bluuebunny/crossref_metadata_2025 huggingface dataset:
Using sentencing evidence to effectively establish the balanced application of the death penalty in China
Authors: Huijun Xu
Published: January 2017

Whether a death sentence is fair or not is an fundamental question for a country’s criminal justice system, yet in practice, similar cases still occasionally receive differing judgments. In response to this problem, this paper has proposed to take sentencing evidence as the breakthrough for the balanced application of death penalty. This paper begins by analysing written judgments from 40 cases, which involve 69 individuals and have been sampled from all those archived under the Gazettes section by the Beidafabao,1 Peking University Centre for Legal Information. This analysis provides considerable insight into the type of sentencing evidence admitted in capital cases, as well as the impact that principal evidence has on where death sentences are imposed. Next, in accordance with the basic problems of evidence law, this paper separates out sentencing evidence of capital cases from conventional theories that confuse it with convictions. Taking sentencing evidence as the core, the objective of the empirical analysis and theoretical discussion is to establish guidelines as well as a policy analysis for capital cases in China in the future.
Notions of justice
Authors: Lin Delia
Published: January 2017

This paper compares the conception of justice grounded on the liberal political thought and the Chinese notion of justice deeply rooted in Confucian and Legalist theories from the standpoint of the political culture they each supports. It argues that whereas the former supports the liberal culture marked by the plurality of reasonable doctrines and by seeing persons as free and equal, the latter supports an authoritarian culture based on a dogmatic, comprehensive moral doctrine. Such cultural differences have made it difficult for the Chinese elite holding a Confucian view to negotiate and appreciate the political conception of justice as fairness. This paper suggests that it is important for a modern state to formulate philosophies that accommodate the plurality of diverse and often incompatible doctrines and also to think about justice in procedural terms. For China to achieve this requires a change of political culture.
European defence policy between dependence and autonomy: A challenge of Sisyphean dimensions
Authors: Howorth Jolyon
Published: January 2017

There have been two critical moments in Europe’s tortuous attempts to generate a viable, collective, relatively autonomous, trans-national defence project: the first decade after World War II, and the early decades of the 21st century. In both cases, the main features of the project were similar and in both cases there was an implicit or even explicit symbiosis between European integration and defence integration. In both cases, the same underlying weaknesses in the project stymied progress. These involved disagreements between France and the United Kingdom over the nature of the project itself; American ambivalence; differences among the European member states over how to handle relations with Russia; and unresolved tensions between the European entity and its member states. In the earlier case, these challenges proved fatal to the project. In the later case, they risk nudging it towards irrelevance.
Mortality and Functional Prognosis in a Geriatric Population
Authors: Mackeprang Bent , Brauer Erik
Published: January 2017

The prospects of survival and changes in function (need for care) are evaluated after a two-year period for the 1486 persons resident in the geriatric institution “De Gamles By”, Copenhagen, on January 15, 1967. It is shown that the logarithm of the survival percentages is approximately a linear function of the time. The prospect of survival is slightly better for the females than for the males because of a significantly higher mortality among the dependent men than among the dependent women. There is no difference as regards sex in the mortality rate for the independent patients (25%). The prospect of survival is poorest in the heavily dependent patients, regardless of sex. Only 5% of the patients were discharged to their homes or transferred to a hospital or some other institution. There was an improvement in the care status, regardless of sex, in 4%, the condition was unchanged in 61%, and there was deterioration in 35% of the 870 patients who survived the two-year period. On the basis of the prospects of surviving whilst waiting for admittance, the saving in institutional places is discussed. The increased need for more accommodation in geriatric institutions is emphasized in order to reduce the unfortunate consequences of the time spent in waiting for admission.
Mortality among Male Disability Pensioners
Authors: Medhus Asbjörn , Kristenson Hans
Published: January 2017

The basic material consists of all 235 men who were granted temporary or permanent disability pension in Malmö for the first time in 1964. By the end of 1974, 111 had died; the expected mortality was 42. The most common causes of death were diseases of the circulatory system, neoplasms, and diseases of the respiratory system. The post-mortem diagnoses of the 111 deceased usually agreed with the main diagnoses at the time of the pension award.
Gynaecological State of Health of 2654 Women in Nurmes 1970–71
Authors: Selander Kirsti
Published: January 2017

The present report describes a gynaecological open care study intended to determine the incidence of gynaecological diseases in the 15–60 year old population of Nurmes and shed light on the effects on gynaecological morbidity of age, parity, certain habits in sexual behavior, socioeconomic situation and previous care. The series comprised 2 654 women who agreed to undergo an examination, i.e. 72.8% of the women 15–60 years of age listed in the census and 80.9% of those in the locality during the study period. The research methods used were: a written anamnesis, personal interview, gynaecological Pap test, clinical gynaecological examination, laboratory tests, histological tests and, when necessary, tests in a central hospital. The final result of the study on gynaecological state of health was the division of the subjects into the following four groups: (1) gynaecologically healthy, (2) subjectively gynaecologically ailing, (3) gynaecologically ill, and (4) asymptomatic persons suffering from gynaecological diseases. Gynaecological morbidity was also measured by the number of those in need of gynaecological treatment. These figures were compared with the number of those who, at some time in their life, had suffered from a gynaecological illness. Of the population studied, 21% were found gynaecologically healthy, 13% were subjectively gynaecologically ailing, 48% were ill and 18% were asymptomatic persons suffering from gynaecological diseases. Of the factors studied, those with the most profound effect on gynaecological morbidity were age and parity. In the younger age groups, up to 25, there were significantly more gynaecologically healthy than gynaecologically ill, after which age the number of those suffering from diseases exceeded the number of healthy subjects. Parous subjects had significantly more gynaecological diseases than nulliparous subjects. The number of births was not related to the total number of gynaecological diseases. Sexual relations increased gynaecological morbidity, though to a lesser degree than parity. Gynaecological morbidity in the different social classes was uniform. Those in the highest income classes accounted, relatively, for the largest number of cured gynaecological diseases.
Standard of Living, Health, and Utilization of Social and Health Services a Survey of the Population of Three Districts in Malmö
Authors: Dahlin Lars
Published: January 2017

A survey of the social and medical conditions of the population in three well-defined districts in Malmö was made in order to obtain background data for the planning of open care. A random choice was made of 70 households from each of the three residential areas for interview purposes. Available data concerning actual individuals were collected from the social and health authorities. Wide variations existed between the three districts. The inhabitants of Kroksbäck, mostly young families with children, were comparatively healthy somatically, whereas many had social problems; mental troubles were common too. In Lorensborg, the inhabitants did not conspicuously deviate from the average, as regards complaints. In Ellstorp, with its elderly population, two in three had impaired health, mostly in the form of somatic complaints; moreover their teeth were in poor condition. One in three of all interviewees had felt ill in some respect during the fortnight preceding the interview, and more than half had some current health problem. Eleven percent of all interviewees had sought medical advice during this fortnight. One in three of the interviewees was using prescribed remedies at the time of the interview. Eleven percent of those in the gainfully employable age range had been sick-listed for some part of the fortnight. The need for a general practitioner service, continuity of care, health centres and integration of social and medical care is discussed.
Smoking Habits among Norwegian Doctors 1974
Authors: Aarø Leif-Edvard , Bjartveit Kjell , Vellar Odd D. , Berglund Else-Lill
Published: January 2017

In the spring of 1974 a representative sample ( N = 1200) of all doctors in Norway (6000) received a mailed questionnaire regarding past and present smoking habits. Close to 95% responded. Among late responders there was a disproportionately high number of smokers.

As compared with the general population, both male and female doctors constitute a small proportion of daily smokers and a large proportion of exsmokers. The greatest contrasts are observed in the younger age groups.

The percentage of daily smokers in this crossectional study on the medical profession is approximately 50% lower than that found in the 1952–53 study on Norwegian doctors. There is also a shift away from cigarette smoking toward the use of pipe and cigars, which is not found in the general population.

Answers to questions regarding reasons for quitting as well as certain attitudinal indicators show that the doctors' reduction in smoking is related to their professional involvement and high level of knowledge concerning the health consequences of smoking.
Utilization of Coronary Care Units in Sweden
Authors: Bloom Bernard S. , Jonsson Egon , Dolk Marie-Louise
Published: January 2017

Coronary care unit usage has expanded rapidly in all high income countries with little attention to effectivity or cost. A study of six randomly chosen Swedish units showed that larger units in teaching hospitals had significantly lower age-adjusted mortality rates, higher proportions of myocardial infarction patients, and greater productivity and efficiency. Comparisons with a study from the United States showed better results in the Swedish hospital units according to all variables measured. Although proof of effectiveness of CCU's is lacking, their continued use is assured. A less than optimal solution is a rational distribution of units based upon epidemiologically determined need, while stressing good organization and efficiency.
The Role of Lay Workers in Community Health Education: Experiences of the North Karelia Project
Authors: Neittaanmäki Liisa , Koskela Kaj , Puska Pekka , McAlister Alfred L.
Published: January 2017

The role of natural community leaders in serving as lay health workers in a comprehensive community health programme has been explored. In rural Finland, nearly 300 persons were trained to detect cardiovascular risk factors (smoking, high-cholesterol diet, high blood pressure) in their communities, and to advise community members of the desirability of lowering these risk factors. Initial data from studies of the lay health workers and their intervention work support the concept that carefully select community health workers who are to varying degrees representative of their local populations, can well act as intermediaries in preventive health care strategies.
Management of Hypertension and Changes in Blood Pressure Level in Patients Included in the Hypertension Register of the North Karelia Project
Authors: Nissinen Aulikki , Tuomilehto Jaakko , Puska Pekka
Published: January 2017

A major subprogramme of the North Karelia Project has been the hypertension programme which aimed at lowering the high blood pressure levels prevalent among the whole population of the province of North Karelia, and especially among middle-aged men. A community-based hypertension register, which served as the major tool of the programme, was established to keep patients under treatment and to gather information about the progress of the programme. The registration of the hypertensive subjects was continued from 1972 to 1977; the registered patients had annual follow-up examinations. After 5 years of the programme, there were approximately 17000 registered patients, which was 9.7% of the total population. The proportion of drop-outs at the annual follow-up examinations was 10–20%. 83% of the registered hypertensive subjects were undergoing drug treatment after 3 years' intervention. The percentage of normotensive subjects increased significantly year by year.
Adjustment and Behaviour of Finnish Immigrant Children in Stockholm
Authors: Aurelius Göran
Published: January 2017

The object of the investigation was to study the behaviour and adjustment of Finnish children following their immigration to Sweden, and to see whether there was any connection between the families' acclimatization and the children's adjustment at the time of the investigation, three years after their migration from Finland. The material consisted of 40 children from 27 families. The parents were interviewed by a Finnish psychologist. The results were co-ordinated with those of an investigation of the same children at school. To judge from the parents' statements, behavioural disorders were to be found in the children more often after immigration than prior to it or three years after. The disturbances most often mentioned as appearing after migration were shyness, poor self-esteem, nail-biting and psychomotor unrest. Children from homes where the parents reported the existence of relationship disturbances, problems with alcohol or depression were more often maladjusted and had greater difficulty in being accepted at school. Even if the adjustment of immigrant children to shcool can be improved by educational measures, this should also be considered in the context of the families' and parents' situation in society.
Secular Changes in the Twinning Rate in Denmark 1931 to 1977
Authors: Rachootin Pamela , Olsen Jørn
Published: January 2017

The present study examines secular changes in the rate of twinning in Denmark during the period 1931–77. Total twinning (i.e., mono- and dizygotic twinning combined) declined from a crude rate of 15.0 twin births per 1000 deliveries in 1931 to 9.6 twin births per 1000 deliveries at the end of the period. After direct adjustment for maternal age and parity (between the years 1935 and 1965), a 22% decline in total twinning rates was noted. Estimates of the rates of dizygotic twinning over the same period, again adjusted for maternal age and parity, show a decline of 29%. Thus there is evidence of a real decline in twinning, independent of the effects of changing patterns of maternal age and parity. These findings are consistent with reports of a general decline in twinning rates from a number of other countries. The interpretation of such secular changes is a matter for speculation.
Mortality of Male Members of the Danish Semiskilled Workers' Union
Authors: Jeune Bernard
Published: January 2017

The mortality of male members of the Danish Semiskilled Workers' Union in 1973 has been analysed in an earlier publication. The aim of the present study was to see if previously indicated trends are being maintained after standardizing mortality rates by county for the period 1973–75. Although regional variations are seen, standardization by county produces only slight differences in age and cause-specific standardized mortality ratios. Earlier findings of high mortality from unnatural causes among members of the Semiskilled Workers' Union, especially in younger age groups, are confirmed. Low mortality in older age groups, which show a deficit of deaths from circulatory diseases and other chronic illnesses, suggests the possibility of a survival population effect.
Mortality and Incidence of Chest Pain after an Exercise Intervention Programme
Authors: Oja Pekka , Pyörälä Kalevi , Kärävä Risto , Punsar Sven
Published: January 2017

One hundred and sixty-six middle-aged Finnish men free of clinical coronary heart disease (CHD), but having at least one CHD risk factor, participated in an 18-month controlled exercise intervention study, one-half as an exercising group and the other half as a matched control group; thereafter all 166 followed a partially controlled exercise programme for the next year. These men formed the intervention group for the present follow-up study covering the subsequent 6 years. The reference group for the follow-up comprised 152 men who fulfilled the same inclusion critera for the original study as the intervention subjects, but who had been excluded from the study for non-medical reasons, mainly because they could not be pair-matched. Mortality statistics were collected, and a postal questionnaire on chest pain symptoms and physical activity was sent to all of the men 8 years after the start of the study. One CHD death and four other deaths occurred in the reference group, and one CHD and no other deaths in the intervention group. Severe chest pain possibly suggestive of myocardial infarction was more common in the reference group than in the intervention group, but no difference was found in angina pectoris symptoms. The level of recent physical activity or smoking did not affect the chest pain symptoms independently.
Resting Systolic Blood Pressure and Heart Rate at Work
Authors: Jonsson Björn G. , Åstrand Irma
Published: January 2017

A random sample ( n = 1 050) of the population of a region in central Sweden performed a submaximal exercise test on bicycle ergometers. The participants were men and women aged 18 to 65 taking part in the REBUS study 1969–71 (3). This paper deals with the partial relationship between heart rate at different rates of work and systolic blood pressure measured at rest (SBP) controlling the influence of other predictors of heart rate. It was found that the relationship was non-linear and that individuals with a relatively high SBP had a lower heart rate than individuals with lower SBP. The curvilinear relationship was more pronounced in women and grew stronger with increasing rate of work.
Pain from the Neck-Shoulder Region and Sick Leave
Authors: Westerling Dagmar , Jonsson Björn G.
Published: January 2017

A sample population aged 18 to 65 selected at random in a region of the county of Stockholm was examined in an epidemiological study of met and unmet needs for medical and social services—the Rebus study (3). The study, comprising about 2500 men and women, was conducted from 1969 to 1971. The frequency of neck and shoulder problems was found to increase with age and occupational physical exertion. The frequency of symptoms was higher in women than in men. Those individuals who had to lift 40 (♂) 60 (♀) kg to do their job exhibited a significantly lower frequency of neck-shoulder problems than others. Sick leave was more common among persons with neck-shoulder problems also when comparisons were made for age, sex, and physical strain at work.
Findings at a Re-Examination of a Self-Administered Questionnaire after Two and a Half Years in a Sample of Sixty-Year-Old Men
Authors: Skarfors Einar , Waern Urban , Lidell Christer
Published: January 2017

The result of examinations conducted by self-administered questionnaire on two occasions almost three years apart in the same sample of men in their sixties is related. An overall consistency of 87% was found, but the proportion of changed answers differed form 7 to 26% among the nine sections of the questionnaire, the highest rate of change occurring in the section on physical habits. Most changes could be anticipated among men in their seventh decade, the rise in knowledge about cardiovascular diseases among relatives being an exception.
The Incidence of Disability Pensions and Mortality among Semi-Skilled Construction Workers in Copenhagen
Authors: Damlund Marianne , Goth Steffen , Hasle Peter , Jeune Bernard , Munk Karen
Published: January 2017

The aim of the present study was to discover whether the incidence of disability pensions and mortality was higher amongst semi-skilled construction workers (SCW) in Copenhagen than in two control groups from the same geographical area. The population investigated consisted of a fixed cohort of 3537 SCW from Copenhagen as per 1/5/1975. The two control groups comprised 3818 Copenhagen members of the Warehouse Workers' union and a group of Copenhagen members of the Semi-skilled Workers' Union age-matched to the SCW cohort, both as per 1/5/75. Up to 31/12/79, a total of 102 SCW were granted disability pensions, compared with 89 and 77 in the two control groups respectively, i.e. a significantly higher frequency of award of disability pension among SCW than among warehouse workers ( p>0.05). This was due especially to a higher frequency of disability pensions granted because of musculoskeletal diseases and cancer in SCW. The number of deaths was recorded from 1/5/75 to 30/11/78. No differences in overall mortality were found among the three groups, although slightly fewer deaths from lung cancer and ischaemic heart diseases and more suicides were observed among the construction workers. Selection bias and the effect of the working environment are discussed against the background of a concurrent investigation of the state of health and working conditions of SCW.
The Concept of Quality of Life
Authors: Hörnquist Jan Olof
Published: January 2017

Despite the fact that, in the current debate, quality of life is depicted as something very desirable, its concept is seldom specified. With regard to previous research into welfare and quality of life, a model of an overall concept of quality of life is presented here. The theoretical analysis ends in and is woven into an empirical application. The application consists of a prospective longitudinal investigation of alcoholics who receive disability pensions. This report is the first in a planned series from the research project “Abuse of alcohol — Disability pension — Quality of life”.
Variations between and within Countries in Hospital Care for Peptic Ulcer
Authors: Jönsson Bengt , Silverberg Raymunda
Published: January 2017

The present study tries to examine variations in utilization rates for hospital care for ulcer disease between and within Denmark and Sweden. The focus is on how utilization rates differ but an attempt is also made to explain why regional differences occur. Hospital patient statistics from both countries show that ulcer disease accounts for 35% more bed-days per 100 000 inhabitants in Denmark than in Sweden. The main source for this difference is duodenal ulcer, where the number of bed-days is 63% higher in Denmark. The differences in length of stay are negligible and the numbers of surgical operations are about the same in the two countries. The greater utilization of hospital resources in Denmark is explained mainly by the fact that more medical cases are treated as in-patients in Denmark than in Sweden. Neither mortality rates nor other data support the hypothesis that the incidence of duodenal ulcer is higher in Denmark than in Sweden. The difference between Denmark and Sweden widens when utilization rates are adjusted for differences in the age structure of the population in the two countries. There are wide variations in utilization rates between regions within both countries. The findings support the hypothesis that the intertemporal change in the technology for management of ulcer disease is one of the main reasons for variations between and within countries.
An Alternative Sampling Approach to the Study of Diabetes Prevalence
Authors: Damsgaard E. M. , Frøland A. , Greene A. , Hauge M.
Published: January 2017

Sampling methods hitherto used in epidemiological surveys have generally faced two major sorts of potential bias: (I) a latent period between listing and testing of listed individuals which can cause a misrepresentation of the population under study, compared with the population basis; (2) population migration and death during the study period. which may result in a discrepancy between the population selected for study and the part of the population examined. A Central Population Register, found in all Scandinavian countries, permits an evaluation of the size of these problems of bias and makes it possible to use an alternative sampling method based on test samples successively drawn from the actual dynamic population. The feasibility of this new approach was tested in an epidemiological survey of diabetes mellitus among individuals in the age group 60–74 years living in a Danish municipality (Fredericia). It is concluded that this alternative dynamic method produces a more representative study population with less bias, thanks to the smaller number of deaths and migration among non-responders during the study, than do the methods previously used. Furthermore, the length of the study period, the size of the test samples, as well as the intervals between selecting samples may be adjusted to the capacity available, thus reducing the resources required. By using a correction in the computer program for selecting test sample size, the sex and age profile of the whole study population may be chosen in accordance with the incidence of the disease studied. In the Scandinavian countries a unique possibility exists to carry out prevalence studies on all kinds of diseases by the method described and evaluated here.
The Ubiquitous 2×2 Table, its Parameters and Their Confidence Limits
Authors: Ipsen Johannes
Published: January 2017

The confidence limits for all parameters derived from a 2×2 contingency table are uniquely determined by the limiting matrices that arise from adding or subtracting certain values to or from the four cell entries. Various methods to determine these addends are discussed and a computer program is presented that produces reliable results. The limiting matrices thus produced bypass the more complicated expressions for the standard errors of the many epidemiological parameters that are used to interpret the 2×2 table.
Treatment of Mental Problems in General Practice
Authors: Tellnes Gunnar , Bjørndal Arild , Fugelli Per
Published: January 2017

The aim of the study was to provide a basis for improving the treatment and prevention of mental problems in a defined local community. The prescribing of psychotropic drugs has been recorded as well as the use of non-drug therapy and the factors which worsened the patients' mental problems. The rate of psychotropic drug-users was 15% for females and 9% for males. The total prescribing during one year amounted to 59 defined daily doses (DDD) per thousand inhabitants per day. Hypnotics/sedatives constituted 30%, anti-histamines 23%, neuroleptics 18%, minor tranquillizers 16%, and antidepressants 13%. About 1/4 of the psychotropic drug-users was prescribed more than 180 DDD per year, representing a risk group for chronic use. The majority of all psychotropic drugs (65%) was prescribed through indirect contacts implying a danger of developing “repeat prescription syndromes”. Less than one half of the patients who might have benefited from referral to a psychiatrist had, in fact, been referred during the previous three years. Somatic disease (among the psychotropic drug-users) and illness among other family members were frequently reported as worsening factors. This indicates the importance of holistic therapy and prophylaxis in general practice. Among our advice for prevention of mental problems to the local authorities was the arrangement of weekly social meetings and clubs for disabled pensioners and elderly people.
The Wearing of Spectacles in Different Social and Educational Groups in a Sample of the Population of Central Finland
Authors: Pärssinen Olavi
Published: January 2017

On the basis of information gathered from a questionnaire study of 6875 people aged from 7 to 46 years and living in Central Finland, it was seen that the wearing of spectacles has much increased during the last five decades. It is calculated that the wearing of spectacles is still on the increae in the population. More females than males wore spectacles in all the age groups studied. The higher the education the more common was the wearing of spectacles. Poor distant vision was the main reason for the wearing of spectacles, up to the presbyopic age. At the presbyopic age, education, accurate close work, and poor distant vision were connected with the wearing of spectacles. The father's occupation seems to have little or no effect on the wearing of spectacles nowadays.
Cerebrovascular Disease: Declining Incidence but Increasing Hospital Utilisation
Authors: Brommels Mats , Tilvis Reijo , Autio Lauri
Published: January 2017

A total of 20680 patients hospitalised in Helsinki during 1970–1980 due to cerebrovascular diseases were found when screening the Finnish National Hospital Discharge Register. The material was categorised according to three-digit ICD-8 diagnosis codes and age, and was analysed for case-fatality, length of stay and discharge status. By identifying all new cases an assessment of the incidence development during the study period was also possible. A fall in the overall age-standardised incidence of cerebrovascular disease was demonstrated, in accordance with disease register studies. The main reason was decline in incidence of haemorrhagic stoke (ICD-8 no. 431) and less well defined types of stroke (436–438). Ischaemic stroke (433), on the other hand, did not decrease in frequency. The diagnostic shift, occurring parallell with a growing mean age of patients, lead to decreasing acute mortality, increasing institutionalisation rates and longer stays in hospital, thus resulting in growing figures of hospital utilisation in spite of the declining incidence.
Early and Late Discharge after Hospital Birth
Authors: Waldenström Ulla , Lindmark Gunilla
Published: January 2017

When an early postnatal discharge program was introduced in Falun, Sweden in 1984, with early discharge defined as discharge 24–48 hours after birth combined with home visits on the following days, an investigation into background characteristics of parents choosing to participate and not to participate in the evaluative study of the program was initiated. 164 participants were compared with 354 non-participants. Data were collected mainly from questionnaires, 8 weeks before term. The participants were a more heterogeneous group than was expected when starting the program. Compared with the non-participants, they were characterized by: a less positive attitude to post-partum care in hospital and greater self-confidence in terms of confidence when thinking of birth and parenthood. They were more often multipara and had experienced rather less complicated pregnancies. They were a little younger and somewhat less well educated as a group, but the proportion of well educated women was the same as among non-participants. They had attended antenatal classes this pregnancy to a lesser extent, but felt better prepared for the delivery. They had a greater number of supportive persons available in case of early discharge. There was no difference between participants and non-participants as regards economy, housing conditions, distance to hospital, proportion of immigrants, paternal interest in childbirth and parenthood, equality in parental relations, social contacts, and leisure activities.
Loneliness Correlates in Advanced Alcohol Abusers
Authors: Åkerlind Ingemar , Hörnquist Jan Olof , Hansson Birgit
Published: January 2017

A previous report on 34 alcohol abusers undergoing rehabilitation revealed that, among 86 medical, social and psychological variables, “feelings of loneliness” were most important for the prognosis. The current analysis was performed in order to illuminate the less satisfactory prerequisites regarding external social factors and needs of the lonely alcohol abuser. Ninety-five abusers, the previously mentioned sample included, were examined twice with an approximate interval of two years. The results indicated that there were no simple or obvious correlations to the external social situation (the amount of contacts, social network, etc). Feelings of loneliness were more closely associated with dissatisfaction with the quality of existing relationships, independent of quantity. Furthermore, even in relation to work and activities, the lonely abusers showed a general dissatisfaction with the existing situation, independent of its nature. In addition, the lonely abusers felt dissatisfied in a number of need domains, although they were only inclined to stress the priority of some social needs. To sum up, the lonely abuser showed a recurrent pattern characterized by discontentment and dissatisfaction, in combination with some traces of passivity in essential life-spheres.
Body Mass Index in the Scandinavian Countries
Authors: Waaler Hans T. , Jensen Gorm , Schnohr Peter , Pietinen Pirjo , Nissinen Aulikki , Larsson Bo , Bengtson Calle
Published: January 2017

Data on the body mass index (BMI) from four Scandinavian countries are compared. The Finnish values are markedly higher than those of the other countries. This holds for both sexes. Among these the Norwegians deviate by showing higher values for females, though not reaching the Finnish level, but lower values for the males. The populations from which the observations are drawn are differently sampled. There is no evidence that differences as to composition in rural/urban populations can explain the differences.
Social, Personality and Environmental Determinants of Smoking in Young Finnish Men
Authors: Hämynen Heikki , Vartiainen Erkki , Sahi Timo , Pallonen Unto , Salonen Jukka T.
Published: January 2017

The study was based on 471 males, aged 19 to 20 years, who started their compulsory military service in three military bases in Southwest, Southeast and Northern Finland in February 1982. Of these subjects 48% smoked regularly and had smoked in the past three weeks. The correlation between the reported number of cigarettes smoked a day and serum thiocyanate was 0.60. Seventy-four per cent of the subjects whose best friend smoked, were current smokers compared with 24% of the others. Proportion of smokers was higher in urban areas than in rural areas. Among the 14 explanatory variables in the multivariate logistic analysis, family members' and friends' smoking, the place of residence, strenuousness of leisure-time physical activities, number of friends, rebelliousness, intelligence test score, and general pessimism were most strongly associated with the likelihood of being a current smoker. The model explained 87% of the smoking variance.
Suicide among Swedish Dentists
Authors: Arnetz Bengt B. , Hörte Lars-Gunnar , Hedberg Anders , Malker Hans
Published: January 2017

In the present study, we have followed a national cohort of dentists, academics, i.e. people with three or more years of post-high school education, and the general population for a period of ten years, and identified all cases of recognized suicide during the period 1961 to 1970. The aim of the study was to assess whether suicide rates are higher among dentists even after adjustment for socioeconomic factors. Results show an elevated standardized mortality ratio (SMR) for male dentists compared to other male academics. Female dentists did not exhibit any increased risk. It is suggested that enhanced interest should be given to the possible etiologic role of not only psychosocial factors but also to psychoorganic consequences of mercury exposure among dentists.
The Yield of Systems for Continuous and Periodic Injury Surveillance in Emergency Care with Emphasis on Farm-Work-Related Accidents
Authors: Jansson Bjarne R.
Published: January 2017

The objective was to analyse the medical consequences, sequence of events and contributory and background factors of farm-work-related accidents. The study is part of a project to develop systems for continuous and periodic injury surveillance in Swedish public health care. Altogether 163 patients were treated for injuries sustained in accidents on 2454 farms during a one-year period. The five most common injurious agents were: material, tools, machinery, foreign bodies and animals. Half of the injuries were due to the victims' having slipped on a floor or on equipment with tools or other objects or to tripping. Reported contributory factors were unsuitable methods of working, failure to use personal safety equipment, deficient inspection, lack of safety devices, design deficiency and haste. Farms consisting of more than 50 hectares (120 acres) were over-represented. The results illustrate the numerous risks associated with work on farms and indicate the need to improve occupational safety in this sector.
Regret among 547 Danish Sterilized Women
Authors: Thranov Ingrid , Kjersgaard Anne Grete , Rasmussen Ole Vedel , Hertz Jens
Published: January 2017

To help identify potential regretters of female sterilization, the women sterilized at Frederiksborg County Hospital, Hørsholm, Denmark, from 1978 through 1982 were contacted by questionnaires, and their medical records were reviewed. Ninety-two per cent (547/594) responded. The median observation time was 50 months. Five per cent of the women ( n=28) regretted the sterilization. The risk of regretting the sterilization was signifincatly increased among women who at sterilization experienced marital disharmony (12.5% regretted), had a child less than one year old (14.7% regretted), had the sterilization performed in connection with another surgical procedure (16.1% regretted), were outside the social groupings (17.0% regretted), or had no paid work (10.0% regretted). No association between number of children at the time of sterilization, prior number of contraceptives used, abortion at sterilization, and later regret was found. Twenty-five per cent of the regretters had had psychiatric problems prior to the sterilization. The regretters were sterilized shortly after their request (median 1 month) compared to 3 months among non-regretters. The main reason for regret of sterilization was the desire for more children, independent of a change in marital status. Sequelae to the sterilization was a common complaint. Refertilization was requested by 1% of the sterilized women. The study suggests that the psychosocial situation should be carefully evaluated in women requesting sterilization. A time lag from request to the sterilization should be mandatory and a thorough pre-sterilization counseling including information about possible sequelae and alternative contraceptives should be given.
Mentally Ill Mothers and Their Children
Authors: Bågedahl-Strindlund M. , Undén G.
Published: January 2017

177 cases of parapartum mental illness and 173 matched obstetric controls were studied retrospectively from the perspective of the social welfare services (SWS). Data covering five years before the index partus until five to seven years thereafter, were studied. Parapartum mentally ill women were known to the SWS to a much greater extent (75%) than their matched controls (33%). They also presented more severe environmental problems than their matched controls. Within the index sample the largest number of adverse factors known to the SWS was found in the addicts and NTI (neuroses and temporary insufficiencies) groups. The dysfunction in the families appeared to be constant throughout the observation period. A large proportion of the index children (32%) had been placed in foster care or adopted. When the index women had applied to the SWS during the first postpartum year the social workers were informed of the fact that she had contacted a psychiatric department in 8 out of 10 cases. However, only in half of these cases had regular collaboration taken place. Collaboration was far more frequent when the mother suffered from severe mental illness than when she was suffering from a less severe mental disturbance.
Problems with Cross-Sectional Data in Research on Working Environment and Health
Authors: Östlin Piroska , Thorslund Mats
Published: January 2017

Occupational turnover due to health related selection might introduce a bias in cross-sectional studies that tends to mask real occupational health effects. People could have changed occupation so that they, when disease occurs and/or the data collection is accomplished, are working in an environment that is irrelevant for the disease in question. The aim of this study was to determine whether there is any difference in morbidity between ‘stable’ workers and ‘changers’. Occurrence of long-term illness was studied on four exposure levels, defined according to the physical demands at work. The study population comprised 10487 men and 10058 women between 25 to 74 years of age, who were interviewed within the scope of the Statistics Sweden Survey of Living Conditions in the years 1977 and 1979–81. Considerable differences in health outcomes were found between stable workers and changers, especially when considering the degree of physical strain at work. Thus, the findings indicate the necessity of detailed recording of occupational histories within the framework of cross-sectional studies, especially when the aim of the investigation is to study and compare health outcomes for workers in occupations with different turnover rates.
Priority Setting with Regard to Placement on Waiting List to a Pain Clinic
Authors: Brattberg Gunilla
Published: January 2017

Short waiting periods for all patients referred to a pain clinic is desirable but ordinarily not possible. In a questionnaire, 25% of the Swedish anaesthetic pain clinics reported a waiting list exceeding 6 months. The long waiting-time shows that some kind of priority setting is necessary. The aim of the present investigation was to study the feasibility of a rational priority setting based on a ranking procedure. Secretary and nurse priority ranked patients according to a system utilizing the physicians's referral and a questionnaire completed by the patient. These priority ratings were compared to the final ranking by the doctor which was done after an interview without access to the questionnaire. The results of the present investigation show that the secretary as well as two nurses generally ‘overestimated’ the patients' pain problems compared with the priority made by the doctor. However, 12 out of 142 patients' problems were ‘underestimated’ but this was deemed to increase risk in only one case. The possible risks with a delegated ranking procedure have, however, to be judged against the disadvantages of no priority setting at all and the advantages of a rational use of staff members. This experiment has indicated the feasibility of a delegated ranking procedure.
Lung Cancer Incidence among Swedish Bakers and Pastrycooks: Geographical Variation
Authors: Wicksell Lottie , Carstensen John M. , Eklund Gunnar , Gustafsson Jan-Åke
Published: January 2017

In a cohort of 14352 Swedish male bakers and pastrycooks, the standardized incidence ratio (SIR) for lung cancer 1961–79 varied significantly between geographical regions. In the three largest towns, the risk in bakers and pastrycooks was at the same level as in all men. When these three towns were excluded, there was a considerable excess risk, even after adjustment for smoking (SIR=1.6, CI=1.2–2.1). The SIR for lung cancer in bakers and pastrycooks were significantly lower in regions where the percentages of employed in big bakeries and confectioneries were high. The result of a case–control study, done within the cohort, suggested a somewhat higher lung cancer risk in bakers compared with pastrycooks. These results support the hypothesis that the excess risk may be due to exposure to carcinogens especially prevalent in small bakeries.
A clinical decision support tool to assist with the interpretation of the 12-lead electrocardiogram
Authors: Breen Cathal , Bond Raymond , Finlay Dewar
Published: January 2017

This article reports the design and testing of a novel interactive method, abbreviated to ANALYSE (systemAtic aNALYsiS of Electrocardiography) to assist interpretation of 12-lead electrocardiogram. 15 participants interpreted a total of 150 12-lead electrocardiogram recordings randomly using a standard and this novel (ANALYSE) reporting format. The overall aggregated mean score attained using the standard format was 53% (range = 38–82%, standard deviation = 12). Conversely, the overall aggregated mean score attained using ANALYSE format was 75% (range = 55%–93%, standard deviation = 9). A total of 14/15 participants consistently scored higher when interpreting electrocardiograms using the ANALYSE format (range = 10% -45%). A significant difference between the aggregated marks scored using the ANALYSE format and the standard format was calculated (Wilcoxon Z Score = −3.2374 (df = 14), p < 0.01). This study demonstrates the clinical utility of a novel method (ANALYSE) to assist the learning of electrocardiogram interpretation and its association with enhanced diagnostic performance in novices.
Assembling (non) treatable cases: The communicative constitution of medical object in doctor–doctor interaction
Authors: Caronia Letizia , Chieregato Arturo , Saglietti Marzia
Published: January 2017

Research on medical interactions shows how the discursive construction of the clinical case impacts diagnostic reasoning and treatment recommendations. Drawing on an ethnographic study in an intensive care unit, we illustrate how this process is at play in a ward that adopts an extreme, guideline-divergent policy as to the use of antibiotics. The article focuses on how physicians assemble the case as ‘treatable’ or ‘not yet treatable’, and how in doing so they ‘talk into being’ two contrastive policies on antibiotics and position themselves toward the one adopted in the ward. The analysis identifies the discursive resources displayed by physicians to both project an infectious disease diagnosis and resist this treatment-implicative trajectory. We argue that the physicians’ contentious discursive construction of the case has crucial consequences in the way the ward’s extreme policy is jointly accomplished as a highly reflexive process sensitive to the contingencies of any particular case.