| 1. |
- Agnafors, Sara, et al.
(författare)
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Health care utilization in children and adolescents with psychiatric disorders
- 2023
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Ingår i: Acta Psychiatrica Scandinavica. - : WILEY. - 0001-690X .- 1600-0447. ; 148:4, s. 327-337
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Mental illness is increasing among young people and likewise the request for health care services. At the same time, somatic comorbidity is common in children and adolescents with psychiatric disorders. There is a lack of studies on health care use in children and adolescents, and the hypothesis was that children and adolescents with psychiatric disorders use more primary-, and specialized somatic health care compared to children without psychiatric disorders. Methods: In this retrospective population-based register study, all individuals aged 3-17 years living in Vastra Gotaland region in Sweden in 2017 were included (n = 298,877). Linear and Poisson regression were used to compare health care use during 2016-2018 between children with and without psychiatric diagnoses, controlling for age and gender. The results were reported as unstandardised beta coefficient (beta) and adjusted prevalence ratio (aPR) respectively. Results: Having a psychiatric diagnosis was associated with more primary care visits (beta 2.35, 95% CI 2.30-2.40). This applied to most diagnoses investigated. Girls had more primary care visits than boys. Likewise, individuals with psychiatric diagnoses had more specialized somatic outpatient care (beta 1.70, 95% CI 1.67-1.73), both planned and unplanned (beta 1.23, 95% CI 1.21-1.25; beta 0.18, 95% CI 0.17-0.19). Somatic inpatient care was more common in those having a psychiatric diagnosis (aPR 1.65, 95% CI 1.58-1.72), with the diagnoses of psychosis and substance use exerting the greatest risk. Conclusions: Psychiatric diagnoses were associated with increased primary-, somatic outpatient- as well as somatic inpatient care. Increased awareness of comorbidity and easy access to relevant health care could be beneficial for patients and caregivers. The results call for a review of current health care systems with distinct division between medical disciplines and levels of health care.
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| 2. |
- Brorsson Lundqvist, Elina, et al.
(författare)
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Physical activity on prescription in Swedish primary care: a survey on use, views, and implementation determinants amongst general practitioners
- 2024
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Ingår i: Scandinavian Journal of Primary Health Care. - 0281-3432 .- 1502-7724. ; 42:1, s. 61-71
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Swedish Physical Activity on Prescription (PAP) has been shown to increase physical activity levels, which is known to lead to positive health effects. PAP is being implemented in Swedish healthcare to various extents. However, there is a lack of knowledge about how Swedish general practitioners (GPs) work with PAP and what hinders and facilitates wider implementation. Aims: This study aimed to survey GPs’ use and views of PAP, identify barriers and facilitators for implementing PAP, and explore associations to gender, practice location, and experience. Methods: The study was framed by the Normalization Process Theory. A survey was sent to 463 GPs at 69 different healthcare centres in Region Västra Götaland. Data were analysed using multiple logistic and linear regressions. Results: A total of 143 GPs completed the survey (response rate 31%). Views on PAP were generally positive amongst respondents, but only 27% reported using PAP regularly. The most prominent reported barriers were insufficient training and resources. Positive views and willingness to collaborate in using PAP were identified as facilitators. Responding GPs in Gothenburg used PAP more often (OR 6.4; 95% CI 2.7–14.8) and were significantly more positive to the method than GPs in other areas of the region. GPs with more than 10 years of practice used PAP more often (OR 2.5; 95% CI 1.1–6.0) than less experienced GPs. Few of the investigated variables were associated with gender. Conclusions: The positive views amongst responding GPs are helpful, but more education, training and resources are needed for successful implementation of PAP in Swedish primary health care.
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| 3. |
- Duggan, E. C., et al.
(författare)
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A Multi-study Coordinated Meta-analysis of Pulmonary Function and Cognition in Aging
- 2019
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Ingår i: Journals of Gerontology Series a-Biological Sciences and Medical Sciences. - : Oxford University Press (OUP). - 1079-5006 .- 1758-535X. ; 74:11, s. 1793-1804
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Tidskriftsartikel (refereegranskat)abstract
- Background: Substantial research is dedicated to understanding the aging-related dynamics among Methods: We performed coordinated analysis of bivariate growth models in data from 20,586 Results: We found consistent but weak baseline and longitudinal associations in levels of pulmonary Conclusions: Results provide limited evidence for a consistent link between simultaneous changes in
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| 4. |
- Iloson, Carina, et al.
(författare)
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Awareness of somatisation disorder among Swedish physicians at emergency departments: a cross-sectional survey.
- 2024
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Ingår i: BMC Psychiatry. - 1471-244X. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- Somatisation is a highly prevalent psychiatric syndrome in both women and men, in which psychological distress is manifested in physical symptoms without a medical explanation. Many patients with somatisation disorder are high healthcare utilisers, particularly at emergency departments. Unnecessary investigations and diagnostic operations occur frequently, which cause both patient suffering and a significant burden on the healthcare system. Emergency department physicians' awareness of somatisation and its manifestations has not previously been studied. This study aimed to investigate awareness about somatisation disorder among physicians working at emergency departments in western Sweden, and to explore differences between gender, specialty, and work experience.A web-based, cross-sectional survey consisting of six dichotomous questions about somatisation disorder was conducted, in December 2021 - January 2022, among licensed physicians of various specialties working at emergency departments in western Sweden. Descriptive analyses and comparative analyses were performed to investigate differences between gender, type of specialty, and years of practice. Data were analysed using chi2 tests and Fisher's exact test.Of the 526 eligible physicians who received the survey, 241 responded; response rate 45.8%. The majority of the respondents (56.4%) were women, and most (35.3%) were specialised in obstetrics/gynaecology. Average years of work experience was 11.1 (SD 8.7) years. Although 71% of respondents were aware of the diagnosis, only 7% knew the diagnostic criteria and only 6% had ever diagnosed a patient with somatisation disorder. Female physicians were more aware of underlying factors than their male colleagues (55.7% vs. 38.2%; p=.010). Type of specialty or years of practice did not affect awareness.Awareness of somatisation disorder is low among physicians working at emergency departments in western Sweden. The findings suggest a need to increase awareness and knowledge and provide training in diagnosing the condition, to ensure correct decisions and optimal patient management. Clinical guidelines need to be developed to support diagnosis, investigation, and treatment, in Sweden as well as internationally.
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| 5. |
- Johansson, Boo, et al.
(författare)
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I Rate My Memory Quite Similar at Age 40 and at Age 70 Findings in a Swedish Longitudinal Study on Subjective Memory over a 30-Year Period
- 2020
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Ingår i: Geropsych-the Journal of Gerontopsychology and Geriatric Psychiatry. - : Hogrefe Publishing Group. - 1662-9647. ; 33:4, s. 235-244
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Tidskriftsartikel (refereegranskat)abstract
- In 1987, we administered a subjective memory questionnaire to 143 40-year-old men, and 30 years later 67 of them again responded to the same questionnaire at age 70. At the follow-up, we also instructed participants to answer the questionnaire in the same manner as they thought they did at age 40 and to perform a picture recognition and a public event test. We employed confirmatory factor analysis to model a latent subjective memory construct. A single-factor solution provided acceptable model fit to data (chi(2)(12) = 9.33, p = .68; chi(2)(12) = 10.48, p = .57) and a decent reliability at both ages for the subjective memory measurements (omega = .82 and .93, respectively). Our longitudinal invariance testing revealed only a partial weak invariance. We also fitted a latent change-score model to the data. As expected, participants on average rated their memory as poorer at age 70 than at 40. Those who reported better overall health and less anxiety reported less memory decline up to age 70. Notably, this was also the case for those who rated memory as worse at age 40. Higher stress and depression at age 70, however, were associated with worse subjective memory already at age 40. The correspondences between memory ratings and tests were low. The correlation between the subjective memory factors at age 40 and 70 was 0.58, while the correlation between the memory factor at age 70 and the retrospective subjective memory factor was 0.87. Our findings suggest that subjective memory is quite consistent, and that we are inclined to preserve the continuity of our own memory functioning over the adult lifespan.
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| 6. |
- Lundqvist, Stefan, et al.
(författare)
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The effects of a 5-year physical activity on prescription (PAP) intervention in patients with metabolic risk factors.
- 2022
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Ingår i: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 17:10
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Tidskriftsartikel (refereegranskat)abstract
- Increased physical activity (PA) has positive effects on health and longevity. In Swedish healthcare, the physical activity on prescription (PAP) method reportedly increases patients' PA levels for up to 12 months, but long-term follow ups are lacking. As it remains difficult to maintain lifestyle changes, our aim was to evaluate adherence and clinical effects at a 5-year follow-up of PAP treatment in primary healthcare.This longitudinal, prospective cohort study included 444 patients, (56% female), aged 27-85 years, with at least one metabolic risk factor. Participants were offered PAP by nurses or physiotherapists. The PAP intervention included an individualised dialogue, a PA recommendation by written prescription, and individually adjusted follow-up over 5 years, according to the Swedish PAP model. Patient PA level, metabolic risk factors, and health related quality of life (HRQoL) were measured at baseline and at the 6-month, 1.5-year, 2.5-year, 3.5-year, and 5-year follow-ups. Estimated latent growth curves were used to examine levels and rates of change in the outcomes.The study dropout rate was 52%, with 215 of 444 patients completing the 5-year follow-up. At follow-up, the mean PA level had increased by 730 MET-minutes per week or 3 hours of moderate-intensity PA/week when compared to baseline. During the 5-year intervention, we observed significant positive changes (p ≤ 0.05) in 9 of 11 metabolic risk factors and HRQoL parameters: body mass index, waist circumference, systolic and diastolic blood pressure, fasting plasma glucose, triglycerides, cholesterol, high-density lipoprotein, and mental component summary.This first evaluation of a 5-year PAP intervention in primary care demonstrated positive long-term (5 years) effects regarding PA level, metabolic health, and HRQoL. The recorded long-term adherence was ~50%, which is in line with medical treatment. Despite limitations, PAP can have long-term effects in an ordinary primary care setting.
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| 7. |
- Praetorius Björk, Marcus, 1982
(författare)
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Bio-behavioral inquiries regarding cognitive aging and distance to death: The role of gender, APOE, grip strength and subjective memory
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- To better understand the nature of cognitive functioning later in life, it is important to gain further knowledge regarding factors that contribute to cognitive aging. Therefore, the overall aim of this thesis was to investigate cognitive change in relation to a select set of bio-behavioral markers (i.e. gender, APOE, grip strength and subjective memory) while taking time to death into account. The studies are all based on the OCTO-Twin study, a Swedish longitudinal population-based study on people aged 80 years and older, assessed every other year, at a maximum of five times. The aim of study I was to examine gender differences in levels and rates of change in cognitive performance in the oldest old in the context of time to death. The study did not show any cognitive differences between men and women, with the exception that men showed a steeper rate of decline in semantic memory. This effect was driven by those who had developed dementia and therefore declined at a faster rate than women. The aim of study II was to explicate the assumed negative association between the apolipoprotein E (APOE) ε4 and levels and rates of cognitive change later in life. We found that there was a negative effect of the APOE ε4 allele prior to death also late in life, especially when it came to episodic memory performance. Notably, the influence of APOE on levels and rates of change was highly influenced by incident dementia. The aim of Study III was to examine potential associations regarding levels and change between cognitive performance and grip strength later in life. The results indicated consistent developmental associations across all cognitive domains in levels and rates of cognitive change and grip strength. In study IV, we investigated level and rate of change in subjective memory in relation to impending death, in addition to its associations with objective memory measurements. The results showed a subjective decline in memory in relation to impending death and that the level and within-person change in subjective memory and objective memory are related. In sum, this thesis shows that gender, APOE, grip strength and subjective memory are related to cognitive decline in relation to impending death. Keywords: levels and rates of change in cognitive performance, oldest old, time to death, APOE, gender, grip strength, subjective memory
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| 8. |
- Praetorius Björk, Marcus, 1982, et al.
(författare)
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Ett förlängt arbetsliv – forskning om arbetstagarnas och arbetsmarknadens förutsättningar
- 2014
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Arbetsmarknadsutskottet har genom riksdagsförvaltningens utvärderings- och forskningssekretariat tagit fram en forskningsbaserad underlagsrapport om förutsättningarna för ett längre arbetsliv. Fokus riktas i rapporten mot arbetstagare som är 55 år eller äldre. Bakgrunden är att den ökande medellivslängden och en allt äldre befolkning aktualiserar frågor om hur arbetskraften kan tas tillvara. Huvudfrågan är vilka kroppsliga och kognitiva förutsättningar det finns för att arbeta länge, samt hur arbetsmarknaden är utformad för att tillvarata erfaren arbetskraft. Underlaget belyser förutsättningar utifrån kön och olika sektorer på arbetsmarknaden, liksom hur utvecklingen har sett ut tidigare och kan förväntas se ut framöver. Utskottet har tidigare intresserat sig för frågorna, bland annat genom ett öppet seminarium om erfaren arbetskraft i mars 2013. Forskningsgenomgången har tagits fram av Marcus Praetorius, doktorand i psykologi vid Göteborgs universitet, som under hösten 2013 har deltagit i utvärderings- och forskningssekretariatets doktorandprogram med finansiering av forskningsrådet Forte (tidigare FAS). Projektledare har varit forskningssekreterare Anna Kåring Wagman. I arbetet har också forskningssekreterare Lars Eriksson och Fanny Lindvall, praktikant, deltagit. Roland Kadefors, professor i sociologi och arbetsvetenskap vid Göteborgs universitet, och Boo Johansson, professor i geropsykologi vid Göteborgs universitet, har läst och på ett mycket förtjänstfullt sätt kommenterat underlaget. Som brukligt är svarar författaren för innehåll och slutsatser i forskningsgenomgången.
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| 9. |
- Praetorius Björk, Marcus, 1982, et al.
(författare)
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Gamma-Glutamyltransferase (GGT) as a biomarker of cognitive decline at the end of life: contrasting age and time to death trajectories
- 2018
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Ingår i: International psychogeriatrics. - 1041-6102 .- 1741-203X. ; 30:7, s. 981-990
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Tidskriftsartikel (refereegranskat)abstract
- Background:: A recently published study suggests that Gamma-Glutamyltransferase (GGT) in midlife is related to an increased risk of dementia. In the present longitudinal study, we explore the effects of serum GGT on cognitive decline and dementia also in more advanced ages. Methods:: We analyzed GGT in a sample of 452 individuals, aged 80 years and older at baseline, with the purpose to explore subsequent effects on cognitive performance. We specifically modeled GGT to cognitive change, time to death, and dementia. Results:: Our main finding is that a higher level of GGT is associated with cognitive decline prior to death and vascular dementia in late life. These findings were evident across cognitive domains. Conclusions:: This is the first longitudinal study to report on significant associations in late life between GGT, cognitive performance and dementia. Further research is needed to examine the underlying mechanisms of GGT as a marker of age-related cognitive decline.
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| 10. |
- Praetorius Björk, Marcus, 1982, et al.
(författare)
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I forgot when I lost my grip - Strong associations between cognition and grip strength in level of performance and change across time in relation to impending death
- 2016
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Ingår i: Neurobiology of Aging. - : Elsevier BV. - 0197-4580. ; 38, s. 68-72
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Tidskriftsartikel (refereegranskat)abstract
- An association between level of cognitive function and grip strength is well established while evidence for longitudinal associations of change in the two functions is still unclear. We examined associations between cognition and grip strength in levels of performance and in longitudinal change in late life in a population-based sample, aged 80 years and older at baseline, followed until death. The sample consisted of 449 non-demented individuals drawn from the OCTO-twin study. A test battery assessing 6 cognitive domains and grip strength was administered at five occasions with measurements intervals of two years. We fitted time to death bivariate growth curve models, adjusted for age, education and sex which resulted in associations between grip strength and cognition in both levels of performance (across all cognitive domains) and rates of change (in four out of six domains). These results show that cognition and grip strength change conjointly in later life and that the association between cognition and grip strength is stronger prior to death than earlier in life.
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