{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T08:15:43Z","timestamp":1789978543634,"version":"4.0.1"},"reference-count":34,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2015,5,26]],"date-time":"2015-05-26T00:00:00Z","timestamp":1432598400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Several recent studies have found a higher risk of multiple sclerosis (MS) among people with a low level of education. This has been suggested to reflect an effect of smoking and lower vitamin D status in the social class associated with lower levels of education.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The objective of this paper is to investigate the association between level of education and MS risk adjusting for the known risk factors smoking, infectious mononucleosis, indicators of vitamin D levels and body size.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Within the case-control study on Environmental Factors In MS (EnvIMS), 953 MS patients and 1717 healthy controls from Norway reported educational level and history of exposure to putative environmental risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Higher level of education were associated with decreased MS risk ( p trend = 0.001) with an OR of 0.53 (95% CI 0.41\u20130.68) when comparing those with the highest and lowest level of education. This association was only moderately reduced after adjusting for known risk factors (OR 0.61, 95% CI 0.44\u20130.83). The estimates remained similar when cases with disease onset before age 28 were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>These findings suggest that factors related to lower socioeconomic status other than established risk factors are associated with MS risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1352458515579444","type":"journal-article","created":{"date-parts":[[2015,5,27]],"date-time":"2015-05-27T11:24:38Z","timestamp":1432725878000},"page":"104-111","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":43,"title":["Level of education and multiple sclerosis risk after adjustment for known risk factors: The EnvIMS study"],"prefix":"10.1177","volume":"22","author":[{"given":"Kjetil","family":"Bj\u00f8rnevik","sequence":"first","affiliation":[{"name":"Department of Global Public Health and Primary Care, University of Bergen, Norway\/The Norwegian Multiple Sclerosis Competence Center, Department of Neurology, Haukeland University Hospital, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trond","family":"Riise","sequence":"additional","affiliation":[{"name":"Department of Global Public Health and Primary Care, University of Bergen, Norway\/The Norwegian Multiple Sclerosis Competence Center, Department of Neurology, Haukeland University Hospital, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna","family":"Cortese","sequence":"additional","affiliation":[{"name":"The Norwegian Multiple Sclerosis Competence Center, Department of Neurology, Haukeland University Hospital, Norway\/The KG Jebsen Centre for MS-Research, Department of Clinical Medicine, University of Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trygve","family":"Holm\u00f8y","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Norway\/Department of Neurology, Akershus University Hospital, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margitta T","family":"Kampman","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurology, University of Troms\u00f8, Norway\/Centre for Clinical Research and Education, University Hospital of North Norway, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Magalhaes","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics and Occupational Health, McGill University, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kjell-Morten","family":"Myhr","sequence":"additional","affiliation":[{"name":"The Norwegian Multiple 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Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2015,5,26]]},"reference":[{"key":"bibr1-1352458515579444","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2012.198"},{"key":"bibr2-1352458515579444","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2009.03.019"},{"key":"bibr3-1352458515579444","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0027670"},{"key":"bibr4-1352458515579444","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0003639"},{"key":"bibr5-1352458515579444","doi-asserted-by":"publisher","DOI":"10.1111\/ene.12586"},{"key":"bibr6-1352458515579444","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.48.1.204"},{"key":"bibr7-1352458515579444","doi-asserted-by":"publisher","DOI":"10.1177\/1352458510397686"},{"key":"bibr8-1352458515579444","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kws350"},{"key":"bibr9-1352458515579444","doi-asserted-by":"publisher","DOI":"10.1136\/jech-2013-203184"},{"key":"bibr10-1352458515579444","first-page":"1013","volume":"99","author":"Shavers 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