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Alcohol expectancy and hazardous drinking: a 6-year longitudinal and nationwide study of medical doctors.

https://arctichealth.org/en/permalink/ahliterature99472
Source
Eur Addict Res. 2010;16(1):17-22
Publication Type
Article
Date
2010
Author
Kjersti S Grotmol
Per Vaglum
Øivind Ekeberg
Tore Gude
Olaf G Aasland
Reidar Tyssen
Author Affiliation
Department of Behavioral Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway. k.s.grotmol@medisin.uio.no
Source
Eur Addict Res. 2010;16(1):17-22
Date
2010
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Adult
Alcohol Drinking - epidemiology - psychology
Alcoholic Intoxication - epidemiology - psychology
Cohort Studies
Female
Follow-Up Studies
Humans
Longitudinal Studies
Male
Middle Aged
Norway - epidemiology
Physicians - trends
Abstract
AIM: The study's aim was to determine whether medical doctors' expectancy that alcohol use reduces tension predicts the extent of their hazardous drinking and whether this effect is mediated by drinking to cope. METHODS: A group of Norwegian medical doctors' (n = 288) alcohol use was followed for 6 years. The expectancy that alcohol reduces tension and the use of alcohol to cope with tension were measured 3.5 years after graduation (T1), and hazardous drinking was evaluated at T1 and 9.5 years after graduation (T2). RESULTS: At T1, 15% of men and 3% of women reported hazardous drinking. At T2, these proportions were 16 and 2%, respectively. Men reported a higher expectancy than women that alcohol reduces tension (p = 0.03), whereas there was no sex difference in drinking to cope. Adjusted predictors of hazardous drinking at T2 were male sex (p
PubMed ID
19887805 View in PubMed
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Analgesic prescribing patterns in Norwegian nursing homes from 2000 to 2011: trend analyses of four data samples.

https://arctichealth.org/en/permalink/ahliterature276993
Source
Age Ageing. 2016 Jan;45(1):54-60
Publication Type
Article
Date
Jan-2016
Author
Reidun Sandvik
Geir Selbaek
Oyvind Kirkevold
Dag Aarsland
Bettina Sandgathe Husebo
Source
Age Ageing. 2016 Jan;45(1):54-60
Date
Jan-2016
Language
English
Publication Type
Article
Keywords
Acetaminophen - therapeutic use
Age Factors
Aged
Aged, 80 and over
Aging - psychology
Analgesics - therapeutic use
Analgesics, Non-Narcotic - therapeutic use
Analgesics, Opioid - therapeutic use
Chi-Square Distribution
Cognition
Dementia - psychology
Drug Prescriptions
Drug Utilization Review
Female
Homes for the Aged - trends
Humans
Logistic Models
Male
Multivariate Analysis
Norway
Nursing Homes - trends
Observational Studies as Topic
Odds Ratio
Practice Patterns, Physicians' - trends
Randomized Controlled Trials as Topic
Time Factors
Abstract
the analgesic drug use has been reported to increase in general in nursing home patients. However, there is insufficient evidence in terms of what agents are used, variations of use over time and to whom these drugs are prescribed.
we investigated the prescribing patterns of scheduled analgesic drugs in Norwegian nursing home patients from 2000 to 2011, with the association to age, gender, cognitive function and type of nursing home unit.
secondary analyses of four study samples (three observational studies and one randomised controlled trial).
nursing home patients included in study samples from 2000 (n = 1,926), 2004 (n = 1,163), 2009 (n = 850) and 2011 (n = 1,858) located in 14 Norwegian counties.
trend analyses of analgesic drug prescriptions. Percentages were described using t-test, ?(2) and Mann-Whitney U test and multivariate logistic regression.
the odds ratio for receiving any pain medication in 2011 compared with 2000 was 2.6 (95% CI 2.23-2.91), this is corresponding to a 65% increase from 34.9 to 57.6%. The paracetamol prescription increased by 113%, from 22.7% in 2000 to 48.4% in 2011. Strong opioids (fentanyl, buprenorphine, morphine, oxycodone) increased from 1.9% in 2000 to 17.9% in 2011 (P
Notes
Comment In: Age Ageing. 2016 Jan;45(1):7-826764389
Erratum In: Age Ageing. 2016 Mar;45(2):32326941355
PubMed ID
26764395 View in PubMed
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Association Between Use of Primary-Prevention Implantable Cardioverter-Defibrillators and Mortality in Patients With Heart Failure: A Prospective Propensity Score-Matched Analysis From the Swedish Heart Failure Registry.

https://arctichealth.org/en/permalink/ahliterature309191
Source
Circulation. 2019 11 05; 140(19):1530-1539
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
11-05-2019
Author
Benedikt Schrage
Alicia Uijl
Lina Benson
Dirk Westermann
Marcus Ståhlberg
Davide Stolfo
Ulf Dahlström
Cecilia Linde
Frieder Braunschweig
Gianluigi Savarese
Author Affiliation
Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden (B.S., A.U., L.B., M.S., D.S., C.L., F.B., G.S.).
Source
Circulation. 2019 11 05; 140(19):1530-1539
Date
11-05-2019
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Aged
Aged, 80 and over
Death, Sudden, Cardiac - epidemiology - prevention & control
Defibrillators, Implantable - trends
Electric Countershock - adverse effects - instrumentation - mortality - trends
Female
Heart Failure - diagnosis - mortality - physiopathology - therapy
Humans
Male
Middle Aged
Practice Patterns, Physicians' - trends
Primary Prevention - trends
Propensity Score
Registries
Risk assessment
Risk factors
Sweden - epidemiology
Time Factors
Treatment Outcome
Abstract
Most randomized trials on implantable cardioverter-defibrillator (ICD) use for primary prevention of sudden cardiac death in heart failure with reduced ejection fraction enrolled patients >20 years ago. We investigated the association between ICD use and all-cause mortality in a contemporary heart failure with reduced ejection fraction cohort and examined relevant subgroups.
Patients from the Swedish Heart Failure Registry fulfilling the European Society of Cardiology criteria for primary-prevention ICD were included. The association between ICD use and 1-year and 5-year all-cause and cardiovascular (CV) mortality was assessed by Cox regression models in a 1:1 propensity score-matched cohort and in prespecified subgroups.
Of 16?702 eligible patients, only 1599 (10%) had an ICD. After matching, 1305 ICD recipients were compared with 1305 nonrecipients. ICD use was associated with a reduction in all-cause mortality risk within 1 year (hazard ratio, 0.73 [95% CI, 0.60-0.90]) and 5 years (hazard ratio, 0.88 [95% CI, 0.78-0.99]). Results were consistent in all subgroups including patients with versus without ischemic heart disease, men versus women, those aged
Notes
CommentIn: Circulation. 2019 Nov 5;140(19):1540-1542 PMID 31476898
CommentIn: Circulation. 2020 Mar 17;141(11):e648-e649 PMID 32176544
CommentIn: Circulation. 2020 Mar 17;141(11):e646-e647 PMID 32176545
PubMed ID
31476893 View in PubMed
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Barriers to integrating personalized medicine into clinical practice: a best-worst scaling choice experiment.

https://arctichealth.org/en/permalink/ahliterature128034
Source
Genet Med. 2012 May;14(5):520-6
Publication Type
Article
Date
May-2012
Author
Mehdi Najafzadeh
Larry D Lynd
Jennifer C Davis
Stirling Bryan
Aslam Anis
Marco Marra
Carlo A Marra
Author Affiliation
Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
Source
Genet Med. 2012 May;14(5):520-6
Date
May-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
British Columbia
Cross-Sectional Studies
Decision Making
Female
Genetic Privacy
Genetic Testing
Genome, Human
Genomics
Humans
Individualized Medicine - trends
Male
Middle Aged
Physician's Practice Patterns
Physicians - trends
Practice Guidelines as Topic
Questionnaires
Sequence Analysis, DNA
Abstract
As advances in genomics make genome sequencing more affordable, the availability of new genome-based diagnostic and therapeutic strategies (i.e., personalized medicine) will increase. This wave will hit front-line physicians who may be faced with a plethora of patients' expectations of integrating genomic data into clinical care. The objective of this study was to elicit the preferences of physicians about regarding applying personalized medicine in their clinical practice as these strategies become available.
Using a best-worst scaling (BWS) choice experiment, we estimated the relative importance of attributes that influence physicians' decision for using personalized medicine. Six attributes were included in the BWS: type of genetic tests, training for genetic testing, clinical guidelines, professional fee, privacy protection laws, and cost of genetic tests. A total of 197 physicians in British Columbia completed the experiment. Using latent class analysis (LCA), we explored the physicians' heterogeneities in preferences.
"Type of genetic tests" had the largest importance, suggesting that the physicians' decision was highly influenced by the availability of genetic tests for patients' predisposition to diseases and/or drug response. "Training" and "guidelines" were the attributes with the next highest importance. LCA identified two classes of physicians. Relative to class 2, class 1 had a larger weight for the "type of genetic tests," but smaller weights for "professional fee" and "cost of tests."
We measured relative importance of factors that affect the decision of physicians to incorporate personalized medicine in their practice. These results can be used to design the policies for supporting physicians and facilitating the use of personalized medicine in the future.
PubMed ID
22241089 View in PubMed
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[Change in attitude towards antibiotic prescriptions among Icelandic general practitioners].

https://arctichealth.org/en/permalink/ahliterature271099
Source
Laeknabladid. 2016 Jan;102(1):27-32
Publication Type
Article
Date
Jan-2016
Author
Anna Mjöll Matthíasdóttir
Thórólfur Guðnason
Matthías Halldórsson
Ásgeir Haraldsson
Karl G Kristinsson
Source
Laeknabladid. 2016 Jan;102(1):27-32
Date
Jan-2016
Language
Icelandic
Publication Type
Article
Keywords
Anti-Bacterial Agents - therapeutic use
Attitude of Health Personnel
Bacterial Infections - diagnosis - drug therapy - microbiology
Bacteriological Techniques
Cross-Sectional Studies
Drug Prescriptions
Drug Resistance, Bacterial
General Practitioners - psychology
Guideline Adherence
Health Care Surveys
Health Knowledge, Attitudes, Practice
Humans
Iceland
Inappropriate Prescribing
Logistic Models
Medical Overuse
Multivariate Analysis
Practice Guidelines as Topic
Practice Patterns, Physicians' - trends
Predictive value of tests
Surveys and Questionnaires
Time Factors
Abstract
Antibiotic use is a leading cause of antibiotic resistance and it is therefore important to reduce unnecessary prescribing in Iceland where antibiotic use is relatively high. The purpose of this study was to explore antibiotic prescribing practices among Icelandic physicians and compare the results with results of comparable studies from 1991 and 1995 conducted by the Directorate of Health, Iceland.
A descriptive cross-sectional study was carried out among all general practitioners registered in Iceland in 1991 and 1995 and all physicians registered in March 2014. Data was collected with questionnaires regarding diagnosis and treatment of simple urinary tract infection, acute otitis media and pharyngitis. A multiple logistic regression analysis was performed and level of significance p=0.05.
Response rates were 85% and 93% in 1991 and 1995 but 31% in 2014. Proportion of physicians who consider themselves prescribing antibiotics more than 10 times per week was 36% in 1991, 32% in 1995 and 21% in 2014. Proportion of trimethoprim-sulfamethoxazole as first choice for simple urinary tract infection reduced from 43% and 45% to 8% in 2014. In 2014, general practitioners considered themselves 87% less likely to prescribe an antibiotic for acute otitis media than in 1991 (p
PubMed ID
26734720 View in PubMed
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Changes in alcohol drinking patterns and their consequences among Norwegian doctors from 2000 to 2010: a longitudinal study based on national samples.

https://arctichealth.org/en/permalink/ahliterature121090
Source
Alcohol Alcohol. 2013 Jan-Feb;48(1):99-106
Publication Type
Article
Author
Judith Rosta
Olaf G Aasland
Author Affiliation
Research Institute of the Norwegian Medical Association, Sentrum, 0107 Oslo, Norway. judith.rosta@legeforeningen.no
Source
Alcohol Alcohol. 2013 Jan-Feb;48(1):99-106
Language
English
Publication Type
Article
Keywords
Adult
Aged
Alcohol Drinking - epidemiology - trends
Alcoholic Intoxication - diagnosis - epidemiology
Data Collection - trends
Female
Humans
Longitudinal Studies
Male
Middle Aged
Norway - epidemiology
Physicians - trends
Prospective Studies
Abstract
To describe changes in the patterns and consequences of alcohol use among Norwegian doctors from 2000 to 2010.
Longitudinal study based on data from nation-wide postal surveys in 2000 and 2010 among a representative sample of 682 doctors in Norway. The Alcohol Use Disorder Identification Test (AUDIT) was used to measure the changes in drinking patterns (frequency of drinking, frequency of heavy drinking and quantity of drinking), symptoms of alcohol dependence and adverse consequences of drinking. A score above 8 was defined as hazardous drinking.
From 2000 to 2010, the proportion of doctors who used alcohol twice a week or more significantly increased from 31.4 (27.9-34.9) % to 48.7 (44.9-48.7) %, and the proportion of those who drank to intoxication weekly or more decreased significantly from 6.6 (4.7-8.6) % to 2.5 (1.3-1.7) %. The proportion who scored above 8 on the AUDIT decreased from 10.7 (8.4-13.0) % in 2000 to 8.2 (6.2-10.3) % in 2010. There was a significant increase in the partial AUDIT-score for drinking patterns (t = 2.4; P = 0.016), and a significant decrease in the partial AUDIT-score for adverse consequences of drinking (t = -3.6; P 
PubMed ID
22940613 View in PubMed
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Changes in attitudes towards hastened death among Finnish physicians over the past sixteen years.

https://arctichealth.org/en/permalink/ahliterature298467
Source
BMC Med Ethics. 2018 05 30; 19(1):40
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
05-30-2018
Author
Reetta P Piili
Riina Metsänoja
Heikki Hinkka
Pirkko-Liisa I Kellokumpu-Lehtinen
Juho T Lehto
Author Affiliation
Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland. piili.reetta.p@student.uta.fi.
Source
BMC Med Ethics. 2018 05 30; 19(1):40
Date
05-30-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Age Factors
Aged
Attitude of Health Personnel
Attitude to Death
Death
Euthanasia
Female
Finland
Humans
Male
Medical Oncology
Middle Aged
Morphine - administration & dosage
Physicians - trends
Religion and Medicine
Resuscitation Orders
Sex Factors
Specialization
Suicide, Assisted
Surveys and Questionnaires
Abstract
The ethics of hastened death are complex. Studies on physicians' opinions about assisted dying (euthanasia or assisted suicide) exist, but changes in physicians' attitudes towards hastened death in clinical decision-making and the background factors explaining this remain unclear. The aim of this study was to explore the changes in these attitudes among Finnish physicians.
A questionnaire including hypothetical patient scenarios was sent to 1182 and 1258 Finnish physicians in 1999 and 2015, respectively. Two scenarios of patients with advanced cancer were presented: one requesting an increase in his morphine dose to a potentially lethal level and another suffering a cardiac arrest. Physicians' attitudes towards assisted death, life values and other background factors were queried as well. The response rate was 56%.
The morphine dose was increased by 25% and 34% of the physicians in 1999 and 2015, respectively (p?
PubMed ID
29843682 View in PubMed
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Current antihypertensive drug therapy in 12,436 Swedish patients, 90 years and above, in relation to sex and comorbidity.

https://arctichealth.org/en/permalink/ahliterature307518
Source
Blood Press. 2020 06; 29(3):168-174
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
06-2020
Author
Fredrik Wallentin
Björn Wettermark
Thomas Kahan
Author Affiliation
Department of Clinical Sciences, Danderyd Hospital, Division of Cardiovascular Medicine, Karolinska Institutet, Stockholm, Sweden.
Source
Blood Press. 2020 06; 29(3):168-174
Date
06-2020
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Age Factors
Aged, 80 and over
Antihypertensive Agents - therapeutic use
Blood Pressure - drug effects
Comorbidity
Data Warehousing
Drug Utilization - trends
Female
Humans
Hypertension - diagnosis - drug therapy - physiopathology
Male
Practice Patterns, Physicians' - trends
Registries
Retrospective Studies
Sex Factors
Sweden - epidemiology
Abstract
Purpose: To describe current antihypertensive treatment in very old hypertensive patients according to sex and comorbidity.Materials and methods: We used the Stockholm regional healthcare data warehouse (Vårdanalysdatabasen) providing information on all healthcare consultations, diagnoses, hospitalizations, dispensed prescription drugs, sex and age in 2.1 million people living in the greater Stockholm region, Sweden. This cross-sectional analysis identified 12,436 individuals with a diagnosis of hypertension, who were 90 years or older.Results: Mean age was 92.6?±?2.6 years, 75% were women; and 34% of women and 24% of men had no diagnoses of concomitant diabetes or cardiovascular disease. The number of dispensed drug classes was similar (2.1?±?1.4) in women and in men. Women more often used angiotensin receptor blockers and beta-blockers, while men more frequently used ACE inhibitors and calcium channel blockers (all p?
PubMed ID
31878801 View in PubMed
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Decrease in primary but not in secondary abdominal surgery for Crohn's disease: nationwide cohort study, 1990-2014.

https://arctichealth.org/en/permalink/ahliterature305821
Source
Br J Surg. 2020 10; 107(11):1529-1538
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
10-2020
Author
T D Kalman
Å H Everhov
C Nordenvall
M C Sachs
J Halfvarson
A Ekbom
J F Ludvigsson
P Myrelid
O Olén
Author Affiliation
Division of Surgery, Department of Clinical and Experimental Medicine, Faulty of Health Sciences, Linköping University, Department of Surgery, County Council of Östergötland, Linköping, Sweden.
Source
Br J Surg. 2020 10; 107(11):1529-1538
Date
10-2020
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Abdomen - surgery
Adolescent
Adult
Aged
Aged, 80 and over
Child
Colectomy - trends
Crohn Disease - surgery
Female
Follow-Up Studies
Humans
Intestine, Small - surgery
Kaplan-Meier Estimate
Male
Middle Aged
Practice Patterns, Physicians' - trends
Proctectomy - trends
Registries
Reoperation - trends
Sweden
Young Adult
Abstract
Treatment of patients with Crohn's disease has evolved in recent decades, with increasing use of immunomodulatory medication since 1990 and biologicals since 1998. In parallel, there has been increased use of active disease monitoring. To what extent these changes have influenced the incidence of primary and repeat surgical resection remains debated.
In this nationwide cohort study, incident patients of all ages with Crohn's disease, identified in Swedish National Patient Registry between 1990 and 2014, were divided into five calendar periods of diagnosis: 1990-1995 and 1996-2000 with use of inpatient registries, 2001, and 2002-2008 and 2009-2014 with use of inpatient and outpatient registries. The cumulative incidence of first and repeat abdominal surgery (except closure of stomas), by category of surgical procedure, was estimated using the Kaplan-Meier method.
Among 21?273 patients with Crohn's disease, the cumulative incidence of first abdominal surgery within 5?years of Crohn's disease diagnosis decreased continuously from 54·8 per cent in 1990-1995 to 40·4 per cent in 1996-2000 (P?
PubMed ID
32452553 View in PubMed
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Decreasing mortality and changes in treatment patterns in patients with acromegaly from a nationwide study.

https://arctichealth.org/en/permalink/ahliterature291422
Source
Eur J Endocrinol. 2018 May; 178(5):459-469
Publication Type
Journal Article
Date
May-2018
Author
Daniela Esposito
Oskar Ragnarsson
Daniel Granfeldt
Tom Marlow
Gudmundur Johannsson
Daniel S Olsson
Author Affiliation
Department of EndocrinologyInstitute of Medicine, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden.
Source
Eur J Endocrinol. 2018 May; 178(5):459-469
Date
May-2018
Language
English
Publication Type
Journal Article
Keywords
Acromegaly - epidemiology - etiology - mortality - prevention & control
Adenoma - mortality - physiopathology - secretion - therapy
Adult
Aged
Cohort Studies
Combined Modality Therapy
Female
Follow-Up Studies
Growth Hormone-Secreting Pituitary Adenoma - mortality - physiopathology - secretion - therapy
Health Care Surveys
Health Transition
Human Growth Hormone - secretion
Humans
Hypopituitarism - epidemiology - etiology - mortality - prevention & control
Male
Middle Aged
Mortality
Practice Patterns, Physicians' - trends
Prevalence
Registries
Sex Factors
Sweden - epidemiology
Abstract
New therapeutic strategies have developed for the management of acromegaly over recent decades. Whether this has improved mortality has not been fully elucidated.
The primary aim was to investigate mortality in a nationwide unselected cohort of patients with acromegaly. Secondary analyses included time trends in mortality and treatment patterns.
A total of 1089 patients with acromegaly were identified in Swedish National Health Registries between 1987 and 2013. To analyse time trends, the cohort was divided into three periods (1987-1995, 1996-2004 and 2005-2013) based on the year of diagnosis.
Using the Swedish population as reference, standardized mortality ratios (SMRs) were calculated with 95% confidence intervals (CIs).
Overall SMR was 2.79 (95% CI: 2.43-3.15) with 232 observed and 83 expected deaths. Mortality was mainly related to circulatory diseases (SMR: 2.95, 95% CI: 2.35-3.55), including ischemic heart disease (2.00, 1.35-2.66) and cerebrovascular disease (3.99, 2.42-5.55) and malignancy (1.76, 1.27-2.26). Mortality decreased over time, with an SMR of 3.45 (2.87-4.02) and 1.86 (1.04-2.67) during the first and last time period, respectively (P?=?.015). During the same time periods, the frequency of pituitary surgery increased from 58% to 72% (P?
PubMed ID
29483205 View in PubMed
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33 records – page 1 of 4.