Hopelessness the ‘active ingredient’? : associations of hopelessness and depressive symptoms with Interleukin-6.

Objective: Previous research has revealed a relationship of depressive symptoms and hopelessness with cardiovascular diseases (CVDs) which are associated with elevated levels of interleukin-6 (IL-6). The objective of this study was to explore whether depressive symptoms and hopelessness are independent predictors of IL-6 levels. Method: Hopelessness, depressive symptoms, and IL-6 were measured in 45 Swedish adults (26 women and 19 men; age range: 31-65 years). Two separated linear regressions were conducted with hopelessness and depressive symptoms serving as individual predictors of IL-6. Another regression analysis examined whether the two predictors predict IL-6 when controlling for each other. The regression coefficients of the models with one predictor and with both predictors were compared. Results: As predicted, after adjusting for age, BMI, illness, smoking, and gender, more depressive symptoms and more hopelessness predicted higher IL-6 levels in independent regressions. When controlling for each other, hopelessness, but not depressive symptoms, predicted IL-6 levels. Finally, when controlling for hopelessness, the regression between depressive symptoms and IL-6 level was significantly reduced; however, there was no significant change in the regression between hopelessness and IL-6 level when controlling for depressive symptoms. Conclusions: Thus, these results suggest that depressive symptoms and hopelessness are not independent predictors of IL-6 levels. Future research should explore the interplay of hopelessness and depressive symptoms on other risk factors of CVDs

Adverse health effects of low levels of perceived control in Swedish and Russian community samples

Background: This cross-sectional study of two middle-aged community samples from Sweden and Russia examined the distribution of perceived control scores in the two populations, investigated differences in individual control items between the populations, and assessed the association between perceived control and self-rated health. Methods: The samples consisted of men and women aged 45–69 years, randomly selected from national and local population registers in southeast Sweden (n = 1007) and in Novosibirsk, Russia (n = 9231). Data were collected by structured questionnaires and clinical measures at a visit to a clinic. The questionnaire covered socioeconomic and lifestyle factors, societal circumstances, and psychosocial measures. Self-rated health was assessed by standard single question with five possible answers, with a cut-off point at the top two alternatives. Results: 32.2 % of Swedish men and women reported good health, compared to 10.3 % of Russian men and women. Levels of perceived control were also significantly lower in Russia than in Sweden and varied by socio-demographic parameters in both populations. Sub-item analysis of the control questionnaire revealed substantial differences between the populations both in the perception of control over life and over health. Logistic regression analysis revealed that the odds ratios (OR) of poor self-rated health were significantly increased in men and women with low perceived control in both countries (OR between 2.61 and 4.26). Conclusion: Although the cross-sectional design does not allow causal inference, these results support the view that perceived control influences health, and that it may mediate the link between socioeconomic hardship and health

Suboptimal health: a new health dimension for translational medicine

Background One critical premise of disease-related biomarkers is the definition of the counterpart normality. Contrary to pre-clinical models that can be carefully tailored according to scientific need, heterogeneity and uncontrollability is the essence of humans in health studies. Fully characterization of consistent parameters that define the normal population is the basis to individual differences normalization irrelevant to a given disease process. Self claimed normal status may not represent health because asymptomatic subjects may carry chronic diseases or diseases at their early stage such as cancer, diabetes and hypertension. Methods This paper exemplifies the characterization of the suboptimal health status (SHS) which represents a new public health problem in a population with ambiguous health complaints such as general weakness, unexplained medical syndrome and chronic fatigue. We applied clinical informatics approaches and developed a questionnaire for measuring SHS. The validity and reliability of this approach were evaluated in a small pilot study and then in a cross-sectional study of 3,405 individuals. Results The final questionnaire congregated into a score (SHSQ-25) which could significantly distinguish among several abnormal conditions. Conclusion SHSQ-25 could be used as a translational medicine instrument for health measuring in the general population

Are there differences in all-cause and coronary heart disease mortality between immigrants in Sweden and in their country of birth? A follow-up study of total populations

BACKGROUND: Mortality from cardiovascular diseases is higher among immigrants than native Swedes. It is not clear whether the high mortality persists from the country of birth or is a result of migration. The purpose of the present study was to analyse whether all-cause and coronary heart disease mortality differ between immigrants in Sweden and in the country of birth. METHODS: Two cohorts including the total population from Swedish national registers and WHO were defined. All-cause and CHD mortality are presented as age-adjusted incidence rates and incidence density ratios (IDR) in eight immigrant groups in Sweden and in their country of birth. The data were analysed using Poisson regression. RESULTS: The all-cause mortality risk was lower among seven of eight male immigrant groups (IDR 0.39–0.97) and among six of eight female immigrant groups (IDR 0.42–0.81) than in their country of birth. The CHD mortality risk was significantly lower in male immigrants from Norway (IDR = 0.84), Finland (IDR = 0.91), Germany (IDR = 0.84) and Hungary (IDR = 0.59) and among female immigrants from Germany (IDR = 0.66) and Hungary (IDR = 0.54) than in their country of birth. In contrast, there was a significantly higher CHD mortality risk in male immigrants from Southern Europe (IDR = 1.23) than in their country of birth. CONCLUSION: The all-cause mortality risk was lower in the majority of immigrant groups in Sweden than in their country of birth. The differences in CHD mortality risks were more complex. For countries with high CHD mortality, such as Finland and Hungary, the risk was lower among immigrants in Sweden than in their country of birth. For low-risk countries in South Europe, the risk was higher in immigrants in Sweden than in South Europe

Can screening and brief intervention lead to population-level reductions in alcohol-related harm?

A distinction is made between the clinical and public health justifications for screening and brief intervention (SBI) against hazardous and harmful alcohol consumption. Early claims for a public health benefit of SBI derived from research on general medical practitioners' (GPs') advice on smoking cessation, but these claims have not been realized, mainly because GPs have not incorporated SBI into their routine practice. A recent modeling exercise estimated that, if all GPs in England screened every patient at their next consultation, 96% of the general population would be screened over 10 years, with 70-79% of excessive drinkers receiving brief interventions (BI); assuming a 10% success rate, this would probably amount to a population-level effect of SBI. Thus, a public health benefit for SBI presupposes widespread screening; but recent government policy in England favors targeted versus universal screening, and in Scotland screening is based on new registrations and clinical presentation. A recent proposal for a national screening program was rejected by the UK National Health Service's National Screening Committee because 1) there was no good evidence that SBI led to reductions in mortality or morbidity, and 2) a safe, simple, precise, and validated screening test was not available. Even in countries like Sweden and Finland, where expensive national programs to disseminate SBI have been implemented, only a minority of the population has been asked about drinking during health-care visits, and a minority of excessive drinkers has been advised to cut down. Although there has been research on the relationship between treatment for alcohol problems and population-level effects, there has been no such research for SBI, nor have there been experimental investigations of its relationship with population-level measures of alcohol-related harm. These are strongly recommended. In this article, conditions that would allow a population-level effect of SBI to occur are reviewed, including their political acceptability. It is tentatively concluded that widespread dissemination of SBI, without the implementation of alcohol control measures, might have indirect influences on levels of consumption and harm but would be unlikely on its own to result in public health benefits. However, if and when alcohol control measures were introduced, SBI would still have an important role in the battle against alcohol-related harm

Injury risk and patterns in newly transferred football players: A case study of 8 seasons from a professional football club

This case study investigated injury risk and patterns in players newly transferred to a professional football club. Time-loss injuries were recorded prospectively over 8-seasons (2008-2015). Injury incidence overall, in match and training, and patterns (contact, non-contact, sprain, strain, overuse and re-injury) were compared in transferred players (n=25) across their first versus second seasons and with those in players currently at the club at the moment of the transfer (n=55 individual players, 134 in total). Incidence Rate Ratios [IRR] in transferred players in their first versus second competitive season ranged from a 0.9 lower risk in training to a 1.5 higher risk of sustaining a contact injury (respective p values: 0.74, 0.19, inferences: unclear, likely harmful) in the first season. IRR for transferred players in their first and second seasons compared to rates in the same seasons in current players ranged from a 0.5 lower risk of incurring an overuse injury to a 1.1 higher risk of match injury (respective p values: 0.18, 0.89, inferences: unclear, possibly harmful), both occurring in season 1. For the between season and group comparisons, effect sizes regarding mean injury layoff time and matches missed ranged from trivial to small (0.03-0.22). Although limited to one club, these findings are positive as generally there was no meaningful increase in injury risk or burden in newly transferred players. Potential explanations include systematic pre-participation screening and injury prevention protocols and player rotation strategies in place at the club

Socioeconomic conditions and number of pain sites in women

<p>Abstract</p> <p>Background</p> <p>Women in deprived socioeconomic situations run a high pain risk. Although number of pain sites (NPS) is considered highly relevant in pain assessment, little is known regarding the relationship between socioeconomic conditions and NPS.</p> <p>Methods</p> <p>The study population comprised 653 women; 160 recurrence-free long-term gynecological cancer survivors, and 493 women selected at random from the general population. Demographic characteristics and co-morbidity over the past 12 months were assessed. Socioeconomic conditions were measured by Socioeconomic Condition Index (SCI), comprising education, employment status, income, ability to pay bills, self-perceived health, and satisfaction with number of close friends. Main outcome measure NPS was recorded using a body outline diagram indicating where the respondents had experienced pain during the past week. Chi-square test and forward stepwise logistic regression were applied.</p> <p>Results and Conclusion</p> <p>There were only minor differences in SCI scores between women with 0, 1-2 or 3 NPS. Four or more NPS was associated with younger age, higher BMI and low SCI. After adjustment for age, BMI and co-morbidity, we found a strong association between low SCI scores and four or more NPS, indicating that there is a threshold in the NPS count for when socioeconomic determinants are associated to NPS in women.</p

Rationale for a Swedish cohort consortium

We herein outline the rationale for a Swedish cohort consortium, aiming to facilitate greater use of Swedish cohorts for world-class research. Coordination of all Swedish prospective population-based cohorts in a common infrastructure would enable more precise research findings and facilitate research on rare exposures and outcomes, leading to better utilization of study participants' data, better return of funders' investments, and higher benefit to patients and populations. We motivate the proposed infrastructure partly by lessons learned from a pilot study encompassing data from 21 cohorts. We envisage a standing Swedish cohort consortium that would drive development of epidemiological research methods and strengthen the Swedish as well as international epidemiological competence, community, and competitiveness.Peer reviewe

Determinants of cardiovascular disease and other non-communicable diseases in Central and Eastern Europe: Rationale and design of the HAPIEE study

BACKGROUND: Over the last five decades, a wide gap in mortality opened between western and eastern Europe; this gap increased further after the dramatic fluctuations in mortality in the former Soviet Union (FSU) in the 1990s. Recent rapid increases in mortality among lower socioeconomic groups in eastern Europe suggests that socioeconomic factors are powerful determinants of mortality in these populations but the more proximal factors linking the social conditions with health remain unclear. The HAPIEE (Health, Alcohol and Psychosocial factors In Eastern Europe) study is a prospective cohort study designed to investigate the effect of classical and non-conventional risk factors and social and psychosocial factors on cardiovascular and other non-communicable diseases in eastern Europe and the FSU. The main hypotheses of the HAPIEE study relate to the role of alcohol, nutrition and psychosocial factors. METHODS AND DESIGN: The HAPIEE study comprises four cohorts in Russia, Poland, the Czech Republic and Lithuania; each consists of a random sample of men and women aged 45–69 years old at baseline, stratified by gender and 5 year age groups, and selected from population registers. The total planned sample size is 36,500 individuals. Baseline information from the Czech Republic, Russia and Poland was collected in 2002–2005 and includes data on health, lifestyle, diet (food frequency), socioeconomic circumstances and psychosocial factors. A short examination included measurement of anthropometric parameters, blood pressure, lung function and cognitive function, and a fasting venous blood sample. Re-examination of the cohorts in 2006–2008 focuses on healthy ageing and economic well-being using face-to-face computer assisted personal interviews. Recruitment of the Lithuanian cohort is ongoing, with baseline and re-examination data being collected simultaneously. All cohorts are being followed up for mortality and non-fatal cardiovascular events. DISCUSSION: The HAPIEE study will provide important new insights into social, behavioural and biological factors influencing mortality and cardiovascular risk in the region