bluuebunny/crossref_metadata_2025 huggingface dataset:
Say Goodbye to the Fries: Graduate Careers in Media, Cultural and Communication Studies
Authors: Cunningham Stuart , Bridgstock Ruth
Published: January 2017

This article addresses the paucity of systematic data on graduate careers in the arts and humanities in the broader context of enduring public and policy debates about the benefits of education to society, the relation between public and private good that is derivable from education, and the specific disciplinary angle that can be brought to bear on these questions from media, cultural and communication studies. We report findings from a survey of ten years of graduates from Queensland University of Technology's courses in media, cultural and communication studies, which indicate very high employment levels and generally positive accounts of the relevance of courses to working life. A major insight that can be drawn from the research is that media, cultural and communication studies deliver capabilities, skills and orientations that are themselves strongly aligned with the kinds of transferable generic attributes that facilitate transition into the workplace.
The Relationship between Entertainment Producers and Higher Education Providers
Authors: McKee Alan , Silver Jon
Published: January 2017

Cameron, Verhoeven and Court have noted that many screen producers do not see their tertiary education as being beneficial to their careers. We hypothesise that universities traditionally have not trained students in producing skills because of the division of labour between arts and business faculties, and because their focus on art rather than entertainment has downplayed the importance of producing. This article presents a Scholarship of Teaching and Learning (SOTL) whole-of-program evaluation of a new cross-faculty Bachelor of Entertainment Industries degree at QUT, devoted to providing students with graduate attributes for producing, including creative skills (understanding story, the aesthetics of entertainment, etc.), business skills (business models, finance, marketing, etc.) and legal skills (contracts, copyright, etc.). Stakeholder evaluations suggest that entertainment producers are highly supportive of this new course.
Blogging the 2009 Queensland State Election
Authors: Kimber Megan
Published: January 2017

The internet has become important in political communication in Australia. Using Habermas's ideal types, it is argued that political blogs can be viewed as public spheres that might provide scope for the expansion of deliberative democratic discussion. This hypothesis is explored through analysis of the group political blog Pineapple Party Time. It is evident that the bloggers and those who commented on their posts were highly knowledgeable about and interested in politics. From an examination of these posts and the comments on them, Pineapple Party Time did act as a public sphere to some degree, and did provide for the deliberative discussion essential for a democracy, but it was largely restricted to Crikey readers. For a deliberative public sphere and democratic discussion to function to any extent, the public sphere must be open to all citizens, who need to have the access and knowledge to engage in deliberative discussion.
Media Ethnography and the Disappearance of Communication Theory
Authors: Nightingale Virginia
Published: January 2017

This article revisits the interplay of theories and research focusing on the interplay between anthropology, and communication and media studies, It argues that where initially media ethnographies (selectively) borrowed theories and methods from anthropology, today it is anthropological media ethnography that holds sway. The result is a shift away from media audience research. I suggest this is because the concept of audience is necessarily linked to assumed theories of communication. Yet it is precisely a theory of communication (as opposed to theories of culture) that is missing today. The article advocates that instead of borrowing theories of communication, we need to begin the more difficult task of retheorising it in order to better address contemporary media problems.
‘Grounding the Internet’: Categorising the Geographies of Locative Media
Authors: Nitins Tanya , Collis Christy
Published: January 2017

The advent of mobile internet and GPS led some to predict ‘the death of geography’. With information no longer anchored to specific locations, there were concerns that geography would simply dissolve into a placeless, global ‘Space of flows’. However, locative media is now shifting the focus away from placeless flows and back to geography. By equipping many mobile phones with GPS, locative media are now ‘grounding the internet’. This article provides an overview of existing literature and research in this field in order to develop a synthetic overview of the various types of locative media, and the geographies arising from them.
Public Service Broadcasting and Social Networking Sites: The Norwegian Broadcasting Corporation on Facebook
Authors: Moe Hallvard
Published: January 2017

Social networking sites have become staples in everyday life in many parts of the world. Public service broadcasters have ventured on to such services, aiming to reach new users. This move triggers a line of question about the borders between the public and the commercial, the control of content and the shifting power in media policy. Focusing on the Norwegian Broadcasting Corporation's use of Facebook, this article offers insights into what exactly is new about the challenges posed by social networking sites, and explores how this instance of hybrid arrangements impacts on our understanding of public service media.
Delicious Market Devices: Abc Magazines Media Kits
Authors: Burns Maureen
Published: January 2017

Like all our objects of research, public service media are not prey waiting in the world – we create them as research objects when we research and when we write. This is easy to forget in the case of public service media, which seem so familiar as research objects because they are already so overwritten. Often we begin the creation of our public service media research object from assumptions that we don't even feel the need to unpack. Public service media institutions might be (and have been) written as discourses, practices, philosophies, politics and/or histories. This article examines what it means to write and research public service media, and it discusses whether descriptions of assemblages that favour particular types of human agency over others – and human agency generally over non-human agents – are sufficient, or whether our research and writing practices might benefit from a hybridisation of methods as well as object(s).
Global Nature, Global Brand: Bbc Earth and David Attenborough's Landmark Wildlife Series
Authors: Richards Morgan
Published: January 2017

Landmark wildlife series like Life on Earth (1979), Planet Earth (2006) and Frozen Planet (2011) are synonymous with the BBC, and are largely seen as unquestioned embodiments of its public service values. Yet the landmark format for wildlife programming was designed from its outset to appeal to international television markets, particularly the US market. This article examines the history and evolution of David Attenborough's landmark series, tracing the development of the landmark format from its roots in the BBC's programming policy of the early 1960s through broader changes in national and international television markets to the development of the global brand BBC Earth. Combining close analysis of landmark wildlife series with ethnographic interviews with BBC Natural History Unit staff and detailed archival research, the article focuses on the role of BBC wildlife documentary in debates about how public service media should be defined and understood. It is concluded that landmark wildlife series have always evinced the tensions between the BBC's public service values and the need for these series to appeal to global television markets.
‘Submission’ to the rule of excellence: Ordinary affect and precarious resistance in the labor of organization and management studies
Authors: Ashcraft Karen Lee
Published: January 2017

In an unusually direct style of address, the article moves toward a novel critical practice stimulated by affect theory: inhabited criticism. This more-than-representational approach enacts vigilant attunement to the lively scenes, bodies, and trajectories of ordinary affects. I cultivate the practice by staging successive encounters with the contemporary labor of scholarship and, specifically, with an assemblage condensed as The Rule of Excellence. The first half of the article addresses The Rule through reigning critical practices in organization studies, which are recast as vacated criticism (disembodied analysis), humanized criticism (confessional tale), and reciprocated criticism (dialogue across dualisms) in order to sift their affective postures and implications for resistance. The second half then calls on affect theory to address The Rule anew, as an agentic, transpersonal current that animates academic landscapes and figures in troubling yet indeterminate ways. By performing, not only theorizing, inhabited criticism, I demonstrate how it can transcend stubborn dualisms and nourish relational enactments difficult to accomplish within the current critical practices of organization and management studies. Ultimately, I argue that inhabited criticism can (a) help us come to terms with the affective demands and limitations of all modes of criticism and (b) enact an alternative posture of resistance rooted in ‘sense-abilities’ of home, field, and their relation.
Adorno’s grey, Taussig’s blue: Colour, organization and critical affect
Authors: Beyes Timon , De Cock Christian
Published: January 2017

In this article, we seek to open up the study of affect and organization to colour. Often simply taken for granted in organizational life and usually neglected in organizational thought, colour is an affective force by default. Deploying and interweaving the languages of affect theory, critical theory and organization studies, we discuss colour as a primary phenomenon for the study of ‘critical affect’. We then trace colour’s affect in conditioning the unfolding of organization in two particular ‘colour/spaces’ – Adorno’s grey and Taussig’s blue of our title – and discuss both its ambiguity and critical potential. Finally, we ponder what colour might do to the style of an organizational scholarship attuned to affect, where sentences blur with things and forces more than they seek to represent them.
Work as affective experience: The contribution of Christophe Dejours’ ‘psychodynamics of work’
Authors: Dashtipour Parisa , Vidaillet Bénédicte
Published: January 2017

Psychoanalytic perspectives (such as the Kleinian/Bionian and Lacanian literature) have made significant contributions to the study of affect in organizations. While some have pointed out the affects involved in work tasks, most of this literature generally focuses on the affects linked to organizational life (such as learning, leadership, motivation, power, or change). The center of attention is not on affects associated with the work process itself. We draw from the French psychodynamic theory of Christophe Dejours—who is yet to be known in English language organization studies—to make the following contributions. First, we show the relationship between affect and working by discussing Dejours’ notions of affective suffering, the real of work, the significance of the body, and ‘ordinary sublimation’. Second, we advance critical research in organization studies by demonstrating the centrality of work in the affective life of the subject. Third, the article reinterprets Menzies’ well-known hospital case study to illustrate how Dejours’ theory extends existing psychoanalytical approaches, and especially to point to the significant role of the work collective in supporting workers to work well. We conclude by suggesting that if the centrality of work in the affective life of the subject is acknowledged, it follows that resistance strategies, and work collectives’ struggle for emancipation, should focus on reclaiming work.
Adapting a National Guideline for Local Use: A Comparative Case Study in a US and an Israeli Health Maintenance Organization
Authors: Shye Diana , Porath Avi , Browne Jonathan Betz
Published: January 2017

Objectives:

We compared the way a US and an Israeli health maintenance organization (HMO) used the Fifth Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (the JNG V) in developing a hypertension guideline.

Methods:

Comparative case study. We describe and contrast the two HMOs, the social contexts in which they function, their motivations for creating a local guideline and their guideline development processes. We then compare the two HMO guidelines with each other and with the JNC-V. Based on this analysis, we offer provisional answers to some key concerns raised by local adaptations of national or international guidelines. These include whether adaptations will reflect local cost-containment concerns in ways that could threaten quality of care, whether guidelines constitute a threat to physician autonomy and the relationship between local adaptations and the evolution of national or international guidelines.

Results:

The HMO guidelines differed substantially, and in similar ways, from the JNC-V in format, coverage and emphasis of topics. They differed from it minimally, but also in similar ways, in the content of their recommendations. Each HMO guideline ‘improvised’ on the JNC-V in ways that differed to reflect local needs and objectives but did not significantly distort the original. Quality of care considerations appeared to predominate over cost considerations, and we found no evidence that guidelines threatened physician autonomy.

Conclusions:

Local adaptations may function as part of the iterative process through which national or international guidelines evolve in ways more suitable for potential local use.
Best Place of Care for Older People after Acute and during Subacute Illness: A Systematic Review
Authors: Parker Gillian , Bhakta Padma , Katbamna Savita , Lovett Caroline , Paisley Suzy , Parker Stuart , Phelps Kay , Baker Richard , Jagger Carol , Lindesay James , Shepperdson Billie , Wilson Andrew
Published: January 2017

Objectives:

To assess the evaluative research literature on the costs, quality and effectiveness of different locations of care for older patients.

Methods:

A systematic review of evaluative research from 1988 using CRD4 guidelines. Twenty-five databases were searched, using processes developed specially for this review. Library OPACS, the Internet and research registers were also searched for relevant material. The final stage of the review was confined to randomised and pseudo-randomised trials. Studies were selected for review by pairs of researchers working independently who then met to reach a decision. Analysis was predominantly descriptive; simple pooled odds ratios were used to explore some outcomes.

Results:

Eighty-four papers from 45 trials were included. Firm conclusions were difficult to draw, except in relation to some outcomes for stroke units, early discharge schemes and geriatric assessment units. Few trials in this area have adequately addressed issues of patients' quality of life and costs to health services, social care providers, patients and their families.

Conclusions:

Despite considerable recent development of different forms of care for older patients, evidence about effectiveness and costs is weak. However, evidence is also weak for longer-standing care models. A substantial service evaluation agenda emerges from this review. This study also raises questions about the usefulness of systematic review techniques in the area of service delivery and organisation.
Does Ageism Affect the Management of Ischaemic Heart Disease?
Authors: Bond Matthew , Bowling Ann , McKee Dorothy , Kennelly Marian , Banning Adrian P , Dudley Nigel , Elder Andrew , Martin Anthony
Published: January 2017

Objectives:

To analyse access by age to exercise testing, coronary angiography, revascularisation (percutaneous transluminal coronary angioplasty/stent insertion and coronary artery bypass graft surgery) and receipt of thrombolysis, where indicated, for hospital patients with diagnosed cardiovascular disease.

Method:

Retrospective case note analysis, tracking each case backwards and forwards by 12 months from the patient's date of entry to the study. The setting was a district hospital in the eastern part of outer London. The case notes eligible for inclusion were those of elective and emergency in-patients with an in-patient ICD-10 code of ischaemic heart disease, angina pectoris or acute myocardial infarction and a consecutive 20% sample of new cardiac outpatients with these diagnoses.

Results:

Analysis of 712 case notes showed that older hospital patients with ischaemic heart disease, and with indications for further investigation, were less likely than younger people to be referred for exercise tolerance tests and cardiac catheterisation and angiography. This was independent of both gender and severity of condition. Older patients did not appear to be discriminated against in relation to receipt of indicated treatments (revascularisation or thrombolysis), although, in the case of revascularisation, older patients were more likely to have been filtered out at the investigation stage (catheterisation and angiography), so selection bias partly explains this finding.

Conclusions:

The current findings from a single hospital are comparable with the results from a broader study of equity of access by age to cardiological interventions in another district hospital in the same region. Although only two hospitals were analysed, the similarity of findings enhances the generalisability of the results presented here. It appears that age per se causes older cardiac hospital patients to be treated differently.
Setting Priorities on Waiting Lists: Point-Count Systems as Linear Models
Authors: Hadorn David ,   Steering Committee of the Western Canada Waiting List Project
Published: January 2017

The Western Canada Waiting List Project (WCWL) is a federally funded initiative designed to develop tools for managing waiting lists. The principal tools developed by WCWL are point-count measures that assess the severity of patients' conditions and the extent of benefit expected from wait-listed services. Points are assigned according to the severity of patients' symptoms and clinical findings. Points on each factor are added and the total score is considered indicative of relative clinical urgency. Such point-count measures function as linear models from a statistical perspective. This paper describes the relevance of this functional relationship for the development and validation of priority criteria.
Not a ‘proper’ solution? The Gap between Professional Guidelines and Users' Views about the Safety of Using Emergency Contraception
Authors: Ziebland Sue , Maxwell Krista
Published: January 2017

Objectives:

As a form of contraception which is used after sex, emergency contraception occupies a singular place in the birth control repertoire. The relatively high UK incidence of pregnancy terminations and of teenage pregnancy, combined with the recognition that much early sex remains unplanned and unprotected, has led to calls for better access to emergency contraceptive methods. In this study a combination of self-completion questionnaires and semi-structured interviews was used to explore views of emergency contraception among women who were using the method.

Methods:

Five hundred and ten women attending two family planning clinics in Oxford and London completed a questionnaire in the waiting room and 53 women who were attending for emergency contraception took part in semi-structured interviews.

Results:

The view, presented in recently published UK guidelines, that emergency contraception is a reliable method and not dangerous to repeat, was not shared by the respondents. The rationale for and sources of women's concerns about the strength of the dose of hormonal emergency contraception and the nature of side-effects are explored.
Public, Private and Voluntary Residential Mental Health Care: Is There a Cost Difference?
Authors: Knapp Martin , Chisholm Daniel , Astin Jack , Lelliott Paul , Audini Bernard
Published: January 2017

Objectives:

To determine how public (NHS or local government), private (for-profit) and voluntary (non-profit) providers of residential mental health care compare. Do they support different clienteles? And do their services cost different amounts?

Methods:

Based on a cross-sectional survey of residential care facilities and their residents in eight English and Welsh localities, the characteristics and costs of care in the different sectors (NHS, local government, private, voluntary) were compared. Variations in cost were examined in relation to residents' characteristics using multiple regression analyses, which also allowed standardisation of results before making inter-sectoral comparisons.

Results:

Private and voluntary providers of residential care support different clienteles from the public sector. The patterns of inter-sectoral cost differences vary between London and non-London localities. In London, voluntary sector facilities may be more cost-efficient than the other sectors, but local government/private sector comparisons show no consistent difference. Outside London, the results suggest clear cost advantages for the private and voluntary sectors over the local government sector.

Conclusions:

Private and voluntary providers may have some economic advantages over their public counterparts. However, outcomes for residents were not studied, leaving unanswered the question of comparative cost-effectiveness.
Does Volume Really Affect Outcome? Lessons from the Evidence
Authors: Sowden Amanda J. , Sheldon Trevor A.
Published: January 2017

There is a prevailing consensus that the quality of health services can be improved by concentrating care in the hands of those providers who carry out larger volumes of activity. The substantial research literature indicates a positive volume-quality relationship. However, these conclusions are largely based on observational studies using administrative databases which are poorly adjusted for case mix. Better control for confounding shows that volume-quality effects in several cases may be an artefact. The research is also difficult to interpret because of the limited measurement of outcomes, poor analysis of the relative contributions of the clinician and the hospital levels, and the lack of clarity about the direction of cause and effect. Most research is insufficiently reliable to inform policy on the use of volume for credentialling or for the re-configuration of services.
Can We Trust the Quality of Routine Hospital Outpatient Information in the UK?
Authors: Shaw Alison , Somerset Maggie , Dunn Liz , Peters Tim , Faulkner Alex , Sharp Deborah
Published: January 2017

Background:

A validation study of routine hospital outpatient data was carried out as part of a broader project focusing on outpatient re-attendance. The aim was to compare two patient administration system (PAS) data items with the same information collected directly from hospital clinicians.

Methods:

A total of 140 cases from four specialties at four National Health Service hospitals was randomly selected for comparison. The specific data items compared were the grade of doctor seen and the management decision taken following an outpatient appointment. The proportion of cases in which there was agreement was calculated, together with kappa values and relevant statistics indicating the accuracy of the PAS data when compared with information compiled immediately after the consultation by the relevant clinician.

Results:

There was agreement between the clinician's data and the PAS data in 118/140 (84.3%) cases for grade of doctor seen and in 105/139 (76.7%) cases for the management decision. There was complete agreement for both items in 88/139 (62.6%) cases. Kappa values indicated good agreement between the two data sources. However, ‘sensitivity’ statistics suggested that the likely accuracy of each data item varied.

Conclusion:

Although there was good agreement within individual categories between the two sources, 37% of patient computerised records held at least one inconsistency in this small study focusing on only two data items. Further systematic evaluation is needed to test the extent to which other items are similarly discrepant.
Evidence-Based Policy: Rhetoric and Reality
Authors: Raine Rosalind
Published: January 2017

Evidence-based policy has been hailed as the current zeitgeist in health care. Its intuitive appeal is clear but its implementation is problematic. This case study demonstrates the practical difficulties of using this approach for purchasing health care. New technologies suffer from limited knowledge about both their long-term benefits and their adverse effects. This undermines attempts to assess effectiveness and efficiency in local populations. Furthermore, the use of evidence should not be assumed to eliminate the need to apply value judgements, which has repercussions for the attainment of equity of access to health care. It is therefore unrealistic to view this approach as a panacea. Rather, evidence-based medicine should contribute to the decision-making process, in conjunction with other considerations such as equity and patient preference.
The use of teledermoscopy in the accurate identification of cancerous skin lesions in the adult population: A systematic review
Authors: Bruce Amy F , Mallow Jennifer A , Theeke Laurie A
Published: January 2017

Background

The use of teledermoscopy in the diagnostic management of pre-cancerous and cancerous skin lesions involves digital dermoscopic images transmitted over telecommunication networks via email or web applications. Teledermoscopy may improve the accuracy in clinical diagnoses of melanoma skin cancer if integrated into electronic medical records and made available to rural communities, potentially leading to decreased morbidity and mortality.

Objective and method

The purpose of this paper is to present a systematic review of evidence on the use of teledermoscopy to improve the accuracy of skin lesion identification in adult populations. The PRISMA method guided the development of this systematic review. A total of seven scholarly databases were searched for articles published between the years of 2000 and 2015. All studies were critically appraised using the Rosswurm and Larrabee critique worksheet, placed in a matrix for comparison evaluating internal and external validity and inspected for homogeneity of findings.

Results

Sixteen articles met inclusion criteria for this review. A majority of the studies were cross-sectional and non-experimental. Ten of the 16 focused on interobserver concordance and diagnostic agreement between teledermoscopy and another comparator. Instrumentation in conducting the studies showed inconsistency with reported results.

Discussion

Higher level evidence is needed to support clinical application of teledermoscopy for accuracy of diagnostic measurement in the treatment of pre-cancerous and cancerous skin lesions in adults. Future research is needed to develop a standardized, reliable and valid measurement tool for implementation in clinical practice.
Individual differences in pain sensitivity predict the experience of unfairness
Authors: Wang Haixia , Li Kefeng , Xie Xiaofei
Published: January 2017

Pain has shaped our evolutionary history, and pain-free experiences are critical for our health. There are, however, enormous individual differences in pain sensitivity, and the psychological consequences of this heterogeneity are only poorly understood. Here, we investigated whether individual differences in pain sensitivity predicted the experience of unfairness. We found that the magnitude of pain sensitivity correlated with the extent to which participants experienced unfairness. This association was due to the shared human alarm system of unfairness and pain sensitivity. This finding may elucidate mechanisms for producing a new and positive cycle of a healthy experience between fairness and feeling pain-free.
Exclusion of illegally obtained confessions in China
Authors: Guo Zhiyuan
Published: January 2017

The exclusion of illegally obtained evidence has long been the focus of theoretical research and legislative reform in China. After years of efforts, the exclusionary rule has finally found a foothold in Chinese statute. However, after the exclusionary rule has been officially established, the initial fervour for reform has given way to a difficult slog of changing actual practice. This article is based on a comprehensive empirical survey on the implementation of the exclusionary rule conducted by the author as the primary investigator. This article will address three key issues that stood out in the empirical surveys: the definition and scope of illegally obtained confession, proof of illegally obtained confession, and suppression hearing. In addressing each issue, the author will follow the similar structure: first share the empirical findings on the implementation of the exclusionary rule across the country, then examine the contributing factors causing the failure of implementation and identify the existing challenges that China encountered in implementing the new rules, and finally put forward some potential solutions to these problems based on comparative study and China’s special situation.
Records Based on Clinical Examination as an Indicator of Alcohol Involvement in Injuries at Emergency Stations
Authors: Honkanen Risto
Published: January 2017

Clinical detection of alcohol involvement (AI) and its recording (ethyl sign) in accident patients was evaluated by comparing the ethyl signs with blood alcohol concentrations (BAC) in 1012 injury victims. Of the 337 BAC-positive cases 50% had a positive ethyl sign, while an additional 13% had some reference to alcohol in their patient notes. Thus, the overall recording rate was 63%. Computer analysis of the statistics from the same emergency station revealed positive ethyl signs in 13.5% of all the 44 372 patients in 1973. The drunken victims of falls (44%) and fights & assaults (26%) formed the main bulk (70%) of all drunken injury patients. Ethyl sign was found to be a specific, though not a sensitive, indicator of AI and a useful device for studying the strain alcohol places upon the emergency services, statistically.
The Function of Drug Company Representatives
Authors: Hemminki Elina , Pesonen Terttu
Published: January 2017

The drug industry has a major influence on drug prescribing habits through their medical representatives. We therefore set out to see whether their work was more concerned with providing information or with selling, more with demand or with supply, and how much it cost in Finland. We interviewed currently employed and former representatives and contact persons in health institutions, and analysed advertisements for vacancies for medical representatives. It seems that companies regard detailing more as a sales activity than as public relations and that this trend towards selling has gained in importance in recent years. The number of representatives engaged in the pharmaceutical industry exceeds the demand for their services. The drug companies allotted in 1975 detailing at least 5000 Fmk ($1300) per physician per year. Our conclusion is that drug detailing is neither necessary nor beneficial for the health services.
Construction of the Computerized Accident Registration System in a Casualty Department
Authors: Honkanen Risto , Michelsson Jarl-Erik
Published: January 2017

The main benefit of computerized accident registration systems is that they assist, with the help of multi-dimensional cross-tabulation of variables, in the identification of high injury risk areas in the community. The E code of the International Classification of Diseases has been the traditional means for the causal classification of injuries. The applicability of its abridged version in ambulatory care settings was tested by the development of a classification with 50 accident type categories in the framework of the computerized statistics in a large casualty department treating more than 30000 new injuries annually. With maximally effective coding, the proportion of the ‘Other accidents’ category of the E code (E929) of all injuries can be reduced to 10%, but not less than that without its division into subcategories. Obviously, the E code should be further developed, better to meet the needs of ambulatory care. The registration system of this casualty department includes also a 15-category accident place classification, a 3-digit ICD diagnosis as well as demographic and time variables. In order to improve its problem identification power, accident object (agent) should still be added into its variable arsenal.
The Child and Family Eight Years after Undesired Conception
Authors: Rantakallio Paula , Myhrman Antero
Published: January 2017

This survey is a follow-up study, up to the age of 8 years of children reported to have been born from pregnancies not desired by the mother, in Northern Finland in 1966. The data were collected by means of a postal questionnaire sent separately to families and school teachers. Each child was assigned a control, born from a desired pregnancy and similar at the time of birth as regards mother's marital status, parity, and place of residence and also the social class of the father. No difference between the groups was found in the emotional development of the children. School performance was poorer among the unwanted children, but the difference was statistically significant only in respect of the need for additional instruction in writing. Evidence was also found that the parents in the control families worried more about the health of their children than did those of the unwanted children. Even when the social standing of the families was matched as regards time of birth, the families with unwanted children showed more downward and less upward social mobility during the intervening 8 years than did the control families, and there were also indications of differences in lifestyle preference between the families. The conclusion was therefore drawn that undesired conception selects a subgroup of less capable families from each social class, and that the differences found in the children can also be explained by differences in social and economic standing between these two groups of families.
Health Insurance Records in the Course of Alcoholism
Authors: Berglund Mats
Published: January 2017

The Health Insurance Records of 32 male alcoholics were related to outcome after 2 years, with regard to drinking habits, self-esteem, social stability and Temperance Board registrations. The numbers of sickness benefit days were found significantly related to drinking habits ( p <0.05), self-esteem ( p <0.01), social stability ( p <0.01) and Temperance Board registrations ( p <0.001). These levels of significance were generally higher than those between the outcome variables themselves. The number of sickness benefit days was superior to the incidence of sickness in describing the clinical course. Categorization according to the diagnoses did not increase the strength of the relationships with the outcome variables. The number of sickness benefit days during the 5-year period prior to the first examination was significantly related to Temperance Board registrations ( p <0.01) and social stability ( p <0.05) during the follow-up period but not to drinking habits or self-esteem. No relationship was found between the number of sickness benefit days during this 5-year period and the follow-up period. It is concluded that Health Insurance Records are of use in follow-up studies on alcoholics.
Utilization of a Hospital Emergency Department in Stockholm
Authors: Magnusson Gudjon
Published: January 2017

Utilization of hospital emergency departments in Stockholm increased by 30% between 1973 and 1977. One of the five health districts, the southwest (SW) district had the highest visiting rates, 40% above average. The Huddinge Hospital, a new university hospital, was opened in the SW district in 1972. Utilization of the Huddinge emergency department was studied over 15 months for a representative sample (17004 people) from the population. By record linkage, information from Stockholm County's Medical Information System was used together with specially collected data from the emergency department. The demographic profile of the catchment area for the Huddinge hospital differs in several respects from the average for Stockholm County. The present work is an attempt to evaluate the influence of three predisposing factors: age, sex and marital status, on the utilization of the emergency department. Compared with non-users the following groups were found to be overrepresented at the emergency department: women aged 15–34, children to unmarried parents, and divorced and widowed men and women.
The Hospital Emergency Department as the Primary Source of Medical Care
Authors: Magnusson Gudjon
Published: January 2017

The role of hospital emergency departments has gradually changed, particularly in large urban areas, where these departments have increasingly become outpatient clinics for everyday ailments rather than centres for the treatment of injuries and emergencies. The main objectives for the present study were: (1) to compare the utilization of district general practitioners and the hospital emergency department by a defined population; (2) estimate how many of the visits to the hospital emergency department are general practitioner-type visits. The results demonstrate the pattern of medical care usage in an area with hospital emergency department services which provide a 24-hour availability and open access, while the primary care services are available only during office hours, are understaffed and have limited access. The study is based on a 1/30 sample (1032 individuals) from the population in the catchment area of a health centre in Stockholm. During the study period (15 months) 30% of the population visited the hospital emergency department, while 15% consulted district general practitioners. Of the visits to the hospital emergency department, 17 per cent were for injuries and between 39 and 64% were general practice-type visits, according to the criteria used in the study.
Mortality among the Widowed in Sweden
Authors: Mellström Dan , Nilsson Åke , Odén Anders , Rundgren Åke , Svanborg Alvar
Published: January 2017

This study consists of three parts. In the first part the risk of death for widowed persons is studied as a function of time interval since the day of bereavement. The effects of bereavement on mortality are investigated in all widowed people in Sweden (about 360000) from 1968 to 1978. Among widowers above 65 years of age there are nine deaths per 1000 in excess compared with married men during the first 3 months after bereavement. In comparison with married people in the age group 70–74 it is found that among widows there is an increased mortality by 22% and among widowers by 48% during the first 3 months after bereavement. Further observation, during a period of altogether 11 years, showed that excess mortality continues, though at a lower level. In the second part, causes of death in the age group 70–74, divided according to marital status, are studied on the basis of data from the National Central Bureau of Statistics. The excess in mortality is due mainly to cancer and cardiovascular deaths, but also accidents, suicides and cirrhosis of the liver. The third part deals with differences between marital status groups with respect to tobacco smoking and alcohol abuse by using data from the population study of “70-year-olds in Göteborg” (H 70). By using data from central registers together with data from the population study it is possible to show that life style factors have an impact on the difference in mortality pattern between married and widowed people in Sweden.
Middle-Aged Men before and after Disability Pension
Authors: Månsson Nils-Ove , Israelsson Bo
Published: January 2017

A total of 5950 male Malmö residents (from five cohorts, 1926–30) were health screened on two occasions, with an interval of 4–8 years. Disability pensions were granted to 215, of whom 123 were screened both before and after being pensioned. Those 123 constitute the study group reported on here. Among answers to the questionnaire, back and joint pain were the most common complaints mentioned. However, the most striking distinction between the study group and controls was the values of γ-GT (gamma glutamyltransferase), indicating overcon-sumption of alcohol in the group of prospective pensioners. Complaints concerning the back were also an out-standing feature of those belonging to the highest deciles of γ-GT after—but not before—the disability pension had been granted.
Accuracy of Self-Reported Body Weight Compared to Measured Body Weight
Authors: Jalkanen Laura , Tuomilehto Jaakko , Tanskanen Antti , Puska Pekka
Published: January 2017

In 1977, in the evaluation of the prevention programme for cardiovascular diseases, 11880 persons in Eastern Finland were asked to report their own weight on a questionnaire. Each participant was weighed during the following clinical examination. The data of the self-reported body weight were analysed according to sex, age, measured weight and body-mass index (BMI). The results showed that older people underestimated their weight to a greater extent than did younger people of both sexes. The error between measured and self-reported weight was greater in heavier subjects than in thinner individuals. In both sexes weight estimate error (measured weight minus self-reported weight) correlated more strongly with high BMI than with measured weight. Associations between weight estimate error and other variables were studied using a multiple regression model. Men whose annual family income was low were more likely to underestimate their weight than the men with a high annual income. In general, women reported their weight more correctly than men did. Older women were more likely to report their weight less than younger women, whereas women who visited their doctor frequently or who had higher annual family incomes were more aware of their actual body weight than those who had few doctor's consultations or whose family income was low. In men 5.2% and in women 8.3% of the variation in the weight estimate error was explained by the regression model. Women with higher education living in urban areas and who had recently attempted to reduce their weight had greater errors in their self-reported weight than did other women of the same age and BMI.
Standardized Performance Tests and Their Impact on the Decisions Determining the Type of Rehabilitation Program
Authors: Foldspang Anders
Published: January 2017

In the health and social sectors, many diagnostic and prognostic tests are carried out without a constant watch on (1) what influence the test results have on decisions, and (2) the impact of these decisions on every day clinical work. Consequently, it is not known whether the additional information gained, if any, justifies the expenditure necessary for resources involved in a testing procedure. In fact, the net impact of testing in every day clinical work may be negative. By carrying out a testing procedure, under the before mentioned conditions, resources would be wasted. Since the early 1970's a battery of standardized performance tests have been used at the Vocational Rehabilitation Clinic in Aarhus, Denmark. Originally, the aim of the tests was to identify and give an early discharge to those clients, that were, in any case, shown to be fit for a social pre-term pension. An early discharge of these clients would enable the Clinic to counsel a greater number of clients who were suited to vocational rehabilitation. The test period lasts two weeks, and the average stay in the Clinic amounts to about 3 months. During the years 1981 to 1983, a total of 607 clients were discharged from the Clinic. Out of the 607, 379 had been given the battery of tests. Those tested stayed 16 days longer at the clinic than the rest of the clients. A few clients got an early discharge. The associations between the test results and case closure status were weak. Furthermore, these weak associations occurred in 6 out of 51 tests. On the other hand, case closure status could be predicted on the basis of already available demographic, social, and health information on the individual clients. The conclusion is, that standardized performance testing seems to have raised the resource consumption of the clinic without any demonstrable benefit in terms of client selection. The need for continuous socio-medical and epidemiological evaluation of rehabilitation tests and procedures is stressed.
The Working Capacity of the Alcohol Abuser
Authors: Hömquist Jan Olof , Hansson Birgit , Åkerlind Ingemar
Published: January 2017

Thirty-four alcohol abusers treated at various rehabilitational locations in Sweden were the subjects of an extensive and interdisciplinary study. Thereafter, the working capacity of each subject was followed over a two-year period. Twelve individuals regained capacity for work, either, partially or completely. Thirteen subjects were sick-listed or remained unemployed. The remaining 9 abusers were quickly and unexpectedly pensioned. In order to predict the rehabilitational outcome from the interdisciplinary findings at the onset of the time period, stepwise multiple regression analyses were performed. Those who felt less lonely and had no drinking buddies appeared most likely to be rehabilitated vocationally. This core combination of characteristics accounted for about one third of the variability in the outcome criterion, either trichotomized or dichotomized. Rehabilitational success could be even more strongly predicted by the appearance of such features as less prolonged abuse, social introversion (not cohabiting, reserved attitudes and having only a few friends), orientation to the future and a history of psychiatric care. An elevated level of plasma albumin and a decreased plasma-IgA value raised additionally the multiple correlation coefficient.
Two Doses of MMR Vaccine—Sufficient to Eradicate Measles, Mumps and Rubella?
Authors: Fahlgren Karin
Published: January 2017

A review has been done of the available literature on measles, mumps, rubella and vaccines against these diseases. So far, 17 studies on the same virus strains as those in M-M-R II have been published. The rate of seroconversion is practically 100% for rubella, generally more than 90% for measles and between 40 and 100% for mumps. Immediate side effects of vaccinaton are mild in infants and negligible in schoolchildren. However, the follow-up periods are short. In the only 10-year follow-up published, 14 subjects remained at the end of the period, and the vaccine studied differed from M-M-R II. Large, well-documented studies of MMR vaccination in unselected populations are rare. It must be of crucial importance that the immunity situation is followed up continuously for both vaccinated and non-vaccinated individuals when a mass vaccination programme has been introduced as there will be a risk of outbreaks of diseases mostly among young adults.