bluuebunny/crossref_metadata_2025 huggingface dataset:
Enhancing Practitioner Knowledge Through a Unique Abstracting Format Used With Research on Social Work Practice Journal Articles
Authors: Holosko Michael J.
Published: February 2009

In an effort to bridge the long-standing schism between social work researchers and practitioners, Research on Social Work Practice ( RSWP) presents an additional structured abstract for inclusion in their published articles called the practitioner knowledge abstract (PKA). Its conceptualization and rationale are presented, as are some case examples. Its intent is to assist in disseminating empirical knowledge in nonthreatening ways to our practitioners, who are the very persons most likely to use and implement such information. This concept was developed by the author with the full endorsement of the editor and editorial board of RSWP. The journal felt the need to respond to current publication concerns voiced about the standards, review practices, scholarship, editorial processes, and readership of our professional social work journals. It is hoped that other core journals in the profession follow suit, if this idea is amenable to their mandates.
Contributions of Therapist Characteristics and Stability to Intensive In-home Therapy Youth Outcomes
Authors: Greeson Johanna K. P. , Shenyang Guo  , Barth Richard P. , Hurley Sarah , Sisson Jocelyn
Published: February 2009

Objective: This study examines the influence of therapist and youth characteristics on post-discharge outcomes from intensive in-home therapy. Method: Data for 1,416 youth and 412 therapists were obtained from a behavioral health services provider. The Huber—White method was used to account for nested data; ordered logistic regression was employed to assess outcomes. Results: Therapist gender and employment stability were significantly associated with youth outcomes. The likelihood of an undesirable outcome was significantly less for cases with female therapists. Conclusion: Findings underscore the need for additional study concerning the impact of therapist characteristics and stability on youth outcomes, and to improve the understanding of the relationship between the two. Future studies in these areas would advance social work practice in family-based treatment programs.
What Protects a Child during Migration?
Authors: Moilanen Irma , Myhrman Antero
Published: February 2009

Protective factors for mental health during migration were studied in school-aged children and adolescents who had returned from Sweden to Finland during the years 1984-85. Each of the 320 migrant children and adolescents was assigned a control from the same class at school, matched by age and sex, and a non-migrant. Information was gathered from the parents, teachers and children themselves. The returning migrant children and adolescents more often lacked a father than did the controls, and returning migrant boys more often had psychiatric disorders in their teachers' estimations than did the controls, but no such difference was found among the girls. Good adaptation to this change in life was enhanced by good family relationships, good peer relationships, verbalisation ability, good cognitive abilities, as indicated by school achievements, and a clear linguistic identity.
Greek Immigrant Children in Southern Sweden in Comparison with Greek and Swedish Children
Authors: Neiderud J.
Published: February 2009

Greek immigrant children belonging to the second generation of immigrants in Sweden have been compared with Swedish children and Greek children in Greece regarding general living conditions. Interviews were performed in the homes of all participants. The parents in the two Greek groups had the lowest educational level. The yearly salary of immigrant families was similar to that of the Swedish families. Immigrant and Swedish parents worked outside their homes to the same extent, Greek immigrant mothers fulltime, Swedish mothers mostly part time. For economical reasons the immigrant parents looked after their children within the family while the Swedish families almost always utilized community day care facilities. The immigrant families had fewer children than the Swedish and Greek rural families and their dwellings were smaller. Corporal punishment was a common method of upbringing in Greece and among the immigrants. The immigrant families had extremely few contacts with Swedish families. A majority of the immigrant families were unsure about their future in Sweden, whether or not to stay. In conclussion, the Greek immigrant group in many respects had adapted to Swedish customs but they had also at the same time retained much of the Greek cultural characteristics.
HIV Infectiousness and the AIDS Epidemic
Authors: Rees Malcolm
Published: February 2009

The paper outlines a theory of the AIDS epidemic based on assumptions regarding the changes in infectiousness over the life cycle of the disease. It proposes a short initial period of infectiousness, followed by a long dormant period, which is in turn succeeded by another period of infectiousness, longer than the first period. Each of the two periods of infectiousness can generate an associated epidemic. It is suggested that the Western homosexual epidemic is based on initial stage infectiousness, while the African heterosexual epidemic is mainly the result of end stage infectiousness.
The AIDS Epidemic in Sweden
Authors: Herlitz Claes , Brorsson Bengt
Published: February 2009

This study calculates the cost of medical care during the different stages of HIV infection, from the asymptomatic period to a confirmed AIDS diagnosis. Also, we have estimated the total cost of taking specimens and performing tests related to HIV infection, and the cost of information, research, etc. Medical costs were based on estimates of the average cost per day and the total number of days at the various stages of HIV infection. The cost estimates for testing include costs related to taking specimens, analysing samples, managing test results, etc. The cost outlook until 1990 is discussed using different assumptions concerning incidence, survival and the level of preventive efforts. The total estimated costs for medical care, HIV tests, information, etc. doubled between 1986 and 1987. During 1987, costs totaled 313 million Swedish kronor (SEK). The costs for specimens and tests totaled SEK 124 million, medical costs for HIV positives who had not developed AIDS totaled SEK 31 million, and medical costs for AIDS patients totaled SEK 26 million. The costs discussed in this study will probably increase by at least 50% by 1990.
Sickness Absenteeism in an Engineering Industry—an Analysis with Special Reference to Absence for Neck and Upper Extremity Symptoms
Authors: Dimberg Lennart , Olafsson Ari , Stefansson Eythor , Aagaard Hans , Odén Anders , B.J. Andersson Gunnar , Hagert Carl-Göran , Hansson Tommy
Published: February 2009

Neck and upper extremity symptoms (NES) are reported to increase among industrial workers. In order to quantify sickness absenteeism and relate it to some factors a questionnaire study was performed among 2814 workers occupied at a Swedish engineering industry. Questions pertaining to age, sex, worker category, work with vibrating handtools, type of job and smoking habits were analyzed and correlated to sickness absenteeism for the previous year (1983). We found that the average days lost for personal illness was 17.2 days; 16.2 for men and 23.5 days for women. Ninety-four persons, 77 men and 17 women comprising 3.0% of all employees were sicklisted for NES corresponding to 3.3% of total sickness time lost. Blue-collar workers were sicklisted for NES five times more often than white collar workers and women in type 3 jobs (high NE stress), twice that of men occupied in the same type of job. Smokers had significantly higher absenteeism than non-smokers for any reason studied including NES. The study indicated a high prevalence of present NES problems (23%) but also that NES as a cause of leave of absence was relatively rare (3%).
Psychological Aspects of Early and Late Discharge after Hospital Delivery
Authors: Arborelius Elisabeth , Lindell Ditte
Published: February 2009

Early discharge after hospital delivery is common in other countries. In Sweden it was not introduced until recent years. Previous investigations have mainly focused on medical risk factors. However, few investigations have been done regarding psychological factors. This study, comprising 44 families (7 primaparae and 37 multiparae) in an early discharge group (discharge 0-2 days after hospital birth) and a late discharge group (discharge 5-6 days), indicates that parents in the early discharge group had more negative experiences of their earlier postpartum stay. The mothers in the early discharge group experienced less sibling revalry compared to the mothers in the control group. There were no other differences between the groups. The parents were equally satisfied with their choices in both groups. Early discharge, as a voluntary alternative, presents an increased service for parents, since the parents may choose the most suitable postpartum care.
The Tromsø Heart Study
Authors: Knutsen Synnøve Fønnebø , Knutsen Raymond
Published: February 2009

Intervention on high risk persons for CHD has shown varying results depending on the effectiveness of the intervention. Most studies have concentrated on the high-risk person only. The present study focuses on the high-risk family as an entity. 1373 high-risk men, 30-55 years, were identified on the basis of high total cholesterol and/or low relative HDL (HDL-cholesterol/tot. cholesterol) in the Tromsø II screening in 1979/80, and randomly allocated to intervention or control group. The 673 men in the intervention group and their families, were offered advice to reduce their risk during two home visits and later by quarterly newsletters. Follow-up blood samples drawn 1.5 years following the home-visit, show a small reduction in total cholesterol and an increase in the ratio of HDL cholesterol/total cholesterol. Both the intervention and control group were invited to the examination in connection with the Tromsø III screening in 1986/87 and are being followed for 10 years on cardiovascular morbidity and mortality.
The Risk of Accidents Among Older Drivers
Authors: Brorsson Bengt
Published: February 2009

The number of older persons holding a driver's licence is rapidly increasing, as is the number of older persons driving a car. This paper examines driver accident-risk by age group, focusing on the older driver. Two different measures of accident risk are used; involvement in personal injury traffic accidents per million kilometers driven, and involvement in traffic accidents where one or more pedestrians were injured per million kilometers driven. The latter measure is used to refute the assumption that the elderly's risk of being involved in personal injury accidents might, to some extent, be explained by the fact that older drivers generally tend to run a higher risk than younger drivers of being injured in the event of a traffic accident. Another motive is that it provides a measure of the extent to which drivers of different ages present a risk to their fellow road users.

This study shows that drivers in the 75-84 age group are at four to six times greater risk than are middle-aged drivers of being involved in personal injury traffic accidents.
The ‘health-related selection effect’ on occupational morbidity rates
Authors: Östlin Piroska
Published: February 2009

The aim of this study was to investigate the extent to which differences between physically light and heavy work, with respect to the development of health problems, might in cross-sectional data be eliminated or diminished by health-related selection into and out of occupations. The study population comprised 12,314 men and 12,393 women between 25 and 74 years of age, who were interviewed within the framework of the Statistics Sweden Survey of Living Conditions. For all respondents, detailed occupational histories were recorded. For all the diseases and functional disorders studied, morbidity differences were apparently diminished compared to what would be expected if there was no selection. This association was most apparent when studying musculoskeletal disorders, impaired hearing and impaired working capacity for men.
Changing Smoking, Drinking, and Eating Behaviour among Pregnant Women in Denmark
Authors: Olsen Jørn , Frische Grethe , Poulsen Anni O. , Kirchheiner Helle
Published: February 2009

Health behaviour during pregnancy was examined before and after a comprehensive health campaign targeted at pregnant women in Odense, Denmark. Furthermore, lifestyle habits were compared before and during the campaign with similar habits in Aalborg, Denmark. All 13,815 pregnant women (equal numbers from each city) were enrolled in the study, and 11,980 gave information on eating, drinking, and smoking habits during pregnancy. Data collection in both cities took place from April 1984 to April 1987. The campaign, which was entitled “Healthy Habits for Two”, ran from April 1985 to April 1987 in the city of Odense only.

No significant change in health behaviour in the Odense area was noted after the start of the campaign.
Attitudes towards HIV infection and sexual risk behaviour
Authors: Schmidt K. , Krasnik A. , Brendstrup E. , Zoffmann H. , Larsen S.O.
Published: February 2009

To describe attitudes towards HIV infection in relation to sexual risk behaviour and sociodemographic factors in a representative sample of Danish men 16-55 years of age, a self-administered anonymous questionnaire was distributed in connection with a personal health interview and returned by prepaid mail. The response rate was 55%, corresponding to 1,155 participants.

In contrast to the official AIDS prevention strategy, 28% of the participants stated that HIV infected persons should be forbidden to have sexual relationships, and 44% that they should be registered by the authorities. 33% of the participants had had sexual behaviour which may be associated with increased risk of HIV infection: more than one female partner during the previous 12 months, sexual contact with prostitutes or sex with other men. Despite good basic knowledge of AIDS, only 41-59% of these men perceived themselves at risk, and only 47-54% of men perceiving themselves at risk had adopted risk-reducing sexual behaviour. The results indicate a need for innovative health education of the general public about AIDS prevention at community and individual level.

In the absence of effective treatment and without prospect of a vaccine in the near future the prevention of AIDS must focus on modifying behaviour associated with increased risk of HIV infection, in particular sexual behaviour.
Health care utilization after referral from a hospital emergency department
Authors: Hansagi Helen , Allebeck Peter , Edhag Olof
Published: February 2009

In a trial, patients who came to a hospital Emergency Department (ED) with non-urgent complaints were advised and referred to primary health care outside the hospital. The effect of this was assessed by measuring health care utilization one year before and one year after the referral, using the Stockholm County computerized medical information system and ED medical records. The proportion of the 189 referred patients who visited the ED decreased from 48% to 42%, whereas in a control group of 107 patients the proportion increased from 41% to 51%. A small proportion, 7%, of the referred patients with four or more ED visits accounted for 45% of the total number of ED visits the year before the trial. These frequent ED users did not reduce their ED utilization more than frequent ED users in the control group.

The use of health care centres increased in the referred group and was practically unchanged in the control group. However, those referred patients who continued to use the ED still quite often did so for non-urgent complaints.
Sudden Infant Death Syndrome During Weekends and Holidays in Norway in 1967-1985
Authors: Kaada Birger , Sivertsen Erling
Published: February 2009

A few previous studies have revealed an increased risk for sudden infant death syndrome (SIDS) during weekends and holidays suggesting environmental factors as potential trigger mechanisms for death. In the present study, the weekend/holiday effect has been assessed on the basis of 1480 SIDS cases in 19 Norwegian counties during a 19-year period (1967-85). The phenomenon has been confirmed for 17 of the 19 counties. Special attention has been attached to differences in the geographical and seasonal distribution of the phenomenon. Deaths of other causes in infancy did not display such a dependency on the day of the week.
Parents' response to recurrent middle ear infection in their children
Authors: Bexell Anna , Råstam Lennart , Isacsson Sven-Olof , Ingvarsson Leif
Published: February 2009

Recurrent ear infection in children during pre-school years is an important public health problem. Common advice given to parents is to minimize exposure of susceptible children to crowding and air pollution. This study aimed at investigating what changes parents undertake to improve the health of an otitis-prone child. Parents of children with 5 events before age thirty months (index children; n = 198) and a matched control group (n = 396) were asked to fill in a questionnaire. Results show that 22.3% of indexfamilies and 9.5% (p< 0.001) of control families had changed one or more of the following conditions: working hours, child day-care, housing and smoking habits. In summary, index families and control families were remarkably similar given the striking difference in otitis media, a finding that rises concern.
Effects of Cardiac Rehabilitation after Coronary Artery Bypass Grafting on Readmissions, Return to Work, and Physical Fitness. A Case-control Study
Authors: Perk Joep , Hedbäck Bo , Engvall Jan
Published: February 2009

In a case-control study 49 consecutive post-coronary artery bypass grafting (CABG) patients (10 f, 39 m) participating in a comprehensive rehabilitation programme were compared with 98 individually matched double control patients, receiving standard care. The rehabilitation programme, starting 6 weeks after surgery, consisted of follow-up at a coronary clinic, repeated health education, and physical training in out-patient groups. During the first year after CABG, fewer study group patients were readmitted to hospital (14% vs 32%, p<0.01) and on fewer occasions (1.1 vs 2.9, p<0.05). Fewer patients used anxiolytic drugs (0% vs 15%, p<0.01). At the one year post-CABG exercise test we found in the study group a tendency to a greater increase in work capacity, as compared with the values obtained at the preoperative exercise test (33 vs 25 W ns). There were no differences in the rates of returning to work (59% vs 64%). In a long-term follow-up study (av. 38 months post-CABG) the patients were asked to fill in a questionnaire evaluating perceived physical work capacity and training habits. The study group patients rated their physical work capacity higher, and more patients had continued with regular physical training (66% vs 46%, p = 0.05). There were fewer patients using anxiolytic drugs (9% vs 30%, p<0.01). Although the programme did not influence the return to work we conclude that it improved the quality of life of our patients as it entailed fewer readmissions and reduced the use of anxiolytic medication; in addition it promoted physical fitness and training habits.
Quality of Life
Authors: Hörnquist Jan Olof
Published: February 2009

To understand and assess the concept “quality of life”, it must be analyzed. In this report it is postulated that quality of life covers life as a whole as well as different subdomains of life. Life quality is defined as perceived global satisfaction and satisfaction within a number of key domains with special emphasis on well-being. A comprehensive chart of relevant life domains is presented and a flexible package of tested rating techniques outlined. In order to obtain valid and sensitive assessments, pincer operations with various types of ratings are recommended.
An Evaluation of the Effectiveness of Tobacco-Control Legislative Policies in European Community Countries
Authors: Dalla-Vorgia P. , Sasco A. J. , Skalkidis Y. , Katsouyanni K. , Trichopoulos D.
Published: February 2009

The purpose of this paper was to assess the effectiveness of anti-tobacco smoking legislation from 1948 onwards in reducing actual per capita tobacco consumption in the twelve countries of the European Economic Community (EEC). In order to undertake these assessments a score was assigned to every legislative measure, indicating the a priori likely impact of this measure on tobacco consumption. Two approaches were then utilized. In the first, it was found that the cumulative anti-tobacco legislative score correlates well in time with a reduction of tobacco consumption. In the second, cross-sectional data from the EEC countries and multiple regression modelling were used to estimate the elasticities of tobacco price, per capita income and cumulative anti-tobacco legislation score; it was found that legislation has an impact on tobacco consumption which, although considerably smaller than the corresponding impact of tobacco price levels, is nominally significant and potentially important. The evaluative approaches utilized in this paper are based on observational data of ecologic nature and can provide only weak evidence about the causal nature of the reported associations. Nevertheless, this limited evidence suggests that legislative measures may be effective both by affecting price levels and through other mechanisms, including health education and the formation of a more general anti-smoking ethos.
Health Workers and AIDS
Authors: Krasnik Allan , Fouchard Jan R. , Bayer Thomas , Keiding Niels
Published: February 2009

The objective of the study was to measure the level of HIV/AIDS related anxiety among health care workers and identify its determinants. Data were obtained by means of a mailed, anonymous, self-administered questionnaire distributed to 2561 Danish medical doctors, nurses and nursing aides drawn randomly from the lists of members of the respective national associations. The data were analysed on the basis of a pre-study model including 12 variables hypothesizing a hierarchy of causal dependencies with anxiety at the top.

44% of the participants expressed HIV/AIDS related anxiety — hospital workers more than primary care workers, the older less than the younger. Anxiety was significantly associated with negative/restrictive attitudes towards HIV positives and gay men and with low levels of knowledge about HIV transmission and less education about HIV/AIDS.

Negative/restrictive attitudes towards HIV positives were associated both with less knowledge regarding HIV transmission and fewer contacts with HIV positives. Similar associations were found regarding gay men.

It is suggested that new kinds of training programmes be established which focus much more on attitudes and norms concerning HIV/AIDS — especially among health care workers with only occasional contact with HIV patients.
The Impact on work Ability of Ileal Conduit Urinary Diversion
Authors: Nordström Gun M. , Nyman Claes R. , Theorell Töres
Published: February 2009

The purpose of the study was to investigate to what extent ileal conduit urinary diversion influenced patients' capacity to work. Sixty-sex urostomy patients were interviewed. Forty-seven of those were employed before surgery. Sixteen of 47 patients (34%) made permanent changes in their working conditions immediately after surgery, i.e. they did not resume work or they changed from full-time to part-time work. The working conditions changed in similar ways for another 15 patients who initially had been able to resume. Bladder cancer patients were more likely to work less than patients with incontinence/bladder dysfunction. Nineteen patients obtained disability pension either immediately after surgery or later. Eight of those considered stoma related problems, mainly leakage, as the main reason for inability to work. Diagnosis, gender, and type of work did not seem to affect the frequency of disability pension.
Clinical Factors, Psycho-Social Stressors and Sick-Leave Patterns in a Group of Swedish and Greek Patients
Authors: Löfvander Monica , Papastavrou Dimitri
Published: February 2009

To assess patterns of illness behaviour in immigrant Greeks, 50 Greek and 50 Swedish consecutive patients were examined by a Swedish general practitioner and a Greek psychotherapist at a primary health centre in Stockholm. In addition to a physical examination an overall psychiatric assessment of the patients was made, partly with the help of rating scales. Psycho-social stressors were also rated. In spite of modest somatic and psychiatric findings, the majority of the Greek patients had been on long-term sick-leave and none of them could be rehabilitated. This illness behaviour, with passivity as the most notable response to pain, was very evident in the Greek group and was assessed as being strongly related to psycho-social stressors as well as to iatrogenic damage. All of the patients whose sick-leave had been of short duration prior to their first visit to the health centre could be rehabilitated. Psycho-social counselling given to the Greek patients in their native tongue had only marginal effect.
Is the Effect of Alternative Medical Treatment Only a Placebo Effect?
Authors: Lynöe Niels
Published: February 2009

A common assertion about alternative medical technologies is that their results are solely built upon the placebo effect. The reason for this assertion is due to the facts that the placebo effect is perceived as an irrational quantity, and that the placebo effect is considered unspecific. If it is possible to rehabilitate the placebo effect by interpreting it as a specific effect, what consequences would it have for school medicine and the view of certain alternative medical technologies? To answer these question it is necessary to investigate just what sort of phenomenon the placebo effect is, and what determines its dimensions.
Salmonella and Shigella Carriers Among Refugees from the Middle East and Sri Lanka in Denmark
Authors: Kjersem Helge , Jepsen Søren , Larsen Leith , Black Finn
Published: February 2009

One per cent of ten thousand refugees were asymptomatic carriers of Salmonella and Shigella species found by a differentiated health check programme at a Danish Red Cross arrival centre in Denmark 1985 and 1986. Six patients with typhoid fever and one with S. parathyphi-A septicaemia all fell ill within the first few weeks after arrival. A child of a chronic S. typhi carrier developed typhoid fever four months after arrival. Cases of sporadic and mild diarrhoea occurred due to Salmonella and Shigella species. The carriers were instructed in prophylactic, hygienic measures and no outbreaks developed.

The health check system in this period seemed to be sufficient in relation to preventing outbreaks of infections caused by non-typhoid Salmonella and Shigella species. The relative cost-effectiveness of a more intensive S. typhi screening on arrival is questionable. The organization of health check systems should be reviewed regularly, as each refugee situation is different and will change in different periods.
Work and “lifestyle” in occupational mortality in Denmark
Authors: Tüchsen Finn , Zebitz Ursula
Published: February 2009

Using social class standardization Fox and Adelstein found that 18% of all mortality was attributed to work, while 82% was attributable to lifestyle. Fox and Adelstein had access to 25 occupational orders. We have made similar calculations on Danish mortality statistics including 146 occupational groups. Our results are very different: more than 50% of all mortality among Danish men seems to be related to work. Of 51,317 work-related deaths in 10 years, one third were due to cancer, and half due to cardiovascular diseases (CVD).

The marked differences in results have lead to considerations on the applicability of the model and the underlying assumptions. One conclusion is that social differences and differences in mortality between social groups are so small in Denmark that a few subgroups with “deviant” mortality and/or lifestyle will be determinants of the results. Inclusion of more occupational groups increases the percentage of deaths associated with work.
The Penetrating Educational Effect of a Mass-Media Based Fund-Raising Campaign “Heart for Life”
Authors: V Fønnebø , J. Søgaard A.
Published: February 2009

A one-Sunday fund-raising TV-show in 1987 was broadcasted by the state-owned TV-channel in Norway which is the only channel covering the whole country. The six-hour TV-show consisted of a considerable amount of information on risk of heart disease intermingled with entertainment and money-counting results. Mass media had covered the forthcoming TV-show extensively. The show is presently evaluated as a nationwide mass-media based health education campaign through a stratified random sample of 976 persons aged 15 years and above. More than 95% of the population were aware of the campaign and 75% followed the TV-show beyond the news reports. The sampled persons were asked for self-reported changes in health knowledge and behaviour. Fifty-seven per cent reported that they gained new knowledge and 25% reported behaviour changes in a positive direction. Women reported more knowledge gain than men. Low socioeconomic groups reported more gain in knowledge and more positive changes in health behaviour than high groups. A close association was found between reported new knowledge and change of health behaviour (p < 0.001). The results of the study indicate that this campaign has reached segments of the population that previously have been difficult to reach and that this is possibly due to the extensive advance coverage of the show in the mass media and the “entertaining” character of the show with emotional appeals in addition to factual information.
Brief Communication
Authors: Andréasson Sven , Parmander Marianne , Allebeck Peter
Published: February 2009

A randomised clinical trial was conducted in order to compare treatment results between Minnesota model treatment for alcohol abuse and outpatient treatment. The trial had to be discontinued due to problems in recruitment of subjects and a high rate of attrition among subjects allocated to Minnesota model treatment. In this paper the problems encountered during the trial are discussed. Different methods of recruitment of subjects to a randomised trial are compared.
HIV Infection and Health Personnel
Authors: Brattebø Guttorm , Wisborg Torben
Published: February 2009

A survey was made of a sample of 359 Norwegian health workers to assess attitudes towards HIV infected colleagues, and how the respondents would behave if they themselves became HIV infected. Two thirds of the 268 (75%) who responded would not allow that a HIV positive health worker treated their family, and 47% supported routine HIV screening of health workers to protect patients. Most of the respondents were opposed to disability pensioning of HIV infected health personnel in general, and would not ask for this if were found HIV positive. One hundred ninety-six would not tell colleagues if they became HIV infected. Within this group, the proportion (153/196) that would not accept practising HIV positive health personnel was significantly larger than that among those who would report own seropositivity (24/64). The study revealed substantial anxiety, and inconsistencies between expected behaviour of others, and the respondents' own reactions also were found.
Referral of non-urgent cases from an emergency department
Authors: Hansagi Helen
Published: February 2009

A phenomenon of great concern in several Western countries is the number of patients with non-urgent ailments attending the often overloaded hospital emergency departments (EDs). With a view to providing these patients with more appropriate care, they were, in a trial at Huddinge Hospital, Sweden, advised and directed to other care facilities by a specially trained nurse.

A survey indicated that 84% of the patients who agreed to a referral followed the advice given. Referred patients were satisfied with the specific service at the ED to the same extent as were control patients receiving care according to the usual routines of the ED. Moreover, the former were more likely to have a positive general attitude towards the ED.

There was a positive relationship between improvement of presenting symptom and satisfaction with care at the ED, and between satisfaction and favourable attitude towards the ED. However, although patients were willing to engage in a primary health care oriented behaviour, they did not report improvement to the same extent as did ED treated patients and their general attitude towards primary health care facilities was not more favourable, at least not within a few weeks after referral.
Brief Communication
Authors: Honkanen Risto J. , Mönkkönen Raija
Published: February 2009

The applicability of the ICD E code as a causal indicator of nonfatal injuries has been criticized. New codes have been developed to replace the ICD codes. We compared the coding reliability of the ICD E and place vs. the Nordic mechanism (M) and place codes. The mean accuracy (76 vs. 70%) ( p < 0.002) and the intercoder reliability (84 vs. 69%) ( p < 0.001) were better for the E than M code. The accuracy of the place codes was the same (83%). A short training improved ( p < 0.001) the accuracy of all four codes. The replacement of the E code with the M code would not improve the reliability of data on causes of injuries.
Ethics and Preventive Medicine
Authors: Svensson Tomas , Sandlund Mikael
Published: February 2009

Today different issues of medical ethics are in focus of the debate. A theoretical sequence starting at a “prepathogenic” level, ending in terminal care, is delineated to clarify the different characteristics of medical interventions. In this article we will discuss some ethical problems concerning interventions in the first parts of this sequence. Preventive measures at the population level are contrasted to the situation when the patient feels ill and calls for an intervention. Certain elements of paternalism are often interwoven in preventive medicine and health promotion.—The field of preventive medicine calls for a vivid theoretical and ethical discussion, which can mean better opportunities for effective prevention.
The quality of retrospective questions about occupational history — a comparison between survey and census data
Authors: Wärneryd Bo , Thorslund Mats , östlin Piroska
Published: February 2009

The main purpose of the present study was to assess the quality of information about occupational history obtained via retrospective interview questions. This assessment is achieved by linking interview data from the Swedish survey of Living Conditions (ULF) with occupational information about the same individuals obtained from a number of censuses. This has been done for the census years 1960, 1970, 1975 and 1980. In both ULF and the census, occupations have been classified according to the Nordic Occupational Classification (NYK). Both data sources contain errors. There are also differences in definitions and measurement procedures. Still, the survey question on occupational history gives results of good quality in terms of agreement with census data. This is especially the case for coarse levels of the classification scheme (NYK 1-digit level). The agreement is somewhat lower for the comparisons farthest back in time.
What Causes Stress for Mothers of Children with MBD?
Authors: Virtanen Timo A. , Moilanen Irma K. , Ihalainen Minna M.
Published: February 2009

Adapting the paradigm developed by Richard Lazarus, parenting stress and coping were studied among mothers of 6-9-year-old children ( n = 42) with different symptoms of Minimal Brain Dysfunction (MBD) (hyperkinesis, perceptual or motor deficits, learning disabilities or speech disorders) and among mothers of non-disabled children ( n = 42) matched for age, sex, social status of the family and marital status. Mothers of children with MBD were found to experience more parenting difficulties and more negative cognitive appraisals of their stakes in parenting than their matched controls. The mothers of children with hyperkinesis and perceptual or motor deficits considered their mastery lower and experienced less positive affects than their matched controls. The mothers of children with speech disorders experienced less positive affects than their matched controls. Mothers of children with both few and several symptoms experienced more parenting difficulties in the child domain than their matched controls. Mothers of children with several symptoms considered their mastery lower and experienced less positive affects; mothers of children with few symptoms appraised their stakes in parenting more negatively than their matched controls. No significant differences were found between mothers of children with MBD with few and several symptoms.
Self-assessed Quality of Life and Metabolic Control in Persons with Insulin-Dependent Diabetes Mellitus (IDDM)
Authors: Hanestad Berit Rokne , Hörnquist Jan Olof , Albrektsen Grethe
Published: February 2009

The aim of the study was to analyse the association between satisfaction with life and glycosylated haemoglobulin (MbAl). A quality of life questionnaire was administered to 247 persons with IDDM at a Diabetic Clinic in Bergen, Norway. The material was divided into two groups depending on their level of HbAl; HbAl > 0.09 was labelled poorly regulated and a level of HbAl ≥ 0.09 was labelled well regulated. The groups were compared with regard to different life domains and well-being scales. The statistical analysis showed that the well-regulated group had significantly higher average scores considering the somatic and activity/behavioural life domain ratings, the latter being only significantly different among people with higher education. The well-gegulated group had lower average scores in the psychological and social life domain ratings, but these differences were not statistically significant. Among the well-being scales we found a statistically significant difference between poor and well-regulated persons only regarding sociability and loneliness. Well-regulated persons felt on average less sociable and more lonely than poorly-regulated persons.
The effect of a weight reduction program on cardiovascular risk factors among overweight hypertensives in primary health care
Authors: Jalkanen Laura
Published: February 2009

The aim of the study was to test the effect of a non-pharmacological weight reduction program on cardiovascular risk factors among overweight hypertensives in a primary health care setting. Forty-nine overweight hypertensive patients completed the 12-month program. The patients were randomly allocated into either intervention or control groups. The examinations included interviews by a nutritionist, pertinent laboratory tests, and a medical examination. The intervention involved an individually planned energy-restricted diet of 1000-1500 kcal per day, weekly discussions, and various leaflets on diet modification and on increase of physical activity. The mean body weight was reduced by 5 kg in the intervention group, but remained unchanged in the control group. The intervention group reduced their fat intake by 14 g/day while the control group increased it by 9 g/day on the average. In the intervention group, the total serum cholesterol decreased, HDL-cholesterol increased and triglycerides decreased significantly. The systolic blood pressure fell by 8 mm Hg and 15 mm Hg in the intervention and control groups, respectively. The diastolic blood pressure fell on average by 11 mm Hg in both groups. The results demonstrate the comprehensive weight reduction program to be effective in the control of cardiovascular risk factors.
Role modelling and cigarette smoking
Authors: Pedersen Willy , Lavik Nils Johan
Published: February 2009

Risk factors for the onset of cigarette smoking were examined by means of a prospective longitudinal study in 1230 Norwegian adolescents aged 12-18. In particular the importance of role modelling was focused. The findings revealed that the age periode between 12 and 15 is most important when it comes to the initiation of smoking. Among those who initiate smoking, the incidence rates of quitting is low, indicating that most of the initiators quickly seem to develop a relatively stable smoking habit. Smoking initiation can be divided into two stages. The first, experimental one, is predicted by peer modelling and low socioeconomic status (SES). The second, establishing a regular pattern of use, is predicted by modelling of parental smoking and the interaction between female sex and low SES. Studying the characteristics of the regular smokers cross-sectionally, peer modeling showed the strongest correlates. Studying the predictors of the transitions longitudinally, the more complex picture described above was uncovered. This indicates that the complexity of the role modelling process can only be simulated adequately by means of prospective research methods and by paying attention to such parameters as gender, age, SES and stage in the smoking acquisition process.
A Perinatal Audit of Stillbirths in Three Danish Counties
Authors: Andersen Karen Vitting , Lange Aksel P. , Helweg-Larsen Karin
Published: February 2009

All stillbirths in 1985 and 1986 in three Danish counties were assessed in a perinatal audit. The aim was to investigate if departure from generally accepted standards of satisfactory perinatal care might have contributed to stillbirths, and also to investigate if differences in the structure of antenatal care and the delivery systems might have any influence on the rate of stillbirths. 119 cases were evaluated, 70 were classified as unavoidable deaths, in 48 cases a different treatment might have improved the infant's possibility of survival and in one case consensus was not reached. The most frequent cause of suboptimal care was inadequate antenatal care of obvious signs of intrauterine growth retardation. Directives for visitation between surgical and obstetric departments were essential to the rate of stillbirth. The results indicate that it might be possible to achieve a further decrease in the number of stillbirths by intensifying the postgraduate training of the professionals and by issueing guidelines for the sharing of care responsibilities.
Event, incidence, and fatality rates of cerebrovascular diseases in Enköping-Håbo, Sweden, 1986-1988
Authors: åsberg Kerstin Hulter , Parrow Anders
Published: February 2009

In order to study the need for medical care among elderly stroke patients, a prospective registration of cerebrovascular diseases started on January 1, 1986 in Enköping-Håbo health service district, Sweden. This article reports the design of the stroke register and the registration procedures, the annual events of stroke, both first-ever and recurrent, during 1986 - 1988 and the fatality rate with special regard to the very old population. The annual incidence of first-ever stroke was 0.33/1,000 among persons younger than 65 years of age, 10.6/1,000 among persons aged 65-84 years, and 34.5/1,000 among persons aged 85 years and older. The fatality rate of first-ever strokes was 7.5% within one month for persons younger than 65 years of age, 20.3% in the age-group 65-84 years, and 41% for the population 85 years and older. These results are compared with a similar Swedish study from Söderhamn and four comparable international studies. The results from this study gave a basis for designing special care programs in hospital and in home-care also for old stroke patients.
Heritability of defects of far vision in young adults — a twin study
Authors: Jaakko M. Teikari , Jaakko Kaprio , Markku Koskenvuo , James O'Donnell
Published: February 2009

Heritability of defects of far vision in young adults — a twin study. J. Teikari, J. Kaprio, M. Koskenvuo and J. O'Donnel (University of Helsinki, Department of Public Health, Hartmaninkatu 3, SF-00290 Helsinki, Finland).

A questionnaire to study defects in far vision in the Finnish Twin Cohort Study was sent to 600 twin pairs of 30 and 31 years of age divided equally by gender and zygosity. An excess in female prevalence of defects in far vision was observed (p < 0.001). Validation of the questionnaire method to assess negative spherical equivalent of refraction was performed by asking the twins to send their last prescription for glasses. Accuracy of the questionnaire method to detect a defect in far vision was tested using a subsample of cases where actual refraction obtained from the prescription for glasses was available. This actual refraction value was compared with the individuals answers to the questions of far vision. Of the subjects 5.5% were false negatives and 1.8% of the individuals were false positives. In 152 pairs one or both twins had a defect in far vision. Under a threshold liability model, the proportion of total (phenotypic) variance in liability attributable to additive genetic effects was 0.91 in this twin data, while no evidence for effects due to dominance was found.
Diseases and symptoms as predictors of hospital care in an aged population
Authors: Anttila Sari K.
Published: February 2009

Diseases and symptoms as predictors of hospital care in an aged population. A prospective register-based study.

The association between diseases and symptoms and general hospital care was studied in a geographically defined population of 1040 persons aged 65 years or over (90% of the eligible non-institutionalized elderly). In eight years, 25% of the subjects used over 60 hospital bed-days. In age-controlled analyses high use of hospital care was predicted by chronic urinary infections and in women also by chronic bronchitis, diabetes mellitus and heart failure. Among men, the risk of high use of hospital care was greatest in those reporting chronic urinary infection (risk ratio 1.9), and among women in those reporting chronic bronchitis (2.1) and diabetes (2.0). As far as symptoms were concerned, the highest risks of hospital care were found in men reporting tremor (risk ratio 1.6) and depressive symptoms (1.5); and in women reporting memory disturbances and dizziness (risk ratios 1.9 and 1.7, respectively). High use of care was predicted by six symptoms in men and seven in women. Reported symptoms proved to be better predictors of high use of hospital care than reported diagnoses.
Alcohol consumption in a Danish cohort during 11 years
Authors: Sælan Henrik , Møller Lars , Køster Anne
Published: February 2009

Alcohol consumption in a Danish cohort during 11 years. Sælan, H., Møller, L. and Køster, A. Social Welfare Department City of Copenhagen, Bernstoffsgade 17, DK-1592 Copenhagen V, Denmark.

A cohort living in Copenhagen County, originally consisting of 1198 persons, 577 men and 621 women, 40-years of age in 1976, was reexamined in 1981, and again in 1987. Of the original cohort 1052 (88%) participated in 1976, 992 (84%) in 1981, and 965 (85%) in 1987. The purpose of this study was to describe changes in alcohol consumption in the cohort, with the view of identifying subgroups, who have changed their alcohol consumption behaviour to a certain extent. Alcohol consumption was measured by the same questionnaire all three times as to the level of consumption and frequency.

Alcohol consumption peaked in 1981 (45-year olds) with 10.4 drinks on average a week. Men increased their consumption by 8% and women by 37%. There was an overall downward tendency in the consumption frequency among men, whereas the opposite was the case among women. The two groups are converging toward a weekly consumption frequency.

It seems now that women are leading the change toward a greater wine consumption in relative and absolute terms. It is therefore concluded that female consumption should be considered as a target in future preventive programmes.