a university degree (high vs low education -120 g per year (95% CI -150; -90) and -70 g per year (95% CI -90; -60), respectively). CONCLUSIONS: Existing differences in BMI between higher and lower educated individuals at early adulthood became more pronounced during lifetime, which possibly impacts on obesity-related chronic disease risk in persons with lower educational attainment.
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  • Adamsson Eryd, Samuel, et al. (author)
  • Carotid intima-media thickness is associated with incidence of hospitalized atrial fibrillation.
  • 2014
  • In: Atherosclerosis. - : Elsevier BV. - 1879-1484 .- 0021-9150. ; 233:2, s. 673-678
  • Journal article (peer-reviewed)abstract
    • Carotid intima-media thickness (IMT) is a measure of arterial thickening and a risk predictor for myocardial infarction and stroke. It is unclear whether IMT also predicts atrial fibrillation (AF). We explored the association between IMT and incidence of first AF hospitalization in a population-based cohort.
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  • Ali, Sadiq Mohammad, et al. (author)
  • Gender differences in daily smoking prevalence in different age strata: A population-based study in southern Sweden.
  • 2009
  • In: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 37:2, s. 146-152
  • Journal article (peer-reviewed)abstract
    • Objectives: To investigate gender differences in daily smoking prevalence in different age groups in southern Sweden. Methods: The 2004 public-health survey in Skåne is a cross-sectional study. A total of 27,757 persons aged 18-80 years answered a postal questionnaire, which represents 59% of the random sample. A logistic regression model was used to investigate the associations between gender and daily smoking according to age. The multivariate analysis was performed to investigate the importance of possible confounders (country of origin, education, snus use, alcohol consumption, leisure-time physical activity, and BMI) on the gender differences in daily smoking in different age groups. Results: 14.9% of the men and 18.1% of the women were daily smokers. Middle-aged respondents were daily smokers to a significantly higher extent than young and old respondents. The prevalence of daily smoking also varied according to other demographic, socioeconomic, health related behaviour, and BMI characteristics. The crude odds ratios of daily smoking were 1.79 (1.42-2.26) among women compared to men in the 18-24 years age group, and 0.95 (0.80-1.12) in the 65-80 years age group. These odds ratios changed to 2.00 (1.49-2.67) and 0.95 (0.76-1.18), respectively, when all confounders were included. CONCLUSIONS: For the first time in Sweden women have a higher prevalence of daily smoking than men. The odds ratios of daily smoking are highest among women compared to men in the youngest age group of 18-24 years and the odds ratios decrease with increasing age. The findings point to a serious public health problem. Strategic interventions targeting young women's tobacco smoking are needed.
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  • Ali, Sadiq Mohammad, et al. (author)
  • Social capital, the miniaturisation of community, traditionalism and first time acute myocardial infarction: A prospective cohort study in southern Sweden.
  • 2006
  • In: Social Science and Medicine. - : Elsevier BV. - 1873-5347 .- 0277-9536. ; 63:8, s. 2204-2217
  • Journal article (peer-reviewed)abstract
    • This longitudinal study investigates the impact of social participation, trust and the combinations of social participation and trust on the incidence of first time acute myocardial infarction (AMI) in the population of Scania, southern Sweden. It is based on the cross-sectional 2000 public-health survey in Scania with a 59% participation rate and 13,604 participants, and prospective morbidity/mortality data collected for three years (January 2000-December 2002). The study cohort was followed prospectively to examine first ever AMI Hazard rate ratios (HRR) for first time AMI in the social participation, trust and social participation/trust combinations were calculated in a Cox regression model with adjustments for age, sex, education, economic stress, daily smoking, leisure time physical activity, body mass index (BMI), and self-reported health. The prevalence of low social participation was 32.8% among men and 31.5% among women. The prevalence of low trust was 40.0% among men and 44.2% among women. The three-year first time AMI rate was significantly higher among people with higher age, low education, daily smoking, poor self-reported health (among men), low social participation, and the combinations of low social participation/high trust and low social participation/low trust. The results show that low social participation but not trust was significantly associated with first time AMI after adjustment for age and sex. The positive association between low social participation and myocardial infarction remained significant after further adjustments for education, economic stress, daily smoking, physical activity and BMI, and became not significant only after additional adjustment for self-reported health, HRR 1.3 (0.9-2.0). High trust in combination with low social participation as well as low social capital (low trust/low social participation) were significantly associated with AMI, but after multiple adjustments only the low social participation/high trust category remained significant, HRR 1.6 (1.0-2.6).
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  • André-Petersson, Lena, et al. (author)
  • Social support at work and the risk of myocardial infarction and stroke in women and men.
  • 2007
  • In: Social Science and Medicine. - : Elsevier BV. - 1873-5347 .- 0277-9536. ; 64:4, s. 830-841
  • Journal article (peer-reviewed)abstract
    • It has been proposed that lack of social support in a work place characterized by high levels of stress, may increase the likelihood of future cardiovascular disease. The aim of this study was to analyze the prospective impact of social support at work in combination with self-reported work stress on incidence of myocardial infarction (MI) and stroke in a cohort of 4707 women (mean age: 54.2 years) and 3063 men (mean age: 55.5 years) in Malmo, Sweden. The results are based oil self-reports of work-related stress and social support collected at baseline examinations between the years 1992 and 1996. Work-stress was operationalized according to the Karasek job strain model. Data on incidence of NIL and stroke were obtained from national and regional registers. At the end of follow-up, December 31, 2001, 38 women had experienced an MI and 53 had had a stroke. Corresponding figures for men were 114 MIs and 81 strokes. The first finding was that social support at work was an independent predictor of an M I and stroke among women. The second finding was that there was no evidence to support the iso-strain model. The third finding was that low levels of social support at work together with a passive work situation indicated an increased risk of a future cardiovascular outcome (NI I or stroke) during follow-up in the female group. In men, no association was found between any psychosocial work conditions and incidence of MI or stroke during the same follow-up period. (c) 2006 Elsevier Ltd. All rights reserved.
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20.
  • Axelsson, Jakob H, et al. (author)
  • Sexual orientation and self-rated health: the role of social capital, offence, threat of violence, and violence.
  • 2013
  • In: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 41:5, s. 508-515
  • Journal article (peer-reviewed)abstract
    • Objective: To study the association between sexual orientation and self-rated health, including trust, offence, threat of violence, and violence. Design/setting/participants/measurement: The 2008 Public Health Survey in Skåne is a cross-sectional postal questionnaire study. A total of 28,198 persons aged 18-80 years responded (55%). Logistic regressions analysed the association between sexual orientation and self-rated health. Results: 27.4% of all men and 30.0% of all women rated their health as poor. Poor self-rated health was significantly more prevalent in higher age, among immigrants, people with lower education, low social support, low trust, experience of being offended, experience of threat of violence and violence, and bisexual and other orientation. Homosexual and bisexual men and women had higher age-adjusted odds ratios of having felt offended compared to heterosexual respondents. The odds ratios of low trust, threat of violence (men), and experience of violence (women) were significant for respondents with bisexual orientation but not for respondents with homosexual orientation. In the age-adjusted model, no significant association was observed between homosexual orientation and poor self-rated health among women. All other associations between sexual orientation and health were significant in the age-adjusted model but non-significant in the multiple models. Conclusions: Associations between sexual orientation and health disappear after multiple adjustments including trust and experience of offence, threat of violence, and violence. The study suggests that the group with bisexual orientation seems to be more exposed to low social capital (trust), threat of violence, and violence than the group with homosexual orientation.
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22.
  • Beach, Dennis, 1956-, et al. (author)
  • Rurality and education relations : metro-centricity and local values in rural communities and rural schools
  • 2019
  • In: European Educational Research Journal. - : Sage Publications. - 1474-9041. ; 18:1, s. 19-33
  • Journal article (peer-reviewed)abstract
    • Based on ethnographic fieldwork in six different types of rural area and their schools in different parts of Sweden, this article identifies how rural schools relate to the local place and discusses some of the educational implications from this. Recurrent references to the local community were present in some schools and people there explicitly positioned themselves in the local rural context and valorised rurality positively in education exchanges, content and interactions, with positive effects on young people's experiences of participation and inclusion. These factors tended to occur in sparsely populated areas. An emphasis on nature and its value as materially vital in people's lives was present as was a critique of middle-class metrocentricity. Such values and critique seemed to be absent in other areas, where rurality was instead often represented along the metrocentric lines of a residual space in modernizing societies.
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25.
  • Bots, Michiel L., et al. (author)
  • Common Carotid Intima-Media Thickness Measurements Do Not Improve Cardiovascular Risk Prediction in Individuals With Elevated Blood Pressure The USE-IMT Collaboration
  • 2014
  • In: Hypertension. - 1524-4563. ; 63:6, s. 1173-1181
  • Journal article (peer-reviewed)abstract
    • Carotid intima-media thickness (CIMT) is a marker of cardiovascular risk. It is unclear whether measurement of mean common CIMT improves 10-year risk prediction of first-time myocardial infarction or stroke in individuals with elevated blood pressure. We performed an analysis among individuals with elevated blood pressure (ie, a systolic blood pressure 140 mm Hg and a diastolic blood pressure 90 mm Hg) in USE-IMT, a large ongoing individual participant data meta-analysis. We refitted the risk factors of the Framingham Risk Score on asymptomatic individuals (baseline model) and expanded this model with mean common CIMT (CIMT model) measurements. From both models, 10-year risks to develop a myocardial infarction or stroke were estimated. In individuals with elevated blood pressure, we compared discrimination and calibration of the 2 models and calculated the net reclassification improvement (NRI). We included 17 254 individuals with elevated blood pressure from 16 studies. During a median follow-up of 9.9 years, 2014 first-time myocardial infarctions or strokes occurred. The C-statistics of the baseline and CIMT models were similar (0.73). NRI with the addition of mean common CIMT was small and not significant (1.4%; 95% confidence intervals, -1.1 to 3.7). In those at intermediate risk (n=5008, 10-year absolute risk of 10% to 20%), the NRI was 5.6% (95% confidence intervals, 1.6-10.4). There is no added value of measurement of mean common CIMT in individuals with elevated blood pressure for improving cardiovascular risk prediction. For those at intermediate risk, the addition of mean common CIMT to an existing cardiovascular risk score is small but statistically significant.
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26.
  • Britton, Annie R, et al. (author)
  • Alcohol consumption and common carotid intima-media thickness : The USE-IMT study
  • 2017
  • In: Alcohol and Alcoholism. - : Oxford University Press (OUP). - 0735-0414 .- 1464-3502. ; 52:4, s. 483-486
  • Journal article (peer-reviewed)abstract
    • Aims: Epidemiological evidence indicates a protective effect of light to moderate alcohol consumption compared to non-drinking and heavy drinking. Although several mechanisms have been suggested, the effect of alcohol on atherosclerotic changes in vessel walls is unclear. Therefore, we explored the relationship between alcohol consumption and common carotid intima media thickness, a marker of early atherosclerosis in the general population. Methods: Individual participant data from eight cohorts, involving 37,494 individuals from the USE-IMT collaboration were used. Multilevel age and sex adjusted linear regression models were applied to estimate mean differences in common carotid intima-media thickness (CIMT) with alcohol consumption. Results: The mean age was 57.9 years (SD 8.6) and the mean CIMT was 0.75 mm (SD 0.177). About, 40.5% reported no alcohol consumed, and among those who drank, mean consumption was 13.3 g per day (SD 16.4). Those consuming no alcohol or a very small amount (<5 g per day) had significantly lower common CIMT values than those consuming >10 g per day, after adjusting for a range of confounding factors. Conclusion: In this large CIMT consortium, we did not find evidence to support a protective effect of alcohol on CIMT.
  •  
27.
  • Chaix, Basile, et al. (author)
  • Assessment of the magnitude of geographical variations and socioeconomic contextual effects on ischaemic heart disease mortality: a multilevel survival analysis of a large Swedish cohort
  • 2007
  • In: Journal of Epidemiology and Community Health. - : BMJ. - 1470-2738 .- 0143-005X. ; 61:4, s. 349-355
  • Journal article (peer-reviewed)abstract
    • Background: In a public health perspective, it is of interest to assess the magnitude of geographical variations in ischaemic heart disease (IHD) mortality and quantify the strength of contextual effects on IHD. Objective: To investigate whether area effects vary according to the individual and contextual characteristics of the population, socioeconomic contextual influences were assessed in different age groups and within territories of differing population densities. Design: Multilevel survival analysis of a 28-year longitudinal database. Participants: 341 048 residents of the Scania region in Sweden, reaching age 50-79 years in 1996, followed up over 7 years. Results: After adjustment for several individual socioeconomic indicators over the adult age, Cox multilevel models indicated geographical variations in IHD mortality and socioeconomic contextual effects on the mortality risk. However, the magnitude of geographical variations and strength of contextual effects were modified by the age of individuals and the population density of their residential area: socioeconomic contextual effects were much stronger among non-elderly than among elderly adults, and much larger within urban territories than within rural ones. As a consequence, among non-elderly residents of urban territories, the socioeconomic contextual effect was almost as large as the effect of individual 20-year cumulated income. Conclusions: Non-elderly residents of deprived urban neighbourhoods constitute a major target for both contextual epidemiology of coronary disease and public health interventions aimed at reducing the detrimental effects of the social environment on IHD.
  •  
28.
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29.
  • Chaix, Basile, et al. (author)
  • Neighborhood socioeconomic deprivation and residential instability - Effects on incidence of ischemic heart disease and survival after myocardial inforction
  • 2007
  • In: Epidemiology. - : Ovid Technologies (Wolters Kluwer Health). - 1531-5487 .- 1044-3983. ; 18:1, s. 104-111
  • Journal article (peer-reviewed)abstract
    • Background: Previous literature has shown that neighborhood socioeconomic position influences the risk of ischemic heart disease, but little is known about the mechanisms linking the residential context to ischemic heart disease incidence and mortality. We examined whether neighborhood socioeconomic position and neighborhood residential stability (as a determinant of social interaction patterns) have an influence on ischemic heart disease risk. Moreover, we investigated whether dissimilar contextual influences operate at different stages of the disease process, ie, on incidence, 1-day case-fatality, and long-term survival after acute myocardial infarction (MI). Methods: Using a large 27-year longitudinal cohort (baseline: 1 January 1996) defined in the Scania region, Sweden, we estimated multilevel survival models adjusted for individual sociodemographic factors and previous diseases of the persons. Results: After adjustment, multilevel survival models indicated that the incidence of ischemic heart disease increased with neighborhood socioeconomic deprivation but was only weakly associated with neighborhood residential instability (for high vs low residential instability, hazard ratio = 1.2; 95% credible interval = t.0-1.4). Conversely, beyond effects of individual and contextual socioeconomic circumstances and distance to the hospital, we saw a markedly higher I-day case-fatality (4.9; 1.8-15) and shorter survival time after MI among individuals still alive 28 days after MI (4.3; 1.2-17) in neighborhoods with a high versus low residential instability. Conclusions: Effects of residential instability on post-MI survival may be mediated by the lower availability of social support in residentially unstable neighborhoods, suggesting a new class of intermediate processes that should be taken into account when investigating contextual influences on ischemic heart disease. Moreover, dissimilar contextual effects may operate at various stages of the disease process (ie, on incidence, case-fatality, and survival after MI).
  •  
30.
  • Chaix, Basile, et al. (author)
  • Neighbourhood social interactions and risk of acute myocardial infarction.
  • 2008
  • In: Journal of Epidemiology and Community Health. - : BMJ. - 1470-2738 .- 0143-005X. ; 62:1, s. 62-68
  • Journal article (peer-reviewed)abstract
    • STUDY OBJECTIVE: Previous studies of neighbourhood effects on ischaemic heart disease (IHD) have used census or administrative data to characterise the residential context, most commonly its socioeconomic level. Using the ecometric approach to define neighbourhood social interaction variables that may be relevant to IHD, neighbourhood social cohesion and safety were examined to see how they related to acute myocardial infarction (AMI) mortality, after adjustment for individual and neighbourhood confounders. DESIGN: To construct social interaction variables, multilevel models were used to aggregate individual perceptions of safety and cohesion at the neighbourhood level. Linking data from the Health Survey in Scania, Sweden, and the Population, Hospital, and Mortality Registers, multilevel survival models were used to investigate determinants of AMI mortality over a three year and nine month period. PARTICIPANTS: 7791 Individuals aged 45 years and over. MAIN RESULTS: The rate of AMI mortality increased with decreasing neighbourhood safety and cohesion. After adjustment for individual health and socioeconomic variables, low neighbourhood cohesion, and to a lesser extent low safety, were associated with higher AMI mortality. Neighbourhood cohesion effects persisted after adjustment for various neighbourhood confounding factors (income, population density, percentage of residents from low-income countries, residential stability) and distance to the hospital. There was some evidence that neighbourhood cohesion effects on AMI mortality were caused by effects on one-day case-fatality, rather than on incidence. CONCLUSIONS: Beyond commonly evoked effects of the physical environment, neighbourhood social interaction patterns may have a decisive influence on IHD, with a particularly strong effect on survival after AMI.
  •  
31.
  • Chaix, Basile, et al. (author)
  • Recent Increase of Neighborhood Socioeconomic Effects on Ischemic Heart Disease Mortality: A Multilevel Survival Analysis of Two Large Swedish Cohorts.
  • 2007
  • In: American Journal of Epidemiology. - : Oxford University Press (OUP). - 0002-9262 .- 1476-6256. ; 165, s. 22-26
  • Journal article (peer-reviewed)abstract
    • Studies have shown that the decrease in ischemic heart disease mortality over the past decades was paralleled by an increase in socioeconomic disparities. Using two large Swedish cohorts defined in 1986 and 1996, the authors examined whether the effect of neighborhood socioeconomic position on ischemic heart disease mortality strengthened over the period and whether the relative contribution of individual and neighborhood socioeconomic effects changed over time. Multilevel survival models adjusted for individual factors indicated that neighborhood socioeconomic effects on ischemic heart disease mortality increased markedly between the two periods (hazard ratios for residing in the most vs. least deprived neighborhoods were 1.60 (95% credible interval: 1.36, 1.89) for the 1986 cohort and 2.54 (95% credible interval: 1.99, 3.21) for the 1996 cohort). Comparing the neighborhood socioeconomic effect with the strongly predictive effect of 15-year individual income indicated that the neighborhood effect was two times weaker than the individual effect in the 1986 cohort (-48%, 95% credible interval: -22%, -68%) but of comparable magnitude in the 1996 cohort (-11%, 95% credible interval: -42%, 29%). This increase in the contribution of neighborhood factors to the socioeconomic gradient in ischemic heart disease urges investigation into the exact mechanisms between the residential context and coronary health.
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32.
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33.
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34.
  • Den Ruijter, Hester M., et al. (author)
  • Common Carotid Intima-Media Thickness Measurements in Cardiovascular Risk Prediction A Meta-analysis
  • 2012
  • In: JAMA: The Journal of the American Medical Association. - : American Medical Association (AMA). - 1538-3598. ; 308:8, s. 796-803
  • Journal article (peer-reviewed)abstract
    • Context The evidence that measurement of the common carotid intima-media thickness (CIMT) improves the risk scores in prediction of the absolute risk of cardiovascular events is inconsistent. Objective To determine whether common CIMT has added value in 10-year risk prediction of first-time myocardial infarctions or strokes, above that of the Framingham Risk Score. Data Sources Relevant studies were identified through literature searches of databases (PubMed from 1950 to June 2012 and EMBASE from 1980 to June 2012) and expert opinion. Study Selection Studies were included if participants were drawn from the general population, common CIMT was measured at baseline, and individuals were followed up for first-time myocardial infarction or stroke. Data Extraction Individual data were combined into 1 data set and an individual participant data meta-analysis was performed on individuals without existing cardiovascular disease. Results We included 14 population-based cohorts contributing data for 45 828 individuals. During a median follow-up of 11 years, 4007 first-time myocardial infarctions or strokes occurred. We first refitted the risk factors of the Framingham Risk Score and then extended the model with common CIMT measurements to estimate the absolute 10-year risks to develop a first-time myocardial infarction or stroke in both models. The C statistic of both models was similar (0.757; 95% CI, 0.749-0.764; and 0.759; 95% CI, 0.752-0.766). The net reclassification improvement with the addition of common CIMT was small (0.8%; 95% CI, 0.1%-1.6%). In those at intermediate risk, the net reclassification improvement was 3.6% in all individuals (95% CI, 2.7%-4.6%) and no differences between men and women. Conclusion The addition of common CIMT measurements to the Framingham Risk Score was associated with small improvement in 10-year risk prediction of first-time myocardial infarction or stroke, but this improvement is unlikely to be of clinical importance. JAMA. 2012;308(8):796-803 www.jama.com
  •  
35.
  • Eikendal, Anouk L M, et al. (author)
  • Common Carotid Intima-Media Thickness Relates to Cardiovascular Events in Adults Aged
  • 2015
  • In: Hypertension. - 1524-4563. ; 65:4, s. 707-707
  • Journal article (peer-reviewed)abstract
    • Although atherosclerosis starts in early life, evidence on risk factors and atherosclerosis in individuals aged <45 years is scarce. Therefore, we studied the relationship between risk factors, common carotid intima-media thickness (CIMT), and first-time cardiovascular events in adults aged <45 years. Our study population consisted of 3067 adults aged <45 years free from symptomatic cardiovascular disease at baseline, derived from 6 cohorts that are part of the USE-IMT initiative, an individual participant data meta-analysis of general-population-based cohort studies evaluating CIMT measurements. Information on risk factors, CIMT measurements, and follow-up of the combined end point (first-time myocardial infarction or stroke) was obtained. We assessed the relationship between risk factors and CIMT and the relationship between CIMT and first-time myocardial infarction or stroke using a multivariable linear mixed-effects model and a Cox proportional-hazards model, respectively. During a follow-up of 16.3 years, 55 first-time myocardial infarctions or strokes occurred. Median CIMT was 0.63 mm. Of the risk factors under study, age, sex, diastolic blood pressure, body mass index, total cholesterol, and high-density lipoprotein cholesterol related to CIMT. Furthermore, CIMT related to first-time myocardial infarction or stroke with a hazard ratio of 1.40 per SD increase in CIMT, independent of risk factors (95% confidence interval, 1.11-1.76). CIMT may be a valuable marker for cardiovascular risk in adults aged <45 years who are not yet eligible for standard cardiovascular risk screening. This is especially relevant in those with an increased, unfavor-able risk factor burden.
  •  
36.
  • Engström, Gunnar, et al. (author)
  • Occupation, Marital Status, and Low-Grade Inflammation. Mutual Confounding or Independent Cardiovascular Risk Factors?
  • 2006
  • In: Arteriosclerosis, Thrombosis and Vascular Biology. - 1524-4636. ; 26:Dec 15, s. 643-648
  • Journal article (peer-reviewed)abstract
    • Objective - We explored the relationships between inflammatory proteins, occupation, and marital status, and their independent associations with incidence of cardiovascular disease ( CVD). Methods and Results - Five inflammation-sensitive proteins ( ISPs) ( fibrinogen, ceruloplasmin, haptoglobin, alpha 1-antitrypsin, orosomucoid) were measured in 6075 apparently healthy men. Incidence of coronary events and stroke was followed over 18 years in relation to occupation and marital status. All ISPs showed higher concentrations in divorced men and in manual workers. Except for fibrinogen, this remained significant after adjustments for confounding factors. Adjusted for traditional cardiovascular risk factors, incidence of coronary events was significantly increased in unskilled manual workers and in divorced men. The relative risks were slightly reduced after further adjustments for ISPs ( from 1.79 to 1.70 in unskilled manual workers; from 1.58 to 1.51 in divorced men). All ISPs were significantly associated with incidence of coronary events, after adjustments for traditional risk factors. This relationship was essentially unchanged after further adjustments for occupation and marital status. Conclusion - Inflammation could contribute to, but not fully explain, the increased cardiovascular risk in manual workers and divorced men. Although the ISPs vary greatly by occupational and marital status, this does not confound the relationship between ISPs and incidence of CVD.
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37.
  • Fernández, Leyden, et al. (author)
  • Co-PATHOgenex web application for assessing complex stress responses in pathogenic bacteria
  • 2024
  • In: Microbiology Spectrum. - : American Society for Microbiology. - 2165-0497. ; 12:1
  • Journal article (peer-reviewed)abstract
    • Pathogenic bacteria encounter various stressors while residing in the host. They respond through intricate mechanisms of gene expression regulation, ensuring their survival and adaptation. Understanding how bacteria adapt to different stress conditions through regulatory processes of specific genes requires exploring complex transcriptional responses using gene co-expression networks. We employed a large transcriptome data set comprising 32 diverse human bacterial pathogens exposed to the same 11 host-mimicking stress conditions. Using the weighted gene co-expression network analysis algorithm, we generated bacterial gene co-expression networks. By associating modular eigengene expression with specific stress conditions, we identified gene co-expression modules and stress-specific stimulons, including genes with unique expression patterns under specific stress conditions. Suggesting a new potential role of the frm operon in responding to bile stress in enteropathogenic bacteria demonstrates the effectiveness of our approach. We also revealed the regulation of streptolysin S genes, involved in the production, processing, and export of streptolysin S, a toxin responsible for the beta-hemolytic phenotype of group A Streptococcus. In a comparative analysis of stress responses in three Escherichia coli strains from the core transcriptome, we revealed shared and unique expression patterns across the strains, offering insights into convergent and divergent stress responses. To help researchers perform similar analyses, we created the user-friendly web application Co-PATHOgenex. This tool aids in deepening our understanding of bacterial adaptation to stress conditions and in deciphering complex transcriptional responses of bacterial pathogens.IMPORTANCEUnveiling gene co-expression networks in bacterial pathogens has the potential for gaining insights into their adaptive strategies within the host environment. Here, we developed Co-PATHOgenex, an interactive and user-friendly web application that enables users to construct networks from gene co-expressions using custom-defined thresholds (https://avicanlab.shinyapps.io/copathogenex/). The incorporated search functions and visualizations within the tool simplify the usage and facilitate the interpretation of the analysis output. Co-PATHOgenex also includes stress stimulons for various bacterial species, which can help identify gene products not previously associated with a particular stress condition. Unveiling gene co-expression networks in bacterial pathogens has the potential for gaining insights into their adaptive strategies within the host environment. Here, we developed Co-PATHOgenex, an interactive and user-friendly web application that enables users to construct networks from gene co-expressions using custom-defined thresholds (https://avicanlab.shinyapps.io/copathogenex/). The incorporated search functions and visualizations within the tool simplify the usage and facilitate the interpretation of the analysis output. Co-PATHOgenex also includes stress stimulons for various bacterial species, which can help identify gene products not previously associated with a particular stress condition.
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38.
  • Forsell, Karl, et al. (author)
  • Miljöhälsorapport barn i norr 2021 : Barns hälsa och miljö i norra Sverige
  • 2021
  • Reports (other academic/artistic)abstract
    • Denna rapport behandlar barns hälsa och miljöi Sveriges fyra nordligaste län, och baserasfrämst på nationella barnmiljöhälsoenkäter,särskilt den senaste från 2019. Dessa enkätundersökningarom tre åldersgrupper ger en bildav hur de som svarat upplevt barnens miljöochhälsoförhållanden, men har inte syftet attvetenskapligt fastställa samband mellan orsakoch verkan. Därför beskrivs enkätresultaten iljuset av bredare kunskaper, främst från forskningoch objektiva mätningar. Resultaten gerockså en viktig signal om hur läget och trendernaär i förhållandet till olika mål som berörmiljö och hälsa. De globala målen för hållbarutveckling som är grunden för Agenda 2030inrymmer i många fall de svenska miljö- ochfolkhälsomålen.Andelen barn i norra Sverige som rapporteratsha astma och/eller allergisk snuva har ökatfrån enkäten 2011 till enkäten 2019, och i denäldsta åldersgruppen (12-åringar) uppges astmavanligare i norra Sverige än i resten av landet.För besvär som upplevs bero på problem i inomhusmiljönses inga tydliga skillnader varkensedan förra enkäten eller mellan norra Sverigeoch övriga delar av landet. Trots att en ganskastor andel rapporterar att de har fuktskador ibostaden, så är det få som uppger att miljöni bostaden leder till besvär. Bland 12-åringarnaanges skolmiljön mer ofta orsaka besvär.Enligt enkäten utsätts nu endast cirka 1 % avbarnen för miljötobaksrök i bostaden, vilketkan jämföras med att drygt 6 % av de gravida inorra Sverige 2003 rökte under graviditeten .Var tionde tolvåring i norra Sverige lyssnardagligen på musik i hörlurar med hög volym.Fyra procent uppges ha tinnitus. Vidare uppgervar femte tolvåring att de blir mycket störda avljud när de är i skolan. I samma grupp har 12% svårt att somna på grund av trafikbuller.Luftkvaliteten utanför bostaden upplevs avsvarande från norra Sverige vara bättre jämförtmed övriga landet och skillnaden tycks haökat mellan 2011 och 2019. En lägre andel avtolvåringarna besväras ofta eller ibland av luktfrån bilavgaser i norra Sverige jämfört med iövriga landet, däremot förekommer hos en högreandel av barnen i norra Sverige vedeldningi bostaden. Andelen med vedeldande grannarhar dock tydligt minskat sedan 2011.Att ha sitt dricksvatten från egen brunn ärvanligast i Jämtland, övriga län ligger närmarelandet i övrigt. Samtidigt är andelen som testatsitt vatten från egen brunn lägst i Jämtland. Avde som testat uppgav dock ingen att vattnetbedömts otjänligt. Enkäten efterfrågade dockinte vad som testats, det är exempelvis oklartom testerna omfattat även arsenik och radon.Enligt enkäten uppnår knappt 40 % av barneni norra Sverige Livsmedelsverkets rekommenderadeintag av fisk (2-3 ggr/vecka). Närdet gäller fisk med risk för högt innehåll avmiljögifter så var det ovanligt med ett högreintag än Livsmedelsverkets rekommenderademaxintag.Rapporten berör utöver vad som ovannämnts ytterligare några områden av betydelse,t ex fysisk aktivitet och solskydd. Dendiskuterar också möjligheter till förbättringarav miljö-hälsosituationen i norra Sverige, ochutgör därmed ett underlag till det lokala ochregionala förändringsarbetet . Satsningar för attfå ner rökvanor i befolkningen är ett slåendeexempel på att man inom relativt kort tid kanfå effekter – och att miljöhälsoenkäter är ettbra verktyg för att följa ett förändringsarbete.Nästa enkät om barns hälsa och miljö i norraSverige beräknas genomföras 2027.
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39.
  • Gijsberts, Crystel M, et al. (author)
  • Race/Ethnic Differences in the Associations of the Framingham Risk Factors with Carotid IMT and Cardiovascular Events.
  • 2015
  • In: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 10:7
  • Journal article (peer-reviewed)abstract
    • Clinical manifestations and outcomes of atherosclerotic disease differ between ethnic groups. In addition, the prevalence of risk factors is substantially different. Primary prevention programs are based on data derived from almost exclusively White people. We investigated how race/ethnic differences modify the associations of established risk factors with atherosclerosis and cardiovascular events.
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40.
  • Giordano, Giuseppe Nicola, et al. (author)
  • Testing the association between social capital and health over time: a family-based design.
  • 2013
  • In: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 13:Jul,17
  • Journal article (peer-reviewed)abstract
    • The past decade has seen a vast increase in empirical research investigating associations between social capital and health outcomes. Literature reviews reveal 'generalized trust' and 'social participation' to be the most robust of the commonly used social capital proxies, both showing positive association with health outcomes. However, this association could be confounded by unmeasured factors, such as the shared environment. Currently, there is a distinct lack of social capital research that takes into account such residual confounding.
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41.
  • Hallengren, Erik, et al. (author)
  • Fasting levels of growth hormone are associated with carotid intima media thickness but are not affected by fluvastatin treatment
  • 2017
  • In: BMC Cardiovascular Disorders. - : Springer Science and Business Media LLC. - 1471-2261. ; 17:1
  • Journal article (peer-reviewed)abstract
    • Background: Growth hormone (GH) has been linked to cardiovascular disease but the exact mechanism of this association is still unclear. We here test if the fasting levels of GH are cross-sectionally associated with carotid intima media thickness (IMT) and whether treatment with fluvastatin affects the fasting level of GH. Methods: We examined the association between GH and IMT in 4425 individuals (aged 46-68 years) included in the baseline examination (1991-1994) of the Malmö Diet and Cancer cardiovascular cohort (MDC-CC). From that cohort we then studied 472 individuals (aged 50-70 years) who also participated (1994-1999) in the β-Blocker Cholesterol-Lowering Asymptomatic Plaque Study (BCAPS), a randomized, double blind, placebo-controlled, single-center clinical trial. Using multivariate linear regression models we related the change in GH-levels at 12 months compared with baseline to treatment with 40 mg fluvastatin once daily. Results: In MDC-CC fasting values of GH exhibited a positive cross-sectional relation to the IMT at the carotid bulb independent of traditional cardiovascular risk factors (p = 0.002). In a gender-stratified analysis the correlation were significant for males (p = 0.005), but not for females (p = 0.09). Treatment with fluvastatin was associated with a minor reduction in the fasting levels of hs-GH in males (p = 0.05) and a minor rise in the same levels among females (p = 0.05). Conclusions: We here demonstrate that higher fasting levels of GH are associated with thicker IMT in the carotid bulb in males. Treatment with fluvastatin for 12 months only had a minor, and probably not clinically relevant, effect on the fasting levels of hs-GH.
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42.
  • Hansen, Kristina, et al. (author)
  • Age at smoking initiation and self-rated health among second grade high school boys and girls in Scania, Sweden, a cross-sectional study.
  • 2015
  • In: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 15:1
  • Journal article (peer-reviewed)abstract
    • Smoking is usually initiated early in life and most adult regular smokers have started smoking before 18 years of age. A younger age at smoking initiation is associated with risk taking behaviours and worse health outcomes regarding psychological and somatic conditions, suggested to be caused by exposure during critical developmental periods. The present study aims to investigate self-rated health among second grade high school boys and girls related to age at smoking initiation (<14 years of age and ≥ 14 years of age) among current and former smokers, compared to never smokers.
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43.
  • Hansen, Kristina, et al. (author)
  • Early exposure to secondhand tobacco smoke and the development of allergic diseases in 4 year old children in Malmo, Sweden
  • 2010
  • In: BMC Pediatrics. - : Springer Science and Business Media LLC. - 1471-2431. ; 10
  • Journal article (peer-reviewed)abstract
    • Background: Earlier studies have shown an association between secondhand tobacco smoke and allergy development in children. Furthermore, there is an increased risk of developing an allergy if the parents have an allergy. However, there are only few studies investigating the potential synergistic effect of secondhand tobacco smoke and allergic heredity on the development of an allergy. Methods: The study was population-based cross-sectional with retrospective information on presence of secondhand tobacco smoke during early life. The study population consisted of children who visited the Child Health Care (CHC) centres in Malmo for their 4-year health checkup during 2006-2008 and whose parents answered a self-administered questionnaire (n = 4,278 children). The questionnaire was distributed to parents of children registered with the CHC and invited for the 4-year checkup during the study period. Results: There was a two to four times increased odds of the child having an allergy or having sought medical care due to allergic symptoms if at least one parent had an allergy, while there were rather small increased odds related to presence of secondhand smoke during the child's first month in life or at the age of 8 months. However, children with heredity for allergies and with presence of secondhand tobacco smoke during their first year in life had highly increased odds of developing an allergy and having sought medical care due to allergic symptoms at 4 years of age. Thus, there was a synergistic effect enhancing the independent effects of heredity and exposure to secondhand tobacco smoke on allergy development. Conclusions: Children with a family history of allergies and early exposure to secondhand tobacco smoke is a risk group that prevention and intervention should pay extra attention to. The tobacco smoke effect on children is an essential and urgent question considering it not being self chosen, possibly giving life lasting negative health effects and being possible to reduce.
  •  
44.
  • Hansen, Kristina, et al. (author)
  • The effect of smoking on carotid intima-media thickness progression rate and rate of lumen diameter reduction.
  • 2015
  • In: European Journal of Internal Medicine. - : Elsevier BV. - 1879-0828 .- 0953-6205.
  • Journal article (peer-reviewed)abstract
    • The purpose of the study was to investigate the long-term associations between smoking habits, environmental tobacco smoke exposure (ETS), carotid intima-media thickness (IMT) progression rate, and rate of lumen diameter reduction in the carotid artery during a 16-year follow-up. Another objective was to investigate if an effect of smoking on progression rate could be explained by increased low grade inflammation.
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45.
  •  
46.
  • Hillberg, Emil, et al. (author)
  • Active Network Management for All : ANM4L a collaborative research project
  • 2020
  • Reports (other academic/artistic)abstract
    • Developments of the power system are driven by the need to decrease the environmental footprint, to meet international climate goals, pushing for fossil‐free energy system. The transition towards clean energy will require power systems to adapt on a global scale with significant investments needed in fossil‐free electricity generation and transport. Renewable Energy Sources (RES) play an increasingly important role in the power system and may become the dominant sources of electricity. Significant RES are integrated in distribution grids globally, resulting in an increased need for distribution grids to perform new and complex tasks necessary for continued grid stability. The rapidity of small‐scale investments calls for agile, alternative grid development solutions. This agility is furthermore necessary to meet challenges arising from demand scenarios encompassing intermittent renewables along with electrification of transport and heat sectors. New technologies and markets are emerging to provide flexibility in consumption, generation, and power transfer capacity. Active Network Management (ANM) solutions provides alternative methods for planning and operation of the power system, through monitoring and control of multiple grid assets. This paper presents an overview of the ongoing project ANM4L, where a toolbox will be developed to support operation and planning of distribution grids.The project ANM4L (Active network management for all - anm4l.eu), will develop and demonstrate innovative ANM solutions for increasing integration of distributed generation in electricity distribution systems. ANM solutions will consider management of active and reactive power to avoid overload situations and maintain voltage limits. The goal is to decrease the need of curtailment of renewable energy, theoretically enabling further integration of distributed generation potentially even above the current design limitations of the electricity network. Core research and development activities of the ANM4L project include development of:  ANM methods for local energy systems.  Economic considerations to provide decision support.  A toolbox to support the planning and operation. The toolbox, methods and business models for ANM will be demonstrated in real life distribution grids in both Sweden and Hungary. Furthermore, the project will consider the replicability and scalability necessary for these ANM solutions to be applied across the EU. 
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48.
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49.
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50.
  • Ledman, Kristina, 1972-, et al. (author)
  • Being and becoming a female student and worker in gendered processes of vocational education and training
  • 2021
  • In: Gender and Education. - : Informa UK Limited. - 0954-0253 .- 1360-0516. ; 33:5, s. 514-530
  • Journal article (peer-reviewed)abstract
    • This article reports results of an ethnographic study of how girls are positioned, and position themselves, in relation to gender regimes in three vocational programmes in Swedish upper secondary education: Restaurant Management & Food, Health & Social Care, and Vehicle & Transport. The comparison shows that there are different possible feminine positions where the girls resist and comply to varying degrees both within and between the programmes, with expectations interrelated with discourses of consumption, caring and production. However, generally the position of emphasised femininity is most prominent and becoming a female worker in the programmes’ settings involves complying with feminine ideals of a caring discourse, regardless of whether the VET is oriented towards education for masculine production work, or feminine consumption work.
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Berglund, Göran (9)
Hillberg, Emil (9)
Janzon, Lars (9)
Edvall, Maria (9)
Bots, Michiel L. (9)
Rosvall, Jörgen (9)
Samuelsson, Olof (8)
Modén, Birgit (8)
Ohlsson, Henrik (7)
Johansson, Monica, 1 ... (7)
Mathiesen, Ellisiv B ... (7)
Östergren, Per Olof (6)
Beach, Dennis, 1956 (6)
Nylund, Mattias, 198 ... (6)
Rundek, Tatjana (6)
Nakti, Ghassen (6)
Öhrn, Elisabet, 1958 (5)
Pirouzifard, MirNabi (5)
Johansson, Monica (5)
Rosvall, Per-Åke (5)
Salonen, Jukka T. (5)
Grobbee, Diederick E ... (5)
Lonn, Eva M. (5)
Anderson, Todd J. (5)
Britton, Annie R. (5)
Melander, Olle (4)
Persson, Margaretha (4)
Lindström, M (4)
Östling, Gerd (4)
Nyberg, Fredrik, 196 ... (4)
Nijpels, Giel (4)
Li, Huiqi (4)
Mangrio, Elisabeth (4)
Isacsson, Sven-Olof (4)
Price, Jacqueline F. (4)
Nwaru, Chioma, 1980 (4)
Dekker, Jacqueline M ... (4)
Evans, Greg W. (4)
de Graaf, Jacqueline (4)
Holewijn, Suzanne (4)
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Swedish Environmental Protection Agency (1)
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