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Immigrant women who have lived longer in a destination often have relatively low levels of fertility, which is sometimes taken as evidence of the adaptation of behavior. This evidence is almost exclusively based on studies of immigrants from high-fertility settings, while the fertility of immigrants from low-fertility settings has been largely overlooked. Research has also rarely studied the fertility of immigrants who migrated as children, despite the methodological advantages of applying such an approach. This study focuses on women who grew up in Sweden with a migration background from low-fertility origins. We expect that Sweden's welfare regime makes it easier for women to combine childbearing and working life, regardless of migration background, thereby facilitating an adaptation of fertility behavior toward that prevailing in Sweden. We find evidence of adaptation in terms of birth timing for at least half of the country-origin groups that we study, but very little evidence of adaptation in terms of completed fertility. Further, we find that, in comparison with ancestral Swedes, completed fertility differentials are larger for second-generation individuals than for immigrants who arrived during childhood. This is evidence against the notion of “straight-line” adaptation for immigrants and the children of immigrants who are born in Sweden.

One million Health Profile Assessments (HPB) have been carried out in Sweden since 1988. HPB includes questions about health habits and health experiences. Furthermore some physiological and medical measurements have been carried out. Data from completed HPB:s have been registered since 1988 in a database, which is used for statistical analyzes and research. Health outcomes have been obtained from several national registers. Since 2018, 20 papers have been published internationally. Low physical fitness, overweight and obesity have increased in the Swedish working population. Higher prevalence of severe illness is seen among those with one or more of these risk factors.

The main aim was to examine the association between occupational groups and incident cardiovascular disease (CVD), and to which extent associations are mediated by lifestyle-associated variables (cardiorespiratory fitness, smoking, BMI, exercise, and diet). A total of 304.702 participants (mean age 42.5 yrs., 47% women), who performed a health profile assessment in Sweden between 1982 and 2019, were included in the analyses. CVD incidence was obtained from national registers. All participants were free from CVD prior to the health profile assessment. Occupational group was defined using the Swedish Standard Classification of Occupations and analyzed separately (13 different occupational groups) as well as after aggregation into four occupational groups (white-collar high-skilled, white-collar low-skilled, blue-collar high-skilled and blue-collar low-skilled). Cardiorespiratory fitness, BMI, exercise, smoking, and diet were included as mediators and analyzed separately in single models and simultaneously in one multiple mediation model. All mediation analyses were adjusted for sex, age, length of education and calendar time. White-collar high-skilled was set as reference in all analyses. Blue-collar and low-skilled occupation had a higher risk of incident CVD compared to reference. Cardiorespiratory fitness, BMI, exercise, smoking, and diet mediated 48% to 54% of the associations between reference and the other aggregated occupational groups. In the single model, the strongest mediators were cardiorespiratory fitness, smoking and BMI. In conclusion, blue-collar and low skilled occupations had a significantly higher risk for incident CVD compared to white-collar high-skilled workers, with the association mediated to a large extent by variation in lifestyle-associated variables.

PurposeThe purpose of the study is to test if it, by the use of a survey methodology, is possible to measure managers' awareness on, and specifically if there exist preconceived beliefs on, overall equipment effectiveness (OEE) results. The paper presents the design of the survey methodology as well as a test of the survey in one case company.Design/methodology/approachActual OEE logs from a case company are collected and a survey on the data is designed and managers at the same case company are asked to answer the survey. The survey results are followed-up by an interview study in order to get deeper insights to both the results of the survey as well as the OEE strategy at the case company.FindingsThe findings show that the managers at this particular case company, on a general level, does not suffer too much from preconceived beliefs. However, it is clear that the managers have a preconceived belief that lack of material is logged as a loss much more often than what it actually is.Research limitations/implicationsThe test has only been performed with data from one case company within the automotive manufacturing industry and only the managers at that case company has been active in the test.Practical implicationsThe survey methodology can be replicated and used by other companies to find out how aware their employees are on their OEE results and if possible preconceived beliefs exists.Originality/valueTo the authors' knowledge, this is the first attempt at measuring if preconceived beliefs on OEE results exist.

This paper explores discourses around Lean by examining the perceptions of new users of Lean in the public sector. The paper draws on actor–network theory as the basis for exploring what these new users think about Lean and uses data analysis tools to extrude concepts of significance. The data suggests that Lean continues to retain diverse, parallel and competing perspectives. The responses also signal that key concepts of Lean are missing from the discourses, and that this highlights a need to discuss Lean as a mindset—not just as a set of tools. The paper suggests future directions for research to further explore the issues emphasised by respondents.

Previous research suggests that young adults from out-of-home care (OHC) are at high risk of low education and unemployment. However, there are no studies on their risk of long-term NEET (Not in Employment, Education or Training). This study compared the risk of NEET at age 21-23 among OHC youth across Denmark, Finland and Sweden, using register data for an entire birth cohort born in 1987. The Nordic countries share many features, but there are differences in the provision of after-care support and in the linkage between the educational system and the labour market. The results show that about a fourth in Denmark and Sweden and a third in Finland were NEET, suggesting that the welfare systems were not able to compensate for the OHC youth's childhood disadvantages. To a significant extent, the excess risk of NEET was attributed to poor school performance. Implications for research, policy and practice are discussed.

OBJECTIVE This abbreviated version of the American College of Occupational and Environmental Medicine's (ACOEM) Low Back Disorders Guideline reviews the evidence and recommendations developed for non-invasive and minimally invasive management of low back disorders. METHODS Systematic literature reviews were accomplished with article abstraction, critiquing, grading, evidence table compilation, and guideline finalization by a multidisciplinary expert panel and extensive peer-review to develop evidence-based guidance. Consensus recommendations were formulated when evidence was lacking. A total of 70 high-quality and 564 moderate-quality trials were identified for non-invasive low back disorders. Detailed algorithms were developed. RESULTS Guidance has been developed for the management of acute, subacute, and chronic low back disorders and rehabilitation. This includes 121 specific recommendations. CONCLUSION Quality evidence should guide treatment for all phases of managing low back disorders.

Background: Geographical variations in the incidence and tumour stage distribution of oesophageal cancer in Sweden are not well characterised.Methods: Using data from the Swedish Cancer Registry ov...

In this study, we provide demographic insight into the still relatively new family form of same-sex marriage. We focus on period trends in same-sex marriage formation and divorce during 1995–2012 in Sweden and the role of childbearing in same-sex unions. The period begins with the introduction of registered partnership for same-sex couples and also covers the introduction of formal same-sex marriage in 2009. We use register data for the complete population of Sweden to contrast patterns in male and female same-sex marriage formation and divorce. We show that female same-sex union formation increased rapidly over the period, while trends for male same-sex unions increased less. The introduction of same-sex marriage legislation in 2009 appears to have had little effect on the pace of formation of same-sex unions. In contrast, legal changes supporting parental rights in same-sex unions may have fueled the formation of female same-sex marriages as well as parenthood in such unions. Further, we show that divorce risks in the marital unions of two women are much higher than in other types of marriages. We find some convergence of divorce risks across union types at the end of our study period: male same-sex unions have the same divorce risk levels as opposite-sex marriages, and the elevated risks of divorce in female same-sex unions appear to have stabilized at somewhat lower levels than those observed in the late 1990s. Electronic supplementary material The online version of this chapter (10.1007/s13524-019-00847-6) contains supplementary material, which is available to authorized users.

To describe time trends in combinations of cardiorespiratory fitness (CRF) and body mass index (BMI) status, and to analyse their associations with cardiovascular disease (CVD) incidence and mortality and all-cause mortality.Prospective cohort study with data from occupational health screenings in Swedish employees, including n = 471 216 (aged 18-74 years) between 1995 and 2020, and n = 169 989 in risk analyses. Cardiorespiratory fitness was estimated from a submaximal cycle test. High CRF was defined as top quartile, and low CRF as bottom quartile. Body mass index was used to define normal weight (18.5-24.9 kg/m2), overweight (25.0-29.9 kg/m2), and obesity (≥30 kg/m2). Outcome data (CVD incidence and mortality, all-cause mortality) were obtained from national registers. From 1995 to 2020, the combination of obesity + low CRF increased from 2.1% to 5.3% (relative increase 154%) whereas the combination of normal weight + high CRF decreased from 13.2% to 9.3% (-30%) (both P 0.001). Negative changes were more pronounced in men, younger ages, and non-university educated. At the end of the period, prevalence of obesity + low CRF were higher in men vs. women (3.1% vs. 2.2%), older vs. younger (3.7% vs. 1.7%), and in non-university vs. university educated (5.0% vs. 0.3%), all P-value0.001. Having a high CRF attenuated the risk of all three outcomes in all BMI categories, especially in individuals with obesity (hazard ratio 3.90 vs. 6.67 for CVD mortality). Both a low BMI and a high CRF prolonged age of onset for all three outcomes.The combination of obesity with low CRF has increased markedly since the mid-90s, with clear implications for increased CVD morbidity and mortality, and all-cause mortality.

We demonstrate how the Bayesian framework for forensic interpretation can be adapted for casework involving postmortem intervals (PMI) utilizing taphonomic data as well as how to overcome some of the limitations of current approaches for estimating and communicating uncertainty. A model is implemented for indoor cases based on partial body scores from three different anatomical regions as correlated functions of accumulated temperature (AT). The multivariate model enables estimation of PMI for human remains also when one or two local body scores are missing or undetermined, e.g. as a result of burns, scars or covered body parts. The model was trained using the expectation maximization algorithm, enabling us to account for uncertainty of PMI and/or ambient temperature in the training data. Alternative approaches reporting the results are presented, including the likelihood curve, likelihood ratios for competing hypotheses and posterior probability distributions and credibility intervals for PMI. The applicability or the approaches in different forensic scenarios is discussed.

Sweden is often considered a forerunner in family change and developments towards less gendered family production patterns. In this study, we focus on recent developments towards more gender-equal sharing of parental leave in Sweden. We explore how fathers’ use of parental leave has changed over time before and since the turn of the century. As the parental leave benefit is individual and earnings-based, we examine how fathers’ individual socio-economic and demographic characteristics are associated with their parental leave uptake over time, to determine whether there are forerunners and laggards in recent family change. Multinomial logistic regression models were applied to data from national registers. Our study demonstrates a bifurcation in trends in recent decades. This is associated with the extension of reforms that reserve part of the leave for fathers, the so-called “daddy months”, but stretches beyond the impact of any such reforms. Taking a long leave of over two months was pioneered by better-educated residents of metropolitan areas and surrounding suburbs, as well as Swedish-born fathers. Young fathers, low-income earners and foreign-born fathers lagged behind in these developments. We regard the unstable labour market situation of the latter as a contributing factor in widening social inequalities in family-related behaviour.

International audience; A potentially sensitive way to detect disease outbreaks is syndromic surveillance, i.e. monitoring the number of syndromes reported in the population of interest, comparing it to the baseline rate, and drawing conclusions about outbreaks using statistical methods. A decision maker may use the results to take disease control actions or to initiate enhanced epidemiological investigations. In addition to the total count of syndromes there are often additional pieces of information to consider when assessing the probability of an outbreak. This includes clus-tering of syndromes in space and time as well as historical data on the occurrence of syndromes, seasonality of the disease, etc. In this paper, we show how Bayesian theory for syndromic surveillance applies to the occurrence of neurological syndromes in horses in France. Neurological syndromes in horses may be connected e.g. to West Nile Virus (WNV), a zoonotic disease of growing concern for public health in Europe. A Bayesian method for spatio-temporal cluster detection of syndromes and for determining the probability of an outbreak is presented. It is shown how surveillance can be performed simultaneously for a specific class of diseases (WNV or diseases similar to WNV in terms of the information available to the system) and a non-specific class of diseases (not similar to WNV in terms of the information available to the system). We also discuss some new extensions to the spatio-temporal models and the computational algorithms involved. It is shown step-by-step how data from historical WNV outbreaks and surveillance data for neurological syndromes can be used for model construction. The model is implemented using a Gibbs sampling procedure, and its sensitivity and specificity is evaluated. Finally, it is illustrated how predictive modelling of syndromes can be useful for decision making in animal health surveillance.

OBJECTIVE This abbreviated version of the American College of Occupational and Environmental Medicine's Low Back Disorders guideline reviews the evidence and recommendations developed for invasive treatments used to manage low back disorders. METHODS Comprehensive systematic literature reviews were accomplished with article abstraction, critiquing, grading, evidence table compilation, and guideline finalization by a multidisciplinary expert panel and extensive peer-review to develop evidence-based guidance. Consensus recommendations were formulated when evidence was lacking and often relied on analogy to other disorders for which evidence exists. A total of 47 high-quality and 321 moderate-quality trials were identified for invasive management of low back disorders. RESULTS Guidance has been developed for the invasive management of acute, subacute, and chronic low back disorders and rehabilitation. This includes 49 specific recommendations. CONCLUSION Quality evidence should guide invasive treatment for all phases of managing low back disorders.

Preliminary evidence points to higher morbidity and mortality from coronavirus disease 2019 (COVID-19) in certain racial and ethnic groups, but population-based studies using microlevel data are lacking so far. We used register-based cohort data including all adults living in Stockholm, Sweden, between January 31, 2020 (the date of the first confirmed case of COVID-19) and May 4, 2020 (n = 1,778,670) to conduct Poisson regression analyses with region/country of birth as the exposure and underlying cause of COVID-19 death as the outcome, estimating relative risks and 95% confidence intervals. Migrants from Middle Eastern countries (relative risk (RR) = 3.2, 95% confidence interval (CD: 2.6, 3.8), Africa (RR = 3.0, 95% CI: 2.2, 4.3), and non-Sweden Nordic countries (RR = 1.5, 95% CI: 1.2, 1.8) had higher mortality from COVID-19 than persons born in Sweden. Especially high mortality risks from COVID-19 were found among persons born in Somalia, Lebanon, Syria, Turkey, Iran, and Iraq. Socioeconomic status, number of working-age household members, and neighborhood population density attenuated up to half of the increased COVID-19 mortality risks among the foreign-born. Disadvantaged socioeconomic and living conditions may increase infection rates in migrants and contribute to their higher risk of COVID-19 mortality. Funding Agencies|Swedish Research Council for Health, Working Life and WelfareSwedish Research CouncilSwedish Research Council for Health Working Life & Welfare (Forte) [2016-07128, 2016-07115, 2016-07105, 2019-00603]

In this study, we provide an account of mortality levels in Sweden during 2020, with a focus both on excess mortality and mortality due to COVID-19 deaths. We present various measures of life expectancy of women and men based on age-specific death rates during 2020. Our measures of excess mortality are based on comparisons with benchmarks based on a previous mortality forecast for 2020 by Statistics Sweden and the observed mortality rates during an average of 2017-2019. We present data on regional and seasonal variation in excess mortality as well as estimates of Years of Potential Life lost due to COVID-19. We decompose the excess mortality in 2020 into what can be explained by COVID-19 and changes in mortality by other causes. We also provide some estimates on the impact of the excess mortality in 2020 on the remaining life expectancy for different cohorts of Swedish women and men. We demonstrate that the impact of COVID-19 mortality was concentrated to higher ages and among men in particular. Some younger age groups rather experienced a negative excess mortality. The mortality situation during 2020 pushed life expectancy back to levels previously observed during 2018 for women and 2017 for men.

Overall equipment effectiveness (OEE) is a common performance measure used in manufacturing industry to identify and prioritize losses to perform improvement work on in order to increase the effectiveness of equipment. There exist challenges though, both in implementing OEE as well as in running an OEE-program. Some of these challenges include lack of training and awareness, lack of focus, risk of misunderstanding the measure etc. This paper will deal with some of the possible misconceptions within the use of OEE that might arise during implementation or in continuously running an OEE-program. Some of the topics of misconceptions that will be discussed include: no financial issues are taken into consideration; that the factors of availability; performance and quality are not weighted; the connection to productivity is not always clear; the importance of cross-functionality of the measurement and work method; the issue of comparison of OEE results; and last but not least the view on and hunt for world class levels. The paper will discuss these (and some additional ones) theoretically and suggest some counter-actions so that they may be avoided.

A key feature of risk analysis is that risk assessment and risk management should be functionally separated. However, the usefulness of a risk assessment may be limited if the output is not designed to help with risk management decisions. The COMRISK project investigated the communication between risk assessors and risk managers. The overall goal of the project was to identify current practices and challenges in communication between risk assessors and risk managers during the risk analysis process, and thus increase and improve the understanding and the quality of the communication between them. Specific actions to achieve this aim included reviewing of historical food safety cases, analysing risk assessment requests, identifying communication guiding documents, including legislation and agreements, conducting semi‐structured interviews with risk assessors and risk managers, and identifying tools for facilitating the communication between risk assessors and risk managers. It was concluded that the usefulness of a risk assessment is strongly dependent on well‐defined and mutually recognised risk questions and that scarce or poor communication between risk assessors and risk managers is one of the major reasons when an output from risk assessment fails to support risk management. The communication between risk assessors and risk managers preceding the onset of the risk assessment, when the risk assessment requests with its risk questions are defined, is especially identified as one of the critical points to ensure a risk assessment that is fit for purpose. However, difficulties in understanding were also reported for the communication between risk assessors and risk managers during and after the risk assessment. Lack of communication is seldom a result of formal constraints or agreements nor can it be explained by a wish of the risk assessors or risk managers. Instead, perceived constraints or traditions appear to be possible underlying factors leading to scarce or poor communication between risk assessors and risk managers. It is essential that both risk assessors and risk managers acknowledge the crucial importance of communication between them while at the same time respect their different roles in a risk analysis.According to respondents, the best solution to facilitate the framing of the risk assessment questions isan open dialogue between risk assessors and risk managers to agree on the goal of the assessment and to build trust. Further, the interviewresults indicate that a formal systematic process may facilitate communication during the risk analysis. Where there is uncertainty, e.g due to data gaps or issues related to the methodology and models, it should be acknowledged and described properly by risk assessors to risk managers. Training of risk assessors and risk managers may improve the possibility of a timely and fit‐for‐purpose output.Such a training should give a deeper insight in the risk management process, give a better understanding of the risk managers role, and especially raise the awareness of the importance of the communication between risk assessors and risk managers.To improve the risk analysis process, it is also important that the risk assessor gets feedback regarding how risk assessments have met the needs of the risk managers.The present study also found that aspects of risk communication studied in this project are not extensively discussed in the guidance documents for risk analysis. More research is needed to identify the barriers for a fit for purpose communication.

ObjectivesIdentify and compare health risk indicators for common chronic diseases between different occupational groups. Methods A total of 72,855 participants (41% women) participating in an occupational health servicescreening in 2014–2019 were included. Occupation was defined by the Swedish Standard Classification of Occupation, and divided into nine major and additionally eight sub-major groups. These were analysed separately, as white- and blue-collar occupations and as low- and high-skilled occupations. Seven health risk indicators were self-reported: exercise, physical work situation, sitting at work and leisure, smoking, diet, and perceived health, whereas cardiorespiratory fitness, BMI and blood pressure were measured. These were further dichotomized (yes/no) and as clustering of risk indicators (≥3 vs. ResultsThe greatest variation in OR across sub-major and major occupational groups were seen for daily smoking (OR=0.68 to OR=5.12), physically demanding work (OR=0.55 to OR=45.74) and high sitting at work (OR=0.04 to OR=1.86). For clustering of health risk indicators, blue-collar workers had significantly higher clustering of health risks (OR: 1.80; 95% CI 1.71-1.90) compared to white-collar workers (reference). Compared to high-skilled white-collar workers, low-skilled white-collar workers had similar OR (2.00; 1.88-2.13) as high-skilled blue-collar workers (1.98; 1.86-2.12), with low-skilled blue-collar workers having the highest clustered risk (2.32; 2.17-2.48).ConclusionThere were large differences in health risk indicators across occupational groups, mainly between high-skilled white-collar occupations and the other occupations, with important variations also between major and sub-major occupational groups. Future health interventions should target the occupational groups identified with the highest risk for effective disease prevention.

BACKGROUND: Identify and compare health risk indicators for common chronic diseases between different occupational groups. METHODS: A total of 72,855 participants (41% women) participating in an occupational health service screening in 2014-2019 were included. Occupation was defined by the Swedish Standard Classification of Occupation, and divided into nine major and additionally eight sub-major groups. These were analysed separately, as white- and blue-collar occupations and as low- and high-skilled occupations. Seven health risk indicators were self-reported: exercise, physical work situation, sitting at work and leisure, smoking, diet, and perceived health, whereas cardiorespiratory fitness, BMI and blood pressure were measured. These were further dichotomized (yes/no) and as clustering of risk indicators (≥3 vs.

The objective of this study was to determine if a relationship between microbial neoformation of volatiles and the post-mortem interval (PMI) exists, and if the volatiles could be used as a tool to improve the precision of PMI estimation in decomposed human remains found in an indoor setting. Chromatograms from alcohol analysis (femoral vein blood) of 412 cases were retrospectively assessed for the presence of ethanol, N-propanol, 1-butanol, and acetaldehyde. The most common finding was acetaldehyde (83% of the cases), followed by ethanol (37%), N-propanol (21%), and 1-butanol (4%). A direct link between the volatiles and the PMI or the degree of decomposition was not observed. However, the decomposition had progressed faster in cases with microbial neoformation than in cases without signs of neoformation. Microbial neoformation may therefore act as an indicator of the decomposition rate within the early decomposition to bloating stages. This may be used in PMI estimation based on the total body score (TBS) and accumulated degree days (ADD) model, to potentially improve the model’s precision. Electronic supplementary material The online version of this article (10.1007/s00414-020-02436-4) contains supplementary material, which is available to authorized users.

Aims: The purpose of this research was to describe the current prevalence and historic trends in overweight, obesity and severe obesity in Sweden. Methods: Data on BMI, age, gender, education and geographic region were obtained in n=447,925 Swedish adults through a nationwide screening test (1995–2017). To account for sampling variations, we quantified prevalence estimates and time trends using standardized values (direct method) to all 18–74-year-old Swedes, using nationwide databases. Rates of overweight (BMI ⩾25 kg/m2), obesity (BMI ⩾30 kg/m2) and severe obesity (BMI ⩾35 kg/m2) were calculated across gender, age, education and geographic categories. Years were grouped into two-year sampling periods (except the first period where we used three years) for increased power. We used multivariable logistic regression to quantify independent associations between age, gender, education and region with obesity development and current prevalence rates. Results: In 2016/17 the unstandardized prevalence of overweight, obesity and severe obesity were 55.1%, 16.6% and 4.2%, respectively. Factors associated with a higher obesity prevalence were male gender, older age, lower education and residing in a rural region (all P

The last half a century has witnessed swift changes in patterns of family formation and family dissolution in developed countries, followed by increased attention to these changes and to the causes and consequences of such change. In the wake of these developments, the field of family demography has developed in new directions. In the European context, Sweden and the other Nordic countries have frequently been referred to as forerunners in many aspects of family change, and these countries have gained much attention in family-demographic research. In the current contribution, we give an overview of the current state of Swedish family-demographic affairs.

A well-known argument claims that socioeconomic differentials in children’s family structures have become increasingly important in shaping child outcomes and the resources available to children in developed societies. One assumption is that differentials are comparatively small in Nordic welfare states. Our study examines how children’s experiences of family structures and family dynamics vary by their mother’s educational attainment in Finland. Based on register data on the childbearing and union histories of women in Finland born from 1969 onwards, we provide life-table estimates of children’s (N = 64,162) experiences of family dissolution, family formation, and family structure from ages 0–15 years, stratified by mother’s education level at the child’s birth. We find huge socioeconomic disparities in children’s experiences of family structures and transitions. Compared to children of highly educated mothers, children of mothers with low levels of education are almost twice as likely to be born in cohabitation and four times as likely to be born to a lone mother. They are also much more likely to experience further changes in family structure—particularly parental separation. On average, children of low-educated mothers spend just half of their childhood years living with both their parents, whereas those of high-educated mothers spend four-fifths of their childhood with both parents. The sociodemographic inequalities among children in Nordic welfare states clearly deserve more scholarly attention. Electronic supplementary material The online version of this article (10.1007/s11113-018-9485-1) contains supplementary material, which is available to authorized users.

This paper explores how Engineering students and Work and Welfare students reflect upon their own engagement in a one-week cross-disciplinary project. To develop a better understanding of what unfolds during these activities we collected data through anonymous surveys two consecutive years. Data from these 141 respondents were analysed using a learning history approach and are presented as narratives. Results show major disruptions and conflicts driving the student projects, exposing inviting confrontations, social identity threats, managing diversity, and friction of ideas. Whereas this in many cases led to new and better project solutions, these real-world experiences raise awareness of the need for tools and methods for training students. The aim of the paper is to learn from students’ experiences through narrative distance, and fill a gap in the literature between problem-based learning (PBL) and the learning history method. Discussing different experiences of cross-disciplinary teamwork through the explanations of these theories, we also lay out potential questions for future research on the topic.

This study's objective is to obtain accuracy and precision in estimating the postmortem interval (PMI) for decomposing human remains discovered in indoor settings. Data were collected prospectively from 140 forensic cases with a known date of death, scored according to the Total Body Score (TBS) scale at the post-mortem examination. In our model setting, it is estimated that, in cases with or without the presence of blowfly larvae, approximately 45% or 66% respectively, of the variance in TBS can be derived from Accumulated Degree-Days (ADD). The precision in estimating ADD/PMI from TBS is, in our setting, moderate to low. However, dividing the cases into defined subgroups suggests the possibility to increase the precision of the model. Our findings also suggest a significant seasonal difference with concomitant influence on TBS in the complete data set, possibly initiated by the presence of insect activity mainly during summer. PMI may be underestimated in cases with presence of desiccation. Likewise, there is a need for evaluating the effect of insect activity, to avoid overestimating the PMI. Our data sample indicates that the scoring method might need to be slightly modified to better reflect indoor decomposition, especially in cases with insect infestations or/and extensive desiccation. When applying TBS in an indoor setting, the model requires distinct inclusion criteria and a defined population.

Aim: To study how change in cardiorespiratory fitness over time is associated with the development of poor self-rated health in healthy Swedish adults, and whether this association varies with sex, age, body mass index and cardiorespiratory fitness at baseline. A secondary aim was to study the influence of other predictors of self-rated health. Methods: A total of 98,718 participants (45% women, mean age 42.2 years) with two assessments from occupational health service screenings between 1988 and 2019 (mean duration 4.3 years), with good self-rated health at baseline were included. Cardiorespiratory fitness was assessed as estimated maximal oxygen consumption using submaximal cycle testing. Change in cardiorespiratory fitness was expressed as percentage annual change. Poor self-rated health at follow-up was defined as percieving self-rated health as ‘poor’ or ‘very poor’. Results: A large decrease in cardiorespiratory fitness (⩾−3%) was associated with a 34% higher risk of poor self-rated health compared to maintainers (−1 to +1%) after multi-adjustment including change in body mass index, back/neck pain, stress, exercise habits and sleep quality or sleep problems. The associations for decreasers were stronger with longer follow-up time (>10 years). Preserving, or changing to, risk level for body mass index, back/neck pain, stress, exercise and sleep quality/problems were associated with a higher risk of poor self-rated health. Conclusions: Preserving or increasing cardiorespiratory fitness is associated with a lower risk of poor self-rated health, independently of change in other health-related variables, which may act as a protection against future poor self-rated health. This is of high clinical value, and strategies for maintaining or improving cardiorespiratory fitness have the potential to influence both disease and mortality.

Introduction Sexual minority individuals have a higher risk of anxiety and depression compared with heterosexuals. However, whether the higher risk is spread equally across the sexual minority population is not clear. Aim To investigate the association between sexual orientation and self-reported current anxiety and a history of diagnosis of depression, paying particular attention to possible subgroup differences in risks within the sexual minority population, stratified by sex and to examine participants' history of medical care for anxiety disorders and depression. Methods We conducted a population-based study of 874 lesbians and gays, 841 bisexuals, and 67,980 heterosexuals recruited in 2010 in Stockholm County. Data were obtained from self-administered surveys that were linked to nationwide registers. Main Outcome Measures By using logistic regression, we compared risks of current anxiety, histories of diagnosed depression, and register-based medical care for anxiety and/or depression in lesbian and gay, bisexual, and heterosexual individuals. Results Bisexual women and gay men were more likely to report anxiety compared with their heterosexual peers. Bisexual individuals and gay men also were more likely to report a past diagnosis of depression. All sexual minority groups had an increased risk of having used medical care for anxiety and depression compared with heterosexuals, with bisexual women having the highest risk. Conclusion Bisexual women appear to be a particularly vulnerable sexual minority group. Advocating for non-discrimination and protections for lesbian, gay, and bisexual people is a logical extension of the effort to lower the prevalence of mental illness.

A Work in Progress pilot study. The National Academy of Engineers report on the Attributes of the Engineer of 2020 proposes substantial changes in engineering education that support greater intellectual diversity, improved complex thinking skills, better team skills, and engineers that, in general, are more innovative and adaptable to the changing complexities faced by today’s industries. While considerable work has been done in research to practice towards developing these skills, there is limited data available on the advantages and/or disadvantages of differing educational systems. In this pilot study the researchers identified two cohort groups for initial study. These included a senior year student cohort in a U.S. program and a senior year cohort in Norway. The study asks a central question as to what extent the different programs help to promote or hinder development of the attributes of the Engineer of 2020. Assessments included measurements of student typology, critical thinking, self-efficacy, and creativity/ innovation. While curricular content is similar between the two programs, the pedagogical approach is substantially different. While outcome differences were relatively small due to small sample sizes and student variation, results in some areas encourage the authors to think about a broader, more comprehensive study that could help to provide more definitive differences the two types of pedagogical approaches.

Sedentary behaviors (SB) can be associated with poorer mental health, but it remains unclear whether contexts for these behaviors may be important. We assessed relationships of SB in leisure-time and occupational contexts with frequent symptoms of depression and anxiety. Data originate from the Swedish Health Profile Assessment (HPA) database, a health assessment offered to employees working for companies or organizations connected to healthcare services. Analyses are based on data from 2017 onwards (N = 23,644; 57% male, mean age = 42 years). Two self-report questions assessed proportions of time spent in SB in leisure contexts and in the occupational setting. Logistic regressions examined relationships of SB in each context with the self-reporting of frequent symptoms of depression/anxiety. A separate model for the leisure plus occupational SB was also generated. Fully-adjusted models included exercise frequency. Compared to those reporting that they were 'almost never' sedentary in leisure-time contexts, a detrimental dose-response with frequent depression/anxiety symptoms was observed with increasing proportions of sedentary time: 50% of the time (OR = 1.44; 1.23-1.70), 75% (OR = 2.95; 2.45-3.54), almost always (OR = 3.85; 2.84-5.22). For occupational SB, the only associations were among those who reported being sedentary almost always, compared to almost never (OR = 1.47; 1.25-1.73). Associations of 'overall' SB with depression/anxiety symptoms mirrored the dose-response relationship for leisure-time SB. Exercise frequency attenuated the association for leisure-time SB only, but it remained statistically significant. Adults who spend ≥50% of their leisure-time in sedentary pursuits experience more frequent symptoms of depression and anxiety, compared to those who are less sedentary in that context.

Background People belonging to sexual minority groups have higher levels of suicidality than heterosexuals. However, findings regarding suicide death are sparse. Using unique national data from two countries, we investigated whether individuals entering a same-sex marriage (SSM), a proxy group of sexual minority individuals, had higher suicide rates than those entering opposite-sex marriage (OSM). Methods A cohort study of all males and females who entered an SSM (n=28 649) or OSM (n=3 918 617) in Denmark and Sweden during 1989–2016 was conducted. Incidence rate ratios (IRRs) for suicide were calculated using adjusted Poisson regression models. Results In total, 97 suicides occurred among individuals who had entered an SSM compared with 6074 among those who entered an OSM, corresponding to an adjusted IRR of 2.3 (95% CI 1.9 to 2.8). For people who entered SSM, a 46% decline was noted over time from an IRR of 2.8 (95% CI 1.9 to 4.0) during 1989–2002 to 1.5 (95% CI 1.2 to 1.9) during 2003–2016. The excess suicide mortality was present in all age groups but most pronounced among younger individuals aged 18–34 years of age (IRR 2.7, 95% CI 1.5 to 4.8) and females (IRR 2.7, 95% CI 1.8 to 3.9). Conclusion This large register-based study found higher suicide rates among individuals who entered an SSM, compared with those who entered an OSM. A lower suicide rate was noted for individuals in SSMs in recent years. More research is needed to identify the unique suicide risk and protective factors for sexual minority people.

OBJECTIVE: To report in vivo measurements of lumbar facet joint subchondral bone mineral density used in the description of facet joint loading patterns and to interrogate if low-back pain is associated with changes in subchondral bone mineral density. MATERIALS AND METHODS: In vivo measurements of lumbar facet joint subchondral bone mineral density (L1/2 to L5/S1) in Hounsfield units were performed on 89 volunteers (56 controls and 33 with low back pain) by computed tomography osteoabsorptiometry at subchondral regions between 1.5 mm and 2.5 mm below the joint surface. The facet surface was divided in five topographic zones: cranial, lateral, caudal, medial and central. RESULTS: 1,780 facet joint surfaces were analyzed. Facets were denser (p

The aim was to investigate sex- and age-specific associations between cardiorespiratory fitness, all-cause and cause-specific mortality, and cardiovascular disease (CVD) morbidity. 266.109 participants (47% women, 18-74 years) free from CVD, participating in occupational health service screenings in 1995-2015 were included. CRF was assessed as estimated maximal oxygen consumption (estVO

Treatment of degenerative spinal disorders by fusion produces abnormal mechanical conditions at mobile segments above or below the site of spinal disorders and is clinically referred to as adjacent segments disc disease (ASDD) or transition syndrome in the case of a previous surgical treatment. The aim of the current study is to understand with the help of poro-elastic finite element models how single or two level degeneration of lower lumbar levels influences motions at adjacent levels and compare the findings to motions produced by single or two level fusions when the adjacent disk has varying degree of degeneration. Validated grade-specific finite element models including varying grades of disc degeneration at lower lumbar levels with and without fusion were developed and used to determine motions at all levels of the lumbar spine due to applied moment loads. Results showed that adjacent disc motions do depend on severity of disc degeneration, number of disc degenerated or fused, and level at which degeneration or fusion occurred. Furthermore, single level degeneration and single level fusion produced similar amount of adjacent disc motions. The pattern of increase in adjacent segment motions due to disc degeneration and increase in motions at segment adjacent to fusion was similar. Based on the current study, it can be concluded that disc degeneration should also be considered as a risk factor in addition to fusion for generating adjacent disc degeneration. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:123-130, 2017.

Minority sexual orientation is a predictor of suicide ideation and attempts, though its association with suicide mortality is less clear. We capitalize on Sweden’s extensively linked databases, to investigate whether, among married individuals, same-sex marriage is associated with suicide. Using a population-based register design, we analyzed suicide risk among same-sex married women and men (n = 6456), as compared to different-sex married women and men (n = 1181723) in Sweden. We selected all newly partnered or married individuals in the intervening time between 1/1/1996 and 12/31/2009 and followed them with regard to suicide until 12/31/2011. Multivariate Poisson regression was used to calculate adjusted incidence risk ratios (IRR) with 95 % confidence intervals (CI). The risk of suicide was higher among same-sex married individuals as compared to different-sex married individuals (IRR 2.7, 95 % CI 1.5–4.8), after adjustment for time at risk and socioeconomic confounding. Sex-stratified analyses showed a tentatively elevated risk for same-sex married women (IRR 2.5, 95 % CI 0.8–7.7) as compared to different-sex married women. Among same-sex married men the suicide risk was nearly three-fold greater as compared to different-sex married (IRR 2.895 % CI 1.5–5.5). This holds true also after adjustment for HIV status. Even in a country with a comparatively tolerant climate regarding homosexuality such as Sweden, same-sex married individuals evidence a higher risk for suicide than other married individuals.

This study explores the political construction of Inspiria Science Center. The ambition is to bring the science center itself in focus and contribute to our understanding of the relationship between a science center and its community. It employs actor–network theory and discourse models treating the construction of Inspiria as a specific historical event, expressed in approximately 160 newspaper articles over a period of more than 10 years. The outcome describes how Inspiria Science Center transforms from a voluntary based project and kids playing with Lego bricks in the Faculty of Engineering’s basement to a national science center with Fiscal Budget funding and a regional development agenda. The outcome recognizes major disruptions and conflicts driving the transformation, exposing how the science center is not just context or an arena for someone else, but an actor in the science-learning network. Based on the findings we suggest developing specific models on the construction of a science center to increase the awareness towards mechanisms involved in gaining (and regaining) support.

Introduction Regular exercise has been associated with better mental health, but relationships of cardiorespiratory fitness (CRF) with mental health symptoms are less certain. We conducted a large cross-sectional study to examine associations of exercise frequency and objectively measured CRF with symptoms of depression and anxiety. Methods Data originates from the Swedish Health Profile Assessment (HPA) database, a general health assessment offered to all employees working for companies or organizations connected to occupational and health services. Participants reported the frequency (last 30 days) of structured exercise and completed a 6-min VO2max test on a cycle ergometer to determine CRF. Data on relevant covariates including leisure-time sedentary behavior were also collected. The study outcome was self-reported frequent (often/very often) symptoms of depression and anxiety. Results Complete data from 36,595 participants were analyzed (41% female, mean age = 42 years). In fully-adjusted models, compared to those in the lowest exercise frequency category (never/sometimes), those exercising 1–2 times/week and ≥3 times/week had 0.75 (95% CI = 0.68–0.82) and 0.72 (95% CI = 0.65–0.79) lower odds of reporting frequent symptoms of depression/anxiety, respectively. For CRF, crude models indicated a dose-response with the odds of frequent depression/anxiety symptoms reducing with higher CRF levels (low versus medium and high, respectively). No associations were found after adjustment for leisure-time sedentary behavior. Conclusions Exercising at least 1–2 times per week is associated with lower odds of depression/anxiety symptoms. Leisure-time sedentary behavior attenuates relationships of CRF with depression/anxiety symptoms.

Als Student der Wissenschaftstheorie an der Universitat Goteborg in Schweden Ende der sechziger Jahre habe ich zum ersten Mal Karl Poppers Logik der Forschung und Hans Alberts Traktat uber kritische Vernunft gelesen. Dieser erste Kontakt mit der Philosophie des Kritischen Rationalismus hat einen tiefen Eindruck bei mir hinterlassen. Besonders aufschlussreich fand ich Alberts Ausfuhrungen uber das Prinzip der zureichenden Begrundung und das Prinzip der kritischen Prufung. Albert zeigt, dass das Prinzip der zureichenden Begrundung zu einem Trilemma (dem Munchhausentrilemma) fuhrt, wahrend das Prinzip der kritischen Prufung es ermoglicht, das Trilemma zu vermeiden und Erkenntnisfortschritt zu erzielen.

Background Long‐term trend analyses of cardiorespiratory fitness (VO2max) in the general population are limited. Objectives To describe trends in VO2max from 1995 to 2017 in the Swedish working force and to study developments across categories of sex, age, education, and geographic regions. Methods A total of 354 277 participants (44% women, 18‐74 years) who participated in a nationwide occupational health service screening between 1995 and 2017 were included. Changes in standardized mean values of absolute (L/min) and relative (mL/min/kg) VO2max, and the proportion with low (

Work from social and biological sciences has shown that adult sex ratios are associated with relationship behaviours. When partners are abundant, opportunities for mate switching may increase and relationship stability decrease. To date, most of the human literature has used regional areas at various levels of aggregation to define partner markets. But, in developed countries, many individuals of reproductive age spend a considerable amount of time outside their residential areas, and other measures may better capture the opportunities to meet a (new) partner. Here, we use Danish register data to test whether the sex ratio of the occupational sector is linked to divorce. Our data cover individuals in Denmark who married during 1981–2002 and we control for age at and duration of marriage, education and parity. Results support the prediction that a higher proportion of opposite-sex individuals in one's occupational sector is associated with higher divorce risk. This holds for both men and women, but associations are somewhat stronger for men and vary by education. Our results highlight the need to study demographic behaviours of men and women simultaneously, and to consider partner markets beyond geographical areas so that differing strategies for males and females may be examined.

The importance of youth physical activity (PA) for adulthood PA, performance, and health was retrospectively evaluated.A total of 258,146 participants (49% women), aged 19-70, with a first-time health-profile assessment between 1982 and 2015, provided self-reported data on current perceived health, PA, lifestyle, and physical education class participation, and PA outside school hours before age 20. Data on anthropometrics, blood pressure, and estimated maximal oxygen consumption (VOWomen participating in physical education class, compared with those who did not, had significantly lower OR (range: 0.81-0.87) for perceiving poor overall health, general obesity, and high diastolic blood pressure after adjustment for potential confounders, and increased OR (range: 1.17-1.23) for exercising regularly and a normal/high VOPhysical education class participation and additional PA after school hours were both important for perceived health, PA, VO

Study question Have seasonal variations in births by factors related to maternal education, age, parity and re-partnering changed over a 72-year period? Summary answer Seasonal variation in births has been reduced overall but also changed its pattern over the last seven decades. What is known already The number of births varies markedly by season, but the causes of this variation are not fully understood. Seasonality of births is, in some populations, strongly influenced by sociodemographic factors. Study design size duration A longitudinal study design was used by analysing the seasonal variation in live births between 1940 and 2012, and relating it to mothers' sociodemographic characteristics at the time of childbirth (maternal education, age, parity and re-partnering). Participants/materials setting methods Register data on 6 768 810 live births in Sweden between 1940 and 2012 were used. Information on biological parents are available for more than 95% of all births. Multinomial logistic regressions were used to calculate predicted probabilities of giving birth for each calendar month. Main results and the role of chance Between 1940 and 1999, Swedish birth rates showed the typical seasonal variation with high numbers of births during the spring, and low numbers of births during the last quarter of the year. However, during the 21st century, the seasonal variation in fertility declined so that only minor variation in birth rates between February and September now remains. Still, the pattern of low birth rates at the end of the year remains and has even become more pronounced from the 1980s onwards. The characteristic 'Christmas effect' that used to be visible in September has vanished over the last 30 years. The roles in seasonal variation of maternal education, the mother's age, parity and instances where the mother has re-partnered between subsequent births changed during the second half of the 20th century. From 1980s onwards, the decline in birth rates during the last quarter of the year became particularly pronounced among highly educated mothers. Over the 72 years studied, the seasonal variation among first-time mothers declined steadily and has almost disappeared at the end of the study period. Using data that cover ~180 000 births in each month, all meaningful results are statistically significant. Limitations reasons for caution The study uses data from one Nordic country only, making it difficult to draw conclusions that may hold for other countries. Wider implications of the findings The typical seasonal variation reported for Sweden between 1940 and 1999, with high numbers of births during the spring and low numbers of births during the last quarter of the year, is in line with results from most other European countries during the same time period. However, the significant decline in seasonal variation in the early 21st century is a novel development. The study underlines that in a society with low fertility and efficient birth control, active choices and behaviours associated with an individual's sociodemographic characteristics tend to matter more for the seasonal timing of childbearing than environmental factors related to the physiological ability to reproduce and cultural-behavioural factors related to the frequency of intercourse. Study funding/competing interests The study was funded by the Swedish Research Council (Vetenskapsradet) via the Swedish Initiative for Research on Microdata in the Social and Medical Sciences (SIMSAM): Stockholm University SIMSAM Node for Demographic Research (grant registration number 340-2013-5164). The authors declare no conflicts of interest. Trial registration number Not applicable.