| 1. |
- Bergdahl, Ingvar A., et al.
(författare)
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Mercury in serum predicts low risk of death and myocardial infarction in Gothenburg women.
- 2013
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Ingår i: International archives of occupational and environmental health. - : Springer Science and Business Media LLC. - 1432-1246 .- 0340-0131. ; 86:1, s. 71-7
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Purpose Markers of mercury (Hg) exposure have shown both positive and negative associations with cardiovascular disease (CVD). We assessed the association between serum Hg (S–Hg) and risk of cardiovascular disease in a prospective population-based cohort, with attention to the roles of dental health and Wsh consumption. Methods Total mortality, as well as morbidity and mortality from acute myocardial infarction (AMI) and stroke, was followed up for 32 years in 1,391 women (initially age 38–60), in relation to S–Hg at baseline, using Cox regression models. Potential confounders (age, socioeconomic status, serum lipids, alcohol consumption, dental health, smoking, hypertension, waist-hip ratio, and diabetes) and other covariates (e.g., Wsh consumption) were also considered. Results Hazard ratios (HR) adjusted only for age showed strong inverse associations between baseline S–Hg and total mortality [highest quartile: hazard ratio (HR) 0.76; 95% conWdence interval (CI) 0.59–0.97], incident AMI (HR 0.56; CI 0.34–0.93), and fatal AMI (HR 0.31; CI 0.15–0.66). Adjustment for potential confounding factors, especially dental health, had a strong impact on the risk estimates, and after adjustment, only the reduced risk of fatal AMI remained statistically signiWcant. Conclusions There was a strong inverse association between Hg exposure and CVD. Likely, reasons are confounding with good dental health (also correlated with the number of amalgam Wllings in these age groups) and/or Wsh consumption. The results suggest potential eVects of dental health and/or Wsh consumption on CVD that deserve attention in preventive medicine.
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| 2. |
- Bixby, H., et al.
(författare)
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Rising rural body-mass index is the main driver of the global obesity epidemic in adults
- 2019
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Ingår i: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 569:7755, s. 260-4
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Tidskriftsartikel (refereegranskat)abstract
- Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities(.)(1,2) This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity(3-6). Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low- and middle-income regions-was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing-and in some countries reversal-of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.
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| 3. |
- Brorsson, Annika, et al.
(författare)
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Serious, frightening and interesting conditions: differences in values and attitudes between first-year and final-year medical students.
- 2002
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Ingår i: Medical Education. - : Wiley. - 0308-0110. ; 36:6, s. 555-560
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Tidskriftsartikel (refereegranskat)abstract
- CONTEXT AND OBJECTIVE: During medical education and training, the values and attitudes of medical students are shaped both by knowledge and by role models. In this study, the aim was to compare the views of first- and final-year students concerning patients with different medical conditions. PARTICIPANTS AND METHOD: In the spring of 1998 all first- and final-year medical students at Göteborg and Lund Universities, Sweden, were invited to answer a questionnaire. A total of 20 medical conditions were to be rated on visual analogue scales, according to three aspects: their perceived seriousness, the student's own fear of them and interest in working with these conditions in the future. RESULTS: The overall response rate was 75%. Concerning seriousness, there was a high degree of concordance between the first- and final-year students. Concerning their own fear, the concordance was less pronounced. When the conditions were rated from the aspect of interest, for the final-year students, gastric or duodenal ulcer replaced infection with Ebola virus for the first-year students, among the five highest-ranked conditions. The correlations between seriousness and fear were lower among the final-year students, but this reached statistical significance only in a few cases. DISCUSSION: A reasonable interpretation of the results is that the values and attitudes of the students were influenced by increased knowledge, as well as by role models encountered during the clinical parts of the training. Conditions less likely to be contracted become less feared, and conditions with effective treatment become more interesting; and the converse was true for each of these changes.
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| 4. |
- Di Angelantonio, E., et al.
(författare)
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Association of Cardiometabolic Multimorbidity With Mortality
- 2015
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Ingår i: JAMA. - : American Medical Association (AMA). - 0098-7484 .- 1538-3598. ; 314:1, s. 52-60
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Tidskriftsartikel (refereegranskat)abstract
- IMPORTANCE: The prevalence of cardiometabolic multimorbidity is increasing. OBJECTIVE: To estimate reductions in life expectancy associated with cardiometabolic multimorbidity. DESIGN, SETTING, AND PARTICIPANTS: Age- and sex-adjusted mortality rates and hazard ratios (HRs) were calculated using individual participant data from the Emerging Risk Factors Collaboration (689,300 participants; 91 cohorts; years of baseline surveys: 1960-2007; latest mortality follow-up: April 2013; 128,843 deaths). The HRs from the Emerging Risk Factors Collaboration were compared with those from the UK Biobank (499,808 participants; years of baseline surveys: 2006-2010; latest mortality follow-up: November 2013; 7995 deaths). Cumulative survival was estimated by applying calculated age-specific HRs for mortality to contemporary US age-specific death rates. EXPOSURES: A history of 2 or more of the following: diabetes mellitus, stroke, myocardial infarction (MI). MAIN OUTCOMES AND MEASURES: All-cause mortality and estimated reductions in life expectancy. RESULTS: In participants in the Emerging Risk Factors Collaboration without a history of diabetes, stroke, or MI at baseline (reference group), the all-cause mortality rate adjusted to the age of 60 years was 6.8 per 1000 person-years. Mortality rates per 1000 person-years were 15.6 in participants with a history of diabetes, 16.1 in those with stroke, 16.8 in those with MI, 32.0 in those with both diabetes and MI, 32.5 in those with both diabetes and stroke, 32.8 in those with both stroke and MI, and 59.5 in those with diabetes, stroke, and MI. Compared with the reference group, the HRs for all-cause mortality were 1.9 (95% CI, 1.8-2.0) in participants with a history of diabetes, 2.1 (95% CI, 2.0-2.2) in those with stroke, 2.0 (95% CI, 1.9-2.2) in those with MI, 3.7 (95% CI, 3.3-4.1) in those with both diabetes and MI, 3.8 (95% CI, 3.5-4.2) in those with both diabetes and stroke, 3.5 (95% CI, 3.1-4.0) in those with both stroke and MI, and 6.9 (95% CI, 5.7-8.3) in those with diabetes, stroke, and MI. The HRs from the Emerging Risk Factors Collaboration were similar to those from the more recently recruited UK Biobank. The HRs were little changed after further adjustment for markers of established intermediate pathways (eg, levels of lipids and blood pressure) and lifestyle factors (eg, smoking, diet). At the age of 60 years, a history of any 2 of these conditions was associated with 12 years of reduced life expectancy and a history of all 3 of these conditions was associated with 15 years of reduced life expectancy. CONCLUSIONS AND RELEVANCE: Mortality associated with a history of diabetes, stroke, or MI was similar for each condition. Because any combination of these conditions was associated with multiplicative mortality risk, life expectancy was substantially lower in people with multimorbidity.
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| 5. |
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| 6. |
- Eklund, Mona, et al.
(författare)
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Daily activities mediate the relationship between personality and quality of life in middle-aged women
- 2010
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Ingår i: Quality of Life Research. - : Springer Science and Business Media LLC. - 0962-9343 .- 1573-2649. ; 19:10, s. 1477-1486
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The aim of this study was to test a model proposing that the relationship between personality factors and women's quality of life (QoL) is mediated by degree of depression and the way in which every day activity and general health were appraised. Specifically, the paper addressed the mediating contribution of activity. METHODS: A sample of 488 women, 38 or 50 years old, filled out questionnaires regarding the target variables. The personality traits measured were extraversion and neuroticism, and the activity aspect addressed was the value linked with everyday activities. Additionally, general health and depressive state was rated. Structural equation modeling was used to analyze the data. RESULTS: A model was found where health, activity and depressive state mediated the association between personality and QoL. Health explained in total nearly 30% of the variation in QoL. Activity predicted 12% of the variance in QoL, partly as a unique factor and partly mediated by depressive state and health. Extraversion was linked to QoL only through activity, and neuroticism through depressive state and health. CONCLUSIONS: Our analysis supported that there was a link between personality and QoL and that perceived general health was an important contributor to QoL. Moreover, it contributed new knowledge regarding the importance of valued and satisfying activities. If this proves to be a consistent finding in future studies, including intervention research, monitoring women's daily activities might be a pathway to improved QoL.
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| 7. |
- Erlandsson, Lena-Karin, et al.
(författare)
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Women's Perceived Frequency of Disturbing Interruptions and Its Relationship to Self-Rated Health and Satisfaction with Life as a Whole
- 2010
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Ingår i: Stress and Health. - Oxford : Wiley. - 1532-3005 .- 1532-2998. ; 26:3, s. 225-232
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Tidskriftsartikel (refereegranskat)abstract
- Abstract: Daily occupations form a pattern dominated by a few main occupations intertwined with hidden occupations. A third category is denoted unexpected occupations or minor events that interrupt the rhythm of main and hidden occupations. The phenomenon of unexpected occupations can be interpreted as an illustration of interruptions in daily life or daily minor stressors. The study aimed to investigate women's perceived frequency of such disturbing interruptions, and possible relationships with their self-rated health and satisfaction with life as a whole. The study included 202 women aged 38 years, and 286 women aged 50 years who replied to a mailed questionnaire. The results showed that perceived high frequency of interruptions was related to poor subjective health among the younger women, and to low satisfaction with life as a whole in both age groups. Furthermore, the younger women perceived disturbing interruptions more frequently than the older ones, and among the younger women those who had children living at home and lived with a partner experienced disturbing interruptions more frequently than those without children living at home or those living single. The results should be interpreted with caution because the measurement of perceived interruptions has not yet been subjected to psychometric evaluation. Copyright (C) 2009 John Wiley & Sons, Ltd.
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| 8. |
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| 9. |
- Gaziano, Liam, et al.
(författare)
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Mild-to-moderate kidney dysfunction and cardiovascular disease : Observational and mendelian randomization analyses
- 2022
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Ingår i: Circulation. - : Wolters Kluwer. - 0009-7322 .- 1524-4539. ; 146:20, s. 1507-1517
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: End-stage renal disease is associated with a high risk of cardiovascular events. It is unknown, however, whether mild-to-moderate kidney dysfunction is causally related to coronary heart disease (CHD) and stroke.METHODS: Observational analyses were conducted using individual-level data from 4 population data sources (Emerging Risk Factors Collaboration, EPIC-CVD [European Prospective Investigation into Cancer and Nutrition-Cardiovascular Disease Study], Million Veteran Program, and UK Biobank), comprising 648 135 participants with no history of cardiovascular disease or diabetes at baseline, yielding 42 858 and 15 693 incident CHD and stroke events, respectively, during 6.8 million person-years of follow-up. Using a genetic risk score of 218 variants for estimated glomerular filtration rate (eGFR), we conducted Mendelian randomization analyses involving 413 718 participants (25 917 CHD and 8622 strokes) in EPIC-CVD, Million Veteran Program, and UK Biobank.RESULTS: There were U-shaped observational associations of creatinine-based eGFR with CHD and stroke, with higher risk in participants with eGFR values <60 or >105 mL·min-1·1.73 m-2, compared with those with eGFR between 60 and 105 mL·min-1·1.73 m-2. Mendelian randomization analyses for CHD showed an association among participants with eGFR <60 mL·min-1·1.73 m-2, with a 14% (95% CI, 3%-27%) higher CHD risk per 5 mL·min-1·1.73 m-2 lower genetically predicted eGFR, but not for those with eGFR >105 mL·min-1·1.73 m-2. Results were not materially different after adjustment for factors associated with the eGFR genetic risk score, such as lipoprotein(a), triglycerides, hemoglobin A1c, and blood pressure. Mendelian randomization results for stroke were nonsignificant but broadly similar to those for CHD.CONCLUSIONS: In people without manifest cardiovascular disease or diabetes, mild-to-moderate kidney dysfunction is causally related to risk of CHD, highlighting the potential value of preventive approaches that preserve and modulate kidney function.
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| 10. |
- Gregson, J., et al.
(författare)
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Cardiovascular Risk Factors Associated With Venous Thromboembolism
- 2019
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Ingår i: JAMA Cardiology. - : American Medical Association (AMA). - 0965-2590 .- 2380-6583 .- 2380-6591. ; 4:2, s. 163-173
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Tidskriftsartikel (refereegranskat)abstract
- IMPORTANCE It is uncertain to what extent established cardiovascular risk factors are associated with venous thromboembolism (VTE). OBJECTIVE To estimate the associations of major cardiovascular risk factors with VTE, ie, deep vein thrombosis and pulmonary embolism. DESIGN, SETTING, AND PARTICIPANTS This study included individual participant data mostly from essentially population-based cohort studies from the Emerging Risk Factors Collaboration (ERFC; 731728 participants; 75 cohorts; years of baseline surveys, February 1960 to June 2008; latest date of follow-up, December 2015) and the UK Biobank (421537 participants; years of baseline surveys, March 2006 to September 2010; latest date of follow-up, February 2016). Participants without cardiovascular disease at baseline were included. Data were analyzed from June 2017 to September 2018. MAIN OUTCOMES AND MEASURES Hazard ratios (HRs) per 1-SD higher usual risk factor levels (or presence/absence). Incident fatal outcomes in ERFC (VTE, 1041; coronary heart disease [CND], 25131) and incident fatal/nonfatal outcomes in UK Biobank (VTE, 2321; CHD, 3385). Hazard ratios were adjusted for age, sex, smoking status, diabetes, and body mass index (BMI). RESULTS Of the 731728 participants from the ERFC. 403 396 (55.1%) were female, and the mean (SD) age at the time of the survey was 51.9 (9.0) years; of the 421537 participants from the UK Biobank, 233 699 (55.4%) were female, and the mean (SD) age at the time of the survey was 56.4 (8.1) years. Risk factors for VTE included older age (ERFC: HR per decade, 2.67; 95% CI, 2.45-2.91; UK Biobank: HR, 1.81; 95% CI, 1.71-1.92), current smoking (ERFC: HR, 1.38; 95% CI, 1.20-1.58; UK Biobank: HR, 1.23; 95% CI, 1.08-1.40), and BMI (ERFC: HR per 1-SD higher BMI, 1.43; 95% CI, 1.35-1.50; UK Biobank: HR, 1.37; 95% CI, 1.32-1.41). For these factors, there were similar HRs for pulmonary embolism and deep vein thrombosis in UK Biobank (except adiposity was more strongly associated with pulmonary embolism) and similar HRs for unprovoked vs provoked VTE. Apart from adiposity, these risk factors were less strongly associated with VTE than CHD. There were inconsistent associations of VTEs with diabetes and blood pressure across ERFC and UK Biobank, and there was limited ability to study lipid and inflammation markers. CONCLUSIONS AND RELEVANCE Older age, smoking, and adiposity were consistently associated with higher VTE risk.
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