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Seven male tank truck drivers were followed for about 3 h during ordinary work. They rated the perception of heavy work operations on Borg's CR-10 scale. The heart rates were monitored every minute. The hose was pulled out an average of 22.3 m and the corresponding mean rating was 3.2, a little above 'Moderate' on the CR-10 scale. The heart rate averaged 137 beats/min at the end of this operation. When transforming the physiological parameter heart rate to a subjective strain intensity, surprisingly high agreement was obtained between the results from the field study and the predicted ratings. By transforming ordinally scaled data from another study to a scale with ratio properties, the results could be compared with this study. Good agreement was found between the variables.

This paper discusses coefficient of dynamic friction Mu(sub k), and perceived discomfort for differently textured surfaces when touched by a normal hand, a 'sweaty' hand and a hand contaminated with glycerol, paraffin oil or lard. Fourteen male subjects applied forces of 1, 10 or 20 N using the index finger of the dominant hand while striking across a specimen of the same polycarbonate material with 100, 75, 50 or 25% skin-contact area (by ridges). Surface pressures in the range 6-288 kPa were recorded. Generally there was a very low correlation between Mu(sub k) and perceived discomfort. Wider grooves and increased normal forces were associated with discomfort but did not necessarily provide more friction. Unlike most materials, palmar skin showed sticky characteristics and Mu(sub k) frequently exceeded 1.0 when the surface loads were low. The coefficient of friction on palmar skin decreased with increasing surface loads. A considerable reduction of Mu(sub k) was noticed when the normal force increased. A 20-fold increase in normal force from 1 to 20 N (an increase in surface load from 6.3 to 81.4 kPa) resulted in only an eight-fold increase in frictional force while Mu(sub k) dropped from 2.22 to 0.85. A decrease was noticed for all tested surfaces and during all tested environmental conditions; however, increased normal force increased the perceived discomfort. A 25-50% increase in coefficient of friction could be gained under contaminated conditions using two out of four fairly similar textures. Grooves in surfaces reduced Mu(sub k) under normal and sweaty conditions, but improved Mu(sub k) when contaminants were present. Patterns with a large skin-contact area showed either a high or a low coefficient of friction depending on the environmental conditions. A plain, glossy, non-textured surface of polycarbonate under normal skin conditions yielded Mu(sub k) = 2.22 when the surface pressure was low (6 kPa). When the skin was exposed to paraffin oil, Mu(sub k) dropped drastically to 0.28. Oil and lard reduced Mu(sub k), but sweat increased it in relation to a normal hand. Wider grooves in the texture provide friction during contaminated conditions at the price of discomfort.

Abstract In this paper, the software CCBuilder and its methods to generate synthetic three-dimensional (3D) microstructures of WC-Co cemented carbides are presented. Generating synthetic microstructures is critical, as it enables accurate virtual testing where influences from microstructural parameters can be investigated in a systematic and controlled way. The model of the microstructure is based on a voxel description of the material volume and the WC grains are represented as truncated triangular prisms. The grains are inserted into the simulation domain and to obtain a realistic microstructure a combination of packing and a Monte Carlo Potts simulation is used. The orientations of all individual WC grains are known and it is shown that the microstructure is built up of two interpenetrating networks, the WC grains and the Co phase. Numerical studies are presented to show how input parameters to CCBuilder, such as grain size, grain shape, packing strategy, voxel density, system size, and Monte-Carlo steps affect the resulting simulated microstructure. The obtained microstructures are geometrically realistic and the contiguity of the carbide phase shows very good agreement with published experimental data. Highlights • A software CCBuilder to generate synthetic 3D microstructures of WC-Co is presented. • The methodology to generate the microstructures is discussed. • CCBuilder combines various packing strategies with a Monte Carlo Potts simulation. • Studies are presented of how input to CCBuilder affects the resulting microstructure. • The contiguity of the carbide phase shows very good agreement with experimental data. [ABSTRACT FROM AUTHOR]

The objective was to outline results from our scientific studies on the associations among childhood behavior, adult personality, and biochemical factors in smoking habits. The studies consisted of: (1) follow-up of young criminals and controls, subdivided into risk for antisocial behavior groups, based on childhood rating levels of a projective test; and adult smoking habit groups; and (2) a large group of young adults examined on the same inventories. Personality in terms of KSP and EPQ-I scale scores, controlled for intelligence, indicated that the high and very high risk groups displayed significantly higher self-rated impulsiveness, anxiety, and nonconformity, as compared to the low risk group. Further, the very high risk group subjects, found to be overrepresented among subjects with heavy smoking habits, displayed lower mean platelet MAO-B activity and higher thyroid hormone levels than the low risk group. Thus, the higher the childhood risk for antisocial behavior, the clearer the adult personality pattern making subjects more disposed for smoking appeared; and the higher smoking habits, the stronger the relationships with biochemical measures. Results are discussed in terms of possible underlying mechanisms influencing personality and smoking habits. [ABSTRACT FROM AUTHOR]

This article reviews a method for calculating an equilibrium interfacial phase diagram depicting regions of stability for different interface structures as function of temperature and chemical potentials. Density functional theory (DFT) is used for interfacial energies, Monte Carlo simulations together with cluster expansions based on DFT results for obtaining configurational free energies, and CALPHAD-type modeling for describing the thermodynamic properties of the adjoining bulk phases. An explicit case, vanadium doped cemented carbides, is chosen to illustrate the progress in the research field and the interfacial diagram, a complexion diagram, for the phase boundary WC(0 0 0 1)/Co is constructed as function of temperature and chemical potentials. [ABSTRACT FROM AUTHOR]

Background & Aims Functional dyspepsia (FD) is associated with anxiety but it is not clear if one causes the other. We investigated whether anxiety and depression precede the onset of FD (based on the modified Rome III criteria) and gastroesophageal reflux symptoms (GERS) in a population-based follow-up study. Methods Participants from the Kalixanda study (n = 3000), randomly selected from the national population register of Sweden, were given the validated Abdominal Symptom Questionnaire 1998–2001; 1000 of these participants then were selected randomly to undergo esophagogastroduodenoscopy and were given the Abdominal Symptom Questionnaire along with the Hospital Anxiety and Depression Scale questionnaire. All eligible subjects who underwent endoscopy (n = 887) were invited to participate in a follow-up study in June–August 2010 and were given the same questionnaires. Data were analyzed by logistic regression. Results Of the 703 subjects who completed the follow-up questionnaires (79.3%); 110 were found to have FD at baseline (15.6%) and 93 at the follow-up examination (13.3%); 48 of these were new cases of FD. GERS without organic disease was reported by 273 individuals (38.8%) at baseline and by 280 at follow-up examination (39.8%); 93 cases were new. Major anxiety was associated with FD at the follow-up evaluation (odds ratio [OR], 6.30; 99% confidence interval [CI], 1.64–24.16). Anxiety was associated with postprandial distress syndrome at baseline (OR, 4.83; 99% CI, 1.24–18.76) and at the follow-up examination (OR, 8.12; 99% CI, 2.13–30.85), but not with epigastric pain syndrome. Anxiety at baseline was associated with new-onset FD at the follow-up examination (OR, 7.61; 99% CI, 1.21–47.73), but not with GERS. Conclusions In a study of the Swedish population, anxiety at baseline, but not depression, increased the risk for development of FD by 7.6-fold in the next 10 years. Anxiety did not affect risk for GERS. [ABSTRACT FROM AUTHOR]

Abstract: Objective: to investigate the association between country of origin of women and their use of complementary pain reduction methods (i.e. non-pharmacological) during childbirth in Sweden. Design: cross-sectional design. Setting: a national register-based study. Participants: 215,497 singleton deliveries (including the first birth of each woman during the period) of women aged 18–47 years in Sweden between 1996 and 1998, divided into 12 subgroups of countries or regions. Measurements: the use of complementary pain reduction methods during childbirth was analysed by logistic regression, adjusting for parity, level of education, number of antenatal care visits, complications in pregnancy, complications during childbirth, use of any pharmacological methods and use of epidural/spinal analgesia during childbirth. Findings: all subgroups of foreign-born women, except those from Finland, had lower odds of complementary pain reduction methods during childbirth than Swedish-born women. Women from Bosnia, Arab countries, Sub-Saharan Africa, Turkey, Iran and Asia had about 40% lower odds for use of complementary pain reduction methods during childbirth than Swedish-born women. Women who used epidural analgesia had higher odds for use of complementary pain reduction methods during childbirth than women who did not use any pharmacological methods. Key conclusion: most subgroups of foreign-born women showed lower odds for and a different pattern in the use of complementary pain reduction methods during childbirth than Swedish-born women. These findings raise questions of whether the Swedish health-care system and care providers have sufficient awareness of and insight into the socio-cultural context of giving birth. [Copyright &y& Elsevier]

Background & Aims: The Rome III criteria for functional dyspepsia have been changed to include 2 distinct syndromes: postprandial distress syndrome and epigastric pain syndrome. We investigated risk factors for functional dyspepsia among the functional dyspepsia subgroups defined by the Rome III criteria. Methods: We performed a cross-sectional population-based study in a primary care setting (the Kalixanda study). A random sample (n = 2860) of the adult population from 2 northern Swedish municipalities (n = 21,610) was surveyed using a validated postal questionnaire to assess gastrointestinal symptoms (response rate, 74.2%; n = 2122). A randomly selected subgroup (n = 1001) of responders was invited to undergo an esophagogastroduodenoscopy (participation rate, 73.3%) including biopsy specimen collection, Helicobacter pylori culture and serology, and symptom assessments. Results: Of the 1001 subjects examined by endoscopy, 202 (20.2%; 95% confidence interval [CI], 17.7–22.7) were classified as having uninvestigated dyspepsia and 157 (15.7%; 95% CI, 13.4–18.0) as having functional dyspepsia. Major anxiety (Hospital Anxiety and Depression Scale score ≥11) was associated with uninvestigated dyspepsia (odds ratio [OR], 3.01; 95% CI, 1.39–6.54), as was obesity (body mass index ≥30 kg/m2) (OR, 1.86; 95% CI, 1.15–3.01). Major anxiety was associated with functional dyspepsia and postprandial distress syndrome (OR of 2.56 [95% CI, 1.06–6.19] and 4.35 [95% CI, 1.81–10.46], respectively), as was use of nonsteroidal anti-inflammatory drugs (OR, 2.49 [95% CI, 1.29–4.78] and 2.75 [95% CI, 1.38–5.50], respectively). Depression was not associated with any dyspepsia group. Conclusions: Anxiety but not depression is linked to uninvestigated dyspepsia, functional dyspepsia, and postprandial distress syndrome but not to epigastric pain syndrome. [Copyright &y& Elsevier]

Abstract: The objective was to examine early adolescent projective risk indicators for the development of antisocial behaviour as related to adult personality traits, psychopathy, and violent behaviour over the life span. Assessment data included Rorschach (Rr) ratings (at age 11–14 years), personality inventories (EPQ-I and KSP scales), and a shortened Psychopathy Check List (PCL) (administered at age 32–40 years), obtained from a group of 199 male subjects; and smoking habits (at age 36–44 years) obtained from 125 of those subjects. Results, controlled for intelligence, indicated that the high and very high risk groups, as determined by level of total Rr risk scores, were (1) significantly higher on self-rated IVE Impulsiveness, the anxiety-related KSP Muscular Tension, and nonconformity traits, as compared to the low Rr risk group — the very high risk group also scoring significantly higher on the EPQ Psychoticism scale, related to aggressiveness and cruelty; (2) higher on clinically rated PCL total sum and factor scores; and (3) they were overrepresented among Ss with subsequent violent offence, and Ss with heavy smoking habits. The results are discussed in terms of the possible usefulness of psychodynamic oriented cognitive-emotional indicators in the search for underlying mechanisms in the development of disinhibitory psychopathology. [Copyright &y& Elsevier]

Abstract: This study investigated the association between the recently minted concept of linking social capital and incidence of coronary heart disease (CHD). A follow-up study of 1,358,932 men and 1,446,747 women in Sweden aged 45–74 years was conducted between 1 January 1998 and 31 December 1999. Neighbourhood linking social capital was conceptualised as proportions of individuals voting in local government elections at neighbourhood level. The neighbourhood- and individual-level factors were analysed within a multilevel framework. Linking social capital was associated with CHD in both men and women beyond individual-level factors: in neighbourhoods with low linking social capital the odds ratios were 1.19 (CI=1.14–1.24) and 1.29 (CI=1.21–1.38) for men and women, respectively, after adjustment for age, country of birth, education, marital status, and housing tenure. The significant between-neighbourhood variance (i.e. the random intercept) showed significant differences in CHD incidence between neighbourhoods. Even in a relatively egalitarian society, as exemplified by the Swedish Welfare State, individual health is affected by differences between neighbourhoods in linking social capital. The use of linking social capital represents a novel conceptual advance in research on the association between CHD, one of the major causes of death in Western countries, and the multidimensional aspects of social capital. [Copyright &y& Elsevier]

Background & Aims: Barrett’s esophagus (BE) is associated with esophageal adenocarcinoma, the incidence of which has been increasing dramatically. The prevalence of BE in the general population is uncertain because upper endoscopy is required for diagnosis. This study aimed to determine the prevalence of BE and possible associated risk factors in an adult Swedish population. Methods: A random sample (n = 3000) of the adult population (n = 21,610) in 2 municipalities was surveyed using a validated gastrointestinal symptom questionnaire (response rate, 74%); a random subsample (n = 1000; mean age, 53.5 years; 51% female) underwent upper endoscopy. Endoscopic signs suggestive of columnar-lined esophagus (CLE) were defined as mucosal tongues or an upward shift of the squamocolumnar junction. BE was diagnosed when specialized intestinal metaplasia was detected histologically in suspected CLE. Results: BE was present in 16 subjects (1.6%; 95% confidence interval, 0.8–2.4): 5 with a long segment and 11 with a short segment. Overall, 40% reported reflux symptoms and 15.5% showed esophagitis; 103 (10%) had suspected CLE, and 12 (1.2%) had a visible segment ≥2 cm. The prevalence of BE in those with reflux symptoms was 2.3% and in those without reflux symptoms was 1.2% (P = .18). In those with esophagitis, the prevalence was 2.6%; in those without, the prevalence was 1.4% (P = .32). Alcohol (P = .04) and smoking (P = .047) were independent risk factors for BE. Conclusions: BE was found in 1.6% of the general Swedish population. Alcohol and smoking were significant risk factors. [Copyright &y& Elsevier]

Although many validation studies of FFQ have been reported, only a few addressed the effect of inclusion of dietary supplement use on the validity of micronutrient estimates. The purpose of the present study was to assess reproducibility and validity of a self-administered FFQ, intended to measure total nutrient intake from diet and from dietary supplements, in a random population-based sample of 248 middle-aged and elderly men (40-74 y old) in central Sweden. Fourteen 24-h recall interviews were used as the reference method. Participants were telephoned about once a month for 1 y, covering every day of the week, twice in random order. Spearman correlation coefficients increased 13% (from 0.49 to 0.62), between FFQ-based micronutrient estimates and the fourteen 24-h recall interviews (reference method) when supplement use was included. Correct classification into highest quintiles was also improved by 14% (from 37 to 51%). There were no differences in mean intraclass correlation coefficients for 1-y reproducibility between total micronutrient intake and micronutrients from foods only. The increase in the validity of micronutrient estimates due to inclusion of supplements in nutrient intake assessment has important implications for sample size in epidemiologic studies. Because a dramatic increase in dietary supplement use has occurred in recent decades in many countries, the issue of including supplements in dietary assessment should be of highest priority in nutritional epidemiologic studies of chronic diseases. [ABSTRACT FROM AUTHOR]

This study is based on a consecutive series of 52 male alcoholics who have been followed up for 4 years after inpatient detoxification. The aim was to identify risk factors for readmission for alcohol detoxification. Information was collected individually, and psychiatric status, physiologic conditions at admission, personality profile, platelet monoamine oxidase (MAO) activity level, current psychosocial living conditions, as well as those during childhood/adolescence, and a history of alcohol and drug abuse were comprised. This information was supplemented by register data on hospital admissions covering the period of 4 years before the admission in question to 4 years after it. The main findings of this follow-up study revealed five risk factors for readmission; namely, heavy drinking before admission, a high gamma-glutamyltransferase level at admission, previous somatic care, and a sensation-seeking behavior in combination with a low platelet MAO activity level (odds ratios ranging from 4.2 to 10.2). The second year after admission seemed to be the most critical time for readmission. [Copyright &y& Elsevier]

Focuses on a study in Sweden, which was conducted on the effects mortality will have on indicators of socio-economic position, in relation to employment status (SEI), housing tenure and education. Information on the methodology used; Results of the methods which were used; Indepth look at the study.

Examines the long-term illness among indigenous and foreign-born population in Sweden. Association between ethnicity and long-term illness in a Swedish population; Implications for the increase of population in Western Europe; Focus on the health conditions of foreign-born people.

Analyzes the influence of ethnicity, age, sex, marital status and dat of immigration on suicide rates in Sweden. Relationship between psychiatric illness and suicide; Significance of the findings for primary health care and psychiatric care planning; Ethnicity as a risk factor for suicide when controlled for sex and age in a Poisson regression analysis.

Abstract: Objectives: To investigate the effect of transvaginal estradiol on bone mineral density and bone metabolism. Methods: One hundred and fifteen women (mean age 73.8±3.2 years) were randomly assigned to a 2-year open-label parallel group clinical trial and were treated with either transvaginal estradiol (7.5μg/24h), or no estradiol. Both groups received 400 IU vitamin D and 500mg calcium/day. The bone mineral density (BMD) was assessed in the hip and spine using DXA technique and in the heel using DXL technique. Results: The intention to treat analysis showed that the increase in BMD in the estradiol group was significant at total hip by 0.6% (P =0.04) while the control group decreased in their BMD by 0.7%. At lumbar spine the estradiol group increased in BMD by 2.6% (P =0.011) while the control group increased by 2.2%. Bone turnover markers and PTH-levels decreased while 25-OH vitamin D levels increased in both groups, a probable effect of the calcium and vitamin D supplementation. The bone resorption marker CTx decreased more significantly in the treatment group (P =0.016). Conclusions: The transvaginal estradiol treatment of 7.5μg/24h had a small but significant effect on the BMD of total hip and lumbar spine after a follow-up of 2 years. [Copyright &y& Elsevier]

Background: Studies have shown that patients with depression have higher rates of coronary heart disease (CHD) than people in the general population. However, large-scale population-based data on incidence rates of CHD in people with depression are needed. This study analyzed whether hospitalization for depression predicts CHD in men and women after accounting for socioeconomic status and geographic region. Methods: Data from the family coronary heart disease database at the Karolinska Institute, Stockholm, were used to identify all people in Sweden aged 25 to 64 at onset of depression and aged 25 to 79 at onset of nonfatal CHD during the study period (1987 to 2001). Standardized incidence ratios (SIRs) of CHD among those with and without depression were compared. All analyses were conducted in 2005. Results: There were 1767 cases of CHD among those with depression during the study period. The risk of developing CHD was strongest for those aged <40; the SIR was 2.17 (95% confidence interval [CI]=1.50–3.03). The risk was attenuated with increasing age in both men and women. People aged 70 to 79 at onset of depression did not have an increased risk of CHD. Conclusions: Even after accounting for socioeconomic status and geographic region, depression is a clinically significant risk factor for developing CHD, especially in men and women aged 25 to 50. Primary healthcare teams should make particular efforts to identify young to middle-aged women and men who have depression, especially in combination with other CHD risk factors. [Copyright &y& Elsevier]

There is scant knowledge of the effects of country of birth on the health of individuals in the years prior to and after retirement. The aim of this study was to consider country of birth in relation to health status, instrumental activities of daily living (IADL) and all-cause mortality when adjusted for socioeconomic status (SES). Cross-sectional data were collected between 1986 and 1991 on 8959 individuals between the ages of 55 and 74. Self-reported data were analysed using a logistic regression model while the mortality data were analysed by means of a proportional hazard model. In the present study, immigrants from Southern Europe, Eastern Europe and Finland carried significantly increased risks of poor health even after adjustment for SES. Southern Europeans, refugees from Developing countries and Finns exhibited an increased risk of impaired IADL compared to Swedes, even after adjustment for SES. In conclusion, country of birth was associated with poor health status and impaired IADL. This association remained after adjustment for SES. In accordance with pre-study expectations, mortality was predicted by impaired IADL and male gender. Country of birth was not associated with all-cause mortality. [Copyright &y& Elsevier]

Although our knowledge of the relationship between migration and health in women is increasing, we still have a limited knowledge of the migration and health of women of reproductive age. A cross-sectional analysis of a simple random sample of 10,661 women aged 20–49 in Sweden in 1980–1985 and 9585 such women in 1992–1997 was carried out to assess their health. The risk factors for self-reported, poor health and psychosomatic complaints for female refugees and women from Finland, Southern Europe, Western countries and Sweden were examined. Country of birth was a significant risk factor for poor self-reported health and psychosomatic complaints, with women from Southern Europe, female refugees and Finnish women being at higher risk in this respect than Swedish women. The increased risk remained significant after adjustment for demographic and socio-economic factors. Swedish-born women, female refugees, and Finnish women reported poorer health and had more psychosomatic complaints (not Finns) in the 1990s than in the 1980s. [Copyright &y& Elsevier]

Objective To study the risk of myocardial infarction (MI) in patients with atrial fibrillation (AF) treated in primary health care with warfarin or acetylsalicylic acid (ASA, aspirin). Methods The study population included subjects (n = 12,283) 45 years or older diagnosed with AF who were treated in 75 primary care centres in Sweden between 2001 and 2007. MI was defined as a hospital stay for MI during 2001 through 2010 registered in the Swedish Patient Register. Associations between warfarin or ASA treatment and incident MI were explored using Cox regression analysis, by estimating hazard ratios (HRs) and 95% confidence intervals (95% CIs). Adjustment was made for age, socio-economic factors and cardio-vascular co-morbidity. Results Persistent treatment (“per protocol” treatment) with warfarin alone was present among 32.4% of women and 37.4% of men, and with ASA alone among 30.0% of women and 28.1% of men. The fully adjusted HRs for MI, compared to those with no antithrombotic treatment, with warfarin treatment for women were 0.26 (95% CI 0.16–0.41) and for men 0.28 (95% CI 0.20–0.39); and the corresponding HRs for those treated with ASA were for women 0.57 (95% CI 0.37–0.87), and for men 0.44 95% CI (0.31–0.63). The fully adjusted HR for MI when comparing patients with warfarin treatment to those with ASA treatment was for women 0.46 (95% CI 0.27–0.80), and for men 0.58 (95% CI 0.38–0.89). Conclusions Warfarin seems to prevent MI among AF patients in a primary healthcare setting, which emphasizes the importance of persistent anticoagulant treatment in those patients. [ABSTRACT FROM AUTHOR]

Abstract: Background: Little is known about longitudinal changes of cerebrospinal fluid (CSF) biomarkers during cognitive decline in neurodegenerative disease progression. Objective: To investigate longitudinal changes in CSF biomarkers – total-tau (T-tau), phospho-tau (P-tau) and β-amyloid (Aβ42) – during cognitive decline. Methods: Forty memory clinic patients (47.5% females), aged 61.3±7.6 (S.D.) years, non-demented at baseline, underwent lumbar puncture and neuropsychological testing at two occasions. Baseline mean MMSE-score was 28.3±1.8. Patients were divided into three groups based on baseline memory functioning; severely impaired (SIM), moderately impaired (MIM) and no impairment (NIM). Results: There was a significant increase in P-tau in the SIM-group during follow-up, while P-tau in MIM and NIM did not change. Eighty-three percent of the SIM-patients converted to dementia (80% AD), while most MIM- and NIM-patients remained non-demented. T-tau- and Aβ42-levels did not change in any of the memory groups during follow-up. Conclusion: Increasing P-tau levels during cognitive decline and conversion to dementia suggest that P-tau may be useful as a longitudinal marker of the neurodegenerative process. [Copyright &y& Elsevier]

Abstract: Little is known about the association between neighborhood social disorganization and coronary heart disease (CHD). This study used the theoretical frameworks of the Chicago school and the Stirling County group in order to analyze the impact of neighborhood violent crime and neighborhood unemployment on CHD in an urban setting, the capital of Sweden. The entire population of Stockholm County aged 35–64 years on January 1, 1998 was included in the study. All individuals were followed for CHD until December 31, 1998. Small area neighborhood units were used to define neighborhoods. The neighborhood-level variables were calculated as rates of violent crime or unemployment in the small area neighborhood units, categorized in quintiles. Multilevel logistic regression was used to estimate odds ratios and neighborhood-level variance in three different models. When rates of neighborhood violent crime or neighborhood unemployment increased, the risk of CHD increased among both women and men. In neighborhoods with the highest rates of violent crime (quintile 5), the odds ratios were 1.75 (CI=1.37–2.22) and 1.39 (CI=1.19–1.63) for women and men, respectively. In neighborhoods with the highest unemployment rates, the corresponding odds ratios were 2.05 (CI=1.62–2.59) and 1.50 (CI=1.28–1.75). These average neighborhood effects on CHD (fixed effects) remained almost unaltered after inclusion of the individual-level variables. The neighborhood-level variance indicated significant differences in CHD between neighborhoods, and the neighborhood-level and individual-level variables partly explained the variance between neighborhoods (random effects). Public safety and social stability in socially disorganized neighborhoods need to be improved in order to promote cardiovascular health. [Copyright &y& Elsevier]

Background: The positive health effects of physical activity are well known. However, there are few studies of the association between different levels of physical activity and all-cause mortality among elderly people.Methods: A national random sample of 3206 women and men aged ≥65 were interviewed in 1988 and 1989 and followed until December 31, 2000, for all-cause mortality. Cox regression was used to analyze the association between five different levels of physical activity and all-cause mortality, after adjustment for gender, age, education, smoking habits, body mass index, diabetes, hypertension, and self-rated health. All analyses were conducted in 2003.Results: For elderly people who were physically active occasionally, the risk of all-cause mortality was 28% lower than for those who were physically inactive (hazard ratio [HR]=0.72; confidence interval [CI]=0.64–0.81), after adjustment for all explanatory variables. For those who were physically active once a week, the risk of all-cause mortality was 40% lower than for those who were physically inactive (HR=0.60; CI=0.50–0.71). For those who were physically active more frequently, the reduction in all-cause mortality risk was about the same as for those who were physically active once a week. Diabetes, hypertension, and daily smoking were, as expected, significant risk factors for all-cause mortality.Conclusions: Physical activity, even occasionally, decreases the risk of all-cause mortality among elderly people. Preventive resources among the elderly should include moderate exercise such as walking. [Copyright &y& Elsevier]

Few studies have examined the relationship between social, cultural and religious participation, political empowerment and coronary heart disease (CHD). The aim of this study was to examine whether low social participation, as described in a social participation index, predicted incidence rates of CHD. This is a follow-up study, from 1990–91 to 31 December 2000, of 6861 Swedish women and men, who were interviewed about their social participation, education, housing tenure and smoking habits. A social participation index was constructed, based on 18 variables from the survey. The outcome measure was CHD morbidity and mortality. Respondents with a CHD incident from 1986 until interview were excluded from the study. Data were analysed using Cox’ regression and the results are presented as hazard ratios (HR) with 95% confidence intervals (CI). In the sex- and age-adjusted model there was a gradient between the social participation index and CHD, so that persons with low social participation had the highest risk of CHD with HR=2.15; CI=1.57–2.94, followed by HR=1.67; CI=1.23–2.27 for those with middle social participation. In the full model, when education, housing tenure and smoking habits were included, the increased risk of CHD for persons with low social participation remained high, with HR=1.69, CI=1.21–2.37.We conclude that persons with low social participation in the social participation index exhibited an increased risk of CHD that remained after adjustment for education, housing tenure and smoking habits. [Copyright &y& Elsevier]