Efficacy of a real-time patient feedback system: patient satisfaction study in psychiatry.

Aim: The aim of the study was two-fold: first, to assess the efficacy of an electronic real-time feedback system; second, to examine patient satisfaction.Methods: This was a mixed-method study. Data were collected from two psychiatric outpatient clinics using electronic patient feedback devices. The efficacy of the real-time feedback system was assessed by calculating the overall response rate, and the response rate to each individual five-point Likert scale statement and open-ended question by using descriptive statistics. Patient satisfaction was examined by analyzing the response rate to each statement. Open-ended feedback was analyzed by using inductive qualitative content analysis.Results: The overall response rate was 21.0% (n = 1658) and response rates varied by statements. Most of the patients saw that they received the appointment to the outpatient clinic quickly enough (n = 1404, 85%), the personnel treated them well (n = 1126, 95%), the information about the care was understandable (n = 1066, 94%), and decisions regarding their care were made together with them (n = 1051, 94%). Of the patients, 94% (n = 1052) would recommend the service. Positive open-ended feedback highlighted good service, skilled staff, perceived benefits and help from care. Critique and development areas dealt with the large number of forms that required filling out beforehand, subjective experience of long waiting times, and having too many collaborative professionals present during treatment.Conclusions: The real-time feedback system proved to be an efficient method of gathering patient feedback. Patient satisfaction seemed to be high with received care in all fields.

Effect of intensive exercise in early adult life on telomere length in later life in men.

A career as an elite-class male athlete seems to improve metabolic heath in later life and is also associated with longer life expectancy. Telomere length is a biomarker of biological cellular ageing and could thus predict morbidity and mortality. The main aim of this study was to assess the association between vigorous elite-class physical activity during young adulthood on later life leukocyte telomere length (LTL). The study participants consist of former male Finnish elite athletes (n = 392) and their age-matched controls (n = 207). Relative telomere length was determined from peripheral blood leukocytes by quantitative real-time polymerase chain reaction. Volume of leisure-time physical activity (LTPA) was self-reported and expressed in metabolic equivalent hours. No significant difference in mean age-adjusted LTL in late life (p = 0.845) was observed when comparing former male elite athletes and their age-matched controls. Current volume of LTPA had no marked influence on mean age-adjusted LTL (p for trend 0.788). LTL was inversely associated with age (p = 0.004).Our study findings suggest that a former elite athlete career is not associated with LTL later in life. Key pointsA career as an elite-class athlete is associated with improved metabolic health in late life and is associated with longer life expectancy.A career as an elite-class athlete during young adulthood was not associated with leukocyte telomere length in later life.Current volume of leisure-time physical activity did not influence telomere length in later life.

A former career as a male elite athlete--does it protect against type 2 diabetes in later life?

AIMS/HYPOTHESIS: The aim of this study was to determine the prevalence of impaired glucose regulation in male Finnish former elite athletes and age- and area-matched controls. We hypothesised that vigorous physical activity during young adulthood protects from disturbances in glucose regulation in later life. METHODS: In 2008, 392 former male elite athletes (mean age 72.7 ± 6.1 years) and 207 controls (mean age 71.6 ± 5.6 years) participated in a clinical study (participation rate: 50.6%). The former athletes were divided into three groups based on their active career sport: endurance, mixed and power sports. Participants without a history of diabetes (n = 537) underwent a 2 h 75 g OGTT. Current volume of leisure-time physical activity (LTPA) was determined by self-reported questionnaires and expressed in metabolic equivalent hours (MET-h). Data on reimbursable diabetes medication from participants and non-participants was obtained from the register of the Finnish Social Insurance Institution. RESULTS: Compared with the controls, the former elite athletes had a significantly lower risk of type 2 diabetes (OR 0.72, 95% CI 0.53, 0.98). The risk of type 2 diabetes decreased with increased LTPA volume (OR 0.98, 95% CI 0.97, 0.99 per 1 MET-h/week). The former elite athletes also had a significantly lower risk of impaired glucose tolerance (IGT) than the controls (OR 0.58, 95% CI 0.38, 0.87). CONCLUSIONS/INTERPRETATION: A former career as an elite athlete protected from both type 2 diabetes and IGT in later life. In addition, the volume of current LTPA was inversely associated with the prevalence of type 2 diabetes.

Telomere length in circulating leukocytes is associated with lung function and disease.

Several clinical studies suggest the involvement of premature ageing processes in chronic obstructive pulmonary disease (COPD). Using an epidemiological approach, we studied whether accelerated ageing indicated by telomere length, a marker of biological age, is associated with COPD and asthma, and whether intrinsic age-related processes contribute to the interindividual variability of lung function. Our meta-analysis of 14 studies included 934 COPD cases with 15 846 controls defined according to the Global Lungs Initiative (GLI) criteria (or 1189 COPD cases according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria), 2834 asthma cases with 28 195 controls, and spirometric parameters (forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC) of 12 595 individuals. Associations with telomere length were tested by linear regression, adjusting for age, sex and smoking status. We observed negative associations between telomere length and asthma (ß= -0.0452, p=0.024) as well as COPD (ß= -0.0982, p=0.001), with associations being stronger and more significant when using GLI criteria than those of GOLD. In both diseases, effects were stronger in females than males. The investigation of spirometric indices showed positive associations between telomere length and FEV1 (p=1.07×10(-7)), FVC (p=2.07×10(-5)), and FEV1/FVC (p=5.27×10(-3)). The effect was somewhat weaker in apparently healthy subjects than in COPD or asthma patients. Our results provide indirect evidence for the hypothesis that cellular senescence may contribute to the pathogenesis of COPD and asthma, and that lung function may reflect biological ageing primarily due to intrinsic processes, which are likely to be aggravated in lung diseases.

Former male elite athletes and risk of hypertension in later life.

OBJECTIVE: The aim of this study was to assess whether a former career as an elite athlete protects from hypertension in later life. We hypothesized that vigorous physical activity during young adulthood protects against hypertension later in life. METHODS: The study population (n = 3440) consists of 2037 former male elite athletes and 1403 matched controls. Of those, 599 (392 former athletes, 207 controls) participated in a clinical study in 2008. The athletes were divided into three groups: endurance, mixed and power sports. Assessment of hypertension was based on athletes' entitlement to reimbursable antihypertensive medication from the Finnish Social Insurance Institution; among the clinical study participants, this was also based on self-reported current use of antihypertensive drugs or measured hypertension. The current volume of leisure-time physical activity (LTPA) was determined by questionnaires. RESULTS: Among the participants, the former athletes had lower age-adjusted prevalence of hypertension than the controls [odds ratio (OR) 0.69, 95% confidence interval (CI) 0.49-0.98] and the endurance athletes had the lowest OR (OR 0.43, 95% CI 0.23-0.80). OR for the prevalence of hypertension decreased (OR 0.90, 95% CI 0.84-0.96 per 10 metabolic equivalent hours/week) when there was an increase in the volume of LTPA. The former athletes without blood pressure-lowering medication had significantly lower SBP than the controls [139.2 mmHg (SD 18.7) vs. 144.2 mmHg (SD 19.5)] (P = 0.027). CONCLUSION: A former career as an elite athlete seems to be associated with a lower prevalence of hypertension in later life. The volume of current LTPA was inversely related to prevalence of hypertension.

Lifetime physical activity and cancer incidence--a cohort study of male former elite athletes in Finland.

OBJECTIVES: Physical activity has been shown to decrease the risk of certain cancers. Objective of this study was to assess the effect of physical activity on cancer incidence in former male athletes in older age. DESIGN: A cohort of 2448 elite male athletes and 1712 referents was followed-up for cancer incidence during 1986-2010 through the Finnish Cancer Registry. METHODS: Standardised incidence ratios were calculated with the general male population as the reference. Self-reported questionnaire-based data on covariates were used in Cox regression analyses comparing the risk of cancer in athletes and referents. RESULTS: The overall cancer incidence was lower in athletes than in the general population, standardised incidence ratio 0.89 (95% confidence interval 0.81-0.97). It was lowest among middle-distance runners (standardised incidence ratio 0.51, 95% confidence interval 0.22-1.01), long-distance runners (standardised incidence ratio 0.57, 95% confidence interval 0.35-0.88) and jumpers (standardised incidence ratio 0.60, 95% confidence interval 0.37-0.92). The standardised incidence ratio of lung cancer among athletes was 0.40 (95% confidence interval 0.27-0.55) and that of kidney cancer 0.23 (95% confidence interval 0.06-0.57). The hazard ratio for lung cancer between athletes and referents increased from the unadjusted ratio of 0.29 (95% confidence interval: 0.18-0.48) to 0.61 (95% confidence interval: 0.30-1.26) after adjustment for smoking status and pack-years of smoking. CONCLUSIONS: Former male elite athletes evidently have less cancer than men on the average. The lesser risk can be attributed to lifestyle factors, notably less frequent smoking among the athletes.

Physical activity, mood and the functioning of daily living A longitudinal study among former elite athletes and referents in middle and old age.

We studied whether factors related to type of sport participated in as young adults and level of and changes in physical activity later in life predict changes in mood as well as functioning during a 6-year follow-up. A cohort of male Finnish former athletes (N=504), referents (N=349) was followed up for changes in physical activity, in relation to subsequent self-reported mood and functioning of daily living in 1985, 1995, and 2001. The mean age of the cohort was 68.6 years in 2001. Multinomial logistic regression analysis was used to assess changes in mood and functioning between 1995 and 2001 in relation to baseline values and changes in exposure variables and covariates. A low level of physical activity in 1985 predicted a decrease in physical functioning between 1995 and 2001 in the lowest physical activity compared to the highest quintile as well as poor physical functioning at the end of follow-up in 2001. An increase in physical activity between 1985 and 1995 protected against onset of anxiety between 1995 and 2001. Physical activity for elderly seems to have an important role in reducing the progress of deficiencies in physical functioning and in preventing onset of anxiety.