Showing papers by "Stockholm County Council published in 2006"
TL;DR: Reliability was tested between pairs of therapists for 168 children between 4 and 18 years and between 25 parents and their children's therapists, demonstrating that MACS has good validity and reliability.
Abstract: The Manual Ability Classification System (MACS) has been developed to classify how children with cerebral palsy (CP) use their hands when handling objects in daily activities. The classification is designed to reflect the child's typical manual performance, not the child's maximal capacity. It classifies the collaborative use of both hands together. Validation was based on the experience within an expert group, a review of the literature, and thorough analysis of children across a spectrum of function. Discussions continued until consensus was reached, first about the constructs, then about the content of the five levels. Parents and therapists were interviewed about the content and the description of levels. Reliability was tested between pairs of therapists for 168 children (70 females, 98 males; with hemiplegia [n=52], diplegia [n=70], tetraplegia [n=19], ataxia [n=6], dyskinesia [n=19], and unspecified CP [n=2]) between 4 and 18 years and between 25 parents and their children's therapists. The results demonstrated that MACS has good validity and reliability. The intraclass correlation coefficient between therapists was 0.97 (95% confidence interval 0.96-0.98), and between parents and therapist was 0.96 (0.89-0.98), indicating excellent agreement.
1,778 citations
TL;DR: Recent efforts to screen all twins born between 1959 and 1985, and young twin pairs when they turn 9 and 12 years of age, are described, and initial frequencies of common conditions and exposures are presented.
Abstract: The Swedish Twin Registry was first established in the late 1950s. Today it includes more than 170,000 twins--in principle, all twins born in Sweden since 1886. In this article we describe some ongoing and recently completed projects based on the registry. In particular, we describe recent efforts to screen all twins born between 1959 and 1985, and young twin pairs when they turn 9 and 12 years of age. For these studies, we present initial frequencies of common conditions and exposures.
393 citations
TL;DR: Spacious preschool environments with trees, shrubbery, and broken ground trigger physical activity and yield sun protection in outdoor play and access to such environments is recommended in community architecture.
282 citations
TL;DR: The aim of this study was to assess the association between fish consumption during the first year of life and development of allergic diseases by age 4.
Abstract: Background: Fish consumption during infancy has been regarded as a risk factor for allergic disease but later evidence suggests a protective role. However, methodological limitations in the studies make conclusions uncertain. The aim of this study was to assess the association between fish consumption during the first year of life and development of allergic diseases by age 4.
Methods: A prospective birth cohort of 4089 new-born infants was followed for 4 years using parental questionnaires at ages 2 months, 1, 2 and 4 years to collect information on exposure and health effects. The response rate at 4 years was 90%. A clinical investigation was performed at age 4 years, which included blood sampling for analysis of specific IgE to common food and airborne allergens.
Results: Parental allergic disease and onset of eczema or wheeze during the first year of life delayed introduction of fish in the child's diet. After exclusion of such children to avoid disease-related modification of exposure, regular fish consumption during the first year of life was associated with a reduced risk for allergic disease by age 4, ORadj 0.76 (95% CI 0.61–0.94) and sensitization, ORadj 0.76 (0.58–1.0). The reduced risk appeared most pronounced for multiple disease, ORadj 0.56 (0.35–0.89). IgE-sensitization to fish was only present among 18 of the 2614 children.
Conclusion: Regular fish consumption before age 1 appears to be associated with a reduced risk of allergic disease and sensitization to food and inhalant allergens during the first 4 years of life.
270 citations
TL;DR: Exposure to maternal cigarette smoking in utero is a risk factor for recurrent wheezing, as well as doctor's diagnosed asthma in children up to two yearsof age.
Abstract: Background
Exposure to cigarette smoking during foetal and early postnatal life may have implications for lung health. The aim of this study was to assess the possible effects of such exposure in utero on lower respiratory disease in children up to two years of age.
241 citations
TL;DR: Certain features of the anthroposophic lifestyle, such as restrictive use of antibiotics and antipyretics, are associated with a reduced risk of allergic disease in children.
Abstract: Background The anthroposophic lifestyle has several features of interest in relation to allergy: for example, a restrictive use of antibiotics and certain vaccinations. In a previous Swedish study, Steiner school children (who often have an anthroposophic lifestyle) showed a reduced risk of atopy, but specific protective factors could not be identified. Objective To investigate factors that may contribute to the lower risk of allergy among Steiner school children. Methods Cross-sectional multicenter study including 6630 children age 5 to 13 years (4606 from Steiner schools and 2024 from reference schools) in 5 European countries. Results The prevalence of several studied outcomes was lower in Steiner school children than in the reference group. Overall, there were statistically significant reduced risks for rhinoconjunctivitis, atopic eczema, and atopic sensitization (allergen-specific IgE ≥0.35 kU/L), with some heterogeneity between the countries. Focusing on doctor-diagnosed disease, use of antibiotics during first year of life was associated with increased risks of rhinoconjunctivitis (odds ratio [OR], 1.97; 95% CI, 1.26-3.08), asthma (OR, 2.79; 95% CI, 2.03-3.83), and atopic eczema (OR, 1.63; 95% CI, 1.22-2.17). Early use of antipyretics was related to an increased risk of asthma (OR, 1.54; 95% CI, 1.11-2.13) and atopic eczema (OR, 1.32; 95% CI, 1.02-1.71). Children having received measles, mumps, and rubella vaccination showed an increased risk of rhinoconjunctivitis, whereas measles infection was associated with a lower risk of IgE-mediated eczema. Conclusion Certain features of the anthroposophic lifestyle, such as restrictive use of antibiotics and antipyretics, are associated with a reduced risk of allergic disease in children.
219 citations
TL;DR: How smoking interacts with HLA-DR shared epitope genes, the main genetic risk factors for RA, and result in a high risk of RA in individuals exposed to both of these risk factors is focused on.
Abstract: Rheumatoid arthritis (RA) is a complex disease in which environmental agents are thought to interact with genetic factors that influence susceptibility. This interaction triggers immunologic events that eventually result in the clinical signs of arthritis. Knowledge of the chain of etiological events that lead to the development of RA is incomplete. In this review, we describe the experimental approaches that are used to address the issue of gene-environment interactions in the etiology of RA, and discuss relevant examples of such interactions. We focus on how smoking, the best-known environmental risk factor for RA, interacts with HLA-DR shared epitope genes, the main genetic risk factors for RA, and result in a high risk of RA in individuals exposed to both of these risk factors. From these and other related findings, we can begin to define the distinct environmental risk factors (such as smoking) that in certain genetic contexts (for example, the presence of HLA-DR shared epitope alleles) can trigger immune reactions (such as autoantibodies to citrullinated peptides) many years before onset of RA, and consider how these immune reactions might contribute to clinical symptoms in a subset of affected patients. Increased knowledge about these and other events involved in the development of RA should enable the design of new tools for suppressing RA pathogenesis before the onset of disease.
190 citations
TL;DR: It is suggested that smoking in the context of HLA-DR SE might trigger immunity to citrulline-modified proteins and that this immunity, after several years, might cause arthritis.
186 citations
TL;DR: Some support is provided for an association between long-term air pollution exposure and fatal cardiovascular disease in first-time MI cases and population controls in Stockholm county in 1992 to 1994.
Abstract: BACKGROUND:Cohort studies have reported increased risks of cardiopulmonary mortality from long-term air pollution exposure, but the evidence is limited and inconclusive. We studied the association ...
149 citations
TL;DR: There was no significant translocation of inhaled 35-nm particles to the systemic circulation over a 24-h period and particle labeling stability was tested in vitro during 48 h.
Abstract: Human pulmonary retention of 35 nm 99mTc-labeled carbonaceous particles, produced with a modified Technegas generator, was followed for 24 h using a gamma camera imaging technique. Nine healthy subjects and four asthmatics inhaled the test particles. Particle labeling stability was tested in vitro during 48 h. We also measured in vivo leaching in blood and in urine for 24 h. One additional subject was exposed to particles with unstable labeling. There were no significant differences between healthy and asthmatic subjects in any of the parameters studied. Particle retention after 24 h was 102% (SD ± 4.7). Cumulative in vitro leaching of 99mTc activity from the particles was 1.7% (±1.1) after 24 h. In blood samples, 80 min after exposure, 1.1% (± 0.4) of initially deposited activity was detected and 91% of the activity was not bound to particles. In urine sampled during the first 24 h after exposure, 3.6% (± 0.9) of lung deposited activity was detected. Lung retention was 30% after 1 h in the subject expose...
107 citations
TL;DR: Higher levels of exposure for the ERI components were associated with increased prevalence of sleep disturbances and fatigue, and the strongest association was seen between high overcommitment and fatigue.
Abstract: Objectives: The objective of this study was to investigate the validity of the effort–reward imbalance (ERI) model in relation to disturbed sleep and fatigue. Methods: The study population derived from a subset of the WOLF (WOrk, Lipids, Fibrinogen) cohort study of cardiovascular risk in a working population who replied to the ERI-questionnaire comprising 789 men and 214 women. Cox regression analysis was used to calculate the prevalence ratio (PR) for sleep disorders and fatigue in relation to the components of ERI. Results: As sleep disturbances and fatigue, based on literature, were defined to be represented by the uppermost quintile, 14% of the men and 23% of the women were affected by sleep disturbances while 14 and 26%, respectively, were affected by fatigue. Higher levels of exposure for the ERI components were associated with increased prevalence of sleep disturbances and fatigue. For men, the strongest association was seen between high overcommitment and fatigue (PR 5.77, 95% confidence interval 2.89–11.5). For women, high effort and sleep disturbances (PR 4.04, CI 1.53–10.7), high effort/reward ratio and sleep disturbances (PR 4.13, CI 1.62–10.5), and between low reward and fatigue (PR 4.36, CI 1.79–10.6) yielded the most obvious associations. Conclusions: The present study adds sleep disturbances and fatigue to the list of adverse consequences of effort–reward imbalance.
TL;DR: In this paper, the authors studied the association between early-life supplementation of vitamins A and D in water-soluble form or in peanut oil and allergic diseases up to 4 years of age.
Abstract: Background Early vitamin supplementation is given routinely to infants in many countries, but it is unclear whether this affects the risk of allergic diseases. Objectives We sought to study the association between early-life supplementation of vitamins A and D in water-soluble form or in peanut oil and allergic diseases up to 4 years of age. Methods A prospective birth cohort of 4089 newborn infants was followed for 4 years using parental questionnaires repeatedly to collect information on exposure and health. At 4 years, the response rate was 90%, and allergen-specific IgE levels to food and airborne allergens were measured in 2614 of the participating children. Results Vitamins A and D were given to 98% of the children in infancy, and vitamins based in peanut oil dominated (90%). Children supplemented with vitamins A and D in water-soluble form during the first year of life had an almost 2-fold increased risk of asthma (adjusted odds ratio [OD], 2.18; 95% CI, 1.45-3.28), food hypersensitivity (adjusted OR, 1.89; 95% CI, 1.33-2.65), and sensitization to common food and airborne allergens (adjusted OR, 1.88; 95% CI, 1.34-2.64) at age 4 years compared with those receiving vitamins in peanut oil. No increased risk of IgE antibodies to peanut was seen in children receiving vitamins in peanut oil. Conclusion Supplementation of vitamins A and D in water-soluble form seems to increase the risk of allergic disease up to the age of 4 years compared with supplementation with the same vitamins given in peanut oil. Clinical implications Vitamins A and D in oil does not seem to increase the risk of allergic disease during childhood.
TL;DR: Lorry drivers experienced the highest exposure and taxi drivers the lowest with bus drivers in an intermediate position, regardless of whether NO2 or particles were used as exposure indicator, indicating that the taxi drivers’ exposure mainly depends on exhaust from surrounding traffic.
Abstract: Aim: The aims of this study have been to investigate the occurrence of systematic differences in the personal exposure to motor exhaust between different groups of taxi, bus and lorry drivers, and to study if these are influenced by the choice of exposure indicator. Methods: We used one indicator of the gaseous phase, nitrogen dioxide (NO2), and one of the particle phase (measured by DataRAM), of the exhausts. A total of 121 drivers were included in the study: 39 taxi drivers, 42 bus drivers and 40 lorry drivers. Personal measurements were performed during one working day. Nitrogen dioxide was measured with passive diffusive samplers and particles with Data-RAM, a logging instrument using nephelometric monitoring. The instrument measures particles between 0.1 and 10 μm in size. Results: The average exposure to NO2 for lorry drivers was 68 μg/m3; for bus drivers 60 μg/m3 and for taxi drivers 48 μg/m3. For particles the exposure was 57 μg/m3 for lorry drivers, 44 μg/m3 for bus drivers and 26 μg/m3 for taxi drivers. The result remained unchanged when exposures were adjusted for variation in urban background levels of NO2 and particulate matter with an aerodynamic diameter <10 μm (PM10). Conclusion: Lorry drivers experienced the highest exposure and taxi drivers the lowest with bus drivers in an intermediate position, regardless of whether NO2 or particles were used as exposure indicator. The levels of both NO2 and particles were higher for bus drivers in the city than for them driving in the suburbs. Using diesel or petrol as a fuel for taxis had no influence on the exposure for the drivers, indicating that the taxi drivers’ exposure mainly depends on exhaust from surrounding traffic.
TL;DR: A large number of children in Europe are diagnosed with asthma and atopic diseases and the reasons for the rise in asthma and allergies remain unclear, and longitudinal epidemiological studies are essential to identify risk or protective factors.
Abstract: Background: The reasons for the rise in asthma and allergies remain unclear. To identify risk or protective factors, it is essential to carry out longitudinal epidemiological studies, preferably birth cohort studies. In Europe, several birth cohort studies on asthma and atopic diseases have been initiated over the last two decades. Aim: One of the work packages within the Global Allergy and Asthma European Network (GA 2 LEN) project was designed to identify and compare European birth cohorts on asthma and atopic diseases. The present review (part I) describes their objectives, study settings, recruitment process and follow-up rates. A subsequent review (part II) will compare outcome and exposure parameters. Methods: For each birth cohort, we collected detailed information regarding recruitment process, study setting, baseline data (pregnancy, birth, parents/siblings) as well as follow-up rates, outcome and exposure parameters at each time point. Results: We identified and assessed 18 European birth cohorts on asthma, allergic rhinitis and eczema. Six of these studies also focused on food allergies. The birth cohorts were mostly initiated in the 1990s with predominantly urban/ metropolitan settings. Many studies were able to maintain high follow-up rates, even after five or more years. Conclusions: Due to the unique cooperation within the GA 2 LEN project a common database was established containing study characteristics of European birth cohorts on asthma and atopic diseases. This can be used as a basis for evaluating the possibility to pool data and perform meta-analyses, as well as to recommend criteria for conducting future birth cohorts.
TL;DR: This poster presents a poster presenting a poster presented at the 2016 European Congress of Epilepsy and Immunology entitled “Evaluating the immune response to corticosteroids and their applications in the treatment of asthma.
Abstract: BACKGROUND: The Global Allergy and Asthma European Network (GA2LEN) is a consortium of 26 leading European research centres committed to establish a European research area of excellence in the field of allergy and asthma. AIM: One of the GA2LEN work packages was designed to identify and compare the existing European birth cohort studies on asthma and atopic diseases. The present review compares their subjective and objective outcomes as well as exposure variables. METHODS: A common database was established to assess study characteristics of observational birth cohort studies designed to examine asthma and atopic diseases. Data were collected by visiting most of the participating research teams and interviewing all relevant study personnel. For each study, the type of objective/subjective outcome parameters and potentially influential factors were recorded precisely for every time point during follow-up. RESULTS: Eighteen birth cohort studies on asthma and atopic diseases were identified in eight European countries. Thirteen studies collected data on specific immunoglobulin E (IgE) to various inhalant and food allergens, whereas 12 performed skin prick tests (many at several time points during follow up). Several studies measured lung function, but across the cohorts no comparable standard procedures were used. For subjective evaluation of asthma and allergic rhinitis most studies applied the ISAAC questionnaire (sometimes modified), whereas the assessment of eczema was rather heterogeneous across the studies. CONCLUSION: This GA2LEN initiative established a unique common database of 18 European birth cohorts on asthma and atopic diseases. For selected cohorts, it seems that pooling data and performing common analyses may be possible to examine associations between certain exposure variables (e.g. pet ownership, tobacco smoke exposure and day-care) and selected outcome measures for atopy, asthma or allergic rhinitis (e.g. sensitization assessed by IgE or skin prick tests, doctor's diagnosis of asthma, parental perception regarding asthma/wheezing or hay fever symptoms).
TL;DR: The patients were considerably more troubled than Swedish norm groups at intake and they showed improvement on all outcome measures during therapy, however, the post therapy means did not fully reach the norm group means.
Abstract: The aims of this naturalistic study are to present patient characteristics and analyse various outcome measures at termination for psychoanalytic psychotherapies with young adults. Patients (n = 134) between 18 and 25 years were included, of whom 92 received individual and 42 group therapy. One third had a self-reported personality disorder. The patients were considerably more troubled than Swedish norm groups at intake and they showed improvement on all outcome measures during therapy. However, the post therapy means did not fully reach the norm group means. The largest positive changes (pre- versus post-therapy) were with respect to the patients' overall health and functioning. Changes were more moderate in self-reported symptoms, self-concept, and self-representation, while changes in interpersonal problems and object representations were small. The results of this study are discussed in the context of advantages and disadvantages of naturalistic versus randomized controlled study designs.
TL;DR: Results strongly suggest that SOCS3, located in a chromosomal region previously linked to the disease (17q25), is a susceptibility gene for atopic dermatitis.
Abstract: In a systematic analysis of global gene-expression patterns, we found that SOCS3 messenger RNA was significantly more highly expressed in skin from patients with atopic dermatitis than in skin from healthy controls, and immunohistochemical analysis confirmed a similar elevation of SOCS3 protein. Furthermore, we found a genetic association between atopic dermatitis and a haplotype in the SOCS3 gene in two independent groups of patients (P<.02 and P<.03). These results strongly suggest that SOCS3, located in a chromosomal region previously linked to the disease (17q25), is a susceptibility gene for atopic dermatitis.
TL;DR: SLS induces an inflammatory response in keratinocytes and alters the mRNA expression of important barrier lipid enzymes and markers of keratinocyte differentiation, of possible importance for the irritant properties of SLS.
TL;DR: Urban and rural area should be considered in an exposure index for classification of the exposure to RF from mobile phones and may be assessed by first base station during mobile phone calls or, if this information is not available, possibly by using home address as a proxy.
Abstract: Mobile phone use is increasing but there is also concern for adverse health effects. Well-designed prospective studies to assess several health outcomes are required. In designing a study of mobile phone use, it is important to assess which factors need to be considered in classifying the exposure to radiofrequency fields (RF). A pilot study was performed in Sweden and in the UK 2002 to 2003 to test the feasibility of recruiting a cohort of mobile phone users from a random population sample and from mobile phone subscription lists for a prospective study. As one part of this pilot study, different factors were evaluated regarding possible influence on the output power of the phones. By local switch logging, information on calls made from predefined subscriptions or dedicated handsets were obtained and the output power of phones during calls made indoors and outdoors, in moving and stationary mode, and in rural as well in urban areas were compared. In this experiment, calls were either 1, 1.5 or 5 min long. The results showed that high mobile phone output power is more frequent in rural areas whereas the other factors (length of call, moving/stationary, indoor/outdoor) were of less importance. Urban and rural area should be considered in an exposure index for classification of the exposure to RF from mobile phones and may be assessed by first base station during mobile phone calls or, if this information is not available, possibly by using home address as a proxy.
TL;DR: The validated question ‘Have you had childhood eczema?’ was validated and showed that the question overestimated prevalence of AE in childhood and may overestimate AE as a risk factor for hand Eczema in adult population surveys.
Abstract: Atopic eczema (AE) is a major risk factor for hand eczema. In Scandinavian population-based studies, the occurrence of AE in childhood has often been assessed by the question 'Have you had childhood eczema?' In the present study, this question was validated. A questionnaire was sent to 600 cases with AE and 600 controls without eczema or allergic disease, identified in school medical records from the 1960s. The response rate was 70.5%, and the mean age of the respondents was 36.7 years. The specificity of the question was 70.7% and the sensitivity 89.9%. The sensitivity was higher and the specificity lower in a subgroup with current hand eczema compared with a group without hand eczema. The results showed that the question overestimated the prevalence of AE in childhood by a factor of 1.6. When used for risk assessment, the question provided a better estimate of the risk of current hand eczema as compared with the lifetime risk of hand eczema. In conclusion, the validated question overestimated prevalence of childhood AE and may overestimate AE as a risk factor for hand eczema in adult population surveys.
TL;DR: The aim of this paper was to summarize the presentations and discussions on the theme Irritants and Wet Work at the second conference on Occupational and Environmental Exposures of Skin to Chemicals held in Stockholm June 2005 to bring the focus points to a broader group of professionals and stimulate further discussions.
Abstract: The aim of this paper was to summarize the presentations and discussions on the theme Irritants and Wet Work at the second conference on Occupational and Environmental Exposures of Skin to Chemicals held in Stockholm June 2005 (OEESC-2005) to bring the focus points to a broader group of professionals and stimulate further discussions. Occupational skin diseases are common diseases with a huge potential for prevention. The risk factors are mostly well known, and the ongoing high occurrence of occupational skin diseases may be seen as a paradox problem. Although all mechanisms involved in occupational skin diseases are not shown throughout, much is known. The existing knowledge justifies the relevance of reducing exposure and introducing prevention programmes. The questions identified for further research included an internationally agreed-upon definition of wet work; better methods to assess the exposure to wet work; the effect of combined exposure to water and water-soluble irritants; the importance of wet work with frequent/short wet-dry cycles versus working longer periods with wet hands; testing skin protection and skin care products; long-term skin effects from alcohol-based hand disinfectants; workplace testing of evidence-based prevention programmes in prospective randomized, controlled intervention studies.
TL;DR: The level of air pollution exposure when cycling seemed to be comparable with the levels of exposure when sitting inside a vehicle and the VE during cycling was four times higher than resting value, which led to increased exposure to air pollution.
Abstract: The purpose of the study was to determine the level of energy expenditure and exposure to air pollution for bicycle messengers. Relationships between heart rate (HR) and oxygen uptake, and between HR and pulmonary ventilation (VE) for each participant were established in laboratory tests. Air pollution and HR were measured during one working day. The total oxygen uptake was then described as the total energy expenditure in Joule (J) and in multiples of the energy expenditure at rest (MET). The mean energy expenditure during a working day (8 h) was 12 MJ, (4.8 MET). The level of air pollution exposure when cycling seemed to be comparable with the levels of exposure when sitting inside a vehicle. The VE during cycling was four times higher than resting value. Increased VE led to increased exposure to air pollution.
TL;DR: Poisson regression analyses are less time-consuming, and therefore might be used for confounder selection and most of the analyses, and extended Cox regression analyses would allow a joint estimation of long-term and short-term health effects of time-varying exposures.
Abstract: Short-term fluctuations of ambient air pollution have been associated with exacerbation of cardiovascular disease. A multi-city study was designed to assess the probability of recurrent hospitalization in a cohort of incident myocardial infarction survivors in five European cities. The objective of this paper is to discuss the methods for analyzing short-term health effects in a cohort study based on a case-series. Three methods were considered for the analyses of the cohort data: Poisson regression approach, case-crossover analyses and extended Cox regression analyses. The major challenge of these analyses is to appropriately consider changes within the cohort over time due to changes in the underlying risk following a myocardial infarction, slow time trends in risk factors within the population, dynamic cohort size and seasonal variation. Poisson regression analyses, case-crossover analyses and Extended Cox regression analyses gave similar results. Application of smoothing methods showed the capability to adequately model the complex time trends. From a practical point of view, Poisson regression analyses are less time-consuming, and therefore might be used for confounder selection and most of the analyses. However, replication of the results with Cox models is desirable to assure that the results are independent of the analytical approach used. In addition, extended Cox regression analyses would allow a joint estimation of long-term and short-term health effects of time-varying exposures.
TL;DR: The use of self‐reported questionnaires has the drawback of recall bias, and studies based on hospital records reflect selected populations and may miss less severe cases of AD.
Abstract: Background: Atopic dermatitis (AD) is common in the population, and studies have shown that the disease is on the increase. Studies based on hospital records reflect selected populations and may miss less severe cases of AD, and the use of self-reported questionnaires has the drawback of recall bias. Objectives: To investigate some possible factors influencing recall bias when questionnaires are used to establish the prevalence of childhood eczema in an adult population. Methods: A questionnaire regarding past and present eczema was sent to 557 cases (with signs suggesting the diagnosis AD) and 554 matched controls (subjects lacking signs of AD) born during 1960-1969 and identified in school health medical records. Cases and controls were aged 31-42 years at the time of the study and 70.5% returned the questionnaire. Results: Of 403 cases, 29% did not report childhood eczema in the questionnaire. There was a difference between those who did recall their childhood AD (remembering group, RG), and those who did not (forgetful group, FG) in who had documented the diagnostic signs in the school health records. In the RG the signs were reported by both parents and school health personnel in 51% of cases, and in the FG this was true of only 16%. The RG had a higher prevalence of eczema after 15 years of age and of hand eczema. The RG also reported more visits to physicians after the age of 15 years and more time taken as sick leave due to eczema. Conclusions: Several factors influence how well people remember their AD in childhood. These factors include disease activity in adult life, disease severity, and who noticed the eczema in childhood. (Less)
TL;DR: In this article, patients' development across stages in long-term psychodynamic psychotherapy or psychoanalysis was studied in relation to various parameters of their therapists' training, or personal therapies.
Abstract: Patients' development across stages in long-term psychodynamic psychotherapy or psychoanalysis was studied in relation to various parameters of their therapists' training, or personal, therapies. T ...
TL;DR: Socks appeared to yield less dust from mattresses at relatively low dust amounts and more dust at high dust amounts than ALK samples, and levels of allergens and microbial agents in sock samples taken by study participants are moderately to highly correlated to levels in ALK sample taken by fieldworkers.
Abstract: Dust collection by study participants instead of fieldworkers would be a practical and cost-effective alternative in large-scale population studies estimating exposure to indoor allergens and microbial agents. We aimed to compare dust weights and biological agent levels in house dust samples taken by study participants with nylon socks, with those in samples taken by fieldworkers using the sampling nozzle of the Allergology Laboratory Copenhagen (ALK). In homes of 216 children, parents and fieldworkers collected house dust within the same year. Dust samples were analyzed for levels of allergens, endotoxin, (1-->3)-beta-D-glucans and fungal extracellular polysaccharides (EPS). Socks appeared to yield less dust from mattresses at relatively low dust amounts and more dust at high dust amounts than ALK samples. Correlations between the methods ranged from 0.47-0.64 for microbial agents and 0.64-0.87 for mite and pet allergens. Cat allergen levels were two-fold lower and endotoxin levels three-fold higher in socks than in ALK samples. Levels of allergens and microbial agents in sock samples taken by study participants are moderately to highly correlated to levels in ALK samples taken by fieldworkers. Absolute levels may differ, probably because of differences in the method rather than in the person who performed the sampling. Practical Implications Dust collection by participants is a reliable and practical option for allergen and microbial agent exposure assessment. Absolute levels of biological agents are not (always) comparable between studies using different dust collection methods, even when expressed per gram dust, because of potential differences in particle-size constitution of the collected dust.
TL;DR: This work has shown clear results regarding sensitization to different inhalant allergens in adolescents and adults that are consistent with those seen in children under the age of 15 years old.
Abstract: Summary
Background Although the relationship between sensitization to different inhalant allergens in adolescents and adults has been intensively studied, information concerning sensitization in children is scarce in particular to pollens.
Objectives In 4-year-old children to elucidate the pollen immunoglobulin (IgE) antibody profile (birch only, timothy only and combinations of three pollens (birch, timothy or mugwort) and to relate the results to other inhalant and food allergens, as well as the presence of allergic diseases.
Methods A total of 2551 4-year-old children belonging to a prospective birth cohort, which has been followed longitudinally (BAMSE), were investigated with respect to IgE antibodies to pollen and other inhalant and food allergens, and expression of allergic disease, based on questionnaire data.
Results Eleven percent (n=285) of the children were sensitized to pollen. Birch was the dominating cause of pollen sensitization (birch sensitization only, n=133); followed by timothy grass pollen (n=56) and a combination of two (n=64) or three (n=30) pollens. A remarkably high proportion of the children sensitized only to birch was also sensitized to other inhalant allergens. This was not seen for children sensitized only to timothy. The highest frequencies of IgE reactivity to food were found in the group of children sensitized to the combination of birch, timothy and mugwort pollen. Children sensitized to timothy only, exhibited symptoms of allergic disease significantly less frequently compared with children sensitized to birch only. Sensitization to birch pollen was found to be closely associated with rhinitis and eczema compared with asthma. The highest frequency of asthma and/or rhinitis and/or eczema was reported in children sensitized to at least two pollens.
Conclusion Our results demonstrate that birch is the dominating source of pollen sensitization at the age of four in Sweden. This might associate with the pattern of sensitization to other inhalant and food allergens as well as influence on the expression of allergic disease in this particular age group.
TL;DR: The intervention seemed to impact on work conditions and on the perceived quality of nursing rather than on the health and well-being of staff, and the importance of involving the middle management in early project planning and decisions was emphasized.
Abstract: This study evaluated the impact of an intervention programme at individual, worksite, and organizational level, for eldercare nursing staff at 12 eldercare units. The project aimed at empowering auxiliary nurses and nursing assistants, thus promoting good working conditions, health and well-being of eldercare staff, and improving their evaluation of the quality of nursing care. Questionnaire responses from the nursing staff (n=200) before and after an 18-month intervention programme evaluated the effects using ANOVA, repeated measures for the statistical analyses. Although the improvements were limited, the intervention seemed to impact on work conditions and on the perceived quality of nursing rather than on the health and well-being of staff. Work at nursing homes or at home-care was shown to modify the outcome due to different needs and priorities for work unit improvements. Staff turnover and multiple reorganizations are discussed as inhibiting factors for performance as well as for the evalu...
TL;DR: Therapists with a psychoanalytic or eclectic orientation are systematically different in terms of the outcomes they tend to contribute to with their patients, partly accounted for by differences in their therapeutic attitudes.
Abstract: Background. Previous research has reported large differences in treatment results between individual therapists practising the same type of psychotherapy, but little is as yet known about the factors explaining this variation. In previous studies the authors have found associations with therapeutic attitudes as measured by the TASC 2 scales. Methods. A sample of 160 therapists were clustered in a non-parametric latent class (LC) regression modelling of their patients' repeated self-ratings on the SCL-90 across stages in psychotherapeutic treatment. This classification was then explored in relation to the therapists' TASC 2 scores. Results. Five classes were identified differing widely in terms of the patients' outcome trajectories. Membership in these classes was significantly influenced by the therapists' scores on the TASC 2 scales. The adjustment, neutrality and artistry scales of the TASC 2 were found specifically discriminative. A discriminant analysis confirmed the findings in general. Collectively, the TASC 2 scales were able to assign 56% of the therapists to their correct latent class, in comparison with 20% by chance. Conclusions. Therapists with a psychoanalytic or eclectic orientation are systematically different in terms of the outcomes they tend to contribute to with their patients. This variation is partly accounted for by differences in their therapeutic attitudes. © 2006 The British Psychological Society.
TL;DR: The nationwide smoking cessation quitline appears to have had a positive effect on GPs' engagement in smoking cessation, and a paradigm shift regarding awareness of the complexity of smoking cessation support may be ongoing amongst Swedish GPs.
Abstract: This cross-sectional study assessed changes between 1999 and 2003 in attitudes among Swedish general practitioners (GPs) toward smoking cessation activities and also assessed the effect of a nationwide quitline on GPs' smoking cessation activities. A random sample of 621 Swedish GPs answered a questionnaire mailed to their home addresses in spring 2003. When possible, the results of the present study were compared with results from a similar study conducted in 1999. Main outcome measures were GPs' self-reported activities, perceived barriers to engaging in smoking cessation, and referrals to the quitline. Between 1999 and 2003, GPs increased their overall smoking cessation activities and were more aware of the complexity of smoking cessation support. Significantly more GPs experienced smoking cessation support as "too time consuming" and preferred to refer smokers to counselors specializing in smoking cessation. GPs referring patients to the quitline were more likely to be active in other smoking cessation activities. One out of five GPs had advised their patients to use oral smokeless tobacco as a means to stop smoking. A paradigm shift regarding awareness of the complexity of smoking cessation support may be ongoing amongst Swedish GPs. The nationwide smoking cessation quitline appears to have had a positive effect on GPs' engagement in smoking cessation.