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16-year excess all-cause mortality of newly diagnosed type 2 diabetic patients: a cohort study.

https://arctichealth.org/en/permalink/ahliterature147637
Source
BMC Public Health. 2009;9:400
Publication Type
Article
Date
2009
Author
Lars J Hansen
Niels de Fine Olivarius
Volkert Siersma
Author Affiliation
Department of Public Health, The Research Unit for General Practice and Section of General Practice, University of Copenhagen, Copenhagen, Denmark. l.hansen@gpract.ku.dk
Source
BMC Public Health. 2009;9:400
Date
2009
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Aged
Aged, 80 and over
Cohort Studies
Denmark - epidemiology
Diabetes Mellitus, Type 2 - mortality
Female
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Mortality - trends
Risk
Risk factors
Sex Distribution
Abstract
Studies have shown that type 2 diabetic patients have higher all-cause mortality than people without diabetes, but it is less clear how diabetes affects mortality in elderly patients and to what degree mortality differs between diabetic men and women. The aim of the present study is to investigate the age- and sex-specific all-cause mortality pattern in patients with type 2 diabetes in comparison with the Danish background population.
Population-based cohort study of 1323 patients, diagnosed with clinical type 2 diabetes in 1989-92 and followed for 16 years. Median (interquartile range) age at diagnosis was 65.3 (55.8-73.6) years. The age- and sex-specific hazard rates were estimated for the cohort using the life table method and compared with the expected hazard rates calculated with Danish register data from the general population.
In comparison with the general population, diabetic patients had a 1.5-2.5 fold higher risk of dying depending on age. The over-mortality was higher for men than for women. It decreased with age in both sexes, and among patients over 80 years at diagnosis the difference between the observed and the expected survival was small.
We found an excess mortality of type 2 diabetic patients compared with the background population in all age groups. The excess mortality was most pronounced in men and in young patients.
Notes
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Cites: Diabetes Care. 1986 May-Jun;9(3):313-53731999
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PubMed ID
19878574 View in PubMed
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Alcohol consumption and mortality in patients with mild Alzheimer's disease: a prospective cohort study.

https://arctichealth.org/en/permalink/ahliterature276322
Source
BMJ Open. 2015;5(12):e007851
Publication Type
Article
Date
2015
Author
Sine Berntsen
Jakob Kragstrup
Volkert Siersma
Gunhild Waldemar
Frans Boch Waldorff
Source
BMJ Open. 2015;5(12):e007851
Date
2015
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Alcohol Drinking
Alzheimer Disease - mortality - psychology
Denmark - epidemiology
Female
Humans
Male
Prospective Studies
Abstract
To investigate the association between alcohol consumption and mortality in patients recently diagnosed with mild Alzheimer's disease (AD).
A post hoc analysis study based on a clinical trial population.
The data reported were collected as part of the Danish Alzheimer's Intervention Study (DAISY), a longitudinal multicentre randomised controlled study on the efficacy of psychosocial intervention in patients with mild AD across five county districts in Denmark.
321 patients with mild AD (Mini-Mental State Examination = 20) were included. Data regarding current daily alcohol consumption were obtained from the patient's primary caregivers at inclusion.
All-cause mortality retrieved from The Danish Civil Registration System over a period of 36 months after baseline.
Information about alcohol consumption was obtained from all 321 study participants: 8% were abstinent, 71% only had alcohol occasionally (1 or
Notes
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PubMed ID
26656463 View in PubMed
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Association between subjective memory complaints and nursing home placement: a four-year follow-up.

https://arctichealth.org/en/permalink/ahliterature99079
Source
Int J Geriatr Psychiatry. 2009 Jun;24(6):602-9
Publication Type
Article
Date
Jun-2009
Author
Frans Boch Waldorff
Volkert Siersma
Gunhild Waldemar
Author Affiliation
Research Unit and Department of General Practice, Institute of Public Health, University of Copenhagen, Denmark. fbw@gpract.ku.dk
Source
Int J Geriatr Psychiatry. 2009 Jun;24(6):602-9
Date
Jun-2009
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Attitude to Health
Denmark
Family Practice - statistics & numerical data
Female
Homes for the Aged
Humans
Institutionalization - statistics & numerical data
Male
Memory Disorders - diagnosis - epidemiology - psychology
Nursing Homes
Proportional Hazards Models
Prospective Studies
Quality of Life
Risk factors
Abstract
OBJECTIVE: In order to evaluate whether elderly persons with subjective memory complaints may be regarded as a group of potentially vulnerable patients who need close follow-up, we investigated the risk of nursing home placement during a 4-year follow-up period. METHODS: Prospective cohort survey with 4-year follow-up in general practice. Cox proportional hazard models were used to examine the influence of risk factors on nursing home placement. RESULTS: A total 758 non-nursing home residents aged 65 years and older consulted the General Practitioners in October and November 2002 of whom 50 nursing home placements were observed. Subjective memory complaints were associated with an adjusted Hazard Ratio (HR) of 2.59 for nursing home placement. Other statistical significant covariates were MMSE
PubMed ID
19058296 View in PubMed
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Back on track-Smoking cessation and weight changes over 9 years in a community-based cohort study.

https://arctichealth.org/en/permalink/ahliterature275028
Source
Prev Med. 2015 Dec;81:320-5
Publication Type
Article
Date
Dec-2015
Author
Rasmus Køster-Rasmussen
Caroline Amalie Permin
Volkert Siersma
Jan Erik Henriksen
Berit Lilienthal Heitmann
Poul Erik Heldgaard
Niels de Fine Olivarius
Source
Prev Med. 2015 Dec;81:320-5
Date
Dec-2015
Language
English
Publication Type
Article
Keywords
Adult
Aged
Cohort Studies
Denmark
Female
Humans
Male
Middle Aged
Regression Analysis
Risk factors
Smoking - physiopathology
Smoking Cessation
Weight Gain - physiology
Weight Loss - physiology
Abstract
To examine the impact of smoking cessation on body weight compared with normal long-term weight development.
Of 1970 adults (20-69 years) in a rural town in Denmark invited to take part in the study in 1998-2000, 1374 (70%) participated. After 9 years, 1121 participated in the follow-up study. Weight changes were compared using multivariable regression models.
The mean baseline weight of never-smokers was 76.4 kg (SD 16.0). The adjusted weight of smokers and ex-smokers differed by -4.2 kg (95% CI: -5.9, -2.6), and -0.7 kg (95% CI: -2.5, 1.1), respectively. The adjusted weight gain rate (kg/year) of never-smokers, smokers, and ex-smokers was 0.213, 0.127, and 0.105, respectively. The absolute post cessation weight gain (PCWG) was 5.0 kg (SD 7.0), and the adjusted PCWG was 2.8 kg (95% CI: 1.7, 3.9) compared with never-smokers, and 3.5 kg (95% CI: 2.3, 4.8) compared with smokers. The follow-up weight did not differ between quitters and never-smokers (0.1 kg; 95% CI: -2.4, 2.6).
Smokers weigh less than never-smokers. By quitting, they gain weight and end up weighing the same as comparable never-smokers. Weight gain rates differ by smoking status. Consequently, PCWG depends on the length of follow-up. Our graphical model indicates that smoking cessation results in a return to normal weight development.
PubMed ID
26441298 View in PubMed
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Benefits and harms of screening men for abdominal aortic aneurysm in Sweden: a registry-based cohort study.

https://arctichealth.org/en/permalink/ahliterature296578
Source
Lancet. 2018 06 16; 391(10138):2441-2447
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
06-16-2018
Author
Minna Johansson
Per Henrik Zahl
Volkert Siersma
Karsten Juhl Jørgensen
Bertil Marklund
John Brodersen
Author Affiliation
Department of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden; Cochrane Sweden, Skåne University Hospital, Lund, Sweden. Electronic address: minna.johansson@vgregion.se.
Source
Lancet. 2018 06 16; 391(10138):2441-2447
Date
06-16-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal - diagnosis - epidemiology - mortality - surgery
Humans
Incidence
Male
Mass Screening
Medical Overuse - statistics & numerical data
Middle Aged
Registries
Risk assessment
Sweden
Unnecessary Procedures - statistics & numerical data
Abstract
Large reductions in the incidence of abdominal aortic aneurysm (AAA) and AAA-related mortality mean that results from randomised trials of screening for the disorder might be out-dated. The aim of this study was to estimate the effect of AAA screening in Sweden on disease-specific mortality, incidence, and surgery.
Individual data on the incidence of AAA, AAA mortality, and surgery for AAA in a cohort of men aged 65 years who were invited to screening between 2006 and 2009, were compared with data from an age-matched contemporaneous cohort of men who were not invited for AAA screening. We also analysed national data for all men aged 40-99 years between Jan 1, 1987, and Dec 31, 2015, to explore background trends. Adjustment for confounding was done by weighting the analyses with a propensity score obtained from a logistic regression model on cohort year, marital status, educational level, income, and whether the patient already had an AAA diagnosis at baseline. Adjustment for differential attrition was also done by weighting the analyses with the inverse probability of still being in the cohort 6 years after screening. Generalised estimating equations were used to adjust the variance for repeated measurement and in response to the weighting.
AAA mortality in Swedish men has decreased from 36 to ten deaths per 100?000 men aged 65-74 years between the early 2000s and 2015. Mortality decreased at similar rates in all Swedish counties, irrespective of whether AAA screening was offered. After 6 years with screening, we found a non-significant reduction in AAA mortality associated with screening (adjusted odds ratio [aOR] 0·76, 95% CI 0·38-1·51), which means that two men (95% CI -3 to 7) avoid death from AAA for every 10?000 men offered screening. Screening was associated with increased odds of AAA diagnosis (aOR 1·52, 95% CI 1·16-1·99; p=0·002) and an increased risk of elective surgery (aOR 1·59, 95% CI 1·20-2·10; p=0·001), such that for every 10?000 men offered screening, 49 men (95% CI 25-73) were likely to be overdiagnosed, 19 of whom (95% CI 1-37) had avoidable surgery that increased their risk of mortality and morbidity.
AAA screening in Sweden did not contribute substantially to the large observed reductions in AAA mortality. The reductions were mostly caused by other factors, probably reduced smoking. The small benefit and substantially less favourable benefit-to-harm balance call the continued justification of the intervention into question.
Research Unit and Section for General Practice, FoUU-centrum Fyrbodal, Sweden, and the region of Västra Götaland, Sweden.
Notes
CommentIn: Lancet. 2018 Jun 16;391(10138):2394-2395 PMID 29916370
CommentIn: Lakartidningen. 2018 Sep 5;115: PMID 30204225
CommentIn: Lakartidningen. 2018 Sep 5;115: PMID 30204226
PubMed ID
29916384 View in PubMed
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Breast cancer screening implementation and reassurance.

https://arctichealth.org/en/permalink/ahliterature259198
Source
Eur J Public Health. 2014 Apr;24(2):258-63
Publication Type
Article
Date
Apr-2014
Author
Jenny Osterø
Volkert Siersma
John Brodersen
Source
Eur J Public Health. 2014 Apr;24(2):258-63
Date
Apr-2014
Language
English
Publication Type
Article
Keywords
Aged
Breast Neoplasms - psychology - radiography
Denmark
Female
Humans
Intention to Treat Analysis
Mammography
Mass Screening - psychology
Middle Aged
Questionnaires
Abstract
Women not offered screening mammography reported higher levels of negative psychosocial aspects than women offered screening. This was demonstrated in a questionnaire survey where 1000 women were included: 500 women living in areas where the public authorities had never offered screening mammography and 500 women living in areas where women had been invited to screening mammography for >10 years. After this baseline survey, nationwide screening mammography was implemented. The aim of this follow-up study was to resurvey the 1000 women and to investigate if the identified difference in reported psychosocial aspects had disappeared or been reduced because of the nationwide screening implementation.
The 1000 women included in the previous survey were posted part I of the questionnaire Consequences of Screening in Breast Cancer (COS-BC1) in August 2011, nearly 5 years after they received the COS-BC1 the first time.
A total of 677 women returned the questionnaire. There was no statistically significant difference between the two groups in reported psychosocial aspects. Women new to screening reported less negative psychosocial aspects compared with the previous survey.
An implementation of a screening mammography programme provides reassurance for those women invited to the screening. This reassurance is in contrast to the unbalanced proportion between the intended benefits and the unintended harms of the screening programme.
PubMed ID
23788014 View in PubMed
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Clinical indications for antibiotic use in Danish general practice: results from a nationwide electronic prescription database.

https://arctichealth.org/en/permalink/ahliterature290688
Source
Scand J Prim Health Care. 2017 Jun; 35(2):162-169
Publication Type
Journal Article
Date
Jun-2017
Author
Rune Aabenhus
Malene Plejdrup Hansen
Volkert Siersma
Lars Bjerrum
Author Affiliation
a The Research Unit for General Practice and Section of General Practice , University of Copenhagen , Copenhagen , Denmark.
Source
Scand J Prim Health Care. 2017 Jun; 35(2):162-169
Date
Jun-2017
Language
English
Publication Type
Journal Article
Keywords
Adolescent
Adult
Aged
Anti-Bacterial Agents - therapeutic use
Bacterial Infections - drug therapy
Child
Child, Preschool
Denmark
Drug Prescriptions - statistics & numerical data
Electronic Prescribing - statistics & numerical data
Family Practice - statistics & numerical data
Female
Humans
Male
Middle Aged
Practice Patterns, Physicians' - statistics & numerical data
Retrospective Studies
Young Adult
Abstract
To assess the availability and applicability of clinical indications from electronic prescriptions on antibiotic use in Danish general practice.
Retrospective cohort register-based study including the Danish National Prescription Register.
Population-based study of routine electronic antibiotic prescriptions from Danish general practice.
All 975,626 patients who redeemed an antibiotic prescription at outpatient pharmacies during the 1-year study period (July 2012 to June 2013).
Number of prescriptions per clinical indication. Number of antibiotic prescriptions per 1000 inhabitants by age and gender. Logistic regression analysis estimated the association between patient and provider factors and missing clinical indications on antibiotic prescriptions.
A total of 2.381.083 systemic antibiotic prescriptions were issued by Danish general practitioners in the study period. We identified three main clinical entities: urinary tract infections (n?=?506.634), respiratory tract infections (n?=?456.354) and unspecified infections (n?=?416.354). Women were more exposed to antibiotics than men. Antibiotic use was high in children under 5 years and even higher in elderly people. In 32% of the issued prescriptions, the clinical indication was missing. This was mainly associated with antibiotic types. We found that a prescription for a urinary tract agent without a specific clinical indication was uncommon.
Clinical indications from electronic prescriptions are accessible and available to provide an overview of drug use, in casu antibiotic prescriptions, in Danish general practice. These clinical indications may be further explored in detail to assess rational drug use and congruence with guidelines, but validation and optimisation of the system is preferable.
Notes
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PubMed ID
28585886 View in PubMed
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Does a history of physical exposures at work affect hand-grip strength in midlife? A retrospective cohort study in Denmark.

https://arctichealth.org/en/permalink/ahliterature113962
Source
Scand J Work Environ Health. 2013 Nov;39(6):599-608
Publication Type
Article
Date
Nov-2013
Author
Anne Møller
Susanne Reventlow
Åse Marie Hansen
Lars L Andersen
Volkert Siersma
Rikke Lund
Kirsten Avlund
Johan Hviid Andersen
Ole S Mortensen
Author Affiliation
Department of Occupational Medicine, Køge Sygehus, Lykkebæaekvej 1, DK-4600 Køge, Denmark. annemoller1972@gmail.com.
Source
Scand J Work Environ Health. 2013 Nov;39(6):599-608
Date
Nov-2013
Language
English
Publication Type
Article
Keywords
Cross-Sectional Studies
Denmark
Female
Hand - physiology
Hand Strength
Humans
Male
Middle Aged
Occupational Exposure
Abstract
The aim of this cohort study was to examine associations between physical exposures throughout working life and hand-grip strength (HGS) in midlife.
The Copenhagen Aging and Midlife Biobank (CAMB) provided data about employment and HGS for 3843 Danes. Individual job histories, including duration of employment in specific jobs, were assigned exposures from a job exposure matrix. Exposures were standardized to ton-years (lifting 1000 kg each day in one year), stand-years (standing/walking for six hours each day in one year) and kneel-years (kneeling for one hour each day in one year). The effects of exposure-years on HGS were analyzed as linear effects and cubic splines in multivariate regression models, adjusted for potential confounders.
Mean age was 59 years among both genders and HGS was 49.19 kg [standard deviation (SD) 8.42] and 30.61 kg (SD 5.49) among men and women, respectively. Among men, exposure to kneel-years was associated with higher HGS [>0.030 kg (P=0.007) per exposure-year]. Ton- and stand-years were not associated with HGS among either men or women in linear analyses. In spline regression analyses, associations between ton- and stand-years and HGS were non-linear and primarily positive among men. Among women, the associations were non-linear and, according to ton-years, primarily negatively associated with HGS but statistically insignificant.
A history of physical exposures at work explained only a minor part of the variation in HGS, though exposure to kneeling throughout working life was associated with a slightly higher HGS among men. Exposure to lifting and standing/walking was not associated with HGS.
PubMed ID
23665642 View in PubMed
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Does physical exposure throughout working life influence chair-rise performance in midlife? A retrospective cohort study of associations between work and physical function in Denmark.

https://arctichealth.org/en/permalink/ahliterature275582
Source
BMJ Open. 2015;5(11):e009873
Publication Type
Article
Date
2015
Author
Anne Møller
Susanne Reventlow
Åse Marie Hansen
Lars L Andersen
Volkert Siersma
Rikke Lund
Kirsten Avlund
Johan Hviid Andersen
Ole Steen Mortensen
Source
BMJ Open. 2015;5(11):e009873
Date
2015
Language
English
Publication Type
Article
Keywords
Denmark
Female
Health status
Humans
Linear Models
Male
Middle Aged
Multivariate Analysis
Occupational Health
Physical Examination
Physical Exertion
Physical Fitness - physiology
Posture
Retrospective Studies
Sex Factors
Walking
Workplace
Abstract
Our aim was to study associations between physical exposures throughout working life and physical function measured as chair-rise performance in midlife.
The Copenhagen Aging and Midlife Biobank (CAMB) provided data about employment and measures of physical function. Individual job histories were assigned exposures from a job exposure matrix. Exposures were standardised to ton-years (lifting 1000 kg each day in 1 year), stand-years (standing/walking for 6 h each day in 1 year) and kneel-years (kneeling for 1 h each day in 1 year). The associations between exposure-years and chair-rise performance (number of chair-rises in 30 s) were analysed in multivariate linear and non-linear regression models adjusted for covariates.
Mean age among the 5095 participants was 59 years in both genders, and, on average, men achieved 21.58 (SD=5.60) and women 20.38 (SD=5.33) chair-rises in 30 s. Physical exposures were associated with poorer chair-rise performance in both men and women, however, only associations between lifting and standing/walking and chair-rise remained statistically significant among men in the final model. Spline regression analyses showed non-linear associations and confirmed the findings.
Higher physical exposure throughout working life is associated with slightly poorer chair-rise performance. The associations between exposure and outcome were non-linear.
Notes
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PubMed ID
26537502 View in PubMed
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The effectiveness of computer reminders versus postal reminders for improving quality assessment for point-of-care testing in primary care: a randomized controlled trial.

https://arctichealth.org/en/permalink/ahliterature268548
Source
J Eval Clin Pract. 2015 Feb;21(1):13-20
Publication Type
Article
Date
Feb-2015
Author
Volkert Siersma
Marius Brostrøm Kousgaard
Susanne Reventlow
Ruth Ertmann
Peter Felding
Frans Boch Waldorff
Source
J Eval Clin Pract. 2015 Feb;21(1):13-20
Date
Feb-2015
Language
English
Publication Type
Article
Keywords
Aged
Computers
Denmark
Female
Humans
International Normalized Ratio
Male
Middle Aged
Point-of-Care Systems - utilization
Postal Service
Primary Health Care - organization & administration
Quality Improvement - organization & administration
Reminder Systems - instrumentation
Abstract
This study aimed to evaluate the relative effectiveness of electronic and postal reminders for increasing adherence to the quality assurance programme for the international normalized ratio (INR) point-of-care testing (POCT) device in primary care.
All 213 family practices that use the Elective Laboratory of the Capital Region, Denmark, and regularly conduct INR POCT were randomly allocated into two similarly sized groups. During the 4-month intervention, these practices were sent either computer reminders (ComRem) or computer-generated postal reminders (Postal) if they did not perform a split test to check the quality of their INR POCT for each calendar month. The adherence of the practices was tracked during the subsequent 8 months subdivided into two 4-month periods both without intervention. Outcomes were measures of split test procedure adherence.
Both interventions were associated with an increase in adherence to the split test procedure - a factor 6.00 [95% confidence interval (CI) 4.46-7.72] and 8.22 [95% CI 5.87-11.52] for ComRem and Postal, respectively - but there is no evidence that one of the interventions was more effective than the other. In the ComRem group, the expected number of split tests (out of four) was 2.54 (95% CI 2.33-2.76) versus 2.44 (95% CI 2.24-2.65) in the Postal group, P?=?0.14. There was a slight decrease in adherence over the two follow-ups, but neither intervention was better than the other in achieving a lasting improvement in adherence.
Computer reminders are as efficient as postal reminders in increasing adherence to a quality assurance programme for the INR POCT device in primary care.
PubMed ID
24953533 View in PubMed
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