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This Special Section explores the interplay between Indigenous peoples, industry, and the state in five proposed and active mining projects in Canada and Sweden. The overall aim is to identify factors shaping the quality of Indigenous community-industry-state interactions in mining and mine development. An ambition underlying the research is to develop knowledge to help manage mining related land-use conflicts in Sweden by drawing on Canadian comparisons and experience. This paper synthesizes the comparative research that has been conducted across jurisdictions in three Canadian provinces and Sweden. It focuses on the interplay between the properties of the governance system, the quality of interaction and governance outcomes. We combine institutional and interactive governance theory and use the concept of governability to assess how and why specific outcomes, such as mutually beneficial interaction, collaboration, or opposition, occurred. The analysis suggests there are measures that can be taken by the Swedish Government to improve the governability of mining related issues, by developing alternative, and more effective, avenues to recognize, and protect, Sámi rights and culture, to broaden the scope and increase the legitimacy and transparency of the EIAs, to raise the quality of interaction and consultation, and to develop tools to actively stimulate and support collaboration and partnerships on equal terms. Generally, we argue that Indigenous community responses to mining must be understood within a larger framework of Indigenous self-determination, in particular the communities' own assessments of their opportunities to achieve their long-term objectives using alternative governing modes and types of interactions. [ABSTRACT FROM AUTHOR]

Study design:Prospective, population-based study. This paper is part of the Stockholm Thessaloniki Acute Traumatic Spinal Cord Injury Study (STATSCIS).Objectives:To evaluate and compare outcomes, length of stay (LOS), associated conditions and medical complications at 1-year post-trauma.Settings:The Greater Thessaloniki region, Greece, and the Greater Stockholm region, Sweden. While Stockholm follows a SCI system of care, Thessaloniki follows a fragmented ‘non-system’ approach.Subjects:Out of the 87 cases in Thessaloniki and the 49 cases in Stockholm who comprised the study population of STATSCIS, 75 and 42 cases respectively were successfully followed-up during the first year post-trauma.Results:Significantly superior outcomes (that is, survival with neurological recovery, functional ability and discharge to home) and shorter LOS for initially motor complete cases occurred in Stockholm. Management routines known to increase long-term morbidity, for example, long-term tracheostomy and indwelling urethral catheters were significantly more common in Thessaloniki. Major medical complications, that is, multiple pressure ulcers, heterotopic ossification and bacteremia/sepsis were more frequent in Thessaloniki.Conclusions:Our findings show how two rather similar cohorts of TSCI manifest large discrepancies in terms of 1-year outcomes and complications, depending on the type of management they receive. As the major difference between regions was the presence or absence of a SCI system of care, rather than differences in availability of modern medicine, the mere presence of the latter does not seem to be sufficient to guarantee adequate outcomes. This study provides strong evidence as to the urgent need of implementing a SCI system of care in Greece. [ABSTRACT FROM AUTHOR]

Study design:Prospective, population-based study. This paper is part of the Stockholm Thessaloniki Acute Traumatic Spinal Cord Injury Study (STATSCIS).Objectives:To characterize patient populations and to compare acute management after traumatic spinal cord injury (TSCI).Settings:The Greater Thessaloniki region in Greece and the Greater Stockholm region in Sweden.Methods:Inception cohorts with acute TSCI that were hospitalized during the study period, that is September 2006 to October 2007, were identified. Overall, 81 out of 87 cases consented to inclusion in Thessaloniki and 47 out of 49 in Stockholm. Data from Thessaloniki were collected through physical examinations, medical record reviews and communication with TSCI cases and medical teams. Data from Stockholm were retrieved from the Nordic Spinal Cord Injury Registry.Results:There were no significant differences between study groups with regard to core clinical characteristics. In contrast, there were significant differences in (1) transfer logistics from the scene of trauma to a tertiary-level hospital (number of intermediate admissions, modes of transportation and duration of transfer) and (2) acute key therapeutic interventions, that is, the use of mechanical ventilation (49% in Thessaloniki versus 20% in Stockholm), and performance of tracheostomy (36% in Thessaloniki versus 15% in Stockholm); spinal surgery was performed significantly more often and earlier in Stockholm than in Thessaloniki.Conclusions:Despite largely similar core clinical characteristics, Stockholm and Thessaloniki cases underwent significantly different acute management, most probably to be attributed to adaptations to the differing regional approaches of care one following a systematic approach of SCI care and the other not. [ABSTRACT FROM AUTHOR]

From the mid-1960s to around 1980, Sweden extended its family policies that provide financial and in-kind support to families with children very quickly. The benefits were closely tied to previous work experience. Thus, women born in the 1950s faced markedly different incentives when making fertility choices compared to women born only 15–20 years earlier. This paper examines the evolution of completed fertility patterns for Swedish women born in 1925–1958 and makes comparisons to women in neighbouring countries where the policies were not extended as much as in Sweden. The results suggest that the extension of the policy raised the level of fertility, shortened the spacing of births, and induced fluctuations in the period fertility rates, but it did not change the negative relationship between women’s educational level and completed fertility. [ABSTRACT FROM AUTHOR]

This paper compares several methods of generating confidence intervals for forecasts of population size. Two rest on a demographic model for age-structured populations with stochastic fluctuations in vital rates. Two rest on empirical analyses of past forecasts of population sizes of Sweden at five-year intervals from 1780 to 1980 inclusive. Confidence intervals produced by the different methods vary substantially. The relative sizes differ in the various historical periods. The narrowest intervals offer a lower bound on uncertainty about the future. Procedures for estimating a range of confidence intervals are tentatively recommended. A major lesson is that finitely many observations of the past and incomplete theoretical understanding of the present and future can justify at best a range of confidence intervals for population projections. Uncertainty attaches not only to the point forecasts of future population, but also to the estimates of those forecasts' uncertainty. [ABSTRACT FROM AUTHOR]

The "two-sex problem" is one of attempting to preserve the essential character of male and female rates of marriage (or birth), since the expression of those rates is influenced both by the age-sex composition of the population and the underlying age-sex schedule of preferences. The present paper focuses on marriage and advances a theoretically based, realistic, and conceptually simple solution. In the continuous case, where exact male and female ages are used, equation (11) provides a mathematical relationship which equates the sum of the male and female marriage propensities of the observed population with that of the model. When discrete age intervals are used, the two-sex consistency condition is given by equation (14) which equates observed and model population rates calculated using the harmonic means of the number of persons in the relevant male and female age groups. The harmonic mean consistency condition is shown to be fully sensitive to the competitive nature of the "marriage market." When compared with alternative approaches to the two-sex problem in the context of data for Sweden, 1961-64, the simple harmonic mean method yields results fairly similar to those of the other methods. None of the two-sex methods do particularly well at predicting the actual distribution of marriages, however. The likely reason is that the underlying marriage preferences changed, a circumstance which emphasizes the importance of carefully conceptualizing how observed behavior can be decomposed into the effects produced by age-sex composition and those produced by the underlying preferences. [ABSTRACT FROM AUTHOR]

Background and Aims: A strong cardiorespiratory fitness is suggested to have beneficial effects on cardiovascular risk; the exact mechanisms underlying the cardioprotective effects of fitness remain uncertain. Our aim was to investigate associations between cardiorespiratory fitness and multiple plasma proteins, in order to obtain insights about physiological pathways associated with the effects of exercise on cardiovascular health. Methods: In the Prospective investigation of Obesity, Energy and Metabolism (POEM) study (n=444 adults aged 50 years, 50% women), cardiorespiratory fitness was measured by a maximal exercise test on bicycle ergometer with gas exchange (VO2peak) normalized for body lean mass (dual-energy X-ray absorptiometry (DXA)). We measured 82 cardiovascular proteins associated with cardiovascular pathology and inflammation in plasma samples with a proximity extension assay. Results: In sex-adjusted linear regression, VO2peak was associated with 18 proteins after Bonferroni correction for multiple testing (p<0.0006). Following additional adjustment for fat mass (DXA), fasting glucose (mmol/L), low-density lipoprotein (LDL, mmol/L), smoking status, waist/hip ratio, blood pressure (mmHg), education level, and lpnr (lab sequence number), higher VO2peak was significantly associated with lower levels of 6 proteins: fatty-acid binding protein-4 (FABP4), interleukin-6 (IL-6), leptin, cystatin-B (CSTB), interleukin-1 receptor antagonist (IL-1RA), and growth differentiation factor 15 (GDF-15), and higher levels of 3 proteins: galanin, kallikrein-6 (KLK6), and heparin-binding EGF-like growth factor (HB-EGF), at nominal p-values (p<0.05). Conclusions: We identified multiple novel associations between cardiorespiratory fitness and plasma proteins involved in several atherosclerotic processes and key cellular mechanisms such as inflammation, energy homeostasis, and protease activity, which shed new light on how exercise asserts its beneficial effects on cardiovascular health. Our findings encourage additional studies in order to understand the underlying causal mechanisms for these associations. [ABSTRACT FROM AUTHOR]

Background: Pectus excavatum (PE) is the most common congenital chest wall deformity. Most individuals with PE suffer from psychosocial problems, with low self-esteem and poor body image. Correctional surgery for PE is available, the most widely used is the Nuss procedure. The Nuss procedure has previously been reported to improve self-esteem, body image and health-related quality of life (HRQoL). To assess HRQoL among individuals with PE, the Nuss Questionnaire modified for Adults (NQ-mA) and Single Step Questionnaire (SSQ) has been developed. The aim of the current study was to translate and culturally adapt NQ-mA and SSQ to fit a Swedish context, and to evaluate the psychometric properties, and validate the culturally adapted versions. Methods: Individuals who had undergone the Nuss procedure for pectus excavatum were invited to participate in a multicentre study with cross-sectional design. HRQoL was assessed by NQ-mA, SSQ and RAND-36. Psychometric properties for NQ-mA and SSQ were evaluated by content validity index and construct validity (exploratory factor analysis, confirmatory factor analysis, and inter-scale correlations). Known-groups validity, as well as floor and ceiling effects, were evaluated. Internal consistency reliability was examined using Cronbach's alpha. Results: In total 236 individuals participated in the study. Content validity index for NQ-mA showed satisfactory results, except for two items. Factor analysis for NQ-mA suggested a two-factor model, with exclusion of two items. Subscales correlated adequately with RAND-36's domains. Known-groups validity for NQ-mA demonstrated high sensitivity for between-group differences. Ceiling effects were present in several items. Cronbach's alpha for NQ-mA was.89. Confirmatory factor analysis for SSQ resulted in a three-factor model, with exclusion of five items. However, this model was shown to be unstable through further exploratory factor analysis testing, and no further psychometric tests were conducted for SSQ. Conclusion: The 10-item Swedish version of NQ-mA was shown to be valid for research and clinical assessment of HRQoL in individuals with pectus excavatum. The Swedish version of SSQ requires revision of items before further validation can be performed. [ABSTRACT FROM AUTHOR]

Objectives: The interactions between nutritional supplementation and physical activity on changes in physical function among older adults remain unclear. The primary objective of this study was to examine the impact of nutritional supplementation plus structured physical activity on 400M walk capacity in mobility-limited older adults across two sites (Boston, USA and Stockholm, Sweden). Design: All subjects participated in a physical activity program (3x/week for 24 weeks), involving walking, strength, balance, and flexibility exercises. Subjects were randomized to a daily nutritional supplement (150kcal, 20g whey protein, 800 IU vitamin D) or placebo (30kcal, non-nutritive). Setting: Participants were recruited from urban communities at 2 field centers in Boston MA USA and Stockholm SWE. Participants: Mobility-limited (Short Physical Performance Battery (SPPB) ≤9) and vitamin D insufficient (serum 25(OH) D 9 - 24 ng/ml) older adults were recruited for this study. Measurements: Primary outcome was gait speed assessed by the 400M walk. Results: 149 subjects were randomized into the study (mean age=77.5±5.4; female=46.3%; mean SPPB= 7.9±1.2; mean 25(OH)D=18.7±6.4 ng/ml). Adherence across supplement and placebo groups was similar (86% and 88%, respectively), and was also similar across groups for the physical activity intervention (75% and 72%, respectively). Both groups demonstrated an improvement in gait speed with no significant difference between those who received the nutritional supplement compared to the placebo (0.071 and 0.108 m/s, respectively (p=0.06)). Similar effects in physical function were observed using the SPPB. Serum 25(OH)D increased in supplemented group compared to placebo 7.4 ng/ml versus 1.3 ng/ml respectively. Conclusion: Results suggest improved gait speed following physical activity program with no further improvement with added nutritional supplementation. [ABSTRACT FROM AUTHOR]

Background/objectives: Results from studies evaluating the sustainability of diets combining environmental and nutritional aspects have been diverse; thus, greenhouse gas emissions (that is, carbon footprint (CF)) of diets in line with dietary recommendations in free-living individuals warrants further examination. Here, changes in dietary CF related to changes in food choice during a weight loss trial among lactating women who received a 12-week diet intervention based on the Nordic Nutrition Recommendations (NNR) 2004 were analyzed. The objective of this study was to examine if a diet intervention based on NNR 2004 results in reduced dietary CF.Subjects/methods: Changes in dietary CF were analyzed among 61 lactating women participating in a weight loss trial. Food intake data from 4-day weighed diet records and results from life cycle analyses were used to examine changes in dietary CF across eight food groups during the intervention, specified in the unit carbon dioxide equivalent (CO2eq/day). Differences in changes in dietary CF between women receiving diet treatment (D-group) and women not receiving it (ND-group) were compared.Results: There was no difference in change in dietary CF of the overall diet between D- and ND-group (P>0.05). As for the eight food groups, D-group increased their dietary CF from fruit and vegetables (+0.06±0.13 kg CO2eq/day) compared with a decrease in ND-group (-0.01±0.01 kg CO2eq/day) during the intervention, P=0.01.Conclusions: A diet intervention in line with NNR 2004 produced clinically relevant weight loss, but did not reduce dietary CF among lactating women with overweight and obesity. Dietary interventions especially designed to decrease dietary CF and their coherence with dietary recommendations need further exploration. [ABSTRACT FROM AUTHOR]

The objective of this study is to validate two abridged versions of the mini-mental state examination (MMSE): one intended for use in face-to-face interviews, and the other developed for telephonic interviews, using data from Sweden and the US to validate the abridged scales against dementia diagnoses as well as to compare their performance to that of the full MMSE scale. The abridged versions were based on eight domains from the original MMSE scale. The domains included in the MMSE-SF were registration, orientation, delayed recall, attention, and visual spatial ability. In the MMSE-SF-C, the visual spatial ability item was excluded, and instead, one additional orientation item was added. There were 794 participants from the Swedish HARMONY study [mean age 81.8 (4.8); the proportion of cognitively impaired was 51 %] and 576 participants from the US ADAMS study [mean age 83.2 (5.7); the proportion of cognitively impaired was 65 %] where it was possible to compare abridged MMSE scales to dementia diagnoses and to the full MMSE scale. We estimated the sensitivity and specificity levels of the abridged tests, using clinical diagnoses as reference. Analyses with both the HARMONY and the ADAMS data indicated comparable levels of sensitivity and specificity in detecting cognitive impairment for the two abridged scales relative to the full MMSE. Receiver operating characteristic curves indicated that the two abridged scales corresponded well to those of the full MMSE. The two abridged tests have adequate validity and correspond well with the full MMSE. The abridged versions could therefore be alternatives to consider in larger population studies where interview length is restricted, and the respondent burden is high. [ABSTRACT FROM AUTHOR]

The article examines the influence of linguistic distance on the labor market outcomes of a sample of 5,041 first generation immigrants in Sweden between 1970 and 1990. The article exploits register data from the Swedish Longitudinal Database, examining a population of individuals from 11 non-Nordic countries of origin. The analysis focuses on the transition to the Swedish labor market, comparing the last occupation before migration with the first occupation after, measured by the ISEI score. Using OLS regression, the results finds important differences in the initial labor market outcomes that are linked to the individual's linguistic distance. More specifically, individuals proficient in languages belonging to the same language family as Swedish and familiar with the Latin alphabet are found to enjoy an advantage in the initial transition to the Swedish labor market. This finding exists net of the influence of the individual's region of origin, and is particularly accentuated among formally highly skilled males. This appears to confirm the comparatively large demands for destination-specific skills in high-status occupations, favoring linguistically more proximate individuals. Among females, no consistent advantage among the linguistically most proximate can be observed among the formally highly skilled, potentially explained by differing selection mechanisms into the labor market. In general, however, the mechanisms through which linguistic distance affects the individual's initial occupation in Sweden appear to operate similarly along gender lines. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the study was to compare primary total hip arthroplasty (THA) implantations between different countries in terms of THA number per inhabitant, age, and procedure type and to compare the survival curve including all THAs using hip arthroplasty registers. Methods: THA registers were compared between different countries with respect to the number of primary implantations per inhabitant and age, procedure type and survival curve. We performed a literature search for all national hip arthroplasty registers providing annual reports for 2009 or, if not available, a more recent period. The data from these reports were analysed in terms of number, age distribution and procedure type of primary THAs and survival curves. Results: We identified nine hip arthroplasty registers, which comprised sufficient data to be included. A large variation was found in the annual number of primary THA implantations per inhabitant. The procedure type varied greatly as well, e.g. in Sweden 67 % are cemented THAs whereas in Emilia-Romagna (Italy) 89 % are cementless THAs. Conclusions: This study revealed large differences in terms of the annual number of primary THAs per inhabitant and primary THA procedure type across countries. These data can be used to rank local primary THA implantations within an international context. [ABSTRACT FROM AUTHOR]

Background: The possible benefit of lifetime physical activity (PA) in reducing prostate cancer incidence and mortality is unclear.Methods: A prospective cohort of 45,887 men aged 45-79 years was followed up from January 1998 to December 2007 for prostate cancer incidence (n=2735) and to December 2006 for its subtypes and for fatal (n=190) prostate cancer.Results: We observed an inverse association between lifetime (average of age 30 and 50 years, and baseline age) total PA levels and prostate cancer risk. Multivariate-adjusted incidence in the top quartile of lifetime total PA decreased by 16% (95% confidence interval (CI)=2-27%) compared with that in the bottom quartile. We also observed an inverse association between average lifetime work or occupational activity and walking or bicycling duration and prostate cancer risk. Compared with men who mostly sit during their main work or occupation, men who sit half of the time experienced a 20% lower risk (95% CI=7-31%). The rate ratio linearly decreased by 7% (95% CI=1-12%) for total, 8% (95% CI=0-16%) for localised and 12% (95% CI=2-20%) for advanced prostate cancer for every 30 min per day increment of lifetime walking or bicycling in the range of 30 to 120 min per day.Conclusions: Our results suggest that not sitting for most of the time during work or occupational activity and walking or bicycling more than 30 min per day during adult life is associated with reduced incidence of prostate cancer. [ABSTRACT FROM AUTHOR]

We investigated common genetic variation in the entire ESR1 and EGF genes in relation to endometrial cancer risk, myometrial invasion and endometrial cancer survival. We genotyped a dense set of single-nucleotide polymorphisms (SNPs) in both genes and selected haplotype tagging SNPs (tagSNPs). The tagSNPs were genotyped in 713 Swedish endometrial cancer cases and 1567 population controls and the results incorporated into logistic regression and Cox proportional hazards models. We found five adjacent tagSNPs covering a region of 15 kb at the 5' end of ESR1 that decreased the endometrial cancer risk. The ESR1 variants did not, however, seem to affect myometrial invasion or endometrial cancer survival. For the EGF gene, no association emerged between common genetic variants and endometrial cancer risk or myometrial invasion, but we found a five-tagSNP region that covered 51 kb at the 5' end of the gene where all five tagSNPs seemed to decrease the risk of dying from endometrial cancer. One of the five tagSNPs in this region was in strong linkage disequilibrium (LD) with the untranslated A61G (rs4444903) EGF variant, earlier shown to be associated with risk for other forms of cancer. [ABSTRACT FROM AUTHOR]

The aim was to evaluate human papillomavirus (HPV) 'reflex genotyping' in cases of minor cytological abnormalities detected in the gynaecological screening programme in Stockholm, Sweden. Liquid-based cytology samples showing minor cytological abnormalities were analysed using HPV genotyping (Linear Array, Roche diagnostics). Colposcopically directed cervical biopsies were obtained and the HPV test results were correlated with the histological results. In all, 63% (70/112) of the samples were high-risk (HR) HPV (HR-HPV) positive. A statistically significant correlation was found between high-grade cervical lesions and HR-HPV (P=0.019), among which HPV 16, 18, and 31 were the most important. The negative predictive value of HR-HPV detection for histologically confirmed high-grade lesions was 100%. An age limit for HPV reflex testing may be motivated in cases of low-grade squamous intraepithelial neoplasia (LSIL), because of high HR-HPV prevalence among younger women. By using HPV reflex genotyping, additional extensive workup can safely be avoided in about 50% of all cases of atypical squamous cells of undetermined significance (ASCUS) and LSIL among women 30 years. This screening strategy could potentially reduce the total abnormal cytology-reporting rate in the Swedish screening programme by about 1% and provide more accurately directed follow-up, guided by cytological appearance and HPV test results. [ABSTRACT FROM AUTHOR]

This study examined the relationship between the approval times for new pharmaceuticals and the number of adverse drug reactions reported to the Swedish Medical Products Agency. Yearly time-series data concerning the number of adverse drug reactions, as well as data concerning prices and quantities sold for 25 pharmaceutical substances during the period 1972-1996 were used. The results show that shorter approval times are associated with more adverse drug reactions, but also that the effects are quite small. [ABSTRACT FROM AUTHOR]

We extend Nathan Keyfitz's research on continuous change in life expectancy over time by presenting and proving a new formula for decomposing such change. The formula separates change in life expectancy over time into two terms. The first term captures the general effect of reduction in death rates at all ages, and the second term captures the effect of heterogeneity in the pace of improvement in mortality at different ages. We extend the formula to decompose change in life expectancy into age-specific and cause-specific components, and apply the methods to analyze changes in life expectancy in Sweden and Japan. [ABSTRACT FROM AUTHOR]

Rectangularization of human survival curves is associated with decreasing variability in the distribution of ages at death. This variability, as measured by the interquartile range of life table ages at death, has decreased from about 65 years to 15 years since 1751 in Sweden. Most of this decline occurred between the 1870s and the 1950s. Since then, variability in age at death has been nearly constant in Sweden, Japan, and the United States, defying predictions of a continuing rectangularization. The United States is characterized by a relatively high degree of variability, compared with both Sweden and Japan. We suggest that the historical compression of mortality may have had significant psychological and behavioral impacts. [ABSTRACT FROM AUTHOR]

This article develops and applies two expressions for the rate of change of a population's mean age. In one, aging is shown to be negatively related to contemporary birth rates and death rates. In a general sense, aging occurs when vital rates are too low, as illustrated through applications to the United States, the Netherlands, and Japan. The other expression relates the rate of aging to a population's demographic history, in particular to changes in mortality, migration, and the annual number of births. Applications to the United States and Sweden show that the dominant factor in current aging in these countries is a history of declining mortality. Migration also contributes significantly but in opposite directions in the two countries. The two approaches are integrated after recognizing that the rate of change in the mean age is equal to the covariance between age and age-specific growth rates. A decomposition of this covariance shows that the two seemingly unrelated expressions contain exactly the same information about the age pattern of growth rates. [ABSTRACT FROM AUTHOR]

Methods are presented which produce Maximum Likelihood Estimates (MLE) of the degree of heterogeneity in individual mortality risks under a variety of assumptions about the age trajectory of those mortality risks. With these estimates of the degree of population heterogeneity it is possible to adjust comparisons of mortality risks across populations for the effects of population heterogeneity, differential mortality selection, and different age trajectories of the force of mortality. These methods are demonstrated by applying a variety of standard assumptions about the age trajectory of the force of mortality to the analysis of a broad range of cohort mortality data for the U.S. and Swedish populations. The estimates of the degree of heterogeneity, produced under all of the selected force of mortality models, consistently indicated a considerable degree of heterogeneity in mortality risks. [ABSTRACT FROM AUTHOR]

An important study by Friedlander investigated some of the effects of different demographic responses on national demographic transitions. England and Sweden were advanced as cases that approximated the suggested hypothetical models of transitions. His argument implied that the rural population of a country (in this case Sweden) experiencing mortality decline but little industrialization would reduce its fertility rates if our-migration from agricultural areas were not possible. This present study, using more complete data and better measures, concludes that this did not occur in Sweden--it did not conform to Friedlander's hypothesized model. Because the potential implications of these findings could be profound and wide-ranging, there is a need for more studies of individual countries using better data and giving more careful attention to Davis's theory on which the Friedlander hypothesis is based. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was to assess the criterion validity of a newly developed self-reported last 7-day physical activity questionnaire (SAPAQ) for use in Swedish adolescents with a wide variation in body fatness.Measurements: We compared the self-reported total number of MET-minutes with objectively assessed variables of physical activity obtained by accelerometry in 49 (18 male, 31 female subjects) 17-year-old adolescents.Results: Self-reported physical activity was significantly and inversely related to time spent sedentary (r=-0.45; P<0.001) and significantly and positively associated with time spent in physical activity (r=0.51; P<0.001) and the total amount of physical activity (r=0.49; P<0.001). Gender and body fat did not affect the associations between self-reported and objectively assessed physical activity.Conclusion: Our results indicate that the newly developed questionnaire is a valid method for ranking individuals in terms of the total amount of physical activity in Swedish adolescents. [ABSTRACT FROM AUTHOR]

Background: Malignant disorders in childhood are life-threatening conditions, and issues regarding the children's health-related quality of life (HRQOL) are crucial in paediatric oncology. The overall aim of this study was to explore HRQOL in children with cancer in two countries, Argentina and Sweden, which have different cultural contexts. The specific aims were: to determine HRQOL by gender, age, diagnosis, treatment modality, time since diagnosis, and parental education/employment across cultures. Further aims were to assess the child/parent relationship in HRQOL and the influence of demographic variables in psychosocial and physical HRQOL in each country. Methods: A cross-sectional study was performed in 2014, including 58 children (24 females, 34 males) and 62 parents/guardians. The instrument, the Pediatric Quality of Life Inventory™ (PedsQL™, generic, cancer and fatigue modules), and medical records were used. The response rate was 97%. Results: The mean age of the children was 8.67 years (SD 5.1, range 2–18 years) and the mean time on treatment was 10.7 months (SD 8.7, range 1–30 months). The most common diagnosis was leukaemia (57%). In Argentina, in comparison with Sweden, a higher estimation of generic HRQOL was reported among adolescents (p = 0.022) and more cancer-related problems among school-age children (p < 0.0001). Children and parents in both countries confirmed the major problem with fatigue and multimodality therapy regimes, but lower levels of fatigue were reported in Argentina. Adolescents and children with solid tumours appeared as vulnerable groups. In Sweden, children whose mothers had post-secondary education reported less cancer-related problems (p = 0.031). Good relationships were found between child/parent reports in Argentina regarding the fatigue module (p = 0.034) and physical subscale (p = 0.014), and in Sweden regarding generic health (p = 0.004), including psychosocial (p = 0.006) and physical subscales (p = 0.042), and cancer (p = 0.001), and fatigue (p < 0.0001) modules. In Sweden, psychosocial health (OR 7.5; p = 0.007) and physical health (OR 6.2; p = 0.011) were positively influenced by being a school-age child. Conclusions: Fatigue is as a major problem across cultures. Still, being in school facilitates recovery. Good relationships in psychosocial HRQOL highlight professional challenges regarding severe issues and open communication, and the need of performing comparative studies of HRQOL of children with cancer from different cultural backgrounds. [ABSTRACT FROM AUTHOR]