• Association between abdominal and general obesity and respiratory symptoms, asthma and COPD. Results from the RHINE study 

      Kisiel, Marta A.; Arnfelt, Oscar; Lindberg, Eva; Jogi, Oscar; Malinovschi, Andrei; Johannessen, Ane; Benediktsdottir, Bryndis; Franklin, Karl; Holm, Mathias; Gomez Real, Francisco; Sigsgaard, Torben; Gislason, Thorarinn; Modig, Lars; Janson, Christer (Journal article; Peer reviewed, 2023)
      Introduction Previous studies on the association between abdominal and general obesity and respiratory disease have provided conflicting results. Aims and objectives We aimed to explore the associations of abdominal ...
    • Association of respiratory symptoms and lung function with occupation in the multinational Burden of Obstructive Lung Disease (BOLD) study 

      Ratanachina, Jate; Amaral, Andre F.S.; De Matteis, Sara; Lawin, Herve; Mortimer, Kevin; Obaseki, Daniel O.; Harrabi, Imed; Denguezli, Meriam; Wouters, Emiel F.M.; Janson, Christer; Nielsen, Rune; Gulsvik, Amund; Cherkaski, Hamid Hacene; Mejza, Filip; Mahesh, Padukudru Anand; Elsony, Asma; Ahmed, Rana; Tan, Wan C.; Loh, Li Cher; Rashid, Abdul; Studnicka, Michael; Nafees, Asaad A.; Seemungal, Terence; Aquart-Stewart, Althea; Al Ghobain, Mohammed; Zheng, Jinping; Juvekar, Sanjay; Salvi, Sundeep; Jogi, Rain; Mannino, David M.; Gislason, Thorarinn; Buist, A. Sonia; Cullinan, Paul; Burney, Peter G.J.; Hafizi, Hasan; Aliko, Anila; Bardhi, Donika; Tafa, Holta; Thanasi, Natasha; Mezini, Arian; Teferici, Alma; Todri, Dafina; Nikolla, Jolanda; Kazasi, Rezarta; Bengrait, Amira; Haddad, Tabarek; Zgaoula, Ibtissem; Ghit, Maamar; Roubhia, Abdelhamid; Boudra, Soumaya; Atoui, Feryal; Yakoubi, Randa; Benali, Rachid; Bencheikh, Abdelghani; Ait-Khaled, Nadia; Jenkins, Christine; Marks, Guy; Bird, Tessa; Espinel, Paola; Hardaker, Kate; Toelle, Brett; Dawes, Torkil; Lamprecht, Bernd; Schirhofer, Lea; Islam, Akramul; Ahmed, Syed Masud; Islam, Shayla; Islam, Qazi Shafayetul; Mesbah-Ul-Haque, NN; Chowdhury, Tridib Roy; Chatterjee, Sukantha Kumar; Mia, Dulal; Das, Shyamal Chandra; Rahman, Mizanur; Islam, Nazrul; Uddin, Shahaz; Islam, Nurul; Khatun, Luiza; Parvin, Monira; Khan, Abdul Awal; Islam, Maidul; Kpangon, Arsene; Kpossou, Karl; Agodokpessi, Gildas; Ayelo, Paul; Fayomi, Benjamin; Mbatchou, Bertrand; Ashu, Atongno Humphrey; Wang, Wen; Zhong, NanShan; Liu, Shengming; Lu, Jiachun; Ran, Pixin; Wang, Dali; Zhou, Yumin; Laja, Hendrik; Ulst, Katrin; Zobel, Vappu; Lill, Toomas-Julius; Adegnika, Ayola Akim; Welte, Tobias; Bodemann, Isabelle; Geldmacher, Henning; Schweda-Linow, Alexandra; Benedikdtsdottir, Bryndis; Jörundsdottir, Kristin; Gudmundsdottir, Lovisa; Gudmundsdottir, Sigrun; Gundmundsson, Gunnar; Koul, Parvaiz A.; Malik, Sajjad; Hakim, Nissar A.; Khan, Umar Hafiz; Chowgule, Rohini; Shetye, Vasant; Raphael, Jonelle; Almeda, Rosel; Tawde, Mahesh; Tadvi, Rafiq; Katkar, Sunil; Kadam, Milind; Dhanawade, Rupesh; Ghurup, Umesh; Hirve, Siddhi; Sambhudas, Somnath; Chaidhary, Bharat; Tambe, Meera; Pingale, Savita; Umap, Arati; Umap, Archana; Shelar, Nitin; Devchakke, Sampada; Chaudhary, Sharda; Bondre, Suvarna; Walke, Savita; Gawhane, Ashleshsa; Sapkal, Anil; Argade, Rupali; Gaikwad, Vijay; Brashier, Sundeep Bill; Londhe, Jyoti; Madas, Sapna; Aikman, Althea Akosua Francia; Sooronbaev, Talant M.; Estebesova, Bermet M.; Akmatalieva, Meerim; Usenbaeva, Saadat; Kydyrova, Jypara; Bostonova, Eliza; Sheraliev, Ulan; Marajapov, Nuridin; Toktogulova, Nurgul; Emilov, Berik; Azilova, Toktogul; Beishekeeva, Gulnara; Dononbaeva, Nasyikat; Tabyshova, Aijamal; Mwangoka, Ernest; Kambwili, Mayamiko; Chipeta, Martha; Banda, Gloria; Mkandawire, Suzgo; Banda, Justice; Sholehah, Siti; Benjelloun, Mohamed C.; Nejjari, Chakib; Elbiaze, Mohamed; El Rhazi, Karima; Franssen, F.F.E.; Wesseling, G.J.; Erhabor, Gregory; Awopeju, Olayemi; Adewole, Olufemi; Endresen, Tina; Svendsen, Lene Løvendahl; Irfan, Muhammad; Fatmi, Zafar; Zahidie, Aysha; Shaukat, Natasha; Iqbal, Meesha; Idolor, Luisito F.; de Guia, Teresita S.; Francisco, Norberto A.; Roa, Camilo C.; Ayuyao, Fernando G.; Tady, Cecil Z.; Tan, Daniel T.; Banal-Yang, Sylvia; Balanag, Vincent M.; Reyes, Maria Teresita N.; Dantes, Renato B.; Amarillo, Lourdes; Berratio, Lakan U.; Fernandez, Lenora C.; Garcia, Gerard S.; Naval, Sullian S.; Reyes, Thessa; Roa, Camilo C.; Sanchez, Ma. Flordeliza; Simpao, Leander P.; Nizankowska-Mogilnicka, Ewa; Frey, Jakub; Harat, Rafal; Nastalek, Pawel; Pajak, Andrzej; Skucha, Wojciech; Szczeklik, Andrzej; Twardowska, Magda; Bárbara, Cristina; Rodrigues, Fátima; Dias, Hermínia; Cardoso, João; Almeida, João; Matos, Maria João; Simão, Paula; Santos, Moutinho; Ferreira, Reis; Alorainy, H.; El-Hamad, E.; Al Hajjaj, Hajjaj; Hashi, A.; Dela, R.; Fanuncio, R.; Doloriel, E.; Marciano, I.; Safia, L.; Bateman, Eric; Jithoo, Anamika; Adams, Desiree; Barnes, Edward; Freeman, Jasper; Hayes, Anton; Hlengwa, Sipho; Johannisen, Christine; Koopman, Mariana; Louw, Innocentia; Ludick, Ina; Olckers, Alta; Ryck, Johanna; Storbeck, Janita; Gunasekera, Kirthi; Wickremasinghe, Rajitha; Elsadig, Hana A.; Osman, Nada Bakery; Noory, Bandar Salah; Mohamed, Monjda Awad; Osman, Hasab Alrasoul Akasha Ahmed; ed Elhassan, Namarig Moham; El Zain, Abdel Mu'is; Mohamaden, Marwa Mohamed; Khalifa, Suhaiba; Elhadi, Mahmoud; Hassan, Mohand; Abdelmonam, Dalia; Kamal, Rashid; Eltigani, Hind; Umar, Stephen's; Abdeen, Aya; Osman, Mihad; Mohamed, Malaz; Eltayeb, Roa; Abelazeez, Mohamed; Altaher, Hoyam; Mohamed, Lina; Abdarahman, Rabee; Mohamed, Rayan; Haram, NN; Ismaeel, Rimaz; Olafsdottir, Inga Sif; Nisser, Katarina; Spetz-Nyström, Ulrike; Hägg, Gunilla; Lund, Gun-Marie; Lutchmansingh, Fallon; Conyette, Liane; Tabka, Zouhair; Daldoul, Hager; Boukheroufa, Zaki; Chouikha, Firas; Khalifa, Wahbi Belhaj; Kocabaş, Ali; Hancioglu, Attila; Hanta, Ismail; Kuleci, Sedat; Turkyilmaz, Ahmet Sinan; Umut, Sema; Unalan, Turgay; Gnatiuc, Louisa; Azar, Hadia; Patel, Jaymini; Amor, Caron; Potts, James; Tumilty, Michael; McLean, Fiona; Dudhaiya, Risha; McBurnie, Mary Ann; Vollmer, William M.; Gillespie, Suzanne; Sullivan, Sean; Lee, Todd A.; Weiss, Kevin B.; Jensen, Robert L.; Crapo, Robert; Enright, Paul; Cain, John; Copeland, Rebecca; Hazen, Dana; Methvin, Jennifer (Journal article; Peer reviewed, 2023)
      Background Chronic obstructive pulmonary disease has been associated with exposures in the workplace. We aimed to assess the association of respiratory symptoms and lung function with occupation in the Burden of Obstructive ...
    • Asthma, allergic rhinitis and atopic dermatitis in association with home environment - The RHINE study 

      Wang, Juan; Janson, Christer; Malinovschi, Andrei; Holm, Mathias; Franklin, Karl A.; Modig, Lars; Johannessen, Ane; Schlünssen, Vivi; Gislason, Thorarinn; Jögi, Nils Oskar; Norbäck, Dan (Journal article; Peer reviewed, 2022)
      We studied home environment exposures in relation to asthma, allergic rhinitis and atopic dermatitis among offspring of participants (parents) in the Respiratory Health in Northern Europe (RHINE) study (age ≤ 30 y). Totally ...
    • Body mass index and weight change are associated with adult lung function trajectories: the prospective ECRHS study 

      Peralta, Gabriela P.; Marcon, Alessandro; Carsin, Anne-Elie; Abramson, Michael J.; Accordini, Simone; Amaral, André F.S.; Antó, Josep Maria; Bowatte, Gayan; Burney, Peter; Corsico, Angelo; Demoly, Pascal; Dharmage, Shyamali C.; Forsberg, Bertil; Fuertes, Elaine; Garcia-Larsen, Vanessa; Gislason, Thorarinn; Gullón, José-Antonio; Heinrich, Joachim; Holm, Mathias; Jarvis, Deborah; Janson, Christer; Jõgi, Rain; Johannessen, Ane; Leynaert, Bénédicte; Rovira, Jesús Martínez-Moratalla; Nowak, Dennis; Probst-Hensch, Nicole; Raherison, Chantal; Sánchez-Ramos, José Luis; Sigsgaard, Torben; Siroux, Valérie; Squillacioti, Giulia; Urrutia, Isabel; Weyler, Joost; Zock, Jan-Paul; Garcia-Aymerich, Judith (Journal article; Peer reviewed, 2020)
      Background Previous studies have reported an association between weight increase and excess lung function decline in young adults followed for short periods. We aimed to estimate lung function trajectories during adulthood ...
    • Breathlessness across generations: results from the RHINESSA generation study 

      Ekström, Magnus; Johannessen, Ane; Abramson, Michael J.; Benediktsdóttir, Bryndís; Franklin, Karl A.; Gislason, Thorarinn; Real, Francisco Gomez; Holm, Mathias; Janson, Christer; Jogi, Rain; Lowe, Adrian J.; Malinovschi, Andrei; Martínez-Moratalla, Jesús; Oudin, Anna; Sánchez-Ramos, José Luis; Schlünssen, Vivi; Svanes, Cecilie (Journal article; Peer reviewed, 2022)
      Background Breathlessness is a major cause of suffering and disability globally. The symptom relates to multiple factors including asthma and lung function, which are influenced by hereditary factors. No study has evaluated ...
    • Chronic airflow obstruction and ambient particulate air pollution 

      Amaral, André F.S.; Burney, Peter G.J.; Patel, Jaymini; Minelli, Cosetta; Mejza, F; Mannino, David M.; Seemungal, Terence A.R.; Mahesh, Padukudru Anand; Lo, Li Cher; Janson, Christer; Juvekar, Sanjay; Denguezli, Meriam; Harrabi, Imed; Wouters, Emiel F.M.; Cherkaski, Hamid; Mortimer, Kevin; Jogi, Rain; Bateman, Eric D.; Fuertes, Elaine; Al Ghobain, Mohammed; Tan, Wan; Obaseki, Daniel O.; El Sony, Asma; Studnicka, Michael; Aquart-Stewart, Althea; Koul, Parvaiz; Lawin, Herve; Nafees, Asaad Ahmed; Awopeju, Olayemi; Erhabor, Gregory E.; Gislason, Thorarinn; Welte, Tobias; Gulsvik, Amund; Nielsen, Rune; Gnatiuc, Louisa; Kocabas, Ali; Marks, Guy B.; Sooronbaev, Talant; Ngahane, Bertrand Hugo Mbatchou; Barbara, Cristina; Sonia Buist, Buist (Journal article; Peer reviewed, 2021)
      Smoking is the most well-established cause of chronic airflow obstruction (CAO) but particulate air pollution and poverty have also been implicated. We regressed sex-specific prevalence of CAO from 41 Burden of Obstructive ...
    • Clinical remission of asthma and allergic rhinitis-in a longitudinal population study 

      Heldin, Johanna; Malinovschi, Andrei; Johannessen, Ane; Alving, Kjell; Holm, Mathias; Franklin, Karl A.; Forsberg, Bertil; Schlünssen, Vivi; Jögi, Rain; Gislason, Thorarinn; Benediktsdottir, Bryndis; Svanes, Cecilie; Janson, Christer (Journal article; Peer reviewed, 2022)
      Background: Although asthma and allergic rhinitis are chronic diseases, some patients experience periods of remission. Information on prognostic factors associated with the remission of asthma and allergic rhinitis is ...
    • The coexistence of asthma and COPD: risk factors, clinical history and lung function trajectories 

      Marcon, Alessandro; Locatelli, Francesca; Dharmage, Shyamali C.; Svanes, Cecilie; Heinrich, Joachim; Leynaert, Bénédicte; Burney, Peter; Corsico, Angelo; Caliskan, Gulser; Calciano, Lucia; Gislason, Thorarinn; Janson, Christer; Jarvis, Deborah; Jõgi, Rain; Lytras, Theodore; Malinovschi, Andrei; Probst-Hensch, Nicole; Toren, Kjell; Casas, Lidia; Verlato, Giuseppe; Garcia-Aymerich, Judith; Accordini, Simone (Journal article; Peer reviewed, 2021)
      Patients with concomitant features of asthma and chronic obstructive pulmonary disease (COPD) have a heavy disease burden. Using data collected prospectively in the European Community Respiratory Health Survey, we ...
    • Cohort profile: the multigeneration Respiratory Health in Northern Europe, Spain and Australia (RHINESSA) cohort 

      Svanes, Cecilie; Johannessen, Ane; Bertelsen, Randi Jacobsen; Dharmage, Shyamali; Benediktsdottir, Bryndis; Bråbäck, Lennart; Gislason, Thorarinn; Holm, Mathias; Jögi, Oskar; Lodge, Caroline J; Malinovschi, Andrei; Martinez-Moratalla, Jesus; Oudin, Anna; Sánchez-Ramos, José Luis; Timm, Signe; Janson, Christer; Real, Francisco Gomez; Schlünssen, Vivi (Journal article; Peer reviewed, 2022)
      Purpose The Respiratory Health in Northern Europe, Spain and Australia (RHINESSA) cohort was established to (1) investigate how exposures before conception and in previous generations influence health and disease, ...
    • Cross-sectional study on exhaled nitric oxide in relation to upper airway inflammatory disorders with regard to asthma and perennial sensitization 

      Krantz, Christina; Accordini, Simone; Alving, Kjell; Corsico, Angelo G.; Demoly, Pascal; Ferreira, Diogenes S.; Forsberg, Bertil; Garcia-Aymerich, Judith; Gislason, Thorarinn; Heinrich, Joachim; Jõgi, Rain; Johannessen, Ane; Leynaert, Bénédicte; Marcon, Alessandro; Martínez-Moratalla Rovira, Jesús; Nerpin, Elisabet; Nowak, Dennis; Olin, Anna-Carin; Olivieri, Mario; Pereira-Vega, Antonio; Raherison-Semjen, Chantal; Real, Francisco Gomez; Sigsgaard, Torben; Squillacioti, Giulia; Janson, Christer; Malinovschi, Andrei (Journal article; Peer reviewed, 2022)
      Background: Fractional exhaled nitric oxide (FeNO) is a well-known marker of type-2 inflammation. FeNO is elevated in asthma and allergic rhinitis, with IgE sensitization as a major determinant. Objective: We aimed to ...
    • Dampness and mold at home and at work and onset of insomnia symptoms, snoring and excessive daytime sleepiness 

      Wang, Juan; Janson, Christer; Lindberg, Eva; Holm, Mathias; Gislason, Thorarinn; Benediktsdóttir, Bryndís; Johannessen, Ane; Schlünssen, Vivi; Jõgi, Rain; Franklin, Karl A.; Norbäck, Dan (Journal article; Peer reviewed, 2020)
      Aim To investigate whether exposure to dampness and mold at home and at work induce sleep disturbances and daytime sleepiness among adults. Materials and methods Associations between onset of sleep disturbances and ...
    • Female sex hormones and symptoms of obstructive sleep apnea in European women of a population-based cohort 

      Sigurðardóttir, Erla S.; Gislason, Thorarinn; Benediktsdottir, Bryndis; Hustad, Simon Steinar; Dadvand, Payam; Demoly, Pascal; Franklin, Karl A.; Heinrich, Joachim; Holm, Mathias; van der Plaat, Diana A.; Jõgi, Rain; Leynaert, Benedicte; Lindberg, Eva; Martinez-Moratalla, Jesus; De Aja, Leire Sainz; Pesce, Giancarlo; Pin, Isabelle; Raherison, Chantal; Pereira-Vega, Antonio; Real, Francisco Gomez; Triebner, Kai Philipp (Journal article; Peer reviewed, 2022)
      Background The prevalence of obstructive sleep apnea is higher in women after menopause. This is suggested to be a result of an altered sex hormone balance but has so far not been confirmed in a population-based ...
    • Health-related quality of life as associated with asthma control, psychological status and insomnia 

      Rask-Andersen, Anna; Leander, Mai; Sundbom, Fredrik; Lampa, Erik; Oudin, Anna; Leynaert, Bénédicte; Svanes, Cecilie; Gislason, Thorarinn; Torén, Kjell; Janson, Christer (Journal article; Peer reviewed, 2022)
      Background: Asthma is associated not only with lower health-related quality of life (HRQL) but also with psychological health and insomnia. The aim of this study was to investigate associations between HRQL, asthma symptoms, ...
    • Indoor Airborne Microbiome and Endotoxin: Meteorological Events and Occupant Characteristics Are Important Determinants 

      Abouelhana, Hesham Amin Mohamed; Šantl-Temkiv, Tina; Cramer, Christine; Finster, Kai; Gomez Real, Francisco; Gislason, Thorarinn; Holm, Mathias; Janson, Christer; Jögi, Nils Oskar; Jogi, Rain; Malinovschi, Andrei; Marshall, Ian P. G.; Modig, Lars; Norbäck, Dan; Shigdel, Rajesh; Sigsgaard, Torben; Svanes, Cecilie; Thorarinsdottir, Hulda; Wouters, Inge M.; Schlünssen, Vivi; Bertelsen, Randi Jacobsen (Journal article; Peer reviewed, 2023)
      Airborne bacteria and endotoxin may affect asthma and allergies. However, there is limited understanding of the environmental determinants that influence them. This study investigated the airborne microbiomes in the homes ...
    • Inflammatory bowel disease and asthma. Results from the RHINE study 

      Kisiel, Marta A.; Sedvall, Martin; Malinovschi, Andrei; Franklin, Karl A.; Gislason, Thorarinn; Shlunssen, Vivi; Johansson, Ane; Modig, Lars; Jogi, Rain; Holm, Mathias; Svanes, Cecilie; Lindholdt, Louise; Carlson, Marie; Janson, Christer (Journal article; Peer reviewed, 2023)
      Background Asthma and inflammatory bowel disease (IBD) are common inflammatory diseases. The aim of this study was to investigate the associations of IBD with asthma and respiratory symptoms. Methods This study is ...
    • Long-term exposure to low-level air pollution and greenness and mortality in Northern Europe. The Life-GAP project 

      Xu, Shanshan; Marcon, Alessandro; Bertelsen, Randi Jacobsen; Benediktsdottir, Bryndis; Brandt, Jørgen; Engemann, Kristine; Frohn, Lise Marie; Geels, Camilla; Gislason, Thorarinn; Heinrich, Joachim; Holm, Mathias; Janson, Christer; Markevych, Iana; Modig, Lars; Orru, Hans; Schlunssen, Vivi; Sigsgaard, Torben; Johannessen, Ane (Journal article; Peer reviewed, 2023)
      Background Air pollution has been linked to mortality, but there are few studies examining the association with different exposure time windows spanning across several decades. The evidence for the effects of green space ...
    • Low serum DHEA-S is associated with impaired lung function in women 

      Triebner, Kai; Pesce, Giancarlo; van der Plaat, Diana A.; Courbon, Dominique; Hustad, Steinar; Sigsgaard, Torben; Nowak, Dennis; Heinrich, Joachim; Antó, Jósep Maria; Dorado-Arenas, Sandra; Martínez-Moratalla, Jesús; Gullon-Blanco, Jose A.; Sánchez-Ramos, José L.; Rahérison, Chantal; Pin, Isabelle; Demoly, Pascal; Toren, Kjell; Forsberg, Bertil; Lindberg, Eva; Zemp, Elisabeth; Jogi, Rain; Probst-Hensch, Nicole; Dharmage, Shyamali C.; Jarvis, Debbie; Garcia-Aymerich, Judith; Marcon, Alessandro; Gómez-Real, Francisco; Leynaert, Bénédicte; Gislason, Thorarinn (Journal article; Peer reviewed, 2020)
      Background Emerging evidence suggests that androgens and estrogens have a role in respiratory health, but it is largely unknown whether levels of these hormones can affect lung function in adults from the general population. ...
    • Maternal and paternal tuberculosis is associated with increased asthma and respiratory symptoms in their offspring: a study from Northern Europe 

      Gyawali, Sanjay; Lopez Cervantes, Juan Pablo; Johannessen, Ane; Gislason, Thorarinn; Holm, Mathias; Janson, Christer; Jögi, Rain; Modig, Lars; Schlünssen, Vivi; Mustafa, Tehmina; Svanes, Cecilie (Journal article; Peer reviewed, 2023)
      Background: Given the profound impact of tuberculosis (TB) on immunity and given murine studies suggesting that infections may influence immunity across generations, we hypothesize that parental TB might impact health and ...
    • Nasal symptoms increase the risk of snoring and snoring increases the risk of nasal symptoms. A longitudinal population study 

      Värendh, Maria; Janson, Christer; Bengtsson, Caroline; Hellgren, Johan; Holm, Mathias; Schlünssen, Vivi; Johannessen, Ane; Franklin, Karl A.; Storaas, Torgeir; Jõgi, Rain; Gislason, Thorarinn; Lindberg, Eva (Journal article; Peer reviewed, 2021)
      Purpose Humans have a preference for nasal breathing during sleep. This 10-year prospective study aimed to determine if nasal symptoms can predict snoring and also if snoring can predict development of nasal symptoms. The ...
    • Pharmacological treatment of asthma in a cohort of adults during a 20-year period: results from the European Community Respiratory Health Survey I, II and III 

      Janson, Christer; Accordini, Simone; Cazzoletti, Lucia; Cerveri, Isa; Chanoine, S; Corsico, Angelo; Ferreira, D.S.; Garcia-Aymerich, Judith; Gislason, Thorarinn; Nielsen, Rune; Johannessen, Ane; Jõgi, Rain; Malinovschi, Andrei; Moratalla, Jesús Martínez; Marcon, Alessandro; Pin, Isabelle; Quint, JK; Siroux, Valerie; Almar, Enrique; Bellisario, Valeria; Franklin, Karl A.; Gullon, JA; Holm, Mathias; Heinrich, Joachim; Nowak, Dennis; Sánchez-Ramos, José Luis; Weyler, Joost; Jarvis, Deborah (Peer reviewed; Journal article, 2019)
      Asthma often remains uncontrolled, despite the fact that the pharmacological treatment has undergone large changes. We studied changes in the treatment of asthma over a 20-year period and identified factors associated with ...