Anxiety and depression lowers blood pressure: 22-year follow-up of the population based HUNT study, Norway

<p>Abstract</p> <p>Background</p> <p>For decades, symptoms of anxiety and depression have been included among psychological factors associated with development of hypertension. Although this has been questioned in recent studies, most findings have been based on a single assessment of mental distress at baseline. We examined these associations using repeated assessments of anxiety, depression and blood pressure.</p> <p>Methods</p> <p>Data on 17,410 men and women aged 20 to 67 participating in the Nord-Trøndelag Health Study (HUNT) in Norway in 1984-86 were re-examined 11 and 22 years later. The main outcome was change in mean blood pressure (mm Hg) during follow-up.</p> <p>Results</p> <p>We found that a high symptom level score (≥80^thpercentile) of combined anxiety and depression at baseline, as compared to a lower symptom level, was associated with lower mean systolic (-0.67 mm Hg, p <it>= </it>0.044) and diastolic (-0.25 mm Hg, p <it>= </it>0.201) blood pressure at year 22. A high symptom level present at all three examinations was associated with a stronger decrease in mean systolic (-1.59 mm Hg, p <it>= </it>0.004) and diastolic (-0.78 mm Hg, p <it>= </it>0.019) blood pressure and with a 20% (p = 0.001) lower risk of developing hypertension (BP ≥140/90 mm Hg) at year 22. The associations were only slightly attenuated in multivariate analyses, with no evidence of a mediating effect of alteration in heart rate.</p> <p>Conclusions</p> <p>This study do not support previous hypothesis that emotional stress may be a cause of hypertension. Our findings indicate that symptoms of anxiety and depression are associated with decrease in blood pressure, particularly when a high symptom level can be detected over decades.</p

Long-term survival and quality of life after intensive care for patients 80 years of age or older

Background: Comparison of survival and quality of life in a mixed ICU population of patients 80 years of age or older with a matched segment of the general population. Methods: We retrospectively analyzed survival of ICU patients ≥80 years admitted to the Haukeland University Hospital in 2000–2012. We prospectively used the EuroQol-5D to compare the health-related quality of life (HRQOL) between survivors at follow-up and an age- and gender-matched general population. Follow-up was 1–13.8 years. Results: The included 395 patients (mean age 83.8 years, 61.0 % males) showed an overall survival of 75.9 (ICU), 59.5 (hospital), and 42.0 % 1 year after the ICU. High ICU mortality was predicted by age, mechanical ventilator support, SAPS II, maximum SOFA, and multitrauma with head injury. High hospital mortality was predicted by an unplanned surgical admission. One-year mortality was predicted by respiratory failure and isolated head injury. We found no differences in HRQOL at follow-up between survivors (n = 58) and control subjects (n = 179) or between admission categories. Of the ICU non-survivors, 63.2 % died within 2 days after ICU admission (n = 60), and 68.3 % of these had life-sustaining treatment (LST) limitations. LST limitations were applied for 71.3 % (n = 114) of the hospital non-survivors (ICU 70.5 % (n = 67); post-ICU 72.3 % (n = 47)). Conclusions: Overall 1-year survival was 42.0 %. Survival rates beyond that were comparable to those of the general octogenarian population. Among survivors at follow-up, HRQOL was comparable to that of the age- and sex-matched general population. Patients admitted for planned surgery had better short- and long-term survival rates than those admitted for medical reasons or unplanned surgery for 3 years after ICU admittance. The majority of the ICU non-survivors died within 2 days, and most of these had LST limitation decisions

Factors Associated with Enhanced Gross Motor Progress in children with Cerebral Palsy : A Register-based Study

Author's accepted version (post-print).This is an Accepted Manuscript of an article published by Taylor & Francis in Physical & Occupational Therapy In Pediatrics on 01/05/2018, available online: http://www.tandfonline.com/10.1080/01942638.2018.1462288.Available from 02/05/2019.acceptedVersio

Lower-risk gambling limits : linked analyses across eight countries

The Lower Risk Gambling Guidelines project was funded by a grant to the Canadian Centre on Substance Use and Addiction from Mise sur Tois a now defunct, independent, not-for-profit organization that received an annual contribution to conduct safer gambling initiatives from the Quebec crown corporation in charge of conducting and managing gambling in the province of Quebec, Canada. Publisher Copyright: © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.A common public health initiative in many jurisdictions is provision of advice to people to limit gambling to reduce the risk of gambling-related harm. The purpose of this study is to use consistent methodology with existing population-based prevalence surveys of gambling and related harms from different countries to identify quantitative limits for lower risk gambling. Risk curve analyses were conducted with eleven high quality data sets from eight Western countries. Gambling indicators were monthly expenditure, percentage of income spent on gambling, monthly frequency, and number of different types of gambling. Harm indicators included financial, emotional, health, and relationship impacts. Contributing data sets produced limit ranges for each gambling indicator and each harm indicator, which were compared. Gender differences in limit ranges were minor. Modal analysis, an assessment of the mean of the upper and lower range limits, indicated that the risk of harm increases if an individual gambles at these levels or greater: $60 to$120 CAD monthly, five to eight times monthly, spends more than 1 to 3% of gross monthly income or plays three to four different gambling types. This study provides further evidence that lower-risk gambling guidelines can be based upon empirically derived limits.Peer reviewe

Essays on Distance Based (Non-Euclidean) Tests for Spatial Clustering in Inhomogeneous Populations : Adjusting for the Inhomogeneity through the Distance Used

This thesis consits of four papers dealing with distance based (non-Euclidean) tests for spatial clustering in inhomogeneous populations. The density adjusted distance (DAD), which considers the underlying density, is defined in the first paper. The proposed distance can be used together with any of the old distance based methods developed for traditional homogeneous spatial patterns. The test statistics in distance based tests can all be seen as a weighted sum of distance measures for distances between n cases with known co-ordinates. DAD based test statistics are developed and their performance is compared with the performance of previously suggested tests by simulation in the second paper. The tests are compared in different types of data set and for various kinds of clustering. It is shown that no test is the optimal choice for all alternative hypotheses and that the tests are unequally sensitive to the structure of the underlying data. Tests based on the DAD are often a good alternative. Test statistics and graphical tools for the Empirical Distribution Function of DAD are developed and examined in the third paper. We show that the result of an EDF test combined with EDF plots provides more information about the possible nature of clustering in a sample than the result of a parametric test only

Risk of problem gambling among occupational groups: a population and registry study.

Aims: To identify which occupational groups have elevated levels of regular gambling participation and at-risk and problem gambling, and to explore job-specific factors associated with elevated levels. Methods: Statistical analyses were performed on data from the 2015 Swedish population study on gambling and health. The principal registry variable was occupation, classified according to the Swedish version of the International Standard Classification of Occupations (ISCO-08). Two gambling variables were studied: regular gambling participation and at-risk and problem gambling, as measured by the Problem Gambling Severity Index (PGSI). For statistical regression analyses, socio-demographic data were used such as gender, income, and country of origin. Results: We found significant differences between occupational groups with regard to the two gambling variables. In general, manual jobs with predominantly male workers scored high, especially when there was no fixed workplace. Several significant differences remained when we controlled for gender. We also found support for three types of workers having elevated levels on the gambling variables: (1) building, construction and service, mobile, (2) vehicle drivers, and (3) monotonous manual indoor work. These results were confirmed by comparisons with propensity score matched controls. Conclusion: A policy implication of this study is that some occupational groups should be prioritised in the prevention of problem gambling. Theoretically, the study shows that occupational categories represent real-life cultures and contexts of gambling and non-gambling as distinct from the abstract socio-demographic factors that are usually considered in relation to gambling participation and problem gambling

Problem Gambling Features and Gendered Gambling Domains Amongst Regular Gamblers in a Swedish Population-Based Study

This study aimed to investigate, from a gender perspective, how different features of problem gambling present in men and women who gamble regularly in Sweden were distributed in four domains based on gambling type (chance or strategy) and setting (public or domestic). Problem gambling features were based on the nine items in the Problem Gambling Severity Index (PGSI). It was hypothesized that men and women gamble in different domains. Further, it was hypothesized that male gamblers overall experienced more problems with gambling than female gamblers, although in the same domains they would report the same level of problems. A further hypothesis predicted that regular female gamblers would experience more health and social problems and men would experience more financial difficulties. Interviews with a subsample of gamblers (n = 3191) from a Swedish nationally representative sample (n = 8179) was used to examine how features of problem gambling correspond with gender and the domains. Only the first hypothesis was fully supported. Men were more likely to participate in forms of gambling requiring strategy in a public setting, and women were more likely to participate in chance-based gambling in a domestic setting. Male and female gamblers had similar levels of problem gambling in the bi-variate analysis, but if controlling for age and gambling in multiple domains, women were more at risk than men. Additionally, men and women presented similar health and economic situations. The differences between male and female gamblers in Sweden have implications for research and prevention

The concerned significant others of people with gambling problems in a national representative sample in Sweden - a 1 year follow-up study

Background: Research into the impact of problem gambling on close social networks is scarce with the majority of studies only including help-seeking populations. To date only one study has examined concerned significant others (CSOs) from an epidemiological perspective and it did not consider gender. The aim of this study is to examine the health, social support, and financial situations of CSOs in a Swedish representative sample and to examine gender differences. Methods: A population study was conducted in Sweden in 2008/09 (n = 15,000, response rate 63%). Respondents were defined as CSOs if they reported that someone close to them currently or previously had problems with gambling. The group of CSOs was further examined in a 1-year follow up (weighted response rate 74% from the 8,165 respondents in the original sample). Comparisons were also made between those defined as CSOs only at baseline (47.7%, n = 554) and those defined as CSOs at both time points. Results: In total, 18.2% of the population were considered CSOs, with no difference between women and men. Male and female CSOs experienced, to a large extent, similar problems including poor mental health, risky alcohol consumption, economic hardship, and arguments with those closest to them. Female CSOs reported less social support than other women and male CSOs had more legal problems and were more afraid of losing their jobs than other men. One year on, several problems remained even if some improvements were found. Both male and female CSOs reported more negative life events in the 1 year follow-up. Conclusions: Although some relationships are unknown, including between the CSOs and the individuals with gambling problems and the causal relationships between being a CSO and the range of associated problems, the results of this study indicate that gambling problems not only affect the gambling individual and their immediate close family but also the wider social network. A large proportion of the population can be defined as a CSO, half of whom are men. While male and female CSOs share many common problems, there are gender differences which need to be considered in prevention and treatment

Forms of gambling, gambling involvement and problem gambling: evidence from a Swedish population survey.

The purpose of this study was to explore the association between problem gambling (PG) and participation in different forms of gambling in order to elucidate relationships between PG, gambling involvement and gambling intensity. Using data from the first wave of the Swedish Longitudinal Gambling Study (Swelogs) (n = 4,991), the study tested four hypotheses, namely that (1) some forms of gambling are more closely associated with PG than other forms; (2) high gambling involvement is associated with PG; (3) gambling involvement is positively associated with the intensity of gambling; and (4) the relationship between gambling involvement and PG is influenced by the specific forms of gambling in which individuals participate. All four hypotheses were supported. More specifically, the study found that while many PGs regularly participate in multiple forms of gambling, half of PGs participate regularly in only one or two forms of gambling. The study concluded that some forms of gambling are more closely associated with problem gambling than other forms, and that gambling policy and regulation, as well as the development of responsible gambling initiatives, should focus on these forms