BackgroundThere is potential for medical research on the basis of routine data used from general practice electronic health records (GP eHRs), even in areas where there is no common GP research platform. We present a case study on menopausal women with hypertension and metabolic syndrome (MS). The aims were to explore the appropriateness of the standard definition of MS to apply to this specific, narrowly defined population group and to improve recognition of women at high CV risk.MethodsWe investigated the possible uses offered by available data from GP eHRs, completed with patients interview, in goal of the study, using a combination of methods. For the sample of 202 hypertensive women, 47–59 years old, a data set was performed, consisted of a total number of 62 parameters, 50 parameters used from GP eHRs. It was analysed by using a mixture of methods: analysis of differences, cutoff values, graphical presentations, logistic regression and decision trees.ResultsThe age range found to best match the emergency of MS was 51–55 years. Deviations from the definition of MS were identified: a larger cut-off value of the waist circumference measure (89 vs 80 cm) and parameters BMI and total serum cholesterol perform better as components of MS than the standard parameters waist circumference and HDL-cholesterol. The threshold value of BMI at which it is expected that most of hypertensive menopausal women have MS, was found to be 25.5. The other best means for recognision of women with MS include triglycerides above the threshold of 1.7 mmol/L and information on statins use. Prevention of CVD should focus on women with a new onset diabetes and comorbidities of a long-term hypertension with anxiety/depression.ConclusionsThe added value of this study goes beyond the current paradigm on MS. Results indicate characteristics of MS in a narrowly defined, specific population group. A comprehensive view has been enabled by using heterogenoeus data and a smart combination of various methods for data analysis. The paper shows the feasibility of this research approach in routine practice, to make use of data which would otherwise not be used for research.

Population aging is the global demographic trend in EU countries in the last decades. Aging is associated with unfavorable sociodemographic factors such as widowhood, lower physical and mental functioning, and fewer possibilities for social participation. All these factors have been found to be associated with loneliness – a feeling of social isolation. Living with feeling of loneliness may, in turn, have negative implications on quality of life, physical and mental health, and mortality, of elderly individuals. The aim was to assess associations of feeling of loneliness with sociodemographic and psycho-social characteristics and comorbidities of older individuals from the general population. The sample consisted of 189 (58% F) older individuals (> 50 years) (mean ± SD, 78.47 ± 6.65), attenders in Primary Health Care. Apart from sociodemographic characteristics and comorbidities, participants were described by psychological characteristics, assessed by a set of standard questionnaires, including: UCLA loneliness scale, MSPSS (Multidimensional Scale of Perceived Social Support), GAS (Geriatric Anxiety Scale), GDS (Geriatric Depression Scale), ADL (Activities of Daily Living), IADL (Instrumental Activities of Daily Living), GSE (General Self-Efficacy) and ERQ (Emotional Regulation Questionnaire). The effect of particular blocks of factors on status loneliness was assessed by the hierarchical regression model. We also analyzed if any of psychological characteristics mediate associations between comorbidities and loneliness, when controlling for sociodemographic characteristics. The results indicated that older individuals who lived alone, had difficulties in relations with their family members, suffered from depression, and had lower level of education, felt much lonely. Individuals who were generally engaged in hobbies, were less lonely. The level of comorbidity was shown to be associated with loneliness, with some diagnoses contributing more than some others. Some psychological traits can lessen feeling of loneliness, while anxiety and depression make it worsen. Mediation analysis informed us on how to help patients with comorbidities to feel less lonely, including interventions such as those that can reduce anxiety and depression, improve cognitive abilities and emotional regulation, and enhance social support.

The study aimed to determine behavioral responses (symptoms) to chronic stress of senior medical students induced by academic demands and to identify learning and lifestyle behaviors associated with these symptoms. The study included 116 students of the two last university years (5 th and 6 th) of the Faculty of Medicine, University of Osijek, eastern Croatia. A newly formed 31-item questionnaire was used for this purpose. A large majority of students (95.7%) had at least one symptom and 62% had 3 or more, out of the maximum 6 symptoms examined. Symptoms showed a tendency for grouping in a graded manner. Participant students were divided into two groups according to the lower or higher levels of the symptom complexity expression (<3 vs ≥3 symptoms) and differences in their learning and lifestyle behaviors were assessed accordingly. Lifestyle behaviors which showed significant differences indicate low physical activity, lack of extracurricural activities, disrupted sleep schedule and variations in body weight in the exam period. Study results are expected to inform future studies and prevention of mental and global health decline in senior medical students.