| 1. |
- Ålander, Ture, et al.
(författare)
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Abuse in Women and Men with and without Functional Gastrointestinal Disorders
- 2008
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Ingår i: Digestive Diseases and Sciences. - : Springer Science and Business Media LLC. - 0163-2116 .- 1573-2568. ; 53:7, s. 1856-1864
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Tidskriftsartikel (refereegranskat)abstract
- We aimed to investigate the history of abuse in childhood and adulthood and health-related quality of life (HRQL) in women and men with FGID in the general adult population. A cross-sectional study in a random population sample (n = 1,537, 20-87 years) living in Osthammar municipality, Sweden, in 1995 was performed. Persons with FGID (n = 141) and a group of abdominal symptom-free controls (SSF, n = 97) were selected by means of a validated questionnaire assessing gastrointestinal symptoms (the ASQ). Abuse, anxiety and depression (the HADS) and HRQL (the PGWB) were measured. Women with FGID had a higher risk of having a history of some kind of abuse, as compared with the SSF controls (45% vs.16%, OR = 2.0, 95% CI: 1.01-3.9; SSF = 1), in contrast to men (29% vs. 24% n.s.). Women with a history of abuse and FGID had reduced HRQL 91 (95% CI 85-97) as compared with women without abuse history 100 (95% CI 96-104, P = 0.01, "healthy" = 102-105 on PGWB). Childhood emotional abuse was a predictor for consulting with OR = 4.20 (95% CI: 1.12-15.7.7). Thus, previous abuse is common in women with FGID and must be considered by the physician for diagnosis and treatment of the disorder.
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| 2. |
- Lisspers, Karin, et al.
(författare)
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Organisation of asthma care in primary health care in Mid-Sweden
- 2005
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Ingår i: Primary Care Respiratory Journal. - : Springer Science and Business Media LLC. - 1471-4418 .- 1475-1534. ; 14:3, s. 147-153
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To investigate the organisation of asthma care in 240 primary health care centres (PHCCs) in Mid-Sweden. METHODS: A cross-sectional study. Main outcomes were occurrence and structure of nurse-based asthma clinics according to nationally recommended criteria, and access and use of spirometers. RESULTS: 238 PHCCs (99%) responded. 16% reported a complete, and 37% an incomplete, asthma clinic. 47% of PHCCs had no asthma clinic. The incomplete asthma clinics usually lacked sufficient asthma nurse time, a scheduled nurse surgery and a responsible GP. 77% of the PHCCs had access to a spirometer and on average 19 spirometries/1000 inhabitants/year were performed. There was a large variation in the use of spirometers. CONCLUSION: Half of the PHCCs had an asthma clinic and a majority had access to a spirometer. More frequent use of spirometry and increased time provision for the asthma nurse would be likely to produce a substantial improvement in the standard of asthma care in primary health care.
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| 3. |
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| 4. |
- Peterson, Magnus, et al.
(författare)
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Treatment practice in chronic epicondylitis : a survey among general practitioners and physiotherapists in Uppsala County, Sweden
- 2005
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Ingår i: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 23:4, s. 239-41
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate treatment practice among general practitioners (GPs) and physiotherapists (PTs) in chronic epicondylitis of 3 months' duration or more. DESIGN: Postal survey. SETTING AND SUBJECTS: All 129 GPs and all 77 PTs at 35 primary health care centres in Uppsala County, Sweden, received the questionnaire. MAIN OUTCOME MEASURES: Proportion of responders using various treatments (five specified alternatives + open question). RESULTS: The questionnaire was answered by 70% of the GPs and 61% of the PTs. Ergonomic counselling, stretching, and orthotic devices were common, and used to a similar extent by GPs and PTs. Acupuncture was also common, but less so among GPs than PTs. Transcutaneous electric nerve stimulation was used by relatively few GPs and PTs. The open question revealed that dynamic exercise, particularly eccentric, was used by most PTs but only one GP. A majority of GPs prescribed sick leave and anti-inflammatory treatment with an NSAID or cortisone injections. CONCLUSION: A large number of treatment methods in chronic epicondylitis were reported, none of which is properly evidence-based and some of which are even known to be ineffective. There is a need for randomized controlled studies of potentially effective treatments in this condition.
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| 5. |
- Rodhe, Nils, et al.
(författare)
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Asymptomatic bacteriuria in a population of elderly residents living in a community setting : prevalence, characteristics and associated factors
- 2006
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Ingår i: Family Practice. - : Oxford University Press (OUP). - 0263-2136 .- 1460-2229. ; 23:3, s. 303-7
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Tidskriftsartikel (refereegranskat)abstract
- Background. Asymptomatic bacteriuria (ASB) is common among the elderly in institutionalcare, but less is known about its prevalence among the elderly living in community settings.Knowledge of the prevalence of ASB in this population could contribute to a reduction inunnecessary use of antibiotics.Objective. To study the prevalence of ASB and associated health and social factors in apopulation of elderly people, aged 80 and over, in a community setting.Design. A cross-sectional study.Setting. The catchment area of a primary health care centre in a Swedish middle-sized town.Method. All residents, aged 80 and over, except for those in institutional living, were invited. Astructured interview was carried out and urinary culture obtained.Results. ASB was found in 14.8% of the participants, in 19.0% of the women and 5.8% of themen. In women independent associations with ASB were found for urinary incontinence (OR:2.99, CI: 1.60–5.60), reduced mobility (OR: 2.68, CI: 1.42–5.03) and oestrogen treatment (OR: 2.20,CI: 1.09–4.45).Conclusion. Bacteriuria is common among the elderly living in non-institutional communitysettings, especially among women, although not as common as among the elderly in institutionalsettings. A woman over 80, with urinary incontinence, and needing support to walk has arisk of nearly 50% of presenting with ASB, a condition about which there is consensus not totreat with antibiotics. This should be borne in mind when examining patients with diffusesymptomatology and an accidental finding of bacteriuria.
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| 6. |
- Vægter, Keld, et al.
(författare)
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Effect of mailed feedback on drug prescribing profiles in general practice : a seven-year longitudinal study in Storstrom County, Denmark
- 2010
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Ingår i: Upsala Journal of Medical Sciences. - : Uppsala Medical Society. - 0300-9734 .- 2000-1967. ; 115:4, s. 238-244
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Tidskriftsartikel (refereegranskat)abstract
- Background. Whether written feedback on drug prescribing in general practice affects prescribing habits is controversial. Most short-term studies showed no effect. However, the issue has not been tested in long-term studies involving the local general practitioner community. Aims of the study. To assess whether prescribing levels in general practice are affected by long-term, unsolicited, systematically repeated, mailed feedback. Methods. Each of the 94 general practices in Storstrom County, Denmark, received semi-annual, mailed feedback about their prescribing volumes and costs within 13 major drug groups, in relation to the levels for all the other 93 practices over a 7-year period in a project initiated by the local general practitioner association. Data on the number of defined daily doses (DDDs) prescribed per 1000 listed patients in each practice per 6-months, and practice characteristics, were obtained from the Pharmaceutical Database at the County Health Department. Results. There was a large variation in drug prescribing volume between practices, but little within-practice variation over time. After adjustments for the influence of practice size and other potential outcome-affecting variables, there was no evidence of a general change of prescribing volume over time, no change among practices with a high or a low prescribing level, and no significant change within the various drug groups. Conclusions. We found no significant effects on prescribing levels of mailed feedback, even when repeated semi-annually during 7 years and initiated by the local general practitioner community.
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| 7. |
- Ålander, Ture, et al.
(författare)
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Psychological illness is commonly associated with functional gastrointestinal disorders and is important to consider during patient consultation : a population-based study
- 2005
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Ingår i: BMC Medicine. - : Springer Science and Business Media LLC. - 1741-7015. ; 3:1, s. 8-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Some individuals with functional gastrointestinal disorders (FGID) suffer long-lasting symptoms without ever consulting their doctors. Our aim was to study co-morbidity and lifestyle differences among consulters and non-consulters with persistent FGID and controls in a defined adult population. METHODS: A random sample of the general adult Swedish population was obtained by a postal questionnaire. The Abdominal Symptom Questionnaire (ASQ) was used to measure GI symptomatology and grade of GI symptom severity and the Complaint Score Questionnaire (CSQ) was used to measure general symptoms. Subjects were then grouped for study by their symptomatic profiles. Subjects with long-standing FGID (n = 141) and subjects strictly free from gastrointestinal (GI) symptoms (n = 97) were invited to attend their local health centers for further assessment. RESULTS: Subjects with FGID have a higher risk of psychological illness [OR 8.4, CI95(4.0-17.5)] than somatic illness [OR 2.8, CI95(1.3-5.7)] or ache and fatigue symptoms [OR 4.3, CI95(2.1-8.7)]. Subjects with psychological illness have a higher risk of severe GI symptoms than controls; moreover they have a greater chance of being consulters. Patients with FGID have more severe GI symptoms than non-patients. CONCLUSION: There is a strong relation between extra-intestinal, mental and somatic complaints and FGID in both patients and non-patients. Psychological illness increases the chance of concomitantly having more severe GI symptoms, which also enhance consultation behaviour.
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