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Incidence, age distribution and complications of gonorrhoea in Sweden.

The incidence of gonorrhoea in Sweden has shown a tendency to increase in recent years, particularly in the age-groups 15-19 and 20-24 years. However, an extrapolation of the annual incidence curve to 1970 for the 15-19-year age-group suggests that some deceleration in that increase may be expected.Study of gonococcal complications seen at Göteborg hospitals during the period 1950-59 indicates that the frequency of gonococcal salpingitis is higher than had previously been reported; this is attributed to the inclusion in the material studied of patients from departments other than those exclusively concerned with the venereal diseases.The authors conclude that, in view of the high frequency of gonorrhoea in the young and of gonococcal complications, gonorrhoea in Sweden cannot be considered an unimportant public health problem.

Adult↗

The changing age-structure in Sweden and its impact on mental illness.

In Sweden, as in other developed countries, the increased expectation of life has led to a growing preponderance of the older age-groups. The need for a thorough study of the effect of this new situation on the general health level of the population is evident, but material for such a study is still largely lacking. The article below discusses the difficulties of investigating the situation in the field of mental illness, and describes an enquiry into the senile psychoses in Stockholm. No sign was discerned of a trend towards an increasing morbidity-risk for senile psychosis in the different age-groups, the increasing number of admissions to hospitals being due to other, mainly social and economic, causes. This finding is of interest in the light of the cautious conclusion reached in Sweden that the increased economic burden created by the growing number of old persons can largely be offset by an increase in the relative number of able-bodied persons in the higher age-groups.

Aged↗

[Geographical inequalities in the distribution of general practitioners in Sweden].

AIM: To estimate trends in the inequalities in the distribution of general practitioners in Sweden during the past fifteen years. METHODS: Relative inequality indicators. We plotted the Lorenz curves and calculated the Gini coefficients for the entire country during 1986, 1991, 1996 and 2001. RESULTS: During the past 15 years in all a declining trend was noted in the inequalities in the geographical distribution of general practitioners in Sweden, with the lowest level in 1996. CONCLUSIONS: The degree of inequality in the geographical distribution of general practitioners appeared rather stable during the period, although with some increase in the final year studied. Since equality is part of quality, policy makers in all levels--national, regional and local--should pay attention as to how human resources are distributed.

Family Practice↗

Comparing youth health in Sweden and Bosnia.

The Adolescence Medical Group in Sweden has performed a questionnaire every second year since 1990. The questionnaire is performed during school hours in seventh and ninth grade and also in the second grade in the upper secondary school (gymnasium). The questionnaire is completed anonymously. The schools are not chosen by statistical methods, but more depending on youth-health-iterested school doctors and nurses who have interest in these studies. The result of these studies has been used locally in each community, but also been reported for example i Acta Pediatrica. After the war in Bosnia there has been different projects to help to build up the countries health system, for example in psychiatry. The question was laso raised how the youth health was in Bosnia. Representatives from the Adolescence section in Sweden were invited to Bosnia to introduce the questionnaire and also to help in analysing the results. We were also in Bosnia to present results to local authorities and those who performed the study locally.

Adolescent↗

Image quality of digital and film radiographs in applications sent to the Dental Insurance Office in Sweden for treatment approval.

In July 2002, a new dental insurance program was introduced in Sweden. For all patients over 65 years, prior approval for all prosthetic work would need to be obtained from the Dental Insurance Office. From October to December 2002, 540 cases were randomly selected for evaluation from the 14,624 applications that had been sent from throughout Sweden to the Dental Insurance Office in Lund. Our aims were to appraise the quality of the radiographic examinations and to compare the quality of the digital with the film (X-ray film) radiographs. The radiographic examinations were evaluated as a whole in relation to the proposed treatment and in detail using specific criteria such as density, contrast, unsharpness, angulation, and receptor position error. The quality variables were evaluated as acceptable or unacceptable. A total of 4,687 intra-oral and 206 panoramic radiographs were evaluated. Thirteen per cent of the intra-oral radiographs and 9% of the panoramic radiographs were taken with a digital technique. Most of the digital radiographs--7o% of the intra-oral and 61% of the panoramic radiographs--were submitted on microdisk. Twenty-eight per cent of the intra-oral digital radiographs, however, were submitted on paper. The radiographic quality in 15o cases (28%) were found to be unacceptable for assessment of the proposed treatment. The most common error--both in digital and X-ray film radiographs--was in receptor position. Significantly more errors were found in the intraoral digital radiographs compared to the radiographs taken with X-ray film. Most of the errors in the digital radiographs were detected in the paper copies. In conclusion, it is possible to improve the radiographic quality in applications for treatment approval, and the dentists had more difficulties with the digital technique than with X-ray film.

Aged↗

[Increasing incidence of ciprofloxacin resistant gonorrhea in Sweden. Choose a correct antibiotic and follow up the treatment!].

The incidence of gonorrhoea has increased in Sweden and is now three times higher than in the middle of the 1990's. A remarkable increase of ciprofloxacin resistant gonorrhoea has been reported in Stockholm and other parts of Sweden during 2003. Among men attending a clinic for homosexual men in Stockholm the ciprofloxacin resistant cases have increased from a low level to over 50% during the last year. Most of the homosexual men are exposed in Stockholm and one serotype is dominant. Also in the county of Gävleborg there has been an outbreak of ciprofloxacin resistant gonorrhoea among young heterosexual men and women. No resistance to cefixime, ceftriaxone and spectinomycin has been noted and these antibiotics are then a better first choice of treatment in a Swedish context.

Anti-Infective Agents↗

Experiences against HIV/AIDS/STDS of Somalis in exile in Gothenburg, Sweden.

Since 1989, the City of Göteborg Immigrant Services Administration has been making efforts to inform about HIV/AIDS. The purpose has been to ensure that even immigrant residents of the City of Göteborg (Gothenburg) have access to relevant information about HIV/AIDS. The administration's efforts have been a part of the collected efforts of Gothenburg to prevent the spreading of HIV. This paper attempts to discover and describe experiences against HIV/AIDS/STDs of Somalis in Exile in Gothenburg, Sweden. A qualitative sociological in-depth interviews with 13 individuals (6 women and 7 men) and with semi-structured and themetized emerging design was carried on. A follow up focus group interviews with 10 individuals (2 women and 8 men) was also performed. The paper reveals that the general understanding of subjects on the issues under discussion is almost the same though details may vary from one research participant to the other. They have described this through narratives. STDs and specially HIV/AIDS was perceived as something dishonourable by the subjects. The HIV/AIDS is perceived as a sin which Allah sends to punish those who have fornication or sex without marriage (Zinna). Of course, this tendency of shying off the problem leads to ignorance of how to behave, which in turn decreases the risk of perceptions and as a result may also increase the risk of being infected. As concerns protection as a preventive measure, attitudes vary. The traditionalists have argued that condom increased the possibility of promiscuity or fonication, while young and more modern people saw condom as something good. We may conclude that Somalis who have arrived in Western world and in Sweden as adults did never have a modern sexual education for themselves due to socio-cultural reasons and this has important implication for giving proper information to their children about sex organs, human sexual development and preventive measures against HIV/AIDS/STDs. These immigrant parents should be offered culturally sensitive communication and educational programmes aimed at raising their awareness about teenagers sexuality and the preventive measures against HIV/AIDS/STDs.

Acquired Immunodeficiency Syndrome↗

Low socio-economic status is a risk factor for respiratory symptoms: a comparison between Finland, Sweden and Estonia.

OBJECTIVE: To assess the relation of socio-economic status to respiratory symptoms common in asthma and chronic bronchitis, and to compare risk factors for these symptoms between three neighbouring countries. DESIGN: A postal survey was performed in 1996 as a part of comparative studies in Finland, Sweden and Estonia (the FinEsS studies). A random sample of 58,661 subjects aged 20-64 years were invited, of whom 44,483 participated. RESULTS: Respiratory symptoms were most prevalent among manual workers, who were at significantly increased risk for chronic respiratory symptoms. The same pattern of increased risk appeared when the analyses were made among non-smokers only: for recurrent wheeze, manual workers in industry yielded an OR of 1.91 (95%CI 1.62-2.24) and in the service sector an OR of 1.50 (95%CI 1.27-1.78). The corresponding figures for chronic productive cough were 1.45 (95%CI 1.22-1.71) and 1.20 (95%CI 1.02-1.42), respectively. Risk factor profiles for respiratory symptoms were similar in Finland, Sweden and Estonia, except for gender differences in Estonia. CONCLUSIONS: Belonging to the socio-economic group of manual workers correlated with an increased risk for chronic respiratory symptoms, independently of smoking habits, in each country. Women manual workers in industry suffered most from respiratory symptoms.

Adult↗

Temperament and character in cross-cultural comparisons between Swedish and Iranian people and Iranian refugees in Sweden--personality in transition?

The aim of the study was a cross-cultural comparison of personality traits between individuals from two very different cultures and refugees who resettled several years before from one to the other. Four hundred forty four Swedish individuals of the normal population; and 100 Iranian refugees in Sweden, and a group of 335 individuals from Tehran, capital of Iran, were investigated by means of the Temperament and Character Inventory, a questionnaire to assess temperament and character Iranians are those that are most frequently correctly classified followed by the Swedish based on temperament scores by means of a Discriminance analyses. Iranian refugees in Sweden were classified to about 50 per cent as Swedish and to slightly more then one-third as Iranians. Especially concerning character, 4 per cent only could be correctly classified as refugees. The results give some perspective on the adaptation process and personality changes in refugees several years after resettlement in another country with a complete different culture.

Adaptation, Psychological↗

[Nepropathia epidemica on the increase and spreading south in Sweden].

2.086 cases of laboratory-confirmed NE were reported in Sweden during the 7-year period 1997-2003. The average age of the patients was 49,3 years and 62 per cent were men. Most cases were reported during the winter. The yearly incidence rates ranged from 1.6 cases per 100.000 in 2000 to 6.3 cases per 100.000 in 1998 varying with a 3 year cyclicity. The majority of cases were reported from the northern most counties of Sweden. The highest incidence rate was found in the county of Västerbotten (70 cases per 100.000 in 1998). However the number of cases further south seem to increase. The total number of reported cases has also increased. Comparison with previous 7-year period (1990-1996) gives an increase of 86 per cent. Handling fire-wood and hay are risk activities as well as cleaning and dusting in summerhouses.

Adolescent↗

[Contact tracing a year back is worthwhile. Follow the Vasterbottens example to prevent Chlamydia transmission in Sweden!].

UNLABELLED: Contact tracing is proved to be a good way to prevent asymptomatic sexually transmitted infections, such as Chlamydia trachomatis, from spreading. According to the Swedish law a physician has to report all cases of genital C. trachomatis to the County Medical Officer of Health and to the National institute for Infectious Disease Control and perform contact tracing. An evaluation of the sexual history 6 months back in time is recommended and standard in most of the country. The county of Västerbotten has one of the lowest incidenses of C. trachomatis in Sweden though the population is younger than the Swedish average. During year 2002 the contact tracing in Västerbotten was evaluated by sending a questionnaire to everyone who reported a case of genital C. trachomatis. We recived 534 (98%) out of 544 questionnaires. The patients reported 1360 partners, 2.5 on average, 1129 were identified. 761 had a known test result and 497 of them were positive, 0.9 on average. 72% of the contact tracers evaluated the sexual history > or = 12 months back in time. 78% of the contact tracings were performed by four social workers. Their patients reported 2.5 partners on average and 80% evaluated > or = 12 months back in time. 14 persons did only one contact tracing, 1.3 partners/index on average, 40% evaluated > or = 12 months back in time. 82% of the partners had sex with the infected patient 0-6 months before the patients was diagnosed with C. trachomatis, 75% out of those with a known test result were infected, 16% had sex 7-12 months before diagnosis, 30% infected. (The C. trachomatis prevalence in Sweden is estimated to be 2.7-4.9% among young women.) CONCLUSION: A few experienced persons tracing for at least 12 month back in time is probably two important reasons why Västerbotten has such a small C. trachomatis incidence.

Adolescent↗

[Morbidity and social class in Finland, Sweden and Norway].

Investigations of living standards in Norway, Sweden and Finland in 1986-1987 yielded new comparative data on public health and disease as related to social class. Long-term troublesome illness was less common in Sweden than in Finland and Norway. In all three countries the jobless category and skilled working women accounted for the highest morbidity. Among men, morbidity was greatest for agricultural workers in Finland and Norway, and lowest for Swedes of social class 1--i.e., highly placed and highly educated white collar workers.

Adult↗

[GHB, GBL and butanediol poisonings--a serious problem in Western Sweden].

Acute poisoning with GHB (Gamma-hydroxybutyrate, Gamma-hydroxybutyric acid) has been an increasing medical and social problem during the last decade in Sweden, especially on the west coast. The number of poisonings decreased in the beginning of this millennium but has again increased during the last years. At the same time the number of seizures by the police has increased similarly as well as the number of drug-related deaths. During 2004 the number of GHB-abuse related deaths in western Sweden was seven, approximately the same figures as for heroin. Two other substances which are transformed to GHB in the human body, GBL (gamma-butyrolactone) and 1,4-butanediol, have during the last years presented themselves among the same users as for GHB. Since GBL and butanediol are not classified as illicit drugs the possibilities for the police force to intervene and capture the drugs are severely restricted. Intoxication by GBL and butanediol has shown to be as dangerous as intoxication by GHB. Acute intoxications and abuse of these drugs is still a serious medical and social problem. A legal classification of GBL and butanediol as narcotics appears to be medically motivated.

4-Butyrolactone↗

Occurrence of Helicobacter species other than H. hepaticus in laboratory mice and rats in Sweden.

The aim of this study was to determine which Helicobacter species other than H. hepaticus colonize laboratory mice and rats in Sweden. We analyzed 63 intestinal samples from mice and 42 intestinal samples from rats by partial 16S rDNA sequence analysis. Previously these samples had been found positive for Helicobacter species but negative for H. hepaticus in a polymerase chain reaction screening assay at the National Veterinary Institute in Sweden. H. ganmani, H. typhlonius, H. rodentium, an uncharacterized Helicobacter species ('hamster B'), and a possibly novel species were detected in mice. The possibly novel species was most closely related to H. apodemus strain YMRC 000216 (98.3% sequence similarity). Two different Helicobacter species were detected in rats: H. ganmani and H. rodentium. H. ganmani colonization of rats has not previously been reported.

Animals↗

SmiNet-2: Description of an internet-based surveillance system for communicable diseases in Sweden.

Electronic systems for communicable diseases surveillance enhance quality by simplifying reporting, improving completeness, and increasing timeliness. In this article we outline the ideas and technologies behind SmiNet-2, a new comprehensive regional/national system for communicable disease surveillance in Sweden. The system allows for reporting from physicians (web form) and laboratories (direct from lab data system) over the internet. Using a unique personal identification number, SmiNet-2 automatically merges clinical and laboratory notifications to case records. Privileged users, at national and county level, work against a common central server containing all notifications and case records. In addition, SmiNet-2 has separate county servers with tools for outbreak investigations, contact tracing and case management. SmiNet-2 was first used in September 2004. Individual counties receive up to 90% of all notifications electronically. In its first year, SmiNet-2 received 54 980 clinical notifications and 32,765 laboratory notifications, which generated 58,891 case records. Since most clinicians in Sweden have easy access to the internet, a general web-based reporting has been feasible, and it is anticipated that within a few years all reporting to SmiNet-2 will be over the internet. In this context, some of the major advantages of SmiNet-2 when compared with other systems are timeliness in the dataflow (up to national level), the full integration of clinical and laboratory notifications, and the capability to handle more than 50 diseases with tailor-made notification forms within one single system.

Communicable Diseases↗

[Reports on eye diseases and their care in Sweden in the 18th century].

The paper presents the physicians, active in the 1800 century in Sweden, who have reported in the annual proceedings of the Royal Swedish Academy of Sciences, dealing with diseases and care of the eye. These articles, earlier described in a paper by the author, show a wide panorama in this field, discussing cataract surgery as well as surgery of other parts of the eye, injuries and diseases and ways of treatment. Most physicians have gone through their basic medical education in Sweden, completed with often many years studying abroad at well-known universities or hospital clinics. Some of them, particulary Acrel and Odhelius, specialized in eye surgery.

Congresses as Topic↗

Good work for dentists--ideal and reality for female unpromoted general practice dentists in a region of Sweden.

Female unpromoted general practice dentists (GPDs) in the Public Dental Health Service (PDHS) constitute about one fourth of all working dentists in Sweden. Unpromoted means that the position is without managerial functions. According to many reports, they have a problematic psychosocial work situation. THIS THESIS AIMED TO: Describe the perceived health for these GPDs, in comparison with others with a similar work situation. Analyse their sense of support in comparison with others. Describe how they perceived "good work", i.e. both the healthy and socially responsible work, and whether there was a difference between their ideal and their reality. Analyse patterns in two aspects - the moral and the career aspects - of "good work" for dentists. In zooo, questionnaires were sent to all female unpromoted GPDs in the PDHS in a region of Sweden. The response rate was 94%. RESULTS: The dentists felt unwell, worse than other compared groups. There was little support from the management. There was little inter-colleague contact. There was no cross-sectional assciation between collegial neworks and support, but the qualitative investigation showed that collegial networks were perceived as positive. There was a great difference between ideal and reality concerning good work. The dentists felt a lack of influence, and this was the greatest difference of all. Three components of good work - "moral values and skill discretion", "career development" and "work environment" were found. The dentists emphasized the moral basis of their work, confirming the character of dentistry as primarily human service work. IN CONCLUSION: There were serious work environmental problems among these dentists. The dentists felt unwell and felt a great lack of influence on important decisions. There was little inter-colleague contact, but collegial networks were perceived as positive. There was little support from the management, indicating a clear weakness in the relations between employers and female unpromoted GPDs in the PDHS. Three components of good work were found, where the moral component was the most important but it also showed the greatest difference between ideal and reality. Thus, the dentists emphasized the moral basis of their work, confirming the character of dentistry as primarily human service work and not industrial work. The dentists with the highest level of commitment perceived the largest differences. The PDHS organization has therefore failed to convince or engage those whom it ought to engage, i.e. those with the greatest commitment. The way to improve the female unpromoted GPDs' work situation would be through increased influence and support, bridging the gap between ideal and reality.

Adult↗

Mentally disordered offenders in Sweden.

This article reviews the laws in Sweden concerning mentally disordered offenders. It also contains some figures on the relationship between mentally disordered offenders and other offenders sentenced to prison. The rules in Sweden are very different from other countries in that the responsibility concept has been abolished and thus there is no acquittal on a psychiatric basis.

Commitment of Persons with Psychiatric Disorders↗