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  • 1.
    Andréen, Lotta
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Spigset, Olav
    Andersson, Agneta
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Nyberg, Sigrid
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Bäckström, Torbjörn
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Pharmacokinetics of progesterone and its metabolites allopregnanolone and pregnanolone after oral administration of low-dose progesterone.2006In: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 54, no 3, p. 238-244Article in journal (Refereed)
  • 2. Bamia, Christina
    et al.
    Orfanos, Philippos
    Juerges, Hendrik
    Schoettker, Ben
    Brenner, Hermann
    Lorbeer, Roberto
    Aadahl, Mette
    Matthews, Charles E.
    Klinaki, Eleni
    Katsoulis, Michael
    Lagiou, Pagona
    Bueno-de-mesquita, H. B.
    Eriksson, Sture
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Mons, Ute
    Saum, Kai-Uwe
    Kubinova, Ruzena
    Pajak, Andrzej
    Tamosiunas, Abdonas
    Malyutina, Sofia
    Gardiner, Julian
    Peasey, Anne
    de Groot, Lisette C. P. G. M.
    Wilsgaard, Tom
    Boffetta, Paolo
    Trichopoulou, Antonia
    Trichopoulos, Dimitrios
    Self-rated health and all-cause and cause-specific mortality of older adults: Individual data meta-analysis of prospective cohort studies in the CHANCES Consortium2017In: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 103, p. 37-44Article in journal (Refereed)
    Abstract [en]

    Objectives: To evaluate, among the elderly, the association of self-rated health (SRH) with mortality, and to identify determinants of self-rating health as “at-least-good”.

    Study design: Individual data on SRH and important covariates were obtained for 424,791 European and United States residents, ≥60 years at recruitment (1982–2008), in eight prospective studies in the Consortium on Health and Ageing: Network of Cohorts in Europe and the United States (CHANCES). In each study, adjusted mortality ratios (hazard ratios, HRs) in relation to SRH were calculated and subsequently combined with random-effect meta-analyses.

    Main outcome measures: All-cause, cardiovascular and cancer mortality.

    Results: Within the median 12.5 years of follow-up, 93,014 (22%) deaths occurred. SRH “fair” or “poor” vs. “at-least-good” was associated with increased mortality: HRs 1.46 (95% CI 1·23–1.74) and 2.31 (1.79–2.99), respectively. These associations were evident: for cardiovascular and, to a lesser extent, cancer mortality, and within-study, within-subgroup analyses. Accounting for lifestyle, sociodemographic, somatometric factors and, subsequently, for medical history explained only a modest amount of the unadjusted associations. Factors favourably associated with SRH were: sex (males), age (younger-old), education (high), marital status (married/cohabiting), physical activity (active), body mass index (non-obese), alcohol consumption (low to moderate) and previous morbidity (absence).

    Conclusion: SRH provides a quick and simple tool for assessing health and identifying groups of elders at risk of early mortality that may be useful also in clinical settings. Modifying determinants of favourably rating health, e.g. by increasing physical activity and/or by eliminating obesity, may be important for older adults to “feel healthy” and “be healthy”.

  • 3.
    Björn, Inger
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Bäckström, Torbjörn
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Drug related negative side effects is a common reason for poor compliance in hormone replacement therapy1999In: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 32, no 2, p. 77-86Article in journal (Refereed)
    Abstract [en]

    Objectives: The reasons for poor compliance with hormone replacement therapy (HRT) and, in particular drug-related reasons, have not yet been fully elucidated. In this study, a cohort of peri- or postmenopausal women—mainly workers from a small town and surrounding rural area—was studied. The aim of the study was to investigate why some women never start or discontinue HRT, even when great effort has been made to inform and fulfill the demands of the patient. Methods: All women who were given a HRT prescription at a gynecological practice between September 1991 and December 1992 participated in a longitudinal study. A written questionnaire was mailed to these patients in 1996. Data from the questionnaire was supplemented with information from the medical records. Care of patients included initial information, follow-up within 4 months, yearly visits supplemented with contacts on demand. Results: 356 women received the questionnaire, among which 92% replied. A total of 2% never started HRT. Seventy-five percent continued the therapy for more than 3 years. Reasons for discontinuing HRT were negative side-effects (35%), desire to find out if climacteric symptoms had ended (26%), fear of cancer and thrombosis (25%), weariness of bleeding (19%) and a wish to deal with the problems ‘naturally’ (15%). Conclusions: Compliance with HRT can be high if adequate information is given and follow-ups are made. The main reason for poor compliance was negative side-effects, most likely progestin-related. The results of this study suggest that the future challenge will be to minimize negative side-effects of HRT.

  • 4.
    Dahmoun, Marju
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Ödmark, Inga-Stina
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Risberg, Björn
    Karlsson, Mats G
    Pavlenko, Tatjana
    Bäckström, Torbjörn
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Apoptosis, proliferation, and sex steroid receptors in postmenopausal endometrium before and during HRT.2004In: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 49, no 2, p. 114-123Article in journal (Refereed)
  • 5.
    Hickey, A
    et al.
    University Institute for Ageing, Newcastle University, UK.
    Newham, J
    Institute of Health and Society, Newcastle University, Newcastle upon Tyne NE2 4AX, UK.
    Slawinska, MM
    Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne NE1 8ST, UK.
    Kwasnicka, D
    School of Psychology and Speech Pathology, Curtin University, Bentley, Australia.
    McDonald, S
    Institute of Health and Society, Newcastle University, Newcastle upon Tyne NE2 4AX, UK.
    Del Din, S
    Institute of Neuroscience, Newcastle University Institute for Ageing, Newcastle University, UK.
    Sniehotta, FF
    Institute of Health and Society, Newcastle University, Newcastle upon Tyne NE2 4AX, UK.
    Davis, Paul A.
    Department of Sport, Exercise and Rehabilitation, Northumbria University, UK.
    Godfrey, Alan
    Institute of Neuroscience, Newcastle University Institute for Ageing, Newcastle University, UK.
    Estimating cut points: a simple method for new wearables2016In: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 83, p. 78-82Article in journal (Refereed)
    Abstract [en]

    Wearable technology is readily available for continuous assessment due to a growing number of commercial devices with increased data capture capabilities. However, many commercial devices fail to support suitable parameters (cut points) derived from the literature to help quantify physical activity (PA) due to differences in manufacturing. A simple metric to estimate cut points for new wearables is needed to aid data analysis.

    Objective

    The purpose of this pilot study was to investigate a simple methodology to determine cut points based on ratios between sedentary behaviour (SB) and PA intensities for a new wrist worn device (PRO-Diary™) by comparing its output to a validated and well characterised ‘gold standard’ (ActiGraph™).

    Study design

    Twelve participants completed a semi-structured (four-phase) treadmill protocol encompassing SB and three PA intensity levels (light, moderate, vigorous). The outputs of the devices were compared accounting for relative intensity.

    Results

    Count ratios (6.31, 7.68, 4.63, 3.96) were calculated to successfully determine cut-points for the new wrist worn wearable technology during SB (0–426) as well as light (427–803), moderate (804–2085) and vigorous (≥2086) activities, respectively.

    Conclusion

    Our findings should be utilised as a primary reference for investigations seeking to use new (wrist worn) wearable technology similar to that used here (i.e., PRO-Diary™) for the purposes of quantifying SB and PA intensities. The utility of count ratios may be useful in comparing devices or SB/PA values estimated across different studies. However, a more robust examination is required for different devices, attachment locations and on larger/diverse cohorts.

  • 6.
    Oudin Åström, Daniel
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Bertil, Forsberg
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Joacim, Rocklöv
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Heat wave impact on morbidity and mortality in the elderly population: a review of recent studies2011In: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 69, no 2, p. 99-105Article in journal (Refereed)
    Abstract [en]

    Future research should focus on studying susceptibilities and to non-fatal events which are not as studied as mortality. Studies on the modification of type of urban environment, housing and mortality and morbidity in the elderly population are also needed.

  • 7.
    Stewart Williams, Jennifer
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Research Centre for Gender, Health and Ageing, University of Newcastle, Australia.
    Ling, Rod
    Searles, Andrew M
    Doran, Christopher M
    Byles, Julie
    Identification of higher hospital costs and more frequent admissions among mid-aged Australian women who self-report diabetes mellitus2016In: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 90, p. 58-63Article in journal (Refereed)
    Abstract [en]

    Objective: To ascertain whether the hospital costs for mid-aged Australian women who self-reported diabetes mellitus (DM) and who had one or more hospital admission during an eight and a half year period were higher than the hospital costs for other similarly aged non-DM women. Methods: The sample comprised 2,392 mid-aged women, resident in New South Wales (NSW) Australia and participating in the Australian Longitudinal Study on Women’s Health (ALSWH), who had any NSW hospital admissions during the eight and a half year period 1 July 2000 to 31 December 2008. Analyses were conducted on linked data from ALSWH surveys and the NSW Admitted Patient Data Collection (APDC). Hospital costs were compared for the DM and non-DM cohorts of women. A generalized linear model measured the association between hospital costs and self-reported DM. Results: Eight and a half year hospital costs were 41% higher for women who self-reported DM in the ALSWH surveys (p < 0.0001). On average, women who self-reported DM had significantly (p < 0.0001) more hospital admissions (5.3) than women with no reported DM (3.4). The average hospital stay per admission was not significantly different between the two groups of women. Conclusions: Self-reported DM status in mid-aged Australian women is a predictor of higher hospital costs. This simple measure can be a useful indicator for public policy makers planning early-stage interventions that target people in the population at risk of DM.

  • 8. Triebner, Kai
    et al.
    Accordini, Simone
    Calciano, Lucia
    Johannessen, Ane
    Benediktsdóttir, Bryndís
    Bifulco, Ersilia
    Demoly, Pascal
    Dharmage, Shyamali C.
    Franklin, Karl A.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Garcia-Aymerich, Judith
    Gullón Blanco, José Antonio
    Heinrich, Joachim
    Holm, Mathias
    Jarvis, Debbie
    Jõgi, Rain
    Lindberg, Eva
    Martínez-Moratalla, Jesús
    Muniozguren Agirre, Nerea
    Pin, Isabelle
    Probst-Hensch, Nicole
    Raherison, Chantal
    Sánchez-Ramos, José Luis
    Schlünssen, Vivi
    Svanes, Cecilie
    Hustad, Steinar
    Leynaert, Bénédicte
    Gómez Real, Francisco
    Exogenous female sex steroids may reduce lung ageing after menopause: A 20-year follow-up study of a general population sample (ECRHS)2019In: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 120, p. 29-34, article id S0378-5122(18)30602-9Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Menopause involves hypoestrogenism, which is associated with numerous detrimental effects, including on respiratory health. Hormone replacement therapy (HRT) is often used to improve symptoms of menopause. The effects of HRT on lung function decline, hence lung ageing, have not yet been investigated despite the recognized effects of HRT on other health outcomes.

    STUDY DESIGN: The population-based multi-centre European Community Respiratory Health Survey provided complete data for 275 oral HRT users at two time points, who were matched with 383 nonusers and analysed with a two-level linear mixed effects regression model.

    MAIN OUTCOME MEASURES: We studied whether HRT use was associated with the annual decline in forced vital capacity (FVC) and forced expiratory volume in one second (FEV1).

    RESULTS: Lung function of women using oral HRT for more than five years declined less rapidly than that of nonusers. The adjusted difference in FVC decline was 5.6 mL/y (95%CI: 1.8 to 9.3, p = 0.01) for women who had taken HRT for six to ten years and 8.9 mL/y (3.5 to 14.2, p = 0.003) for those who had taken it for more than ten years. The adjusted difference in FEV1 decline was 4.4 mL/y (0.9 to 8.0, p = 0.02) with treatment from six to ten years and 5.3 mL/y (0.4 to 10.2, p = 0.048) with treatment for over ten years.

    CONCLUSIONS: In this longitudinal population-based study, the decline in lung function was less rapid in women who used HRT, following a dose-response pattern, and consistent when adjusting for potential confounding factors. This may signify that female sex hormones are of importance for lung ageing.

  • 9.
    Ödmark, Inga-Stina
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Bäckström, Torbjörn
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Haeger, Magnus
    Jonsson, Björn
    Bixo, Marie
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Effects of continuous combined conjugated estrogen/medroxyprogesterone acetate and 17beta-estadiol/norethisterone acetate on lipids and lipoproteins2004In: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 48, no 2, p. 137-146Article in journal (Refereed)
  • 10.
    Ödmark, Inga-Stina
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Carlström, Kjell
    Jonsson, Björn
    Jonasson, Aino Fianu
    Conjugated estrogen/progestagen versus tibolone hormone replacement therapy in postmenopausal women: effects on carbohydrate metabolism and serum sex hormone-binding globulin2006In: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 53, no 1, p. 89-96Article in journal (Refereed)
    Abstract [en]

    Objective: To study the effects of different types of continuous hormone replacement therapy on carbohydrate metabolism.

    Method: Postmenopausal women were treated with conjugated estrogens, 0.625 mg/medroxyprogesterone acetate, 2.5 or 5mg (CEE/MPA) or tibolone 2.5 mg daily for 13 28-day cycles. Serum glucose and insulin were measured before and during a 75 g oral glucose tolerance test (OGTT) at baseline and after 3, 6 and 13 cycles and areas under the curve (AUC) were calculated. Sex hormone-binding globulin (SHBG) was measured as an additional marker of nutritional and insulin status.

    Results: Neither CEE/MPA2.5 mg nor tibolone had any effects on carbohydrate metabolism whileAUCinsulin, AUCglucose and also body mass index (BMI) increased after 13 cycles of treatment in the CEE/MPA 5 mg group. SHBG increased significantly during CEE/MPA treatment and decreased significantly during treatment with tibolone. The effects on SHBG were less pronounced in the CEE/MPA 5 mg group. Pretreatment SHBG showed significant negative correlations to BMI and to variables that may reflect a certain degree of insulin resistance, the most pronounced being fasting glucose. Changes in SHBG during treatment with tibolone were negatively correlated to pretreatment SHBG and positively to BMI, AUCinsulin and fasting insulin resistance index, while no such correlations were found in the CEE/MPA groups. There were no correlations between changes in AUCinsulin and AUCglucose on one hand and basal variables or treatment SHBG on the other in the CEE/MPA groups.

    Conclusion: The effects of tibolone and CEE/MPA on carbohydrate metabolism were considered to have clinical significance only for CEE/MPA 5 mg, indicating a less favourable role of the higher progestagen dose. The results further support the important role of metabolic and insulin status in the physiological regulation of SHBG and also indicate that the suppressive effect of tibolone on circulating SHBG is mainly depends on pretreatment SHBG levels. SHBG does not reflect changes in carbohydrate metabolism during CEE/MPA treatment.

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