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Träfflista för sökning "WAKA:ref ;pers:(Lissner Lauren 1956);pers:(Björkelund Cecilia 1948)"

Sökning: WAKA:ref > Lissner Lauren 1956 > Björkelund Cecilia 1948

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  • Bengtsson, Calle, 1934-, et al. (författare)
  • A framework for quantifying net benefits of alternative prognostic models
  • 2012
  • Ingår i: Statistics in Medicine. - 0277-6715. ; 31:2, s. 114-130
  • Tidskriftsartikel (refereegranskat)abstract
    • New prognostic models are traditionally evaluated using measures of discrimination and risk reclassification, but these do not take full account of the clinical and health economic context.We propose a framework for comparing prognostic models by quantifying the public health impact (net benefit) of the treatment decisions they support, assuming a set of predetermined clinical treatment guidelines. The change in net benefit is more clinically interpretable than changes in traditional measures and can be used in full health economic evaluations of prognostic models used for screening and allocating risk reduction interventions.We extend previous work in this area by quantifying net benefits in life years, thus linking prognostic performance to health economic measures; by taking full account of the occurrence of events over time; and by considering estimation and cross-validation in a multiple-study setting. The method is illustrated in the context of cardiovascular disease risk prediction using an individual participant data meta-analysis. We estimate the number of cardiovascular-disease-free life years gained when statin treatment is allocated based on a risk prediction model with five established risk factors instead of a model with just age, gender and region. We explore methodological issues associated with themultistudy design and show that cost-effectiveness comparisons based on the proposed methodology are robustagainst a range of modelling assumptions, including adjusting for competing risks.
  • Bengtsson, Calle, 1934-, et al. (författare)
  • Alcohol habits in Swedish women: observations from the population study of women in Gothenburg, Sweden 1968-1993
  • 1998
  • Ingår i: Alcohol and Alcoholism. ; 33, s. 533-540
  • Tidskriftsartikel (refereegranskat)abstract
    • Department of Primary Health Care, Göteborg University, Sweden. In a prospective population study of women in Gothenburg, Sweden, three examinations were conducted with 12-year intervals between 1968-1969 and 1992-1993. There were 1462 participants aged 38-60 years in the baseline study in 1968-1969, with a participation rate of 90.1%. This paper describes longitudinal changes and secular trends with respect to women's alcohol habits. An alcohol frequency questionnaire was validated at baseline and was re-administered at all examinations. Between 1968-1969 and 1980-1981, the proportion of alcohol abstainers decreased significantly both in 38-year-old and 50-year-old women. Women reporting alcohol intake at least once per week had higher socio-economic status and higher education than other women. Serum gamma-glutamyl transpepsidase concentration was higher in women with the heavier alcohol intake, while a number of potential cardiovascular risk indicators were higher in women with the lower intake. Daily intake of wine and spirits was about as common at all three examinations, whereas moderate intake of wine and spirits was more common in 1980-1981 and 1992-1993 than in 1968-1969. There seemed to be an increase in overall consumption of alcohol, mainly due to the increase in moderate drinking, but there was no indication of a large increase in heavy consumption of alcohol. PMID: 9811207 [PubMed - indexed for MEDLINE]
  • Bengtsson, Calle, 1934-, et al. (författare)
  • Associations of serum lipid concentrations and obesity with mortality in women: 20 year follow up of participants in prospective population study in Gothenburg, Sweden
  • 1993
  • Ingår i: British Medical Journal. ; 307, s. 1385-1388
  • Tidskriftsartikel (refereegranskat)abstract
    • Department of Primary Health Care, University of Gothenburg, Sweden. OBJECTIVE--To examine association of different measures of serum lipid concentration and obesity with mortality in women. DESIGN--Prospective observational study initiated in 1968-9, follow up examination after 12 years, and follow up study based on death certificates after 20 years. SETTING--Gothenburg, Sweden. SUBJECTS--1462 randomly selected women aged 38-60 at start of study. MAIN OUTCOME MEASURES--Total mortality and death from myocardial infarction as predicted by serum cholesterol and triglyceride concentrations, body mass index, and ratio of circumference of waist to circumference of hips. RESULTS--170 women died during follow up, 26 from myocardial infarction. Serum triglyceride concentration and waist:hip ratio were significantly associated with both end points (relative risk of total mortality for highest quarter of triglyceride concentration v lower three quarters 1.86 (95% confidence interval 1.30 to 2.67); relative risk for waist:hip ratio 1.67 (1.18 to 2.36)). These associations remained after adjustment for background variables. Serum cholesterol concentration and body mass index were initially associated with death from myocardial infarction, but association was lost after adjustment for background variables. Serum triglyceride concentration and waist:hip ratio were independently predictive of both end points (logistic regression coefficient for total mortality for triglyceride 0.514 (SE 0.150), p = 0.0006; coefficient for waist:hip ratio 7.130 (1.92), p = 0.0002) whereas the other two risk factors were not (coefficient for total mortality for cholesterol concentration -0.102 (0.079), p = 0.20; coefficient for body mass index -0.051 (0.027), p = 0.05). CONCLUSIONS--Lipid risk profile appears to be different in men and women given that serum triglyceride concentration was an independent risk factor for mortality while serum cholesterol concentration was not. Consistent with previous observations in men, localisation of adipose tissue was more important than obesity per se as risk factor in women. PMID: 8274890 [PubMed - indexed for MEDLINE]
  • Bengtsson, Calle, 1934-, et al. (författare)
  • The Prospective Population Study of Women in Gothenburg, Sweden, 1968-69 to 1992-93. A 24-year follow-up study with special reference to participation, representativeness, and mortality
  • 1997
  • Ingår i: Scandinavian Journal of Primary Health Care. ; 15, s. 214-219
  • Tidskriftsartikel (refereegranskat)abstract
    • Department of Primary Health Care, Göteborg University, Sweden. OBJECTIVE: To describe the fourth phase of the Prospective Population Study of Women in Gothenburg, Sweden, with special reference to participation and survival. DESIGN: Prospective population study. SETTING: City of Gothenburg with about 430,000 inhabitants. PARTICIPANTS: 1462 participants and 128 refusers aged 38-60 years at the time of the initial study in 1968-69, 282 women who were sampled but not invited to the study in 1968-69, and 266 women participating since 1980-81 and 32 women for the first time in 1992-93. MAIN OUTCOME MEASURES: Participation rate, survival, anthropometric and metabolic characteristics. RESULTS: The participation rate throughout the study period was high. The participants were mainly characteristic of women of the same ages in the general population even after 24 years. The mortality after 24 years was higher in non-participants than in participants, while there was no difference in survival between women who were invited and women who were not invited to the study. CONCLUSIONS: The initial participants were mainly characteristic of the general population, also after a long follow-up period. The long-term survival was lower in initial refusers than in initial participants. PMID: 9444727 [PubMed - indexed for MEDLINE]
  • Bengtsson, Calle, 1934-, et al. (författare)
  • [Time to stop basing the risk on BMI]
  • 2009
  • Ingår i: Läkartidningen. - 0023-7205. ; 106:26-27, s. 1752-3
  • Tidskriftsartikel (refereegranskat)
  • Bentham, James, et al. (författare)
  • A century of trends in adult human height
  • 2016
  • Ingår i: eLIFE. ; 5
  • Tidskriftsartikel (refereegranskat)abstract
    • Being taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.522.7) and 16.5 cm (13.319.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8144.8). The height differential between the tallest and shortest populations was 19-20 cm a century ago, and has remained the same for women and increased for men a century later despite substantial changes in the ranking of countries.
  • Björkelund, Cecilia, 1948-, et al. (författare)
  • Long-term effects of a primary health care intervention program for women: lower blood pressure and stable weight
  • 2000
  • Ingår i: Family Medicine. ; 32, s. 246-251
  • Tidskriftsartikel (refereegranskat)abstract
    • Department of Primary Health Care, Sahlgrenska Hospital, Göteborg University, Sweden. cecilia.bjorkelund@allmed.gu.se BACKGROUND: In Strömstad, with 10,000 inhabitants, a cardiovascular prevention program was launched during 1985-1987 because of high rates of cardiovascular disease. To study long-term effects in women, an 8-year follow-up was conducted. METHODS: Participants (n = 114) and nonparticipants (n = 269) in the lifestyle intervention program in 1985-1987 (both groups with cardiovascular risk factors) were compared regarding risk factor levels after 8 years. Effects were also compared to another community not exposed to intervention. RESULTS: After 8 years, intervention participants showed significant reduction of mean systolic blood pressure compared to the control group and had higher intake of dietary fibers and more-positive attitudes to and better knowledge of healthy diets. There was no increase of mean body weight or serum triglyceride levels whatsoever in the intervention group. Compared with another female population not exposed to intervention, body weight and systolic blood pressure changed in a significantly more favorable way. CONCLUSIONS: Results from the prevention program could be discerned after 8 years. Advantages in risk factor changes could also be found when comparing with another female population. Given the high level of stroke in women within the community, the blood pressure advantage in the intervention group is particularly encouraging. PMID: 10782370 [PubMed - indexed for MEDLINE]
  • Björkelund, Cecilia, 1948-, et al. (författare)
  • Reproductive history in relation to relative weight and fat distribution
  • 1996
  • Ingår i: International Journal of Obesity. ; 20, s. 213-219
  • Tidskriftsartikel (refereegranskat)abstract
    • Department of Primary Health Care, Sahlgrenska University Hospital, Göteborg University, Gothenburg, Sweden. OBJECTIVE: To investigate the relationship between reproductive history and body composition. DESIGN: Prospective population study in Sweden. SUBJECTS: 1462 randomly selected women representing five separate age cohorts (38, 46, 50, 54 and 60 at the 1968-1969 baseline examination) have been followed longitudinally. MEASUREMENTS: Relative weight, fat distribution, and fat cellularity were related to menarche, parity, lactation, menopause and oestrogen medication. RESULTS: Age of menarche did not show any association with subsequent fat distribution, nor did length of lactation time. On the other hand parity was positively associated to total as well as central obesity, and lactation time was positively associated to abdominal fat cell diameter. Premenopausal women showed higher mean body weight and hip circumference than postmenopausal women of the same age. Change from pre- to postmenopausal status was associated with increase of waist circumference as well as reduction of hip circumference, resulting in an increased waist-hip ratio (WHR). Oestrogen replacement suggested some postponement of this increase. CONCLUSION: Parity and menopause are the reproductive factors most associated with gradual changes in body fat distribution. Oestrogen medication seems to play an additional role in diminishing waist circumference increase and could thus contribute to decreased cardiovascular morbidity in women. PMID: 8653141 [PubMed - indexed for MEDLINE]
  • Björkelund, Cecilia, 1948-, et al. (författare)
  • Secular trends in cardiovascular risk factors with a 36-year perspective: observations from 38- and 50-year-olds in the Population Study of women in Gothenburg
  • 2008
  • Ingår i: Scandinavian Journal of Primary Health Care. - 1502-7724. ; 26:3, s. 140-6
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: To study secular trends in cardiovascular risk factors in four different cohorts of women examined in 1968-1969, 1980-1981, 1992-1993 and 2004-2005. DESIGN: Comparison of four representative cohorts of 38- and 50-year-old women over a period of 36 years. SETTING: Gothenburg, Sweden with approximately 450,000 inhabitants. SUBJECTS: Four representative samples of 38- and 50-year-old women were invited to free health examinations (participation rate 59-90%, n =1901). MAIN OUTCOME MEASURES: Body mass index (BMI), systolic and diastolic blood pressure (SBP, DBP), leisure time exercise, use of antihypertensive medication, smoking, levels of haemoglobin, b-glucose, s-cholesterol, s-triglycerides and HDL-cholesterol. RESULTS: There was no significant difference in mean BMI from 1968-1969 versus 2004-2005. Mean leisure time exercise was significantly higher in later born cohorts; in 1968, around 15% were physically active compared with 40% in 2004. SBP and DBP, mean s-cholesterol and s-triglyceride levels were significantly lower in both 38- and 50-year-old cohorts in 2004-2005 versus 1968-1969. HDL-cholesterol (not measured until 1992-1993), showed a significantly higher mean level in 2004-2005. Reduction of risk factors was apparent in women with a high as well as low level of physical activity. Smoking declined most in women with high levels of physical activity. CONCLUSIONS: Several cardiovascular risk factors related to lifestyle have improved in middle-aged women from the 1960s until today. Most of the positive trends are observed in women with both low and high physical activity.
  • Björkelund, Cecilia, 1948-, et al. (författare)
  • Sleep disturbances in midlife unrelated to 32-year diabetes incidence: the prospective population study of women in Gothenburg
  • 2005
  • Ingår i: Diabetes Care. ; 28, s. 2739-2744
  • Tidskriftsartikel (refereegranskat)abstract
    • Department of Primary Health Care, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden. cecilia.bjorkelund@allmed.gu.se OBJECTIVE: To study the relation between diabetes incidence and sleep problems in a population-based sample of women followed for 32 years. RESEARCH DESIGN AND METHODS: The researchers conducted a prospective population study initiated in 1968-1969, with follow-ups in 1974-1975, 1980-1981, 1992-1993, and 2000-2001 in Gothenburg, Sweden. A total of 1,462 women born in 1908, 1914, 1918, 1922, and 1930, representative of women of the same ages in the general population, initially participated (90% participation rate). Reported sleep duration, sleep problems, and use of sleeping medication were related to incident diabetes from 1968 to 2000. Associations between sleep problems and diabetes were corrected for waist-to-hip ratio (WHR), BMI, subscapular skinfold, fasting blood glucose and serum lipid concentrations, blood pressure, heart rate, smoking, physical activity, education, and socioeconomic status. Additionally, associations between BMI, WHR, and sleep problems were examined. RESULTS: Over 32 years, 126 women (8.7%) developed diabetes. Associations between diabetes and initial sleep problems were tested in a Cox regression analysis, taking into consideration factors associated (P < 0.1) with diabetes. Sleep problems in 1968 did not increase risk of developing diabetes during the following 32 years. Obesity, particularly centralized, was associated with sleep problems. CONCLUSIONS: No association between sleep problems and developing diabetes was seen in this 32-year follow-up of middle-aged women. Obesity, on the other hand, known to cause increased risk of diabetes, was associated with current sleep problems. PMID: 16249549 [PubMed - indexed for MEDLINE]
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