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Objectives. To investigate how age, malnutrition, and the level of plasma cortisol and phosphate in patients with Parkinson's disease (PD) at time of diagnosis are associated with body composition and handgrip strength in males and females compared to controls. Materials & Methods. This cross-sectional study includes baseline data from a cohort of newly diagnosed patients with Parkinson's disease (N = 75; M/F = 41/34) in the New Parkinsonism in Umeå study (NYPUM). Body Impedance (BIS), handgrip strength (HGS) assessments, and evaluation of risk for malnutrition (Mini Nutritional Assessment (MNA) score) and cognitive performance (Mini-Mental State Examination (MMSE)) were performed at time of PD diagnosis. Results. Low fat-free mass index (FFMI), MNA score, and a high Unified Parkinson's Disease Rating Scale (UPDRS-total and UPDRS-III) were associated with high daytime levels of P-cortisol in total PD population but not in controls. Partial correlations reveal that high fat mass percent (FM (%)) and low FFMI were associated with older age in males with PD but not females with PD. Risk of malnutrition was associated with P-cortisol in males but not in females with PD (r =-0.511, P=0.001, and n = 41 and r =-0.055, P=0.759, and n = 34, respectively). Multiple linear regressions show that an interaction between P-cortisol and P-phosphate, older age, and high UPDRS-III score were associated with HGS in total patient population and males but not females. Conclusions. Age-and disease-associated risk factors that decrease muscle mass and HGS and increase FM (%) in patients with PD differ between males and females by an association with levels of cortisol and phosphate.

Background: Life-style interventions, including smoking cessation and weight control are of importance for managing future escalating prevalence of obesity. Smoking habits and obesity have jointly great impact on mortality, however mechanisms behind the effect and variables involved in the obesity paradox is still unknown.

Objectives: This study examines risk factors for all-cause, cardiovascular, and cancer mortality in males and females with high cardiovascular risk, mediated by smoking habits, body mass index (BMI, kg/m2), and serum phosphate (S-P) levels.

Methods: Patients were admitted to the Vindeln Patient Education Center in groups of 30 for a four-week residential comprehensive program (114 hours) focusing on smoking cessation, stress reduction, food preferences and selections, and physical exercise. The follow-up, in years from 1984 to 2014 corresponds to 30 years. This study included 2,504 patients (1,408 females and 1,096 males). Cox regression analysis was used to assess mortality risk associated with smoking habits, low and high BMI, and low and high S-P levels.

Results: High BMI (>34,2 kg/m2), current smoking, type 2 diabetes mellitus (T2DM), high serum calcium (S-Ca), mmol/L and high systolic blood pressure (SBP, mmHg) were associated with all-cause mortality irrespective of sex. Former and current smoking females had a high all-cause mortality (adjusted hazard ratio [HR] 1.581; 95% CI 1.108–2.256, adjusted hazard ratio [HR] 1.935; 95% CI 1.461–2.562, respectively) while current smoking and high BMI increased risk for cardiovascular mortality (adjusted hazard ratio [HR] 3.505; 95% CI 2.140–5.740 and [HR] 1.536; 95% CI 1.058–2.231, respectively). Neither low nor high levels of S-P predicted all-cause, cardiovascular disease (CVD) and cancer mortality in males or females while low levels of S-P predicted all-cause mortality in smokers (adjusted hazard ratio [HR] 1.713; 95% CI 1.211–2.424). In non-smokers, low BMI (<27.6 kg/m2) was protecting and high BMI a risk for all-cause mortality. In males, ischemic heart disease (IHD), and low serum albumin (S-Alb) were associated with all-cause mortality. In females, an interaction between high BMI and smoking (HbmiSM) decreased the cardiovascular mortality (adjusted hazard ratio [HR] 0.410; 95% CI 0.179–0.937, respectively).

Conclusions: High BMI and current smoking were associated with all-cause mortality in both males and females in the present high cardiovascular-risk cohort. In current smokers and non-smokers, T2DM and high S-Ca were associated with an increase in all-cause mortality, while low S-P was associated with all-cause mortality in smokers. Interaction between high BMI and smoking contribute to the obesity paradox by being protective for cardiovascular mortality in females.

Background: This study investigates the associations between changes in serum Triglycerides (S-TG), -Urate (S-Urate), and -Glucose (S-Glu) and changes in serum Calcium (S-Ca), -Magnesium (S-Mg), and -Phosphate (S-P) in patients with type 2 diabetes compared with non-diabetic patients. Methods: The analysis is based on data collected from a secondary prevention population of women and men (W/M) at risk for cardiovascular disease (type 2 diabetes, 212/200; non-diabetes 968/703). The whole population (n = 2083) had a mean age of 51.0 (9.7) years and was stratified for sex and according to type 2 diabetes or non-diabetes. The patients were followed for, either half a year or one year and changes in risk factors were calculated from follow-up to baseline, the time when patients were admitted to the health center. The pattern of relationships was evaluated using a structural equation model. Results: Higher S-TG and S-Glu but lower S-Urate was revealed at baseline in type 2 diabetes women and men as compared to their counterparts, non-diabetes patients. Women with type 2 diabetes had higher S-Ca and lower S-Mg than non-diabetes women. Changes in S-Glu were associated with changes in S-Ca (+), baseline S-Ca (+), and S-Urate (-) in type 2 diabetes men. Changes in S-Urate were associated with changes in S-Mg (+) in type 2 diabetes women and non-diabetes men. In men with non-diabetes, changes in S-Glu were associated with changes in S-Mg (-). In women with non-diabetes, changes in S-Glu were associated with changes in S-P (-) and changes in S-Urate with changes in S-Ca (+). Conclusion: With respect to metabolic disturbances in non-diabetes and the awareness of risk for type 2 diabetes, changes in S-Glu and changes in S-Ca, S-Mg, and S-P should be considered as risk factors for cardiovascular disease. Increased early detection and corrections of high S-Ca, low S-Mg, and S-P in obese patients may improve their metabolism and reduce the risk of CVD in patients with type 2 diabetes. Trial registration number: ISRCTN: ISRCTN79355192

The aim of this study is to investigate whether the prediction of all-cause mortality from traditional risk factors is improved by adding electrolytes (serum-phosphate (S-P), serum-calcium (S-Ca) and serum-magnesium (S-Mg)) in a Cox regression. The study uses an 18-year follow-up of patients (n=2504) referred by physicians in primary health care and hospitals to the Vindeln Patient Education (VPE) Center, mainly with a diagnosis of hypertension (HT), type 2 diabetes mellitus (DM) and/or obesity.

Cox regression, with the latest registered value and baseline values for risk factors, was used to study all-cause mortality in men and women. 221 out of 1096 men and 157 out of 1408 women died during the 18-year follow-up (20% and 11% respectively). The Cox regression analysis reveals that high blood glucose (B-Glu) and low S-Mg were significantly associated with increased all-cause mortality in the whole patient population as well as in men and women separately. Among women, type 2 DM and systolic blood pressure (SBP) and among men, high S-Ca, S-P, S-urate and body mass index (BMI) were the main predictors of all-cause mortality. There is significantly improved prediction of all-cause mortality with electrolytes added to the traditional risk factors. High B-Glu and low S-Mg in both men and women, and high S-Ca and S-P in men, are significantly associated with all-cause mortality. The metabolic disturbance in this high-risk group of patients can be more fully understood if ionic imbalance is included in the prediction of mortatlity.

The main purpose of this study is to integrate and discuss results from studies that focus on the effects of repeated test taking of the Swe-SAT. Messick’s four-faceted model of validity is used as an integrating and an analytic tool. Another purpose is to use results from supplementary education as a reference in this integration.

The summarized conclusion is that the existing rule concerning repeated test taking for the Swedish Scholastic Assessment Test (Swe-SAT) is relevant. It is relevant as the test taker has a chance to obtain a good estimate of his or her knowledge and ability. The unintended social consequences are reduced if actions are taken to motivate test takers to repeat the test.

The conclusion is quite the opposite for supplementary education. A

change in the rule that eliminates the usage of supplementary grades in the selection procedure will result in higher validity.

The conclusion is also that the Messick model is a very useful tool for validation. When applying the Messick model, the aim and the direction of the process of validation will be systemized and optimized as well as nuanced.

This study was about students and their study achievements. Data from available records for students admitted to the study programme of business administration was used. The students (N19393) were born in the period 1972–1984, living in Sweden and registered on the study programme sometime between 1993 and 2000. The students were divided into three groups on the basis of the grounds on which the students had been admitted. The first group had been admitted on the basis of their credits from uppersecondary school, the second on the basis of their SweSAT-scores and the third group on the basis of their SweSAT-scores with additional credit for work experience. Study achievement was defined as the number of credits the students managed to attain each semester. The purpose of the study was to see if there were any differences in academic achievement between the three groups. Attention was also given to social background and sex. The results showed that approximately 50% of the students were women. The proportion of students from Social Group 1 was highest among those who had been admitted on the basis of their SweSAT-scores. The most common upper-secondary school programme, for the students who had completed upper-secondary school 1997 or later, was the Programme for Social Science (Samhällsvetenskaplig utbildning). About one fifth of the students who had completed upper secondary school 1997-1999 had taken supplementary secondary-education-level courses after they had left upper-secondary school. The study showed that the female students attained more course points per semester than the male students. There were also differences, in terms of the number of credits attained per term, between the students from the three groups and between students with different social backgrounds. However, these differences were not as extensive as the differences between male and female study achievements.

Students and their study achievements are in focus in this report. Attention is given to the three and a half year long Programme for Social Work. The students (N2956) where divided into three groups, according to the grounds on which they had been admitted to the programme. The first group had been admitted on the basis of their credits from upper-secondary school, the second on the basis of their SweSAT-scores and the third group on the basis of their SweSAT-scores with additional credit for work experience. The purpose of the study was to see if there were any differences in academic achievement between the three groups. Academic achievement was defined as the number of credits achieved at university. Attention was also given to social backgrounds and male/female variance. The results showed that approximately 85% of the students were women. The proportion of students from Social Group 1 was highest among those who had been admitted on the basis of their credits from upper-secondary school. The most common uppersecondary school programme was the Programme for Social Science (Samhällsvetenskaplig utbildning). About one fourth of the students who had completed upper-secondary school 1997-1999 had taken supplementary secondary education level courses after they had left upper-secondary school. The study showed that the female students attained more course points per

term compared to the male students. There were also differences, in terms of the number of credits attained per term, between the students from the three groups and between students with different socio-economic backgrounds. However, these differences were not as extensive as the differences between male and female study achievements.

The Swedish Scholastic Aptitude Test (SweSAT) is used in the process of selection to higher education in Sweden. The SweSAT is administered twice a year and consists of 122 items. The total raw score is transformed into a normed score, which is used in the selection procedure. The main purpose of this study was to investigate the effects of repeated test taking regarding the SweSAT. The effects are described in relation to the test taker who chooses to retest. Another purpose was to relate the effects of repeated test taking to the individual subtests of the SweSAT and to analyse the self selection process related to repeated test taking. Multivariate linear models for repeated measurements were used to describe the effects of repeated test taking in relation to the test taker. Calibrated scores were used as a basis for relating the effects to subtests. The summarised conclusions were that test takers with high SweSAT score repeated the test more often than those with low scores. Males and test takers from social group I repeated the test more often than females and social group III, respectively. Repeated test taking had its main effect from the first to the second testing for all social groups and both sexes. This main effect of repeated test taking was related to two subtests, WORD and DTM, for all social groups. For the other subtests, social groups II and III were favoured by subtest DS, social group II was favoured by READ and social group III was favoured by subtest ERC. With reference to total normed test score the results indicated that there was a marginal difference between social groups I and II, when controlled for sex and age. Social group I had a higher mean score than the other social groups. Males had higher mean scores than females. The summarised conclusion was that the differences in mean scores between social groups I and III were higher than between males and females.

The Swedish Scholastic Aptitude Test (SweSAT) is, together with

grade point average (GPA), used in the selection procedure for higher education in Sweden. The SweSAT is administered twice a year, it consists of 122 items and the total raw score is transformed to a normed score which is used in the selection procedure. Certain rules apply to the SweSAT when it is used for selection to higher education and one of these rules is that the test taker can repeat the test. The main purpose of this study was to investigate the effects of repeated test taking for the SweSAT. The effects are described in terms of normed score, partly in relation to the rules for selection, and partly in relation to the test taker who elect to retest. The result indicates that the effects of repeated test taking mainly occur between the first and second testing. This is a tendency that is observed when the effects of repeated test taking are analysed in relation to the rules for selection as well as in relation to the test taker. According to the rules for the SweSAT in the selection system the best score is used if a certain applicant has more than one valid score and the model for description of score gains in this study is based on this fact. Another purpose was to relate the effects of repeated test taking to subtests of the SweSAT. Proportional stratified sampling and multivariate linear models are used when describing the effects of repeated test taking in relation to the test taker, while a reference population and a calibrated raw score is used as a basis when the effects are related to subtests. With regard to subtests, the main effect of repeated test taking is related to three subtests: WORD, DS and ERC. The summarised conclusion that is made in this study is that the effects of repeated test taking between the first and second test occasion, in terms of standard deviation units for total normed score for the SweSAT, is about 0.2 and this finding is in congruence with findings in earlier studies. Plausible hypotheses for

the obtained results are discussed.

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