Educational attainment and mortality in schizophrenia

Background Individuals suffering from schizophrenia have a reduced life expectancy with cardiovascular disease (CVD) as a major contributor. Low educational attainment is associated with schizophrenia, as well as with all-cause and CVD mortality. However, it is unknown to what extent low educational attainment can explain the increased mortality in individuals with schizophrenia. Aim Here, we quantify associations between educational attainment and all-cause and CVD mortality in individuals with schizophrenia, and compare them with the corresponding associations in the general population. Method All Norwegian citizens born between January 1, 1925, and December 31, 1959, were followed up from January 1, 1990, to December 31, 2014. The total sample included 1,852,113 individuals, of which 6548 were registered with schizophrenia. We estimated hazard ratios (HR) for all-cause and CVD mortality with Cox models, in addition to life years lost. Educational attainment for index persons and their parents were included in the models. Results In the general population individuals with low educational attainment had higher risk of all-cause (HR: 1.48 [95% CI: 1.47–1.49]) and CVD (HR: 1.59 [95% CI: 1.57–1.61]) mortality. In individuals with schizophrenia these estimates were substantially lower (all-cause: HR: 1.13 [95% CI: 1.05–1.21] and CVD: HR: 1.12 [95% CI: 0.98–1.27]). Low educational attainment accounted for 3.28 (3.21–3.35) life years lost in males and 2.48 (2.42–2.55) years in females in the general population, but was not significantly associated with life years lost in individuals with schizophrenia. Results were similar for parental educational attainment. Conclusions Our results indicate that while individuals with schizophrenia in general have lower educational attainment and higher mortality rates compared with the general population, the association between educational attainment and mortality is smaller in schizophrenia subjects than in the general population.publishedVersio

Research Directions in the Clinical Implementation of Pharmacogenomics: An Overview of US Programs and Projects

Response to a drug often differs widely among individual patients. This variability is frequently observed not only with respect to effective responses but also with adverse drug reactions. Matching patients to the drugs that are most likely to be effective and least likely to cause harm is the goal of effective therapeutics. Pharmacogenomics (PGx) holds the promise of precision medicine through elucidating the genetic determinants responsible for pharmacological outcomes and using them to guide drug selection and dosing. Here we survey the US landscape of research programs in PGx implementation, review current advances and clinical applications of PGx, summarize the obstacles that have hindered PGx implementation, and identify the critical knowledge gaps and possible studies needed to help to address them

Genome-wide meta-analysis of 241,258 adults accounting for smoking behaviour identifies novel loci for obesity traits

Few genome-wide association studies (GWAS) account for environmental exposures, like smoking, potentially impacting the overall trait variance when investigating the genetic contribution to obesity-related traits. Here, we use GWAS data from 51,080 current smokers and 190,178 nonsmokers (87% European descent) to identify loci influencing BMI and central adiposity, measured as waist circumference and waist-to-hip ratio both adjusted for BMI. We identify 23 novel genetic loci, and 9 loci with convincing evidence of gene-smoking interaction (GxSMK) on obesity-related traits. We show consistent direction of effect for all identified loci and significance for 18 novel and for 5 interaction loci in an independent study sample. These loci highlight novel biological functions, including response to oxidative stress, addictive behaviour, and regulatory functions emphasizing the importance of accounting for environment in genetic analyses. Our results suggest that tobacco smoking may alter the genetic susceptibility to overall adiposity and body fat distribution.Peer reviewe

New genetic loci link adipose and insulin biology to body fat distribution.

Body fat distribution is a heritable trait and a well-established predictor of adverse metabolic outcomes, independent of overall adiposity. To increase our understanding of the genetic basis of body fat distribution and its molecular links to cardiometabolic traits, here we conduct genome-wide association meta-analyses of traits related to waist and hip circumferences in up to 224,459 individuals. We identify 49 loci (33 new) associated with waist-to-hip ratio adjusted for body mass index (BMI), and an additional 19 loci newly associated with related waist and hip circumference measures (P < 5 × 10(-8)). In total, 20 of the 49 waist-to-hip ratio adjusted for BMI loci show significant sexual dimorphism, 19 of which display a stronger effect in women. The identified loci were enriched for genes expressed in adipose tissue and for putative regulatory elements in adipocytes. Pathway analyses implicated adipogenesis, angiogenesis, transcriptional regulation and insulin resistance as processes affecting fat distribution, providing insight into potential pathophysiological mechanisms

Health, health behaviors, and health dissimilarities predict divorce: results from the HUNT study

Background Poor health and health behaviors are associated with divorce. This study investigates the degree to which six health indicators and health behaviors among husbands and wives are prospectively related to divorce, and whether spousal similarities in these factors are related to a reduced risk of marital dissolution. Theoretically, a reduced risk is possible, because spousal similarity can help the couple’s adaptive processes. Methods The data come from a general population sample (19,827 couples) and 15 years of follow-up data on marital dissolution. The following characteristics were investigated: Poor subjective health, obesity, heavy drinking, mental distress, lack of exercise, and smoking. Associations between these characteristics among husbands and wives and later divorce were investigated with Cox proportional hazards regression analyses. Results All the investigated characteristics except obesity were associated with marital dissolution. Moreover, spousal similarities in four of these characteristics (heavy drinking, mental distress, no exercise, and smoking) reduced the risk of divorce, compared to the combined main effects of husbands and wives. Nevertheless, couples concordant in these health issues still had higher risks of divorce than couples without these characteristics. Conclusion Couples with similar health and health behavior are at a lower risk of divorce than are couples who are dissimilar in health. Health differences may thus be seen as vulnerabilities or stressors, supporting a health mismatch hypothesis. This study demonstrates that people who are similar to each other are more likely to stay together. Harmonizing partners’ health behaviors may be a target in divorce prevention

Begrunnelser for lokal kreativ næring: Instrumentell kulturpolitikk som tilslørende begrep

Politiske satsinger rettet mot kunst- og kulturbedrifter, såkalt kreativ næring, som i løpet av de siste tiårene er initiert i norsk og nordisk kultur- og næringspolitikk, forstås gjerne som et tydelig uttrykk for en økonomisk orientert instrumentalisme. Men kan alle politiske strategier og retorikk som behandler kunst og kultur som næring forstås som et utslag av økonomisk instrumentalisme? Målet med artikkelen er å problematisere etablerte forståelser av instrumentell kulturpolitikk, gjennom å utforske hvordan kreativ næring omtales og begrunnes i kommunal kultursektor og offentlig næringsarbeid. Vi undersøker hvordan fenomenet kreativ næring tematiseres og diskuteres i offentlig kulturarbeid og næringsutviklingsarbeid på lokalt nivå, der en stor del av det politiske og praktiske arbeidet knyttet til utvikling av kultur- og næringsliv utføres i Norge. Gjennom dokumentstudier av kommunale planer samt kvalitative intervjuer med kulturbyråkrater og næringsutviklere, undersøker vi om det ligger ulike begrunnelser til grunn for å innta et næringsperspektiv i kunst- og kulturpolitikken. I diskusjonen av det empiriske materialet tar vi i bruk ulike analytiske perspektiver på kulturpolitiske begrunnelser og instrumentalisme. Vi argumenterer for at tendensen til å samle alle politiske strategier og all politisk retorikk om kreativ næring i én generell kategori – instrumentell kulturpolitikk – bidrar til en tilsløring av vesentlige nyanser