Search

Background and Aim: Overall, suicide rates in the Nordic region, Denmark, Finland, Iceland, Norway and Sweden, have declined in the past 40 years. The aim of this study was to determine trends in suicide mortality from 2000 to 2018., Methods: Data were obtained from official suicide statistics for men and women, 15 years and older. Gender and age groups in four calendar periods were analyzed using Joinpoint Estimated Regression Coefficient., Results: The crude regional suicide rate was 17.1, 2000-2004, decreased to 14.1 per 100,000 inhabitants in 2015-2018. Age-standardized rates are 13.6-11.3. The crude rate decreased by 19.5% (16.3% age-standardized), 19.3% for males and 20.5% for females. The largest decrease was found in Finland (34.9%), the smallest in Norway (1.4%). In males, the exception was an increased suicide rate among all Icelandic except 15-24-year olds, and in 45-64 year-old Norwegians. Among females, an increase was seen among 15-24-year olds in all countries except Iceland, in all age groups in Norway, and in 25-44-year olds in Sweden. In males, a decline of the suicide rated lower than 10% was noted in 25-44 olds in Norway and in 15-64 year-olds in Sweden., Discussion: A robust decrease was observed in the overall regional suicide rate in recent years. Exceptions are rising rates in Icelandic males, in Norwegian females, and the youngest female groups in all except Iceland. The small decline among middle-aged males in Norway and Sweden is of concern.

Introduction: Suicides are number 16 as a cause of death worldwide. Causes are not always known, often associated with depression or trauma. Suicide incidence has decreased world- wide in the past three decades. The economic crisis of 2008 led to an increase in many countries. Many confounding factors make comparisons between countries difficult. This study assesses the possible impact of economic crises in Iceland on suicide incidence., Material and Methods: The work is based on suicide data from 1911 to 2017 and six economic crises from 1918 to 2008. The incidence is calculated five and ten years before and after the index year of each crisis. Possible crisis impact was assessed by applying a quasi-Poisson model to the data. Variance can be greater than model shows, so overdispersion was assessed. The evolution over time is assessed by inspection of cumulative sum of squared -residuals (CUSUMSQ)., Results: Suicide incidence increased from 1930, beginning to decline around 1990. Given a small population size there are wide upwards incidence fluctuations, within and outside the crisis -periods. The crises of 1931 and 1948 showed an increase, wheras in the others there is no change or a decrease. The sizes of deviations from expected value are, for the whole period, in compliance with the quasi-poisson model for counts., Conclusion: There is no statistical correlation between the six economic crises and suicide incidence in the Icelandic data. The study is based on population incidence and does not preclude a negative impact of economic crises on individuals.

Objective: To assess the effects of fish (lean or oily) and fish oil consumption on blood lipid concentration during weight loss., Design: Randomized, controlled 8-week trial of energy-restricted diet varying in fish and fish oil content. Subjects, 324 men and women, aged 20-40 years, body mass index 27.5-32.5 kg m(-2), from Iceland, Spain and Ireland, were randomized to one of four groups: (1) control (sunflower oil capsules, no seafood), (2) cod diet (3 x 150 g week(-1)), (3) salmon diet (3 x 150 g week(-1)), (4) fish oil (DHA/EPA capsules, no seafood). The macronutrient composition of the diets was similar between the groups and the capsule groups were single-blinded., Measurements: Total cholesterol (TC), high-density lipoprotein (HDL) and low-density lipoprotein cholesterol, triacylglycerol (TG) and anthropometrics were measured at baseline and end point., Results: The difference in logTG lowering between the control group and the cod diet, salmon diet and fish oil from baseline to end point was -0.036 (95% CI -0.079 to 0.006), -0.060 (-0.101 to -0.018) and -0.037 (-0.079 to 0.006), respectively. Reduction in TC was about 0.2 mmol l(-1) greater in the fish groups (cod and salmon) than in the control group, but only of borderline significance when adjusting for weight loss. HDL tended to decrease less in the diet groups consuming a significant amount of n-3 fatty acids (salmon and fish oil)., Conclusion: Weight-loss diet including oily fish resulted in greater TG reduction than did a diet without fish or fish oil. Controlled trials using whole fish as a test meal are encouraged to be able to elucidate the role of different constituents of fish for human health.

Background: Distant healing, a form of spiritual healing, is widely used for many conditions but little is known about its effectiveness., Methods: In order to evaluate distant healing in patients with a stable chronic condition, we randomised 409 patients with chronic fatigue syndrome (CFS) from 14 private practices for environmental medicine in Germany and Austria in a two by two factorial design to immediate versus deferred (waiting for 6 months) distant healing. Half the patients were blinded and half knew their treatment allocation. Patients were treated for 6 months and allocated to groups of 3 healers from a pool of 462 healers in 21 European countries with different healing traditions. Change in Mental Health Component Summary (MHCS) score (SF-36) was the primary outcome and Physical Health Component Summary score (PHCS) the secondary outcome., Results: This trial population had very low quality of life and symptom scores at entry. There were no differences over 6 months in post-treatment MHCS scores between the treated and untreated groups. There was a non-significant outcome (p = 0.11) for healing with PHCS (1.11; 95% CI -0.255 to 2.473 at 6 months) and a significant effect (p = 0.027) for blinding; patients who were unblinded became worse during the trial (-1.544; 95% CI -2.913 to -0.176). We found no relevant interaction for blinding among treated patients in MHCS and PHCS. Expectation of treatment and duration of CFS added significantly to the model., Conclusions: In patients with CFS, distant healing appears to have no statistically significant effect on mental and physical health but the expectation of improvement did improve outcome., (Copyright (c) 2008 S. Karger AG, Basel.)

Objective: To investigate the effect of including seafood and fish oils, as part of an energy-restricted diet, on weight loss in young overweight adults., Design: Randomized controlled trial of energy-restricted diet varying in fish and fish oil content was followed for 8 weeks. Subjects were randomized to one of four groups: (1) control (sunflower oil capsules, no seafood); (2) lean fish (3 x 150 g portions of cod/week); (3) fatty fish (3 x 150 g portions of salmon/week); (4) fish oil (DHA/EPA capsules, no seafood). The macronutrient composition of the diets was similar between the groups and the capsule groups, were single-blinded., Subjects: A total of 324 men and women aged 20-40 years, BMI 27.5-32.5 kg/m(2) from Iceland, Spain and Ireland., Measurements: Anthropometric data were collected at baseline, midpoint and endpoint. Confounding factors were accounted for, with linear models, for repeated measures with two-way interactions. The most important interactions for weight loss were (diet x energy intake), (gender x diet) and (gender x initial-weight)., Results: An average man in the study (95 kg at baseline receiving 1600 kcal/day) was estimated to lose 3.55 kg (95% CI, 3.14-3.97) (1); 4.35 kg (95% CI, 3.94-4.75) (2); 4.50 kg (95% CI, 4.13-4.87) (3) and 4.96 kg (95% CI, 4.53-5.40) on diet (4) in 4 weeks, from baseline to midpoint. The weight-loss from midpoint to endpoint was 0.45 (0.41-0.49) times the observed weight loss from baseline to midpoint. The diets did not differ in their effect on weight loss in women. Changes in measures of body composition were in line with changes in body weight., Conclusion: In young, overweight men, the inclusion of either lean or fatty fish, or fish oil as part of an energy-restricted diet resulted in approximately 1 kg more weight loss after 4 weeks, than did a similar diet without seafood or supplement of marine origin. The addition of seafood to a nutritionally balanced energy-restricted diet may boost weight loss.

The study of school bullying has recently assumed an international dimension, but is faced with difficulties in finding terms in different languages to correspond to the English word bullying. To investigate the meanings given to various terms, a set of 25 stick-figure cartoons was devised, covering a range of social situations between peers. These cartoons were shown to samples of 8- and 14-year-old pupils (N = 1,245; n = 604 at 8 years, n = 641 at 14 years) in schools in 14 different countries, who judged whether various native terms cognate to bullying, applied to them. Terms from 10 Indo-European languages and three Asian languages were sampled. Multidimensional scaling showed that 8-year-olds primarily discriminated nonaggressive and aggressive cartoon situations; however, 14-year-olds discriminated fighting from physical bullying, and also discriminated verbal bullying and social exclusion. Gender differences were less appreciable than age differences. Based on the 14-year-old data, profiles of 67 words were then constructed across the five major cartoon clusters. The main types of terms used fell into six groups: bullying (of all kinds), verbal plus physical bullying, solely verbal bullying, social exclusion, solely physical aggression, and mainly physical aggression. The findings are discussed in relation to developmental trends in how children understand bullying, the inferences that can be made from cross-national studies, and the design of such studies.

Background: Distant healing as a treatment modality is frequently used by patients and healers. Some preliminary evidence suggests possible effects. Since patients suffering from multiple chemical sensitivity and chronic fatigue syndrome have only few effective treatment options, distant healing will be offered as a treatment within a formal trial of distant healing., Design and Method: A four-armed randomized trial will include 400 patients with self-attributed, environmental problems who fulfil the diagnostic criteria of severe idiopathic chronic fatigue, chronic fatigue syndrome or multiple chemical sensitivity. Patients will be recruited by specialized general practitioners and environmental clinics. They will be treated by healers distributed all over Europe, coming from various healing traditions and nationalities. Each patient will be treated by 3 healers. Healers will have no contact with the patients and will only be provided with the patient's Christian name and a photograph. The patients will be randomized to one of 4 groups in a 2 x 2 factorial design. They will either receive (distant) healing or not, and either know or not know this decision. Thereby the effects of expectation and of time can be disentangled from the specific effects of healing., Outcome Measure: Primary outcome measure will be the mental health summary scale of the MOS SF-36. The measure will be taken at the beginning and at the end of a 6- month treating or waiting period, respectively. A variety of moderator variables will be considered to evaluate which of these may be predictive of outcome., (Copyright 2002 S. Karger GmbH, Freiburg)

In epidemiology, the risk of disease in terms of a set of covariates is often modelled by logistic regression. The resulting linear predictor can be used to define the extent of risk between extremes, and to calculate an attributable risk for the covariates taken together. As is well known, straightforward use of the linear predictor, on the sample from which it was derived, to obtain estimates the relative and attributable risk will be biased, often seriously. Use of the jack-knife technique is extended to produce asymptotically unbiased estimates of relative and attributable risks. The asymptotic variances associated with these estimates are derived by using the formulae of conditional variances. They are applied to the results of a case-control study of stomach cancer.

Anaemia of uncertain origin is common in elderly people and is reported to be more common in men than women. We have investigated retrospectively a database of haematological and biochemical data on 16.332 people referred to an outpatient laboratory and compared the blood haemoglobin (Hb) concentration of the sexes. In men the mean adult Hb values of 151 g/1 started to decline at the age of 60 to reach the level of 138 g/1 by the age of 80 and older. In women, by contrast, the mean adult Hb concentration of 134 g/1 started to increase at the age of 50 to 137 g/1 then declining after the age of 70. A multiple regression analysis of variables likely to influence measured Hb values indicated that 6,7 g/1 of the observed 13 g/1 decrease in elderly men could not be explained by chance or selection bias and that an increase of Hb values in women was sustained until after 80 years of age. Results would suggest that sex or sex hormone related factors influence haemoglobin concentrations in elderly people.

Analgesic intake was investigated for 96 patients with cancer of the renal pelvis and ureter (including papillomas) and 294 hospital controls. In comparison with persons who never used analgesics, increased relative risks (RR) were seen for users of phenacetin-containing drugs after adjustment for smoking and high-risk occupational exposure (men: RR = 2.4; women: RR = 4.2). A significant relative risk for aspirin use among women was also observed. There was an indication of a dose-effect relationship for both types of analgesics. The influence of phenacetin and aspirin on the development of renal pelvis and ureter tumours could not be separated since in this study the two compounds occurred so frequently in the same formulation. Experimental studies and phenacetin metabolism makes it biologically most relevant to attribute the observed association in the present study to the phenacetin component of the drugs.

In 1980 and 1982 two case reports documented reactivation of pulmonary tuberculosis in patients who had used nonsteroidal anti-inflammatory drugs (NSAIDs). A case-control study was designed to test the hypothesis that such an association does exist. Data for 38 patients were obtained from the patients' family physicians, and each patient was matched with a control from the same practice for age, sex, race and length of time in that practice. A statistically significant relation was found between the reactivation of tuberculosis and the use of NSAIDs. However, further research is imperative to determine whether the association is direct, indirect or secondary to an unknown factor. Physicians should keep in mind that NSAIDs are potent anti-inflammatory agents and may thus activate, spread and mask infections.