scholarly journals Early childhood adversity and non-affective psychosis: a study of refugees and international adoptees in Sweden

2021 ◽  
pp. 1-10
Author(s):  
Anders Hjern ◽  
Jesús Palacios ◽  
Bo Vinnerljung
Keyword(s):  
Early Childhood ◽  
Psychotic Disorders ◽  
Cox Regression ◽  
Psychiatric Morbidity ◽  
Childhood Adversity ◽  
First Year ◽  
Hazard Ratios ◽  
International Adoptees ◽  
First Year Of Life ◽  
Risk Pattern

Abstract Background Previous Scandinavian studies have shown increased levels of psychiatric morbidity in young refugees and international adoptees with an origin outside Europe. This study investigated their risk of non-affective psychotic disorders (NAPD) and whether this risk is influenced by early childhood adversity, operationalised as age at adoption/residency, and/or gender. Methods Register study in Swedish national cohorts born 1972–1990 including 21 615 non-European international adoptees, 42 732 non-European refugees that settled in Sweden at age 0–14 years and 1 610 233 Swedish born. The study population was followed from age 18 to year 2016 for hospitalisations with a discharge diagnosis of NAPD. Hazard ratios (HRs) were calculated in gender stratified Cox regression models, adjusted for household income at age 17. Results The adjusted risks of NAPD were 2.33 [95% confidence interval (CI) 2.07–2.63] for the international adoptees and 1.92 (1.76–2.09) for the former child refugees, relative to the Swedish-born population. For the international adoptees there was a stepwise gradient for NAPD by age of adoption from adjusted HR 1.66 (1.29–2.03) when adopted during the first year of life to adjusted HR 4.56 (3.22–6.46) when adopted at ages 5–14 years, with a similar risk pattern in women and men. Age at residency did not influence the risk of NAPD in the refugees, but their male to female risk ratio was higher than in Swedish-born and the adoptees. Conclusion The risk pattern in the international adoptees gives support to a link between early childhood adversity and NAPD. Male gender increased the risk of NAPD more among the refugees.

scholarly journals Enough with the tables, we need ideas.

2019 ◽  
Vol 4 (3) ◽  
Author(s):  
Antony Stevens
Keyword(s):  
Early Childhood ◽  
Health Outcomes ◽  
Interpersonal Violence ◽  
Contingency Table ◽  
Population Studies ◽  
First Year ◽  
Central Brazil ◽  
To Come ◽  
First Year Of Life ◽  
The Way

One of the consequences of owning a farm in Central Brazil is that I frequently meet people who do things and have life narratives that we are unlikely to come across in texts on sociology or epidemiology. In the nearby town they live in streets that have postal codes that would place all the residents in the same cell of a contingency table. But in each residence lives a family with a separate and unique story. I believe that it is worth asking whether it is really the perceived similarities that determine their health outcomes. Yes, perhaps when sanitation is involved, but there are other health outcomes that would not be centered on the postcode. I have spent the last two years helping to link notifications of interpersonal violence with birth and mortality records. The idea is to find some way to stop men harming their partners. If this can be achieved by changing the way the law reacts to the violence then these linkages may prove useful, especially when legal and penal records are included in the studies. But what if what needs to be changed is the way a boy is treated in his first year of life? It is unlikely that information collected at the time of the violence would be accurate about events in early childhood. How could record linkages tell us that we should be looking elsewhere? I have no idea. But I believe it to be the most important question in population studies today. Statisticians are always pleased to tell us that we have failed to prove something. We need a methodology that tells us where to look. Also it must be based on something with more possibilities than those currently offered by diluted Marxism.

6116Thromboembolic risk in infection-related atrial fibrillation: is infection or atrial fibrillation the sinner?

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Gundlund ◽  
J B Olesen ◽  
J H Butt ◽  
M A Christensen ◽  
G H Gislason ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Hospital Admission ◽  
Cox Regression ◽  
Anticoagulation Therapy ◽  
First Year ◽  
Thromboembolic Events ◽  
Cox Regression Analysis ◽  
Hazard Ratios ◽  
Study Population ◽  
Hospital Contact

Abstract Introduction Infection-related atrial fibrillation (AF) has been associated with similar risk of thromboembolic events as AF without a concurrent infection. However, it is unknown whether the increased thromboembolic risk in this patient group is primarily associated with AF or with the infection. Purpose We compared type of infection and 1-year outcomes in patients with AF during an infection and in patients with infection without AF. Methods By crosslinking data from Danish nationwide registries, AF naïve patients admitted with an infection from 1996–2016 were identified. Patients with infection-related AF (defined as patients who developed AF during their hospital admission with infection) were matched 1:3 on age, calendar year, sex, and type of infection (gastrointestinal infection, pneumonia, urinary tract infection, sepsis, and other infections) with those who had infection without AF. Cumulative incidences of thromboembolic events were calculated using the Aalen Johansen estimator and adjusted hazard ratios (HR) of thromboembolic events and hospital contacts with AF were assessed by multivariable Cox regression analysis comparing those with infection-related AF with those with infection without AF. Results The study population comprised 30,711 patients with infection-related AF and 92,133 patients with infection without AF (median age 79 years [interquartile range 71–86] and 47.6% males in both groups). In general, patients with infection-related AF had more concurrent diseases than patients with infection without AF. During the first week after the hospital admission, 9.8% of the patients with infection-related AF and 0.1% of the patients with infection without AF initiated oral anticoagulation therapy. During the first year after the infection, 7.6% of patients with infection-related AF and 4.4% of patients with infection without AF had a thromboembolic event, while 36.1% and 1.8% had a new hospital-contact with AF. Cumulative incidences of thromboembolic events are depicted in the Figure. In the multivariable models, infection-related AF was associated with an increased 1-year risk of thromboembolic events and new hospital contacts with AF compared with infection without AF (HR 2.05, 95% confidence interval (CI) 1.94–2.17 for thromboembolic events and HR 26.06, 95% CI 24.72–27.48 for new AF episodes, respectively). Conclusion More than one third of patients with infection-related AF had a new hospital contact with AF during the first year after their infection. Further, infection-related AF was associated with a significantly increased 1-year risk of thromboembolic events compared with infection without AF. Consequently, this study suggests that AF begets AF, even if it presents during an infection. Acknowledgement/Funding None

scholarly journals Birth characteristics and all-cause mortality: a sibling analysis using the Uppsala birth cohort multigenerational study

2016 ◽  
Vol 7 (4) ◽  
pp. 374-383 ◽  
Author(s):  
S. Juárez ◽  
A. Goodman ◽  
B. De Stavola ◽  
I. Koupil
Keyword(s):  
Birth Weight ◽  
Cox Regression ◽  
Adult Life ◽  
University Hospital ◽  
First Year ◽  
Maternal Characteristics ◽  
All Cause Mortality ◽  
Early Adult Life ◽  
Birth Characteristics ◽  
First Year Of Life

This paper investigates the association between perinatal health and all-cause mortality for specific age intervals, assessing the contribution of maternal socioeconomic characteristics and the presence of maternal-level confounding. Our study is based on a cohort of 12,564 singletons born between 1915 and 1929 at the Uppsala University Hospital. We fitted Cox regression models to estimate age-varying hazard ratios of all-cause mortality for absolute and relative birth weight and for gestational age. We found that associations with mortality vary by age and according to the measure under scrutiny, with effects being concentrated in infancy, childhood or early adult life. For example, the effect of low birth weight was greatest in the first year of life and then continued up to 44 years of age (HR between 2.82 and 1.51). These associations were confirmed in within-family analyses, which provided no evidence of residual confounding by maternal characteristics. Our findings support the interpretation that policies oriented towards improving population health should invest in birth outcomes and hence in maternal health.

Antibiotic use in the first year of life and asthma in early childhood

2004 ◽  
Vol 34 (7) ◽  
pp. 1011-1016 ◽  
Author(s):  
J.C. Celedon ◽  
A. Fuhlbrigge ◽  
S. Rifas-Shiman ◽  
S.T. Weiss ◽  
J.A. Finkelstein
Keyword(s):  
Early Childhood ◽  
Antibiotic Use ◽  
First Year ◽  
First Year Of Life

A systematic review of risk factors during first year of life for early childhood caries

2012 ◽  
Vol 23 (4) ◽  
pp. 235-250 ◽  
Author(s):  
Pamela Margaret Leong ◽  
Mark Gregory Gussy ◽  
Su-Yan L. Barrow ◽  
Andrea de Silva-Sanigorski ◽  
Elizabeth Waters
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Early Childhood ◽  
Early Childhood Caries ◽  
First Year ◽  
First Year Of Life ◽  
Childhood Caries

scholarly journals The influence of gestational age at term on breastfeeding: a cohort study

2021 ◽  
Vol 55 ◽  
Author(s):  
Nathallia Seródio Michelin ◽  
Hélio Rubens de Carvalho Nunes ◽  
Maria Antonieta de Barros Leite Carvalhaes ◽  
Cristina Maria Garcia de Lima Parada
Keyword(s):  
Gestational Age ◽  
Exclusive Breastfeeding ◽  
Cox Regression ◽  
Final Analysis ◽  
Negative Influence ◽  
First Year ◽  
Baby Bottle ◽  
One Year ◽  
First Year Of Life

ABSTRACT Objective: To identify the effect of the category gestational age at term on breastfeeding in he first hour of life, the duration of exclusive breastfeeding, and practice of breastfeeding twelve months from birth. Method: Single cohort, with a one-year prospective follow-up of 541 children. A hierarchical analysis was performed, with models adjusted per Cox regression, considering critical p < 0.05. Results: During raw analysis there was a statistical difference on breastfeeding in the first hour of life (RR = 1.54; CI 95% = 1.12–2.12; p = 0.008). However, in the final analysis, there was no association between gestational age at term and breastfeeding in the first hour of life, duration of exclusive breastfeeding, and the practice of breastfeeding twelve months from birth. Secondarily, higher age and education, cesarean section, birth at private services, and the need for resuscitation were observed to have a negative influence. Duration of previous pregnancy favored breastfeeding in the first hour of life. Using baby bottle and pacifier was negative for breastfeeding in the first year of life. Conclusion: There was no association between the category gestational age at term and breastfeeding. The association of outcomes pointed out by the scientific literature have been confirmed.

scholarly journals Changes in Albuminuria Predict Cardiovascular and Renal Outcomes in Type 2 Diabetes: A Post Hoc Analysis of the LEADER Trial

2021 ◽  
Author(s):  
Frederik Persson ◽  
Stephen C Bain ◽  
Ofri Mosenzon ◽  
Hiddo J.L. Heerspink ◽  
Johannes F. E. Mann ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cox Regression ◽  
Major Adverse Cardiovascular Events ◽  
First Year ◽  
Treatment Groups ◽  
Renal Outcomes ◽  
Hazard Ratios ◽  
Post Hoc ◽  
Design And Methods

<b>OBJECTIVE</b> <p>A <i>post hoc</i> analysis to investigate the association between 1-year changes in albuminuria and subsequent risk of cardiovascular and renal events. </p> <p><b>RESEARCH DESIGN AND METHODS</b></p> <p>LEADER was a randomized trial of liraglutide up to 1.8 mg/day versus placebo added to standard care for 3.5–5 years, in 9,340 participants with type 2 diabetes and high cardiovascular risk. We calculated change in urinary albumin-to-creatinine ratio (UACR) from baseline to 1 year in participants with >30% reduction (<i>N</i>=2,928), 30–0% reduction <i>N</i>=1,218) or any increase in UACR (<i>N</i>=4,124) irrespective of treatment. Using Cox regression, risks of major adverse cardiovascular events (MACE) and a composite nephropathy outcome (from 1 year to end of trial in subgroups by baseline UACR [<30 mg/g, 30–300 mg/g or ≥300 mg/g]) were assessed. The analysis was adjusted for treatment allocation alone as a fixed factor and for baseline variables associated with cardiovascular and renal outcomes.</p> <p><b>RESULTS</b></p> <p>For MACE, hazard ratios (HRs) for those with >30% and 30%–0% UACR reduction were 0.82 (95% CI 0.71–0.94; <i>P</i>=0.006) and 0.99 (0.82–1.19; <i>P</i>=0.912), respectively, compared with any increase in UACR (reference). For the composite nephropathy outcome, respective HRs (95% CI) were 0.67 (0.49–0.93; <i>P</i>=0.02) and 0.97 (0.66–1.43; <i>P</i>=0.881). Results were independent of baseline UACR and consistent in both treatment groups. After adjustment, HRs were significant and consistent in >30% reduction subgroups with baseline micro- or macroalbuminuria. </p> <p><b>CONCLUSIONS</b></p> <p>A reduction in albuminuria during the first year was associated with fewer cardiovascular and renal outcomes, independent of treatment. Albuminuria monitoring remains an important part of diabetes care, with great unused potential. </p>

scholarly journals Changes in Albuminuria Predict Cardiovascular and Renal Outcomes in Type 2 Diabetes: A Post Hoc Analysis of the LEADER Trial

2021 ◽  
Author(s):  
Frederik Persson ◽  
Stephen C Bain ◽  
Ofri Mosenzon ◽  
Hiddo J.L. Heerspink ◽  
Johannes F. E. Mann ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cox Regression ◽  
Major Adverse Cardiovascular Events ◽  
First Year ◽  
Treatment Groups ◽  
Renal Outcomes ◽  
Hazard Ratios ◽  
Post Hoc ◽  
Design And Methods

<b>OBJECTIVE</b> <p>A <i>post hoc</i> analysis to investigate the association between 1-year changes in albuminuria and subsequent risk of cardiovascular and renal events. </p> <p><b>RESEARCH DESIGN AND METHODS</b></p> <p>LEADER was a randomized trial of liraglutide up to 1.8 mg/day versus placebo added to standard care for 3.5–5 years, in 9,340 participants with type 2 diabetes and high cardiovascular risk. We calculated change in urinary albumin-to-creatinine ratio (UACR) from baseline to 1 year in participants with >30% reduction (<i>N</i>=2,928), 30–0% reduction <i>N</i>=1,218) or any increase in UACR (<i>N</i>=4,124) irrespective of treatment. Using Cox regression, risks of major adverse cardiovascular events (MACE) and a composite nephropathy outcome (from 1 year to end of trial in subgroups by baseline UACR [<30 mg/g, 30–300 mg/g or ≥300 mg/g]) were assessed. The analysis was adjusted for treatment allocation alone as a fixed factor and for baseline variables associated with cardiovascular and renal outcomes.</p> <p><b>RESULTS</b></p> <p>For MACE, hazard ratios (HRs) for those with >30% and 30%–0% UACR reduction were 0.82 (95% CI 0.71–0.94; <i>P</i>=0.006) and 0.99 (0.82–1.19; <i>P</i>=0.912), respectively, compared with any increase in UACR (reference). For the composite nephropathy outcome, respective HRs (95% CI) were 0.67 (0.49–0.93; <i>P</i>=0.02) and 0.97 (0.66–1.43; <i>P</i>=0.881). Results were independent of baseline UACR and consistent in both treatment groups. After adjustment, HRs were significant and consistent in >30% reduction subgroups with baseline micro- or macroalbuminuria. </p> <p><b>CONCLUSIONS</b></p> <p>A reduction in albuminuria during the first year was associated with fewer cardiovascular and renal outcomes, independent of treatment. Albuminuria monitoring remains an important part of diabetes care, with great unused potential. </p>

Familial factors and suicide: an adoption study in a Swedish National Cohort

2010 ◽  
Vol 41 (4) ◽  
pp. 749-758 ◽  
Author(s):  
A. von Borczyskowski ◽  
F. Lindblad ◽  
B. Vinnerljung ◽  
R. Reintjes ◽  
A. Hjern
Keyword(s):  
Risk Factor ◽  
Alcohol Abuse ◽  
Cox Regression ◽  
Environmental Influence ◽  
Psychiatric Morbidity ◽  
Adoption Study ◽  
Parental Suicide ◽  
Hazard Ratios ◽  
Biological Parents ◽  
National Cohort

BackgroundParental characteristics influence the risk of offspring suicide. In this study we wanted to separate the hereditary from the environmental influence of such factors by comparing their effects in the adopted versus non-adopted.MethodA register study was conducted in a national cohort of 2 471 496 individuals born between 1946 and 1968, including 27 600 national adoptees, followed-up for suicide during 1987–2001. Cox regression was used to calculate hazard ratios (HR) for suicide of socio-economic indicators of the childhood household and biological parents' suicide, alcohol abuse and psychiatric morbidity separately in the adopted and non-adopted. Differences in effects were tested in interaction analyses.ResultsSuicide and indicators of severe psychiatric disorder in the biological parents had similar effects on offspring suicide in the non-adopted and adopted (HR 1.5–2.3). Biological parents' alcohol abuse was a risk factor for suicide in the non-adopted group only (HR 1.8 v. 0.8, interaction effect: p=0.03). The effects of childhood household socio-economic factors on suicide were similar in adopted and non-adopted individuals, with growing up in a single parent household [HR 1.5 (95% confidence interval 1.4–1.5)] as the most important socio-economic risk factor for the non-adopted.ConclusionsThe main familial effects of parental suicide and psychiatric morbidity on offspring suicide are not mediated by the post-natal environment or imitation, in contrast to effects of parental alcohol abuse that are primarily mediated by the post-natal environment. Social drift over generations because of psychiatric disorders does not seem likely to explain the association of socio-economic living conditions in childhood to suicide.

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