Bertil Marklund

Attitudes and Behaviors with Regards to Androgenic Anabolic Steroids Among Male Adolescents in a County of Sweden

Aims. The aim of this study was to investigate attitudes towards androgenic anabolic steroids among male adolescents who have used anabolics compared to those who have not. Design and Setting. 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. Participants and Measurements. 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). Findings. 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 [odds ratio (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). Conclusion. Attitudes towards 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.

Working together — primary care doctors’ and nurses’ attitudes to collaboration

Background: Multidisciplinary teamwork is recommended for various disorders and it has been suggested that it is a way to meet the new challenges and demands facing general practitioners (GPs) in modern society. Attempts to introduce the method in primary care have failed partly due to GPs’ unwillingness to participate. The aim of this study was to measure attitudes towards collaboration among GPs and district nurses (DN) and to investigate whether there is a correlation between a positive attitude toward collaboration and high self-esteem in the professional role. Methods: The Jefferson Scale of Attitudes toward Physician Nurse Collaboration and the Professional Self-Description Form (PSDF) was used to study a cohort of 600 GPs and DNs in Västra Götaland region. The purpose was to map differences and correlations of attitude between DNs and GPs, between male and female GPs, and between older and younger DNs and GPs. Results: Four hundred and one answers were received. DNs (mean 51.7) were significantly more positive about collaboration than GPs (mean 49.4). There was no difference between younger and older, male and female GPs. DNs scored higher on the PSDF-scale than GPs. Conclusions: DNs were slightly more positive about collaboration than GPs. A positive attitude towards collaboration did not seem to be a part of the GPs’ professional role to the same extent as it is for DNs. Professional norms seem to have more influence on attitudes than do gender roles. DNs seem more confident in their profession than GPs.

Nonprescription Drug—Related Problems and Pharmacy Interventions

OBJECTIVE: To document the number and types of drug-related problems (DRPs) identified in customers purchasing nonprescription products in Swedish pharmacies; describe the distribution of DRPs by customers gender, age, underlying ailment, and class of drug; determine whether problems are identified to the same extent in pharmacies with staffed nonprescription self-service departments as in pharmacies with over-the-counter sales; and document the number and types of pharmacy interventions to prevent or resolve DRPs, including reasons for drug switches and referrals to physicians. METHODS: A computerized instrument for documentation of DRPs and pharmacy interventions was developed. The study was conducted in 45 volunteer pharmacies in Sweden during 10 weeks in late 1999. RESULTS: A total of 1425 problems and 2040 interventions were recorded by 308 pharmacy practitioners. Relatively fewer DRPs were documented in pharmacies with self-service departments. The most common DRPs were uncertainty about the indication for the drug (33.5%) and therapy failure (19.5%). Dyspepsia was the most frequently specified symptom (11.4%). Consumers of dermatologic products had significantly higher rates of problems than expected in relation to sales volume. The most common ways of responding to a problem were with consumer drug counseling (61.1%), switching of drugs (43.9%), and referral to a physician (27.5%). CONCLUSIONS: The study has demonstrated a need for more professional attention and intervention by pharmacy staff to prevent and rectify DRPs in nonprescription consumers. It seems especially important to make sure that consumers receive the appropriate drugs for their current ailments.

Social physique anxiety and sociocultural attitudes toward appearance impact on orthorexia test in fitness participants

This study investigates how scores on the Social Physique Anxiety Scale (SPAS) and the Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ) relate to Bratmans orthorexia test (BOT) scores with regard to age, sex, and self‐reported exercise frequency and duration in a sample of Swedish participants in fitness center activities. A total of 251 participants (166 women and 85 men) completed the SPAS, the SATAQ, and a questionnaire focusing on exercise frequency and duration. The results indicated that the SATAQ subdomain internalization could itself explain the variation in BOT results. In women, the results indicated that exercise frequency, followed by SPAS score and the SATAQ subdomains internalization and awareness, could together explain the variation in BOT results. Fitness centers could make a point of emphasizing that some physical ideals are neither healthy nor realistic, thus strengthening member self‐image and preventing social physique anxiety, eating disorders, and negative attitudes toward appearance.

Characteristics of frequent attenders in different age and sex groups in primary health care.

Little is known about the characteristics of frequent attenders within different age bands and sex groups. Frequent attenders have an age and sex-specific morbidity. They have a higher consulting frequency for most medical problems and a significantly higher consumption of antibiotics than other patients. Objective r - r To compare frequent attenders in different age and sex groups with a control group according to characteristics and use of primary health care. Design r - r Descriptive study of medical records. Setting r - r Primary health care centre. Subjects r - r 341 frequent attenders, divided by age and sex, were compared with 1025 controls from the same area. Main outcome measures r - r Consultation rate, diagnoses, prescribed medicine, referrals and certificates of illness during one year. Results r - r Frequent attenders constituted 3.3% of the population but accounted for 25% of all visits to the GP and 44% of all illness certificates allocated. They were given more antibiotic prescriptions and consulted the GP more often for most medical problems. Frequent attenders had a morbidity, with a preponderance of infections at a young age, musculoskeletal and respiratory problems in middle age, and, among the oldest, circulatory, endocrine and musculoskeletal diseases. Conclusion r - r Frequent attenders had a morbidity within different ages similar to that of the controls, but also a higher consulting frequency for most medical problems and a significantly higher consumption of antibiotics. Are frequent attenders more vulnerable individuals and more prone to all kinds of diseases, or do they just consult more often for the usual medical problems?

PREDICTIVE FACTORS FOR WORK CAPACITY IN PATIENTS WITH MUSCULOSKELETAL DISORDERS

OBJECTIVE To identify predictive factors for work capacity in patients with musculoskeletal disorders. DESIGN A descriptive, evaluative, quantitative study. SUBJECTS/PATIENTS The study was based on 385 patients who participated in a rehabilitation programme. METHODS Patients were divided into 2 groups depending on their ability to work. The groups were compared with each other with regard to sociodemographic factors, diagnoses, disability pension and number of sick days. The patients level of exercise habits, ability to undertake activities, physical capacity, pain and quality of life were compared further using logistic regression analysis. RESULTS Predictive factors for work capacity, such as ability to undertake activities, quality of life and fitness on exercise, were identified as important independent factors. Other well-known factors, i.e. gender, age, education, pain and earlier sickness certification periods, were also identified. Factors that were not significantly different between the groups were employment status, profession, diagnosis and levels of exercise habits. CONCLUSION Identifying predictors for ability to return to work is an essential task for deciding on suitable individual rehabilitation. This study identified new predictive factors, such as ability to undertake activities, quality of life and fitness on exercise.

Young women's sexual health and their views on dialogue with health professionals

Background. Many women who experience sexual problems or who have been subjected to sexual abuse, do not seek help, and often health professionals avoid raising such issues. The aim of this study was to describe young womens sexual health and their views on a dialogue about aspects of sexuality in connection with a gynecologic examination. Method. Cross‐sectional study. Women, 23, 26 and 29 years of age, called for gynecologic screening between March and July 2006 (n = 488; response rate 75%). Descriptive statistics, multiple logistic regression and bivariate analysis were used. Results. The majority (95%) had a positive attitude towards sexuality, although many women reported sexual problems, and one‐fifth (22%) were dissatisfied with their sex life. Women considered it appropriate to be asked about sexuality in general (92%), while a majority (72%) found questions about sexual abuse appropriate. However, depending on the area, the majority (76–99%) had never been asked such questions. Demographic variables, aspects of life, sexuality and sexual abuse were irrelevant for whether women considered it appropriate to be asked questions about aspects of sexuality, by a midwife/doctor in connection with a gynecologic examination. Conclusion. The result can activate health professionals to initiate a dialogue about sexual issues among young women. In this way, many women who experience sexual problems or have been subjected to sexual abuse, may be provided the opportunity to improve their sexual health.

Prevalence of non-healed and healed chronic leg ulcers in an elderly rural population.

Scand J Prim Health Care 2000;18:58–60. ISSN 0281-3432 als who had negated present or previous leg ulceration, giving the total prevalence of 12.6%. Objecti7e – To estimate the prevalence of non-healed and healed Conclusion – The result indicates a certain risk for overestimation of chronic leg ulcers in an elderly rural population. prevalence, as well as underestimation and decreased reliability when Design – All persons 70 years or older were asked about present and basing the figures only on telephone interviews or posted questionprevious leg ulcers. naires. Setting – A rural village in mid-west Sweden with 4000 inhabitants. Participants – 541 persons aged 70 years and above.OBJECTIVE To estimate the prevalence of non-healed and healed chronic leg ulcers in an elderly rural population. DESIGN All persons 70 years or older were asked about present and previous leg ulcers. SETTING A rural village in mid-west Sweden with 4000 inhabitants. PARTICIPANTS 541 persons aged 70 years and above. OUTCOME MEASURES The prevalence of healed or non-healed chronic leg ulcers in the population aged > or = 70. RESULTS Healed or non-healed leg ulcers were reported by 53 persons (9.8%). Examination of these patients and also 100 individuals who had negated present or previous leg ulceration, giving the total prevalence of 12.6%. CONCLUSION The result indicates a certain risk for overestimation of prevalence, as well as underestimation and decreased reliability when basing the figures only on telephone interviews or posted questionnaires.

Type 2 diabetes: perceptions of quality of life and attitudes towards diabetes from a gender perspective

OBJECTIVE To compare obese and normal-weight people with type 2 diabetes (T2DM), with a focus on their attitudes towards the disease, quality of life (QoL) and treatment from a gender perspective. METHODS Two hundred and eighty-seven people with T2DM participated in a cross-sectional study. Health-related quality of life (HRQL) data from the Medical Outcomes Short Form Study 36 (SF 36), Well-Being Questionnaire (W-BQ12), Diabetes Attitude Scale (DAS) and Diabetes Treatment Satisfaction Questionnaire (DTSQs) were used. The results are presented descriptively. The Mann-Whitney U-test was conducted to examine differences between normal-weight and obese diabetics and between women and men. RESULTS The results of this study show that there was a gender difference in the perception of QoL; obese females with diabetes experienced more limitations in daily life due to physical and emotional problems than obese males with diabetes. Obese men had reduced physical and vitality scores compared to normal-weight individuals. Compared to normal-weight females with diabetes, obese women had lower vitality scores, more body pain and more severe physical impacts. The negative emotional impact for obese females with diabetes was also demonstrated by the results of the W-BQ12 questionnaire. Obese females with diabetes felt that the disease was more overwhelming and difficult to handle in comparison to obese males with diabetes. There was no difference between the groups in terms of how they experienced treatment. CONCLUSION There was a gender difference in the perceptions of QoL of people with T2DM. There was also a difference between the QoL of obese and normal-weight people with T2DM, as the obese may suffer from underlying depression. Further investigations are needed for health professionals to be able to meet the unique needs of each specific diabetic group.

Trends in the misuse of androgenic anabolic steroids among boys 16-17 years old in a primary health care area in Sweden.

Objective - To evaluate the effects of an appearance programme in preventing the misuse of androgenic anabolic steroids among male adolescents in a primary health care area in Sweden. Methods - Attitudes to steroid hormones among 16-17 years old male and female adolescents are discussed. A well-established anonymous multiple-choice questionnaire was answered by 921 adolescents and statistically analysed. Results - The misuse of androgenic anabolic steroids tended to decrease after the intervention. Conclusions - The misuse of androgenic anabolic steroids did not increase, and even tended to decrease, after the intervention, indicating that drug-abuse among male adolescents can be decreased through discussions about appearance and attitudes. Repeat and prospective studies have to be done before this intervention programme can be generalised.OBJECTIVE To evaluate the effects of an appearance programme in preventing the misuse of androgenic anabolic steroids among male adolescents in a primary health care area in Sweden. METHODS Attitudes to steroid hormones among 16-17 years old male and female adolescents are discussed. A well-established anonymous multiple-choice questionnaire was answered by 921 adolescents and statistically analysed. RESULTS The misuse of androgenic anabolic steroids tended to decrease after the intervention. CONCLUSIONS The misuse of androgenic anabolic steroids did not increase, and even tended to decrease, after the intervention, indicating that drug-abuse among male adolescents can be decreased through discussions about appearance and attitudes. Repeat and prospective studies have to be done before this intervention programme can be generalised.