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Biomedical subjects

B Smedby

Publications and source records attributed to B Smedby.

At least 19 recordsLinked to original sources
PubMed1992

The European Community 'avoidable death indicators' in Sweden 1974-1985.

Avoidable mortality in Sweden 1974-1985 was analysed using a European Community (EC) Working Group list of 'avoidable death indicators." The list includes causes of death that in certain age groups were defined as indicators of the outcome of medical care intervention or for some conditions, indicators of the national health policies. About 10 out of 14 medical health care indicators occurred in less than 50 cases per year. Death rates decreased over the 12-year period studied for most avoidable death indicators. For women, however, the death rate for malignant neoplasms of the trachea, bronchus and lung increased significantly. Swedish total mortality for ages 5-64 years was lower than the EC standards 1974-1978 and 1980-1984. Most of the avoidable causes of death had a relatively low standard mortality rate (SMR) when compared to both the EC standard and to the Swedish SMR for total mortality. For asthma, however, the Swedish SMR was higher. The development and implementation of the avoidable death concept and methodology is discussed.

Adolescent↗
PubMed1992

Epidemiology and moral philosophy.

To an increasing extent ethical controversies affect and sometimes obstruct public health work and epidemiological research. In order to improve communication between the concerned parties a model for identification and analysis of ethical conflicts in individual-based research has been worked out in co-operation between epidemiologists and moral philosophers. The model has two dimensions. One dimension specifies relevant ethical principles (as beneficence, non-maleficence, autonomy and justice). The other dimension specifies the groups of persons involved in the conflict under consideration (for example: the study-population, individuals who may benefit from the results, the researchers and their personnel, the community at large). The model has been applied to the problem of legitimacy of case-register research and to problems in psychiatric health services research as well as epidemiological research.

Autopsy↗
PubMed1991

Longitudinal studies on environmental factors and disease. A model for analysis of ethical conflicts.

The use of individual-based data in research has recently come in for much discussion. The basic issue of the discussion is how to balance between different legitimate interests: the interest in improving knowledge on matters important to human health and the interest in respecting individual autonomy. In this paper we will use a model for description and analysis of ethical conflicts in individual-based research. The model consists of two dimensions: the first specifies the persons involved in the conflict, the second specifies the relevant ethical principles. We have chosen the case of the Rönnskär study as an example. For illustration we distinguish between: no study, a study without informed consent and a study with informed consent. In the Rönnskär study the decision between the three situations rests upon an assessment of the conflict between two obligations: to improve the working environment and to respect autonomy.

Conflict, Psychological↗
PubMed1989

Life table methods applied to use of medical care and of prescription drugs in early childhood.

Life table methods were applied to analyses of longitudinal data on the use of medical care during the first 5 years of life among all 1701 children born in a Swedish semirural municipality. Cumulative proportions of the children who had used particular types of medical care or prescription drugs at least once by certain ages were estimated. By the fifth birthday, 98% had made at least one visit to any physician and 82% at least one visit to a paediatrician. By the fifth birthday at least one prescription for antibiotics had been purchased at a pharmacy by 82%; and 33% had been admitted to inpatient hospital care at least once (excluding immediate postnatal care). Acute conditions and more chronic diseases were also studied using these methods. At least one visit to a physician at a primary health care centre had been made for acute otitis media in 65% of 5 year olds and for atopic dermatitis in 8%.

Child Health Services↗
PubMed1988

Psychotropic drug use in a Swedish community--patterns of individual use during 2 years.

Psychotropic drug use in a Swedish community with a general population of about 20,000 was studied using data from a research registry on prescriptions. Patterns of individual psychotropic drug use during 2 years, 1980 and 1981, were analyzed. Use during the second year was studied in relation to use during the first year, and individuals with continued and new use were identified. About two thirds of those who obtained psychotropics during the first year continued using such drugs during the following year. Among those with no use during the first year, 6% obtained psychotropic drugs during the second year. Both continued and new use increased with age. Psychotropic drug use was nearly twice as common among women as compared to men among new users, whereas practically no sex difference was observed in continued use among previous users of psychotropics. Despite the finding that male psychotropic drug users were almost as likely as females to continue using these drugs, the overall proportion of continuous users in the population remained considerably higher among women as compared to men. The results from this study suggest that the greater use of psychotropics among women can be explained by a greater extent of occasional use as well as continuous use among women as compared to men.

Adolescent↗
PubMed1988

Patterns of psychotropic drug use in a Swedish community.

In this study individual data on prescription drug purchases in the total population of a Swedish municipality have been analyzed in order to study changes in the use of psychotropic drugs (in this study mainly hypnotics, sedatives and minor tranquillizers) over time. The number of psychotropic prescriptions decreased by 27% during the twelve-year period 1972-1983. The proportion of psychotropic drug users in the total population decreased from 16 to 11%. This decrease in psychotropic drug use was not evenly distributed within the population. The proportion of users decreased from 10 to 4% in the age group 15-44 years and from 23 to 15% in the age group 45-64 years, while the higher proportion of users in the oldest age group, 65 years and older, only decreased from 33 to 28%. Psychotropic drug use was almost twice as common among females as compared to males throughout the study period. Psychotropic drug use among heavy users of prescription drugs in general--identified with the use of a sex- and age-specific definition--was also studied. The decrease in psychotropic drug use during the time period studied was much greater among non-heavy users as compared to heavy users.

Adolescent↗
PubMed1987

Mental health problems in primary health care as seen by doctors.

Mental health problems in primary health care are much more common than can be concluded by routine registration of diagnoses. This has been shown in a previous study by the authors in 1979. In order to test the consistency of these results (Study I) and the reliability of our method a replication was carried out in 1983 at the same health centre but with mainly other doctors (Study II). All visits to the health centre were studied during a period of four weeks. During the study period all doctors recorded mental health problems of importance for the visit in addition to the routine registration of diagnoses. The results of both studies showed a high degree of consistency. Mental health problems were observed in about 17% of the patients in both studies. Sex differences were similar: 20-21% of female patients and 14% of male patients had mental health problems. Psychiatric diagnoses were only registered in six per cent of patients in Study I and five per cent in Study II. Mental problems were especially common in connection with abdominal and chest disorders. The replication thus confirmed our previous findings that mental health problems are common in primary health care. Such problems should therefore be given more attention in the training of doctors in general practice.

Adult↗
PubMed1987

Physician visits and prescribed drugs among young children and their mothers.

The extent to which use of medical services by young children could be predicted by mothers' use of medical services and by certain family characteristics has been studied. The study population comprised 591 children two to four years of age in a Swedish rural municipality. Register data on physician visits and prescription drug purchases during 1979 constituted main sources of information. Statistically significant positive associations were found between number of physician visits made by the children and by their mothers and between number of prescription drug purchases made for the children and for the mothers. More physician visits and prescription drug purchases were made for the children of younger mothers than for those of older mothers. Six to eight per cent of the variation in the use of medical services by the young children was explained in multiple regression models including mainly mothers' use of medical care, mothers' age and children's age.

Adolescent↗
PubMed1979

Overprescribing iron tablets to elderly people in Sweden.

Iron should not be prescribed to middle-aged men or older women with anaemia unless the possibility that the iron deficiency is caused by a gastrointestinal tumour has been considered. Thus the prescribing of iron to elderly people was investigated by studying four different prescription statistics and by reviewing records. Over one in 10 women aged over 65 were prescribed iron tablets. Men and women in the oldest age groups were prescribed iron most frequently. The reasons for prescribing iron were examined at a rural health centre. Out of 327 records of patients who were prescribed iron during 1975, 157 were randomly selected and reviewed. Only 18 out of 48 (38%) patients aged 45-75 (men) and 55-75 (women) and 29 out of 109 (27%) aged over 75 years had probable or possible iron-deficiency anaemia as established from the records. Only nine (19%) of the younger patients had a plausible reason for the anaemia other than a bleeding tumour. Ten (9%) of the older patients were considered to be inoperable cases. Thus, according to the records, only 18 (17%) of the patients over 75 years and nine (19%) of those in the younger age group have been prescribed iron. About 70% of all the patients were considered not to have iron deficiency; 7% had had iron deficiency previously, and 20% probably had anaemia as a result of chronic disease; for 43% no real reason for the iron prescription could be found in the record. Thus it is concluded that iron is overprescribed in Sweden, particularly for elderly people. It should not be prescribed until the possibility of a bleeding gastrointestinal tumour has been excluded.

Aged↗
PubMed1979

Impact of changing age and parity distributions of mothers on perinatal mortality in Sweden, 1953-1975.

A study was made on how the shift in the age and parity distribution of mothers affected the perinatal mortality in Sweden between 1953-55 and 1973-75. During these years the overall perinatal mortality rate fell from 29 to 13 per 1 000 births. The authors used the specific perinatal mortality rates by the mother's age and infant's birth order in 1973-75 to calculate what the overall perinatal mortality rate would have been with the age and parity distributions of mothers in 1953-55 and 1963-65. They conclude that only 1.4 of the 16 per 1 000 decline in perinatal mortality could be attributed to the shift in the mother's age and parity distribution.

Adult↗
PubMed1979

A two-wave interview study of frequency of dental visits and dental complaints.

A panel of 268 persons were interviewed twice at an interval of 2 years concerning their visits to dentists and their dental status. The answers they gave on the two occasions agreed well, except for the year of the last visit if it had taken place long ago. This was true both for the people who had gone to the dentist between the interviews and for those who had not. The panel was also asked whether they had any dental complaints. Sixteen percent of them reported complaints at one or both interviews. Complaints were more common among persons who did not often go to the dentist. The persons with complaints did not always get rid of them by going to a dentist. It is concluded that interview data be used for investigating the dental health and behavior of people who do not often go to the dentist, and that dentists are more successful in maintaining good dental health in people who have no dental complaints than in people who report having complaints.

Appointments and Schedules↗