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PubMed1993

Root caries in Scandinavia in the 1980's and future trends to be expected in dental caries experience in adults.

The large variety of diagnostic criteria used adds some uncertainty to comparisons of recent clinical and epidemiological data on root caries in Scandinavia. Nevertheless, it is apparent that the prevalence of frank carious cavities on the root among 60(+)-year-olds is about 30-40%. When inactive and recurrent lesions and fillings are included, the prevalence is almost 100% in 60(+)-year-olds. At this age, the mean number of root surface fillings is about 7, and the mean number of active caries lesions ranges from 0.9 to 3.4. The degree of gingival recession does not appear to be a direct measure of root caries risk in a population. When the number of teeth at risk is accounted for, the age-dependent increase in prevalence of root caries is very weak. Therefore, comparisons of root caries prevalence between populations are meaningful only when information on number of teeth present and teeth at risk is also available. Recent studies from various parts of the world have demonstrated that caries is ubiquitous in all populations and that caries progression continues throughout life. The impact of this on trends in prevalence and incidence of dental caries in adults is discussed in the light of what is known about the natural history of dental caries.

Adolescent↗
PubMed2005

Disaster preparedness in Scandinavia.

Disaster preparedness in Scandinavia is being improved on the national level, with increased cooperation between the different countries following 9/11. However, focus so far has been largely directed against CBRN threats. The reduction of hospital beds along with centralisation of advanced care as well as financial strains will enforce a closer cooperation between the health boards. The federal health care authorities must have a clear-cut responsibility and mandate to coordinate the nations health care systems in peacetime disasters, and not only during war. This reorganisation has just merely begun.

Cooperative Behavior↗
PubMed2006

Cross-diagnostic validity in a generic instrument: an example from the Functional Independence Measure in Scandinavia.

BACKGROUND: To analyse the cross-diagnostic validity of the Functional Independence Measure (FIM) motor items in patients with spinal cord injury, stroke and traumatic brain injury and the comparability of summed scores between these diagnoses. METHODS: Data from 471 patients on FIM motor items at admission (stroke 157, spinal cord injury 157 and traumatic brain injury 157), age range 11-90 years and 70 % male in nine rehabilitation facilities in Scandinavia, were fitted to the Rasch model. A detailed analysis of scoring functions of the seven categories of the FIM motor items was made prior to testing fit to the model. Categories were re-scored where necessary. Fit to the model was assessed initially within diagnosis and then in the pooled data. Analysis of Differential Item Functioning (DIF) was undertaken in the pooled data for the FIM motor scale. Comparability of sum scores between diagnoses was tested by Test Equating. RESULTS: The present seven category scoring system for the FIM motor items was found to be invalid, necessitating extensive rescoring. Despite rescoring, the item-trait interaction fit statistic was significant and two individual items showed misfit to the model, Eating and Bladder management. DIF was also found for Spinal Cord Injury, compared with the other two diagnoses. After adjustment, it was possible to make appropriate comparisons of sum scores between the three diagnoses. CONCLUSION: The seven-category response function is a problem for the FIM instrument, and a reduction of responses might increase the validity of the instrument. Likewise, the removal of items that do not fit the underlying trait would improve the validity of the scale in these groups. Cross-diagnostic DIF is also a problem but for clinical use sum scores on group data in a generic instrument such as the FIM can be compared with appropriate adjustments. Thus, when planning interventions (group or individual), developing rehabilitation programs or comparing patient achievements in individual items, cross-diagnostic DIF must be taken into account.

Activities of Daily Living↗
PubMed2002

Euthanasia and physician-assisted suicide in Scandinavia--with a conceptual suggestion regarding international research in relation to the phenomena.

This article analyses and compares recent research on Scandinavian physicians' attitudes towards, as well as their practice of, euthanasia and physician-assisted suicide. The studies discussed are quite dissimilar in their design, resulting in considerable difficulties as far as comparability is concerned. Such difficulties are common in these fields of research. As an intended contribution to the amendment of future research, we suggest what we take to be detailed and precise definitions of the terms euthanasia and physician-assisted suicide for use internationally. Our definitions, or interpretations, basically draw on the Dutch experience and understanding of these terms. The Dutch approach implies that acts of abstention from life-prolonging treatment, i.e., withholding and withdrawing treatment, and pain and symptom treatment that theoretically could shorten life (including terminal sedation) are to be considered 'normal medical practice'. Furthermore, death is seen as having natural causes in all of these acts. That, however, is not the case with euthanasia and physician-assisted suicide. When a physician performs either of these acts, he or she is required to state 'unnatural death' in the patient's death certificate. Our conceptual suggestions do not address the ethical status of the various medical decisions that are made with regard to the death of patients; our aim is conceptual clarity only. As far as euthanasia and physician-assisted suicide in Scandinavia is concerned, even though comparisons prove difficult, we do think some observations may be made: physicians from Norway, Denmark and Sweden display differences in both attitude and practice concerning these phenomena. Norwegian physicians are most restrictive with regard to attitude. Danish and Swedish physicians display a more liberal attitude, the latter being the most liberal. These findings did not fit the physicians' practice. Danish physicians have performed euthanasia and physician-assisted suicide more often than Norwegian physicians. Swedish physicians, even though they are the most liberal when it comes to attitude, appear never to have performed euthanasia and very seldom physician-assisted suicide.

Attitude of Health Personnel↗
PubMed1994

Recent trends and future prospects for the elderly in Scandinavia.

After World War II, and all through the 1970s, social and economic development in general, and social policy in particular, raised the standard of living for old people in Scandinavia considerably. Public provision then leveled off and declined through the 1980s, with some variation between the countries. While the aging of the population continues, the political and economic climate now favors cuts rather than expansion of public budgets. Any further development along these lines will reinforce the inequalities, and place a growing number of the elderly and their families at risk.

Aged↗
PubMed1986

Congenital malaria in Scandinavia.

A case of Plasmodium vivax malaria in a 3-week-old infant, born in Norway of a Pakistanian mother, is reported. The child was admitted with a febrile illness of unknown origin, persistent vomiting, reduced body weight, thrombocytopenia, elevated total level of IgM, and a slightly positive specific IgG antibody titer. The mother had malaria during the puerperium, and febrile episodes 6-8 weeks before parturition. This is the first case of congenital malaria reported from Scandinavia.

Adult↗
PubMed1978

The changed epidemiology of hepatitis A infection in Scandinavia.

The prevalence of antibodies against hepatitis A virus (anti-HAV) was studied in a Swedish city population. A great difference was observed in different age groups. Anti-HAV was not found in the serum of young individuals while the prevalence was high in older ages (87% in individuals 60 years or older). This pattern of hepatitis A exposure is quite different from that reported for instance from the Mediterranean area and may indicate a very low frequency of hepatitis A exposure in Scandinavia today. The high prevalence of anti-HAV in older Swedes possibly reflects hepatitis A exposure in childhood during World War I and II when hepatitis A was more common.

Adolescent↗
PubMed1986

Law and psychiatry: Scandinavia in the 1980s.

The major policies and practices with regard to the civil and criminal commitment of the mentally ill in the Scandinavian countries during the 1970s and 1980s are described and discussed. Deinstitutionalization, community work, and outpatient treatment within geographically defined sectors have been introduced in all the Nordic countries. At the same time, criminally committed mental patients constitute an increasing proportion of the involuntarily hospitalized population. The special defense of insanity and tests such as McNaughtan are not used in the Scandinavian countries. The handling and disposition of severely mentally ill criminal defendants is closer to the notions of guilty but mentally ill in some U.S. jurisdictions, although in Scandinavia such persons are hospitalized and do not receive penal sentences. Even though forensic psychiatry has come under much criticism, there is still a need for psychiatric evaluations for courts and there is still a need for the provision of mental health treatment, rehabilitation, and follow-up for mentally disordered offenders.

Commitment of Persons with Psychiatric Disorders↗
PubMedDate not supplied

PVC in Scandinavia.

Poly(vinyl chloride) is a versatile material that is used to manufacture many vital single-use medical devices. Yet, concerns continue regarding its safe use and disposal. This article examines the risk-assessment investigations that have been conducted in Scandinavia and the related discussion. Future scrutiny will focus on modifying the material through the use of different additives.

Humans↗
PubMed1993

Governmental policy and personal experiences. The development towards integration of mobility disabled students into regular schools in Scandinavia.

The Scandinavian countries have been among the leading countries with regard to integration into society for persons with disabilities. This article focuses on two intimately related questions concerning the reform: 1) How did the normalization principle, as governmental policy, intend to improve the living-situation for people with disabilities? 2) How was the reform experienced by some disabled persons who attended compulsory school during its introduction? Our sources are: a) central government documents and reports concerning integration of mobility disabled persons in Norway and Sweden; b) 40 life history interviews with mobility disabled persons in Scandinavia born between 1955 and 1965. The interviews are theme centered upon experiences in education and work.

Adolescent↗
PubMed2001

Structuring rectal cancer treatment in Scandinavia.

By focusing on surgical technique through special training courses, a significant improvement in outcome after surgery for rectal cancer is evident based on the Scandinavian experience. Overall results have improved because of systematic quality assurance of surgery by way of a national rectal cancer registry. Moreover, in Scandinavia, rectal cancer surgery has been taken out of the general surgeon's armamentarium and is performed only by surgeons who specialize in gastrointestinal (Denmark and Norway) or colorectal (Sweden) surgery.

Humans↗
PubMed2005

Comparative health impact assessment of local and regional particulate air pollutants in Scandinavia.

The ongoing program Clean Air for Europe (CAFE) is an initiative from the EU Commission to establish a coordinated effort to reach better air quality in the EU. The focus is on particulate matter as it has been shown to have large impact on human health. CAFE requested that WHO make a review of the latest findings on air pollutants and health to facilitate assessments of the different air pollutants and their health effects. The WHO review project on health aspects of air pollution in Europe confirmed that exposure to particulate matter (PM), despite the lower levels we face today, still poses a significant risk to human health. Using the recommended uniform risk coefficients for health impact assessment of PM, regardless of sources, premature mortality related to long-range transported anthropogenic particles has been estimated to be about 3500 deaths per year for the Swedish population, corresponding to a reduction in life expectancy of up to about seven months. The influence of local sources is more difficult to estimate due to large uncertainties when linking available risk coefficients to exposure data, but the estimates indicate about 1800 deaths brought forward each year with a life expectancy reduction of about 2-3 months. However, some sectors of the population are exposed to quite high locally induced concentrations and are likely to suffer excessive reductions in life expectancy. Since the literature increasingly supports assumptions that combustion related particles are associated with higher relative risks, further studies may shift the focus for abatement strategies. CAFE sets out to establish a general cost effective abatement strategy for atmospheric particles. Our results, based on studies of background exposure, show that long-range transported sulfate rich particles dominate the health effects of PM in Sweden. The same results would be found for the whole of Scandinavia and many countries influenced by transboundary air pollution. However, several health studies, including epidemiological studies with a finer spatial resolution, indicate that engine exhaust particles are more damaging to health than other particles. These contradictory findings must be understood and source specific risk estimates have to be established by expert bodies, otherwise it will not be possible to find the most cost effective abatement strategy for Europe. We are not happy with today's situation where every strategy to reduce PM concentrations is estimated to have the same impact per unit change in the mass concentration. Obviously there is a striking need to introduce more specific exposure variables and a higher geographical resolution in epidemiology as well as in health impact assessments.

Air Pollutants↗
PubMed2002

The Bioethics Convention of the Council of Europe and organ sharing for transplant recipients in Scandinavia.

Even though organ transplantation is often life saving, the lack of donor organs is limiting the number of transplantation procedures. In small countries, like the Scandinavian countries, the small population level highlights this problem of organ availability which is further complicated by the fact that the utilisation of available organs may be prevented by histoincompatibility between the host and donor. This problem can only be solved by sharing both medical information and organs across countries. In Scandinavia, an organ sharing program (Scandiatransplant) was initiated between Denmark, Finland, Iceland, Norway and Sweden in the late 1960's long before the establishment of European Economic Area and the expansion of the European Union in Northern Europe. Even though trade in human organs is prohibited by international conventions, medical procedures and services that are associated with transplant activities are such services whose "free movement" within the Union is guaranteed by the Convention of Rome. These services can thus be offered across the national borders for remuneration. The potential impact of the conventions of the Council of Europe on transplantation services and organ sharing programs within European Union will be discussed.

Bioethics↗
PubMedDate not supplied

Parathyroid surgery in Scandinavia.

A review of the organization and practice of parathyroid surgery in Scandinavia indicated that it was undertaken in about half of the surgical clinics. About half of these clinics treated only primary hyperparathyroidism (HPT), and in the great majority all parathyroid operations were done by one or two surgeons. The results of surgical treatment were compared in two large Scandinavian series of primary HPT, one based on a general survey of parathyroid surgery in 1975, and the other on results obtained during 1971-1980 in centres specializing in endocrine surgery (Bergen, Stockholm, Uppsala). In the latter series 90% of the patients were normocalcaemic at follow-up averaging 4.4 years after parathyroid surgery whereas in the general survey the rate of normocalcaemia was 76%. At hospitals performing less than ten parathyroid operations per year it was only 70% and there was high incidence of persistent HPT (15%) and presumed permanent hypoparathyroidism (14%). The findings strongly advocate special training and interest in parathyroid surgery in order to ensure success.

Adenoma↗
PubMed1984

Effect of cervical cancer screening in Scandinavia.

Mass screening programs for cancer of the cervix were introduced at different times and to different extents in the Scandinavian countries. Iceland and Finland introduced nationwide screening programs in the early 1960s. Ten years after their introduction, marked reductions in incidence and mortality of invasive cervical cancer were observed, seen specifically in the age groups to which screening was targeted. In Sweden and Denmark, mass screening was introduced on a county basis, and changes in incidence and death rates from cervical cancer were recorded which reflected the degree to which organized mass screening had been introduced. These data demonstrate that mass screening scheduled every two to five years can reduce the incidence of invasive cervical cancer by 80%. No evidence is available from Scandinavia that more frequent screening reduces the risk further.

Adult↗
PubMed1980

Studies on the pathogenicity of Yersinia enterocolitica and Y. enterocolitica-like bacteria. 2. Interaction with HeLa cells among environmental and human isolates from Scandinavia.

A total of 412 strains of Yersinia enterocolitica and Y. enterocolitica-like bacteria were examined for their ability to interact with HeLa cell monolayers. Of 331 isolates from environmental sources in Scandinavia, only three strains biochemically classified as Y. pseudotuberculosis were invasive for HeLa cells. Invasiveness was also indicated for one strain (O-serogroup 2) from a disease goat. Another eight strains adhered firmly to the cell surface in great numbers. All of 22 strains belonging to O-serogroup 3 from human patients with gastroenteritis were invasive. Seven strains of O-serogroup 3 from small rodents and water were non-invasive. Among 33 reference strains representing Y. enterocolitica O-serogroup 1-34, invasiveness was indicated for strains with known pathogenicity (O-serogroup 1, 2, 3, 5-27, 8, 9). However, some strains belonging to O-serogroups with uncertain clinical significance were also invasive for HeLa cells. A close correlation between invasiveness and enterotoxin production was demonstrated for the 22 human clinical isolates belonging to O-serogroup 3.

Animals↗
PubMed1996

[Incidence of multiple sclerosis in Scandinavia and Finland].

Review of studies of incidence of multiple sclerosis (MS) over several decades in seven geographical areas scattered over Scandinavia and Finland have shown that incidence rates fluctuate significantly with time in most of the areas, but in an inconsistent pattern. The incidence appeared to be the lowest in the northernmost parts of Norway showing that the well-known north-south gradient for risk of MS does not hold true for high latitudes. The time-space variation in incidence rates supports the view that local non-persistent environmental factors may play a role in the aetiology of the disease.

Denmark↗
PubMed1996

Maternal employment in Scandinavia: a comparison of the after-birth employment activity of Norwegian and Swedish women.

"A striking characteristic of recent Western labour market trends is the rise in employment among mothers of very young children. So far, few studies have analysed the impact of public policies on employment rates of young mothers. In this study we address this issue by comparing two similar countries, Norway and Sweden, which have the same set of policies with slight variations, using data sets with similar designs. We analyse rates of re-entry into paid work after first birth for mothers in 1968-88 by means of hazard regression. One important finding is that the right to paid maternity leave with job security greatly speeds up the return to work."

Developed Countries↗