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  • 1.
    Abdulrazzaq, Sama
    et al.
    Department of Bariatric Surgery/Bariatric Medicine, Hamad General Hospital, Doha, Qatar.
    Elhag, Wahiba
    Department of Bariatric Surgery/Bariatric Medicine, Hamad General Hospital, Doha, Qatar.
    El Ansari, Walid
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Surgery, Hamad General Hospital, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar.
    Mohammad, Amjad Salah
    Departments of General Surgery, Hamad General Hospital, Doha, Qatar.
    Sargsyan, Davit
    Department of Metabolic and Bariatric Surgery, Hamad General Hospital, Doha, Qatar / Weill Cornell Medicine-Qatar, Doha, Qatar.
    Bashah, Moataz
    Department of Metabolic and Bariatric Surgery, Hamad General Hospital, Doha, Qatar / Weill Cornell Medicine-Qatar, Doha, Qatar.
    Is Revisional Gastric Bypass as Effective as Primary Gastric Bypass for Weight Loss and Improvement of Comorbidities?2020In: Obesity Surgery, ISSN 0960-8923, E-ISSN 1708-0428, Vol. 30, p. 1219-1229Article in journal (Refereed)
    Abstract [en]

    Background: Revisional gastric bypass (R-RYGB) surgery is utilized for the management of inadequate weight loss or weight regain observed after some cases of bariatric surgeries. Data on the mid-term effectiveness of primary gastric bypass (P-RYGB) compared to R-RYGB (e.g., post sleeve gastrectomy or gastric banding) are controversial. Methods: Retrospective chart review of all patients who received P-RYGB and R-RYGB (January 2011 - June 2015) at our center. One hundred and twenty patients who underwent P-RYGB and 34 R-RYGB who completed 18 months follow-up were included. We compared the effectiveness of P-RYGB with R-RYGB by assessing four anthropometric, two glycemic, and four lipid parameters, as well as the control of type 2 diabetes (T2DM), hypertension and dyslipidemia in terms of remission, improvement, persistence, relapse and de novo. The current study also assessed mortality and complications rates. Results: There were no significant differences in the baseline characteristics of patients who received P-RYGB with those who received R-RYGB in terms of age, gender and preoperative BMI. However, at 18 months: a) Patients who received P-RYGB had lower mean weight (P = 0.001) and BMI (P <0.001), reflected by a higher mean delta BMI (P = 0.02), TWL%(P <0.0001) and EWL%(P < 0.0001); b) No differences were observed between the two patients groups in terms of glycemic parameters, lipid profiles, and control of T2DM, hypertension, and dyslipidemia; and, c) No deaths were reported among both patients groups, and complication rates were comparable. Conclusion: Although R-RYGB effectively addressed inadequate weight loss, weight regain and recurrence of comorbidities after restrictive bariatric surgery, R-RYGB resulted in inferior weight loss compared to P-RYGB. There were no significant differences between the two procedures in terms of their clinical control of T2DM, hypertension and dyslipidemia. Both procedures exhibited comparable complication rates. 

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  • 2.
    Airaksinen, Jaakko
    et al.
    Medicum, University of Helsinki, Finland.
    Pentti, Jaana
    Clinicum, University of Helsinki, Finland / Finnish Institute of Occupational Health, Helsinki, Finland.
    Suominen, Sakari
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Public Health, University of Turku, Finland.
    Vahtera, Jussi
    Department of Public Health, University of Turku, Finland / Turku University Hospital, Finland.
    Kivimäki, Mika
    Clinicum, University of Helsinki, Finland / Department of Epidemiology and Public Health, University College, London, UK.
    An Example of How Immortal Time Bias Can Reverse the Results of an Observational Study2020In: Epidemiology, ISSN 1044-3983, E-ISSN 1531-5487, Vol. 31, no 2, p. e19-e20Article in journal (Refereed)
  • 3.
    Al-Yahri, Omer
    et al.
    Department of General Surgery, Hamad General Hospital, Doha, Qatar.
    Abdelaal, Abdelrahman
    Department of General Surgery, Hamad General Hospital, Doha, Qatar.
    El Ansari, Walid
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Surgery, Hamad General Hospital, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar.
    Farghaly, Hanan
    Department of Lab Medicine & Pathology, Hamad General Hospital, Doha, Qatar.
    Murshed, Khaled
    Department of Lab Medicine & Pathology, Hamad General Hospital, Doha, Qatar.
    Zirie, Mahmoud A.
    Department of Endocrinology, Hamad General Hospital, Doha, Qatar.
    Al Hassan, Mohamed S.
    Department of General Surgery, Hamad General Hospital, Doha, Qatar.
    First ever case report of co-occurrence of hobnail variant of papillary thyroid carcinoma and intrathyroid parathyroid adenoma in the same thyroid lobe2020In: International journal of surgery case reports, ISSN 2210-2612, E-ISSN 2210-2612, Vol. 70, p. 40-52Article in journal (Refereed)
    Abstract [en]

    Introduction: The hobnail variant of papillary thyroid cancer (PTC) is rare. Intrathyroid parathyroid adenoma (ITPA) is also rare. Co-ocurrence of PTC and ITPA in the same thyroid lobe is extremely rare. Likewise, primary hyperparathyroidism with such non-medullary thyroid carcinoma is rare. The specific molecular profile of hobnail PTC (HPTC) is different from the classic, poorly differentiated and anaplastic variants and may contribute to its aggressive behavior. HPTC's genetic profile remains unclear. Presentation of case: A 61-year-old woman presented to our endocrine clinic with generalized aches, bone pain, polyuria, and right neck swelling of a few months’ duration. Laboratory findings revealed hypercalcemia and hyperparathyroidism. Ultrasound of the neck showed 4.6 cm complex nodule within the right thyroid lobe. Sestamibi scan suggested parathyroid adenoma in the right thyroid lobe. Fine-needle aspiration (FNA) revealed atypical follicular lesion of undetermined significance. She underwent right lobectomy, which normalized the intraoperative intact parathyroid hormone levels. Final pathology with immunohistochemical stains demonstrated HPTC and IPTA (2 cm each). Next-generation sequencing investigated the mutation spectrum of HPTC and detected BRAFV600E mutation. Conclusions: A parathyroid adenoma should not exclude the diagnosis of thyroid carcinoma. Thyroid evaluation is needed for patients with primary hyperparathyroidism to prevent missing concurrent thyroid cancers. Cytomorphologic features to distinguish thyroid from parathyroid cells on FNA cytology must be considered. Immunohistochemical stains are important. BRAFV600E is the most common mutation in HPTC. This is possibly the first reported case of HPTC and ITPA co-occurring within the same thyroid lobe. Studies that define other molecular abnormalities may be useful as therapeutic targets. © 2020 The Author(s)

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  • 4.
    Bjerkeli, Pernilla J.
    et al.
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR).
    Skoglund, Ingmarie
    Department of Primary Health Care, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden / Research and Development Department, Region Västra Götaland, Borås, Sweden.
    Holmgren, Kristina
    Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Does early identification of high work related stress affect pharmacological treatment of primary care patients?: Analysis of Swedish pharmacy dispensing data in a randomised control study2020In: BMC Family Practice, ISSN 1471-2296, E-ISSN 1471-2296, Vol. 21, no 1, article id 70Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The study is part of a randomised controlled trial with the overall aim to evaluate if use of the Work Stress Questionnaire (WSQ), combined with feedback at consultation, can be used by healthcare professionals in primary health care to prevent sickness absence. The specific aim of the present study was to investigate whether there were differences in pharmacy dispensing of prescription medications between the intervention group and the control group. METHODS: The study was a randomized controlled trial. Non-sick-listed employed women and men, aged 18 to 64 years, seeking care at primary health care centres (PHCCs) were eligible participants. The intervention included early identification of work-related stress by the WSQ, general practitioner (GP) training and GP feedback at consultation. Pharmacy dispensing data from the Swedish Prescription Drug Register for a period of 12 months following the intervention was used. Primary outcomes were the number of different medications used, type of medication and number of prescribing clinics. Data was analysed using Mann Whitney U tests and chi-square tests. RESULTS: The study population included 271 individuals (132 in the intervention group and 139 in the control group). The number of different medications used per individual did not differ significantly between the control group (median 4.0) and the intervention group (median 4.0, p-value 0.076). The proportion of individuals who collected more than 10 different medications was higher in the control group than in the intervention group (15.8% versus 4.5%, p = 0.002). In addition, the proportion of individuals filling prescriptions issued from more than three different clinics was higher in the control group than in the intervention group (17.3% versus 6.8%, p = 0.007). CONCLUSION: Systematic use of the WSQ combined with training of GPs and feedback at consultation may affect certain aspects of pharmacological treatment in primary health care patients. In this randomised control trial, analysis of pharmacy dispensing data show that patients in the intervention group had less polypharmacy and filled prescriptions issued from a smaller number of different clinics. TRIAL REGISTRATION: ClinicalTrials.gov. Identifier: NCT02480855. Registered 20 May 2015.

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  • 5.
    Cheng, Lan
    et al.
    Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany / Faculty of Mathematics and Computer Science, University of Bremen, Germany.
    Pohlabeln, Hermann
    Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
    Ahrens, Wolfgang
    Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany / Faculty of Mathematics and Computer Science, University of Bremen, Germany.
    Lauria, Fabio
    Institute of Food Sciences, National Research Council, Avellino, Italy.
    Veidebaum, Toomas
    Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia.
    Chadjigeorgiou, Charalambos
    Research and Education Institute of Child Health, Strovolos, Cyprus.
    Molnár, Dénes
    Department of Pediatrics, Medical School, University of Pécs, Hungary.
    Eiben, Gabriele
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR).
    Michels, Nathalie
    Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Belgium.
    Moreno, Luis A.
    Genud (Growth, Exercise, Nutrition and Development) Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Centro de Investigacion Biomedica en Red Fisiopatologia de la Obesidad y Nutricion (CIBERObn), University of Zaragoza, Spain.
    Page, Angie S.
    Centre for Exercise, Nutrition and Health Sciences, University of Bristol, Bristol, United Kingdom.
    Pitsiladis, Yannis
    Collaborating Centre of Sports Medicine, University of Brighton, United Kingdom.
    Hebestreit, Antje
    Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
    Cross-sectional and longitudinal associations between physical activity, sedentary behaviour and bone stiffness index across weight status in European children and adolescents2020In: International Journal of Behavioral Nutrition and Physical Activity, ISSN 1479-5868, E-ISSN 1479-5868, Vol. 17, no 1, article id 54Article in journal (Refereed)
    Abstract [en]

    Background: The associations between physical activity (PA), sedentary behaviour (SB) and bone health may be differentially affected by weight status during growth. This study aims to assess the cross-sectional and longitudinal associations between PA, SB and bone stiffness index (SI) in European children and adolescents, taking the weight status into consideration. Methods: Calcaneus SI was first measured by quantitative ultrasound among children aged 2-9 years old in 2007/08. It was measured again after 2 years in the IDEFICS study and after 6 years in the I. Family study. A sample of 2008 participants with time spent at sports clubs, watching TV and playing computer/games self-reported by questionnaire, and a subsample of 1037 participants with SB, light PA (LPA) and moderate-to-vigorous PA (MVPA) objectively measured using Actigraph accelerometers were included in the analyses. Weight status was defined as thin/normal and overweight/obese according to the extended International Obesity Task Force criteria. Linear mixed-effects models were used to estimate the cross-sectional and longitudinal associations between PA, SB and SI percentiles, stratified by weight status. Results: The cross-sectional association between weekly duration of watching TV and SI percentiles was negative in thin/normal weight group (β =-0.35, p = 0.008). However, baseline weekly duration of watching TV (β =-0.63, p = 0.021) and change after 2 years (β =-0.63, p = 0.022) as well as the change in weekly duration of playing computer/games after 6 years (β =-0.75, p = 0.019) were inversely associated with corresponding changes in SI percentiles in overweight/obese group. Change in time spent at sports clubs was positively associated with change in SI percentiles after 2 years (β = 1.28, p = 0.001), with comparable effect sizes across weight status. In the subsample with accelerometer data, we found a positive cross-sectional association between MVPA and SI percentiles in thin/normal weight group. Baseline MVPA predicted changes in SI percentiles after 2 and 6 years in all groups. Conclusions: Our results suggested the beneficial effect of PA on SI. However, the increasing durations of screen-based SB might be risk factors for SI development, especially in overweight/obese children and adolescents. © 2020 The Author(s).

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  • 6.
    El Ansari, Walid
    et al.
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Qatar / College of Medicine, Qatar University, Qatar.
    El-Ansari, Kareem
    Hamad General Hospital, Hamad Medical Corporation, Qatar.
    Missing Something? Comparisons of Effectiveness and Outcomes of Bariatric Surgery Procedures and Their Preferred Reporting: Refining the Evidence Base.2020In: Obesity Surgery, ISSN 0960-8923, E-ISSN 1708-0428Article, review/survey (Refereed)
    Abstract [en]

    Comparisons of effectiveness of bariatric surgery (BS) procedures encompass weight loss, metabolic/clinical outcomes, and improvements or worsening of comorbidities. Post-operative physical activity (PA) and diet influence such outcomes but are frequently not included in comparisons of effectiveness. We assessed the value and necessity of including post-operative PA/diet data when comparing effectiveness of BS. Including post-operative PA/diet data has significant benefits for BS and patients. The paper proposes an explicit preferred reporting system (Preferred REporting of post-operative PHYsical activity and Diet data in comparisons of BS effectiveness: PRE-PHYD Bariatric). Including post-operative PA/diet data could result in more accurate appraisals of effectiveness of BS procedures. This could translate into better 'individualized' BS by achieving a better 'fit' between patient and procedure.

  • 7.
    El Ansari, Walid
    et al.
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha 3050, Qatar / College of Medicine, Qatar University, Doha 2713, Qatar .
    El-Menyar, Ayman
    Department of Surgery, Trauma and Vascular Surgery, Clinical Research, Hamad General Hospital, Doha 3050, Qatar / Clinical Medicine, Weill Cornell Medical School, Doha 24144, Qatar.
    Is routine preoperative esophagogastroduodenscopy prior to bariatric surgery mandatory?: Protocol for a systematic review and meta-analysis2020In: International Journal of Surgery Protocols, ISSN 2468-3574, Vol. 22, p. 1-5Article in journal (Refereed)
    Abstract [en]

    Introduction: Routine preoperative esophagogastroduodenscopy (p-EGD) prior to bariatric surgery (BS) is currently widely undertaken, and hence an important issue with many clinical and financial repercussions. Yet, the true extent of why p-EGD is routinely undertaken for all bariatric patients remains not well understood. Methods and analysis: To address this, we will undertake a systematic review and meta-analysis of routine p-EGD prior to BS from around the world. This protocol describes the methodological approach to be adopted and outlines the search strategies and eligibility criteria that will be employed to identify and select studies, and the way by which data from the selected studies will be extracted for analysis. PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), WHO International Clinical Trials Registry Platform, Cochrane Library, MEDLINE, Scopus, clinicaltrials.gov and Google scholar will be searched from 01 January 2000 to 30 April 2019 for original studies written in English that provided prevalence estimates of the outcomes of routine p-EGD prior to BS. STROBE criteria will assess the methodological quality of the selected studies. The use of fixed or random effects model will depend on the results of statistical tests for heterogeneity. Publication bias will be visually estimated by assessing funnel plots. Pooled estimates will be calculated. This protocol conforms to the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines and has been submitted for registration at the PROSPERO International Prospective Register of systematic reviews. No ethical clearance is required for this study. This review will be published in a peer- reviewed journal and will be presented at various national and international conferences. © 2020 The Author(s)

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  • 8.
    El Ansari, Walid
    et al.
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Surgery, Hamad General Hospital, Qatar / College of Medicine, Qatar University, Qatar.
    Salam, Abdul
    Neuroscience Institute, Hamad General Hospital, Qatar.
    Suominen, Sakari
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR).
    Is alcohol consumption associated with poor perceived academic performance?: Survey of undergraduates in Finland2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 4, article id 1369Article in journal (Refereed)
    Abstract [en]

    The relationship between academic performance and alcohol consumption among students remains inconsistent. We assessed this relationship, controlling for sociodemographic characteristics across seven faculties at the University of Turku (1177 undergraduates). An online questionnaire assessed: seven sociodemographic characteristics (age, gender, year/discipline of study, accommodation type, being in intimate relationship, parental education, and income sufficiency); two perceived academic performance (students’ subjective importance of achieving good grades and students’ appraisal of their academic performance compared to peers); and six alcohol consumption behaviors (length of time, amount consumed, frequency, heavy episodic drinking, problem drinking, and possible alcohol dependence). Simple logistic regression assessed relationships between sociodemographic and academic variables with alcohol consumption behaviors; multiple logistic regression assessed the same relationships after controlling for all other variables. Students reported long duration and large amount of drinking (46% and 50%), high frequency of drinking (41%), heavy episodic drinking (66%), problem drinking (29%), and possible alcohol dependence (9%). After controlling, gender was associated with all alcohol consumption behaviors, followed by religiosity (associated with four alcohol behaviors), living situation, marital status, age (each associated with two alcohol behaviors), and parental education and year of study (each associated with one alcohol behavior). Study discipline, income sufficiency, importance of achieving good grades, and academic performance compared to peers were not associated with any alcohol behaviors. Universities need to assess problem drinking and alcohol use disorders among students. Prevention strategies are required to reduce risk. Health promotion efforts could focus on beliefs and expectations about alcohol and target student groups at risk for more efficient and successful efforts. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.

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  • 9.
    Evans, Brittany E.
    et al.
    Behavioural Science Institute, Radboud University, Nijmegen, Netherlands / Centre for Research on Child and Adolescent Mental Health, Karlstad University, Sweden.
    Huizink, Anja
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Section of Clinical Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Netherlands.
    Greaves-Lord, Kirstin
    Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, Netherlands.
    Tulen, Joke H. M.
    Department of Psychiatry, Erasmus University Medical Center, Rotterdam, Netherlands.
    Roelofs, Karin
    Behavioural Science Institute, Radboud University, Nijmegen, Netherlands / Donders Institute for Brain Cognition and Behaviour, Radboud University, Nijmegen, Netherlands.
    van der Ende, Jan
    Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, Netherlands.
    Urbanicity, biological stress system functioning and mental health in adolescents2020In: PLoS ONE, E-ISSN 1932-6203, Vol. 15, no 3, article id e0228659Article in journal (Refereed)
    Abstract [en]

    Growing up in an urban area has been associated with an increased chance of mental health problems in adults, but less is known about this association in adolescents. We examined whether current urbanicity was associated with mental health problems directly and indirectly via biological stress system functioning. Participants (n = 323) were adolescents from the Dutch general population. Measures included home and laboratory assessments of autonomic nervous system and hypothalamic-pituitary-adrenal axis functioning, neighborhood-level urbanicity and socioeconomic status, and mother- and adolescent self-reported mental health problems. Structural equation models showed that urbanicity was not associated with mental health problems directly. Urbanicity was associated with acute autonomic nervous system and hypothalamic-pituitary-adrenal axis reactivity such that adolescents who lived in more urban areas showed blunted biological stress reactivity. Furthermore, there was some evidence for an indirect effect of urbanicity on mother-reported behavioral problems via acute autonomic nervous system reactivity. Urbanicity was not associated with overall autonomic nervous system and hypothalamic-pituitary-adrenal axis reactivity or basal hypothalamic-pituitary-adrenal axis functioning. Although we observed some evidence for associations between urbanicity, biological stress reactivity and mental health problems, most of the tested associations were not statistically significant. Measures of long-term biological stress system functioning may be more relevant to the study of broader environmental factors such as urbanicity. 

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  • 10.
    Evans, Brittany E.
    et al.
    Behavioural Science Institute, Radboud University, Nijmegen, Netherlands / Centre for Research on Child and Adolescent Mental Health, Karlstad, Sweden.
    van der Ende, J.
    Erasmus University Medical Center, CN, Rotterdam, Netherlands.
    Greaves-Lord, Kirstin
    Erasmus University Medical Center, CN, Rotterdam, Netherlands.
    Huizink, Anja C.
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Section of Clinical Developmental Psychology, Amsterdam Public Health Research Institute, Vrije University Amsterdam, BT, Amsterdam, Netherlands.
    Beijers, Roseriet
    Behavioural Science Institute, Radboud University, Nijmegen, Netherlands / Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands.
    de Weerth, Carolina
    Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands.
    Urbanicity, hypothalamic-pituitary-adrenal axis functioning, and behavioral and emotional problems in children: A path analysis2020In: BMC Psychology, E-ISSN 2050-7283, Vol. 8, no 1, article id 12Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Urbanization is steadily increasing worldwide. Previous research indicated a higher incidence of mental health problems in more urban areas, however, very little is known regarding potential mechanisms underlying this association. We examined whether urbanicity was associated with mental health problems in children directly, and indirectly via hypothalamic-pituitary-adrenal (HPA)-axis functioning. METHODS: Utilizing data from two independent samples of children we examined the effects of current urbanicity (n = 306, ages seven to 12 years) and early childhood urbanicity (n = 141, followed from birth through age 7 years). Children's mothers reported on their mental health problems and their family's socioeconomic status. Salivary cortisol samples were collected during a psychosocial stress procedure to assess HPA axis reactivity to stress, and at home to assess basal HPA axis functioning. Neighborhood-level urbanicity and socioeconomic conditions were extracted from Statistics Netherlands. Path models were estimated using a bootstrapping procedure to detect indirect effects. RESULTS: We found no evidence for a direct effect of urbanicity on mental health problems, nor were there indirect effects of urbanicity through HPA axis functioning. Furthermore, we did not find evidence for an effect of urbanicity on HPA axis functioning or effects of HPA axis functioning on mental health problems. CONCLUSIONS: Possibly, the effects of urbanicity on HPA axis functioning and mental health do not manifest until adolescence. An alternative explanation is a buffering effect of high family socioeconomic status as the majority of children were from families with an average or high socioeconomic status. Further studies remain necessary to conclude that urbanicity does not affect children's mental health via HPA axis functioning.

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  • 11.
    Gillsjö, Catharina
    et al.
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). College of Nursing, University of Rhode Island, Kingston, United States.
    Nässén, Kristina
    Academy of Care, Working Life and Social Welfare, University of Borås, Sweden.
    Berglund, Mia
    University of Skövde, Digital Health Research (DHEAR). University of Skövde, School of Health Sciences.
    Suffering in silence: a qualitative study of older adults’ experiences of living with long-term musculoskeletal pain at home2020In: European Journal of Ageing, ISSN 1613-9372, E-ISSN 1613-9380Article in journal (Refereed)
    Abstract [en]

    Long-term musculoskeletal pain is a major, disabling, and often undertreated health problem among the increasing number of older adults worldwide. However, there is limited knowledge of community-dwelling older adults’ experiences of living with this type of pain. The aim of the study was to deepen the understanding of the phenomenon: how older adults experience living with long-term musculoskeletal pain at home. The study design was an inductive qualitative Reflective Lifeworld Research approach grounded in phenomenological epistemology. Data were obtained from 20 community-dwelling older adults, aged 72–97 years. Data were collected through open-ended interviews and analyzed to understand the meanings of the phenomenon. The essence of the phenomenon entailed suffering in silence and encompassed the following constituents: loneliness and restrictions in daily living; ways to endure and distract from pain; not being taken seriously; fear of the future; and valuing joy and meaning in life. Living with long-term musculoskeletal pain restricts access to the world and leads to a suffering in silence. Finding ways to endure and distract from pain and to focus on issues that give joy and meaning in life is predominant in efforts to balance restraints from pain in life. Suffering is reinforced by loneliness, a sense of not being taken seriously by health care providers and fear of an uncertain future. It is necessary to foster increased attentiveness and sensitivity in meeting the needs of each older adult and provide a care that alleviates suffering and preserves and promotes health and well-being. © 2020, The Author(s).

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  • 12.
    Graffe, María Isabel Mesana
    et al.
    Growth, Exercise, NUtrition and Development (GENUD) Research Group, University of Zaragoza, Spain / Instituto Agroalimentario de Aragón (IA2), Spain / Instituto de Investigación Sanitaria Aragón (IIS Aragón), Spain / Red de Salud Materno-infantil y del Desarrollo (SAMID), Spain.
    Pala, V.
    Epidemiology and Prevention Unit, Department of Research, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy.
    De Henauw, S.
    Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
    Eiben, Gabriele
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Section for Epidemiology and Social Medicine, Institute of Medicine Sahlgrenska Academy, University of Gothenburg, Sweden.
    Hadjigeorgiou, C.
    Research and Education Institute of Child Health, Strovolos, Cyprus.
    Iacoviello, L.
    Laboratory of Molecular and Nutritional Epidemiology, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, IS, Italy.
    Intemann, T.
    Department of Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany / Institute for Public Health and Nursing– IPP, Bremen University, Germany.
    Jilani, H.
    Department of Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany / Institute for Public Health and Nursing– IPP, Bremen University, Germany.
    Molnar, D.
    Department of Paediatrics, Medical Faculty, University of Pécs, Hungary.
    Russo, P.
    Institute of Food Sciences, National Research Council, Avellino, Italy.
    Veidebaum, T.
    National Institute for Health Development, Tallinn, Estonia.
    Moreno, L. A.
    Growth, Exercise, NUtrition and Development (GENUD) Research Group, University of Zaragoza, Spain / Instituto Agroalimentario de Aragón (IA2), Saragossa, Spain / Instituto de Investigación Sanitaria Aragón (IIS Aragón), Saragossa, Spain / Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain.
    Dietary sources of free sugars in the diet of European children: the IDEFICS Study2020In: European Journal of Nutrition, ISSN 1436-6207, E-ISSN 1436-6215, Vol. 59, no 3, p. 979-989Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To report dietary free sugars consumption and their different types and food sources in European children.

    METHODS: The present study is based on the IDEFICS study, a European multicenter cohort study in children (2-9 years old) from eight countries, comprising 8308 children (51.4% males). Dietary intake of the previous 24 h was assessed using a computer-assisted 24-h dietary recalls (24-HDR) and the different types of sugars were assessed using the German food composition database.

    RESULTS: Mean total energy intake was 1720 (SD 477) kcal/d for boys and 1631 (SD 451) kcal/d for girls. Total sugars intake was 98 (SD 52) g/day for boys and 93 (SD 49) g/day for girls. Free sugars intake was 81 (SD 49) g/day for boys and 77 (SD 47) g/day for girls. Girls had significantly lower intakes of energy, total and free sugars compared with than boys but did not differ in terms of percent of energy from total (23%) or free sugars (18%). There were large variations between countries in average % energy from free sugars (ranging from 13% in Italy to 27% in Germany). Less than 20% of children were within the recommended intake of 10% of energy from free sugars. The food groups that contributed substantially to free sugars intakes were "Fruit juices", "Soft drinks", "Dairy" and "Sweets and candies".

    CONCLUSIONS: The contribution of free sugars to total energy intake in European children is higher than recommendations. The main food contributors to free sugars intake are sweetened beverages ("Fruit juices" and "Soft drinks"). It is especially important to reduce children's intake of free sugars, focusing in target population on certain foods and food groups.

  • 13.
    Gwozdz, Wencke
    et al.
    Faculty of Agricultural Sciences, Nutritional Sciences and Environmental Management, Justus-Liebig-Universität Gießen, Gießen, Germany / Department of Management, Society, and Communication, CBS Sustainability, Copenhagen Business School, Frederiksberg, Denmark.
    Reisch, Lucia A.
    Department of Management, Society, and Communication, CBS Sustainability, Copenhagen Business School, Frederiksberg, Denmark.
    Eiben, Gabriele
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR).
    Hunsberger, Monica L.
    Department of Public Health and Community Medicine, The Sahlgrenska Academy, University of Gothenburg, Arvid Wallgrens Backe, Gothenburg, Sweden.
    Konstabel, Kenn
    Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia.
    Kovacs, Eva
    Department of Pediatrics, Medical School, University of Pécs, H-7622 Pécs, Hungary.
    Luszczki, Edyta
    Medical Faculty, University of Rzeszów, Rzeszów, Poland.
    Mazur, Artur
    Medical Faculty, University of Rzeszów, ul.Warszawska 26 a, Rzeszów, Poland.
    Mendl, E.
    Department of Pediatrics, Medical School, University of Pécs, H-7622 Pécs, Hungary.
    Saamel, M.
    Department of Surveillance and Evaluation, National Institute for Health Development,Tallinn, Estonia.
    Wolters, Maike
    Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany.
    The effect of smileys as motivational incentives on children's fruit and vegetable choice, consumption and waste: A field experiment in schools in five European countries2020In: Food Policy, ISSN 0306-9192, E-ISSN 1873-5657, article id 101852Article in journal (Refereed)
    Abstract [en]

    To assess whether smiley stamps work as a motivational incentive to promote fruit and vegetable eating among children, we conducted a field experiment in ten primary schools in five European countries using one control and one treatment school per country. The six-week experiment was split into three two-week phases before, during and after the smiley was implemented. During the smiley phase, the children received a smiley stamp for choosing a portion of fruits or vegetables. We find an increase attributed to the smiley stamp on children's fruit and vegetable choice and consumption, but also waste. Comparing the effects across countries, we observe significant variations in the smiley effect. This study thus demonstrates, in general, that a low-cost, easy-to-implement incentive such as a smiley stamp has the potential to motivate school children to increase their fruit and vegetable consumption; the study simultaneously underscores the high relevance of context for the effects of incentives. 

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  • 14.
    Heikkilä, Katriina
    et al.
    Department of Health Services Research and Policy London School of Hygiene and Tropical Medicine London United Kingdom / Finnish Institute of Occupational Health Tampere, Helsinki and Turku Finland.
    Pentti, Jaana
    Department of Public Health University of Turku and Turku University Hospital Turku Finland / Department of Public Health University of Helsinki Finland.
    Madsen, Ida E. H.
    National Research Centre for the Working Environment Copenhagen Denmark.
    Lallukka, Tea
    Finnish Institute of Occupational Health Tampere, Helsinki and Turku Finland / Department of Public Health University of Helsinki Finland.
    Virtanen, Marianna
    Finnish Institute of Occupational Health Tampere, Helsinki and Turku Finland / Department of Public Health and Caring Sciences University of Uppsala Sweden / Stress Research Institute University of Stockholm Sweden.
    Alfredsson, Lars
    Centre for Occupational and Environmental Medicine Stockholm County Council Stockholm Sweden / Institute of Environmental Medicine Karolinska Institute Stockholm Sweden.
    Bjorner, Jakob
    National Research Centre for the Working Environment Copenhagen Denmark.
    Borritz, Marianne
    Department of Occupational and Environmental Medicine Bispebjerg Hospital Copenhagen University Copenhagen Denmark.
    Brunner, Eric
    Department of Epidemiology and Public Health University College London London United Kingdom.
    Burr, Hermann
    Federal Institute for Occupational Safety and Health Berlin Germany.
    Ferrie, Jane E.
    Department of Epidemiology and Public Health University College London London United Kingdom / Bristol Medical School: Population Health Sciences University of Bristol United Kingdom.
    Knutsson, Anders
    Department of Health Sciences Mid Sweden University Sundsvall Sweden.
    Koskinen, Aki
    Finnish Institute of Occupational Health Tampere, Helsinki and Turku Finland.
    Leineweber, Constanze
    Stress Research Institute University of Stockholm Sweden.
    Magnusson Hanson, Linda L.
    Stress Research Institute University of Stockholm Sweden.
    Nielsen, Martin L.
    Lægekonsulenten AS3 Companies Århus Denmark.
    Nyberg, Solja T.
    Department of Public Health University of Helsinki Finland.
    Oksanen, Tuula
    Finnish Institute of Occupational Health Tampere, Helsinki and Turku Finland.
    Pejtersen, Jan H.
    VIVE The Danish Center for Social Science Research Copenhagen Denmark.
    Pietiläinen, Olli
    Department of Public Health University of Helsinki Finland.
    Rahkonen, Ossi
    Department of Public Health University of Helsinki Finland.
    Rugulies, Reiner
    National Research Centre for the Working Environment Copenhagen Denmark / Department of Public Health and Department of Psychology University of Copenhagen Denmark.
    Singh-Manoux, Archana
    Department of Epidemiology and Public Health University College London London United Kingdom.
    Steptoe, Andrew
    Department of Epidemiology and Public Health University College London London United Kingdom.
    Suominen, Sakari
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Public Health University of Turku and Turku University Hospital Turku Finland.
    Theorell, Töres
    Stress Research Institute University of Stockholm Sweden.
    Vahtera, Jussi
    Department of Public Health University of Turku and Turku University Hospital Turku Finland.
    Väänänen, Ari
    Finnish Institute of Occupational Health Tampere, Helsinki and Turku Finland.
    Westerlund, Hugo
    Stress Research Institute University of Stockholm Sweden.
    Kivimäki, Mika
    Department of Public Health University of Helsinki Finland / Department of Epidemiology and Public Health University College London London United Kingdom.
    Job Strain as a Risk Factor for Peripheral Artery Disease: A Multi-Cohort Study2020In: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, ISSN 2047-9980, E-ISSN 2047-9980, Vol. 9, no 9Article in journal (Refereed)
    Abstract [en]

    Background Job strain is implicated in many atherosclerotic diseases, but its role in peripheral artery disease (PAD) is unclear. We investigated the association of job strain with hospital records of PAD, using individual-level data from 11 prospective cohort studies from Finland, Sweden, Denmark, and the United Kingdom. Methods and Results Job strain (high demands and low control at work) was self-reported at baseline (1985-2008). PAD records were ascertained from national hospitalization data. We used Cox regression to examine the associations of job strain with PAD in each study, and combined the study-specific estimates in random effects meta-analyses. We used τ2, I2, and subgroup analyses to examine heterogeneity. Of the 139 132 participants with no previous hospitalization with PAD, 32 489 (23.4%) reported job strain at baseline. During 1 718 132 person-years at risk (mean follow-up 12.8 years), 667 individuals had a hospital record of PAD (3.88 per 10 000 person-years). Job strain was associated with a 1.41-fold (95% CI, 1.11-1.80) increased average risk of hospitalization with PAD. The study-specific estimates were moderately heterogeneous (τ2=0.0427, I2: 26.9%). Despite variation in their magnitude, the estimates were consistent in both sexes, across the socioeconomic hierarchy and by baseline smoking status. Additional adjustment for baseline diabetes mellitus did not change the direction or magnitude of the observed associations. Conclusions Job strain was associated with small but consistent increase in the risk of hospitalization with PAD, with the relative risks on par with those for coronary heart disease and ischemic stroke.

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  • 15.
    Iglesia, Iris
    et al.
    Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, 50009 Zaragoza, Spain / Instituto Agroalimentario de Aragón (IA2), 50013, Zaragoza, Spain / Instituto de Investigación Sanitaria Aragón (IIS Aragón); 50009 Zaragoza, Spain / Red de Salud Materno-infantil y del Desarrollo (SAMID), Instituto de Salud Carlos III, Madrid, 50009 Zaragoza, Spain.
    Intemann, Timm
    Leibniz Institute for Prevention Research and Epidemiology—BIPS, 28359 Bremen, Germany / Institute of Statistics, Bremen University, 28359 Bremen, Germany.
    De Miguel-Etayo, Pilar
    Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, 50009 Zaragoza, Spain / Instituto Agroalimentario de Aragón (IA2), 50013, Zaragoza, Spain / Instituto de Investigación Sanitaria Aragón (IIS Aragón); 50009 Zaragoza, Spain / Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain.
    Pala, Valeria
    Epidemiology and Prevention Unit, Department of Preventive & Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy.
    Hebestreit, Antje
    Leibniz Institute for Prevention Research and Epidemiology—BIPS, 28359 Bremen, Germany.
    Wolters, Maike
    Leibniz Institute for Prevention Research and Epidemiology—BIPS, 28359 Bremen, Germany.
    Russo, Paola
    Epidemology & Population Genetics, Institute of Food Sciences, National Research Council, 83100 Avellino, Italy.
    Veidebaum, Toomas
    Department of Chronic Diseases, National Institute for Health Development, 11619 Tallinn, Estonia.
    Papoutsou, Stalo
    Research and Education Institute of Child Health, 2018 Strovolos, Cyprus.
    Nagy, Peter
    Department of Pediatrics, University of Pécs, 7622 Pécs, Hungary.
    Eiben, Gabriele
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Public Health and Community Medicine, University of Gothenburg, 405 30 Gothenburg, Sweden.
    Rise, Patrizia
    Department of Pharmacological Sciences, University of Milan, 20122 Milan, Italy.
    De Henauw, Stefaan
    Department of Public Health, Ghent University, 9000 Ghent, Belgium.
    Moreno, Luis A.
    Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, 50009 Zaragoza, Spain / Instituto Agroalimentario de Aragón (IA2), 50013, Zaragoza, Spain / Instituto de Investigación Sanitaria Aragón (IIS Aragón); 50009 Zaragoza, Spain / Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain.
    Dairy consumption at snack meal occasions and the overall quality of diet during childhood: Prospective and cross-sectional analyses from the idefics/i.family cohort2020In: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 12, no 3, article id 642Article in journal (Refereed)
    Abstract [en]

    There is scarce information on the influence of dairy consumption between main meals on the overall diet quality through childhood, constituting the main aim of this research. From the Identification and prevention of Dietary-and lifestyle induced health EFfects In Children and infantS (IDEFICS) study, and based on the data availability in each period due to drop outs, 8807 children aged 2 to 9.9 years from eight European countries at baseline (T0: 2007–2008); 5085 children after two years (T1); and 1991 after four years (T3), were included in these analyses. Dietary intake and the Diet Quality Index (DQI) were assessed by two 24 hours dietary recalls (24-HDR) and food frequency questionnaire. Consumption of milk and yogurt (p = 0.04) and cheese (p < 0.001) at snack meal occasions was associated with higher DQI scores in T0; milk and yogurt (p < 0.001), and cheese (p < 0.001) in T1; and cheese (p = 0.05) in T3. Consumers of milk (p = 0.02), yogurt (p < 0.001), or cheese (p < 0.001) throughout T0 and T1 at all snack moments had significantly higher scores of DQI compared to non-consumers. This was also observed with the consumption of cheese between T1 and T3 (p = 0.03). Consumption of dairy products at snack moments through childhood is associated with a better overall diet quality, being a good strategy to improve it in this period. 

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  • 16.
    Keane, Simon
    et al.
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR).
    Améen, Sophie
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR).
    Lindlöf, Angelica
    University of Skövde, School of Bioscience. University of Skövde, Systems Biology Research Environment.
    Ejeskär, Katarina
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR).
    Low DLG2 gene expression, a link between 11q-deleted and MYCN-amplified neuroblastoma, causes forced cell cycle progression, and predicts poor patient survival2020In: Cell Communication and Signaling, ISSN 1478-811X, E-ISSN 1478-811X, Vol. 18, no 1, article id 65Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Neuroblastoma (NB) is a childhood neural crest tumor. There are two groups of aggressive NBs, one with MYCN amplification, and another with 11q chromosomal deletion; these chromosomal aberrations are generally mutually exclusive. The DLG2 gene resides in the 11q-deleted region, thus makes it an interesting NB candidate tumor suppressor gene. METHODS: We evaluated the association of DLG2 gene expression in NB with patient outcomes, stage and MYCN status, using online microarray data combining independent NB patient data sets. Functional studies were also conducted using NB cell models and the fruit fly. RESULTS: Using the array data we concluded that higher DLG2 expression was positively correlated to patient survival. We could also see that expression of DLG2 was inversely correlated with MYCN status and tumor stage. Cell proliferation was lowered in both 11q-normal and 11q-deleted NB cells after DLG2 over expression, and increased in 11q-normal NB cells after DLG2 silencing. Higher level of DLG2 increased the percentage of cells in the G2/M phase and decreased the percentage of cells in the G1 phase. We detected increased protein levels of Cyclin A and Cyclin B in fruit fly models either over expressing dMyc or with RNAi-silenced dmDLG, indicating that both events resulted in enhanced cell cycling. Induced MYCN expression in NB cells lowered DLG2 gene expression, which was confirmed in the fly; when dMyc was over expressed, the dmDLG protein level was lowered, indicating a link between Myc over expression and low dmDLG level. CONCLUSION: We conclude that low DLG2 expression level forces cell cycle progression, and that it predicts poor NB patient survival. The low DLG2 expression level could be caused by either MYCN-amplification or 11q-deletion. Video Abstract.

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  • 17.
    Kivimäki, Mika
    et al.
    Department of Epidemiology and Public Health, University College London, United Kingdom.
    Batty, G. David
    Department of Epidemiology and Public Health, University College London, United Kingdom / School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR, United States.
    Pentti, Jaana
    Clinicum, Faculty of Medicine, University of Helsinki, Finland / Department of Public Health, University of Turku, Finland / Centre for Population Health Research, University of Turku, Finland / Turku University Hospital, Finland.
    Shipley, Martin J.
    Department of Epidemiology and Public Health, University College London, United Kingdom.
    Sipilä, Pyry N.
    Clinicum, Faculty of Medicine, University of Helsinki, Finland.
    Nyberg, Solja T.
    Clinicum, Faculty of Medicine, University of Helsinki, Finland.
    Suominen, Sakari B.
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Public Health, University of Turku, Finland.
    Oksanen, Tuula
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Stenholm, Sari
    Department of Public Health, University of Turku, Finland / Centre for Population Health Research, University of Turku, Finland / Turku University Hospital, Finland.
    Virtanen, Marianna
    School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland.
    Marmot, Michael G.
    Institute of Health Equity, University College London, United Kingdom.
    Singh-Manoux, Archana
    Department of Epidemiology and Public Health, University College London, United Kingdom / INSERM U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Université de Paris, France.
    Brunner, Eric J.
    Department of Epidemiology and Public Health, University College London, United Kingdom.
    Lindbohm, Joni V.
    Clinicum, Faculty of Medicine, University of Helsinki, Finland.
    Ferrie, Jane E.
    Department of Epidemiology and Public Health, University College London, United Kingdom / School of Community and Social Medicine, University of Bristol, United Kingdom.
    Vahtera, Jussi
    Department of Public Health, University of Turku, Finland / Centre for Population Health Research, University of Turku, Finland / Turku University Hospital, Finland.
    Association between socioeconomic status and the development of mental and physical health conditions in adulthood: a multi-cohort study2020In: The Lancet Public Health, ISSN 2468-2667, Vol. 5, no 3, p. e140-e149Article in journal (Refereed)
    Abstract [en]

    Background: Socioeconomic disadvantage is a risk factor for many diseases. We characterised cascades of these conditions by using a data-driven approach to examine the association between socioeconomic status and temporal sequences in the development of 56 common diseases and health conditions. Methods: In this multi-cohort study, we used data from two Finnish prospective cohort studies: the Health and Social Support study and the Finnish Public Sector study. Our pooled prospective primary analysis data comprised 109 246 Finnish adults aged 17–77 years at study entry. We captured socioeconomic status using area deprivation and education at baseline (1998–2013). Participants were followed up for health conditions diagnosed according to the WHO International Classification of Diseases until 2016 using linkage to national health records. We tested the generalisability of our findings with an independent UK cohort study—the Whitehall II study (9838 people, baseline in 1997, follow-up to 2017)—using a further socioeconomic status indicator, occupational position. Findings: During 1 110 831 person-years at risk, we recorded 245 573 hospitalisations in the Finnish cohorts; the corresponding numbers in the UK study were 60 946 hospitalisations in 186 572 person-years. Across the three socioeconomic position indicators and after adjustment for lifestyle factors, compared with more advantaged groups, low socioeconomic status was associated with increased risk for 18 (32·1%) of the 56 conditions. 16 diseases formed a cascade of inter-related health conditions with a hazard ratio greater than 5. This sequence began with psychiatric disorders, substance abuse, and self-harm, which were associated with later liver and renal diseases, ischaemic heart disease, cerebral infarction, chronic obstructive bronchitis, lung cancer, and dementia. Interpretation: Our findings highlight the importance of mental health and behavioural problems in setting in motion the development of a range of socioeconomically patterned physical illnesses. Policy and health-care practice addressing psychological health issues in social context and early in the life course could be effective strategies for reducing health inequalities. Funding: UK Medical Research Council, US National Institute on Aging, NordForsk, British Heart Foundation, Academy of Finland, and Helsinki Institute of Life Science.

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  • 18.
    Kjellsdotter, Anna
    et al.
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Skaraborg Hospital Skövde, Research and Development Centre, Skövde, Sweden.
    Berglund, Mia
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR).
    Jebens, Elisabeth
    Primary Health Care Center, Stenstorp, Sweden.
    Kvick, Jennie
    Primary Health Care Center Mösseberg, Falköping, Sweden.
    Andersson, Susanne
    Department of Health Sciences, University West, Trollhättan, Sweden.
    To take charge of one's life - group-based education for patients with type 2 diabetes in primary care -a lifeworld approach2020In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 15, no 1, article id 1726856Article in journal (Refereed)
    Abstract [en]

    Background: The number of people suffering from diabetes worldwide, including Sweden, has increased. To strengthen the patient's empowerment and thus improve their ability to take care of their own health, patient education in self-care management plays a central role in diabetes care. Purpose: The specific aim in this study was to describe patients' experiences of group-based education using the Taking charge of one's life with type 2 diabetes model. Methods: A qualitative approach with a phenomenological lifeworld perspective was used. The study was based on group and individual interviews and reflection books. Results: The group-based education model made it possible for the patients to learn through reflection concerning their own and others' experiences. The learning that occurred with support from the group reflections and the reflection books contributed to the understanding of the complexity of the illness. This increased the motivation and desire to be responsible for the treatment and implementation of habits. The group contributed to a sense of belonging and community that inspired a continued and active learning. Conclusion: The results showed that from the patients' perspective, this didactic model was both suitable and appreciated, supporting and facilitating learning.

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  • 19.
    Lindmark, Ulrika
    et al.
    Centre for Oral Health, Department of Natural Science and Biomedicine, School of Health and Welfare, Jönköping University, Sweden.
    Ahlstrand, Inger
    Department of Rehabilitation, School of Health and Welfare, Jönköping University, Sweden.
    Ekman, A.
    Department of Social Work, School of Health and Welfare, Jönköping University, Sweden.
    Berg, L.
    Institute of Health and Care Sciences, the Sahlgrenska Academy, University of Gothenburg, Sweden.
    Hedén, Lena
    Faculty of Caring Science, Work Life, and Social Welfare, University of Borås, Sweden.
    Källstrand, Jeanette
    School of Health and Welfare, Halmstad University, Sweden.
    Larsson, Margaretha
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR).
    Nunstedt, Håkan
    Department of Health Sciences, University West, Trollhättan, Sweden.
    Oxelmark, Lena
    Institute of Health and Care Sciences, the Sahlgrenska Academy, University of Gothenburg, Sweden.
    Pennbrant, Sandra
    Department of Health Sciences, University West, Trollhättan, Sweden.
    Sundler, Annelie
    Faculty of Caring Science, Work Life, and Social Welfare, University of Borås, Sweden.
    Larsson, Ingrid
    School of Health and Welfare, Halmstad University, Sweden.
    Health-promoting factors in higher education for a sustainable working life: protocol for a multicenter longitudinal study2020In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 20, no 1, article id 233Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The World Health Organization has highlighted the importance of health promotion for health service providers in order to ensure sustainable working life for individuals involved in providing health services. Such sustainability begins when students are preparing to manage their own future health and welfare in working life. It has been suggested that universities, employees and trainee health professionals should adopt or follow a salutogenic approach that not only complements the providing of information on known health risks but also favors health promotion strategies. This paper describes the study design and data collection methods in a planned study aiming to explore health-promoting factors for a sustainable working life among students in higher education within healthcare and social work. METHODS: This protocol describes a multicenter longitudinal study involving Swedish students on higher education programs in the healthcare and social work sectors. In 2018, the study invited students on seven education programs at six universities to participate. These programs were for qualification as: biomedical laboratory scientists (n = 121); dental hygienists (n = 87); nurses (n = 1411); occupational therapists (n = 111); physiotherapists (n = 48); radiographers (n = 60); and, social workers (n = 443). In total, 2283 students were invited to participate. Participants completed a baseline, a self-reported questionnaire including six validated instruments measuring health-promoting factors and processes. There are to be five follow-up questionnaires. Three while the students are studying, one a year after graduating, and one three years after graduating. Each questionnaire captures different health-promoting dimensions, namely: health-promoting resources (i.e. sense of coherence); occupational balance; emotional intelligence; health and welfare; social interaction; and work and workplace experiences/perceptions. DISCUSSION: This study focuses on the vastly important aspect of promoting a sustainable working life for healthcare and social work employees. In contrast to previous studies in this area, the present study uses different, validated instruments in health promotion, taking a salutogenic approach. It is hoped that, by stimulating the implementation of new strategies, the study's findings will lead to education programs that prepare students better for a sustainable working life in healthcare and social work.

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  • 20.
    Maivorsdotter, Ninitha
    et al.
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR).
    Andersson, Joacim
    Örebro University, Sweden.
    Health as Experience: Exploring Health in Daily Life Drawing From the Work of Aaron Antonovsky and John Dewey2020In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 30, no 7, p. 1004-1018Article in journal (Refereed)
    Abstract [en]

    Research has pursued salutogenic and narrative approaches to deal with questions about how everyday settings are constitutive for different health practices. Healthy behavior is not a distinguishable action, but a chain of activities, often embedded in other social practices. In this article, we have endeavored to describe such a chain of activities guided by the salutogenic claim of exploring the good living argued by McCuaig and Quennerstedt. We use biographical material written by Karl Ove Knausgaard who has created a life story entitled My Struggle. The novel is selected upon an approach influenced by Brinkmann who stresses that literature can be seen as a qualitative social inquiry in which the novelist is an expert in transforming personal life experiences into common human expressions of life. The study illustrates how research with a broader notion of health can convey experiences of health, thereby complementing (and sometimes challenging) public health evidence.

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  • 21.
    Majzoub, Ahmad
    et al.
    Department of Urology, Hamad Medical Corporation, Doha, Qatar / Department of Urology, Weill Cornell Medicine-Qatar, Doha, Qatar.
    Arafa, Mohamed
    Department of Urology, Hamad Medical Corporation, Doha, Qatar / Department of Urology, Weill Cornell Medicine-Qatar, Doha, Qatar / Department of Andrology, Cairo University, Egypt.
    El Ansari, Walid
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Surgery, Hamad Medical Corporation, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar.
    Mahdi, Mohammed
    Department of Urology, Hamad Medical Corporation, Doha, Qatar.
    Agarwal, Ashok
    Department of Urology, Glickman Urology and Kidney Institute, Cleveland Clinic Foundation, OH, United States.
    Al-Said, Sami
    Department of Urology, Hamad Medical Corporation, Doha, Qatar / Department of Urology, Weill Cornell Medicine-Qatar, Doha, Qatar.
    Elbardisi, Haitham
    Department of Urology, Hamad Medical Corporation, Doha, Qatar / Department of Urology, Weill Cornell Medicine-Qatar, Doha, Qatar.
    Correlation of oxidation reduction potential and total motile sperm count: its utility in the evaluation of male fertility potential2020In: Asian Journal of Andrology, ISSN 1008-682X, E-ISSN 1745-7262, Vol. 22, no 3, p. 317-322Article in journal (Refereed)
    Abstract [en]

    Oxidative stress (OS) is detrimental to sperm functions, and the oxidation reduction potential (ORP) is a good measure of OS as it considers the balance between oxidants and reductants. Total motile sperm count (TMSC) is viewed as the single most important semen analysis parameter that can predict male infertility severity, and its correlation with ORP has never been undertaken. The objectives of this study were to assess the correlation between ORP and TMSC, to identify the ORP cutoff value based on the TMSC result, and to compare this cutoff value with previously reported ORP cutoff values in literature. One thousand one hundred and sixty-eight infertile patients and 100 fertile controls were enrolled. Demographic and semen data of the participants were retrieved and analyzed. Wilcoxon's rank-sum test compared variables between infertile men and fertile controls; Spearman's correlation assessed the static ORP (sORP)-TMSC relationship for the whole sample and among each group individually. Using a 20×106TMSC threshold, receiver operator characteristic (ROC) analysis determined the sORP cutoff associated with the highest predictive values. TMSC was significantly negatively correlated with sORP across all participants (r = 0.86, P < 0.001), among infertile patients (r = 0.729, P < 0.001), and among fertile controls (r = 0.53, P < 0.001). A 20-million TMSC threshold determined an sORP cutoff value of 2.34 mV/106sperm/ml to be associated with 82.9% sensitivity, 82.8% specificity, 91.5% positive predictive value (PPV), 68.5% negative predictive value (NPV), and 82.9% overall accuracy. Compared with previously reported cutoff values in searched literature, the 2.34 mV/106sperm/ml cutoff value identified in our study yielded the highest overall diagnostic accuracy in the evaluation of infertile men.

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  • 22.
    Nyberg, Solja T.
    et al.
    Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Finland.
    Singh-Manoux, Archana
    Department of Epidemiology and Public Health, University College London, United Kingdom / Inserm U1153, Epidemiology of Ageing and Neurodegenrative Diseases, Paris, France.
    Pentti, Jaana
    Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Finland / Department of Public Health, University of Turku, Turku University Hospital, Finland / Centre for Population Health Research, University of Turku, Turku University Hospital, Finland.
    Madsen, Ida E. H.
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Sabia, Severine
    Department of Epidemiology and Public Health, University College London, United Kingdom / Inserm U1153, Epidemiology of Ageing and Neurodegenrative Diseases, Paris, France.
    Alfredsson, Lars
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden / Centre for Occupational and Environmental Medicine, Stockholm County Council, Sweden.
    Bjorner, Jakob B.
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Borritz, Marianne
    Bispebjerg University Hospital, Copenhagen, Denmark.
    Burr, Hermann
    Federal Institute for Occupational Safety and Health, Berlin, Germany.
    Goldberg, Marcel
    Faculty of Medicine, Paris Descartes University, Paris, France / Inserm UMS 011, Population-Based Epidemiological Cohorts Unit, Villejuif, France.
    Heikkilä, Katriina
    Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, United Kingdom.
    Jokela, Markus
    Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland.
    Knutsson, Anders
    Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Lallukka, Tea
    Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Finland / Finnish Institute of Occupational Health, Helsinki, Finland.
    Lindbohm, Joni V.
    Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Finland.
    Nielsen, Martin L.
    AS3 Employment, AS3 Companies, Viby J, Denmark.
    Nordin, Maria
    Stress Research Institute, Stockholm University, Sweden / Department of Psychology, Umeå University, Sweden.
    Oksanen, Tuula
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Pejtersen, Jan H.
    VIVE-The Danish Center for Social Science Research, Copenhagen, Denmark.
    Rahkonen, Ossi
    Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Finland.
    Rugulies, Reiner
    National Research Centre for the Working Environment, Copenhagen, Denmark / Department of Public Health, Department of Psychology, University of Copenhagen, Denmark.
    Shipley, Martin J.
    Department of Epidemiology and Public Health, University College London, United Kingdom.
    Sipilä, Pyry N.
    Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Finland.
    Stenholm, Sari
    Department of Public Health, University of Turku, Turku University Hospital, Finland / Centre for Population Health Research, University of Turku, Turku University Hospital, Finland.
    Suominen, Sakari
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Public Health, University of Turku, Turku University Hospital, Finland.
    Vahtera, Jussi
    Department of Public Health, University of Turku, Turku University Hospital, Finland / Centre for Population Health Research, University of Turku, Turku University Hospital, Finland.
    Virtanen, Marianna
    School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland / Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Westerlund, Hugo
    Stress Research Institute, Stockholm University, Sweden.
    Zins, Marie
    Faculty of Medicine, Paris Descartes University, France / Inserm UMS 011, Population-Based Epidemiological Cohorts Unit, Villejuif, France.
    Hamer, Mark
    Division of Surgery and Interventional Science, Faculty of Medical Sciences, University College London, United Kingdom.
    Batty, G. David
    Department of Epidemiology and Public Health, University College London, United Kingdom / School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR, United States.
    Kivimäki, Mika
    Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Finland / Department of Epidemiology and Public Health, University College London, United Kingdom.
    Association of Healthy Lifestyle with Years Lived without Major Chronic Diseases2020In: JAMA Internal Medicine, ISSN 2168-6106, E-ISSN 2168-6114, Vol. 180, no 5, p. 760-768Article in journal (Refereed)
    Abstract [en]

    Importance: It is well established that selected lifestyle factors are individually associated with lower risk of chronic diseases, but how combinations of these factors are associated with disease-free life-years is unknown. Objective: To estimate the association between healthy lifestyle and the number of disease-free life-years. Design, Setting, and Participants: A prospective multicohort study, including 12 European studies as part of the Individual-Participant-Data Meta-analysis in Working Populations Consortium, was performed. Participants included 116043 people free of major noncommunicable disease at baseline from August 7, 1991, to May 31, 2006. Data analysis was conducted from May 22, 2018, to January 21, 2020. Exposures: Four baseline lifestyle factors (smoking, body mass index, physical activity, and alcohol consumption) were each allocated a score based on risk status: Optimal (2 points), intermediate (1 point), or poor (0 points) resulting in an aggregated lifestyle score ranging from 0 (worst) to 8 (best). Sixteen lifestyle profiles were constructed from combinations of these risk factors. Main Outcomes and Measures: The number of years between ages 40 and 75 years without chronic disease, including type 2 diabetes, coronary heart disease, stroke, cancer, asthma, and chronic obstructive pulmonary disease. Results: Of the 116043 people included in the analysis, the mean (SD) age was 43.7 (10.1) years and 70911 were women (61.1%). During 1.45 million person-years at risk (mean follow-up, 12.5 years; range, 4.9-18.6 years), 17383 participants developed at least 1 chronic disease. There was a linear association between overall healthy lifestyle score and the number of disease-free years, such that a 1-point improvement in the score was associated with an increase of 0.96 (95% CI, 0.83-1.08) disease-free years in men and 0.89 (95% CI, 0.75-1.02) years in women. Comparing the best lifestyle score with the worst lifestyle score was associated with 9.9 (95% CI 6.7-13.1) additional years without chronic diseases in men and 9.4 (95% CI 5.4-13.3) additional years in women (P <.001 for dose-response). All of the 4 lifestyle profiles that were associated with the highest number of disease-free years included a body-mass index less than 25 (calculated as weight in kilograms divided by height in meters squared) and at least 2 of the following factors: Never smoking, physical activity, and moderate alcohol consumption. Participants with 1 of these lifestyle profiles reached age 70.3 (95% CI, 69.9-70.8) to 71.4 (95% CI, 70.9-72.0) years disease free depending on the profile and sex. Conclusions and Relevance: In this multicohort analysis, various healthy lifestyle profiles appeared to be associated with gains in life-years without major chronic diseases. 

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  • 23.
    Roos, John Magnus
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Division of Physical Resource Theory, Chalmers University of Technology, Gothenburg / Centre for Consumer Research, School of Business, Economics and Law, University of Gothenburg, Sweden / Department of Business Administration and Textile Management, University of Borås, Sweden.
    Personality and E-shopping: Insights from a Nationally Representative Study2019In: Digital Transformation and Global Society: 4th International Conference, DTGS 2019, St. Petersburg, Russia, June 19–21, 2019, Revised Selected Papers / [ed] Daniel A. Alexandrov, Alexander V. Boukhanovsky, Andrei V. Chugunov, Yury Kabanov, Olessia Koltsova, Ilya Musabirov, Cham: Springer, 2019, p. 257-267Chapter in book (Refereed)
    Abstract [en]

    According to previous research, a high degree of Openness and Neuroticism, and a low degree of Agreeableness are personality determinants of e-shopping. This study aims to explore the relationship between the Five-factor model of personality (i.e. Openness, Conscientiousness, Extraversion, Agreeableness, and Neuroticism) and e-shopping in a Swedish context. In a nationally representative sample, a questionnaire was distributed to 3400 citizens. The response rate was 53 percentage (N = 1812). The questionnaire included measures of the Five-factor model of personality (BFI-ten) and e-shopping. Multiple regression analyses were conducted to test if the Five-factor model of personality predicted e-shopping. The dependent variable was self-reported frequencies of e-shopping during the last 12 months. The first analysis showed that Openness is predicting e-shopping. However, this effect disappeared, when age, educational attainment and income were controlled for. Our conclusion is that the Five-factor model of personality is a poor predictor of e-shopping and that e-shopping frequencies are unrelated to the personality of internet users. Methodological limitations are discussed, for instance the use of a single-item for measuring e-shopping and a short-scale for measuring personality. There are difficulties comparing our findings with previous findings, since the concepts personality and e-shopping have not been defined uniformly. The analyses revealed significant variation in definitions, measurements and methodologies. Caution should also be taken in generalizing the present results to other countries and other time periods. © 2019, Springer Nature Switzerland AG.

  • 24.
    Rosendahl, Dan
    et al.
    Trinity College of the Bible and Trinity Theological Seminary, Evansville, USA.
    Rosendahl, Sirpa
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR).
    Role stress: Experiences of Swedish Non-Lutheran Clergy2019In: Proceedings Book: ICSS XX, 20th International Conference on Social Sciences, 6-7 September 2019, Zurich, EUSER - European Center for Science Education and Research , 2019, p. 218-218Conference paper (Refereed)
  • 25.
    Rosendahl, Dan
    et al.
    Trinity Bible College and Trinity Theological Seminary, Evansville, IN, USA.
    Rosendahl, Sirpa
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR).
    Role-stress: Experiences of Non-Lutheran Clergy2020In: European Journal of Social Sciences, ISSN 2601-8632, Vol. 3, no 1, p. 108-118Article in journal (Refereed)
    Abstract [en]

    Background: About fifty percent of Swedish Non-Lutheran Clergy leave the vocation before retirement resulting in huge personal, financial, psychological, emotional, spiritual and social costs. The factors behind this substantial flood out has scarcely been researched. From the multifaceted problematic aspects of pastoral work, the aim of this study was to explore the clergy’s experiences of work stressors with the focus on Role-stress. Method: A qualitative approach with 19 open ended interviews was used and the interview material underwent qualitative content analysis. Results: Multiple external role-senders together with the individual pastor’s experienced, internal expectations and demands, generated different types of Clergy role-categories that surfaced during the analysis. These roles were accompanied by several role-stressors as apparent with the roles Servants of men and Servants of God and the presence of Vision Conflict. Further the pastor as the Church’s ultimately responsible person is plagued by Role-ambiguity and Role-confusion, and as the Proven trustworthy administrator struggling with Role-conflict. Family-work and Work-family conflicts, especially for female pastors, contributed to Work overload, this consequence also effecting the male colleagues during the generic attempts to meet as many of the Church members’ expectations as possible. The accumulated Work overload, together with a lowered level of Work Satisfaction, boosted the Turnover intentions. Conclusions: Mutual succinct information between employer and employee, active continuous communication and refined and updated organizational structure need to be coordinated in order to lower the level of experienced role stress and thus reduce the present substantial number of Clergy leaving the vocation prematurely.

  • 26.
    Santaliestra-Pasías, Alba M.
    et al.
    GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, Spain / Instituto Agroalimentario de Aragón (IA2), Spain / Instituto de Investigación Sanitaria Aragón (IIS Aragón), Spain / Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Spain.
    González-Gil, Esther M.
    GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, Spain / Instituto Agroalimentario de Aragón (IA2), Spain / Instituto de Investigación Sanitaria Aragón (IIS Aragón), Spain / Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Spain / Institute of Nutrition and Food Technology, Department of Biochemistry and Molecular Biology II, University of Granada, Spain.
    Pala, Valeria
    Department of Research, Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
    Intemann, Timm
    Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany / Institute of Statistics, University of Bremen, Germany.
    Hebestreit, Antje
    Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
    Russo, Paola
    Institute of Food Sciences, National Research Council, Avellino, Italy.
    Van Aart, Carola
    Department of Public Health, Ghent University, Belgium.
    Rise, Patrizia
    Department of Pharmacological Sciences, University of Milan, Italy.
    Veidebaum, Toomas
    National Institute for Health Development, Estonian Centre of Behavioral and Health Sciences, Tallinn, Estonia.
    Molnar, Denes
    Department of Paediatrics, University of Pécs, Hungary.
    Tornaritis, Michael
    Research and Education Institute of Child health, REF, Cyprus.
    Eiben, Gabriele
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Section for Epidemiology and Social Medicine (EPSO), University of Gothenburg, Sweden .
    Moreno, Luis A.
    GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, Spain / Instituto Agroalimentario de Aragón (IA2), Spain / Instituto de Investigación Sanitaria Aragón (IIS Aragón), Spain / Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Spain.
    Predictive associations between lifestyle behaviours and dairy consumption: The IDEFICS study2020In: NMCD. Nutrition Metabolism and Cardiovascular Diseases, ISSN 0939-4753, E-ISSN 1590-3729, Vol. 30, no 3, p. 514-522Article in journal (Refereed)
    Abstract [en]

    Background and aim: Physical activity (PA) and sedentary behaviours (SB) are related to obesity and cardiometabolic risk; however, the literature is controversial regarding the effect of dairy consumption on the development of cardiovascular disease (CVD) risk factors. The aim of this study was to assess longitudinally the relationship between specific lifestyle behaviours (PA and SB) and dairy consumption in a sample of European children and adolescents. Methods and results: Children from the IDEFICS study were included in the analyses. Two measurements, with 2 years' interval, were conducted. A total of 1688 (50.8% boys) children provided information regarding diet, measured by a 24-h dietary recall, PA measured by accelerometers and parent-reported sedentary screen time (SST) at both time points. Different combinations of these behaviours, at each survey and over time, were derived applying specific recommendations. Multilevel ordinal logistic regression and analysis of covariance were used to assess their association with dairy consumption, adjusted for potential confounders. Differences by gender were found regarding dairy product consumption and also adherence to SB and PA recommendations at T0 and T1. Children meeting both lifestyle recommendations, at the two measurement points, had higher probability to consume more milk and yogurt and less cheese than the rest of combinations. Conclusions: These results suggest that European children with a healthy lifestyle, especially regarding PA and SB over time, consumed more milk and yogurt. This study suggests that the protective effect of specific dairy products found in literature could be partially due to the association of their consumption with specific healthy lifestyles.

  • 27.
    Sedghi, Maryam
    et al.
    Medical Genetics Laboratory, Alzahra University Hospital, Isfahan University of Medical Sciences, Iran.
    Moslemi, Ali-Reza
    Department of Pathology, Sahlgrenska University Hospital, Gothenburg University, Sweden.
    Cabrera-Serrano, Macarena
    Department of Neurology, Hospital Universitario Virgen del Rocio, Sevilla, Spain / Instituto de Biomedicina de Sevilla, Universidad de Sevilla, Spain.
    Ansari, Behnaz
    Department of neurology, Isfahan University of Medical Sciences, Iran.
    Ghasemi, Majid
    Department of neurology, Isfahan University of Medical Sciences, Iran.
    Baktashian, Mojtaba
    Medical Genetics Laboratory, Alzahra University Hospital, Isfahan University of Medical Sciences, Iran.
    Fattahpour, Ali
    Radiology Resident, Department of Radiology, Mashhad University of Medical Sciences, Iran.
    Tajsharghi, Homa
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR).
    Recessive Charcot-Marie-Tooth and multiple sclerosis associated with a variant in MCM3AP2019In: Brain Communications, E-ISSN 2632-1297, Vol. 1, no 1, article id fcz011Article in journal (Refereed)
    Abstract [en]

    Variants in MCM3AP, encoding the germinal-centre associated nuclear protein, have been associated with progressive polyneuropathy with or without intellectual disability and ptosis in some cases, and with a complex phenotype with immunodeficiency, skin changes and myelodysplasia. MCM3AP encoded protein functions as an acetyltransferase that acetylates the replication protein, MCM3, and plays a key role in the regulation of DNA replication. In this study, we report a novel variant in MCM3AP (p.Ile954Thr), in a family including three affected individuals with characteristic features of Charcot-Marie-Tooth neuropathy and multiple sclerosis, an inflammatory condition of the central nervous system without known genetic cause. The affected individuals were homozygous for a missense MCM3AP variant, located at the Sac3 domain, which was predicted to affect conserved amino acid likely important for the function of the germinal-centre associated nuclear protein. Our data support further expansion of the clinical spectrum linked to MCM3AP variant and highlight that MCM3AP should be considered in patients with accompaniment of recessive motor axonal Charcot-Marie-Tooth neuropathy and multiple sclerosis.

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  • 28.
    Shahid, Fakhar
    et al.
    Department of General Surgery, Hamad Medical Corporation, Doha, Qatar.
    El Ansari, Walid
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar.
    Ben-Gashir, Mohamed
    Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar.
    Abdelaal, Abdelrahman
    Department of General Surgery, Hamad Medical Corporation, Doha, Qatar.
    Laparoscopic hydrocelectomy of the canal of Nuck in adult female: Case report and literature review2020In: International journal of surgery case reports, ISSN 2210-2612, E-ISSN 2210-2612, Vol. 66, p. 338-341, article id S2210-2612(19)30674-1Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Among adult females, Hydrocele of Canal of Nuck (HCN) is a very rare condition. The majority of the reported cases of HCN were not conclusively diagnosed until surgery was performed on a suspected inguinal hernia. To the best of our knowledge, this is the first case of laparoscopically operated HCN in adult female in Middle East and North Africa Region, and the fourth such case worldwide.

    PRESENTATION OF CASE: A 36-year-old female presented with a painful small swelling in the right groin of 3 months duration. The swelling extended to the right labia majora while standing, and disappeared when the patient was in prone position. There was no lymph node enlargement, no other masses in the abdomen, and no swelling in the contralateral side. Ultrasonography was undertaken and the patient was admitted electively for laparoscopic exploration and repair of non-complicated right inguinal hernia. She was known to have dyslipidemia on medications. Further history and physical examination were unremarkable. Intraoperatively it was diagnosed to be right-sided HCN which was excised and repaired by mesh fixation using transabdominal preperitoneal (TAPP) approach. Her follow up course was unremarkable.

    CONCLUSIONS: This case expands the clinical and intraoperative potential differential diagnosis of adult female groin masses. Surgeons should consider such cases when they observe such swellings intraoperatively. Laparoscopic TAPP approach in such cases is a superior diagnostic and treatment modality.

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  • 29.
    Simonsen, Nina
    et al.
    Public Health Research Program, Folkhälsan Research Center, Finland / Department of Public Health, University of Helsinki, Helsinki, Finland.
    Lahti, Anna
    Public Health Research Program, Folkhälsan Research Center, Finland.
    Suominen, Sakari
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Public Health, University of Turku, Lemminkäisenkatu 1, Turku, Finland.
    Välimaa, Raili
    Faculty of Sport and Health Sciences, Research Center for Health Promotion, University of Jyväskylä, Finland.
    Tynjälä, Jorma
    Faculty of Sport and Health Sciences, Research Center for Health Promotion, University of Jyväskylä, Finland.
    Roos, Eva
    Public Health Research Program, Folkhälsan Research Center, Finland / Department of Public Health, University of Helsinki, Helsinki, Finland.
    Kannas, Lasse
    Faculty of Sport and Health Sciences, Research Center for Health Promotion, University of Jyväskylä, Finland.
    Empowerment-enabling home and school environments and self-rated health among Finnish adolescents2020In: Health Promotion International, ISSN 0957-4824, E-ISSN 1460-2245, Vol. 35, no 1, p. 82-92Article in journal (Refereed)
    Abstract [en]

    Perceived health during adolescence has not only immediate consequences for individuals and for society, but also long-term. We need to understand better the health development in this period of the lifespan. Empowerment may be one pathway through which social factors and conditions translate into health effects. This study aimed to examine whether empowerment-enabling home and school environments are associated with self-rated health among adolescents, and whether the associations differ between genders, age or majority/minority language groups. Anonymous questionnaire data from respondents aged 11, 13 and 15 years were obtained from the Health Behaviour in School-aged Children study, conducted in Finland in 2014 in Finnish- and Swedish-speaking schools (n = 5925/1877). The proportion rating their health as excellent varied between 33.6 (11-year-olds) and 23.1% (15-year-olds), boys rating their health as excellent more often than girls in all age groups. Findings showed that indicators of both empowerment-enabling home and school environments were independently and positively related to adolescents' self-rated health. Whereas a respectful, accepting, kind and helpful attitude among classmates and a good home atmosphere were quite consistently associated with excellent health, there were gender and age differences with concern to the other empowerment-enabling indicators. Moreover, there were gender-, age- and language-related differences regarding adolescents' perceptions of how empowerment enabling their environments were. Home and school environments that create opportunities through encouragement and care, and through strengthening feelings of being secure, accepted and respected are potentially empowerment enabling. This study suggests that such environmental qualities are important for the perceived health of young people. 

  • 30.
    Steene-Johannessen, Jostein
    et al.
    Department of Sports Medicine, Norwegian School of Sport Sciences,Oslo, Norway.
    Eiben, Gabriele
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR).
    Ekelund, Ulf
    Department of Sports Medicine, Norwegian School of Sport Sciences,Oslo, Norway.
    Variations in accelerometry measured physical activity and sedentary time across Europe - harmonized analyses of 47,497 children and adolescents2020In: International Journal of Behavioral Nutrition and Physical Activity, ISSN 1479-5868, E-ISSN 1479-5868, Vol. 17, no 1, article id 38Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Levels of physical activity and variation in physical activity and sedentary time by place and person in European children and adolescents are largely unknown. The objective of the study was to assess the variations in objectively measured physical activity and sedentary time in children and adolescents across Europe.

    METHODS: Six databases were systematically searched to identify pan-European and national data sets on physical activity and sedentary time assessed by the same accelerometer in children (2 to 9.9 years) and adolescents (≥10 to 18 years). We harmonized individual-level data by reprocessing hip-worn raw accelerometer data files from 30 different studies conducted between 1997 and 2014, representing 47,497 individuals (2-18 years) from 18 different European countries.

    RESULTS: Overall, a maximum of 29% (95% CI: 25, 33) of children and 29% (95% CI: 25, 32) of adolescents were categorized as sufficiently physically active. We observed substantial country- and region-specific differences in physical activity and sedentary time, with lower physical activity levels and prevalence estimates in Southern European countries. Boys were more active and less sedentary in all age-categories. The onset of age-related lowering or leveling-off of physical activity and increase in sedentary time seems to become apparent at around 6 to 7 years of age.

    CONCLUSIONS: Two third of European children and adolescents are not sufficiently active. Our findings suggest substantial gender-, country- and region-specific differences in physical activity. These results should encourage policymakers, governments, and local and national stakeholders to take action to facilitate an increase in the physical activity levels of young people across Europe.

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  • 31.
    Van Dijk, Willeke
    et al.
    Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Netherlands.
    Huizink, Anja C.
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
    Muller, Jasmin
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR).
    Uvnäs-Moberg, Kerstin
    Section of Anthrozoology and Applied Ethology, Swedish University of Agricultural Sciences, Uppsala, Sweden.
    Ekström-Bergström, Anette
    Department of Health Sciences, University West, Trollhättan, Sweden.
    Handlin, Linda
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR).
    The Effect of Mechanical Massage and Mental Training on Heart Rate Variability and Cortisol in Swedish Employees: A Randomized Explorative Pilot Study2020In: Frontiers In Public Health, ISSN 2296-2565, Vol. 8, article id 82Article in journal (Refereed)
    Abstract [en]

    Work-related stress is relatively common in modern society and is a major cause of sick-leave. Thus, effective stress reducing interventions are needed. This study examined the effects of mental training and mechanical massage, on employee's heart rate variability (HRV) and plasma cortisol at their workplaces. Moreover, it was investigated whether baseline systolic blood pressure (SBP) can explain differences in effectiveness of the intervention. Ninety-three participants from four workplaces were randomly assigned to one of the five programs: (I) Mechanical massage and mental training combined, II) Mechanical massage, III) Mental training, IV) Pause, or V) Control. HRV and plasma cortisol were measured at baseline and after 4 and 8 weeks. SBP was measured at baseline. On the reduction of cortisol levels, a small effect of the mechanical massage program was found, whereas no effect was found for the other programs. None of the programs showed any effect on HRV. Nonetheless, when the level of systolic blood pressure was taken into account, some small beneficial effects on HRV and cortisol of mental training and the mechanical massage were found. This exploratory pilot-study provides useful information for future studies that aim to reduce stress among employees. 

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  • 32.
    Wennström, Berith
    et al.
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Anaesthesia, Skaraborg Hospital, Skövde, Sweden / Department of Surgery, Skaraborg Hospital, Skövde, Sweden / Research and Development Center, Skaraborg Hospital, Skövde, Sweden.
    Johansson, Anna
    Department of Surgery, Skaraborg Hospital, Skövde, Sweden.
    Kalabic, Sabina
    Department of Surgery, Skaraborg Hospital, Skövde, Sweden.
    E-son Loft, Anna-Lena
    Research and Development Center, Skaraborg Hospital, Skövde, Sweden..
    Skullman, Stefan
    Department of Surgery, Skaraborg Hospital, Skövde, Sweden.
    Bergh, Ingrid
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR).
    Patient experience of health and care when undergoing colorectal surgery within the ERAS program2020In: Perioperative Medicine, ISSN 0908-6919, E-ISSN 2047-0525, Vol. 9, article id 15Article in journal (Refereed)
    Abstract [en]

    Background

    Several studies show that the enhanced recovery after surgery (ERAS) program reduces complications postoperatively and leads to faster recovery and shorter hospital stays. However, little is known about patients’ self-reported health in an enhanced recovery context. The aim of this study was firstly to describe patient experiences of health within the concept of ERAS after colorectal (CR) surgery during a hospital stay and within 2 weeks of discharge. Secondly, to explore whether the ASA classification/co-morbidity, sex, and surgical method affect the patient’s experience of health.

    Methods

    Data were collected through the ERAS-HEALTH questionnaire, including two open-ended questions, and through telephone interviews postoperatively. Qualitative and quantitative analysis was used. Patients undergoing CR surgery (n = 80) were included from October 2016 to June 2018.

    Results

    The patients had mainly positive experiences of their hospital stay as well as most of them felt comfortable coming home. However, experienced state of health is affected by factors like surgical method and co-morbidity. Improvements were desired concerning information, food/food intake, pain management, and environment. At home, the patients experienced a lack of information about food/food intake and ostomy care. Decreased appetite and difficulties with micturition were also described. The most troublesome symptom was postoperative fatigue (POF). Analysis of the ERAS-HEALTH questionnaire showed that patients with higher co-morbidity and those who underwent open surgery have a significantly worse experience of their health compared with patients who underwent laparoscopy. However, it seems that the surgical method affects postoperative health to a greater extent than co-morbidity.

    Conclusions

    The patients reported many positive aspects and challenges when being cared for within the ERAS program. However, several improvements are needed to satisfy patient wishes regarding their care both in hospital and at home. Laparoscopic surgery affects patient state of health positively in several respects compared with open surgery.

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  • 33.
    Åberg, Cecilia
    et al.
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). School of Health and Welfare, Jönköping University, Sweden.
    Gillsjö, Catharina
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). College of Nursing, University of Rhode Island, Kingston, USA.
    Hallgren, Jenny
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). School of Health and Welfare, Jönköping University, Sweden.
    Berglund, Mia
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR).
    "It is like living in a diminishing world": older persons' experiences of living with long-term health problems - prior to the STRENGTH intervention2020In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 15, no 1, p. 1-12, article id 1747251Article in journal (Refereed)
    Abstract [en]

    Introduction: Ageing is often associated with multiple long-term health problems influencing older persons' well-being in daily living. It is not unusual that the point of interest in research is often on the management of the actual health problem instead of being holistic and person-centred.Purpose: To describe the phenomenon of living with long-term health problems that influence daily living, from the older persons' perspective.Methods: Qualitative individual interviews were conducted with 34 older persons living with long-term health problems. The data were analysed using a Reflected Lifeworld Research (RLR) approach, grounded in phenomenology. Results: Life with long-term health problems entails living in a diminishing world. It entails living in uncertainty, not being able to trust one's own ability. The freedom to make decisions of your own is deprived by relatives and health-care providers. Living with long-term health problems entails being dependent on support in daily life and a strive to maintain meaningfulness in daily living.Conclusions: The results address a need for extended individual and holistic guidance and support in living with long-term health problems to increase the older person's sense of well-being and meaning in life.

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