Ulla Romild

The Swedish Longitudinal Gambling Study (Swelogs): design and methods of the epidemiological (EP-) track

Swelogs (Swedish Longitudinal Gambling Study) epidemiological (EP‐) track is a prospective study with four waves of data‐collection among Swedish citizens aged 16–84 years at baseline. The major objectives of this track are to provide general population estimates of the prevalence and incidence of problem and at‐risk gambling and enable comparisons with the first Swedish national study on gambling and problem gambling (Swegs) conducted in 1997/1998. The overall study (Swelogs) comprises three tracks of data collection; one epidemiological, one in‐depth and one follow‐up. It is expected to provide information that will inform the development of evidence‐based methods and strategies to prevent the development of gambling problems. This paper gives an overview of the design of the epidemiological track, especially of its two first waves. The baseline wave, performed between October 2008 and August 2009, included 8165 subjects, of whom 6021 were re‐assessed one year later. A stratified random sampling procedure was applied. Computer‐supported telephone interviews were used as the primary method. Postal questionnaires were used to follow‐up those not reached by telephone. The response rate was 55% in the first wave and 74% in the second. The interview and questionnaire data are supplemented by register data.

Incidence of Internet gambling in Sweden: results from the Swedish longitudinal gambling study

In the present study, Internet gambling was studied with data from the first two waves of the Swedish longitudinal gambling study. Self-reported gambling problems, alcohol consumption, smoking, mental health, social support, gender and other socio-demographic factors were evaluated with respect to the prevalence of Internet gambling in 2008 and 2009 and the incidence in 2009. Multivariate logistic regression was used. In 2009 most Internet gamblers (72%) were men. However, women seem to have become more involved in Internet gambling. In 2009, 62.5% of new Internet gamblers since 2008 were men. Mental health, alcohol, smoking and social support were not predictive factors for incident Internet gambling. Self-reported gambling on regulated Internet sites showed higher prevalence rates of problem gamblers than gambling on land-based forms in 2008, but not in 2009. At both time-points, unregulated sites had the highest rates of problem gambling. The findings suggest that a gender perspective on Internet gambling is needed as well as carefully designed policies and research related to the regulation of Internet gambling.

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

BackgroundComparison 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.MethodsWe 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.ResultsThe 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)).ConclusionsOverall 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.

Effects of Different Screening and Scoring Thresholds on PGSI Gambling Risk Segments

High quality gambling participation and prevalence studies are important to monitor and manage risks associated with an ever changing gambling environment. Such studies are expensive and choices must be made to balance precision and cost constraints. Common approaches include not screening infrequent gamblers and/or gamblers with low gambling expenditure, on the assumption that these gamblers are unlikely to be problem gamblers. Some studies combine moderate risk and problem gamblers to obtain robust groups for analysis. The resultant methodological variations compromise comparability and interpretation of changes over time and across jurisdictions. The Victorian Gambling Study 2008–2012 (VGS) and the Swedish Longitudinal Gambling Study 2008–2014 (Swelogs) are large jurisdiction-wide surveys with sample sizes of 15,000 and 8,165 respectively. Both studies screened all past-year gamblers. This paper reports on the modelling of some common methodological variants. Understanding the impact of these different variations enables better design of future studies and facilitates comparisons between existing prevalence studies within and across jurisdictions.

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

Abstract 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.

A gender perspective on gambling clusters in Sweden using longitudinal data

Aims This study describes five groups of gamblers and changes in their gambling involvement and gambling problems over four years with a particular focus on whether gambling problems among men and women develop differently within the five groups. Design The study sample is a subset of participants from the Swedish Longitudinal Gambling Study (Swelogs). Six different clusters of past-year gambling, based on frequency of participation in the nine most common forms of gambling in Sweden (lotteries, horses, number games, sports games, bingo, poker, slot machines, casino games or TV contests) were identified in Two-Way Cluster Analysis after the first wave of data collection in 2008/09. There were 2,508 individuals identified in EP1 (n=5,012) who then also participated in waves EP2 and EP3 and were selected for the present analysis. Methods Statistical analysis was done in SPSS 22.0 using Pearsons Chi-Square test of Independence (or Fishers Exact test when the requirements or expected frequency were not met for Pearsons Test), Mann-Whitney U-test and logistic regression. P-values below 0.05 were regarded as significant. Results Gambling remains gendered in Sweden. Even though the clusters are based on gambling activities, there are differences between men and women within the clusters as regards the gambling participation patterns. Conclusions Men and women gamble differently, but they may still be equals in their total experience of gambling and in relation to how their gambling problems develop. All differences need to be taken into consideration when preventive actions or messages are created.

Factors Associated with Enhanced Gross Motor Progress in Children with Cerebral Palsy: A Register-Based Study

ABSTRACT Aim: To examine associations between interventions and child characteristics; and enhanced gross motor progress in children with cerebral palsy (CP). Methods: Prospective cohort study based on 2048 assessments of 442 children (256 boys, 186 girls) aged 2–12 years registered in the Cerebral Palsy Follow-up Program and the Cerebral Palsy Register of Norway. Gross motor progress estimates were based on repeated measures of reference percentiles for the Gross Motor Function Measure (GMFM-66) in a linear mixed model. Mean follow-up time: 2.9 years. Results: Intensive training was the only intervention factor associated with enhanced gross motor progress (mean 3.3 percentiles, 95% CI: 1.0, 5.5 per period of ≥3 sessions per week and/or participation in an intensive program). Gross motor function was on average 24.2 percentiles (95% CI: 15.2, 33.2) lower in children with intellectual disability compared with others. Except for eating problems (–10.5 percentiles 95% CI: –18.5, –2.4) and ankle contractures by age (–1.9 percentiles 95% CI: –3.6, –0.2) no other factors examined were associated with long-term gross motor progress. Conclusions: Intensive training was associated with enhanced gross motor progress over an average of 2.9 years in children with CP. Intellectual disability was a strong negative prognostic factor. Preventing ankle contractures appears important for gross motor progress.