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A Isacsson

Publications and source records attributed to A Isacsson.

44 records · Page 3Linked to original sources

Patient-number-based computerized medical records in Crete. A tool for planning and assessment of primary health care.

Primary Health Care (PHC) in Crete is in a state of rapid development. The strategy for introducing PHC involves an orientation towards the population and the creation of possibilities for evaluation. A case records system, "Egino", was installed in the University of Heraklion and at the Health Centre in Spili in 1988, and was further developed according to local needs during 1989, when also a Greek version of the statistical system, "DoIt", was installed. The main reasons for establishing a computerized medical information system were (i) to assess the health needs in Crete, (ii) to monitor activities of the primary health care organizations, and (iii) to introduce epidemiological research into primary health care in Greece. The information system was based on specially assigned patient numbers containing several pieces of information about the individual; the system was developed at the Dalby Health Sciences Centre in Sweden. Each month, data were extracted in Spili Health Centre, and these data were regularly used to present incidence and prevalence indices. Some of the data extracted were reported to the health authorities in Greece. "EginO" and "DoIt" gave possibilities to evaluate health services by following the morbidity, while also making it possible to describe and analyse health needs in the population of Spili and other primary health care catchment areas in Greece.

Adolescent↗

Risk factors for ischaemic heart disease in a Greek population. A cross-sectional study of men and women living in the village of Spili in Crete.

We have established a research project in primary health care in Crete with the aim of surveying the cardiovascular risk profile of a defined 'low-risk' population. The study population comprised all men and women aged 15-79 years in the village of Spili (n = 445); the overall attendance rate was 77% (greater than or equal to 82% in those aged 45 years and above). In this cross-sectional study we found a high (44%) prevalence of smoking in men aged 45-64 years as well as a high alcohol intake (48% drank greater than or equal to 210 g of pure alcohol every week). Furthermore, there was a high cholesterol level (6.2 mmol.l-1), and a high prevalence of hypertension and diabetes. Against this background it is somewhat surprising that we did not find any signs of post-myocardial infarction in Spili men aged 63 and under. It is possible that positive factors, i.e. the closely knit social networks, the low unemployment rate, the hard water, and some of the dietary habits, e.g. the high consumption of olive oil, may counter-balance the negative factors mentioned above. It is also possible that the low risk factors in the past explain the low incidence of myocardial infarction today, and that this will change in the years to come.

Adolescent↗

Characteristics of the 'metabolic syndrome X' in a cardiovascular low risk population in Crete.

We have studied hypertension, obesity, diabetes and hypercholesterolaemia in those aged 45-79 years in the Cretan low risk population of Spili (n = 249; attendance 82%) to see if these conditions interacted in the same way as previously described for high risk populations. Hypertension, diabetes, obesity, and hypercholesterolaemia were found to be at least as prevalent in Spili as in Sweden. Furthermore, the previously described 'Metabolic Syndrome X', with insulin resistance and hyperinsulinaemia as a common denominator also seemed to exist in the Spili population where patients with these conditions had higher insulin and C-peptide levels than normals. Our finding should be viewed against the low prevalence of past myocardial infarction in Cretan men from Spili reported by us and confirming the results of the Seven Countries Study.

Aged↗

The epidemiology of sick leave in an urban population in Malmö, Sweden.

The epidemiology of sick leave was studied in the city of Malmö, Sweden, (230,000 inhabitants). Every current and completed sick-leave episode during the year of 1985 was collected for 124,411 persons aged 16 to 65, who were registered with the National Health insurance scheme in 1985. Absence rate, absence incidence, absence prevalence and absence duration were analyzed in relation to age, sex, marital status, nationality, income and place of residence. Absence rate (mean value) in the total population was 25.5 days with a median of three days. The absence rate increased by age. High absence rates were seen for females, single people and some immigrant groups. This was even true for residential areas characterized by a higher proportion of single-person households and households on social welfare, of unemployed and people with a low income and a foreign background. The absence rate gives limited information as to the epidemiology of sick leave. Through adding absence incidence, absence prevalence and absence duration it was possible to get a more comprehensive picture of the phenomenon. Sex-differences in absence rate for instance were mainly explained by differences in absence incidence and prevalence, while differences in absence rate regarding nationality were explained by differences in absence duration. This is an important step towards a better understanding of the factors behind sick leave.

Absenteeism↗

Organization of health care teams and the population's contacts with primary care.

The aim of the study to examine a six-year development of the panorama of contacts and diagnoses at Södra Sandby Health Centre, where care teams had been introduced, and then to compare this development with that of the rest of the Dalby primary care district, where there were no care teams. In Södra Sandby the number of contacts with general practitioners (GPs) increased between 1984 and 1989 by 8% more than expected from the increase in staff, while the number of contacts with district care (district nurses and assistant nurse) increased by 62% more than expected. The corresponding figures for Dalby were 1% and 34%, respectively. The total proportion of the population visiting GPs in Södra Sandby during 1989 was 54%, and in Dalby 58%. The corresponding figure for district care in Södra Sandby was 40%. The proportion of contacts for which no appointment was made in advance decreased in Södra Sandby from 45% in 1984 to 22% in 1989. The corresponding figures for Dalby were 61% and 64%. This study did not find any verification for the fear that the organization of care teams would lead to a reduction in the number of contacts, e.g. on account of the frequency of meetings and conferences. The nurses seemed to retain their independent role, with the population contacting them in their surgeries or the nurses visiting them at home.

Community Health Centers↗

Use of primary health care in Spili, Crete, and in Dalby, Sweden.

A computerized medical record system was introduced in Greek primary health care (PHC) in the village of Spili in Crete. The present study was carried out to study similarities and differences in the pattern of PHC use in Dalby Health Centre, Sweden (DHC), and Spili Health Centre, Greece (SHC). In both Dalby and Spili more than half the population contacted their respective health centre during 1989. Patients contacted DHC more often than SHC, 3.33 vs 2.30 times. Relatively more females than males used the health services in Dalby (64% vs 50%) but not in Spili (57% vs 55%). More visits were made by appointment at DHC than SHC (36.0% vs 12.6%). There were great similarities in the two areas in the ten most common diagnoses, analysed in four age-groups. In both areas, acute upper respiratory infections dominated in the youngest age-groups, and hypertension and diabetes in those aged 45 years and above.

Adolescent↗

Hand function in workers with hand-arm vibration syndrome.

Hand-arm vibration syndrome has been specially addressed in the Scandinavian countries in recent years, but the syndrome is still not sufficiently recognized in many countries. The object of this preliminary study was to describe the nature and character of vibration-induced impairment in the hands of exposed workers. Twenty symptomatic male workers (aged 28 to 65 years) subjected to vibration by hand-held tools were interviewed about subjective symptoms and activities of daily living and were assessed with a battery of objective tests for sensibility, dexterity, grip function, and grip strength. The test results were compared with normative data. The majority of patients complained of cold intolerance, numbness, pain, sensory impairment, and difficulties in handling manual tools and in handwriting. The various objective tests showed considerable variation in indications of pathologic outcome, revealing differences in sensitivity to detect impaired hand function. Semmes-Weinstein monofilament testing for perception of light touch-deep pressure sensation, the small-object shape identification test, and moving two-point discrimination testing for functional sensibility provided the most indications of pathologic outcomes. The authors conclude that vibration-exposed patients present considerable impairment in hand function.

Activities of Daily Living↗