Placental weight and mortality in premenopausal breast cancer by tumor characteristics

Placental weight may be regarded as an indirect marker of hormone exposures during pregnancy. There is epidemiological evidence that breast cancer mortality in premenopausal women increases with placental weight in the most recent pregnancy. We investigated if this association differs by tumor characteristics, including expression of estrogen and progesterone receptors. In a Swedish population-based cohort, we followed 1,067 women with premenopausal breast cancer diagnosed from 1992 to 2006. Using Cox regression models, we estimated hazard ratios for the association between placental weight and risk of premenopausal breast cancer mortality. In stratified analyses, we estimated mortality risks in subjects with different tumor stages, estrogen receptor (ER) or progesterone receptor (PR) status. Compared with women with placental weight less than 600 g, women with a placental weight between 600 and 699 g were at a 50 % increased risk of mortality, however, not significant change in risk was observed for women with placental weight �700 g. Mortality risks associated with higher placental weight were more pronounced among ER- and PR- breast cancer tumors, where both a placental weight 600-699 g and �700 g were associated with a more than doubled mortality risks compared with tumors among women with placental weight less than 600 g. Moreover, stratified analyses for joint receptor status revealed that a consistent increased mortality risk by placental weight was only apparent in women with ER-/PR- breast cancer. The increased mortality risk in premenopausal breast cancer associated with higher placental weight was most pronounced among ER- and PR- tumors. © 2012 Springer Science+Business Media New York

Drinking pattern and socio-cultural aspects on immune response: an overview.

Peer Reviewe

Physical activity, exercise and low-grade systemic inflammation.

Peer Reviewe

The tracking of dietary intakes of children and adolescents in Sweden over six years: the European Youth Heart Study

<p>Abstract</p> <p>Background</p> <p>The stability of dietary habits through various life-stages is not well understood. A better understanding of the tracking of diet over time could have implications for health promotion as well as for the planning of nutritional epidemiology studies. We examined the stability of dietary intakes of children and adolescents over six years.</p> <p>Methods</p> <p>As part of the European Youth Heart Study, in 1998-9, a 24-h dietary recall was performed on over one thousand 9- and 15-year-olds in Sweden. In 2004-5, 40% returned to the follow-up study. These 452 subjects (273 15- and 179 21-year-olds) were assigned to age- and gender-specific tertiles of intakes of food groups, energy, selected nutrients and energy density (low, mid and high) at each time point. The agreement between the classification of subjects into tertiles at both time points was examined using Cohen's weighted κ and other stability coefficients. We included a dropout analysis and considered the effect that energy mis-reporting might have on our results.</p> <p>Results</p> <p>Fair tracking was seen between childhood and adolescence for the milk, fil and yoghurt food group (κ = 0.30), and between adolescence and young adulthood for fruit (κ = 0.24). Slight tracking was observed for most other food groups and fair to slight tracking for all nutrients studied. Only membership of the high milk, fil and yoghurt tertile could be predicted from membership at baseline, in children. Excluding potential energy mis-reporters did not affect the results.</p> <p>Conclusions</p> <p>Despite the long time between data collections, and the method of dietary data collection used, evidence for slight tracking was observed for most food groups and nutrients over these six years.</p

Framtidens gator

Världen över pågår en kraftig urbanisering och även i Sverige växer städerna. Med det ökade trycket på dessa ökar konkurrensen om ytorna. För att städer ska kunna växa på ett hållbart sätt, är det viktigt att utnyttja ytorna effektivt. Av den anledningen behöver andelen resor med personbil minska och andra färdmedel premieras. Syftet med uppsatsen är undersöka bilfria och bilsnåla områden för att ta reda på dels vilka anspråk som kan komma att ställas på gator i sådana områden och dels hur markdispositionen kan komma att behöva ändras när gång- cykel- och kollektivtrafik alltmer ersätter bilen. Vidare är syftet att undersöka vilka funktioner som bör inrymmas i gaturummet i ett bilsnålt område och hur det kan utformas för att möta framtida anspråk i svenska förhållanden. De regler som gaturummet förhåller sig till idag identifieras genom en litteraturstudie. Därefter utreds framtida anspråk på gaturummet och vilka funktioner det kan komma att inrymma genom en framtidsspaning i form av intervjuer och platsbesök. Intervjuerna görs med yrkesverksamma personer i olika yrkesroller inom samhällsbyggnad. Platserna för besöken väljs för deras arbete mot ett minskat bilanvändande samt om funktioner förutom transport inkorporerats i gaturummet. Resultaten av framtidsspaningen tillsammans med dagens krav på gaturummet sammanställs i en punktlista som sedan ligger till grund för två principgestaltningar av bilsnåla gator. Principgestaltningarna ger exempel på hur de principer som tagits fram i punktlistan kan implementeras vid gestaltningen av bilsnåla gator. Eftersom varje plats och varje projekt är unikt, är inte alla principer som tas upp i arbetet applicerbara på varje plats, utan de punkter som är relevanta i respektive situation har identifierats. Punktlistan och principgestaltningarna ska kunna användas som stöd vid planering och projektering vid ombyggnad av befintliga områden och helt nya områden.Urbanization is going on all over the world and also in Sweden cities are growing. With the increased density of the cities, the competition for space intensifies. For cities to be able to grow sustainably, it is important that we utilize the space effectively. Therefore the amount of journeys made by car has to be reduced and other means of transport have to be promoted. The purpose of the thesis is to study car-free and less car dependent areas and cities and to find out what requirements can be put on streets in car-free and less car dependent areas and cities in the future. How the disposition of space can come to change when walking, biking and public transport increasingly begin to replace the car. Furthermore the purpose is to inquire what functions the streets should accommodate in a car-free or less car dependent city or area and how such streets in Swedish conditions can be designed to meet future requirements and incorporate identified functions. The requirements set on streets today are identified through literary studies. Thereafter, future requirements on streets and what functions they might accommodate, are investigated through interviews and site visits. The interviews are made with people in different professions and roles within the city building field. The site visits are made in areas selected for their work towards making the area less car dependent. The results of the interviews and site visits together with today’s requirements on streets are compiled into a list in bullet point form which then become the base of two principal designs for less car dependent streets The principle designs show two examples of how the principles from the bullet point list can be implemented when designing less car dependent streets. Since every place and project is unique, not all the principles that are presented in the thesis, can be applied in every project. A selection has to be made based on site-specific circumstances. The bullet point list and the principle designs can be used when planning and designing renewal of existing areas as well as new development

Sources of Saturated Fat and Sucrose in the Diets of Swedish Children and Adolescents in the European Youth Heart Study: Strategies For Improving Intakes

To compare macronutrient intakes of Swedish children and adolescents to population goals; to identify the major sources of energy, fat, saturated fat and sucrose; and to simulate the effect adherence to current food-based dietary guidelines (FBDG) would have on saturated fat and sucrose intakes. Cross-sectional study. From 24 h recall data, food groups contributing most to energy, fat, saturated fat and sucrose were identified. Based on the prevailing consumption of foods mentioned in the FBDG, we simulated five scenarios: changes in milk and yoghurt; cheese; energy-dense, nutrient-dilute foods; soft drinks; and burger and sausage consumption. Stockholm and Örebro (Sweden) in 1998-1999. Children (n 551, 9·6 years) and adolescents (n 569, 15·5 years) participating in the European Youth Heart Study. Intakes of saturated fat and sucrose exceeded population goals in all age and gender subgroups. Compliance to the goal for saturated fat was lower in children, particularly boys. Compliance to the sucrose goal was lower among adolescents. The major sources of energy, fat, saturated fat and sucrose in the diet reflect not only the traditional Swedish diet but also the influence of energy-dense, nutrient-dilute foods. The simulations suggest that a combination of FBDG is required to bring both saturated fat and sucrose intakes in line with recommendations. Widespread adherence to a combination of FBDG could theoretically bring mean intakes in line with population goals. The effect on overall nutrient intakes as well as consumer acceptance of such changes needs to be considered

Global trends in adolescents\u27 road traffic injury mortality, 1990-2019

Objective: The aim of this study was to determine the trends of road traffic injury (RTI) mortality among adolescents aged 10-14 years and 15-19 years across different country income levels with respect to the type of road users from 1990 to 2019.Methods: We conducted an ecological study. Adolescents\u27 mortality rates from RTIs at the level of high-income countries (HICs), upper-income to middle-income countries (UMICs), lower-income to middle-income countries and low-income countries were extracted from the Global Burden of Disease study. Time series were plotted to visualise the trends in mortality rates over the years. We also conducted Poisson regression using road traffic mortality rates as the dependent variable and year as the independent variable to model the trend of the change in the annual mean mortality rate, with incidence rate ratios (IRRs) and 95% CIs.Results: There were downward mortality trends in all types of road users and income levels among adolescents from 1990 to 2019. HICs had more pronounced reductions in mortality rates than countries of any other income level. For example, the reduction in pedestrians in HICs was IRR 0.94 (95% CI 0.90 to 0.98), while that in UMICs was IRR 0.97 (95% CI 0.95 to 0.99) in adolescents aged 10-14 years.Conclusions: There are downward trends in RTI mortality in adolescents from 1990 to 2019 globally at all income levels for all types of road users. The decrease in mortality rates is small but a promising finding. However, prevention efforts should be continued as the burden is still high

Dietary Energy Density as Marker of Dietary Quality in Swedish Children and Adolescents: The European Youth Heart Study

To investigate if dietary energy density is associated with measures of dietary quality (food group, micronutrient and macronutrient intakes) in children and adolescents

Predicting the Unpredictable - Harder than Expected

Introduction: An earthquake is a hazard that may cause urgent needs requiring international assistance. To ensure rapid funding for such needs-based humanitarian assistance, swift decisions are needed. However, data to guide needs-based funding decisions are often missing in the acute phase, causing delays. Instead, it may be feasible to use data building on existing indexes that capture hazard and vulnerability information to serve as a rapid tool to prioritize funding according to the scale of needs: needs-based funding. However, to date, it is not known to what extent the indicators in the indexes can predict the scale of disaster needs. The aim of this study was to identify predictors for the scale of disaster needs after earthquakes. Methodology: The predictive performance of vulnerability indicators and outcome indicators of four commonly used disaster risk and severity indexes were assessed, both individually and in different combinations, using linear regression. The number of people who reportedly died or who were affected was used as an outcome variable for the scale of needs, using data from the Emergency Events Database (EM-DAT) provided by the Centre for Research on the Epidemiology of Disasters at the Université Catholique de Louvain (CRED; Brussels, Belgium) from 2007 through 2016. Root mean square error (RMSE) was used as the performance measure. Results: The assessed indicators did not predict the scale of needs. This attempt to create a multivariable model that included the indicators with the lowest RMSE did not result in any substantially improved performance. Conclusion: None of the indicators, nor any combination of the indicators, used in the four assessed indexes were able to predict the scale of needs in the assessed earthquakes with any precision.publishedVersio

Time from breast cancer diagnosis to therapeutic surgery and breast cancer prognosis : a population-based cohort study

Theoretically, time from breast cancer diagnosis to therapeutic surgery should affect survival. However, it is unclear whether this holds true in a modern healthcare setting in which breast cancer surgery is carried out within weeks to months of diagnosis. This is a population- and register-based study of all women diagnosed with invasive breast cancer in the Stockholm-Gotland healthcare region in Sweden, 2001 - 2008, and who were initially operated. Follow-up of vital status ended 2014. 7017 women were included in analysis. Our main outcome was overall survival. Main analyses were carried out using Cox proportional hazards models. We adjusted for likely confounders and stratified on mode of detection, tumor size and lymph node metastasis. We found that a longer interval between date of morphological diagnosis and therapeutic surgery was associated with a poorer prognosis. Assuming a linear association, the hazard rate of death from all causes increased by 1.011 (95% CI 1.006 to 1.017) per day. Comparing, e.g., surgery 6 weeks after diagnosis to surgery 3 weeks after diagnosis, thereby confers a 1.26-fold increased hazard rate. The increase in hazard rate associated with surgical delay was strongest in women with largest tumors. Whilst there was a clear association between delays and survival in women without lymph node metastasis, the association may be attenuated in subgroups with increasing number of lymph node metastases. We found no evidence of an interaction between time to surgery and mode of detection. In conclusion, unwarranted delays to primary treatment of breast cancer should be avoided.Swedish Research CouncilSwedish Cancer SocietyStockholm County CouncilFORTEAccepte