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Biomedical subjects

Peter Allebeck

Publications and source records attributed to Peter Allebeck.

At least 37 records · Page 2Linked to original sources
PubMed2004

Attitudes and behaviors with regards to androgenic anabolic steroids among male adolescents in a county of Sweden.

This study investigates attitudes toward androgenic anabolic steroids among male adolescents who have used anabolics compared with those who have not. A cross-sectional survey was performed in the year 2000 in all secondary schools in the county of Halland on the west coast of Sweden. An anonymous multiple-choice questionnaire was distributed to all classes with 14-, 16-, and 18-year-old male adolescents. The response rate was 92.7% (n=4049). Those who admitted having used androgenic anabolic steroids differed in several ways from those who had not. Fewer believed androgenic anabolic steroids to be harmful (OR=0.15, 95% CI 0.08-0.30) and more believed that girls preferred boys with large muscles (OR=6.1, 95% CI 3.4-11.0). They trained more often at gyms (OR=5.6, 95% CI 3.0-10.6), drank more alcohol (OR=4.2, 95% CI 2.0-9.1), and had used narcotic drugs more often (OR=15.3, 95% CI 8.5-27.5) than the other male adolescents. More immigrants than native-born adolescents had used anabolics (OR=4.2, 95% CI 2.2-7.9). Attitudes toward anabolics differ between users and nonusers. These aspects may be beneficial to focus on as one part of a more complex intervention program in order to change these attitudes and decrease the misuse of androgenic anabolic steroids.

Adolescent↗
PubMed2004

Evaluation of a health promotion programme to prevent the misuse of androgenic anabolic steroids among Swedish adolescents.

The aim of this study was to design an appearance programme in order to prevent the misuse of androgenic anabolic steroids among adolescents and to evaluate the adolescents' perception of this programme. The study was performed in all schools in a primary health care area on the south west coast of Sweden. The intervention targeted all 16- and 17-year-old males and females (n = 921). The intervention and evaluation were completed by 451 boys. The strategy of the appearance programme was to create awareness of and to discuss attitudes towards steroid hormones among these adolescents. Youth leaders and health workers, who discussed these subjects with adolescents over a period of 2 years, carried out the intervention programme. The perception of the programme was analysed anonymously using questionnaires. Effects on the total population of youths were assessed by two cross-sectional surveys. The intervention programme was well received by the adolescents. The misuse of androgenic anabolic steroids had a tendency to decrease after the appearance programme. We demonstrated a method for involving the community in an appearance programme to reduce misuse of anabolic steroids and showed that youth were sensitive to our discussions about appearance and attitudes. This study indicates that drug abuse among adolescents can be decreased by health promotion activities, such as group discussions. Controlled studies are needed before the results of this appearance programme can be generalized.

Adolescent↗
PubMed2003

Evaluation of a model for counseling patients with dyspepsia in Swedish community pharmacies.

The outcomes of a counseling model designed to help pharmacists care for customers seeking nonprescription treatment for dyspepsia in Swedish community pharmacies were studied. A protocol containing 10 key questions based on clinical guidelines about dyspepsia symptoms and on studies of drug-related problems (DRPs) was implemented in six community pharmacies in Sweden. During two weeks in April 2002, all adult customers seeking self-care for dyspepsia were asked to participate in the interview. Depending on a customer's answers, pharmacy personnel gave advice, intervened for DRPs, or referred the customer to a physician. Customers who received advice or intervention were followed up by telephone. A total of 319 customers who met the study criteria agreed to participate. Of these, 183 (57%) received self-care advice, 37 (12%) had DRPs, and 39 (12%) were referred to a physician because of their symptoms. Of the 198 customers fulfilling the criteria for a follow-up interview, 130 (66%) participated. Nearly all of these customers were satisfied with their visit to the pharmacy, and 9 in 10 were pleased with the advice received. Eighty-five percent claimed they had followed the self-care advice, and two in three said they felt better. DRPs were resolved in 19 (86%) of the 22 customers with DRPs who were followed up. Only one customer in five who was advised to see a physician actually did so. A counseling model designed to discover and resolve problems related to symptoms and drug use appeared to have a favorable impact on outcomes in customers with dyspepsia seeking nonprescription drug treatment in Swedish pharmacies.

Adult↗
PubMed2003

Co-financing as a means to improve collaboration between primary health care, social insurance and social service in Sweden. A qualitative study of collaboration experiences among rehabilitation partners.

Collaboration between services has often been suggested as a means to increase effectiveness and reduce costs especially in the care and rehabilitation of long-term illness. In Sweden, a special legislation named SOCSAM was introduced in 1994, enabling financial collaboration between governmental and municipal authorities. In this paper we report on a qualitative study on collaboration around patients with musculoskeletal diseases. The aim of the study was to assess differences in goal formulation, collaboration and communication between staff in intervention health centres that have implemented co-financing projects and health centres working under conventional conditions. Focus group interviews were performed with staff at intervention and control health care centres. We found that the interdisciplinary collaboration had improved in the intervention health care centres compared to the controls. Our findings suggest that co-financing can enhance development of better forms of interdisciplinary and interorganisational collaboration through legitimising formulation of common long-term goals, while emphasising mutual benefits.

Cooperative Behavior↗
PubMed2003

Cohort differences in obesity-related health indicators among 70-year olds with special reference to gender and education.

The aim of this study was to describe cohort differences in health indicators among four birth cohorts of 70-year old men and women from Göteborg, Sweden, born in 1901/2, 1905/6, 1911/12, and 1922. With special reference to gender, education, and obesity, it is hypothesized that changes in health among elderly men and women may not be occurring in a uniform manner. The variables studied were: systolic and diastolic blood pressures, triglycerides, cholesterol, height, weight, body mass index, waist-hip ratio, physical inactivity, current smoking, and alcohol consumption, plus selected prevalent diseases. Logistic and linear regression models were used to test for secular trends and effect modification by gender. Most trends in metabolic and lifestyle indicators varied in relation to gender as well as education. For instance, later-born male cohorts were more overweight than earlier-born groups while the later-born female cohorts had similar relative weights but a more centralized fat patterning. These cohort differences further varied by education where later-born men with less education and later-born women with higher education tended to be more overweight, compared to earlier-born cohorts. Finally, significant cohort differences in previously diagnosed myocardial infarction, stroke, and diabetes mellitus at age 70 were observed in men only. Interaction terms revealed that the gender difference was statistically significant only in the case of diabetes mellitus. In conclusion, secular trends in many obesity-related health indicators among 70-year old Swedish cohorts were dependent on both gender and socio-economic factors.

Aged↗
PubMed2003

Sexual and gender-related harassment in medical education and research training: results from a Swedish survey.

OBJECTIVE: The aims of this study were to establish the level of perceived sexual and gender-related harassment in undergraduate and doctoral studies, in which environment the events occurred, which categories of persons had committed the harassment, and other aspects of sexual harassment at the Faculty of Medicine, Gothenburg University. METHODS: A questionnaire was distributed to all registered male and female undergraduate students (n= 605) and doctoral students (n=743) by mail to their home addresses. RESULTS: The response rate was 62% (840/1348). Of the total study population, 59% (495/840) of respondents reported at least one experience of derogatory jokes and comments, 54% (454/840) of respondents reported at least one experience of gender-related discrimination, and 22% (187/840) of respondents reported at least one incident of sexual harassment. More severe types of sexual harassment were reported by 9% (79/840) of respondents. Women, and especially undergraduate women, were more often exposed to all kinds of harassment than were men. Lecturers/professors, doctors and co-students were the categories most often identified as the harassers. The harassment mostly occurred during lectures, clinical work and coffee breaks. The most common types of self-perceived mistreatment were derogatory jokes and comments. CONCLUSION: This survey shows that sexual harassment happens to both men and women, although it is more commonly experienced by female undergraduate and doctoral students, and that it occurs in both the university and hospital environments. Universities should develop action plans to prevent such events. Students and teachers should be well informed about appropriate measures to take in situations where harassment is known or suspected to occur.

Adult↗
PubMed2003

The role of benzodiazepines in elderly suicides.

AIMS: In Sweden, suicides by drug poisoning have decreased in the population at large during the past two decades. However, drug poisoning suicides increased among the elderly during this period. Suicides by benzodiazepine poisoning increased in this age group despite a reduction in prescription sales of these drugs. This study aims therefore to determine the role of benzodiazepines in suicide late in life. METHODS: Information concerning all definite suicides and deaths due to "undetermined" causes recorded among Swedish citizens aged 65 and above during 1992 - 96 was obtained from the Cause-of-Death Register. Death certificates were scrutinized to determine the type of drug employed in drug-related suicides. Results of the post mortem screening for drugs and alcohol were then examined. RESULTS: A benzodiazepine was implicated in 216/548 (39%) of the drug poisoning suicides recorded among the elderly. Death certificates revealed that a benzodiazepine was the sole agent in 72% of these cases. Flunitrazepam or nitrazepam were implicated in 90% of the single benzodiazepine suicides. In addition to the suicides classified as drug poisonings, 82 cases were found in which a drug may have contributed to the cause of death. Benzodiazepines predominated. The terminal cause of death was drowning, often in the victim's own bathtub, in three-quarters of these cases. The annual fatality ratios for the newer benzodiazepine-like hypnotics zopiclone and zolpidem appear to be on the rise. CONCLUSION: Benzodiazepines, especially the hypnotics flunitrazepam and nitrazepam, are common in drug poisoning suicides in the elderly and should be prescribed with caution for this age group.

Aged↗
PubMed2003

Self-reported illness and use of health services in a rural district of Vietnam: findings from an epidemiological field laboratory.

AIMS: The aims of the study were to assess the pattern of self-reported illness as well as use of health services in a rural district in Vietnam, and to analyse these in relation to gender, age, education level, occupation, and economic status. METHODS: A population-based survey of 11,089 households was conducted in 1999. Through household interviews, data were collected on self-reported health, use of health services during the four weeks prior to the interview, and other background factors. RESULTS: The prevalence of self-reported illness was 48%. Cough, fever, and headache were the most commonly reported symptoms (20%) while cardiovascular disorders were least reported (0.6%). Occurrence of illness was significantly lower in groups with higher education, especially among men, but there was no difference between occupational and economic groups. Self-treatment was very common (69%). Private health facilities were used to a large extent, while community health stations played a less important role. Use of district hospitals was significantly higher among employed people. DISCUSSION: An epidemiological field laboratory enabled analysis of self-reported illness and use of health services, which is important for planning of health services. We found a high level of reported illness but a very low utilization of community health services. Better knowledge about illness patterns could be important for improving quality of and access to community health services.

Adolescent↗
PubMed2003

Investigating the association between cigarette smoking and schizophrenia in a cohort study.

OBJECTIVE: Many case-control and cross-sectional studies have observed an association with cigarette smoking after the onset of schizophrenia, and there is evidence to suggest that smoking may improve symptoms in people with this disorder. Here, the authors investigated whether cigarette smoking alters the risk of subsequently developing schizophrenia. No longitudinal studies have previously examined this relationship. METHOD: A cohort of 50,087 Swedish conscripts (98% were ages 18-20) was followed up by record linkage to the National Register of Inpatient Care from 1970 to 1996 to determine hospital admission for schizophrenia. Cox regression was used to obtain hazard ratios and 95% confidence intervals (CIs) for schizophrenia, according to smoking status. RESULTS: Smoking cigarettes at ages 18-20 was associated with a lower rate of developing schizophrenia after adjustment for confounders. There was a linear relationship between the number of cigarettes smoked and a lower risk of schizophrenia (adjusted hazard ratio for linear trend across smoking categories, 0.8 [95% CI=0.7-0.9]), with an adjusted hazard ratio for heavy smokers of 0.5 (95% CI=0.3-0.9) compared to that of nonsmokers. This association persisted when analysis was restricted to subjects diagnosed after the first 5 years following conscription to reduce possible prodromal effects of schizophrenia on smoking. CONCLUSIONS: Cigarette smoking may be an independent protective factor for developing schizophrenia. These results are consistent with animal models showing both neuroprotective effects of nicotine and differential release of prefrontal dopamine in response to nicotine. The harmful effects of cigarette smoking vastly outweigh any possible benefits, but nevertheless, further investigation may lead to important insights regarding the etiology of schizophrenia at a molecular level.

Adolescent↗
PubMed2003

Paternal age and risk for schizophrenia.

BACKGROUND: Previously reported associations between advancing paternal age and schizophrenia could be due to an increase in paternal germ cell mutations or be confounded by heritable personality traits associated with schizophrenia that result in delayed parenthood. AIMS: To investigate this association while adjusting for personality traits related to poor social integration in the subjects. METHOD: A cohort of 50,087 adolescent males was followed up by record linkage to determine hospital admissions for schizophrenia between 1970 and 1996. RESULTS: Advancing paternal age was associated with an increased risk of developing schizophrenia in a 'dose-dependent' manner. The adjusted odds ratio for each 10-year increase in paternal age was 1.3 (95% CI 1.0-1.5; P=0.015). CONCLUSIONS: Advancing paternal age is an independent risk factor for schizophrenia. Adjusting for social integration in subjects made little difference to this association, consistent with the hypothesis that advancing paternal age may increase liability to schizophrenia owing to accumulating germ cell mutations.

Adolescent↗
PubMed2003

Pharmacy practitioners' views on computerized documentation of drug-related problems.

OBJECTIVE: To evaluate the practice by community pharmacy practitioners of computerized documentation of drug-related problems (DRPs) and pharmacy interventions in nonprescription drug consumers. METHODS: A questionnaire was administered in December 1999 to pharmacy practitioners in 45 community pharmacies of different sizes and locations across Sweden to survey their attitudes and experiences after participation in a 10-week period of computerized DRP documentation. RESULTS: The participants (n = 376, response rate 84%) found the development of computerized documentation of DRPs and pharmacy interventions to be very important. The instrument was perceived as easy to learn and to work well in daily practice. The documentation made many practitioners more attentive to the drug-related needs of self-care consumers and changed their perception of good quality in self-care counseling. The weighted multiple linear regression analysis showed no correlation between the proportion of practitioners experiencing time constraints and the DRP documentation rate of their work site. However, the magnitude of interest in the documentation practice had a significant effect on the documentation rate, regardless of the extent of the time constraints experienced (p = 0.004). CONCLUSIONS: The positive findings of the evaluation speak in favor of an expanded implementation of computerized documentation of DRPs and pharmacy interventions. Commitment among participating pharmacy practitioners to the new practice is essential and appears to overcome possible time constraints.

Attitude of Health Personnel↗
PubMed2002

Self reported cannabis use as a risk factor for schizophrenia in Swedish conscripts of 1969: historical cohort study.

OBJECTIVES: An association between use of cannabis in adolescence and subsequent risk of schizophrenia was previously reported in a follow up of Swedish conscripts. Arguments were raised that this association may be due to use of drugs other than cannabis and that personality traits may have confounded results. We performed a further analysis of this cohort to address these uncertainties while extending the follow up period to identify additional cases. DESIGN: Historical cohort study. SETTING: 1969-70 survey of Swedish conscripts (>97% of the country's male population aged 18-20). PARTICIPANTS: 50 087 subjects: data were available on self reported use of cannabis and other drugs, and on several social and psychological characteristics. MAIN OUTCOME MEASURES: Admissions to hospital for ICD-8/9 schizophrenia and other psychoses, as determined by record linkage. RESULTS: Cannabis was associated with an increased risk of developing schizophrenia in a dose dependent fashion both for subjects who had ever used cannabis (adjusted odds ratio for linear trend of increasing frequency 1.2, 95% confidence interval 1.1 to 1.4, P<0.001), and for subjects who had used only cannabis and no other drugs (adjusted odds ratio for linear trend 1.3, 1.1 to 1.5, P<0.015). The adjusted odds ratio for using cannabis >50 times was 6.7 (2.1 to 21.7) in the cannabis only group. Similar results were obtained when analysis was restricted to subjects developing schizophrenia after five years after conscription, to exclude prodromal cases. CONCLUSIONS: Cannabis use is associated with an increased risk of developing schizophrenia, consistent with a causal relation. This association is not explained by use of other psychoactive drugs or personality traits relating to social integration.

Adult↗
PubMed2002

Evaluation of the effect of co-financing on collaboration between health care, social services and social insurance in Sweden.

In this paper, we present an ongoing research project aimed to determine the impact of co-financing on collaboration around patients with musculoskeletal disorders. A trial legislation that allows the social insurance, social services and health care services to unite in co-financing under joint political steering has been tested in different areas in Sweden. In a series of studies, we compare collaboration processes and health outcome for patients with musculoskeletal disorders between health centres with co-financing projects and control health centres without co-financing projects. In this paper the studies are described and some preliminary results are discussed.

Journal Article↗
PubMed2002

Mortality in three different cohorts of 70-year olds: the impact of social factors and health.

BACKGROUND AND AIMS: Little is known about changes in mortality among elderly over time, especially in subgroups differing in social and other background factors. The aim of this study was to analyze differences in mortality in three different cohorts of 70-year olds regarding social factors, social network, self-assessed health and number of diseases. METHODS: We used data from 3 random samples of 70-year olds born in 1901/02 (N=973), 1906/07 (N=1036) and 1911/12 (N=619). At age 70 all participants were given medical examinations and interviewed regarding social background, social network, self-assessed health, need of care and number of diseases. Death records were obtained up to and including 1998. RESULTS: The youngest cohorts had significantly decreased mortality compared to the oldest cohort (RR 0.86; CI 0.78-0.95 and RR 0.88; CI 0.78-0.995 respectively). There were no differences between the two youngest cohorts. Decrease in mortality in the younger cohorts was found among those who lived in their own home, did not feel tired, were non- or ex-smokers and had one or more diseases. CONCLUSIONS: There was a small difference in total mortality between these cohorts of 70-year olds. There were differences in development of mortality in subgroups distributed by health and social factors, indicating more years of life, partly due to life-style factors such as non-smoking.

Aged↗