Attention-deficit/hyperactivity disorder (ADHD) is associated with high rates of psychiatric comorbidity, including depression. However, it is unclear whether ADHD medication increases or decreases the risk for depression.
We studied all individuals with a diagnosis of ADHD born between 1960 and 1998 in Sweden (N = 38,752). We obtained data for prescription of ADHD medication, diagnosis of depression and other psychiatric disorders, and sociodemographic factors from population-based registers. The association between ADHD medication and depression was estimated with Cox proportional hazards regression.
After adjustment for sociodemographic and clinical confounders, ADHD medication was associated with a reduced long-term risk (i.e., 3 years later) for depression (hazard ratio = 0.58; 95% confidence interval, 0.51-0.67). The risk was lower for longer duration of ADHD medication. Also, ADHD medication was associated with reduced rates of concurrent depression; within-individual analysis suggested that occurrence of depression was 20% less common during periods when patients received ADHD medication compared with periods when they did not (hazard ratio = 0.80; 95% confidence interval, 0.70-0.92).
Our study suggests that ADHD medication does not increase the risk of later depression; rather, medication was associated with a reduced risk for subsequent and concurrent depression.
Work ability represents the balance between individual resources, health status and job demands. As far as we are aware, these issues have not been examined in working people with type 1 diabetes (T1D).
To examine how work-related and diabetes-related factors are associated with work ability among male and female workers.
Questionnaires were mailed to a random sample of 2500 people with T1D from the Medication Reimbursement Register of The Social Insurance Institution of Finland. The associations of the predictors of poor work ability were examined in a logistic regression analysis.
The final sample comprised 767 working people aged 18-64 with T1D; overall response rate 49%. One in every three working men and women with T1D had poor work ability. High job demands and low job control were associated with poor work ability in both genders. Physical work and low worktime control were significantly associated with poor work ability in men but not in women with T1D. A self-reported high value of glycosylated haemoglobin was the only diabetes-related variable associated with poor work ability in both men and women.
Work-related factors and poor glycaemic control were associated with poor work ability in individuals with T1D. Thus, job control and worktime control should be taken into account in supporting the work ability of workers with T1D.
To evaluate the prevalence of cervical facet oedema in patients referred for magnetic resonance imaging (MRI) to investigate neck pain and/or radiculopathy, and to investigate whether there is a correlation between the presence of oedema and patients' symptoms.
A retrospective report review of 1885 patients undergoing cervical spine MRI between July 2008 and June 2015 was performed. Exclusion criteria included acute trauma, surgery, neoplastic disease, or infection in the cervical spine. One hundred and seventy-three MRI studies with cervical facet oedema were evaluated by each of the two radiologists. In these patients, the grade of bone marrow oedema (BMO) and corresponding neuroforaminal narrowing at the cervical facets was assessed. Correlation with symptoms was performed based on pre-MRI questionnaire.
The prevalence of cervical facet oedema was 9%; the most commonly affected levels were C3-4, C4-5, and C2-3. A total of 202 cervical facets were evaluated: mild BMO was seen in 35%, moderate in 41%, and severe in 24% of cases. Surrounding soft-tissue oedema was observed in 36%, 69%, and 92% of the BMO grades, respectively. The correlations between unilateral radiculopathy and ipsilateral facet BMO grades were 79%, 83%, and 73% (chi-square, p
Retention of senior employees is a challenge for most developed countries. We aimed to identify psychosocial work environment factors of importance for the retention of older employees by evaluating the association between the psychosocial work environment and voluntary early retirement in a longitudinal study.
Data about work environment, health, and background factors came from the DANES 2008 questionnaire survey. We followed members of the Danish early retirement scheme for up to 4 years in national registers-focusing on the age range, 60-64 years, where early retirement was possible. We used Cox proportional hazard regression to analyze the rate of early retirement.
The study included 16 psychosocial work environment factors. The following 10 psychosocial factors were significant predictors of early retirement in covariate adjusted analyses: Low job satisfaction, low influence in job, low possibilities for development, low role clarity, perceived age discrimination, low recognition from management, low workplace justice, poor trust in management, poor leadership quality, and poor predictability. No significant association with early retirement was found for work pace, quantitative demands, emotional demands, role conflicts, social community between colleagues, and trust between colleagues.
Older employees with high job satisfaction, influence, possibilities for development, positive management relations, and jobs with no age discrimination remained longer at the labor market. However, we found no evidence that low demands or good relations between colleagues could influence older employees' decision on early retirement.
This nationwide study aimed to determine whether venous thromboembolism (VTE) shares familial susceptibility with aortic aneurysm (AA), peripheral artery disease (PAD) and arterial thrombosis and embolisation (ATE) in locations other than the heart and brain.
Nationwide Swedish family study. Data from the Swedish Multi-Generation Register for subjects aged 0-78 years old, covering the period 1964-2010, were linked to the Hospital Register. Familial risks (standardised incidence ratio, SIR) of AA, PAD and ATE were determined for individuals with a first-degree relative (parents/sibling) diagnosed with VTE. Separate analyses were done to determine risks for spouses.
A total of 13 063 individuals had AA, 15 494 had PAD and 7325 had ATE. Fully adjusted familial risks for individuals with family history (parent/sibling) of VTE were 1.04 (95% CI 1.00 to 1.08)) for AA, 1.42 (1.35 to 1.49) for ATE and 1.08 (1.04 to 1.13) for PAD. The familial sibling risks were 1.07 (0.99 to 1.14) for AA, 1.61 (1.48 to 1.74) for ATE and 1.19 (1.11 to 1.26) for PAD. Among individuals younger than 50 years of age, the familial risks were: 1.13 (0.99 to 1.29) for AA, 1.76 (1.62 to 1.91) for ATE and 1.12 (1.03 to 1.21) for PAD. In spouses of patients with VTE, the SIRs were 1.21 (1.17 to 1.25) for AA, 1.19 (1.14 to 1.23) for ATE and 1.26 (1.21 to 1.30) for PAD.
VTE shares only weak familial susceptibility with AA and PAD in the Swedish population. However, ATE partially shares a moderate familial susceptibility and possibly genetic factors with VTE. Moreover, familial non-genetic factors may contribute to the observed familial associations.
To assess the influence of cumulative employment as baggage handler on the risk of incident subacromial shoulder disorders. Baggage handling is characterized by repetitive work primarily consisting of heavy lifting in awkward positions and time pressure.
This cohort study is based on the Copenhagen Airport Cohort consisting of unskilled men with employment at Copenhagen Airport and unskilled men with employment in other firms in the Greater Copenhagen area during the period 1990-2012. Only men were included. We followed the cohort in the National Patient Register and Civil Registration System. The primary exposure was cumulative years of employment as a baggage handler, and the primary outcome was diagnoses and surgical treatment of subacromial shoulder disorders.
The cohort contained 3396 baggage handlers and 63,909 workers in the reference group. Baggage handlers with longer cumulative years of employment had higher incidence compared to baggage handlers with shorter employment; for example, baggage handlers with 10-19 years of employment had incidence rate ratio of 2.07 (95 % confidence interval, 1.27-3.38) compared to baggage handlers with less than 3 years of employment. Spline regression showed an increase in incidence within the first few years after employment whereupon the increased risk remained constant for longer employment. Baggage handlers had increased incidence in younger ages than the reference population.
In this large cohort study, we found increased incidence of subacromial shoulder disorders for workers with longer cumulative years of employment. These results support that long-term lifting in awkward positions and time pressure influences the risk of subacromial shoulder disorders.
Photoperiodic regulation of the circadian rhythms in insect locomotor activity has been studied in several species, but seasonal entrainment of these rhythms is still poorly understood. We have traced the entrainment of activity rhythm of northern Drosophila montana flies in a climate chamber mimicking the photoperiods and day and night temperatures that the flies encounter in northern Finland during the summer. The experiment was started by transferring freshly emerged females into the chamber in early and late summer conditions to obtain both non-diapausing and diapausing females for the studies. The locomotor activity of the females and daily changes in the expression levels of two core circadian clock genes, timeless and period, in their heads were measured at different times of summer. The study revealed several features in fly rhythmicity that are likely to help the flies to cope with high variation in the day length and temperature typical to northern summers. First, both the non-diapausing and the diapausing females showed evening activity, which decreased towards the short day length as observed in the autumn in nature. Second, timeless and period genes showed concordant daily oscillations and seasonal shifts in their expression level in both types of females. Contrary to Drosophila melanogaster, oscillation profiles of these genes were similar to each other in all conditions, including the extremely long days in early summer and the cool temperatures in late summer, and their peak expression levels were not locked to lights-off transition in any photoperiod. Third, the diapausing females were less active than the non-diapausing ones, in spite of their younger age. Overall, the study showed that D. montana clock functions well under long day conditions, and that both the photoperiod and the daily temperature cycles are important zeitgebers for seasonal changes in the circadian rhythm of this species.
Data on nursing home admission in patient's =80 years after isolated coronary artery bypass grafting (CABG) are scarce. The purpose of this study was to evaluate longevity and subsequent admission to a nursing home stratified by age in a nationwide CABG cohort.
All patients who underwent isolated CABG from 1996 to 2012 in Denmark were identified through nationwide registers. The cumulative incidence of admission to a nursing home after CABG was estimated. A Cox regression model was constructed to identify predictors for living in a nursing home 1 year after CABG. Kaplan-Meier estimates were used for survival analysis. Subanalysis on home care usage was performed in the period 2008-2012.
A total of 38 487 patients were included. The median age was 65.4 ± 9.5 years (1455 > 80 years) and 80% were males. The 30-day mortality rate was 2.8%, increasing with age (1.2% in patients
Cites: Scand J Public Health. 2011 Jul;39(7 Suppl):22-521775345
Rodent-borne hantaviruses cause two severe acute diseases: hemorrhagic fever with renal syndrome (HFRS) in Eurasia, and hantavirus pulmonary syndrome (HPS; also called hantavirus cardiopulmonary syndrome [HCPS]) in the Americas. Puumala virus (PUUV) is the most common causative agent of HFRS in Europe. Current routine diagnostic methods are based on serological analyses and can yield inconclusive results. Hantavirus-infected patients are viremic during the early phase of disease; therefore, detection of viral RNA genomes can be a valuable complement to existing serological methods. However, the high genomic sequence diversity of PUUV has hampered the development of molecular diagnostics, and currently no real-time reverse transcription-quantitative (RT)-PCR assay is available for routine diagnosis of HFRS. Here, we present a novel PUUV RT-PCR assay. The assay was validated for routine diagnosis of HFRS on samples collected in Sweden during the winter season from 2013 to 2014. The assay allowed detection of PUUV RNA in 98.7% of confirmed clinical HFRS samples collected within 8 days after symptomatic onset. In summary, this study shows that real-time RT-PCR can be a reliable alternative to serological tests during the early phase of HFRS.
Our aim was to examine the extent to which temporal patterns of sitting during occupational work and during leisure-time, assessed using accelerometry, are associated with intense neck-shoulder pain (NSP) in blue-collar workers.
The population consisted of 659 Danish blue-collar workers. Accelerometers were attached to the thigh, hip, trunk and upper dominant arm to measure sitting time and physical activity across four consecutive days. Temporal sitting patterns were expressed separately for work and leisure by the proportion of total time spent sitting in brief bursts (0-5 min), moderate (>5-20 min) and prolonged (>20 min) periods. The peak NSP intensity during the previous 3 months was assessed using a numerical rating scale (range 0-10) and dichotomized into a lower (=4) and higher (>4) NSP score. Logistic regression analyses with multiple adjustments for individual and occupational factors were performed to determine the association between brief, moderate and prolonged sitting periods, and NSP intensity.
Time in brief bursts of occupational sitting was negatively associated with NSP intensity (adjusted OR 0.68, 95 % CI 0.48-0.98), while time in moderate periods of occupational sitting showed a positive association with NSP (adjusted OR 1.32, 95 % CI 1.04-1.69). Time in prolonged periods of occupational sitting was not associated with NSP (adjusted OR 0.78, 95 % CI 0.78-1.09). We found no significant association between brief, moderate or prolonged sitting periods during leisure, and NSP.
Our findings indicate that the association between occupational sitting time and intense NSP among blue-collar workers is sensitive to the temporal pattern of sitting.
Erratum In: Int Arch Occup Environ Health. 2017 Feb 16;:28210807
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Cites: BMC Public Health. 2012 Mar 02;12:15422385536