bluuebunny/crossref_metadata_2025 huggingface dataset:
Social inequality in diabetes patients’ morbidity patterns from diagnosis to death – A Danish register-based investigation
Authors: Sortsø Camilla , Lauridsen Jørgen , Emneus Martha , Green Anders , Jensen Peter Bjødstrup
Published: July 2017

Aim: Measuring socioeconomic inequalities in health and health care, and understanding determinants of such inequalities, are critical for achieving higher equity in health. Equity in health is a prerequisite for public health and welfare. The aim of the paper is (1) to quantify inequality in diabetes morbidity patterns over patients’ entire life span, and (2) to compare levels of inequality measured through income and educational level, respectively, as proxies for socioeconomic status (SES). Method: Historic individual register data on the entire Danish diabetes population alive in 2011 were gathered. Cox survival analysis and a concentration index decomposition approach were applied to analyse relevant morbidity indicators reflecting patients’ health state at diagnosis and throughout their lives with diabetes. Results: Patients with high education have approximately 26% lower mortality hazard when diagnosed with diabetes and 10–15% lower hazard of developing complications as compared with patients with short education. The outcome variables: ‘severe complications at diagnosis’ and ‘years with severe complications’ inhibit the highest negative concentration index value, indicating that morbidity is concentrated among the lower SES groups, whereas the outcome variables ‘years without complications’ and ‘duration of diabetes’ concentrate among the socioeconomically better-off patients. Conclusions: Significant differences in diabetes patients’ morbidity patterns and survival indicate that diabetes impacts harder on patients of lower SES; these patients experience more severe complications and die earlier. Hence to reduce inequality in health, it is important to invest in efforts targeted towards socially vulnerable groups.
Gender differences in symptoms of depression among adolescents in Eastern Norway: Results from a cross-sectional study
Authors: Granrud Marie Dahlen , Steffenak Anne Kjersti Myhrene , Theander Kersti
Published: July 2017

Aim: The aim of this study was to compare and describe gender differences and the associations between symptoms of depression and family conflict and economics, lifestyle habits, school satisfaction and the use of health-care services among adolescents. Methods: Data were retrieved from Ungdata which is a cross-sectional study. Adolescents ( n=8052) from secondary school grades 8, 9 and 10 (age 13–16 years) participated in the study from 41 municipal schools in four counties. Results: Girls reported a higher prevalence of symptoms of depression than boys. Gender differences were seen on all items related to symptoms of depression, family conflict and economics, lifestyle habits, school satisfaction and health-care services. Multiple regressions showed that family conflicts and economics contributed to 19.2% of the variance in symptoms of depression in girls and 12.4% in boys. School satisfaction made a strong contribution: 21.5% in girls and 15.4% in boys. The total model explained 49% of the total variance in symptoms of depression in girls and 32.5% in boys. Conclusions: Gender demonstrated a pattern through a higher proportion of girls reporting symptoms of depression, family conflict and economics, lifestyle habits, school satisfaction and use of health-care services. Even though the adolescents reported symptoms of depression, few used the school health-care services and public health nurses. This indicates that they need a person-centered approach for symptoms of depression. The findings may have important implications for planning for adolescents in school health services.
Description of OPRA: A Danish database designed for the analyses of risk factors associated with 30-day hospital readmission of people aged 65+ years
Authors: Pedersen Mona K. , Nielsen Gunnar L. , Uhrenfeldt Lisbeth , Rasmussen Ole S. , Lundbye-Christensen Søren
Published: July 2017

Aims: To describe the construction of the Older Person at Risk Assessment (OPRA) database, the ability to link this database with existing data sources obtained from Danish nationwide population-based registries and to discuss its research potential for the analyses of risk factors associated with 30-day hospital readmission. Methods: We reviewed Danish nationwide registries to obtain information on demographic and social determinants as well as information on health and health care use in a population of hospitalised older people. The sample included all people aged 65+ years discharged from Danish public hospitals in the period from 1 January 2007 to 30 September 2010. We used personal identifiers to link and integrate the data from all events of interest with the outcome measures in the OPRA database. The database contained records of the patients, admissions and variables of interest. Results: The cohort included 1,267,752 admissions for 479,854 unique people. The rate of 30-day all-cause acute readmission was 18.9% ( n=239,077) and the overall 30-day mortality was 5.0% ( n=63,116). Conclusions: The OPRA database provides the possibility of linking data on health and life events in a population of people moving into retirement and ageing. Construction of the database makes it possible to outline individual life and health trajectories over time, transcending organisational boundaries within health care systems. The OPRA database is multi-component and multi-disciplinary in orientation and has been prepared to be used in a wide range of subgroup analyses, including different outcome measures and statistical methods.
The global cancer burden and human development: A review
Authors: Fidler Miranda M. , Bray Freddie , Soerjomataram Isabelle
Published: July 2017

Aims: This review examines the links between human development and cancer overall and for specific types of cancer, as well as cancer-related risk-factors and outcomes, such as disability and life expectancy. Methods: To assess human development, the Human Development Index was utilized continuously and according to four levels (low, medium, high, very high), where the low and very high categories include the least and most developed countries, respectively. All studies that assessed aspects of the global cancer burden using this measure were reviewed. Results: Although the present cancer incidence burden is greater in higher Human Development Index countries, a greater proportion of the global mortality burden is observed in less developed countries, with a higher mean fatality rate in the latter countries. Further, the future cancer burden is expected to disproportionally affect less developed regions; in particular, it has been estimated that low and medium Human Development Index countries will experience a 100% and 81% increase in cancer incidence from 2008 to 2030, respectively. Disparities were also observed in risk factors and average health outcomes, such as a greater number of years of life lost prematurely and fewer cancer-related gains in life expectancy observed in lower versus higher Human Development Index settings. Conclusions: From a global perspective, there remain clear disparities in the cancer burden according to national Human Development Index scores. International efforts are needed to aid countries in social and economic transition in order to efficiently plan, implement and evaluate cancer control initiatives as a means to reduce the widening gap in cancer occurrence and survival worldwide.
Industrial Accidents in the Construction Industry
Authors: Fredin Hans , Gerdman Peter , Thorson Jan
Published: July 2017

In this investigation, accidents in the Swedish construction industry in 1967 leading to permanent disability or death were studied. The aims were to illustrate the magnitude of the problem and to create a basis of decision for the taking of preventive measures.

The population consisted of nearly 400 cases. The whole population excluding a 5% non-response was studied. The course of events and causes of the accidents were analysed according to the statements of workers, employers and police. The injured workers were interviewed by telephone; otherwise information was acquired from police reports and injury reports of the National Social Insurance Board.

Not only had the injured been subjected to physical suffering and financial problems as a result of the accidents, but the humanitarian losses, in terms of limitations to family life and leisure activities were striking.

Accident prevention must not be restricted to mere technical and psychological measures. According to our results it would be more fruitful to attack juridical, organizational, professional-economical, political circumstances. It is particularly important that a practical plan be formulated and accepted by the responsible authorities.
General Practitioners' Indications for Psychotropic Drugs
Authors: Hemminki Elina
Published: July 2017

In the present study, an examination has been made of the indications for the prescription of psychotropic drugs in general practice. The study was prompted by the extensive consumption of these drugs that has become apparent within a comparatively short time after their introduction. The hypotheses were that psychotropic drugs are largely prescribed for somatic diseases, and for “non-medical” problems. The study is based on information obtained by questionnaire, from 47 general practitioners. The data obtained supported the first hypothesis. More than one-half of the psychotropic drugs were found to have been prescribed for somatic diseases. The data obtained did not provide direct support for the second hypothesis, but this may have been attributable to the method applied. It is highly probable that a doctor, in completing a questionnaire, would give a medical diagnosis for a “non-medical” problem. This study suggests that one mechanism of the increased utilization of psychotropic drugs is the broadened field of indications.
Early Retirement Pensions in Sweden: Trends and Regional Variations
Authors: Berglind Hans
Published: July 2017

The total number of early retirement pensiones has risen sharply since the end of the 1960s. The increase was greatest during the early 1970s following a reform in 1970 which extended the right to early retirement pension to older workers because of labour market considerations. This article discusses various conceivable explanations for the growth in the number of early retirement pensioners and regional variations of this phenomenon. The following explanatory factors are considered: ( a) The prospects of getting (keeping) a job. ( b) Work capacity. ( c) The nature of the pension scheme. ( d) Alternative possibilities of support. ( e) Preferences concerning early retirement pensions. The discussion focuses on two explanations highlighted in the public debate in Sweden: changes in pension legislation and the role of the solidarity wages policy. An empirical analysis of variations at the provincial level reveals a definite correlation between the proportion of early retirement pensioners and various indices of unemployment and underemployment.
A Model for the Estimation of Change in Knowledge between Two Interview Occasions with Unreliable Responses
Authors: Taube Adam , Wall Stig
Published: July 2017

If a person gives the right answer to a question of yes/no type concerning a certain fact, the answer is correct either because the person knows the truth or because he/she happens to guess the right response alternative. Suppose that such a question is given to the same persons on two occasions, and that between these occasions, a campaign is undertaken, the aim of which is to raise the level of knowledge in the population. A model is introduced for this situation, making it possible to estimate the proportion ( PB) of persons who know the answer before the campaign, the difference ( D=PA-PB) in knowledge after ( PA) vs. before the campaign, and the rate ( g) of persons who guess the correct answer without having the actual knowledge. Asymptotic variances for the estimates are also given. The method is illustrated by means of data from a socio-medical survey in Addis Ababa, were the spread of knowledge concerning various vaccinations was investigated.
Pregnancy and Delivery among Immigrants
Authors: Aurelius Göran , Ryde-Blomqvist Elsa
Published: July 2017

Risk factors during pregnancy and delivery of immigrant women are analysed. Individual birth delivery records of 1235 immigrant women and of 412 Swedish women are studied. Most of the immigrants-65%-were Scandinavians, while 10% had come from Southern Europe and 4% were non-Europeans. The immigrant groups differed somewhat amongst themselves, and also vis-à-vis the Swedes in some social and demographic respects. Participation in antenatal care was not lower among the immigrants than in the control group, but the former did not attend antenatal exercises to the same extent. The perinatal mortality and prematurity rates were 1.5% and 5%-about the same as among the Swedish women. The rate of premature delivery was found to be related to the duration of residence in Sweden. Women who had lived less than one year in this country more often delivered prematurely than did the more settled immigrant women. Further studies on the emotional reactions of immigrant women during pregnancy and delivery are proposed.
What Part Does the Occupational Environment Play in the Occurrence of Accidents?: Views of Accident Victims, Their Fellow-workers, Safety Delegates, and Enterprise Managements
Authors: Andersson R. , Johansson B. , Lindén K. , Svanström K. , Svanström L.
Published: July 2017

In a survey of occupational accident cases admitted to Malmö General Hospital during a period in 1974, interviews were carried out with the accident victims, and, at their work places, with their fellow-workers, safety delegates, and management representatives as well. The interviewees were asked to express their views on aspects of the occupation environment, which might have had a bearing on the causes of the accident in question, for instance noise, harmful substances, physical and mental stress and accident risks. The results showed wide variations between the views of the four groups regarding the same environment situation and the actual accident. Often the explanations were rather descriptions of “supernatural” concepts in other words. This means that in this field there is a great need for an objective instrument for the analysis of accidents and their circumstances. There is no such instrument available today and there is a growing need to develop accident research and its methods, as well as of a practical instrument for the safety work. There is also a need for a more qualitative analysis of accidents. To this end we used a model developed by J. Surry (4) and later modified by the Swedish Work Environment Fund (5). A further development of this model is proposed.
Costs of and Needs for Resources in Hospital Care: A Calculation Model and Applications in Some Typical Cases in Orthopaedic Surgery
Authors: Kolstad Kurt , Wigren Anders
Published: July 2017

It will be necessary in the future to calculate the cost of hospital care of patients subjected to specialist treatment (Alling et al. 1973). This would facilitate a fair distribution of the available resources over the specialties. Also, it would be easier to prove the alleged possibility of saving considerable community funds for instance in the prosthetic surgery of joints (Taylor 1976) if absolute cost figures were at hand. This paper presents a calculation model for estimating the working costs of in-patients requiring various amounts of care in orthopaedic surgery. The working costs of the Department of Orthopaedic Surgery at the University Hospital have been split into three grups: I) basic cost, 2) nursing cost proper, and 3) special costs. The basic cost has been calculated per pa-patient per day and has been subdivided into hotel expenses and doctors' salaries. The nursing cost proper covers mainly staff salaries and wages, which have been apportioned between three categories of patients with regard to the ward staff workloads arising. The categories have been established, following time and motion studies, to determine the work contribution in each case. The special costs refer to the costs of regular laboratory tests, special examinations, and operations. The latter cost group has been estimated from the consumption of materials and by time studies. The model as outlined has then been applied to three common categories of cases in orthopaedic surgery associated with a well-defined handicap and workload. The overall cost of these typical in-patient at the Department of Orthopaedic Surgery at Uppsala has been calculated. Following time and motion studies to chart the relationship between the workload categories, our model should be applicable in most hospitals and specialties. Knowledge of the costs is one necessary basic instrument in costbenefit analysis.
Behavioural Assessments in the School Health Service: A Comparison of Information Obtained from Interviews with Parents, Teachers and Children
Authors: Kornfält Ragnhild
Published: July 2017

The behavioural and adjustment problems of all 410 10–12-year-old children in one particular school district of Southern Sweden were assessed by interviews with the parents, the teachers and the children themselves. Three problem groups were defined: A parents' problem group of 26 children (6%), considered difficult to bring up or in need of expert advice, a teachers' problem group of 52 children (13%), who posed problems in the school situation, and a childrens' problem group of 74 individuals (18%) who complained of psychosomatic and/or discomfort symptoms. The correlation between parents' and teachers' opinions of the children's behavioural problems was less than 0.2. Of the childrens' problem group only 15 (20%) were conceived of as problems by teachers and parents. This lack of agreement is explained by divergences in frames of reference and rules of behaviour between home and school. Parents' and childrens' problems are not identical with those of teachers, a fact which must be taken into account by the School Health Service.
The Relation of Physical Activity Changes to Changes in Serum Cholesterol and Body Weight in a Three-Year Follow-up of Population Sample
Authors: Salonen Jukka T. , Tuomilehto Jaakko , Puska Pekka
Published: July 2017

The purpose of this study was to analyse relationships between change in physical activity and change in serum cholesterol and body weight in a cohort representative of the general population, and their interaction with dietary changes. When controlling for changes in diet, changes in physical activity had little impact on serum cholesterol changes. Dietary changes did not modify this relationship significantly. Physical acitivity changes were more reflected on weight changes.
Geographic Distribution of Rheumatic Disorders and Working Conditions in Sweden
Authors: Bjelle Anders , Allander Erik , Lundquist Bengt
Published: July 2017

Considerable variations in the prevalence of rheumatic disorders were found in a nation-wide interview survey of the adult Swedish population. Rheumatic disorders were more prevalent in Northern than in Southern Sweden, except for one South-Eastern area. Rheumatoid arthritis (RA), osteo-arthritis and back disorders followed the same, pattern. Other inflammatory rheumatic diseases than RA showed similar prevalence figures throughout the country. Soft tissue rheumatism was least frequent in the southernmost parts of Sweden, but otherwise equally distributed. Farming and forestry were most frequent in the Northern and in the South-Eastern areas of Sweden but physical strain from work was most frequent only in Northern Sweden. This variation in working conditions coincided with and may contribute to variations in the prevalence of rheumatic disorders in Sweden.
Smoking and Disease: Attitudes and Knowledge in Middle-aged Men
Authors: Janzon Lars , Lindell Sven-Erik , Trell Erik
Published: July 2017

In a general health screening programme in Malmö, Sweden, 1037 men, 47–48 years old, were questioned on smoking habits and whether they believed in an association between smoking and cancer of the lungs, mouth, larynx and bladder, cardiovascular and respiratory diseases and whether they believed that by giving up smoking they would reduce the risk. The association between smoking and disease was recognized by more ex-smokers than smokers. Less than half of the smokers believed in an association between smoking and the diseases listed in the questionnaire. The prevalence of dyspnoea, chronic bronchitis and asthma increased with increasing tobacco consumption as well as did the proportion using sleeping pills and the percentage with at least three episodes of disability the previous year. Fifty percent of all smokers wished to stop smoking but only 5 out of 10 were convinced of an improvement in health by quitting. The results show that there is a great need in society for well formulated information as to the health hazards of continued smoking and the benefits of giving it up.
Psychological and Physical Long-term Effects of Torture: A Follow-up Examination of 22 Greek Persons Exposed to Torture 1967–1974
Authors: Petersen Hans Draminsky , Abildgaard Ulrik , Daugaard Gedske , Jess Per , Marcussen Henrik , Wallach Marianne
Published: July 2017

After an observation period of about 10 years a follow-up examination was made of 22 Greeks earlier exposed to torture. All had physical symptoms and about 90% of the examinees had chronic psychological symptoms which had appeared after the torture experience, the most notable of which were emotional instability, depression, passivity, fatigue and disturbed sleep. Eight of the victims had a chronic organic psychosyndrome as defined by us. The clinical picture of the torture victims is very similar to other stress-conditioned syndromes, which underlines the significance of the psychological trauma for the pathogenesis. Certain physical symptoms can be related to specific forms of torture; in this series particularly, symptoms of the feet and lower extremities can be related to ‘falanga’ (repeated blows to the soles of the feet). The most noticeable objective finding was unilateral atrophy of testis in 2 of the examinees caused in all probability by genital torture. Treatment of the sequelae to torture should be initiated as early as possible in the course of the illness, and studies on the effect of this treatment should be carried out.
Relation of Alcohol, Physical Activity, Dietary Fat and Smoking to Serum HDL and Total Cholesterol in Young Finnish Men
Authors: Salonen Jukka T. , Hämynen Heikki , Leino Ulla , Kostiainen Ella , Sahi Timo
Published: July 2017

The study was based on 471 men, aged 19 to 20 years, who started their compulsory military service in three military bases in Southwest, Southeast and Northern Finland in February 1982. The data were gathered by means of self-administered questionnaires. A fasting venous blood specimen was taken to determine serum HDL and total cholesterol, gamma-glutamyltransferase and thiocyanate. In this cross-sectional study a few variables based on the self-administered questionnaire explained 8% and 7% of the variation in serum HDL and total cholesterol, respectively. Our results show that easily measurable behavioural factors do contribute to serum HDL and total cholesterol levels in young men. In our study the impact of alcohol consumption on serum HCL cholesterol was greater than in most previous studies. Our findings give additional support to the hypothesis that even a very modest amount of regular physical exercise has the effect of increasing the serum HDL cholesterol level.
Acceptability of Fluoride Use in Finnish Municipalities
Authors: Tuutti Heikki , Honkala Eino , Laurinkari Juhani
Published: July 2017

The aim of this study was, firstly, to determine what methods of delivering fluorides might be acceptable to Finnish municipalities and, secondly, to investigate which characeristics of the municipalities best explain the variation in acceptability of fluorides. A sample, composed of 46 Finnish municipalities and representing the communes according to number of inhabitants was drawn and a mail survey sent to decision-makers ( n=1922). In this survey we assessed the characteristics of each commune and its decision-makers and asked how acceptable various methods of fluoride delivery were. The acceptability of the various methods was: toothpaste 95%, gels and varnishes 81%, rinses 63%, salt 48%, piped water 33%, and milk 11%. In industrialized communes these methods of delivery were usually slightly better accepted than in non-industrialized areas. Acceptability of fluorides seemed to differ in the various regions of Finland, Uusimaa region being the most liberal towards use of fluorides. Members of the labour parties seemed to accept piped water containing fluoride and fluoridated milk significantly more often than did conservatives. Among decision-makers, the various methods of delivery were best accepted by dentists, physicians and members of health councils.
Perinatal Mortality Distributed by Type of Hospital in the Central Hospital District of Helsinki, Finland
Authors: Hemminki Elina
Published: July 2017

In Finland as in many other countries, perinatal mortality is higher in those institutions having a higher level of care. To explain this phenomenon, mortality by weight groups was studied in different hospitals in the Central Hospital District of Helsinki in Finland in 1977–81. Among infants weighing less than 2 500 g, perinatal mortality was higher in the local hospital than in the university hospital, the higher mortality being due to the higher rate of stillborn infants. Among babies weighing over 2 500 g, the mortality was lower in local hospitals than in the university hospital. Further studies to explain the higher mortality of infants weighing over 2 500 g in the university hospital are needed.
Economic Appraisal in Occupational Health and Safety Regulation: A Study of Some Standard Methods
Authors: Lindeneg Klavs
Published: July 2017

In Denmark, Parliament has decided that economic appraisal must be undertaken prior to the establishing of new standards for the working environment. The purpose of this survey of certain standard methods commonly used in economic appraisal is to investigate the usefulness and applicability of these methods in assisting a decision-maker to reach a rational decision when establishing these new standards. The conclusion is that the commonly used methods are, generally speaking, of no use. This is not to say that there may not exist some very particular circumstances in which they might yet apply. But this will not be the case generally. When undertaking economic appraisal is seems more reasonable to tackle the problem from the other end and start the investigation with the political objectives connected with the establishing of any proposed new standard, and then look at the degree to which the various standards can be expected to meet the political objectives.
Mass Screening for Breast Cancer
Authors: Björnsson Sigurδur , Brekkan Ásmundur , Tulinius Hrafn
Published: July 2017

Breast cancer is now the most common cancer in women. There is a certain correlation between the stage of the disease at diagnosis and outcome after treatment. Several studies have been initiated involving mammography with or without physical examination aimed at early detection of breast cancer in asymptomatic women. In order to review the results to date, a meeting was held in Reykjavík in April 1984 organized by international and Icelandic health agencies and attended by senior investigators of the ongoing screening studies. A summary of the available data is presented in this paper along with the conclusions of the meeting.
Mortality from Violent Causes among the Elderly Population in Finland in 1951–1979
Authors: Kivelä Sirkka-Liisa , Honkanen Risto
Published: July 2017

The changes in violence-related mortality rates among the population aged 65 years or older in Finland from 1951–1979 were studied with the help of the official mortality statistics. Factors underlying these changes were also examined. The most distinctive findings were, first, the increase in accident-related mortality rates of both males and females in the 1950s and, second, the sharp decrease of those rates with respect to women from 1960–1975 compared to the decrease for males during that same period. The changes in mortality for males were mainly due to changes in frequency of motor-vehicle fatalities, whereas the changes for females were mainly due to changes in mortality caused by accidental falls and limb fractures. Improvements in classification methods resulting in the decrease of unspecified causes of death were apparently the main cause of the recorded increase in violent mortality in the early 1950s. The incidence of traffic accidents has decreased in the latter half of the 1970s. Thus, the minor decrease in motor-vehicle accident mortality for men most evidently was due to a decreased incidence. The incidence of hip and limb fractures in women increased. Thus, it was not a lowered incidence but instead a decreased case-fatality rate which caused the decreased mortality in females. Early mobilization after hip operations and decreased dependence level among the elderly apparently resulted in the decreased fatality rates.
Methodological Problems in the Studies of Reproductive Failures
Authors: Olsen Jørn
Published: July 2017

Epidemiological studies of reproductive failures are still rather few in spite of the importance of the research. One of several reasons for this could be the methodological problems of such studies. Some of these problems are discussed in this communication.
Results of a One-Year Worksite and Mass Media Based Intervention on Health Behaviour and Chronic Disease Risk Factors
Authors: Puska Pekka , Niemensivu Helena , Puhakka Pertti , Alhainen Liisa , Koskela Kaj , Moisio Simo , Viri Liisa
Published: July 2017

The North Karelia Worksite Intervention Study was carried out to assess the effectiveness of worksite-based innovative intervention on chronic disease risk factors. The one-year intervention combined use of mass media, worksite opinion leaders, risk assessment and counselling and other health education measures. The study used eight medium sized intervention worksites (IW) and eight matched reference worksites (RW). Of the 715 workers 91% participated in the initial survey, and out of these 89% in the one-year follow-up survey. The proportion of current smokers changed from 39% to 30% ( p<0.05) at the IWs while no change took place at the RWs (33%). The effect on smoking was confirmed by serum thiocyanate analyses. An additive score of the three main CHD risk factors changed from 3.1 to 2.7 at the IWs and from 3.2 to 3.0 at the RWs ( p<0.05 for the net change). The results and experiences showed the feasibility of the intervention and significant, although modest, effects on risk factors and health behaviour, notably smoking.
Family Risk Factors of Alcoholism and Drinking Patterns among Non Alcoholic Women: An Inverse Relationship?
Authors: Vaglum Sonja , Vaglum Per , Larsen Øivind
Published: July 2017

95 non alcoholic female employees were personally interviewed and divided into three drinking pattern groups with an increasing level of alcohol consumption: the traditional feminine drinking group (TF) ( n=28), the new feminine drinking group (NF) ( n=37), and the masculine drinking group (M) ( n=30). The groups were compared on family variables which may be regarded as risk factors of alcoholism. The results show an inverse relationship between family risk factors and consumption level, the TF-group having significantly more risk factors than the other two groups. The TF-women more often came from families where the mother and her parents were abstainers, while the father and his parents were more often alcohol abusers or not abstainers. The TF-women were more often attached to their alcoholic fathers as children, while the M-women were more often attached to their mothers. The choice of drinking pattern may be inversely related to the frequency of family risk factors among non alcoholic women.
Methodological Considerations in the Study of Frequency, Risk Factors and Outcome of Reduced Fertility
Authors: Sundby Johanne
Published: July 2017

Infertility is a major health problem for many couples. Many clinicians believe that its prevalence is increasing. This may be attributable to greater concern about infertility in society and development of new treatment methods. Infertility is also a complex medical, social and individual problem. We do not know enough about the risk factors and their mechanisms of action.

In the study of reduced fertility there is a need for clear definitions and careful selection of study populations.

There are several sources of bias. One is selection bias in the ascertainment of infertility couples, others are recall bias and exposure assesment bias. Furthermore, medical classification of causes is difficult in population based studies.

This paper will discuss problems in the interpretation of results of past studies and in methods already in use. Some new design options in future research are presented.
The Population Study of Women in Gothenburg 1980–81—the Third Phase of a Longitudinal Study
Authors: Bengtsson Calle , Gredmark Thomas , Hallberg Leif , Hällstrüm Tore , Isaksson Bjürn , Lapidus Leif , Lindquist Olof , Lindstedt Sven , Lurie Mirek , Nystrüm Ernst , Rybo Güran , Samuelsson Sverker , Rafnsson Vilhjalmur , Sigurdsson Johann A.
Published: July 2017

A representative population sample comprising 1462 women was studied in Gothenburg, Sweden in 1968–69, and a third follow-up study was carried out in 1980–81. The participation rates in the baseline study and during the follow-up studies were high. In 1980–81 women in two new age strata, aged 26 and 38, were added. Women who had moved to or from Gothenburg during the study period were not found to differ from those who were living in Gothenburg during the total study period, while there were a few differences of statistical significance between refusers and participants in 1980–81. The mortality among initial refusers was about doubled compared to that of those who participated in the baseline study.
Occupational Lung Function Impairment in Never-Smoking Danish Welders
Authors: Lyngenbo O. , Groth S. , Groth M. , Olsen O. , Rossing N.
Published: July 2017

In order to study the effect of welding fumes on lung function, 74 high-exposed welders and 31 age-matched electricians were examined in 1982. None had ever smoked tobacco or been exposed to known or potentially noxious agents to the lungs. A significant difference was found between the welders and the control group in vital capacity, total lung capacity, forced expiratory volume in one second, peak expiratory flow rate, maximal expiratory flow rate at 75% of vital capacity, diffusion capacity and slope of the alveolar plateau. The lungs of the welders were physiologically 10–15 years older than those of the control group. Thirty percent of the welders had a well defined respiratory disease. Their lung function impairment was predominantly obstructive (16 persons), but restrictive patterns were also seen (6 persons).
Low Back Trouble Among Urban Bus Drivers in Denmark
Authors: Netterstrøm Bo , Juel Knud
Published: July 2017

The occurrence of low back trouble and possible connection with psychosocial conditions among urban bus drivers were studied using a questionnaire and subsequent registration of hospital discharges. 2045 (83%) full-time male bus drivers in the three largest cities in Denmark answered a questionnaire in 1978 regarding psychosocial factors and health. The prevalence of frequent low back pain was 57%. In a control group of 195 motormen the prevalence was 40%. Standardized Morbidity Ratio for bus drivers discharged from hospital during the period 1978–1984 with the diagnosis lumbar disc herniation was 137 compared to all Danish men. These differences were statistically significant. Of psychosocial factors only “the feeling of being mentally unbalanced” was found to be statistically significantly related to subsequent hospital discharge with a LBT-diagnosis. Long seniority as bus driver of those discharged from hospital with LBT makes it probable that LBT has etiologic factors in the work environment. The sedentary position and whole-body vibrations may be contributory causes.
The Meanings of Social Medicine and Public Health
Authors: Roemer Milton I.
Published: July 2017

The term “social medicine” has been marked by a great deal of confusion in the medical literature, in medical education, and in discussion of systems of health care. It has occupied diverse relationships to the term “public health”, which this article will explore.
Nordic Registers of Visually Impaired Children
Authors: Riise Ruth
Published: July 2017

A Nordic study group, NORDSYN, consisting of ophthalmologists from Denmark (Thomas Rosenberg), Finland (Sirkka-Liisa Rudanko), Iceland (Gudmundur Viggosson), Norway (Tor Flage, Egill Hansen, Ruth Riise) and Sweden (Kristina Tornqvist), has compiled data from registers in Denmark, Finland, Iceland and Norway of 2527 visually impaired children. The Swedish register was established later in 1990. Each record contains the following information: sex, year of birth, year of registration, classification of visual impairment, ocular diagnosis, systemic diagnosis, aetiology and evt. additional impairments. The ocular diagnoses were compiled into groups among which congenital malformations and neuro-ophthalmological diseases were the most dominating. A coding system for aetiology was developed. It was demonstrated, that prenatal factors, including genetic aetiologies, were involved in a large proportion (66%) of the cases. The sex distribution revealed a dominance of males compared to the general population at the same age.

The age-specific national prevalences for registration of childhood blindness (WHO-definition: best corrected visual acuity in the best eye less than 3/60 or visual field less than 10 degrees around fixation for the ages 0–15 years) were (N/100 000): Denmark 41, Finland 15, Iceland 19 and Norway 15. The differences were primarily presumed to be due to varying efficiency in registration.

A coding system for additional impairments was developed. The proportion of visually impaired children with an additional mobility, hearing or mental impairment was between one third and one half of the national materials thus indicating the need for interdisciplinary tracing of and care for the visually impaired child.
Sex Differences in Response Style to Two Self-report Screening Tests on Alcoholism
Authors: Österling Agneta , Berglund Mats , Nilsson Lars-Häkan , Kristenson Hans
Published: July 2017

The revised Malmö modification of the Michigan Alcoholism Screening Test (Mm-MAST) of 10 items including all four CAGE (an acronym for Cut down, Annoyed, Guilty, Eye-opener) items and one item on total sobriety was used in a health screening of a total birth-year cohort in Malmö. Seventy-two percent of the female and 68% of the male population participated. Nine hundred and eleven women and 911 men were included in the study population.

The revised Mm-MAST yielded a higher proportion of scores indicative of problem drinking than the CAGE in both sexes; 4% of the women and 17% of the men had positive Mm-MAST scores (≥ 3 yes-answers). Rates of positive CAGE scores (≥ 2 yes-answers) were 1% and 7%, respectively. Frequencies of problem drinking in the Mm-MAST and CAGE positive scorers, respectively were similar for both women and men. The reliability of the revised Mm-MAST was better in the male population producing a Cronbach's alpha coefficient of 0.69 compared with 0.58 in the female population. In men the four CAGE items had the highest item-total scale correlations, which was found in only one CAGE item in women. We suggest that the revised Mm-MAST is a better screening instrument than the CAGE in both sexes. Nevertheless the reliability of the total revised Mm-MAST was poorer in women and the need for a female oriented alcohol questionnaire is promoted.
Bicycle accidents often cause disability –
Authors: Olkkonen Seppo , Lahdenranta Uolevi , Slätis Pär , Honkanen Risto
Published: July 2017

Social and medical consequences of 278 children and 264 adults injured in bicycle accidents and seen in two hospitals in Helsinki in 1985–86 were analyzed. Information was collected from patient records, by means of a special questionnaire and by telephone interview.

A child outpatient required 1.7 and a child inpatient 3.0 physician visits on an average, while adults required 2.2 and 4.9 visits, respectively. The average duration of hospital stay was 8 days for hospitalized adults and 6 days for children. Rehabilitative care outside the hospital was received by 6% of the adult outpatients and 25% of the inpatients, but none of the injured ***. The mean duration of work disability was 82 days among inpatients, 11 days among outpatients, 127 days among the inpatients injured in motor vehicle collisions and 65 days among inpatients injured in other bicycle accidents. Of inpatients 32% and of outpatients 5% reported persistent (>6 months) disability. Persistent disability was recorded in 11% of children, in 47% of adults and in 67% of elderly inpatients. Most serious consequences were due to intracranial injuries in motor vehicle - bicycle collisions. Of the hospitalized bicyclists 4% sufered from severe cognitive and behavioural changes or sense impairment and of adult inpatients 3% suffered from permanent work disability. The average costs of health and social services were about FIM 1000 per adult outpatient and FIM 13000 per adult inpatient. In prevention high priority should be given to motor vehicle collisions, head injuries and injuries among the elderly bicyelists.
Physiological effects on patients following temporary closing of a geriatric day care unit
Authors: Lökk Johan , Arnetz Bengt , Theorell Töres
Published: July 2017

Geriatric day care is an essential part of modern geriatric care providing rehabilitation and social support. During a 5 week summer closure of a geriatric day care unit, 24 long attenders (defined as patients having day care > 26 weeks), were non-electively discharged and included in this study. Blood samples were drawn one week before the closure (0 week), at the reopening (7 weeks) and 7 weeks after the reopening (14 weeks). The results show a longitudinal tendency of rising plasma prolactin levels during the whole study period. There was a non-significant increase in cortisol during the closure followed by a significant decrease 7 weeks after the reopening. All other measures were unaffected. The study indicates that geriatric patients submitted to longterm day care have a measurable psychophysiological response as a result of a non-controllable closure of a day care unit. The changes in plasma prolactin and cortisol levels are part of a general adaptation pattern. The study shows that elderly have a functional physiological response and chronically sick patients react selectively with regard to the hormone response. Thus, the results indicate that the support during minor life events induced by the closure of the day care ward should be improved.
Healthy organizational culture – healthy employees? Effectiveness of organizational culture on perceived health of German police officers
Authors: Jablonowski Lara
Published: July 2017

The purpose of this study was to examine the effects on individual perceived health of the factors organizational culture, working conditions, physical and mental health, and presenteeism, as moderated by lifestyle factors. A detailed comparison was made between the uniformed police division and the criminal investigation department to explore their perceptions of the supportiveness of their subcultures, working conditions and perceived health. Survey responses, obtained through an online questionnaire, from 258 officers from German police forces showed significant differences in perception. Uniformed officers evaluated their working conditions more positively compared with officers from the criminal investigation department, resulting in a more positively rated perceived health for the uniformed police division. Results showed that the more a police organizational culture fostered their subcultures and health-enhancing working conditions, the higher the perceived physical and mental health. Implications for research and practice are discussed.
Social network analysis of wildlife tourism microentrepreneurial network
Authors: KC Birendra , Morais Duarte B , Peterson M Nils , Seekamp Erin , Smith Jordan W
Published: July 2017

Social networks are an important element of entrepreneurship. Entrepreneurs rely on social networks to access ideas, information, and resources to facilitate their entrepreneurial process. Strong and weak ties influence the entrepreneurial process in unique ways. This study utilized social network analysis approach to examine wildlife tourism microentrepreneurship through in-person structured interviews with 37 microentrepreneurs from North Carolina’s Pamlico Sound Region. Specifically, this study examined the extent of network ties, the type of support received from those network ties, and the process of creating and maintaining the business network ties. Weak ties were more prevalent than strong ties. Support was received in terms of marketing and advertising, information sharing, and product sponsorship. Weak ties were established through professional workshops and seminars or while working in the same territory, whereas reciprocity, togetherness, communication, and trust were identified as major factors to maintain weak ties. This study suggests that cognitive social capital factors (e.g. reciprocity, togetherness, and trust) can be highly important toward effective use of social networks, as well as to ensure entrepreneurial success.
Paradigmatic literacy features in children’s argumentation in peer talk
Authors: Zadunaisky Ehrlich Sara
Published: July 2017

Paradigmatic literacy features refer to ways of thinking and using language associated with academic-scientific discourse or written language. They are intimately bound up with education and appear in their emergent forms, mainly in conversations with adult partners. The present qualitative study investigates whether, and in which ways, paradigmatic literacy features emerge in pre-schoolers and fourth graders' argumentation in natural peer interactions. Segments of peer talk identified as argumentative discursive events served as our basic unit of analysis and were analysed from a discourse analytic perspective. The findings indicate that paradigmatic literacy features are embedded in peer talk at the macro level, in talk of an exploratory nature when children detach themselves from the ‘here and now’ and apply paradigmatic ways of thinking. Similarly, specific linguistic configurations related to academic discourse that manifest authority and degrees of distancing or abstractedness feature in children’s natural conversations as well. In both cases, paradigmatic literacy features fulfil social functions in peer talk. In light of the current findings, we discuss the potential contribution of peer talk to the wider context of dialogism, as well as the scope of literacy beyond the modality in question.