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Biomedical subjects

B S Hanson

Publications and source records attributed to B S Hanson.

At least 19 recordsLinked to original sources
PubMed1998

Intra-urban variation of antibiotic utilization in children: influence of socio-economic factors.

OBJECTIVE: The aim of this study was to investigate the intra-urban variation of antibiotic utilization in children in Malmö and to evaluate the influence of socio-economic factors on this variation. METHODS: In an ecological analysis, the variations in antibiotic utilization in children, expressed as defined daily dose (DDD) or as the number of prescriptions per 1000 inhabitants per day, were compared with variations in socio-economic and demographic factors in the 17 administrative districts of the Swedish city of Malmö (235000 inhabitants). RESULTS: There were large between-area differences in antibiotic utilization, especially in children aged 0-6 years. Socio-economic factors reflecting a privileged situation correlated positively with antibiotic utilization. Thus, in districts with a high median family income and a high employment rate, the utilization of antibiotics was higher than in other districts. Conversely, in districts with a high proportion of blue-collar workers, people with foreign backgrounds and recipients of social benefit, antibiotic utilization was comparatively low. In contrast, the utilization of penicillin V relative to other antibiotics showed an opposite pattern, including positive correlations with the proportion of social benefit, immigrants and blue-collar workers and a negative correlation with employment rate. Conversely, the utilization of macrolides in relation to other antibiotics in children aged 0-6 years was highest in districts inhabited by those who were socio-economically privileged. INTERPRETATION: The findings suggest that utilization of antibiotics in children may vary considerably within a city, that it may increase with the degree of parental affluence, and that such affluence may reduce the utilization of penicillin V relative to other antibiotics.

Adolescent↗
PubMed1998

Equity is out of fashion? An essay on autonomy and health policy in the individualized society.

It is widely recognized that there is a discrepancy between principle and practice with respect to the health equity aim of public policy. This discrepancy is analyzed from two theoretical perspectives: the individualization of society and the fact that individual beliefs and values are connected to one's position in the social structure. These mechanisms influence both the choice of health policy measures and the normative judgements of preventive efforts, both of which tend to be consonant with the views of dominant social groups. In particular, we focus on the treatment of the ethical principle of autonomy and how this is reflected in health policy aimed at influencing health-related behaviour. We examine the current trend towards targeting health information campaigns on certain socio-economic groups and argue that it entails an ethical dilemma. The dominant discourse of the welfare state is contemplated as a means to understand why there tend to be a lack of emphasis on measures that are targeted at socio-economic inequalities. It is argued that there is no substantive basis in the individualized society for perceiving health equity as an independent moral principle and that the driving force behind the professed health equity goal may be in essence utilitarian.

Ethics, Medical↗
PubMed1998

The effects of cold storage and endotoxin challenge on osteoblast viability and interleukin-6 production.

Autogenous hip marrow is an excellent source of pluripotential cells for regenerative procedures. However, before this treatment modality can be employed a method to attenuate osteoclast activity must be developed. The shock of cold storage (4 degrees C) is thought to abate osteoclast activity through the downregulation of osteolytic cytokines produced by osteoblasts. The objective of this study was to evaluate the effects of cold storage (4 degrees C) and endotoxin challenge on bone cell culture viability and interleukin-6 (IL-6) production. These cells (osteoblasts) were primarily harvested from murine calvaria utilizing sequential digestions, separated by density gradient and combined. Twelve-well cell culture plates were inoculated with 2 x 10(4) cells/ml and placed in cold storage for 1-14 d. After cold storage the cultures were then incubated at 37 degrees C for 1-20 d. A set of replicate plates was also challenged with 10 ng/ml endotoxin upon incubation at 37 degrees C for 4 consecutive days. Cells were evaluated daily for alkaline phosphatase activity. Cell culture supernatants were also collected daily and batch assayed for IL-6 production. Cell cultures did not survive more than 48 h of cold storage. There was a decrease in IL-6 secretion in all refrigerated cultures and a significant decrease in those cells refrigerated for 48 h versus control cultures (p < 0.05). Replicate cultures treated with endotoxin secreted significantly increased amounts of IL-6 in both the control cultures and the cultures exposed to 24 h of cold storage versus non-endotoxin-treated control cultures (p < 0.05). These observations suggest that after 48 h of cold storage autogenous marrow may be safe to use because of the dramatic decrease in IL-6 production by osteoblasts.

Alkaline Phosphatase↗
PubMed1998

Does passive smoking in early pregnancy increase the risk of small-for-gestational-age infants?

OBJECTIVES: This study tested the hypothesis that women who deliver small-for-gestational-age infants are more often exposed to passive smoking at home or at work. METHODS: Among a 1-year cohort of nulliparous women in the city of Malmö, Sweden 872 (87.7%) women completed a questionnaire during their first prenatal visit. The study was carried out among women whose pregnancies resulted in a singleton live birth (n = 826), 6.7% of infants were classified as small for their gestational age. RESULTS: Passive smoking in early pregnancy was shown to double a woman's risk of delivering a small-for-gestational-age infant, independent of potential confounding factors such as age, height, weight, nationality, educational level, and the mother's own active smoking (odds ratio [OR] = 2.7). A stratified analysis indicated interactional effects of maternal smoking and passive smoking on relative small-for-gestational-age risk. CONCLUSIONS: Based on an attributable risk estimate, a considerable reduction in the incidence of small-for-gestational-age births could be reached if pregnant women were not exposed to passive smoking.

Adolescent↗
PubMed1997

Reliability and validity assessments of measures of social networks, social support and control--results from the Malmö Shoulder and Neck Study.

The reliability and validity of methods to assess social networks, social support and control were investigated in a population of 12,009 females and males born between 1926 and 1945 (the "Malmö Shoulder and Neck Study"). This study demonstrated an overall reliability with kappa coefficients between 0.70 and 0.47, but the reliability was more varying among females and lower in the youngest age group. The analysis of the construct validity indicated that the different indices measure different aspects of the psychosocial environment, but both theoretical and methodological problems were identified, when the validity of multidimensional concepts are to be determined. The validity of such indices can best be judged by combining quantitative and qualitative methods. Potential validity problems must be kept in mind when these indices are used in epidemiological research. The results from the reliability analysis call for repeated assessments and the sample size must be adjusted vis-a-vis the reliability.

Aged↗
PubMed1997

Psychosocial resources and persistent alcohol consumption in early pregnancy--a population study of women in their first pregnancy in Sweden.

The aim of the study was to test the impact of psychosocial resources on pregnant women, regarding continued alcohol consumption. The study is based on a one-year cohort of nulliparas followed during pregnancy. From a total of 994 invited women 872 (87.7%) agreed to participate in the study. All women who reported any alcohol consumption within the twelve months prior to the administration of the questionnaire were included in this study population (n = 692, 79.4%). 32.8% of the alcohol consumers continued to drink during pregnancy even though the alcohol intake was moderate. In spite of the official Swedish alcohol recommendation for total abstinence during pregnancy, more socially active, and more highly educated women continued drinking alcohol, with wine being the beverage of choice, maybe more as social behavior rather than to cope with stress caused by insufficient psychosocial resources. Younger women or those with fewer years of education tended to stop drinking to a higher degree, but those who continued to drink tended to drink beer or to binge.

Adolescent↗
PubMed1997

Estrogenic hormones and dental implant therapy: the effects of estrogen and progesterone levels on osseointegration of dental implants.

Successful rehabilitation of female service members suffering traumatic injuries to the maxillofacial region is both a physiological and a psychological issue. A clinical evaluation to determine if an association exists between sex hormone levels and dental implant success was undertaken. Endosseous dental implants were placed in three patient groups: (1) male controls, (2) females with high estrogen, and (3) females with low estrogen. Female groupings were based on ovulation cycles. Serum estrogen (ng/dl), serum progesterone [ng/dl], and serum interleukin-6 (pg/ml) were determined at time of implant placement. Pre- and postsurgical photographs and vinyl-polysiloxane impressions were taken to evaluate crestal alveolar bone loss. Upon data analysis, the authors concluded that the balance of alveolar osseous wound healing was not influenced by temporal fluctuations in the ovulatory cycle.

Case-Control Studies↗
PubMed1996

Increased risk of ischaemic heart disease mortality in elderly men using anxiolytics-hypnotics and analgesics. Results of the 10-year follow-up of the prospective population study "Men born in 1914", Malmo, Sweden.

OBJECTIVES: An increased risk of all-cause and cardiovascular mortality in users of anxiolytic-hypnotic drugs (AHD) has been reported, and use of analgesics may be an additional factor. Therefore, we examined the association of AHD and analgesic use, alone and in combination, with all-cause and ischaemic heart disease (IHD) mortality. METHODS: Multivariate 10-year survival analysis in a population based cohort of 500 men born in 1914. Relative risks (RR) were adjusted by relevant confounders (blood pressure, serum cholesterol, diabetes mellitus, smoking habit, high alcohol consumption, history of previous IHD, cancer, and other diseases). RESULTS: The RR of both all-cause and IHD mortality were significantly increased among those using both AHD and analgesics compared to those who took neither of these drugs: RR = 1.8 for all-cause mortality, and RR = 2.7 for IHD mortality. CONCLUSION: Although the number of cases was small, warranting interpretative caution, the current study suggests that the combined use of AHD (mainly benzodiazepines) and analgesics seems to be associated with an increase in all-cause and IHD mortality in elderly men.

Aged↗
PubMed1996

An economic and sociological interpretation of social differences in health-related behaviour: an encounter as a guide to social epidemiology.

We argue that the group-centred analyses of social epidemiology should follow from theoretical considerations that take the situation of the individual as their natural starting point. In a tentative dialogue between economics and sociology, we develop a framework for the analysis of health-related behaviour. Such behaviour is modelled as a process of decision-making at the individual level. Within economics, we draw specifically on the demand-for-health literature and the new institutional economics. Within sociology, Bourdieu's habitus theory is presented in combination with a macro-structural approach where the focus is on the process of individualization. The relationship between these different approaches to health-related behaviour and their implications is discussed. We find that the encounter between different sciences provides valuable insights for future work in the socio-epidemiological tradition.

Decision Making↗
PubMed1996

Psychosocial resources and persistent smoking in early pregnancy--a population study of women in their first pregnancy in Sweden.

STUDY OBJECTIVE: To test the stress hypothesis by characterising women during their first pregnancy who continue to smoke in early pregnancy in comparison with women who quit smoking, with special reference to psychosocial factors like social network, social support, demands, and control in work and daily life. DESIGN: The study is based on a cohort of primigravidas followed during pregnancy. Data were collected by self administered questionnaires during the pregnant womens' first antenatal visit at about 12 weeks. SETTING: The study was performed in the antenatal clinics in the city of Malmö, Sweden. PARTICIPANTS: The participants were all primigravidas living in the city of Malmö, Sweden, over a one year period, 1991-92. A total of 872 (87.7%) of the 994 invited women agreed to participate. The population of this study on smoking includes all primigravidas who at the time of conception were smoking (n = 404, 46.3%). MAIN RESULTS: At the first antenatal visit (63.6% (n = 257) of the prepregnancy smokers were still smoking (a total smoking prevalence of 29.5%). The pregnant smokers were on average younger and had a lower educational level. The highest relative risk (RR) of continued smoking was found among unmarried women RR 2.7 (95% confidence interval) (1.5, 4.8), women having unplanned pregnancies RR 2.2 (1.2, 4.0) and those with a low social participation RR 1.6 (1.0, 2.7), low instrumental support RR 2.6 (1.2, 6.0), low support from the child's father RR 2.1 (1.0, 4.2) and those exposed to job strain RR = 2.3 (1.1, 4.8). The associations were independent of potential confounders such as age, educational level, nationality, cohabiting status, passive smoking, and previous years of smoking. CONCLUSIONS: This study supports the stress hypothesis. Smoking can be one way women handle stress when demands become too great. In order to reduce smoking among pregnant women, maternity centre resources need to be focused more on women with low psychosocial resources who are at highest risk for continued smoking. It is also important to involve actively the woman's partner or other important people in the woman's social network.

Adolescent↗
PubMed1996

Importance of participation rate in sampling of data in population based studies, with special reference to bone mass in Sweden.

OBJECTIVE: To study the effects of participation rate in sampling on "normative" bone mass data. DESIGN: This was a comparison between two randomly selected samples from the same population. The participation rates in the two samples were 61.9% and 83.6%. Measurements were made of bone mass at different skeletal sites and of muscle strength, as well as an assessment of physical activity. SETTING: Malmö, Sweden. SUBJECTS: There were 230 subjects (117 men, 113 women), aged 21 to 42 years. RESULTS: Many subjects participated in both studies (163). Those who took part only in the study with the higher participation rate (67) almost invariably had higher values for bone mass density at the sites measured (up to 7.6% for men) than participants in the study with the lower participation rate. No differences in muscle strength were recorded. CONCLUSION: A high degree of compliance is important to achieve a reliable result in determining normal values in population based studies.

Adult↗
PubMed1996

Alcohol consumption modifies the total lung capacity in smokers.

Smoking-related airflow obstruction can develop with or without emphysema. Moderate alcohol consumption has been suggested to diminish the risk of centrilobular emphysema caused by smoking. Our aim was to study the influence of total energy and nutrient (protein, fat, carbohydrate and alcohol) intake on smoking-related emphysema. Lung function and nutrient intake including alcohol consumption were recorded at age of 68 years in 478 men as part of the population study 'Men Born in 1914' in Malmö, Sweden. In nonsmokers (n = 88) and ex-smokers (n = 223), there were no significant relationships between energy and nutrient intake and lung function. In smokers (n = 167), men in the highest and lowest quintile of total lung capacity (TLC) differed in alcohol intake (p = 0.004) but not in intake of total energy or other nutrients. In smokers with a forced expiratory volume in 1 s/vital capacity ratio of below 70% (n = 81), alcohol intake was positively correlated with TLC (r = 0.31; p = 0.006) after adjustment for smoking and body mass index. We conclude that in men with smoking-related airway obstruction, emphysema defined as large TLC was associated with high alcohol consumption but not with the intake of total energy or other nutrients.

Aged↗
PubMed1996

Dental considerations for a Glanzmann's thrombasthenia patient: case report.

Glanzmann's thrombasthenia is a qualitative platelet disorder characterized by a deficiency in the platelet membrane glycoproteins (GP) IIb-IIIa. It belongs to a group of hereditary platelet disorders typified by normal platelet numbers and a prolonged bleeding time. The bleeding seen in Glanzmann's thrombasthenia usually includes bruising, epistaxis, gingival hemorrhage, and menorrhagia. Spontaneous, unprovoked bleeding is unusual. The severity of bleeding is unpredictable in thrombasthenia and does not correlate with the severity of the platelet GP IIb-IIIa abnormality. The present case report describes the dental treatment of a patient with Glanzmann's thrombasthenia. A 39-year-old female with a history of Glanzmann's thrombasthenia presented for periodontal therapy for spontaneous gingival hemorrhage. The patient had been sporadically seen in the past and had a record of only returning for appointments on an "emergency" basis. The periodontal findings revealed a diagnosis of moderate to advanced adult periodontitis in all quadrants. After all dental options had been discussed, the treatment of choice was determined to be extraction of the remaining dentition and fabrication of immediate dentures. The patient received a loading dose of 5 grams of aminocaproic acid (EACA) intravenously 3 hours prior to the surgery. At the beginning of the extractions 1 gram of EACA per hour continuous infusion and a 6 pack of platelets was administered. The patient tolerated the extractions well. All sites healed normally. The patient has had no difficulty in adjusting to the dentures. The case report discusses a possible treatment option in a noncompliant patient having Glanzmann's thrombasthenia and briefly discusses other hereditary bleeding disorders with similar presentations.

Adult↗
PubMed1995

Social network, social support and the prevalence of neck and low back pain after retirement. A population study of men born in 1914 in Malmö, Sweden.

In this study we investigated the importance of social network and social support systems outside the workplace and workload and psychological job strain in former work for the prevalence of daily neck and low back pain. The study population (n = 621) comprised a random half of all male residents in Malmö, Sweden, born in 1914, of whom 500 (80.5%) participated. Two of the social network and social support indices (social anchorage and availability of material and informational support) were independent of life-style factors (leisure time physical activity, smoking and alcohol consumption) related to daily neck and back pain after retirement (OR = 2.0, 95% CI 1.2-3.4 and OR = 1.7, 95% CI 1.0-2.7, respectively), while the psycho-social and physical factors in former work were not. As no conclusion about the direction of the association can be drawn, prospective studies are needed to further explore these findings.

Aged↗
PubMed1995

The effects of intracanal medicaments, fillers, and sealers on the attachment of human gingival fibroblasts to an exposed dentin surface free of a smear layer.

To date there has been very little research into the possible effects of endodontic therapy on regeneration of the lost periodontal attachment. The objective of this study was to examine the effects of endodontic medicaments on fibroblast attachment to dentin surfaces free of a smear layer. Pulp chambers of extracted third molars were filled with one of the following medicaments: gutta-percha with Roth's zinc oxide and eugenol-based sealer, warm gutta-percha with sealer, warm gutta-percha without sealer, calcium hydroxide, formocresol, cotton pellet, or left empty. A predetermined dentin surface area was then inoculated with human gingival fibroblasts at a concentration of 2 x 10(4) cells per ml. The cells were allowed to adhere to the dentin surface for either 4 or 24 hours, then cell attachment was quantified using a methyl-tetrazolium assay. The data were analyzed using a Kruskal-Wallis one-way analysis of variance and Dunn's multiple comparison test. It was determined that fibroblast attachment was significantly reduced when exposed to formocresol or warm gutta-percha without sealer at both the 4 and 24 hour interval (P < or = 0.05). This suggests that the use of formocresol or warm gutta-percha without sealer in a root canal may impede periodontal wound healing and regeneration.

Analysis of Variance↗
PubMed1994

Social network, social support and heavy drinking in elderly men--a population study of men born in 1914, Malmö, Sweden.

We analysed whether there were associations among different aspects of social network and social support, on one hand, and heavy drinking and alcohol problems on the other. The study sample (n = 621) comprised a random half of all male residents born in 1914 in Malmö, Sweden. Five hundred (80.5%) participated. Heavy drinking was defined as an alcohol consumption above 250 g alcohol per week and alcohol problems were assessed by a modified Michigan Alcoholism Screening test. Eight conceptually differential aspects of social networks and social support were measured. Four of five social network indices (social anchorage, social participation, contact frequency, spousal support) were associated with heavy drinking (OR 1.9-2.5) and two social network indices (social anchorage, spousal support) were associated with alcohol problems (OR 2.1-2.3). The results in this study are independent of social class, but based on a cross-sectional study, so we do not know if heavy drinking has caused social isolation or the contrary. If these results can be verified in a prospective study, a strengthening of the social network of the individual could perhaps lead to more moderate alcohol habits and better health, a finding of potential importance in the field of health promotion.

Aged↗
PubMed1994

Social network, social support and dental status in elderly Swedish men.

The objective of this study was to investigate whether there were associations between different aspects of social network and social support and dental status. The study sample (n = 621) comprised a random half of all male residents in Malmö, Sweden, born in 1914. Five hundred (80.5%) participated. Eight conceptually different aspects of social networks and social support were measured, and all men were clinically examined regarding number of teeth, prevalence of removable dentures, fixed bridges and anterior open tooth spaces. We found that some aspects of dental status were associated with social class, while others were associated with different aspects of social network and social support. Prevalence of complete dentures and fixed bridges was strongly associated with social class, a low number of functioning teeth was associated with both low social class belonging and an insufficient social network and social support, while anterior open tooth spaces were associated mostly with an insufficient social network and social support. This study shows that there are significant associations between some aspects of dental status and the social network and social support of the individual, while other aspects of dental status are associated with social class, which from a psychosocial perspective contribute to a deeper understanding of the backgrounds of dental status.

Aged↗