Håndkraft: Referanseverdier for voksne og faktorer som har sammenheng med håndkraft

Håndkraft: Referanseverdier for voksne og faktorer som har sammenheng med håndkraft Bakgrunn: Håndkraft er en markør på sykdom og generell funksjon, og er ofte brukt som utfallsmål i studier som evaluerer effekt av intervensjoner for å bedre aktivitetsutførelse. Referanseverdier for håndkraft målt med instrumentet Grippit har blitt publisert tidligere, men er basert på et sparsomt utvalg. Referanseverdier for pinsettgrep målt med Grippit er ikke tidligere publisert. Det er hevdet at faktorer som kjønn, alder, hånddominans, høyde, vekt, yrke og fritidsaktiviteter har innflytelse på håndkraft. Imidlertid er det behov for flere studier som kan dokumentere disse sammenhengene. Hensikt: 1) Å etablere referanseverdier for håndkraft og pinsettgrep i aldersgrupper for voksne og 2) å undersøke om personlige faktorer og aktivitetsmønster har sammenheng med håndkraft. Metode: Tverrsnittsstudie. For et mest mulig representativt utvalg ble 566 deltagere (315 kvinner og 251 menn), i alderen 20-95 år, rekruttert fra ulike arenaer som handlesentre, arbeidssteder, eldresentre og et sportssenter. Håndkraft og pinsettgrep ble målt i Newton (N) med det elektroniske instrumentet Grippit. Håndkraft og pinsettgrep ble beregnet for kjønns- og aldersdelte grupper i 10-års intervaller, det første intervallet for 20-29 år og det siste intervallet for 80+ år. Gjennomsnitt, SD og 95% konfidensintervaller (CI) av de målte kraftverdiene ble brukt for å beregne referanseverdier for maksimal-, gjennomsnitts- og sluttkraft. T-tester ble brukt for å sammenligne kraft i høyre og venstre hånd, og mellom høyre- og venstrehendte deltagere. En Pearson korrelasjonsanalyse ble utført for å undersøke sammenhengen mellom håndkraft og pinsettgrep. Multiple regresjonsanalyser ble utført for å beskrive sammenhengen mellom håndkraft og faktorer som korrelerte med håndkraft. Resultater: Mennene var sterkere enn kvinnene i alle aldersgrupper, og de sterkeste kvinnene var like sterke menn i 70-årene. Både kvinner og menn er sterkest i 30-årene, mens kraften avtar etter 40 år. Høyrehendte deltagere var signifikant sterkere i høyre hånd sammenlignet med venstre, for kraftgrep (p<0.001). Det ble ikke funnet forskjell i kraft mellom hendene for venstrehendte deltagere. Når det gjelder pinsettgrep er mennene sterkest i 40-årene, mens kvinner er sterkest i 20-årene. Både kvinner og menn opprettholder kraft i pinsettgrepet fram til 50 år. Det var sterk korrelasjon mellom kraftgrep og pinsettgrep for kvinner (r=0.64, p<0.001) og moderat korrelasjon for menn (r=0.547, p<0.001). Kjønn er sterkeste prediktor for håndkraft, med en forskjell i styrke på 216 N (B=216, p<0.001) mellom kvinner og menn. I de kjønnsdelte regresjonsanalysene var alder, høyde, vekt og regelmessig trening signifikante prediktorer for håndkraft for begge kjønn. Konklusjon: Håndkraft øker fra 20 år og begynner å synke fra 40 år. Menn er sterkere enn kvinner i alle aldersgrupper, og de eldre mennene er like sterke som kvinnene på sitt sterkeste. Det er en sterk sammenheng mellom håndkraft og kjønn, alder, høyde og regelmessig trening

Modeling Effective Albedo as a Function of Land Cover Type and Snow Type

The Center for Environmental Radioactivity (CERAD) project UV-maps aims to obtain geographically distributed time-series of solar ultraviolet (UV) radiation in Norway. Since UV-measurements are limited to a few monitoring stations, a full representation of the spatial and temporal distribution needs to be based on a ra-diative transfer model (RTM). A key parameter is the regional albedo distribution. The albedo model developed here apply a gridded set of local albedo values to derive the regional, effective albedo at any given point. In Norway there is a UV-monitoring network that has been operating since 1996, delivering almost continual 20-years time series of UV data. We use these stations as our modeling reference points. In our albedo model we use land cover information and snow dispersion data for 11 years. Land cover classifications combined with snow classifications constitute a matrix of albedo values, with one albedo value for each combination of land cover type and snow type, under the hypothesis that the snow albedo is affected by the underlying land type. In this paper, we outline how to determine these albedo parameters by regression analysis, and give examples of calculated albedo values for some combinations of land cover and snow type

Anthropometric Factors and Cutaneous Melanoma: Prospective Data from the Population-based Janus Cohort

The aim of the present study was to prospectively examine risk of cutaneous melanoma (CM) according to measured anthropometric factors, adjusted for exposure to ultraviolet radiation (UVR), in a large population-based cohort in Norway. The Janus Cohort, including 292,851 Norwegians recruited 1972–2003, was linked to the Cancer Registry of Norway and followed for CM through 2014. Cox regression was used to estimate hazard ratios (HRs) of CM with 95% confidence intervals (CIs). Restricted cubic splines were incorporated into the Cox models to assess possible non-linear relationships. All analyses were adjusted for attained age, indicators of UVR exposure, education, and smoking status. During a mean follow-up of 27 years, 3,000 incident CM cases were identified. In men, CM risk was positively associated with body mass index, body surface area (BSA), height and weight (all ptrends \u3c 0.001), and the exposure-response curves indicated an exponential increase in risk for all anthropometric factors. Weight loss of more than 2 kg in men was associated with a 53% lower risk (HR 0.47, 95% CI: 0.39, 0.57). In women, CM risk increased with increasing BSA (ptrend50.002) and height (ptrend \u3c 0.001). The shape of the height- CM risk curve indicated an exponential increase. Our study suggests that large body size, in general, is a CM risk factor in men, and is the first to report that weight loss may reduce the risk of CM among men

Beliefs, attitudes and perceptions to sun-tanning behaviour in the Norwegian population: a cross-sectional study using the health belief model

Abstract Background Norway has one of the highest incidences of melanoma in the world. It has been suggested that the majority of all skin cancers could be prevented by changes related to sun-tanning behaviour. This study explores the sun-tanning behaviour of the Norwegian population using a modified Health Belief Model (HBM). Increased knowledge about beliefs, attitudes and sun-tanning behaviour can provide information which may be useful for future sun protection interventions. Methods In 2017, 1004 members of the Norwegian population completed cross-sectional online surveys. People who seek the sun for tanning purposes was the eligibility criterion for this study, reducing the study population to 569. With the aid of the constructs from the HBM, predictive factors explaining sun-tanning behaviour were determined using multivariate linear regression adjusted for demographics (gender, age, education and income). Furthermore, the predictor variables, empowerment and benefits of tanning, were added to the model. Results Five of the constructs in the modified HBM showed significant correlation with sun-tanning behaviour using bivariate analysis. The strongest correlation was perceived barriers of sun protection (0.42), with the next strongest being the benefits of tanning (0.30). The modified model explained 31% of the variation in sun-tanning behaviour using multivariate analysis. Significant predictors from the HBM to sun-tanning behaviour were perceived barriers to sun protection (Beta = 0.36, p < 0.001) and the severity of melanoma (Beta = − 0.20, p < 0.001). In addition, empowerment (Beta = 0.05, p = 0.05) and the benefits of tanning (Beta = 0.28, p < 0.001) proved to be variables with significant effect on sun-tanning behaviour. The demographic factors age, education and income were also associated with sun-tanning behaviour (p < 0.05). Conclusion Based on the results of this study, several factors in the modified HBM had a significant impact on Norwegians’ sun-tanning behaviour. The results indicate that future sun protection interventions should focus on reducing barriers in relation to sun protection behaviour, as well as emphasizing the severity of adverse tanning behaviour and melanoma. Efforts to alter the perceptions of the beneficial factors of tanning behaviour can also be appropriate in health promotion campaigns and interventions. Finally, implementing empowerment strategies could have a positive effect on promoting healthy sun-tanning behaviour

Anthropometric factors and cutaneous melanoma: Prospective data from the population-based Janus Cohort

The aim of the present study was to prospectively examine risk of cutaneous melanoma (CM) according to measured anthropometric factors, adjusted for exposure to ultraviolet radiation (UVR), in a large population‐based cohort in Norway. The Janus Cohort, including 292,851 Norwegians recruited 1972–2003, was linked to the Cancer Registry of Norway and followed for CM through 2014. Cox regression was used to estimate hazard ratios (HRs) of CM with 95% confidence intervals (CIs). Restricted cubic splines were incorporated into the Cox models to assess possible non‐linear relationships. All analyses were adjusted for attained age, indicators of UVR exposure, education, and smoking status. During a mean follow‐up of 27 years, 3,000 incident CM cases were identified. In men, CM risk was positively associated with body mass index, body surface area (BSA), height and weight (all ptrends < 0.001), and the exposure‐response curves indicated an exponential increase in risk for all anthropometric factors. Weight loss of more than 2 kg in men was associated with a 53% lower risk (HR 0.47, 95% CI: 0.39, 0.57). In women, CM risk increased with increasing BSA (ptrend = 0.002) and height (ptrend < 0.001). The shape of the height‐CM risk curve indicated an exponential increase. Our study suggests that large body size, in general, is a CM risk factor in men, and is the first to report that weight loss may reduce the risk of CM among men. This is the peer reviewed version of the article, which has been published in final form at Wiley. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions

Anthropometric factors and Breslow thickness: prospective data on 2570 cases of cutaneous melanoma in the population-based Janus Cohort

Background Breslow thickness is the most important prognostic factor of localized cutaneous melanoma (CM), but associations with anthropometric factors have been sparsely and incompletely investigated. Objectives To examine prediagnostic body mass index (BMI), body surface area (BSA), and height, weight and weight change in relation to Breslow thickness, overall and by anatomical site and histological subtype; and to assess possible nonlinear associations between these anthropometric factors and Breslow thickness. Methods CMs in the Janus Cohort were identified between 1972 and 2014. Linear regression was used to estimate geometric mean ratios (GMRs) of Breslow thickness with 95% confidence intervals (CIs) according to anthropometric factors. Restricted cubic splines in generalized linear models predicted adjusted mean Breslow thickness, and were used to assess possible nonlinear relationships. Results Of 2570 cases of CM, obese patients had a GMR of 1·16 (95% CI 1·04–1·30) of Breslow thickness vs. normal‐weight patients. For BSA and weight, quintile 5 showed GMRs of 1·13 (95% CI 1·00–1·27) and 1·17 (95% CI 1·03–1·33) of Breslow thickness vs. quintile 1, respectively. Associations seemed restricted to superficial spreading melanomas and CMs on the trunk and lower limbs. The associations plateaued at an adjusted mean Breslow thickness of about 2·5 mm (BMI 29 kg m−2, BSA 2·05 m2 and weight 90 kg), before declining for the highest values. No associations were found for height and weight change. Conclusions This large case‐series of incident CM demonstrated positive associations between BMI, BSA, weight and Breslow thickness, and suggested that behavioural or other mechanisms apply at high values. This is the peer reviewed version of the article, which has been published in final form at Wiley. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.

Prediagnostic serum 25-hydroxyvitamin D and melanoma risk

Abstract Previous studies of serum 25-hydroxyvitamin D (25(OH)D) in relation to melanoma have shown conflicting results. We conducted a nested case–control study of 708 cases and 708 controls, using prediagnostically collected serum, to study 25(OH)D and melanoma risk in the population-based Janus Serum Bank Cohort. Stratified Cox regression was used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) adjusted for ultraviolet radiation (UVR) indicators and stratified by ambient UVB of residence and body mass index (BMI). Non-linear associations were studied by restricted cubic splines. Missing data were handled with multiple imputation by chained equations. We found an HR of melanoma risk of 1.01 (95% CI: 0.99, 1.04) and an HR imputed of 1.02 (95% CI: 1.00, 1.04) per 5-nmol/L increase. The spline model showed exposure-risk curves with significantly reduced melanoma risk between 60 and 85 nmol/L 25(OH)D (reference 50 nmol/L). Non-significant J-shaped curves were found in sub-analyses of subjects with high ambient UVB of residence and of subjects with BMI &lt; 25 kg/m 2 . Our data did not yield persuasive evidence for an association between 25(OH)D and melanoma risk overall. Serum levels within the medium range might be associated with reduced risk, an association possibly mediated by BMI