| 41. |
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| 42. |
- Björkelund, Cecilia, 1948, et al.
(författare)
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Women's sleep: longitudinal changes and secular trends in a 24-year perspective. Results of the population study of women in Gothenburg, Sweden
- 2002
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Ingår i: Sleep. ; 25, s. 894-896
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Tidskriftsartikel (refereegranskat)abstract
- Department of Primary Health Care, Göteborg University, Göteborg, Sweden. cecilia.bjorkelund@allmed.gu.se STUDY OBJECTIVES: To present observational data on the frequency of sleep problems, sleep duration, and sleep medication in an urban female population. DESIGN: A prospective population study, initiated in 1968-69, with follow-ups in 1974-75, 1980-81, and 1992-93. SETTING: Göteborg, Sweden, with around 445,000 inhabitants. PARTICIPANTS: 1462 women born in 1908, 1914, 1918, 1922, 1930, and 205 women born in 1942 and 1954, a representative selection of women of the respective age in the general population. INTERVENTIONS: NA. MEASUREMENTS: Reported number of hours slept per night, sleep problems, use of sleeping pills, and sleep satisfaction. RESULTS: The frequency of sleep problems increased with age, as did consultations for sleep problems and the use of sleep medication, while no major differences in these parameters could be discerned in a 24-year secular trend analysis of 38- and 50-year-old women, except a lower sleeping pill use in 50-year-old women in 1992-93. An interesting finding was also that the significant reduction of the proportion of 38-year-old women sleeping more than 8 hours per night between 1968-69 and 1980-81 was not accompanied by a secular deterioration in sleep satisfaction in that age group. CONCLUSIONS: Sleep duration decreased by approximately 0.4 hours per night between the ages of 38 and 66. The frequency of sleep problems increased by around 30% between the ages of 38 and 84. The use of sleeping pills also increased, except in the 50-year-old cohort. PMID: 12489897 [PubMed - indexed for MEDLINE]
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| 43. |
- Blomstrand, Ann, et al.
(författare)
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Effects of leisure time physical activity on well-being among women in a 32-year perspective.
- 2009
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 37:7, s. 706-712
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To explore potential effects of physical activity on well-being in a population study. Results are from baseline and 32-year follow-ups. METHODS: In a population study of 1462 women in five age strata cross-sectional and prospective analysis were carried out. Activity levels were divided into low, intermediate and high. Well-being was based on self-reported well-being using a Likert-type 7-point scale. RESULTS: Cross-sectional analysis showed strong associations between level of physical activity and well-being. The odds ratio (OR) for poor well-being in women with low physical activity compared with physically more active women was, when studied cross-sectionally, after 12 years in 1980-81 3.94, 95% confidence interval (CI) 2.70-5.74, after 24 years in 1992-93 4.01, CI 2.61-6.17, and after 32 years in 2000-01 7.17, CI 3.56-14.44. Similar associations were observed when relating physical activity at baseline to subsequent well-being: after 12 years: OR 2.09, 95% CI 1.31-3.34, after 24 years: OR 2.74; 95% CI 1.56-4.83, and after 32 years: OR 1.49, 95% CI 0.77-2.88. There was a linear correlation between changes in the individual's physical activity level and her simultaneous changes in experience of well-being between 1980-81 and 1992-93 and between 1992-93 and 2000-01 as well as between 1980-81 and 2000-01. CONCLUSIONS: Strong associations were observed between leisure time physical activity level and reported experience of well-being cross-sectionally and prospectively. Well-being increased with concurrent changes in physical activity. Increased physical activity in sedentary individuals appears to promote not only health but also well-being.
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| 44. |
- Blomstrand, Ann, et al.
(författare)
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Forty-four-year longitudinal study of stroke incidence and risk factors - the Prospective Population Study of Women in Gothenburg
- 2022
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Ingår i: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 40:1, s. 139-147
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Tidskriftsartikel (refereegranskat)abstract
- Objective To assess stroke incidence over 44 years and association with risk factors. To study total stroke incidence at 60-82 years of age and risk factors. Design Prospective population study. Setting Gothenburg, Sweden, with similar to 450,000 inhabitants. Subjects A representative sample of a general population of women (1462 in total) in 5 age strata aged 38-60 years in 1968-1969 (the Population Study of Women in Gothenburg, PSWG) were followed up to the ages of 82-104 years in 2012. Further, analysis was also performed for the age interval 60-82 years. Main outcome measures Incidence of total stroke (TS), ischaemic (IS), haemorrhagic (HS), non-specified (NS) and fatal (FS) strokes and association with baseline classic risk factors (such as hypertension, atrial fibrillation, low physical activity, diabetes, high waist-hip-ratio, hyperlipidaemia, smoking), low education, mental stress, pre-eclampsia and oral health as expressed by loss of teeth and bone score. Blood pressure in levels 1-3 according to modern guidelines. Associations with atrial fibrillation, diabetes and myocardial infarction shown in survival analyses. The five cohorts contributed to risk time data concerning associations with TS in the 60-82 age interval from the examination performed when they were 60. Results Three hundred and thirty-seven (23%) women had a first-ever stroke, 64 (19%) fatal. TS was associated with physical inactivity, high triglycerides and low education in multivariable analysis. The main sub-type IS was associated with systolic blood pressure, physical inactivity and low education. Pre-eclampsia showed association with IS only in the univariable analysis. FS was associated with systolic blood pressure and smoking. During 60-82 years of age, having <20 teeth (HR 1.74, CI 1.25-2.42), diabetes (HR 2.28 CI 1.09-4.76), WHR (HR 1.29 per 0.1 units CI 1.01-1.63), systolic blood pressure (HR 1.11 per 10 units CI 1.04-1.18) and smoking (HR 1.57, CI 1.14-2.16), were associated with TS in the combined five cohorts. Conclusions Several classic risk factors showed independent associations with stroke. Vulnerability factors as low education and oral health, reflected by loss of teeth, also showed association with stroke. All these factors are possible to target in primary care preventive interventions.
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| 45. |
- Blomstrand, Ann, et al.
(författare)
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Implementation of a low-budget, lifestyle-improvement method in an ordinary primary healthcare setting: a stepwise intervention study
- 2012
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 2:4
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Tidskriftsartikel (refereegranskat)abstract
- Objective To evaluate, in an ordinary primary healthcare setting, the effects of a screening questionnaire and a self-administered health profile dealing with special reference to the involvement of motivated individuals in need of lifestyle changes. Design Intervention study in a naturalistic context, using a screening questionnaire offered to consecutive patients, followed by a self-administered health profile and a health dialogue. Setting Hisingen primary healthcare area (130033 inhabitants), Gothenburg, Sweden. Participants Men and women aged between 18 and 79, visiting any of the eight public primary healthcare centres (PCC) during an 8-month period, were presented with a screening questionnaire and, were offered, a health profile, a plasma glucose (p-glucose), blood pressure check and a health dialogue. Main outcome measures Motivation level, negative lifestyle factors in screening questionnaire and intraindividual changes in blood pressure, p-glucose, body mass index (BMI) and lifestyle factors between baseline and 1-year follow-up. Results Subjects with less favourable lifestyle and higher motivation chose to participate. A higher percentage of presumptive participants reported a less favourable lifestyle. The presumptive participants also indicated higher motivation. Participants showed more readiness to initiate lifestyle changes compared to non-participants (p<0.001). At 1-year follow-up significant reductions in BMI, waist circumference, waist–hip ratio (WHR), blood pressure and p-glucose were observed. Conclusions The results indicate that the method is on target and applicable to motivated individuals with a ‘risk profile’. A pedagogical model including a self-administered health-profile and a health dialogue, combined with emphasising the individual's own resources, seems to be a feasible method for effective preventive work in primary healthcare.
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| 46. |
- Blomstrand, Ann, et al.
(författare)
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Stroke incidence and association with risk factors in women: a 32-year follow-up of the Prospective Population Study of Women in Gothenburg
- 2014
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 4:oct 28
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To study stroke incidence among women over 32 years of age with a focus on subdividing by stroke type, to consolidate end points and associations with risk factors. Design: Prospective population study initiated in 1968–1969 with follow-ups in 1974, 1980, 1992 and 2001. Setting: Gothenburg, Sweden. Participants: A sample of 1462 women from five age strata examined in 1968–1969, representative of women in the general population. Main outcome measures: Main types of first-ever stroke and fatal stroke during 1968–2001 identified and validated. Stroke incidence rates in different age strata. Association with baseline smoking, body mass index (BMI), waist–hip ratio, hypertension, serum lipids, physical inactivity, perceived mental stress and education. Associations with atrial fibrillation (AF), diabetes, baseline hypertension and myocardial infarction (MI). Blood pressure (BP) levels 1–3, corresponding to modern guidelines, in relation to stroke risk. Results: 184 (12.6%) cases of first-ever stroke, 33 (18%) of them fatal. Validation reduced unspecified stroke diagnoses from 37% to 11%. Age-standardised incidence rate per 100 000 person-years was 448. A multivariate model showed a significant association between ischaemic stroke and high BMI: HR 1.07 (95% CI 1.02 to 1.12), smoking 1.78 (1.23 to 2.57) and low education 1.17 (1.01 to 1.35). Significant association was seen between haemorrhagic stroke and, besides age, physical inactivity 2.18 (1.04 to 4.58) and for total stroke also hypertension 1.45 (1.02 to 2.08). Survival analysis showed a significantly increased risk of stroke in participants with diabetes (p<0.001), AF (p<0.001) and hypertension (p=0.001), but not MI. Stroke risk increased with increasing BP levels but was already seen for diastolic pressure grade 1 and particularly when combined with systolic BP grade 1; 1.62 (1.17 to 2.25). Conclusions: Hypertension, smoking, AF, diabetes and high BMI were associated with increased stroke risk. Low education was associated with stroke. Validation of National Patient Registry diagnoses to increase specified diagnoses improved data quality.
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| 47. |
- 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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| 48. |
- Brotons, Carlos, et al.
(författare)
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Attitudes toward preventive services and lifestyle: the views of primary care patients in Europe. the EUROPREVIEW patient study.
- 2012
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Ingår i: Family practice. - : Oxford University Press (OUP). - 1460-2229 .- 0263-2136. ; 29:Suppl 1
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Tidskriftsartikel (refereegranskat)abstract
- For preventive interventions in general practice to succeed, patients' points of view must be taken into account in addition to those of GPs. Objective. To explore patients’ views and beliefs about the importance of lifestyle and preventive interventions, to assess their readiness to make changes to their lifestyle and their willingness to receive support from GPs. Methods. Cross-sectional survey conducted by EUROPREV in primary care practices in 22 European countries. Patients were consecutively selected and interviewed from September 2008 to September 2009. Results. Seven thousand nine hundred and forty-seven participants, 52.2% females. Only 30.5% of risky drinkers think they need to change, as opposed to 64% of smokers, 73.5% of patients with unhealthy eating habits and 73% with lack of physical activity. Risky drinkers reported that GPs initiated a discussion on alcohol consumption less often (42%) than on smoking (63%), eating habits (59%) or physical activity (55%). Seventy-five per cent, 66% and 63% of patients without hypertension, diabetes or hypercholesterolaemia, respectively, think blood pressure, blood sugar and serum cholesterol should be checked yearly. Women (80%) think they should be screened with the cervical smear test and 72.8% of women aged 30–49 years with mammography, yearly or every 2 years. Conclusions. A high proportion of patients attending primary care with unhealthy lifestyles (especially risky drinkers) do not perceive the need to change their habits, and about half the patients reported not having had any discussion on healthy lifestyles with their GPs. Patients overestimate their need to be screened for cardiovascular risk factors and for cancer.
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| 49. |
- Brotonsc, Carlos, et al.
(författare)
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Prevention and health promotion in clinical practice: the views of general practitioners in Europe.
- 2005
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Ingår i: Preventive medicine. - : Elsevier BV. - 0091-7435. ; 40:5, s. 595-601
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Disease prevention and health promotion are important tasks in the daily practice of all general practitioners (GPs). The objective of this study was to explore the knowledge and attitudes of European GPs in implementing evidence-based health promotion and disease prevention recommendations in primary care, to describe GPs' perceived barriers to implementing these recommendations and to assess how GPs' own health behaviors affect their work with their patients. METHODS: A postal multinational survey was carried out from June to December 2000 in a random sample of GPs listed from national colleges of each country. RESULTS: Eleven European countries participated in the study, giving a total of 2082 GPs. Although GPs believe they should advise preventive and health promotion activities, in practice, they are less likely to do so. About 56.02% of the GPs answered that carrying-out prevention and health promotion activities are difficult. The two most important barriers reported were heavy workload/lack of time and no reimbursement. Associations between personal health behaviour and attitudes to health promotion or activities in prevention were found. GPs who smoked felt less effective in helping patients to reduce tobacco consumption than non-smoking GPs (39.34% versus 48.18%, P < 0.01). GPs who exercised felt that they were more effective in helping patients to practice regular physical exercise than sedentary GPs (59.14% versus 49.70%, P < 0.01). CONCLUSIONS: Significant gaps between GP's knowledge and practices persist in the use of evidence-based recommendations for health promotion and disease prevention in primary care.
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| 50. |
- Bäck, Karin, et al.
(författare)
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Relation between osteoporosis and radiographic and clinical signs of osteoarthritis/arthrosis in the temporomandibular joint: a population-based, cross-sectional study in an older Swedish population.
- 2017
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Ingår i: Gerodontology. - : Wiley. - 1741-2358 .- 0734-0664. ; 34:2, s. 187-194
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to elucidate the relation between osteoporosis and osteoarthritis/arthrosis (OA) in the temporomandibular joint (TMJ).General epidemiological data support the hypothesis that osteoporosis and OA are inversely correlated but is not conclusively investigated in the TMJ.A group of 114 representative elderly women and men, randomised from a comprehensive population study in Gothenburg, Sweden, had bone mineral density established with whole-body, dual-energy X-ray absorptiometry (DXA) as part of a health survey. In addition, dental examinations were performed, including panoramic radiographs exposed as an overview of the TMJ's and jaws. In 88 of the 80-year-old participants (48 women and 40 men), a clinical orofacial examination according to the RDC/TMD system was performed.A diagnosis of osteopenia/osteoporosis was found in 36% of the 114, with a statistically different greater proportion of women. Condylar alterations evaluated from panoramic radiographs were observed in 34%, with no significant gender difference. No significant differences were found in the proportion of individuals with osteopenia/osteoporosis and any condylar radiographic alteration or not. Forty-one of the clinically examined subjects, 47%, fulfilled the criteria for an RDC/TMD diagnosis with no gender difference. All participants graded the orofacial pain as low chronic pain. An opening capacity of <40 mm denoted a higher risk of having pain in the temporomandibular system. No association was found between clinical diagnosis of RDC/TMD and osteopenia/osteoporosis.The prevalence of osteopenia/osteoporosis appears not to be of importance for radiological or clinical findings of OA in the TMJ.
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