bluuebunny/crossref_metadata_2025 huggingface dataset:
Databank: The Caribbean
Authors: Fletcher John , Latham John
Published: July 2017

Tourism activity and economic performance, particularly that of the major tourism generating and receiving countries, are closely linked. The purpose of this section is to provide those indicators which are regarded as being most relevant to international movements and spend. In one issue each year there will appear information relating to the global picture and by region, together with some detail on the most significant nations. The databank paper in Volume 1, Number 1 was the first in this category. Throughout the remainder of the year each issue will concentrate on a specific region – in this case, economic indicators of tourism in the Caribbean are provided and accompanied by a brief commentary. The main sources of data are those statistics published by the World Tourism Organisation (WTO), the World Travel and Tourism Council (WTTC), Eurostat, the Organisation for Economic Cooperation and Development (OECD) and special reports of the Economist Intelligence Unit (EIU). Formal definitions associated with the tables presented are often detailed and lengthy and so are not included here. The reader should consult the source material if necessary.
Tourism Satellite Account for Sweden 1992–93
Authors: Nordström Jonas
Published: July 2017

This paper calculates the consumption expenditure of internal visitors in Sweden, and Swedes' expenditures on outbound tourism, according to the WTO definition of tourism expenditure. The demand-based calculations of national tourism are distributed among same-day visitors and overnight visitors, for leisure and business purposes. The supply side calculations cover the main tourism industries. Daily expenditures of domestic tourists categorized by housing type and purpose are also presented. The calculations show that the consumption expenditures of internal visitors in Sweden were approximately 65 300 million SEK in 1992, which compared to the GDP is about 4.5%. The expenditure of Swedish households on leisure trips in 1992 amounted to 66 544 million SEK, which is 8.6% of adjusted total private consumption. In 1993 this figure declined to 7.8%. The largest reduction was on expenditure on outbound trips.
An Analysis of Restaurant Characteristics and Meal Prices in Melbourne, Australia
Authors: Gunawardana Pemasiri J. , Havrila Inka I.
Published: July 2017

This paper applies the hedonic price function approach to identify and estimate the variations in meal prices according to various characteristics of a sample of restaurants in Melbourne, Australia. The estimated hedonic price functions have important implications for restaurant marketing strategies and provide useful information to customers, and may serve to improve the efficiency in the market for restaurant dining. From the point of view of restaurant operators, the results indicate how short-term and long-term investment decisions may be made to impart particular characteristics. From the perspective of customers, the results provide information on price premia and discounts for restaurant meals according to each of the characteristics, including locations.
Databank: Africa
Authors: Fletcher John , Latham John
Published: July 2017

Tourism activity and economic performance, particularly in the major tourism generating and receiving countries, are closely linked. The purpose of this section is to provide those indicators which are regarded as being most relevant to international movements and spend. In Volume 1, Number 1, information relating to the global and regional pictures of tourism were presented, together with some specific details regarding tourism activity with respect to the most significant nations. Subsequent issues have concentrated on specific world regions. In this issue, economic indicators relating to tourism in Africa are provided.
Estimating the Recreation Use Values of National Parks
Authors: Bennett Jeff
Published: July 2017

A comprehensive application of the travel cost method (TCM) to the estimation of the recreation use values of Dorrigo and Gibraltar Range National Parks is outlined. As well as providing value estimates that are useful for the development of park acquisition and management policy, the application also provides some important lessons for the future use of the TCM. So long as some key assumptions relating to the value of travel time and site congestion are shown to hold, then a stream-lined version of the TCM can be used. The questionnaire required to implement the abridged version is brief, thus encouraging a better response rate. Survey and analysis costs are therefore likely to be lower, making the TCM a more cost-effective decision making tool.
Food Purchases in a Five-Star Hotel: A Case Study of the Aquila Prambanan Hotel, Yogyakarta, Indonesia
Authors: Telfer David J.
Published: July 2017

Five-star hotels in developing countries are often presented as importing most of their food and having minimal contacts with the local economy, resulting in high leakages. This study of the Aquila Prambanan illustrates that, in a favourable agricultural setting with a good distribution system, it is possible for a five-star hotel to purchase most of its food locally. The food ordering process, purchasing patterns and purchasing network of the hotel are explored. A strong relationship was found to exist between food purchases and occupancy rates.
Global Tourism Trends
Authors: Fletcher John , Latham John
Published: July 2017

Tourism activity and economic performance, particularly in the major tourism generating countries, are closely linked. The purpose of this section of the journal is to examine some of the trends and indicators relevant to tourism activity in terms of arrivals and spend. Preceding issues have examined five of the global regions plus the Caribbean in turn and provided a database of economic and tourism statistics which may be helpful to researchers of tourism. This issue returns to the global picture and, in so doing, extends earlier databases and also provides different information to complement those data included in Volume 1, Number 1. The main sources of data are statistics provided by the World Tourism Organisation. Formal definitions associated with the tables are often highly detailed and so are not reproduced here. The reader should consult the source material if additional information is required.
Valuing International Tourism Benefits from Natural Areas
Authors: León Carmelo J.
Published: July 2017

Tourism involves intensive utilization of environmental assets and natural resources. Valuing these assets may be relevant for policy purposes. This paper presents results from a contingent valuation study of the benefits experienced by tourist visitors to natural areas in Gran Canaria (Canary Islands). Construct validity is approached by investigating question format effects. The open-ended format is compared with dichotomous choice methods using a general parametric testing procedure. In general, the single-bounded method does produce larger estimates of consumer surplus than the open-ended method, but these divergences were not significant for German and Italian tourists. In addition, the double-bounded method converges to open-ended results, especially for UK tourists. The former method is also robust with respect to the choice of the bid vector design. The assessed benefits highlight the economic contribution of these assets to the tourism industry.
An Investigation of the Time Series Behaviour of International Tourist Arrivals
Authors: Wong Kevin KF.
Published: July 2017

Most tourism econometric models are based on conventional least squares estimation, which assumes stationarity in their data generating mechanism. However, they fail to recognize the implications of the integrated properties of the historical time series of tourism data. Such time series properties may have important consequences with regard to the theoretical implication and interpretation of these tourism models. In this paper, historical data on international tourist arrivals from six major regions and seventeen individual countries are analysed to determine whether the series is better characterized by a stationary or non-stationary type process. Based on unit root tests, the results in most cases indicate that international tourist arrivals exhibit a non-stationary stochastic process that has the tendency to fluctuate away from a given initial state as time passes. These findings imply that studies which conveniently draw standard inferences from ordinary least squares estimated tourism models based on the levels of international tourist arrivals can be very misleading since non-stationarity in the data will produce inconsistent parameter estimators and unreliable test statistics. Furthermore, model misspecification that arises from unrelated integrated series can seriously bias conventional significance tests towards the acceptance of an apparently significant relationship. In this preliminary investigation, we conclude that econometric tourism models that focus on the levels of international tourist arrivals may not be reliable since the series is non-stationary and is integrated of order one, I(1).
East Asia and the Pacific
Authors: Fletcher John , Latham John
Published: July 2017

Tourism activity and economic performance, particularly in the major tourism generating countries, are closely linked. The purpose of this section of the journal is to examine some of the trends and indicators relevant to tourism activity in terms of arrivals and spend. Preceding issues have examined five of the global regions plus the Caribbean in turn and provided a database of economic and tourism statistics which may be helpful to researchers of tourism. In this issue, economic indicators relating to tourism in the East Asia and the Pacific region are provided. The main sources of data are statistics provided by the World Tourism Organisation. Formal definitions associated with the tables are often highly detailed and so are not reproduced here. The reader should consult the source material if additional information is required.
The Determinants of Expenditures by Mexican Visitors to the Border Cities of Texas
Authors: Asgary Nader , de los Santos Gilberto , Vincent Vern , Davila Victor
Published: July 2017

This study is unique in that it is the first, at least in the literature, to study systematically and analyse empirically the expenditures by Mexican visitors in the border cities of the USA. The authors investigate the expenditure behaviour of Mexican visitors in the Lower Rio Grande Valley (RGV) region of Texas. The paper makes the following contributions to the cross-border tourism literature. It examines the qualitative, socio-economic, and demographic factors that determine the Mexican visitors' expenditures in the border cities, concluding that the expenditure by Mexican visitors is a function of their income level, socio-economic and demographic variables. Specifically as income increases by 1% expenditure increases by 0.22%.
The Economic Impact of Tourism in Israel: A Multi-Regional Input—Output Analysis
Authors: Freeman Daniel , Sultan Esther
Published: July 2017

Tourism has become one of the main export services in Israel in the last five years. The objective of this study was to estimate the comprehensive contribution of tourism to the economy of Israel and its spatial distribution. The study measured the impacts (multipliers) on three levels: direct, indirect and induced. A multi-regional input–output (MRIO) model was used in this research because of its capability to evaluate the impacts of inter-regional interdependencies simultaneously with those of sectoral ones. The results were expressed as multi-regional input–output multipliers. The authors conclude that the sum of the value-added from indirect output was 4% of GDP, and that from induced impacts was 7% of the GDP. There were differences in the impacts within and outside the regions. The analysis of multi-regional impacts through the use of MRIO enabled the authors to estimate simultaneously the magnitude of the impacts within the region, the related impacts in other regions, and the feedback impacts due to the other regions' demand.
Landowner Participation in the Regulation of Outdoor Recreation: Some Problems in Snowmobiling Regulation
Authors: Hultkrantz Lars , Mortazavi Reza
Published: July 2017

This paper focuses on some important choices that have to be made in the design of an environmental regulation system of a recreational activity that is exercised on private property and causes external effect on outsiders. Many types of tourist and recreational uses of private property exhibit these features, such as sport fishing; mountain biking; hiking; motorized and non-motorized boating, road or off-road driving; camping; caravans and mobile-homes parking; etc. Under a licence regulation of snowmobile driving that has been proposed in Sweden, a limited number of zonal licences would be sold at predetermined prices. We develop a ‘classic-style’ regulation model and show that a socially efficient solution can be obtained in a licence system where landowners are allowed to sell licences but not to collect penalty charges.
The Americas
Authors: Bar-On Raphael Raymond
Published: July 2017

The Americas form the second largest destination region in international tourism. The World Tourism Organization (WTO) reported 116 million tourist arrivals (excluding day-visits) in this Region in 1996, 4.8% above 1995, with Receipts from international tourism totalling US$107 billion, 6.4% above 1995 (in current US$ and excluding International Fares, including receipts from day-visitors). Tourist Arrivals are presented for the 51 countries and Cruise Passengers (by Sub-Regions) and Receipts for the Top Ten American earners, also estimates of employment in travel and tourism and forecasts to 2020. Preliminary data for 1997 are also presented.
Environmental Resources as Latent Primary Factors of Production in Tourism: The Case of Forest-Based Commercial Recreation
Authors: Marcouiller David W.
Published: July 2017

The supply of tourism, in many respects, remains an unresolved area of theoretical and empirical development. The reasons for this are many, but the author argues in this paper that one of the limiting core areas of conceptual development in tourism economics is the general need for an analytical framework that captures generic production processes used to produce output from the tourism sector. One important unresolved issue of production includes use of critical resources such as environmental goods that serve as latent primary factor inputs to the production process of tourism. Often, these resources are hidden from analysis due to their non-priced common-pool attributes. This is particularly true in rural amenity-rich regions where nature-based tourism firms are becoming increasingly important to regional economies. Using forest resources as an example, the incorporation of non-priced tourism production inputs more completely specifies the tourism production function, provides a critical linkage to land and recreation resource management, and allows for more integrative tourism planning approaches.
The Demand for Tourism to Greece: A Cointegration Approach
Authors: Lathiras Petros , Siriopoulos Costas
Published: July 2017

Cointegration analysis in modelling tourism demand has rarely been used in previous empirical research studies. This paper attempts to answer two main questions: first, whether certain economic factors are interconnected in the long term with tourism demand, and second, whether a short-run dynamic specification of this demand exists which is statistically adequate and which has appropriate forecasting properties.
Global Tourism Trends to 1997: Africa
Authors: Bar-On Raphael Raymond
Published: July 2017

The World Tourism Organization (WTO) reported 613 million international tourist arrivals (excluding day-visitors) in 1997 worldwide, 3.1% above 1996, with Receipts reported from international tourism totalling US$444 billion, 2.2% above 1996 (in current US$, including receipts from day-visitors, excluding International Fares). Tourist arrivals are presented for 47 countries of WTO's Africa Region (by Sub-Regions), totalling 23.3 million tourist arrivals, 8.1% above 1996, and their receipts from international tourism, totalling US$8.7 billion, 4.8% above 1996.
Diversification and German Tour Operators: The Case of TUI and Coach Tourism
Authors: Gauf Dieter , Hughes Howard
Published: July 2017

The German tour operator market has been relatively stable and dominated by a few large firms over a long period. This paper examines the attempts of the largest operator (TUI) to move into coach tourism. This move may be considered as diversification and it is examined within that context. The move by TUI was not successful for many reasons including the ability of existing small firms to adapt and survive, and the corresponding inability of the large firm to adapt to the requirements of a market with specific operational and customer characteristics. The skills of operating in the ‘mass’ package tour market were apparently not transferable to this smaller market.
The off-Season is ‘No Season’: The Case of the Danish Island of Bornholm
Authors: Lundtorp Svend , Rassing Charlotte R. , Wanhill Stephen
Published: July 2017

For all cold water resorts in peripheral areas, it is the ‘dream’ of the marketing department to expand the season but very few have succeeded. The purpose of this paper is to analyse the possibilities using the Danish Baltic Island of Bornholm as a case example. For the past three years, departing visitors have been surveyed as part of a research programme, ‘Tourism in the peripheral areas of Europe’, with the purpose of analysing tourism demand. Particular attention was given to visitors in the off-season. The sad conclusion is that the findings indicate no realistic possibilities for increasing the off-season market. The visitors in the off-season to Bornholm are mostly visiting friends and relatives, and repeat visitors with a special love for the island. The Bornholm tourism product is the nature, the atmosphere and the landscape. Even though the product is still there in autumn, winter and spring, the holidaymakers prefer to enjoy it in sunshine. Consequently, the tourism businesses, with hotels as an important exception, have adjusted to the short season. A strategy for broadening the season would imply dramatic changes in the operation of the tourist product out of season. Even then, it would be a very uncertain goal.
An Analysis of the Nature, Causes and Marketing Implications of Seasonality in the Occupancy Performance of English Hotels
Authors: Jeffrey Douglas , Barden Robin R. D.
Published: July 2017

Time series factor analysis separates two principal components of seasonality from the monthly occupancy time series of 279 English hotels over the period January 1992 to December 1994. The regional patterns of these two components, measuring the nature and intensity of seasonality and length of season, are presented, and their involvement in the occupancy profiles of individual hotels is explained using multiple regression models. The marketing implications of the results are discussed, incorporating the results of a structured interview survey of participating hoteliers.
WTO's International Tourism Summary for 1998: East Asia and the Pacific
Authors: Bar-On Raphael Raymond
Published: July 2017

The World Tourism Organization published preliminary summaries of international tourist arrivals and receipts for 1998, by region and for the 40 top destinations and 40 top earners. The global total of international tourist arrivals was 625 million in 1998 (excluding day-visits), 2.4% up on 1997 (which had showed a similar increase on 1996), with record arrivals for five regions, although East Asia and the Pacific's 86.9 million arrivals in 1998 were 1.2% down on 1997 (following a similar decrease on 1996). Tourist arrivals are presented for the 40 countries of the six sub-regions of EAP, with annual changes from 1994 to 1997 and some 1998 data and all-year estimates, also Trend-Cycles for Singapore. Receipts reported from international tourism in EAP totalled US$76.6 billion in 1997 (including receipts from day-visitors, excluding International Fares), 7% below 1996 (in current US$), detailed for 34 countries of the region, and in 1998 about US$73.7 billion, 4% below 1997, while global receipts in 1998 were about US$445 billion in 1998, a 2.0% increase on 1997. The data indicate the inter-relations between economic crises, exchange rates, prices to tourists and tourism flows.
Optimal Tourist Bus Tours
Authors: Ladany Shaul P.
Published: July 2017

A model has been suggested for the derivation of the optimal tourist bus tours — attractions to be visited and routes to be taken — that maximizes the total attractiveness of the tour, given constraints on time, cost and/or total distance travelled. The problem was formulated as a linear integer-programming model for the practical situation in which the tour's terminal and starting points do not coincide. A real-life solved example is presented.
A Simultaneous Model of Tourism Flow, Spending and Receipts
Authors: Tse Raymond Y.C.
Published: July 2017

It is generally accepted that more tourists will increase tourism receipts and more tourism receipts will, in turn, give rise to higher levels of domestic consumption. Tourists spend on goods and services within the destination; tourism acts as an export industry by bringing in new revenues from external sources. The amount of tourism expenditure that remains in an area provides a source of income to residents and businesses. Higher levels of tourist receipts in turn increase tourism spending outside the area. This paper, using econometric tests fitted to cross-sectional data (with 32 countries), shows that the number of tourists, tourism receipts and spending, as well as subsequent private domestic consumption, are closely linked. It also shows that both tourism spending abroad and receipts tend to increase with per capita income in the originating country.
Stabilization Policies for the Tourist Sector
Authors: Hjalager Anne-Mette
Published: July 2017

Over the past few decades, tourism has increasingly been included in economic policies at all levels. Not surprisingly, the tourism sector is highly satisfied with this development: the inclusion in economic policies can be taken as an indication of its acceptance as a respectable player — on equal terms with other types of business operations. However, despite the general acceptance and approval of the contribution of tourism to the economy and employment, policies seem to neglect certain characteristics of the tourist trade. This article examines a critical issue: the turbulence caused by exits and entries of firms. Data from the tourism sector in Denmark serve to illustrate the problems with considerable turbulence in the population of tourism enterprises. Instability can be regarded as a major challenge for policy makers. Within the policy tradition of interventionism, two main types of measures can be identified. One tries to boost the sector through intensified marketing, without any attempt to influence inter-firm competition, believing that more demand will enhance survival. The other attempts to affect competitiveness, investments and productivity more directly; the reasoning here is that the business environment has a decisive impact on the turbulence. This article offers a taxonomy of specific policy instruments according to the latter philosophy.
Forecasting Monthly Tourist Departures from Australia
Authors: Kim Jae H.
Published: July 2017

This paper builds time series forecasting models for monthly international tourist departures from Australia, categorized by the major destinations and by the main purposes of travel. Descriptive and statistical analyses reveal that strong trend and seasonality are the major features of all time series considered. The seasonal ARIMA model is used as a forecasting tool and its trend and seasonal components are specified based on inferential outcomes of the HEGY test for seasonal unit roots. Other alternative forecasting methods used include Holt-Winters' exponential smoothing method and the regression models that involve deterministic trend or seasonal dummy variables. It is found that forecasts generated from seasonal ARIMA models are more accurate than other alternative forecasts in most cases.
The Canadian National Tourism Indicators: A Dynamic Picture of the Satellite Account
Authors: Delisle Jacques
Published: July 2017

Canada's National Tourism Indicators constitute a set of statistics that provide historical and current quarterly analysis of tourism, covering tourism commodity supply and demand, employment and prices. The Indicators are based on the work done in developing the Canadian Satellite Account. This article provides an overview of the Indicators: their raison d'être, their uses, the underlying methodologies, the quality of the estimates, benchmarking to the Satellite Account, and production operations. The final section looks at future developments affecting the Indicators.
A Regional Approach for Tourism Satellite Accounts and Links to the National Account
Authors: Rütter Heinz , Berwert Adrian
Published: July 2017

Based on a number of regional and local tourism value-added studies carried out in Switzerland, this paper presents an implementation-oriented and pragmatic approach that provides important theoretical insights and empirical data on which to build regional satellite accounts. Regional and national satellite accounts can be used for tourism-oriented economic analysis as well as for decision making in the area of tourism policy and marketing. The main focus here lies in the empirical determination and balancing of tourism supply and demand through a mixture of top-down and bottom-up methods. The structure of the article is as follows: a brief outline of main theoretical considerations in the tourism sector is followed by a discussion of the most important methodological aspects of the regional approach. The next part deals with the presentation of the individual procedural steps on the demand side (tourism frequencies and expenditures) and the supply side (tourism production) to estimate the direct and indirect regional effects of tourism activities in terms of tourism-relevant gross output, value-added and intermediate consumption. A selection of empirical findings on the demand and supply sides is presented both to document the individual procedural steps discussed before and to highlight the similarities and differences between the regional findings. The paper concludes with an outline of how the methodological approach and the empirical findings can be used in the establishment of a tourism satellite account at the national level.
Providing Decent Employment in the Hospitality and Tourism Industry: The Role of the ILO
Authors: Belau Dirk
Published: July 2017

The International Labour Organization, with representation of governments, employers and workers, is the focal point for labour statistics in the United Nations system. It is contributing to the development of tourism satellite accounts, promoting statistics on employment and working conditions. Various International Labour Standards, including the recently adopted ILO Declaration on Fundamental Principles and Rights at Work, are particularly relevant to the hotel, catering and tourism sector, which is at the forefront of modern human resources development. More labour statistics will help to make better use of modernization to the benefit of all.
Factors Interfering with the Comfort of Old People in Homes for the Aged
Authors: Lilius H. G. , Valtonen Erkki J. , Jokipii S. G.
Published: July 2017

Some factors influencing the comfort of old people (mean age 73 years) in a modern home for the aged were studied. Most (76%) of the old persons were satisfied with their living conditions. Only one-fourth (24%) of the inmates were dissatisfied. The most important factors causing dissatisfaction were discomfort due to illnesses, and disagreement with other residents. On the whole, the old people were more satisfied with their life at the home for the aged than is often supposed.
An Evaluation of the Official Swedish Statistics on Seriously Injured in Road Traffic Accidents
Authors: Sande Jens , Thorson Jan
Published: July 2017

Only 32% of the category “seriously injured” in road traffic accidents were correctly registered as such in the official road traffic accident statistics. Furthermore, 25% were registered, though wrongly, as “slightly injured”. Consequently almost one-half of the seriously injured were not registered at all, and they constituted a drop-out which contributes a bias to the statistics obtained. False registration is primarily associated with short-term hospitalization and absence of surgical operations during the hospital stay, i.e. slight injuries, and low age. The material analysed was comprised of 2 689 individuals from hospital or road traffic accident statistics covering the Uppsala hospital region during 1966.
Varicose Ulcers
Authors: Eriksson E. , Allander E. , Andersson B. , Landegren J.
Published: July 2017

The results of a combined dermatological and surgical treatment of varicose ulcers was studied in 100 patients. This chronic disease, often persisting for decades, was halted in 90% of legs operated upon. Even when the general outcome of the treatment was favourable, it was found that, for 5 out of the 12 ulcers which were the same or larger in size at follow-up than before operation, the patient assessed the result as good or even excellent. This finding deserves further study. It indicates that patients and physicians sometimes use different standards by which to measure therapeutic success.
Organisational Structure and its Effect on the Therapeutic Activity and Effectiveness in an American Mental Health Center
Authors: Andersen Tom
Published: July 2017

The mental health center movement represents a new mode of care for the mentally ill. People are treated on an out-patient basis rather than in institutions. The therapeutic work is mainly carried out by so-called para-professionals who seem to be well qualified for the job. However, when organizing such a treatment system there appear to be several important factors which need to be taken into account: (1) the therapist's need to work individually and independently, (2) the therapist's need for personal training, (3) the therapists' need to be heard when they channel information from the community to the service system, (4) the need for open and direct communication in the system to ensure that the therapists work within the frame of accepted therapeutic procedures, (5) the importance of the therapists' being represented at the highest decision-making level in the system in order to ensure that their needs are met. The author stresses this as an inevitable necessity in order to give the therapists the appropriate working-background.
Conviction for Drunkenness—A Late Symptom among Female Alcoholics
Authors: Medhus Asbjörn
Published: July 2017

A proband group was selected, consisting of 71 female alcoholics subjected to compulsory treatment by the Temperance Board in Malmö. For the period beginning 20 years before, up to, and including a maximum of 9 years after the first compulsory treatment, less than one conviction was expected, according to a calendar year-and age-specific risk table for Swedish women. During that period, 44 of the probands had been convicted for a total of 219 drunkenness offences. Before then, no offences were recorded. In relation to the expected incidence, the observed was not particularly high at the beginning of the period. From the 11th to the 2nd year before the first compulsory treatment, it increased to an extremely high level, where it remained. The ratio of offences per offender and year was constant during the observation period. The average age at the first offence was high: 35.5 years. Gonorrhoea, recorded criminal offence, and receipt of public assistance appeared much earlier. Drunkenness was more common on Fridays and Mondays among the least complicated cases. A more even distribution on week-days seems to be characteristic for the most advanced alcoholics.
Venereal Diseases among Female Alcoholics
Authors: Medhus Asbjörn
Published: July 2017

The incidence of gonorrhoea among 71 female alcoholics was studied from the twentieth year before, to the ninth year after the first compulsory treatment by the Temperance Board of Malmö. Twenty-five probands had, at some time, had gonorrhoea. The mean age at the first infection was high, over 28 years. None the less, the onset of gonorrhoea was an early “symptom”. Recorded criminal offence, receipt of public assistance, and conviction for drunkenness usually appeared later. Each individual's risk of contracting gonorrhoea was assessed from tabulated data concerning the gonorrhoea incidence among Malmö women in general, specified by calendar year and age. A total of 53 infections was observed, as against 6.9 expected. The ratio of observed to expected gonorrhoea was not particularly high in the early period of observation. From the twelfth year before, up to one year before, the first compulsory treatment, the ratio increased to roughly fifteen to one. This high ratio remained during the subsequent years. Syphilis was diagnosed in five probands.
Socio-medical Follow-up Examination of 1143 Greenlanders Surgically Treated for Pulmonary Tuberculosis at Queen Ingrid's Hospital at Godthåb in the Years 1954–1966
Authors: Andersen Søren , Lange Poul Krebs , Rønn Gunnar
Published: July 2017

A follow-up examination of 1 143 Greenlanders operated on for pulmonary tuberculosis in the years 1954–66 is reported. The main group consists of 785 resected patients. At follow-up 2–12 years after operation all patients were traced. One hundred and four (9%) had died; the remaining 1 039 had all been restored to health. Ninety percent of the ex-patients were fully or partially fit and 1% unfit for work. Length of observation, time of resumption of work, reasons for change (if any) of occupation, work capacity in relation to the nature of the surgical interventions, and the patient's general condition as well as housing situation are discussed. National assistance in Greenland is mentioned in brief.
Arteriosclerotic and Other Degenerative Heart Diseases in Finland
Authors: Penttilä Antti , Ahonen Antti
Published: July 2017

A statistical survey of death certificates was made to analyse the ante-mortem and post-mortem medical and medico-legal examinations used in the determination of the cause of death of 12973 decedents who were recorded officially to have died of arteriosclerotic and other degenerative heart diseases in Finland in 1968. The relationship between the regional autopsy rate and the rate of mortality from degenerative heart diseases was studied in particular. The survey indicated that there was no systematic relationship between the type of ante-mortem and post-mortem cause-of-death examinations, including medical and medico-legal autopsies, and the rate of mortality from arteriosclerotic and other degenerative heart diseases in various groups of the Finnish population analysed by age, sex and domicile. This was concluded to be an indication of the reliability of Finnish cause-of-death statistics of degenerative heart diseases which show a generally high rate of mortality and prominent regional differences in the rate of deaths from those diseases among the Finnish male population.
Vitamin D and serum cholesterol
Authors: Lindén Victor
Published: July 2017

During a mass survey for coronary heart disease in Tromsö, Norway, in 1974, 385 men aged 20 to 50 from one particular electoral district completed an additional questionnaire concerning the intake of vitamin D from all sources (natural food, fortified food and vitamin D preparations). The average daily intake of vitamin D during the preceding 12 months was later related to the respective serum cholesterol levels. For the whole material, no association was found. When the men were grouped according to vitamin D intake above and below 2.5 μg and serum cholesterol levels above or below 250 mg%, a significant relationship appeared (using Yates's correction χ2=10.3, P=0.0013 and the correlation coefficient 0.001< P<0.005).
Elderly People's Compliance with Prescriptions, and Quality of Medication
Authors: Hemminki Elina , Heikkilä Jorma
Published: July 2017

We set out to examine how quality of medication influenced patients' use of drugs. 217 elderly people living in homes for the aged in Helsinki were interviewed. They used a considerable number of prescribed drugs: one-third of them had ingested at least four different prescribed drugs during the previous week. This polypharmacy largely concerned symptomatic drugs. Non-compliance with prescription instructions was common, and was more common with the symptomatic drugs. The number of deviations from the instructions correlated positively with the number of drugs, especially the number of symptomatic drugs. According to this study, non-compliance with prescription instructions is not to be condemned as such. In so far as drugs are prescribed in unreasonable large quantities, underuse is a way for the patient to avoid ingesting excessive quantities of drugs.
Increase in Years of Life after Eliminating Causes of Death: Significance for Health Priorities
Authors: Hemminki Elina , Hemminki Kari , Hakulinen Timo , Hakama Matti
Published: July 2017

Increase in years of life after eliminating causes of death: Significance for health priorities. Hemminki, E., Hemminki, K., Hakulinen, T. and Hakama, M. (Dept. of Public Health Sciences, University of Tampere, Dept. of Medical Chemistry, University of Helsinki and the Finnish Cancer Registry, Finland).

The theory of competing risks of death has been applied in this study for the construction of two indices: (1) increase in the expectation of life as a function of age, and (2) increase in the average number of years to be lived by a newborn up to various ages, when selected causes of death are eliminated. The indices have been applied to the 1970 mortality in Finland. Vascular diseases comprise the most important cause of death in both sexes, when the first index is applied. According to the second index, considering ages up to 65 years, violent deaths emerge as the most important cause of death among men and neoplasms appear equally important as vascular diseases among women. The magnitude of a health problem was found to be dependent on the index selected, which should be considered in health planning.
The North Karelia Project: a Programme for Community Control of Cardiovascular Diseases
Authors: Puska Pekka , Koskela Kaj , Pakarinen Hilkka , Puumalainen Pirjo , Soininen Väinö , Tuomilehto Jaakko
Published: July 2017

The North Karelia Project: a programme for community control of cardiovascular diseases. Puska, P., Koskela, K., Pakarinen, H., Puumalainen, P., Soininen, V., and Tuomilehto, J. (Co-ordinating Centre of the North Karelia Project, University of Kuopio, Kuopio, Finland).

In this article the background and principles of the intervention and evaluation of the North Karelia Project are presented. The project is a comprehensive community control programme concerning cardiovascular diseases in the province of North Karelia, Eastern Finland. In the baseline survey of the project (1972), 25–59-year-old males had a particularly high of CVD level risk factors: there were 54% current smokers, the mean cholesterol was 269 mg% and the mean casual blood pressure was 147/90 mmHg. According to the myocardial infarction register the incidence rate of acute myocardial infarction was, during the first year of the project (1972), 13.8 per thousand among 30–64-yearold males. During the first 2 1/2 of the intervention the percentage of current smokers decreased among males from 54 to 42. The percentage of males using low-fat milk increased from 17 to 48. The percentage of males who had had their blood pressure measured during the previous half year increased from 28 to 56 and those under antihypertensive drug treatment from 3.1 to 9.1. Local groups for secondary prevention of myocardial infarction were established all over the province. On the basis of the accumulated experience and theoretical considerations, the project plan has further been elaborated.
Hypertension Programme of the North Karelia Project
Authors: Tuomilehto Jaakko , Puska Pekka , Nissinen Aulikki
Published: July 2017

Hypertension programme of the North Karelia Project. Tuomilehto, J., Puska, P., and Nissinen, A. (Coordinating Centre of the North Karelia Project, University of Kuopio, Kuopio, Finland).

The present article describes the background and principles of a programme for community control of hypertension, which is part of the North Karelia project—a comprehensive community programme for the control of cardiovascular diseases. The hypertension programme also forms part of an international co-operative study by WHO. The programme consists of a community intervention integrated with the service structure. The methods used include health education of the public, education of health service personnel, organization of a service for the spreading of information and also for screening, treatment and follow-up. Every hypertensive person in the community is registered in the hypertension register and checked on annually. The evaluation is made mainly on baseline and terminal survey data from the intervention area and a reference area, the hypertension register, a myocardial infarction register and a stroke register in the intervention area.
Medical Records in Family Practice
Authors: Warren Michael D.
Published: July 2017

Medical records in family practice. A review. Warren, M. D. (Health Services Research Unit, University of Kent, Canterbury, Kent, England).

The organisation of general practice in England is outlined and the independent contractor basis of the family practitioner emphasised. Data from family practice, like data from hospital practice, may be used for clinical management, practice management, or research. Examples of applications in each of these fields are given. The basic records used in family practice—the medical record envelope, the prescription form and the claim for sickness benefit—are described. Some practices record morbidity (E Book or Diagnostic Index), some record systematically details of their activities (L Book or Activities Ledger) and some maintain age and sex registers and other registers of their patients; all these developments are outlined. Attention is drawn to the introduction of problem orientated records and to the use of computers in family practice, but these innovations are not discussed. Outstanding issues are the same as those in hospital record systems—accuracy, definitions, coverage, confidentiality, clerical support and costs, and the use made of the information.
Sick-leave after Road Traffic Accidents
Authors: Hansson Per G.
Published: July 2017

Sick-leave after road traffic accidents. Hansson, P. G. (Dept. of Orthopaedic Surgery I, Sahlgren Hospital, Göteborg, Sweden).

425 road traffic casualties, all covered by the National Insurance Scheme, were followed up regarding duration of inability to work. The average for the whole group was 35 days. There was a close relation between seriousness of injury and time off work. Motorcyclists had the longest time off work and cyclists injured in bicycle accidents the shortest. Casualties with orthopaedic injuries were off work for 120 days, on average, and accounted for 67% of the total paid sick-leave, although they constituted only 20% of those injured. The responsibility for the treatment of trauma is discussed.
Alcohol Problems among Male Disability Pensioners
Authors: Medhus Asbjörn
Published: July 2017

Alcohol problems among male disability pensioners. Medhus A. (Department of Social and Preventive Medicine, University of Lund, Sweden).

The study covers two materials from Malmö: 1. All 235 men who were granted temporary or permanent disability pension for the first time in 1964. 2. A group of 235 men randomly chosen from the 893 men who were granted temporary or permanent disability pension for the first time in 1974. In both materials, the number of convictions for drunkenness during the period 1932–74 was about 4.5 times as high as for Swedish men of the same age. One pensioner in three had been convicted. During the period 1939–74, one pensioner in ten in each material had been subjected to compulsory treatment by Temperance Boards.
Pregnancy in Swedish Teenagers: Perinatal Problems and Social Situation
Authors: Bremberg Sven
Published: July 2017

Teenage pregnancies are considered a major problem, socially and medically, in the USA. In the present study, the scope of the problem in a Swedish population was investigated. Primiparas aged 17 or less constituted 2% of all 8945 women delivered of babies at the University Hospital in Linköping, 1969–72. The most common obstetrical complications and operations did not occur more often in this age group. The incidence of deliveries before the 36th gestational week was increased 3-fold but no significant differences in intra-uterine growth retardation, asphyxia or perinatal mortality were found. One to two years after the delivery, 70% of the young mothers lived in ordinary nuclear families. Their economic position was worse than in a control group of women 21–29 years old. Barely 10% reached the median income of the control group. This disadvantageous situation was not thought to be caused by their early pregnancies, but rather considered part of the life pattern of an underprivileged group otherwise characterized by a low occupational status of their own fathers, a low educational level and a high frequency of teenage pregnancy among their own mothers.
Diabetics in School: Knowledge and Attitudes of School Staff in Relation to Juvenile Diabetics
Authors: Ludvigsson Johnny
Published: July 2017

The purpose of this study was to assess whether the schools satisfy the special requirements of diabetic pupils. Both school staff and parents were of the opinion that diabetic pupils need special consideration at school. However, the results reveal an inadequate knowledge of the basic facts about diabetes and its treatment—a situation which could have dangerous consequences for the child and complicate its schooling in a number of ways. The treatment of juvenile diabetes may also become difficult to manage. Most school staff seemed to lack any source of information about diabetes. The contact between parents and school was not always sufficient and information from the hospital was seldom adequate. At present the school cannot be expected to participate in the treatment of diabetes in the way that could be desired. Improved information of school staff on the subject is recommended, as well as early and repeated contacts between hospital and school. These conclusions are drawn from an investigation in which 308 school staff members and the parents of 61 diabetic pupils answered questionnaires.