Background
Methods
Design and setting
Participants and dropouts
Characteristics | One week | Characteristics | One week | ||
---|---|---|---|---|---|
n = 185 | % | n = 185 | % | ||
Sex | Social support | ||||
Women | 139 | 75 | 18-29 | 38 | 20 |
Men | 46 | 25 | 13-17 | 50 | 27 |
11-12 | 40 | 22 | |||
Age (years) | 10 Very good | 53 | 29 | ||
70-88 | 42 | 22 | No answer | 4 | 2 |
61-69 | 45 | 24 | |||
52-60 | 49 | 27 | Alcohol habit | ||
18-51 | 49 | 27 | Rarely/never | 78 | 42 |
Monthly | 50 | 27 | |||
Feeling painless | Weekly | 57 | 31 | ||
8-10 | 21 | 11 | |||
6-7 | 57 | 31 | Immigrant status | ||
4-5 | 49 | 27 | Immigrant | 23 | 12 |
0-3 Nearly painless | 58 | 31 | Swede | 162 | 88 |
Sleep structure | Civil status | ||||
Big/very big problem | 88 | 48 | Living alone | 61 | 33 |
Moderate problem | 60 | 32 | Living with somebody | 124 | 67 |
No/small problem | 37 | 20 | |||
Education | |||||
Feeling rested | Grade school | 75 | 41 | ||
Big/very big problem | 76 | 41 | Secondary school | 58 | 31 |
Moderate problem | 53 | 29 | College/university | 52 | 28 |
No/small problem | 56 | 30 | |||
Work capacity | |||||
Diet | 0% | 64 | 34 | ||
General diet | 161 | 87 | 25-100% | 53 | 29 |
Special diet | 24 | 13 | Retired | 51 | 28 |
No answer | 17 | 9 | |||
High effort of exercise | |||||
Irregularly/never | 109 | 59 | Socioeconomic status, | ||
1 time per week | 25 | 13 | main occupation | ||
>2 times per week | 51 | 28 | Group A | 70 | 38 |
Group B | 44 | 24 | |||
Medium effort of exercise | Group C | 56 | 30 | ||
Irregularly/never | 100 | 54 | Group D | 12 | 6 |
1 time per week | 19 | 10 | No answer | 3 | 2 |
>2 times per week | 66 | 36 | |||
Socioeconomic status, | |||||
Low effort of exercise | current occupation | ||||
Irregularly/never | 50 | 27 | Group A | 26 | 14 |
1 time per week | 15 | 8 | Group B | 12 | 7 |
>2 times per week | 120 | 65 | Group C | 32 | 17 |
Group D | 90 | 49 | |||
Perform hobbies | No answer | 25 | 13 | ||
Rarely/never | 60 | 32 | |||
Often/sometimes | 125 | 68 | Rheumatic disease | ||
Local/general pain | 25 | 14 | |||
Feeling sexual lust | Osteoarthritis | 24 | 13 | ||
Rarely/never | 81 | 44 | Systemic rheumatic disease | 19 | 10 |
Often/sometimes | 87 | 47 | Infl. joint disease | 117 | 63 |
No answer | 17 | 9 | |||
SOC | |||||
21-55 | 48 | 26 | |||
56-66 | 49 | 27 | |||
67-75 | 48 | 26 | |||
75-90 Very good | 40 | 21 |
Data collection
Instruments
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In order to assess HRQL the Short Form-36 health survey (SF-36), a general questionnaire was used [16]. The Swedish version of SF-36 has shown good reliability and validity [17‐19]. The SF-36 gives eight subscales assessing different aspects of HRQL: Physical Functioning (PF), Role - Physical (RP), Bodily Pain (BP), General Health (GH), Vitality (VT), Social Functioning (SF), Role - Emotional (RE) and Mental Health (MH). The score for each of the eight subscales ranged from 0 to100. A higher score indicated better health [16].
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Feeling painless was assessed by a general question about the average pain intensity the past week and the response ranged from 0 to10, where a lower score indicated less pain (study specific question).
-
Sleep structure was assessed by three questions regarding experiences of problems falling asleep, frequent awakenings during the night and early morning awakening. A fourth question, assessing not feeling rested after sleep, represented a more qualitative aspect of non-restorative sleep and was introduced separately in the analyses as feeling rested. Sleep structure and feeling rested were assessed with five alternatives: (1) No problems; (2) Small problems; (3) Some problems; (4) Great problems; and (5) Very great problems [20‐22].
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Diet was assessed with six alternatives: (1) General diet; (2) Only lacto-vegetarian diet; (3) Most lacto-vegetarian diet but occasionally eat fish and egg; (4) Vegan diet; (5) Gluten-free diet; and (6) Other diet, please describe [23].
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Exercise habits were assessed by three questions about the frequency of exercise on different levels of effort: high, medium and low effort. There were five alternatives: (1) Never; (2) Irregularly; (3) One time per week; (4) Two times per week; and (5) Three or more times per week [24].
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Performing hobbies was assessed with four alternatives: (1) Never; (2) Rarely; (3) Sometimes; and (4) Often (study specific question).
-
Feeling sexual lust was assessed with four alternatives: (1) Never; (2) Rarely; (3) Sometimes; and (4) Often [25].
-
The SOC is a questionnaire based on Antonovsky's salutogenic theory and was used to assess the sense of coherence, measured by comprehensibility, manageability and meaningfulness. The version with 13 questions was selected [10] since this shorter version has shown good reliability and validity [26, 27]. The score for each of the questions ranged from 1 to 7. A higher score indicated a strong SOC [27].
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The Social Network and Social Support Scale (SNASS) is a questionnaire used to assess social network and social support and consists of 19 items. SNASS has shown good reliability and validity [28, 29]. The 10 questions that affect emotional support and practical assistance were included in the present study. The score for each of the 10 questions ranged from: Yes, absolutely = one point; Yes, partly = two points; and No = three points. A lower score indicated a strong emotional support and practical assistance [28, 29].
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Alcohol habit assessed the frequency of alcohol use with five alternatives: (1) Never; (2) Very seldom; (3) Monthly; (4) One or two times per week; and (5) Daily [20].
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Work capacity assessed the degree of the work capacity with six alternatives: (1) 100%; (2) 75%; (3) 50%; (4) 25%; (5) No work capacity; and (6) Retired (study specific question).
-
Socioeconomic status was based on the occupation and classified according to the Swedish socioeconomic classification system, SEI [30].
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The diagnosed rheumatic disease was obtained from medical records.
Statistical procedure and analysis
PF | RP | BP | GH | VT | SF | RE | MH | ||
---|---|---|---|---|---|---|---|---|---|
n = 185 OR (95% CI) | n = 185 OR (95% CI) | n = 185 OR (95% CI) | n = 185 OR (95% CI) | n = 185 OR (95% CI) | n = 185 OR (95% CI) | n = 185 OR (95% CI) | n = 185 OR (95% CI) | ||
Sex | Women | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Men | 1.0 (0.4-2.3) | 1.2 (0.6-2.6) | 1.3 (0.6-2.6) | 1.7 (0.8-3.8) | 0.7 (0.4-1.5) | 1.6 (0.8-3.4) | 1.4 (0.6-3.0) | 1.1 (0.5-2.5) | |
Age | 70-88 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
(years) | 61-69 | 3.1 (0.9-9.6) | 1.1 (0.4-3.2) | 1.1 (0.5-2.8) | 0.8 (0.3-2.2) | 0.8 (0.3-1.9) | 0.8 (0.3-2.0) | 2.1 (0.8-5.4) | 1.8 (0.7-4.9) |
52-60 | 3.8 (1.2-11.8) | 3.3 (1.2-9.0) | 1.7 (0.7-4.1) | 1.3 (0.5-3.4) | 1.1 (0.4-2.6) | 1.4 (0.6-3.5) | 6.4 (2.3-17.3) | 2.3 (0.9-6.3) | |
18-51 | 3.6 (1.2-11.2) | 1.8 (0.7-4.9) | 0.8 (0.3-1.9) | 0.9 (0.3-2.3) | 0.6 (0.3-1.5) | 0.9 (0.4-2.2) | 2.6 (1.0-6.4) | 1.7 (0.7-4.4) | |
SF-36 at | ≥mean | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
baseline | <mean | 24.7 (10.3-59.2) | 5.6 (2.8-11.3) | 4.4 (2.2-8.8) | 9.6 (4.8-19.2) | 4.5 (2.4-8.7) | 5.4 (2.8-10.3) | 7.8 (3.6-16.6) | 10.7 (5.2-22.0) |
Feeling painless | 8-10 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
6-7 | 0.4 (0.1-1.8) | 1.4 (0.4-5.3) | 2.5 (0.7-8.7) | 0.6 (0.2-1.9) | 1.4 (0.4-4.3) | 1.2 (0.4-3.7) | 0.9 (0.3-2.9) | 2.6 (0.7-9.2) | |
4-5 | 0.3 (0.1-1.4) | 1.4 (0.4-5.5) | 5.5 (1.6-19.3) | 0.7 (0.2-2.3) | 1.7 (0.5-5.6) | 3.0 (0.9-9.7) | 0.8 (0.3-2.7) | 1.7 (0.5-6.4) | |
0-3 Nearly painless | 0.4 (0.1-1.8) | 2.2 (0.6-8.4) | 7.9 (1.8-35.3) | 1.1 (0.3-3.5) | 2.9 (0.9-9.4) | 2.1 (0.6-6.8) | 1.4 (0.4-4.7) | 2.2 (0.6-8.0) | |
Sleep structure | Big/very big problem | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Moderate problem | 1.6 (0.6-3.8) | 1.3 (0.6-2.9) | 2.0 (0.9-4.2) | 2.1 (0.9-4.7) | 2.1 (1.0-4.4) | 2.0 (0.9-4.3) | 1.4 (0.7-3.1) | 1.2 (0.5-2.6) | |
No/small problem | 1.1 (0.4-3.1) | 1.9 (0.8-4.7) | 1.7 (0.7-4.1) | 3.1 (1.2-7.8) | 3.3 (1.4-7.8) | 1.9 (0.8-4.7) | 1.0 (0.4-2.3) | 0.9 (0.4-2.3) | |
Feeling rested | Big/very big problem | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Moderate problem | 1.2 (0.5-3.2) | 2.2 (0.9-5.3) | 1.9 (0.9-4.2) | 1.6 (0.7-3.8) | 3.2 (1.4-7.1) | 1.4 (0.6-3.1) | 1.6 (0.7-3.6) | 2.0 (0.8-4.6) | |
No/small problem | 1.2 (0.5-3.1) | 2.6 (1.0-6.4) | 4.0 (1.7-9.3) | 2.5 (1.0-5.8) | 4.6 (2.0-10.6) | 3.4 (1.4-8.2) | 1.5 (0.7-3.5) | 1.5 (0.6-3.6) | |
Diet | General diet | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Special diet | 1.4 (0.5-4.6) | 1.1 (0.4-3.0) | 0.8 (0.3-1.9) | 0.6 (0.2-1.7) | 1.6 (0.6-4.3) | 0.7 (0.3-1.9) | 0.9 (0.3-2.3) | 2.1 (0.7-6.2) | |
High effort | Irregularly/never | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
of exercise | 1 time a week | 1.0 (0.3-3.0) | 1.0 (0.4-2.7) | 0.9 (0.4-2.3) | 1.2 (0.4-3.3) | 1.1 (0.4-2.8) | 0.4 (0.1-0.9) | 1.2 (0.4-3.3) | 0.4 (0.1-1.1) |
>2 times a week | 0.9 ( 0.4-2.3) | 1.4 (0.6-3.1) | 1.1 (0.5-2.4) | 1.4 (0.6-3.2) | 1.4 (0.7-3.0) | 0.5 (0.3-1.2) | 1.0 (0.5-2.3) | 0.5 (0.2-1.1) | |
Medium effort | Irregularly/never | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
of exercise | 1 time a week | 2.1 (0.6-7.7) | 0.4 (0.1-1.6) | 0.5 (0.2-1.4) | 0.7 (0.2-2.3) | 0.9 (0.3-2.7) | 0.3 (0.1-0.9) | 0.9 (0.3-2.9) | 0.6 (0.2-2.0) |
>2 times a week | 2.0 (0.8-4.6) | 1.3 (0.6-2.8) | 1.6 (0.8-3.2) | 1.9 (0.9-4.1) | 1.3 (0.6-2.6) | 0.8 (0.4-1.6) | 1.0 (0.5-2.0) | 1.3 (0.6-2.8) | |
Low effort | Irregularly/never | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
of exercise | 1 time a week | 1.4 (0.3-6.5) | 0.6 (0.2-2.6) | 0.7 (0.2-2.3) | 0.9 (0.2-3.4) | 1.0 (0.3-3.6) | 0.8 (0.2-3.0) | 1.3 (0.3-4.7) | 1.6 (0.4-6.2) |
>2 times a week | 2.8 (1.1-7.3) | 1.4 (0.6-3.3) | 1.1 (0.6-2.3) | 1.4 (0.6-3.0) | 1.4 (0.7-2.8) | 1.6 (0.8-3.4) | 1.8 (0.8-3.9) | 1.5 (0.7-3.3) | |
Performing hobbies | Rarely/never | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Often/sometimes | 1.5 (0.6-3.5) | 1.7 (0.8-3.7) | 0.8 (0.4-1.7) | 1.1 (0.5-2.4) | 0.9 (0.5-1.8) | 0.9 (0.5-1.8) | 1.1 (0.6-2.3) | 0.9 (0.4-1.9) | |
Feeling sexual lust | Rarely/never | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Often/sometimes | 1.5 (0.7-3.5) | 1.0 (0.5-2.1) | 0.7 (0.4-1.4) | 0.5 (0.3-1.2) | 0.8 (0.4-1.6) | 0.6 (0.3-1.3) | 1.8 (0.9-3.8) | 2.0 (0.9-4.4) |
PF | RP | BP | GH | VT | SF | RE | MH | ||
---|---|---|---|---|---|---|---|---|---|
n = 185 OR (95% CI) | n = 185 OR (95% CI) | n = 185 OR (95% CI) | n = 185 OR (95% CI) | n = 185 OR (95% CI) | n = 185 OR (95% CI) | n = 185 OR (95% CI) | n = 185 OR (95% CI) | ||
SOC | 21-55 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
56-66 | 1.2 (0.4-3.4) | 2.9 (0.9-8.5) | 3.0 (1.2-7.2) | 3.1 (1.1-8.4) | 2.8 (1.1-7.0) | 2.4 (0.9-5.8) | 6.3 (2.3-17.7) | 4.7 (1.7-12.7) | |
67-75 | 1.7 (0.5-5.1) | 3.4 (1.2-9.8) | 3.3 (1.3-8.1) | 3.1 (1.1-8.6) | 2.7 (1.1-7.0) | 3.2 (1.2-8.2) | 5.6 (2.0-15.5) | 7.5 (2.5-22.4) | |
75-90 Very good | 1.6 (0.5-5.2) | 4.9 (1.6-15.6) | 5.6 (2.0-15.5) | 5.1 (1.7-15.8) | 7.8 (2.6-23.4) | 9.0 (2.9-27.9) | 11.8 (3.5-39.7) | 10.1 (2.9-35.1) | |
Social support | 18-29 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
13-17 | 2.9 (0.9-9.1) | 1.6 (0.5-4.4) | 1.6 (0.6-4.0) | 2.2 (0.8-6.2) | 1.2 (0.5-3.2) | 1.5 (0.6-3.9) | 3.0 (1.1-8.1) | 1.3 (0.5-3.5) | |
11-12 | 2.2 (0.6-7.2) | 1.9 (0.7-5.7) | 1.2 (0.5-3.3) | 1.6 (0.6-4.9) | 1.9 (0.7-5.3) | 1.3 (0.5-3.6) | 6.0 (1.9-18.5) | 2.5 (0.8-7.5) | |
10 Very good | 2.2 (0.7-6.9) | 2.2 (0.8-6.3) | 1.8 (0.7-4.6) | 2.4 (0.9-6.6) | 2.1 (0.8-5.4) | 1.8 (0.7-4.6) | 5.2 (1.8-15.0) | 1.6 (0.6-4.4) | |
Alcohol habit | Rarely/never | 1.0 | 1.0 | 1. 0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Monthly | 1.1 (0.4-2.9) | 0.7 (0.3-1.7) | 0.8 (0.4-1.8) | 1.1 (0.5-2.5) | 0.7 (0.3-1.5) | 1.1 (0.5-2.5) | 0.9 (0.4-2.2) | 1.4 (0.6-3.3) | |
Weekly | 1.0 (0.4-2.5) | 0.6 (0.3-1.5) | 1.0 (0.5-2.2) | 0.9 (0.4-2.0) | 1.5 (0.7-3.2) | 1.2 (0.5-2.6) | 0.8 (0.4-1.8) | 0.6 (0.3-1.5) | |
Immigrant status | Immigrant | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Swede | 0.7 (0.2-2.6) | 1.5 (0.5-4.4) | 2.2 (0.8-5.8) | 0.9 (0.3-2.4) | 0.6 (0.2-1.6) | 2.1 (0.8-5.5) | 1.5 (0.5-4.2) | 2.8 (0.9-8.0) | |
Civil status | Living alone | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Living with | 0.9 (0.4-2.2) | 0.7 (0.3-1.4) | 0.6 (0.3-1.2) | 1.0 (0.5-2.1) | 0.5 (0.3-1.1) | 0.6 (0.3-1.3) | 1.0 (0.5-2.1) | 0.6 (0.3-1.2) | |
somebody | |||||||||
Education | Grade school | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Secondary school | 1.4 (0.6-3.6) | 1.3 (0.6-3.0) | 1.5 (0.7-3.2) | 1.3 (0.6-2.9) | 1.0 (0.5-2.2) | 3.1 (1.4-7.0) | 1.2 (0.5-2.6) | 1.9 (0.8-4.3) | |
College/university | 2.1 (0.8-5.7) | 1.7 (0.7-4.0) | 1.2 (0.6-2.7) | 0.8 (0.3-1.8) | 1.4 (0.6-3.0) | 1.6 (0.7-3.6) | 1.4 (0.6-3.1) | 1.7 (0.7-4.0) | |
Work capacity | 0% | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
25-100% | 3.3 (1.2-9.2) | 3.0 (1.2-7.2) | 2.7 (1.2-6.0) | 1.9 (0.8-4.7) | 1.6 (0.7-3.6) | 1.7 (0.8-4.0) | 1.8 (0.8-4.4) | 4.3 (1.6-11.5) | |
Retired | 0.9 (0.2-4.6) | 3.7 (0.6-21.6) | 1.6 (0.4-6.3) | 2.7 (0.6-11.3) | 1.4 (0.4-5.4) | 1.2 (0.3-4.8) | 0.8 (0.2-3.2) | 0.8 (0.2-3.9) | |
Socioeconomic | Group A | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
status, | Group B | 1.5 (0.6-4.3) | 2.0 (0.8-5.1) | 1.2 (0.5-2.7) | 0.5 (0.2-1.2) | 1.4 (0.6-3.2) | 1.7 (0.7-4.0) | 1.8 (0.7-4.2) | 1.5 (0.6-3.8) |
main | Group C | 1.5 (0.6-4.0) | 1.6 (0.6-3.8) | 0.9 (0.4-2.0) | 0.8 (0.4-1.9) | 1.1 (0.5-2.4) | 1.4 (0.6-3.1) | 2.2 (0.9-5.2) | 1.6 (0.7-3.9) |
occupation | Group D | 0.3 (0.1-1.8) | 0.4 (0.1-2.2) | 0.5 (0.1-2.0) | 0.4 (0.1-2.0) | 1.9 (0.5-7.3) | 1.3 (0.3-5.1) | 1.1 (0.3-4.5) | 2.3 (0.5-9.8) |
Socioeconomic | Group A | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
status, | Group B | 0.7 (0.1-4.4) | 3.3 (0.6-17.9) | 1.4 (0.3-6.6) | 0.7 (0.1-4.2) | 1.1 (0.3-5.0) | 3.3 (0.6-17.9) | 1.8 (0.3-10.0) | 4.6 (0.6-35.7) |
current | Group C | 0.9 (0.2-3.7) | 2.9 (0.8-11.1) | 1.0 (0.3-3.2) | 0.4 (0.1-1.4) | 1.2 (0.4-3.8) | 1.8 (0.6-6.1) | 1.9 (0.5-7.8) | 3.9 (0.9-16.7) |
occupation | Group D | 0.4 (0.1-1.5) | 1.5 (0.4-5.4) | 0.3 (0.1-0.9) | 0.1 (0.0-0.5) | 0.5 (0.2-1.3) | 0.9 (0.3-2.6) | 0.6 (0.2-1.9) | 0.7 (0.2-2.3) |
Rheumatic | Local/general pain | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
disease | Osteoarthritis | 2.2 (0.5-9.8) | 1.4 (0.3-5.8) | 0.7 (0.2-2.3) | 2.4 (0.6-9.3) | 1.3 (0.4-4.7) | 1.2 (0.3-4.1) | 0.7 (0.2-2.7) | 1.1 (0.3-4.1) |
Systemic rheumatic disease | 0.9 (0.2-4.5) | 0.8 (0.2-3.7) | 0.9 (0.3-3.1) | 0.6 (0.1-3.1) | 0.9 (0.2-3.5) | 1.0 (0.3-3.7) | 0.6 (0.2-2.3) | 1.1 (0.3-4.4) | |
Infl. joint disease | 2.1 (0.7-6.2) | 2.1 (0.7-6.2) | 1.1 (0.4-2.8) | 2.0 (0.7-5.7) | 2.5 (0.9-6.8) | 1.8 (0.7-4.7) | 0.6 (0.2-1.6) | 2.0 (0.7-5.6) |