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S E Norell

Publications and source records attributed to S E Norell.

34 records · Page 2Linked to original sources
PubMed1987

Hospital versus population referents in two case-referent studies.

In case-referent studies, the choice between hospital and population referents involves the consideration of nonresponse, information bias, and selection bias. A case-referent study of astrocytoma and one of pancreatic cancer used both hospital and population referents. In the present report the two series of referents were compared with regard to potential sources of systematic errors. There were differences in reported exposure between the hospital and population referents. These differences seemed to be due to differences in exposure experience ("selection bias") rather than to differences in the quality of reported information ("information bias"). This conclusion was based on two findings. First, in the comparison between the hospital and population referents, similar differences were found in the reported exposure for "hard" questionnaire items as for "soft" questionnaire items. Second, in a comparison between reported radiographs and radiographs according to medical records, the same differences were found for the two series of referents, although there was considerable underreporting of such exposure in both series. Nonresponse rates were somewhat higher among the population referents than among the hospital referents.

Epidemiologic Methods↗
PubMed1986

Sedentary jobs and colon cancer.

The association between physical job activity and colon cancer was examined in a 19-year follow-up study of 1.1 million Swedish men. The relative risk (RR) of colon cancer in men employed in sedentary occupations was estimated at 1.3 (1.2-1.5, 90% confidence interval), with the highest risk for the transverse colon including flexures (RR = 1.6) and the lowest risk for the sigmoid (RR = 1.2). The relative risk for rectal cancer was not elevated. Age, population density, and social class did not confound the relative risk and were controlled for, whereas marital status and geographic region did not. Furthermore, food habits and physical activity during leisure time were examined in the same occupations in another sample and it was judged unlikely that confounding from these factors could explain the association.

Adult↗
PubMed1986

Diet and pancreatic cancer: a case-control study.

In a population-based case-control study carried out in Sweden in 1982-1984, the authors examined the association of pancreatic cancer with several dietary factors, coffee, alcohol, and tobacco. Analyses were based on 99 cases, 138 population controls, and 163 hospital controls. The cases were persons aged 40-79 years diagnosed with cancer of the exocrine pancreas at three surgical departments in Stockholm and Uppsala. The risk increased with higher consumption frequency of fried and grilled meat in the comparison with each series of controls (e.g., relative risk (RR) = 1.7 (90% confidence interval (CI) = 1.1-2.7) for weekly intake and RR = 13.4 (90% CI = 2.4-74.7) for almost daily intake, in the comparison with population controls). Furthermore, associations were found with other fried or grilled foods, but not with meat other than fried or grilled. The risk also increased with the intake of margarine (e.g., RR = 9.7 (90% CI = 3.1-30.2) for 15+ g of margarine on a slice of bread, in the comparison with population controls). In contrast, no excess risk was associated with high intake of butter. A low risk was associated with frequent consumption of fruits and vegetables, particularly carrots (RR = 0.3 (90% CI = 0.2-0.7)) and citrus fruits (RR = 0.5 (90% CI = 0.3-0.9)) for almost daily intake. No consistent associations were found with coffee, artificial sweeteners or alcohol consumption, but a threefold increase in risk was associated with smoking at least one pack of cigarettes per day.

Adult↗
PubMed1985

Hospital care utilization in a 17,000 population sample: 5-year follow-up.

The growing utilization of hospital care, especially of the services of Emergency Departments (ED), has been of great concern for many Western countries. The purpose of this study was to relate the amount of hospital care utilization to the frequency of ED visits. The study, based on a computerized medical information system, was carried out at Huddinge hospital which serves a suburban area of Stockholm, Sweden. ED visits were found to predict hospital care utilization in a 5-year follow-up of a 10% population sample. Persons who had made 2 or more ED visits during a period of 15 months before follow-up (less than 1/8 of the population sample) contributed 24% of all hospital outpatient visits, 29% of all hospital admissions and 31% of all hospital days during the 5-year follow-up period. The number of hospital outpatient visits per 100 personyears was more than 3 times higher among those who had 4 or more ED visits as compared to those who were non-visitors at the ED. Hospital admissions and days were 5 times higher. The utilization of medical specialties differed most in psychiatry, where those with 4 or more ED visits had nearly 17 times more admissions per 100 personyears than non-visitors. The difference increased gradually with increasing number of ED visits and was also evident in each age group. The mortality was also significantly increased for those with several ED visits. Higher migration in the latter group may besides indicate social instability.(ABSTRACT TRUNCATED AT 250 WORDS)

Emergency Service, Hospital↗
PubMed1985

Memory and medication compliance.

Electronic medication monitors were used to study patients' compliance with a three times daily pilocarpine regimen. In addition, standardized tests were used to measure different aspects of patients' memory performance. The 38 mostly elderly patients varied widely in their compliance and memory scores. However, no significant correlation was found between memory and medication compliance. It is concluded that lack of memory may be less important as a cause of non-compliance than is usually believed.

Aged↗
PubMed1985

Respiratory cancers in furniture workers.

In a 19 year follow up study of 8141 furniture workers nasal adenocarcinoma was 63 X 4 times more common than expected. The findings also indicate an excess risk of adenocarcinoma of the maxillary sinus. No increase in risk was found for laryngeal cancer, lung cancer, or sinonasal cancers other than adenocarcinoma.

Adenocarcinoma↗
PubMed1984

Methods in assessing drug compliance.

Methods and problems in assessing drug compliance are related to the selection of study sample and observation period as well as to methods used to measure patient behaviour in taking medications. Patients under treatment with a certain drug regimen are different from the patients for whom that regimen was originally prescribed. Medication compliance during short periods of time, such as 1-2 weeks before or after a visit to the clinic, is likely to be different from that found over longer periods of time. Several studies indicate that estimates by clinical staff are no more accurate than chance selections in determining medication compliance. Patient interviews have usually identified 25-50% of noncompliant patients, but interview data on spacing between doses seem to be more accurate. Pill counts are useful in assessing drug compliance, although compliance may sometimes be overestimated. Medication monitors provide more detailed information on patient behaviour in taking medications.

Behavior↗
PubMed1981

Monitoring compliance with pilocarpine therapy.

I used a recording medication monitor to obtain objective information on self-medication by date and hour from a group of 82 patients using pilocarpine three times daily to prevent visual loss from glaucoma. Doses meant to be taken during the day were missed more than twice as often as morning or evening doses. Of the missed doses, 272 (54%) were noon doses, but only 98 (19%) were morning doses. Medication compliance may be substantially improved by choosing a drug that needs to be taken less often than three times daily. The number of missed doses per day increases significantly during a 20-day period between clinic visits. This suggested that shorter intervals between clinic visits may improve adherence to the drug regimen prescribed.

Aged↗
PubMed1980

A medication monitor and fluorescein technique designed to study medication behaviour.

Methods were developed to study medication behaviour, in order to obtain accurate and detailed information on the patterns of drug-taking in medication with eye drops. A medication monitor was designed, which recorded the date and hour each time the medication bottle was opened. A fluorescein technique was designed to study the ability of patients to administer the eye drops into the conjunctival sac. Some problems in the measurement of medication behaviour are discussed. In a group of patients with open-angle glaucoma, for whom pilocarpine eye drops three times daily had been prescribed, 18% of dose intervals had a duration of 12 h or more and 11% had a duration of 4 h or less. Fluorescein tests indicated that the patients were usually able to administer the eye drops correctly.

Fluoresceins↗
PubMed1980

Self-medication with pilocarpine among outpatients in a glaucoma clinic.

A recording medication monitor and fluorescein technique were used to study self-medication by 82 patients with primary open-angle glaucoma for whom pilocarpine eye drops 3 times a day had been prescribed. Of these patients 34 (41%) missed 6 or more doses during a 20-day period, and for 35 (43%) an 8-hour dose interval was exceeded at least 20% of the time. Consequences may include lack of effectiveness in preventing visual loss and unnecessary prescription of more potent, and more toxic, drugs.

Aged↗
PubMed1979

Improving medication compliance: a randomised clinical trial.

A medical monitor which recorded the date and hour each time a medicine bottle was opened was used to evaluate a programme for improving patients' compliance with their treatment. Eighty-two patients with glaucoma who had been prescribed pilocarpine eye drops three times daily to prevent visual loss were randomised into two groups. Both groups used the medication monitor during two 20-day periods, but before the second period the experimental group were given an education and tailoring programme in an attempt to improve their compliance. Nine patients missed the second treatment period and were excluded from the analysis. The patients in the experimental group showed significantly improved compliance when compared with the control group. The numbers of missed doses were reduced by about half, as was the proportion of time that exceeded the eight-hour dose intervals. Follow-up studies are needed to determine how long the improved compliance persists, but anyone considering setting up an education and tailoring programme should recognise the extent to which therapeutic efforts are wasted because of non-compliance.

Aged↗