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Biomedical subjects

E Osterberg

Publications and source records attributed to E Osterberg.

At least 19 recordsLinked to original sources

Psychological factors in irritable bowel syndrome: a population-based study of patients, non-patients and controls.

BACKGROUND: It has been suggested that psychopathology in irritable bowel syndrome (IBS) patients is a function of patient status rather than of the disease. Although there are many studies comparing IBS patients, IBS non-patients, and controls with each other, no previous study has recruited all three groups from a representative community sample and had all subjects diagnosed by a physician. In the present study we aimed to compare psychological factors in IBS patients, IBS non-patients, and normal controls in a sample recruited from the population. METHODS: Subjects aged 18-45 years were recruited from a random sample of the normal population. Seventeen (2 M and 15 F) IBS patients were matched by sex and age with IBS non-patients and normals. Measures of personality traits, interpersonal distress, and temporary psychological distress were used. A physician diagnosed all 51 subjects in order to exclude possible gastrointestinal diagnoses other than IBS. RESULTS: Controls often differed from IBS non-patients and patients on the personality, interpersonal, and psychological distress measures, while IBS non-patients and patients very rarely differed from each other. All three groups were non-alexithymic. CONCLUSIONS: The results indicate that there are psychopathological differences between normals and IBS persons (patients and non-patients), but they could not confirm that psychopathology was a function of patient status. Whether this psychopathology is a vulnerability factor for IBS, or a consequence of it, remains to be studied.

Adult↗

A population study on irritable bowel syndrome and mental health.

BACKGROUND: Irritable bowel syndrome (IBS) is commonly thought to be associated with psychologic distress. However, in some studies only persons who had sought medical care for IBS (IBS patients) showed an increased frequency of psychiatric symptoms, and nonpatients did not differ significantly from normal subjects. Our aims were 1) to estimate the prevalence of IBS in the population aged 18-45 years, 2) to find the proportion seeking medical care for IBS, and 3) to compare IBS subjects with normals, and IBS patients with IBS nonpatients with regard to mental health. METHODS: Questionnaires on IBS symptoms and the General Health Questionnaire (GHQ) were mailed to 5000 randomly sampled persons aged 18-45 years. The response rate was 58%. RESULTS: IBS was found in 7.4% of the men and 13.3% of the women. Those who had sought medical attention had more severe symptoms. The Likert mean score on the GHQ was 4.7 (95% confidence interval, 4.4-5.0) points higher for the IBS group than for normals (P < 0.001). There was no difference in GHQ scores between IBS patients and nonpatients. CONCLUSIONS: The results indicate that IBS per se is associated with more psychiatric distress, regardless of medical care-seeking. Seeking medical care is associated with more severe IBS symptoms.

Adult↗

Unrecorded alcohol consumption: its economics and its effects on alcohol control in the Nordic countries.

The starting point of this paper is the fact that no country has complete records of alcohol consumption. In addition to being a matter or statistical accuracy, unrecorded alcohol also plays an important role in alcohol policy discussions. Furthermore, its quantity is bound to basic economic laws. These latter two aspects are the main interest in this paper, which discusses, first, what is really meant by unrecorded alcohol consumption and what kind of categories are included in it. The next task is to discuss the economics of different categories of unrecorded alcohol and the mechanisms which lead to increases or decreases in them. The examples in this part of the paper come from the Nordic countries. Arguments about increased smuggling and illegal distilling have always been used against alcohol policy restrictions in the Nordic countries. Recently the level of travellers' alcohol imports and border trade have also been used for the same purpose. In the European Union the task to harmonize alcohol excise taxes is partly given to increased travellers' duty-free allowances and market forces. This policy has already led to reductions in alcohol taxation both in Denmark and Sweden.

Alcohol Drinking↗

The influence of economic interests on alcohol control policy: a case study from Finland.

Finland's participation in the European Union has meant that Finnish markets have been opened to international competition and that the traditional alcohol policy decision-making that revolved around Alko, the state alcohol monopoly company, has become impossible. The influence of private commercial interests increased in the 1990s but not in a straightforward manner. They had their biggest influence in the mid-1990s when the 1994 Alcohol Act was drafted and accepted. After that the influence of commercial interests has declined, and nowadays the alcohol question is again discussed in terms of public health and safety and drinking among young people. Integration did not lead to the expected deregulation of alcohol control but to new forms of regulation, where EU authorities such as the Commission and the EU Court also play an important role. Alcohol policy-making is now more transparent, and free trade and competition without interference are much more stressed than previously. These are the new frames of public intervention in the alcohol question, both in the trade of alcoholic beverages and in the taking care of individuals harmed by the use of alcohol.

Alcohol Drinking↗

Young women with symptoms of urinary tract infection. Prevalence and diagnosis of chlamydial infection and evaluation of rapid screening of bacteriuria.

OBJECTIVE: To estimate the prevalence of chlamydial infection among young women with UTI symptoms. To evaluate chlamydia diagnostics with the aid of enzyme immuno assay (EIA) on first-void urine. To evaluate rapid screening of bacteriuria, including low concentrations of common pathogens. DESIGN: EIA for detection of Chlamydia trachomatis antigen and confirmation with immunofluorescence test (DFA) in urine, cervical and urethral chlamydia culture, nitrite and granulocyte esterase test, urine sediment, chamber count, dipslide and conventional urine culture were performed. SETTING: Primary health care (PHC). PATIENTS: 217 women aged 15-35 years attending PHC for dysuria or urgency-frequency. MAIN OUTCOME MEASURES: Frequency of chlamydial infections. Sensitivity, specificity, predictive values of EIA and bacteriuria screening tests, respectively. RESULTS: The frequency of chlamydial infection was 3.7%. In spite of a high specificity of the EIA test (0.94 without DFA) the number of false positives exceeded the number of true positives. No single bacteriuria test showed sufficient diagnostic efficiency. CONCLUSIONS: Routine chlamydia testing in young women with UTI symptoms is recommended. EIA test on urine is of little use. Assessing diagnosis of UTI symptoms requires insight into the use of several rapid tests and a dialogue with the patient.

Adolescent↗

Protein-rejecting ability of surface-bound dextran in end-on and side-on configurations: comparison to PEG.

There is much interest in attaching polyethylene glycol (PEG) and other hydrophilic, neutral polymers to surfaces to reduce the extent of protein and cell adsorption. Interestingly, these same surface-bound polymers are effective in masking surface charge and reducing electrokinetic effects such as particle electrophoretic mobility, streaming potential, and electroosmosis. It is apparent that similar molecular properties are responsible for both protein and cell rejection and reduction of electrokinetic effects. In this work we compared the fibrinogen-rejecting ability and the effect on electrophoretic mobility of three polymer coatings bound to polystyrene. The three polymers were side-bound dextran, end-bound dextran, and end-bound PEG. The results of these measurements were used to elucidate the importance of polymer packing density and polymer layer thickness on protein adsorption and reduction of electrokinetic effects. Protein adsorption appears not to be sensitive to polymer layer thickness or the presence of dilute polymer tails in a surface coating, while electrokinetic effects are. Protein adsorption is, however, very sensitive to the availability of exposed surface. Finally, the unique effectiveness of PEG is apparent in this research as in previous studies.

Adsorption↗

How do GPs discuss subjects other than illness? Formulating and evaluating a theoretical model to explain successful and less successful approaches to discussing psychosocial issues.

A theoretical model was formed, according to grounded theory, to understand how discussions about psychosocial problems might be designed. It was used in 19 videotaped consultations where it was considered relevant for the physician to take up psychosocial issues. 'Concern' i.e. that the patient could express that which was most pressing, was used as an indicator of outcome. A uniform pattern was observed in those cases where the patients expressed 'concern', in that the physician encouraged the patient by using open-ended questions, by following up the information received, and by having an empathic approach. On the other hand, in consultations where 'concern' was not expressed, it was noticed that the physician often asked close-ended, leading or negative questions, thus putting an end to the dialogue and, as a consequence, to the follow-up phase. Important therapeutic skills would appear to be the ability to reassure and support the patient as well as to be able to explain the connection between the patient's symptoms and psychosocial problems, rather than to solve these problems.

Adult↗

Potential consequences from possible changes to Nordic retail alcohol monopolies resulting from European Union membership.

This paper projects the consequences of modifying or eliminating the current national alcohol retail monopolies in Sweden, Norway and Finland as a possible result of those countries' membership in the European Union (EU). First, the authors project absolute alcohol consumption in each country based on different possible changes in alcohol price and availability. Then they predict the future levels of alcohol-related problems likely to result from increased per capita alcohol consumption (Sweden and Norway only). All of the scenarios examined in this paper are expected to lead to increases in per capita alcohol consumption. The smallest increase in consumption would result from a partial elimination of the current monopoly and a modest reduction in alcohol prices. In that case, projected per capita consumption in Sweden for inhabitants 15 years and older would rise from 6.3 to 9.3 litres; in Norway, from 4.7 to 6.7 litres; and in Finland, from 8.4 to 11.1 litres. The greatest projected increase in consumption would result from a complete elimination of the state monopolies such that all beer, wine and spirits were sold in food shops, grocery stores and gasoline stations, along with a substantial drop in alcohol prices as a result of private competition within each country and increased cross-border alcohol purchases. That scenario would result in projected per capita consumption of 12.7 litres in Sweden, 11.1 litres in Norway and 13.7 litres in Finland. The authors project that a 1-litre increase in consumption would result in a 9.5% increase in total alcohol-related mortality in Sweden and a 9.7% increase in Norway. Further, alcohol-related assaults would increase by 9% in Sweden and 9.6% in Norway. A 5-litre increase in consumption would result in a 62% increase in alcohol-related mortality in Sweden and a 60% increase in Norway, and a 57% increase in alcohol-involved assaults in both countries.

Alcohol Drinking↗

Effects of branching and molecular weight of surface-bound poly(ethylene oxide) on protein rejection.

To understand better the origin of protein rejection observed with surface-bound poly(ethylene oxide) (or PEO), we have measured fibrinogen adsorption for a series of linear and branched, low-molecular-weight PEOs bound to solid polystyrene surfaces. The results show that a dependence on molecular weight is found below 1500 g mol-1 for linear PEO. Branched PEOs are less effective at protein rejection than linear PEOs. The branched PEOs have smaller exclusion volumes (from GPC) than the corresponding linear PEOs, consistent with restriction in conformational freedom for the branched compounds. The protein rejection results are interpreted in terms of entropy changes that result upon protein adsorption. In addition, some practical problems in preparation of PEO glycidyl ethers have been clarified, thus making these PEO derivatives more useful for surface modification.

Adsorption↗

From large projects to case consultation--interaction of alcohol research and policy in Finland.

The interaction of Finnish social alcohol research and alcohol policy will be discussed in this paper. We will examine the history of alcohol research, focusing on the extent that problems related to alcohol policy have been covered in research. We also deliberate upon such questions as to what extent changes in alcohol policy can be linked to the findings of research. Researchers began their work in the 1950s, hoping to find a solution to the problems met in alcohol policy. In the 1960s the era of alcohol policy-centred projects was followed by an era which aimed to increase the factual knowledge of alcohol not necessarily tied to alcohol policy questions. After 1969 alcohol policy questions gained renewed interest. Alcohol research has not directly caused many new measures, but it has influenced the public and private discussion about alcohol policy. Producing results and research reports has been an important way to affect both public discussions and policy making. However, participating in the decision making processes in its different stages has been an even more crucial way to affect alcohol policy. Particularly in the 1970s, the ideas and views presented in studies had fairly immediate and direct repercussions on both alcohol policy and practical measures.

Alcohol Drinking↗

The prices of alcoholic beverages in the Nordic countries.

Apart from Denmark, all the Nordic countries have state-owned monopolies which handle all of the off-premise retail sales of wine and spirits. In some of the countries, the state monopoly also distributes strong and medium-strong beer. This paper discusses how the prices of beer, wine and spirits are set in the Nordic countries and compares the setting of prices in each. The paper shows that there are great differences both between the prices of alcoholic beverages in the Nordic countries and between the price-fixing mechanisms. The main part of the price differential is due to differences in taxation, but substantial discrepancies still exist when we look at prices exclusive of alcohol taxes. The reason for this is to be found in differences in profits and in the efficiency of producing and distributing alcoholic beverages. According to our data, it seems that some of the state monopolies are more effective than firms in the Danish market.

Alcoholic Beverages↗

Effects of alcohol control measures on alcohol consumption.

This paper first very briefly discusses different kinds of alcohol control measures, and after that reviews the available studies of the effects of control measures on alcohol consumption. During recent years the field of evaluation of alcohol control measures has matured and drawn on new technologies. The new prevention evaluation literature has also taken several directions. Taken together, the results of various studies have very clearly shown that control measures can influence drinking patterns, and in turn the rate of drinking problems. However, effects of changes in alcohol prices and availability are also determined by the social, cultural, and economic circumstances characteristic to each country and period.

Alcohol Drinking↗

Evaluation of the adenosine triphosphate test in the diagnosis of urinary tract infection.

Determination by bioluminescence of the bacterial adenosine triphosphate (ATP) level in urine was evaluated as a method for detection of bacteriuria in 1126 women with symptoms of UTI and 530 attending for follow-up. Conventional urine culture was used as reference method. The criterion for bacteriuria was growth of greater than or equal to 10(5) cfu/ml, giving a prevalence of 0.60. ATP levels of less than 10 nmol/l and greater than 50 mmol/l indicated abacteriuria and bacteruiria, respectively, whereas intermediate concentrations required culture if the nitrite test was negative. With this diagnostic strategy the sensitivity and specificity was 0.96 and 0.90 at the first visit and 0.90 and 0.98 at follow-up. With some methodological improvement the ATP test could be useful in medium-sized and small laboratories.

Adenosine Triphosphate↗