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At least 235 records · Page 13Linked to original sources
PubMed1985

Prescription of digitalis in a health centre serving a defined rural population in Iceland.

The use of digitalis glycosides in the Egilsstadir district in eastern Iceland was studied. The district which has a well-defined catchment area has a health centre with three general practitioners serving a registered population of 2802 inhabitants. This is 1.2% of the total population of Iceland with similar age and sex distribution. Twenty-four patients (0.9%) were treated with digitalis glycosides. The most common patient complaint before starting therapy was shortness of breath. The general practitioners started therapy in 17 cases, consultants in seven. Ecg was taken before therapy in 22 cases and showed 15 patients with sinus rhythm. The most common diagnosis was heart failure (62%). The only glycoside used was digoxin. The use of cardiac glycosides in the Egilsstadir health district was low both compared with Iceland as a whole and with other Nordic countries. Considering studies on discontinuation of maintenance digoxin therapy in general practice and also the findings in this study it is suggested that the use of digitalis glycosides in the Egilsstadir health district and in Iceland could be even lower.

Adolescent↗
PubMed1999

Prevalence of carpal tunnel syndrome in a general population.

CONTEXT: Carpal tunnel syndrome (CTS) is a cause of pain, numbness, and tingling in the hands and is an important cause of work disability. Although high prevalence rates of CTS in certain occupations have been reported, little is known about its prevalence in the general population. OBJECTIVE: To estimate the prevalence of CTS in a general population. DESIGN: General health mail survey sent in February 1997, inquiring about symptoms of pain, numbness, and tingling in any part of the body, followed 2 months later by clinical examination and nerve conduction testing of responders reporting symptoms in the median nerve distribution in the hands, as well as of a sample of those not reporting these symptoms (controls). SETTING: A region in southern Sweden with a population of 170000. PARTICIPANTS: A sex- and age-stratified sample of 3000 subjects (age range, 25-74 years) was randomly selected from the general population register and sent the survey, with a response rate of 83% (n = 2466; 46% men). Of the symptomatic responders, 81% underwent clinical examination. MAIN OUTCOME MEASURES: Population prevalence rates, calculated as the number of symptomatic responders diagnosed on examination as having clinically certain CTS and/or electrophysiological median neuropathy divided by the total number of responders. RESULTS: Of the 2466 responders, 354 reported pain, numbness, and/or tingling in the median nerve distribution in the hands (prevalence, 14.4%; 95% confidence interval [CI], 13.0%-15.8%). On clinical examination, 94 symptomatic subjects were diagnosed as having clinically certain CTS (prevalence, 3.8%; 95% CI, 3.1%-4.6%). Nerve conduction testing showed median neuropathy at the carpal tunnel in 120 symptomatic subjects (prevalence, 4.9%; 95% CI, 4.1%-5.8%). Sixty-six symptomatic subjects had clinically and electrophysiologically confirmed CTS (prevalence, 2.7%; 95% CI, 2.1%-3.4%). Of 125 control subjects clinically examined, electrophysiological median neuropathy was found in 23 (18.4%; 95% CI, 12.0%-26.3%). CONCLUSION: Symptoms of pain, numbness, and tingling in the hands are common in the general population. Based on our data, 1 in 5 symptomatic subjects would be expected to have CTS based on clinical examination and electrophysiologic testing.

Adult↗
PubMed2005

Early childhood risk factors associated with type 1 diabetes--is gender important?

BACKGROUND: The incidence of childhood diabetes is increasing in Denmark as in the rest of the world. The aim of this investigation was to study intrauterine and early childhood risk factors for insulin dependent diabetes mellitus, and to evaluate gender differences in the effect of these. METHODS/MATERIAL: A number of 602 diabetic cases aged 0-14 years diagnosed 1996-1999 were identified from the Danish register of childhood diabetes. A total of 1490 non-diabetic healthy children matched by gender and date of birth were randomly selected from the Danish population register. In addition a combination of national register data and questionnaire data was used. RESULTS: High parental age, neonatal infections and pre-eclampsia were associated with type 1 diabetes in boys, whereas being preterm was associated with an increased risk in girls. An increased risk was associated with a family history of diabetes and amniocentesis, while a decreased risk was associated with increasing birth order and maternal smoking. In a multiple logistic regression analysis, the following risk factors were significantly associated with case-control status: maternal smoking (OR: 0.6(0.4-0.9)), neonatal infection in boys (OR: 5.5(1.4-21.8)), neonatal infection in girls (OR: 0.6(0.1-3.0)), amniocentesis (OR: 1.6(1.0-2.6)), preschool siblings (OR: 0.8(0.6-1.0)), introduction of cow's milk after the age of 3 months (OR: 0.7(0.4-0.9)) and a 1st degree family member with diabetes (OR: 9.1(95% CI:5.2-16)). CONCLUSION: The study showed associations between several risk factors and childhood diabetes, for some risk factors the odds ratio in boys were different from the odds ratio in girls.

Adolescent↗
PubMed2001

Injury risks and socioeconomic groups in different settings. Differences in morbidity between men and between women at working ages.

BACKGROUND: It is unclear whether greater injury risk in lower socioeconomic groups at working ages is attributable to differences in work conditions or a reflection of a wider overall pattern of risk. The current study investigates socioeconomic differences in non-fatal injury risks in a variety of settings. METHODS: Data were taken from a community-based injury register built up over one year (November 1989 to October 1990) in a semi-urban Swedish municipality (256,510 inhabitants), and then linked by record to Sweden's National Population Register (based on the census of 1990). Injuries among the age group 20-64 were considered. Age-standardized odds ratios were computed by gender for five injury settings and four socioeconomic groups, using salaried employees as the reference group. RESULTS: Compared with salaried employees, male manual workers and from the unspecified population (long-term unemployed, students, etc.) show an excess risk of injury in all settings except sports. Males from all socioeconomic groups show significantly higher morbidity in production/education areas. Female manual workers show significantly higher morbidity in home settings and in production/education; those from the unspecified population, in home settings, transport areas, and 'other areas'. CONCLUSION: Higher morbidity in lower socioeconomic groups results not only from work-related differences, where 25% of the injuries analysed were incurred, but also from the differential impacts of other living environments, e.g. home and transport areas. Differences between socioeconomic groups in care seeking, injury lethality, injury susceptibility, and risk exposure may influence the social patterning of injury morbidity.

Accidents, Occupational↗
PubMed1994

[Moslems and Hindus in the Netherlands: revised time series].

Estimates of the numbers of Muslim, Hindu, and Buddhist residents of the Netherlands are presented and techniques for producing such estimates described. "Since 1971...estimated numbers of Moslems and Hindus/Buddhists have been...computed annually with the aid of data taken from the international migration statistics. Population growth due to births and deaths was calculated by assuming that the crude rates for Turks, Moroccans, [Tunisians], Pakistani and Indonesians living in the Netherlands apply to the Moslems, and those for the Surinamese apply to the Hindus/Buddhists. More recently other estimates have been achieved on the basis of enumerations from municipal population registers." (SUMMARY IN ENG)

Culture↗
PubMed2001

Use of a cross-sectional survey to estimate outcome of health care: the example of anxiety and depression.

Our study proposes that a population-based cross-sectional survey can be used to estimate the outcome of health care by linking general practice morbidity records to the survey. Using the example of anxiety and depression to test this idea, we conducted a survey of an adult population registered with one general practice in the UK. The Hospital Anxiety and Depression (HAD) questionnaire was used to identify cases and controls. After mailing to a randomly selected adult population of 4002, there was an adjusted response rate of 66% (n = 2,606), with 416 (16%) high-score cases, 506 (19%) medium-score cases, and 1684 (65%) low-score controls. All cases were compared with a sample of controls (n = 450). In the 12 months before the survey, the high-score case group had experienced significantly higher GP contacts (n = 377 [91%] versus 354 [79%]), diagnoses for anxiety or depression (119 [29%] versus 21 [5%]), and related drug treatments (111 [27%] versus 22 [5%]) compared with the control sample. Most of the diagnoses and drug treatments had been initiated at least 9 months before the survey. The linkage between the survey and the clinical records suggested that the health outcome of previously identified anxious and depressed patients was poor, with an estimated two-thirds who will not have fully recovered within an average of 9 months. This study demonstrates the potential for using cross-sectional population surveys to estimate not only the need for health care but also the outcome of health care.

Adolescent↗
PubMed2000

Paternal exposure to lead and infertility.

To assess whether paternal exposure to lead is associated with infertility, we performed a register-based study among married men biologically monitored for exposure to inorganic lead. We obtained information about the marriages and the wives of the men from the Finnish Central Population Register. Data on pregnancies were obtained from medical records. Paternal exposure to lead was assessed on the basis of blood lead measurements. We estimated the risk of infertility, defined as nonoccurrence of a marital pregnancy, by applying binomial regression. For the blood lead categories of 0.5-0.9, 1.0-1.4, 1.5-1.9, 2.0-2.4, and > or =2.5 micromol/L the relative risk of infertility, compared with the risk in the lowest exposure category (<0.5 micromol/L), was 1.27 (95% confidence interval 1.08-1.51), 1.35 (1.12-1.63), 1.37 (1.08-1.72), 1.50 (1.08-2.02), and 1.90 (1.30-2.59), respectively. The findings support the hypothesis that paternal exposure to lead increases the risk of infertility at low occupational exposure levels. We applied proportional hazards regression to the analysis of pregnancy delay. A delay was observed among the wives of men exposed to lead. Exposure to lead was not clearly associated with delayed pregnancy, however, when the analysis was restricted to couples with at least one pregnancy. This finding suggests that the restriction of the study on time to pregnancy to fertile couples may introduce a bias toward no association.

Adult↗
PubMed2006

[Disease management programs between aspiration and reality. Actually, everything was meant to become much better].

By initiating disease management programmes (DMP) the German legislator aimed to optimize the provision of healthcare to chronically ill patients through increasing the competition between sickness funds and healthcare providers and to stimulate quality competition in the healthcare system by simultaneously connecting DMPs to compensatory (wraparound) payments within the risk-adjustment scheme. The intended quality measures have hardly been reflected in the DMP contracts. The present paper presents a preliminary analysis of the population registered for the "Type 2 Diabetes mellitius" DMP: As the sickness funds aim to recruit as many participants as possible, they did not only enrol the high-risk population but relatively young and healthy diabetics as well. Whether DMPs will actually lead to quality improvement and increasing cost-effectiveness cannot be assessed, since the evaluation criteria for DMPs no longer require that sound scientific cost-effectiveness analyses be performed.

Delivery of Health Care↗
PubMed1994

Changes in risk factors explain changes in mortality from ischaemic heart disease in Finland.

OBJECTIVES: To estimate the extent to which changes in the main coronary risk factors (serum cholesterol concentration, blood pressure, and smoking) explain the decline in mortality from ischaemic heart disease and to evaluate the relative importance of change in each of these risk factors. DESIGN: Predicted changes in ischaemic heart disease mortality were calculated by a logistic regression model using the risk factor levels assessed by cross sectional population surveys, in 1972, 1977, 1982, 1987, and 1992. These predicted changes were compared with observed changes in mortality statistics. SETTING: North Karelia and Kuopio provinces, Finland. SUBJECTS: 14,257 men and 14,786 women aged 30-59 randomly selected from the national population register. MAIN OUTCOME MEASURES: Levels of the risk factors and predicted and observed changes in mortality from ischaemic heart disease. RESULTS: The observed changes in the risk factors in the population from 1972 to 1992 predicted a decline in mortality from ischaemic heart disease of 44% (95% confidence interval 37% to 50%) in men and 49% (37% to 59%) in women. The observed decline was 55% (51% to 58%) and 68% (61 to 74) respectively. CONCLUSION: An assessment of the data on the risk factors for ischaemic heart disease and mortality suggests that most of the decline in mortality from ischaemic heart disease can be explained by changes in the three main coronary risk factors.

Adult↗
PubMed1994

[Family reunification and family-formation migration, 1987-1991].

"Indirect estimates were made of family reunification and family formation migration [in the Netherlands], based on such demographic characteristics as nationality, country of birth, age, marital status, year of marriage and family situation after the migration. The estimates are based on the 1992 enumeration from the municipal population registers." (SUMMARY IN ENG)

Behavior↗
PubMed2001

Excess breast cancer risk and the role of parity, age at first childbirth and exposure to radiation in infancy.

Exposure to ionizing radiation is a known risk factor for breast cancer and the fertility pattern is a recognized modifier of breast cancer risk. The aim of this study was to elucidate the interaction between these 2 factors. This study is based on a Swedish cohort of 17 202 women who had been irradiated for skin haemangiomas in infancy between 1920 and 1965. The mean age at treatment was 6 months and the median breast dose was 0.05 Gy (range 0-35.8 Gy). Follow-up information on vital status, parity, age at first childbirth and breast cancer incidence was retrieved through record linkage with national population registers for the period 1958-1995. Analyses of excess relative risk (ERR) models were performed using Poisson regression methods. In this cohort, the fertility pattern differed from that in the Swedish population, with significantly fewer childbirths overall and before 25 years of age but more childbirth after that age. There were 307 breast cancers in the cohort and the standardized incidence ratio (SIR) was 1.22 (95% CI 1.09-1.36). A linear dose-response model with stratification for fertility pattern and menopausal status resulted in the best fit of the data. ERR/Gy was 0.33 (95% CI 0.17-0.53). In absolute terms this means an excess of 2.1 and 5.4 cases per Gy per 10(4) breast-years in the age groups 40-49 and 50-59 years respectively. The fertility pattern influenced the breast cancer risk in this irradiated population in a similar way to that observed in other studies. SIR at dose = 0 was highest, 2.31, among postmenopausal nulliparous women (95% CI 1.48-3.40, n = 62). SIR at dose = 0 was lowest in pre- or postmenopausal women with a first childbirth before 25 years of age; 0.89 (0.71-1.09) and 0.88 (0.58-1.25) respectively. Thus, in addition to the dose-effect response in the cohort, part of the breast cancer excess could be explained by a different fertility pattern. The estimates of ERR/Gy for the various categories of age at first childbirth, number of children, menopausal status and ovarian dose were very similar, contradicting any interaction effects on the scale of relative risk.

Adult↗
PubMed1992

A cohort study on cancer incidence in offspring of male printing workers.

We used multistep register linkage to measure the occurrence of cancer in offspring of male members of the Oslo unions of printers. A file of their children was established through linkage with the Central Population Register. Children born 1950-1987 (N = 12,440) were traced for cancer during 1965-1987 in the Cancer Registry of Norway (193,406 person-years). We found 33 cases of cancer. The standardized incidence ratio was near expected for person-years after age 14 (25 cases observed) but lower than expected for person-years in the age group 0-14 years (eight cases observed, standardized incidence ratio 0.58, 95% confidence interval 0.25-1.14). This negative association was stronger when more precise criteria for time of exposure were applied, especially for children 0-14 years with fathers in categories exposed to lead 1 year before the child's birth. Methodologic problems with this approach are nondifferential exposure misclassification and the need for large data sets. The method could serve as an alternative to the case-control design in reproductive epidemiology.

Adolescent↗
PubMed1996

[Health services accessibility in the Murcia region].

OBJECTIVES: To find the geographical accessibility of primary care services and their support facilities. DESIGN: An observational, crossover study. SETTING: Primary health care. PATIENTS OR OTHER PARTICIPANTS: All those collective and single population groupings (354), included in the population register of the Murcia region with 100 or more inhabitants listed or with less inhabitants but with a health care post. MEASUREMENTS AND MAIN RESULTS: The time (crona) taken by the population of the different health districts and areas of the region to reach primary care and support services was determined by direct observation. Crona was defined as the average of three measurements of the time taken to reach these services by people using their normal means of transport and not exceeding the highway code's speed limits. 335 care posts were counted. Only 1,56% of the population, all belonging to Health Area 4, needed more than 30 minutes to reach their local doctor. 18,36% of the population needed more than 30 minutes to reach their referral hospitals. CONCLUSIONS: The number and distribution of facilities in the health care network guarantee adequate access to their services, except in Area 4. Specific studies will have to be designed to check that access problems are connected more to the road network and transport used than to the number and location of care centres.

Cross-Over Studies↗
PubMed2004

No association between season of birth of patients with schizophrenia and risk of schizophrenia among their siblings.

Previous studies on the relationship between the season of birth of patients with schizophrenia and the risk of schizophrenia among their siblings have yielded contradictory results. We investigated whether proband's month of birth affects siblings' risk of developing schizophrenia. We used the Finnish Hospital Discharge Register to identify all patients born in Finland from 1950 to 1976 who had been hospitalized because of schizophrenia at least once between 1969 and 1995. Their siblings were identified from the National Population Register, and data on siblings were linked to the Hospital Discharge Register to obtain information on any hospitalizations. We used logistic regression to investigate a sibling's probability of developing schizophrenia, defining the proband initially as the first sibling in calendar time to develop schizophrenia, then as the affected sibling with lowest onset age. Within-family dependence was taken into account by using robust standard error estimates. Neither models found any association between proband's month of birth and siblings' odds of developing schizophrenia. Our results support those previous studies that found no association between proband's month of birth and family history of schizophrenia, and suggest that the winter-spring excess of births among patients with schizophrenia is not caused by any genetic or environmental risk factor that operates independently of other risk factors.

Adult↗
PubMed2002

Sexual diversity in urban Norwegians.

The purpose of this study is to describe homosexual and heterosexual experiences in terms of sexual fantasies, sexual attraction, sexual conduct, and falling in love in an urban Norwegian population. In 1997, a random sample of 5,000 persons (18-49 years) was drawn from the population register in Oslo to participate in a sexual behavior survey. Data collection was carried out by means of postal questionnaires and 45% responded. The results indicated that exclusive homosexuality was rare in the population. One exception was the prevalence of homosexual fantasies in women. Compared to respondents who had had exclusively heterosexual contact, respondents reporting bisexual contacts had a significantly higher number of lifetime sex partners, higher frequency of anal and oral sex and masturbation, and lower age at orgasm and masturbation debut. What significantly separated the groups of exclusive heterosexuals, bisexuals, and exclusive homosexuals were attitudes towards various expressions of sexuality and number of lifetime sex partners.

Adult↗
PubMed1986

Prospective study of attainment of social class of severely obese subjects in relation to parental social class, intelligence, and education.

Cross sectional population studies have shown that subjects who are severely obese are of lower social class than comparable subjects who are not obese. This may be ascribed to lower parental social class, poorer education, and lower intelligence test scores of the obese subjects. In this study based on 242 633 draftees appearing before the draft board in Copenhagen between 1956 and 1977, 1144 extremely overweight men (body mass index greater than or equal to 31 kg/m2) were compared with 2123 young men randomly chosen from the remainder of the population. The two groups were followed up for an average period of 12 X 5 years, after which time their occupation was obtained from the National Population Register. Social class was derived from a ranking of occupations based on prestige from 0 (unskilled, manual worker) to 7 (for example, judge, professor). Among the obese subjects, only 300 (30%) out of 1006 attained a position above social class 2, compared with 988 (51%) out of 1948 in the control group. At each level of education and intelligence test score, as registered at the draft board, the obese subjects still showed a significantly lower attainment of social class than the controls. Inclusion of parental social class, information which was available for part of the population, did not eliminate the difference in attainment of social class. The results of this study show that obese subjects not only suffer from a higher risk of somatic diseases but have to live with a social handicap that is independent of parental social class, intelligence, and education.

Educational Status↗
PubMed1978

[Medical genetic study of the population of Uzbekistan. V. The frequency of heterozygous beta-thalassemia in 4 kishlaks of Urgut District, Samarkand Province].

A subject of this investigation is the results of the subtotal examination of 4 villages for the detection of heterozygous beta-thalassemic carriers. 848 persons (55.5% of the registered population) have been examined. The mean frequency of the beta-Th gene was 0.0159, FST-Wahlund--0.00975. Statistically significant differences in the gene frequencies between villages have been revealed (p less than 0.01). The study of genetic distances (by Edwards) has revealed no intertribe differences in gene frequencies. The comparison of findings of the present study with other similar investigations enabled to account for the detected differences in the frequencies of beta-thalassemia as a result of the genetic drift. The importance of choosing populations for the study and methods for detection heterozygous beta-thalassemia are discussed.

Gene Frequency↗
PubMed2006

Sodium in the Finnish diet: 20-year trends in urinary sodium excretion among the adult population.

OBJECTIVE: High sodium intake increases the risk of cardiovascular diseases and may also be associated with higher rates of stomach cancer, asthma disorders and infections. In Finland, cross-sectional population surveys to monitor cardiovascular risk factors have been carried out since the 1970s. The main aim of this paper is to present trends in urinary sodium and potassium excretion from 1979 to 2002. DESIGN: Cross-sectional population surveys on cardiovascular risk factors. SETTING: Surveys were carried out in Finland in 1979, 1982, 1987 and 2002 in four geographical areas: North Karelia, the Kuopio area, Southwestern Finland and the Helsinki area. SUBJECTS: For each survey a random sample stratified by age and sex was drawn from the population register. In this analysis, participants of urine collection subsamples aged 25-64 years (n = 4648) were included. INTERVENTIONS: A 24-h urinary collection was carried out in subsamples (n = 2218-2487) in connection with population risk factor surveys. Urinary sodium and potassium concentrations were analyzed in the same laboratory throughout, using a flame photometer in 1979, 1982 and 1987 and an ion-selective electrode in 2002. RESULTS: Between 1979 and 2002 urinary sodium excretion in Finland decreased from over 220 to less than 170 mmol/day among men and from nearly 180 to less than 130 mmol/day among women. Although potassium excretion decreased somewhat as well, the decrease in sodium-potassium molar ratio was also significant. CONCLUSIONS: The 24-h urinary sodium excretion in Finland has decreased significantly during the last 20 years. However, excretion levels are still considerably higher than recommendations. A further decrease in sodium intake remains a goal for the Finnish food industry and consumers. SPONSORSHIP: All surveys were funded by the National Public Health Institute in Finland.

Adult↗