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Biomedical subjects

S Aro

Publications and source records attributed to S Aro.

At least 37 records · Page 2Linked to original sources
PubMed1994

Hospital use among diabetic patients and the general population.

OBJECTIVE: This register-based linkage study compared hospital use among diabetic and nondiabetic populations. The study focused on overall use, use by disease categories, and inpatient care caused by complications. RESEARCH DESIGN AND METHODS: The patient data were derived from the Hospital Discharge Register and the Central Drug Register in Finland. All drug-treated diabetic patients and discharges of patients in a 3-year period were included in the study. Hospital use was measured by inpatient days, mean length of stay, and discharge rate. RESULTS: Among diabetic patients were eligible for drug reimbursement, 14.2% had at least one hospital stay because of diabetes in a year, while 50.7% had at least one hospital stay for any cause. Only 12.4% of the nondiabetic population was hospitalized annually. Patients with diabetes as the principal diagnosis consumed about 3% of all inpatient days; patients who had diabetes either as the principal or as a subsidiary diagnosis used 8.3%; and people who were eligible for antidiabetic drug reimbursement used 13.3% of total inpatient days. Among diabetic children, the risk for hospitalization was 6.5 times higher than among nondiabetic children. With advancing age, causes other than diabetes increasingly dominated hospitalization among diabetic patients. Inpatient days because of cardiovascular diseases were 1.6-18 times more common among diabetic patients than among nondiabetic patients, depending on gender and age-group. Diabetic patients used many more hospital inpatient days than did the nondiabetic population for a number of other disease categories that are usually not related to diabetes. CONCLUSIONS: Hospital use among diabetic patients is substantially greater than that among the nondiabetic population, mainly because of cardiovascular and microvascular complications, but also because of diseases unrelated to diabetes.

Adolescent↗
PubMed1991

[Personal physician system is tested in Finnish primary health care].

A new system of personal physicians with responsibility for a delimited population is now under test in Finnish primary care. The article presents the experience gained hitherto which indicates inter alia that the physicians involved in primary care are enabled to work more flexibly. Some 100 physicians in primary care and medical personnel at 10 places in Finland are currently participating in the experiment.

Community Health Services↗
PubMed1989

Social ties and survival among the elderly in Tampere, Finland.

The association between social ties and survival was assessed using a stratified sample of 1060 elderly aged 60-89 years in the city of Tampere, Finland. During the 6.5-year follow-up, 240 men and 153 women died. Compared with married men, the death rate ratio among unmarried men was 1.7 and among widowers 1.2. The respective ratios for women were 1.2 and 1.2. Vicinity of children, living alone, loneliness, social contacts, and social participation were used as indicators of social ties. Men and women were analysed separately. None of the indicators were significant predictors of survival in proportional hazard analyses, after adjusting for age, perceived health, functional ability and occurrence of a disabling disease at baseline. The relative hazards ranged between 0.85 and 1.38, and all 95% confidence intervals included unity. However, when social participation was entered into the models as a continuous variable, it was strongly associated with increased survival in both sexes. Social participation is probably not protective as such, but it may rather reflect way-of-life, which is characterized by social competence or 'control of destiny'.

Activities of Daily Living↗
PubMed1987

Trunk muscle function and low back disorders: a ten-year follow-up study.

Low back disorders and trunk muscle function were studied by questionnaire, interview, clinical examination, and performance tests in 902 employees in the metal industry. The survey was repeated after a 10-yr interval for 654 persons. For those who were allowed to participate in the muscle function tests, the prevalences of clinical findings in the low back and of chronic lumbosacral disease were inversely associated with muscle function in both cross-sectional studies. This association seems not to be explained by the interference of pain with muscle function tests. There was no association between muscle function at baseline and either the 10-yr incidence of chronic low back disease or the development of low back symptoms. Men with poor muscle function at baseline had a slightly elevated risk for the appearance of clinical findings at follow-up. There was an inverse association between the clinical findings at baseline and muscle function at follow-up. The association between low back disorder and trunk muscle function seems to result from an effect of the former on the latter, but poor muscle function may also contribute to the risk of disorder.

Back Pain↗
PubMed1987

Effects of a doctors' strike on primary care utilization in Varkaus, Finland.

Changes in out-patient medical care utilization at the health centre of Varkaus were studied during the Finnish doctors' strike in spring, 1984. In this urban and semi-urban area, about 80% of the out-patient medical services to the population are provided by the municipal health centre. Visits to the physicians decreased by 70% during the strike, and for urgent visits the decrease was 55%. The private sector compensated only a very small share of this "deficit". Of the common urgent illnesses the relative decrease was greatest for "cold" and ill-defined "abdominal pains". Open wounds were treated normally although there was some indication that the wounds treated were more serious than normally. The post-strike increase in visits suggests an increase in unmet needs. For all face-to-face encounters the increase was eight per cent, but for low back pain, urinary infection and hypertension the observed post-strike rates were more than 40% higher than expected by pre-strike rates. A marked reduction in various other activities of the health centre, such as telephone calls and home visits, was observed. The present study gave no evidence of harmful effects of the strike. This was the impression of the health care personnel, too. There were no public claims of reduced access to care or its delay. The distress among patients or other experiences of the population were, however, not measured. The strike was fairly short and any conclusions concerning the effects of a more prolonged or extensive strike on health care are unwarranted.

Finland↗
PubMed1987

Occupational class, psychosocial stress and morbidity.

The association between stress and morbidity was studied in an industrial population, which consisted of both white-collar and blue-collar workers (n = 902). Information about living and working conditions, health behaviour, mental well-being and morbidity were obtained by questionnaires, interviews, clinical examinations, and physiological and biochemical measurements. The same cohort was re-examined after five and ten years. Comparison of occupational classes showed consistently that living and working conditions, psychosocial stress, and health and sickness behaviour were more deleterious among blue-collar workers and their morbidity and mortality rates were higher than among white-collar workers. The effect of stress on health was examined both cross-sectionally and longitudinally. Psychosocial stressors at work were related to mental strain, perceived health, and absenteeism. Stress symptoms were strongly associated with perceived health, locomotor symptoms, smoking, drinking, and absenteeism. None of the stress indicators were related to blood pressure. In the follow-up the baseline indicators of stress predicted future chronic illness and angina pectoris, but not hypertension or myocardial infarction. Blood pressure changes were not related to psychosocial factors. Stress did not predict mortality in the ten year follow-up. The study suggests that psychosocial stress is mostly related and may be causally linked to such indicators of morbidity as perceived health, bodily symptoms and sickness behaviour. The aetiological contribution of stress to biologically defined morbidity may be weak.

Attitude to Health↗
PubMed1986

Social class and changes in health-related habits in Finland in 1973-1983.

The aim of this project was to study social class differences with respect to various health-related habits and especially to note the changes in these habits after a 10-year follow-up period. From this study conclusions can be drawn as to whether health education efforts and increased interest in personal health has been more widely adopted by the more educated groups than the less educated groups, whose morbidity and mortality rates are higher. The sample consisted of 902 white-collar and blue-collar workers. Smoking was found to be more common among blue-collar workers in both years. Smoking rates had declined in all groups except female blue-collar workers. Occasions of drinking were more frequent among white-collar than blue-collar workers. However, heavier forms of drinking were more common in male blue-collar than white-collar groups, while the opposite was true among women. Dietary habits in white-collar groups were closer to the "official" recommendations than in the respective blue-collar groups in both years. White-collar men were physically more active at the time of the first investigation, and even more so ten years later. Among women, social class differences were in the same direction, but less marked. In conclusion, in the early 1970s the health-related habits examined were, in most instances, less favourable among blue-collar than white-collar workers. No consistent pattern of change in these habits was observed in the 10-year follow-up. At the end of the follow-up, many of the "inequalities" still persisted.

Adult↗
PubMed1985

Overweight and musculoskeletal morbidity: a ten-year follow-up.

The association of relative weight with various indices of musculoskeletal morbidity was studied in 902 Finnish white-collar and blue-collar workers. Data were collected in the years 1973 and 1983 through a postal questionnaire, by medical examination, and clinical assessment of the condition of the musculoskeletal system. In the overweight group (relative weight greater than or equal to 120 percent), higher mean levels in all musculoskeletal scores (the Musculoskeletal Symptoms Score, the Upper/Lower Extremities Score, the Low Back Score and the Musculoskeletal Findings Score) were observed, compared with the normal weight group. There was no evidence, however of rheumatic complaints in weight-bearing joints being more common in overweight individuals, contrary to the 'wear and tear' hypothesis. In a 10-year follow-up the changes in the musculoskeletal scores were analysed by stepwise multiple regression. Baseline relative weight explained 6.3 percent of the variation in the score based on clinical assessment. Neither baseline weight nor weight change were significant predictors of change in the other scores. No association was observed between overweight and lumbosacral disorders either in the cross-sectional study or in the 10-year follow-up.

Adult↗
PubMed1984

Occupational stress, health-related behavior, and blood pressure: a 5-year follow-up.

The association of occupational stress factors and health-related habits with blood pressure and blood pressure change over a 5-year follow-up was studied in 388 Finnish white-collar and blue-collar workers. The occupational stress factors consisted of noise level, discomfort due to noise, monotony, and self-suppression of opinion. Behavioral variables included the frequency of mild intoxication, leisure-time physical activity, cigarette smoking, relative weight, and change in weight. In the cross-sectional study, only relative weight was positively associated with both the systolic and diastolic blood pressure. For the prediction of blood pressure change, multiple linear regression showed that in the total sample none of the nine variables was a statistically significant predictor of systolic blood pressure change over the follow-up period. The change in weight was the most significant predictor (P less than 0.001) of diastolic blood pressure change, followed by intoxication (P less than 0.01). Further analyses by sex and occupational status showed that among female white-collar workers, intoxication was the strongest predictor of both systolic and diastolic blood pressure changes. In this group, the total model explained 34% of the variability in systolic and 27.7% in diastolic blood pressure change. In other groups and in the total sample, the proportions explained were markedly smaller. Also, in some subgroups, self-suppression, noise, and physical activity were significant predictors of blood pressure change. It is concluded that in comparison with reduction of weight, the other behavioral and stress factors studied seem to be of minor importance in the prevention of high blood pressure in normal populations, even if these factors may be relevant in some susceptible subpopulations or in populations whose exposure levels are extreme.

Adult↗
PubMed1984

Life events or life processes as determinants of mental strain? A 5-year follow-up study.

In a study among Finnish metal industry employees (n = 748) mental strain was measured at the beginning and at the end of a 5-year follow-up. Life event data for the follow-up period were gathered retrospectively through a questionnaire and a later interview. Mental strain was substantially higher among blue-collar than white-collar workers. In contrast, no differences in the occurrence or in the rating of life events was observed between these groups. Self-rated undesirable events were associated with high levels and desirable events with low levels of mental strain. Similar associations were observed in three objectively defined live events, viz. divorce, promotion in the job and change in housing conditions. Life events were, however, also related with the mental strain measured prior to the life events. Both the self-rated and objectively defined desirable events had usually a favourable impact on mental well-being, whereas undesirable events in most cases slightly increased mental strain. The differences in mental strain between occupational status groups seem to be caused by differences in the life processes rather than life events. Furthermore, many life events, e.g. divorce, are actually only discrete moments in long-lasting processes, which have an impact on mental well-being. And last, desirable life events can be seen rather as a preventive than a risk factor of mental strain.

Adult↗