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Accuracy of death certificates of cardiovascular disease in a community intervention in Sweden.

https://arctichealth.org/en/permalink/ahliterature107744
Source
Scand J Public Health. 2013 Dec;41(8):883-9
Publication Type
Article
Date
Dec-2013
Author
Anders Eriksson
Hans Stenlund
Kristin Ahlm
Kurt Boman
Lars Olov Bygren
Lars Age Johansson
Bert-Ove Olofsson
Stig Wall
Lars Weinehall
Author Affiliation
1Research Unit Skellefteå, Internal Medicine, Department of Public Health and Clinical Medicine, Umeå University, Sweden.
Source
Scand J Public Health. 2013 Dec;41(8):883-9
Date
Dec-2013
Language
English
Publication Type
Article
Keywords
Adult
Aged
Cardiovascular Diseases - mortality - prevention & control
Cause of Death
Death Certificates
Female
Humans
Male
Medical Records
Middle Aged
Program Evaluation
Reproducibility of Results
Sweden - epidemiology
Abstract
The aim was to investigate the possibility to evaluate the mortality pattern in a community intervention programme against cardiovascular disease by official death certificates.
For all deceased in the intervention area (Norsjö), the accuracy of the official death certificates were compared with matched controls in the rest of Västerbotten. The official causes of death were compared with new certificates, based on the last clinical record, issued by three of the authors, and coded by one of the authors, all four accordingly blinded.
The degree of agreement between the official underlying causes of death in "cardiovascular disease" (CVD) and the re-evaluated certificates was not found to differ between Norsjö and the rest of Västerbotten. The agreement was 87% and 88% at chapter level, respectively, but only 55% and 55% at 4-digit level, respectively. The reclassification resulted in a 1% decrease of "cardiovascular deaths" in both Norsjö and the rest of Västerbotten.
The disagreements in the reclassification of cause of death were equal but large in both directions. The official death certificates should be used with caution to evaluate CVD in small community intervention programmes, and restricted to the chapter level and total populations.
PubMed ID
23982462 View in PubMed
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Antibodies against cyclic citrullinated peptide and IgA rheumatoid factor predict the development of rheumatoid arthritis.

https://arctichealth.org/en/permalink/ahliterature13865
Source
Arthritis Rheum. 2003 Oct;48(10):2741-9
Publication Type
Article
Date
Oct-2003
Author
Solbritt Rantapää-Dahlqvist
Ben A W de Jong
Ewa Berglin
Göran Hallmans
Göran Wadell
Hans Stenlund
Ulf Sundin
Walther J van Venrooij
Author Affiliation
Umeå Universitet, Umea, Sweden. solbritt.rantapaa.dahlqvist@medicin.umu.se
Source
Arthritis Rheum. 2003 Oct;48(10):2741-9
Date
Oct-2003
Language
English
Publication Type
Article
Keywords
Adult
Aged
Arthritis, Rheumatoid - diagnosis - epidemiology - immunology
Autoantibodies - blood
Case-Control Studies
Citrulline - immunology
Cohort Studies
Female
Humans
Immunoglobulin A - blood
Immunoglobulin G - blood
Immunoglobulin M - blood
Male
Middle Aged
Predictive value of tests
Research Support, Non-U.S. Gov't
Rheumatoid Factor - metabolism
Seroepidemiologic Studies
Abstract
OBJECTIVE: To evaluate the prevalence and predictive value of anti-cyclic citrullinated peptide (anti-CCP) antibodies in individuals who subsequently developed rheumatoid arthritis (RA) and to determine the relationship to rheumatoid factor (RF) of any isotype. METHODS: A case-control study was nested within the Northern Sweden Health and Disease Study and the Maternity cohorts of Northern Sweden. Patients with RA were identified among blood donors whose samples had been taken years before the onset of symptoms. Control subjects matched for age, sex, date of sampling, and residential area were selected randomly from the same cohorts. Anti-CCP antibody and RFs were determined using enzyme immunoassays. RESULTS: Eighty-three individuals with RA were identified as having donated blood before presenting with any symptoms of joint disease (median 2.5 years [interquartile range 1.1-4.7] before RA). In samples obtained before the onset of RA, the prevalence of autoantibodies was 33.7% for anti-CCP, 16.9% for IgG-RF, 19.3% for IgM-RF, and 33.7% for IgA-RF (all highly significant compared with controls). The sensitivities for detecting these autoantibodies >1.5 years and
Notes
Comment In: Arthritis Rheum. 2003 Oct;48(10):2701-514558071
PubMed ID
14558078 View in PubMed
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Appraisals of stress in child-rearing in Swedish mothers pre-schoolers with ADHD. A questionnaire study.

https://arctichealth.org/en/permalink/ahliterature31274
Source
Eur Child Adolesc Psychiatry. 2002 Aug;11(4):185-95
Publication Type
Article
Date
Aug-2002
Author
Christina Kadesjö
Hans Stenlund
Paul Wels
Christopher Gillberg
Bruno Hägglöf
Author Affiliation
Department of Child and Adolescent Psychiatry, University of Umeå, Sweden. kadesjo@telia.com
Source
Eur Child Adolesc Psychiatry. 2002 Aug;11(4):185-95
Date
Aug-2002
Language
English
Publication Type
Article
Keywords
Attention Deficit Disorder with Hyperactivity - psychology
Child
Child Rearing - psychology
Child, Preschool
Comparative Study
Diagnostic and Statistical Manual of Mental Disorders
Factor Analysis, Statistical
Female
Humans
Male
Mothers - psychology
Questionnaires
Reproducibility of Results
Research Support, Non-U.S. Gov't
Stress, Psychological - diagnosis - psychology
Sweden
Abstract
Dutch self-report questionnaire for measuring parental: i) subjective stress, ii) global appraisal of the child-rearing situation, iii) attribution of child-rearing outcomes, and iv) expectation for help was translated into Swedish and applied to mothers of two groups of 3- to 7-year-olds: one with DSM-IV ADHD (n = 131) and one without DSM-IV ADHD (n = 131). The suggested factor structure of the original Dutch report was tested with confirmatory analysis on data from the mothers of children with ADHD [131]. There was no perfect fit to the data, but close enough to judge the factors as applicable to this sample. Factor reliability testing was performed. Results indicated good psychometric properties. Highly significant differences on all the measures in the four different sections (i) through (iv) were found between the ADHD group and the comparison group. The questionnaire is suggested to be useful in clinical work and research projects on problematic child-rearing situations.
PubMed ID
12444428 View in PubMed
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Behavioural changes after anaesthesia: validity and liability of the Post Hospitalization Behavior Questionnaire in a Swedish paediatric population.

https://arctichealth.org/en/permalink/ahliterature29188
Source
Acta Paediatr. 2006 Mar;95(3):340-6
Publication Type
Article
Date
Mar-2006
Author
Mats Karling
Hans Stenlund
Bruno Hägglöf
Author Affiliation
Division of Anaesthesia, University Hospital of Northern Sweden, University of Umeå, Umeå, Sweden. mats.karling@vll.se
Source
Acta Paediatr. 2006 Mar;95(3):340-6
Date
Mar-2006
Language
English
Publication Type
Article
Abstract
AIM: To study the validity and liability of a Swedish translation of the Post Hospitalization Behavior Questionnaire (PHBQ) in children in Sweden. METHODS: The PHBQ was translated using a back-translation method. The subjects were 340 children, ages 2-13 y, admitted for elective surgery or diagnostic procedure with anaesthesia. The results were analysed using exploratory factor analysis with principal component analysis with Oblimin rotation. The fit to data was examined using confirmative factor analysis with a good measure of fit for the model (p>0.09 for all factors). RESULTS: Five factors emerged as being most consistent: general anxiety-withdrawal, eating disturbances, separation anxiety, regression-aggression and sleep anxiety. A panel of child psychologists confirmed the face validity of factors. Internal consistency (Chronbach's alpha) was adequate (0.75-0.87) for subscales and excellent for total score (0.93). Children less than 5 y old had higher scores than older children (mean 0.046+/-0.018 vs -0.0089+/-0.014, p
PubMed ID
16497646 View in PubMed
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Cardiovascular risk factors predate the onset of symptoms of rheumatoid arthritis: a nested case-control study.

https://arctichealth.org/en/permalink/ahliterature290983
Source
Arthritis Res Ther. 2017 06 30; 19(1):148
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
06-30-2017
Author
Heidi Kokkonen
Hans Stenlund
Solbritt Rantapää-Dahlqvist
Author Affiliation
Department of Public Health and Clinical Medicine, Rheumatology, Umeå University, Building 6M, 901 87, Umeå, Sweden. heidi.kokkonen@umu.se.
Source
Arthritis Res Ther. 2017 06 30; 19(1):148
Date
06-30-2017
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Apolipoprotein A-I - blood
Apolipoproteins B - blood
Arthritis, Rheumatoid - blood - diagnosis - epidemiology
Body mass index
Cardiovascular Diseases - blood - diagnosis - epidemiology
Case-Control Studies
Cohort Studies
Diabetes Mellitus - blood - diagnosis - epidemiology
Female
Humans
Male
Middle Aged
Random Allocation
Risk factors
Smoking - adverse effects - blood - epidemiology
Sweden - epidemiology
Abstract
Patients with rheumatoid arthritis (RA) are at increased risk of developing cardiovascular disease (CVD). Our aim was to evaluate the impact of factors related to CVD, such as smoking, lipid levels, hypertension, body mass index (BMI) and diabetes, in individuals prior to the onset of symptoms of RA.
A nested case-control study was performed including data from 547 pre-symptomatic individuals (i.e. individuals who had participated in population surveys in northern Sweden prior to onset of symptoms of RA, median time to symptom onset 5.0 (interquartile range 2.0-9.0) years) and 1641 matched controls. Within the survey, health examinations prior to symptom onset were performed, blood samples were analysed for plasma glucose and lipids, and data on lifestyle factors had been collected with a questionnaire. CVD risk factors were extracted and further analysed with conditional logistic regression models for association with subsequent RA development, including hypertension, apolipoprotein (Apo)B/ApoA1 ratio, BMI, diabetes and smoking habits.
Smoking and BMI?=?25 (odds ratio (OR) (95% confidence interval (CI)) =1.86 (1.48-2.35) and OR?=?1.28 (1.01-1.62), respectively) were associated with increased risk for future RA development. In women, elevated ApoB/ApoA1 ratio (OR?=?1.36 (1.03-1.80)) and smoking (OR?=?1.82 (1.37-2.41)) were significantly associated with being pre-symptomatic for RA, whilst in men smoking (OR?=?1.92 (1.26-2.92)) and diabetes (OR?=?3.62 (95% CI 1.13-11.64)) were significant. In older (>50.19 years) individuals, only smoking (OR?=?1.74 (1.24-2.45)) was significantly associated with increased risk of future RA, whereas in younger individuals the significant factors were elevated ApoB/ApoA1 ratio (OR?=?1.39 (1.00-1.93)), BMI?=?25.0 (OR?=?1.45 (1.04-2.02)) and smoking (OR?=?2.11 (1.51-2.95)). Pre-symptomatic individuals had a higher frequency of risk factors: 41.5% had =3 compared with 30.4% among matched controls (OR?=?2.81 (1.78-4.44)).
Several risk factors for CVD were present in pre-symptomatic individuals and significantly associated with increased risk for future RA. These factors differed in women and men. The CVD risk factors had a greater impact in younger individuals. These results urge an early analysis of cardiovascular risk factors for proposed prevention in patients with early RA.
Notes
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PubMed ID
28666478 View in PubMed
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Caries incidence rates in Swedish adolescents and young adults with particular reference to adjacent approximal tooth surfaces: a methodological study.

https://arctichealth.org/en/permalink/ahliterature30619
Source
Community Dent Oral Epidemiol. 2003 Oct;31(5):361-7
Publication Type
Article
Date
Oct-2003
Author
Hans Stenlund
Ingegerd Mejàre
Carina Källestål
Author Affiliation
Department of Public Health and Clinical Medicine, Epidemiology, Umeå University, 901 85 Umeå, Sweden. hans.stenlund@epiph.umu.se
Source
Community Dent Oral Epidemiol. 2003 Oct;31(5):361-7
Date
Oct-2003
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Bicuspid - pathology
Child
Cohort Studies
Comparative Study
DMF Index
Dental Caries - epidemiology - radiography
Dental Enamel - radiography
Dentin - radiography
Female
Follow-Up Studies
Humans
Incidence
Male
Models, Statistical
Molar - radiography
Radiography, Bitewing
Research Support, Non-U.S. Gov't
Risk assessment
Sweden - epidemiology
Tooth - radiography
Abstract
OBJECTIVES: The objective was to assess the dependence of the caries status of the adjacent approximal surface on the incidence of approximal caries. METHODS: At baseline, the material consisted of a cohort of 536 Swedish children. The individuals were followed through annual bitewing radiographs from the age of 11-13 to 21-22 years. A radiographic scoring system was used to assess the caries status of the surfaces: scores 0 and 1 = sound surface to score 4 = caries in the outer half of the dentine. A model was used to calculate the dependence of the caries status of adjacent approximal tooth surfaces. The unit of analysis was a pair of adjacent approximal surfaces and in all, 12 pairs of posterior approximal surfaces were analysed. RESULTS: The individual caries rates of the 24 posterior approximal surfaces ranged from 1.3 to 8.3 new caries lesions per 100 tooth surface-years. The caries rate of an approximal tooth surface depended on the caries status of the adjacent surface: a sound surface next to a sound surface had a relatively small risk of developing caries, while the risk increased 1.6-32.3 times if the adjacent surface was in a caries state as judged radiographically. The distal surface of the first molar developed caries more often than the mesial surface of the second molar. CONCLUSIONS: The caries rate of an approximal tooth surface was 1.6-32.3 times higher if the adjacent surface was in a caries state compared to when the latter was sound.
PubMed ID
14667007 View in PubMed
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A combination of autoantibodies to cyclic citrullinated peptide (CCP) and HLA-DRB1 locus antigens is strongly associated with future onset of rheumatoid arthritis.

https://arctichealth.org/en/permalink/ahliterature13806
Source
Arthritis Res Ther. 2004;6(4):R303-8
Publication Type
Article
Date
2004
Author
Ewa Berglin
Leonid Padyukov
Ulf Sundin
Göran Hallmans
Hans Stenlund
Walther J Van Venrooij
Lars Klareskog
Solbritt Rantapää Dahlqvist
Author Affiliation
Department of Public Health and Clinical Medicine, Division of Rheumatology, University Hospital, Umeå, Sweden. solbritt.rantapaa.dahlqvist@medicin.umu.se
Source
Arthritis Res Ther. 2004;6(4):R303-8
Date
2004
Language
English
Publication Type
Article
Keywords
Adult
Aged
Arthritis, Rheumatoid - blood - etiology
Autoantibodies - adverse effects - biosynthesis
Case-Control Studies
Cohort Studies
Female
HLA-DR Antigens - immunology
Humans
Male
Middle Aged
Peptides, Cyclic - immunology
Rheumatoid Factor - blood
Abstract
Antibodies against cyclic citrullinated peptide (CCP) and rheumatoid factors (RFs) have been demonstrated to predate the onset of rheumatoid arthritis (RA) by years. A nested case-control study was performed within the Northern Sweden Health and Disease study cohort to analyse the presence of shared epitope (SE) genes, defined as HLA-DRB1*0404 or DRB1*0401, and of anti-CCP antibodies and RFs in individuals who subsequently developed RA. Patients with RA were identified from among blood donors whose samples had been collected years before the onset of symptoms. Controls matched for age, sex, and date of sampling were selected randomly from the same cohort. The SE genes were identified by polymerase chain reaction sequence-specific primers. Anti-CCP2 antibodies and RFs were determined using enzyme immunoassays. Fifty-nine individuals with RA were identified as blood donors, with a median antedating time of 2.0 years (interquartile range 0.9-3.9 years) before presenting with symptoms of RA. The sensitivity for SE as a diagnostic indicator for RA was 60% and the specificity was 64%. The corresponding figures for anti-CCP antibodies were 37% and 98%, and for RFs, 17-42% and 94%, respectively. In a logistic regression analysis, SE (odds ratio [OR] = 2.35), anti-CCP antibodies (OR = 15.9), and IgA-RF (OR = 6.8) significantly predicted RA. In a combination model analysis, anti-CCP antibodies combined with SE had the highest OR (66.8, 95% confidence interval 8.3-539.4) in predicting RA, compared with anti-CCP antibodies without SE (OR = 25.01, 95% confidence interval 2.8-222.2) or SE without anti-CCP antibodies (OR = 1.9, 95% confidence interval 0.9-4.2). This study showed that the presence of anti-CCP antibodies together with SE gene carriage is associated with a very high relative risk for future development of RA.
PubMed ID
15225365 View in PubMed
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Community participation and sustainability--evidence over 25 years in the Västerbotten Intervention Programme.

https://arctichealth.org/en/permalink/ahliterature128405
Source
Glob Health Action. 2012;5:1-9
Publication Type
Article
Date
2012
Author
Margareta Norberg
Yulia Blomstedt
Göran Lönnberg
Lennarth Nyström
Hans Stenlund
Stig Wall
Lars Weinehall
Author Affiliation
Ageing and Living Conditions Programme, Centre for Population Studies, Umeå University, Umeå, Sweden. margareta.norberg@epiph.umu.se
Source
Glob Health Action. 2012;5:1-9
Date
2012
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Cardiovascular Diseases - prevention & control
Consumer Participation - statistics & numerical data
Cross-Sectional Studies
Female
Health Education - organization & administration
Hospitalization - statistics & numerical data
Humans
Male
Middle Aged
Physical Examination
Sex Distribution
Socioeconomic Factors
Sweden
Abstract
Selection bias and declining participation rates are of concern in many long-term epidemiological studies. The Västerbotten Intervention Programme (VIP) was launched in 1985 as a response to alarming reports on elevated cardiovascular disease (CVD) mortality in Västerbotten County in Northern Sweden. The VIP invites women and men to a health examination and health counselling during the year of their 40th, 50th, and 60th birthdays.
To evaluate trends in participation rates and determinants of participation in the VIP from 1990 to 2006.
Registry data on socio-economic status from Statistics Sweden, and mortality and hospitalisation data from the National Board of Health and Welfare, both covering the whole Swedish population, were linked to the VIP and analysed for participants and non-participants.
During 1990-2006, 117,710 individuals were eligible to participate in the VIP, and 40,472 of them were eligible to participate twice. There were 96,560 observations for participants and 61,622 for non-participants. The overall participation rate increased from 56 to 65%. Participants and non-participants had minimal differences in education and age. Initial small differences by sex and degree of urban residence decreased over time. Despite an increasing participation rate in all groups, those with low income or who were single had an approximately 10% lower participation rate than those with high or medium-income or who were married or cohabitating.
Sustainability of the VIP is based on organisational integration into primary health care services and targeting of the entire middle-aged population. This enables the programme to meet population expectations of health promotion and to identify high-risk individuals who are then entered into routine preventive health care services. This has the potential to increase participation rates, to minimise social selection bias, and to reinforce other community-based interventions.
Notes
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PubMed ID
23528041 View in PubMed
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Components of metabolic syndrome predicting diabetes: no role of inflammation or dyslipidemia.

https://arctichealth.org/en/permalink/ahliterature162424
Source
Obesity (Silver Spring). 2007 Jul;15(7):1875-85
Publication Type
Article
Date
Jul-2007
Author
Margareta Norberg
Hans Stenlund
Bernt Lindahl
Christer Andersson
Lars Weinehall
Gãran Hallmans
Jan W Eriksson
Author Affiliation
Epidemiology and Public Health Sciences Section, Department of Public Health and Clinical Medicine, Umea University Hospital, Building 9B, SE-901 85 Umea, Sweden. margareta.norberg@epiph.umu.se
Source
Obesity (Silver Spring). 2007 Jul;15(7):1875-85
Date
Jul-2007
Language
English
Publication Type
Article
Keywords
Adult
Analysis of Variance
Biological Markers - blood
Blood Glucose - metabolism
Blood pressure
Body mass index
Diabetes Mellitus - blood - epidemiology - physiopathology
Dyslipidemias - physiopathology
Female
Health Surveys
Humans
Inflammation - physiopathology
Leptin - blood
Male
Metabolic Syndrome X - complications - epidemiology
Middle Aged
Predictive value of tests
Proinsulin - blood
Risk factors
Sweden
Abstract
The diagnostic criteria and the clinical usefulness of the metabolic syndrome (MetSy) are currently questioned. The objective was to describe the structure of MetSy and to evaluate its components for prediction of diabetes type 2 (T2DM).
This was a case-referent study nested within a population-based health survey. Among 33,336 participants, we identified 177 initially non-diabetic individuals who developed T2DM after 0.1 to 10.5 years (mean, 5.4 years), and, for each diabetes case, two referents matched for sex, age, and year of health survey. Baseline variables included oral glucose tolerance test, BMI, blood pressure, blood lipids, adipokines, inflammatory markers, insulin resistance, and beta-cell function. Exploratory and confirmative factor analyses were applied to hypothesize the structure of the MetSy. The prediction of T2DM by the different factors was evaluated by multivariate logistic regression analysis.
A hypothetical five-factor model of intercorrelated composite factors was generated. The inflammation, dyslipidemia, and blood pressure factors were predicitive only in univariate analysis. In multivariable analyses, two factors independently and significantly predicted T2DM: an obesity/insulin resistance factor and a glycemia factor. The composite factors did not improve the prediction of T2DM compared with single variables. Among the original variables, fasting glucose, proinsulin, BMI, and blood pressure values were predictive of T2DM.
Our data support the concept of a MetSy, and we propose five separate clusters of components. The inflammation and dyslipidemia factors were not independently associated with diabetes risk. In contrast, obesity and accompanying insulin resistance and beta-cell decompensation seem to be two core perturbations promoting and predicting progression to T2DM.
PubMed ID
17636107 View in PubMed
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Determinants of self-rated health in old age: a population-based, cross-sectional study using the International Classification of Functioning.

https://arctichealth.org/en/permalink/ahliterature131873
Source
BMC Public Health. 2011;11:670
Publication Type
Article
Date
2011
Author
Solveig A Arnadottir
Elin D Gunnarsdottir
Hans Stenlund
Lillemor Lundin-Olsson
Author Affiliation
Department of Community Medicine and Rehabilitation, Division of Physiotherapy, Umeå University, Sweden. saa@unak.is
Source
BMC Public Health. 2011;11:670
Date
2011
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Cross-Sectional Studies
Diagnostic Self Evaluation
Female
Health status
Humans
Iceland
International Classification of Diseases
Male
Rural Health
Urban health
Abstract
Self-rated health (SRH) is a widely used indicator of general health and multiple studies have supported the predictive validity of SRH in older populations concerning future health, functional decline, disability, and mortality. The aim of this study was to use the theoretical framework of the International Classification of Functioning, Disability and Health (ICF) to create a better understanding of factors associated with SRH among community-dwelling older people in urban and rural areas.
The study design was population-based and cross-sectional. Participants were 185 Icelanders, randomly selected from a national registry, community-dwelling, 65-88 years old, 63% urban residents, and 52% men. Participants were asked: "In general, would you say your health is excellent, very good, good, fair, or poor?" Associations with SRH were analyzed with ordinal logistic regression. Explanatory variables represented aspects of body functions, activities, participation, environmental factors and personal factors components of the ICF.
Univariate analysis revealed that SRH was significantly associated with all analyzed ICF components through 16 out of 18 explanatory variables. Multivariate analysis, however, demonstrated that SRH had an independent association with five variables representing ICF body functions, activities, and personal factors components: The likelihood of a better SRH increased with advanced lower extremity capacity (adjusted odds ratio [adjOR] = 1.05, p
Notes
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