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PubMed2000

Risk factors for basal cell carcinoma.

The aim of this study was to assess the risk factors for basal cell carcinoma (BCC). A case-control study, carried out in two towns in Yugoslavia, comprised 200 BCC cases and 399 controls. For statistical analysis, univariate and multivariate logistic regressions were used. The risk factors found for BCC were: freckling before the age 15, seven or more weeks per year spent at the seaside during holidays (lifetime average), outdoor work during summer-time, occupational exposure to organic and non-organic dissolvents and organophosphatic compounds, use of tar for cosmetic purposes, and previous BCC in personal history. Subjects who tended to burn and not to tan after sun exposure also showed a significantly higher risk for BCC. Brown eyes and history of acne had a protective effect. This study confirmed the role of both constitutional and environmental factors in the development of BCC.

Acne Vulgaris↗

PubMed2006

The World Veterinary Poultry Association: the beginnings and first 25 years.

The World Veterinary Poultry Association (WVPA) was formed in 1959, the honour of being the first President of the Association going to Professor de Blieck and that of Secretary to Dr R.F. Gordon, who had both championed its formation. The First WVPA Conference (the name "Congress" was not applied until the third meeting) took place in Utrecht in 1960. The second Conference (1962) and the third Congress (1965) were in Cambridge and Paris, respectively. The fourth Congress, in Belgrade (1969), was a landmark one for two reasons: firstly, submitted papers were introduced, and secondly, the notion of a WVPA journal, later to be called Avian Pathology, was first discussed. A year later (1970) the journal came into being, Professor Klimes (Czhechoslovakia), the driving force behind its creation, being the first Editor-in-Chief, with Professor Kosic (Yugoslavia) as production Editor. Due to the ill health of Professor Klimes, Peter Biggs was confirmed as Editor-in-Chief in 1973. A charitable company, Avian Pathology Ltd, was formed in 1980, under which Avian Pathology was published. Dr L.N. (Jim) Payne succeeded Dr Biggs as Editor-in-Chief in 1988. The fifth and six Congresses were in Munich (1973) and Atlanta, Georgia, USA (1977), respectively. Four years later, at the Oslo Congress, it was agreed that the rather crude logo adopted at the fourth Congress should improved. This was done and is the current logo. On the 25th anniversary (1985) of the first WVPA Congress, the eighth Congress was held in Jerusalem. Membership had increased to almost 1000, with members in 39 countries, 22 of which had branches of WVPA. In 4 years it will be time to publish an account of the second 25 years in the history of the WVPA.

Animals↗

PubMed2001

Immigration and leisure-time physical inactivity: a population-based study.

OBJECTIVE: To investigate the relationship between migration status and sedentary leisure-time physical activity status in the city of Malmö, Sweden. METHODS: The public health survey in 1994 is a cross-sectional study. A total of 5,600 individuals aged 20-80 completed a postal questionnaire. The response rate was 71%. The population was categorized according to country of birth. Multivariate analysis was performed using a logistic regression model to investigate the importance of possible confounders for the differences in sedentary leisure-time physical activity status. RESULTS: The prevalence of a sedentary leisure-time physical activity status was 18.1% among men and 26.7% among women. The odds ratio of a sedentary leisure-time physical activity status was significantly higher among men born in Arabic-speaking countries, in All other countries, and among women born in Yugoslavia, Poland, Arabic-speaking countries, and the category all other countries', compared to the reference group born in Sweden. The multivariate analysis including age, sex, and education did not alter these results. CONCLUSION: There were significant ethnic differences in leisure-time physical activity status. This is a CVD risk factor that could be affected by intervention programs aimed at specific ethnic subgroups of the population.

Cross-Sectional Studies↗

PubMed2002

Ethnic differences in self-reported lack of access to a regular doctor: a population-based study.

OBJECTIVE: The aim of this study was to investigate ethnic differences in self-reported lack of access to a regular doctor in Malmö, Sweden. DESIGN: The public health survey in Malmö 1994 was a cross sectional population study. Data were collected from 5600 people aged 20-80 years using a postal questionnaire. The participation rate was 71%. The population was categorised according to country of birth: born in Sweden, other Nordic countries, other Western countries, Yugoslavia, Eastern Europe, Arabic speaking countries and other countries. Multivariate logistic regression analysis was performed in order to investigate the importance of possible confounders on the differences by country of origin in lack of access to a regular doctor. RESULTS: A 56.3% proportion of all men and 48.8% of all women lacked access to a regular doctor. The odds ratios of lacking access were significantly higher among men born in Nordic countries, Arabic countries and other countries compared to men born in Sweden but disappeared after adjustment for age. The same patterns were observed for women born in Eastern Europe, Arabic countries and other countries compared to women born in Sweden, and remained after adjustment for age. In the multivariate analysis including age, education, ability to pay bills every month and self-reported health, no significant differences in lack of access to a regular doctor remained among men, while the odds ratios were significantly lower among women born in other Western countries, but still significantly higher among women born in Arabic speaking countries and all other countries. CONCLUSION: Self-reported lack of access to a regular doctor was significantly higher among men born in Nordic countries, Arabic countries and other countries compared to men born in Sweden, but all these differences disappeared after adjument for age and in the multivariate analysis. Women born in Arabic speaking countries and other countries lacked access to a regular doctor to a significantly higher extent compared with women born in Sweden, and these differences remained in the multivariate analysis.

Adult↗

PubMedDate not supplied

Violence and alienation: an issue of public mental health.

This century has seen more extensive social and political change than ever before. Some, such as antibiotics, has been beneficial, but much has led to alienation and political and cultish ideologies. These in turn have spawned widespread violence. Not all violence is physical; some is inner-directed and can lead to suicide. Some is inspired by genuine idealism but too often this degenerates into cruelty excused as a struggle with alleged evil. Violence can be nation- or even continent-wide-Africa, Latin America, Middle East, Indochina, but also Europe including the former Soviet Union. It is also local, especially in inner cities throughout the world, linked to drugs but also as mindless vandalism. Solutions must be both at the macro level, through the UN and its agencies; the UN charter must be revised to allow appropriate intervention within national borders. At the local level, underlying causes such as human rights abuses and unemployment can be put right. Much more research is needed but action cannot await the findings. The author's recent personal experience in Osijek in former Yugoslavia shows that the most important factor is the people themselves, but outsiders can provide knowledge, resources and support.

Humans↗

PubMedDate not supplied

The changing role of civilian surgeons in conflicts: a meta-analysis of epidemiological data.

Surgical activities in recent conflicts were reviewed based on the published epidemiological data. Ten articles on seven conflicts were identified and reviewed. The surgical activities in these articles were classified into three categories based on their activities: type 1, civilian border camp surgical activities; type 2, military hospitals in military deployment; type 3, civilian hospitals in former Yugoslavia or Palestine camp (most recent conflicts). Comparison of injuries in ratios of head-to-extremities, and critical part-to-extremities, among these three different types of surgical activity showed that type 3 hospitals had a statistically higher number of critical part injuries compared to the other two types of hospital. Type 3 hospitals represent the most recent endemic, regional and indiscriminate killing experiences. The high rates of critical part trauma in studies of recent conflicts show the increasing importance of trauma management skills by civilian surgeons in recent conflicts. Exchange of information among civilian surgeons serving in these difficult and dangerous conditions should be encouraged.

Asia, Southeastern↗

PubMed1997

Bosnian refugees in the Scandinavian countries: a comparative perspective on immigration control in the 1990s.

"In all the Nordic countries, a change of direction in refugee policy has taken place in recent years, primarily for similar reasons to those in the rest of Western Europe. These changes have been sparked off by the situation in the former Yugoslavia, but should also be seen as reflecting something more.... The prospect of a continuing influx of refugee groups, and a corresponding strain on national budgets, creates a backdrop for new thinking in all countries. An interesting aspect of this issue in the Nordic region is that, despite being a fairly homogeneous area, these countries have chosen radically different points of departure for their approach to refugees from Bosnia-Herzegovina. The article identifies these different national strategies and analyses the subsequent tendency towards convergence of policies that has taken place along the way."

Bosnia and Herzegovina↗

PubMed2004

Emergency room utilization in Copenhagen: a comparison of immigrant groups and Danish-born residents.

BACKGROUND: The aim of the study was to investigate whether utilization of the emergency room differed between immigrant groups and Danish-born residents in Copenhagen, Denmark. METHODS: The authors compared the number of emergency room contacts during 1997 among different ethnic groups in the study population. Data were provided by the Statistical Office of the Municipality of Copenhagen. The study population consisted of 183,478 citizens residing in the catchment area of Bispebjerg Hospital in Copenhagen on 1 January 1998. "Contacts" included 22,026 visits made to the emergency room at Bispebjerg Hospital during 1997. Both the study population and "contacts" were characterized by gender, age, income, and country of birth. The immigrants comprised nine ethnic groups according to country of birth. Data were analysed by Poisson regression comparing rate ratios. RESULTS: Persons born in Somalia, Turkey, and ex-Yugoslavia had higher utilization rates of emergency room than Danish-born residents. All other non-Western-born residents had utilization rates similar to Danish-born residents. Persons born in other Western and European countries showed a tendency towards less utilization. CONCLUSION: Higher utilization rates among some immigrant groups may be explained by disparities in health or lack of knowledge about the Danish healthcare system as well as barriers to seeking primary care including language, fear of discrimination, and low satisfaction with primary care. The challenge remains to identify these causal relations, and to find out why utilization patterns vary between immigrant groups.

Adult↗

PubMed2006

Representativity of a postal public health questionnaire survey in Sweden, with special reference to ethnic differences in participation.

AIM: Non-participation in health surveys is a common phenomenon. When differences between participants and non-participants are considerable, the external validity of the sample survey may decrease and false conclusions might be drawn about the health status of the population. For this reason, the authors aimed to investigate the representativity of a postal questionnaire survey performed in the county of Scania, Sweden, in 1999-2000. The survey, which was based on an 18- to 80-year-old population sample, had a 58% response rate (n = 13 604). METHODS: For some variables, the information obtained using the questionnaire was compared with information obtained from a population register that covers all the population in the county (for the 18- to 80-year-old group, n = 850 476). The population register includes, among other data, information on age, gender, educational level, country of birth, and healthcare expenditure. RESULTS: Men, individuals with a low level of education, and immigrants were under-represented in the survey. However, except for immigrants, the under-representation was not large. Among immigrants, particularly those born in former Yugoslavia, the Arabic-speaking countries, and Poland were very significantly under-represented in the study. By contrast, immigrants born in other Nordic countries had responded to almost the same extent as respondents born in Sweden. The survey sample had about the same healthcare utilization costs as did the general population. CONCLUSIONS: In summary, the "Health Survey for Scania, 2000" seems largely representative of the total Scanian population. A major concern, however, is the under-representation of the immigrant population.

Adolescent↗

PubMed1999

A search for Ebola virus in animals in the Democratic Republic of the Congo and Cameroon: ecologic, virologic, and serologic surveys, 1979-1980. Ebola Virus Study Teams.

More than 30 years after the first outbreak of Marburg virus disease in Germany and Yugoslavia and 20 years after Ebola hemorrhagic fever first occurred in central Africa, the natural history of filoviruses remains unknown. In 1979 and 1980, animals in the Democratic Republic of the Congo and Cameroon were collected during the dry season near the site of the 1976 Ebola hemorrhagic fever epidemic. The study objectives were to identify local animals and search for evidence of Ebola virus in their tissues. A total of 1664 animals representing 117 species was collected, including >400 bats and 500 rodents. Vero and CV-1 cells and IFA and RIA were used for virus and antibody detection, respectively. No evidence of Ebola virus infection was found. This study was limited in time and animal collections and excluded insects and plants. Long-term, prospective, multidisciplinary comparative studies will yield more information than will repeat short forays on the ecology of filoviruses.

Animals↗

PubMed1986

HTLV-III infection among 315 intravenous drug abusers: seroepidemiological, clinical, and pathological findings.

Seroepidemiological, clinical, immunological, and pathological features were studied in 315 intravenous drug abusers (IVDA) seen in five centers for drug addicts' assistance in the Friuli Venezia-Giulia region of Italy, close to the borders of Austria and Yugoslavia. No case of AIDS has been observed. Sixty-five (21%) were affected by persistent generalized lymphadenopathy (PGL). HTLV-III seropositivity was noted in 86 (27%) of the overall 315 IVDA, in 50 (77%) of 65 patients with PGL, and in 1 (0.5%) of 205 blood donors tested as a control group. Patients with PGL had a significantly lower OKT4/OKT8 ratio than the rest of the IVDA population and controls. Systemic symptoms were present in 52% of the patients with PGL, the most frequent symptoms being fatigue and night sweats. In 20 patients with PGL, DR typing revealed a significant increase in DR-5 frequency and a significant decrease of DR-2 frequency. The predominant histological features in the lymph nodes taken from 25 patients consisted of an exuberant follicular hyperplasia, capillary vessel proliferation, and plasmacytosis. Nineteen (22%) females reporting occasional prostitution were compared to 10 non-IVDA female prostitutes and concomitantly evaluated. HTLV-III seropositivity was noted in 11 (58%) of 19 IVDA female prostitutes and in none of the 10 non-IVDA prostitutes. Thirty-five couples composed of both IVDA were compared to 24 couples composed of an IVDA and a non-IVDA. Among the 24 couples of whom one or both partners were seropositive, concordance in HTLV-III seropositivity was present in 5/11 (45%) couples composed of both IVDA, and in only 1/13 (8%) couples composed of an IVDA and a non-IVDA. This suggests that the sharing of contaminated needles, universally practiced by our IVDA population, plays a more important role in the transmission of HTLV-III than sexual contact.

AIDS-Related Complex↗

PubMed2005

Human and organizational factors affecting telemedicine utilization within U.S. military forces in Europe.

During the past 10 years, the United States Army installed telemedicine capabilities in more than 30 Army medical treatment facilities within the European Theater, including the former Yugoslavia. In spite of favorable reviews of utilization from the early days of the installations, there has been only limited use for patient care. We conducted a field study of the program implementation within a group of military clinics and hospitals using site visits and interviews. Problems leading to underutilization were identified primarily as organizational factors rather than classic "human factors" or "man-machine interface" problems. The majority of those interviewed felt that: they had not been given adequate information on the role of telemedicine systems in provision of health care; operational and support policies had not been developed adequately; cost-benefit of use was not clearly demonstrated; and that many organizational impediments existed. Additionally, the lack of strong clinician proponents was repeatedly cited. Although limited in scope, this study provides insight into the attitudes of clinicians given the opportunity to use various telemedicine modalities, and identifies organizational problems that could be rectified by a defined mission involving the use of telemedicine and a structure encouraging its acceptance in routine clinical practice. As a result of this study, recommendations were made for changes in implementation practices, which may have civil as well as military implications.

Europe↗

PubMed2002

'Avoidable' mortality among immigrants in Sweden.

BACKGROUND: The concept of studying 'avoidable' mortality as an indicator of the outcome of health care has been applied mainly in studies of time-trends and geographical and socio-economic variation. METHODS: In this study, indicators of 'avoidable' mortality among immigrants in Sweden have been studied. Comparisons of death rates among immigrants and those born in Sweden were made using a linkage of the Population Census and the Cause of Death Register, nationwide sources. RESULTS: For a group of health policy indicators, such as liver cirrhosis and malignant neoplasms of the trachea, bronchus and lung, death rates were about 40-100% higher among immigrants from other Nordic countries, Yugoslavia and Eastern Europe than among the Swedish born population. For causes of death considered amenable to medical care intervention there were, however, small differences. For some conditions, such as cerebrovascular disease, malignant neoplasms of colon and rectum, chronic bronchitis and emphysema, high death rates were found among immigrants from other Nordic countries. For immigrants from other countries, there were no high death rates based on medical care indicators when compared to the Swedish-born population. CONCLUSION: There were few indications of inequity reflected in the mortality outcome of medical care. The variation found in death rates from health policy indicators may reflect differences in smoking and alcohol habits.

Adult↗

PubMed2002

Ethnic differences in daily smoking in Malmö, Sweden. Varying influence of psychosocial and economic factors.

BACKGROUND: The aim was to investigate ethnic differences in daily smoking in Malmö, Sweden, and whether these differences could be explained by psychosocial and economic conditions. METHODS: The public health survey in Malmö 1994 is a cross-sectional study. A total of 5,600 individuals aged 20-80 years were randomly chosen to respond to a postal questionnaire. The participation rate was 71%. The study population was divided into seven categories according to country of birth; Sweden, Denmark/Norway, other Western countries, former Yugoslavia, Poland, Arabic-speaking countries and all other countries. A multivariate analysis was performed using a logistic regression model in order to investigate the importance of possible confounders on the ethnic differences in daily smoking. Finally, variables measuring social network, social support and economic conditions were introduced. RESULTS: The prevalence of daily smoking was significantly higher among both men and women born in Denmark/Norway (39.1% and 37.0%), men born in other Western countries (32.9%), Poland (34.0%) and Arabic-speaking countries (36.4%) than among Swedish men (21.7%) and women (23.8%). Women born in Arabic-speaking countries had a significantly lower smoking prevalence (7.1%). The multivariate analysis, including age, education and snuff, did not affect these results. A reduction of the odds ratio of daily smoking was observed for men born in Arabic-speaking countries and Poland after the introduction of the psychosocial and economic factors in the model. Only small changes were observed for women. CONCLUSION: There were significant ethnic group differences in daily smoking. Psychosocial and economic conditions in Sweden may be of importance in some ethnic groups.

Adult↗

PubMed1987

Sources of information about new drugs and attitudes towards drug prescribing: an international study of differences between primary care physicians.

Doctors in different countries completed a questionnaire relating to the importance they attributed to eight possible sources of information about a new drug, their estimation of patients' expectations of the doctor prescribing drugs under specific circumstances and their therapeutic response to common clinical general practice situations. There were major differences between the stated behaviour of doctors in different countries with regard to the importance they attached to the eight sources of information on drugs. While doctors agreed on the importance of books and journals and on the unimportance of patients, nurses and other paramedicals, there was a major disagreement about the importance of drug company representatives: this source of information about new drugs was rated high in Sweden and Yugoslavia and low in Britain and Belgium. Doctors also differed in their estimation of patients' expectations of how they would prescribe and how they responded to the clinical problems. The differences, which might be due to differences in education about therapeutics or to cultural differences between countries, are important because of the high cost of drugs bills in all countries.

Attitude of Health Personnel↗

PubMed1992

Diagnosis, antibiotic treatment and outcome of acute tonsillitis: report of a WHO Regional Office for Europe study in 17 European countries.

The diagnostic and prescribing habits of general practitioners from 17 European countries for 4094 patients with acute tonsillitis were assessed, and differences in outcome were identified. At least 10 general practitioners from each country filled in a questionnaire for each episode of acute tonsillitis treated during a three month period, November 1989-May 1990. Differences in days of fever and illness were tested by one-way analysis of variance. Bacteriological tests were rarely used for diagnosis in East Germany, Poland and the Netherlands, while a high percentage (70-96%) occurred in Turkey, Romania, Israel, Yugoslavia, Finland and Greece. Group A beta-haemolytic streptococci (40 per cent) and a negative test result (43 per cent) were the most common results. Ninety per cent or more patients were treated with an antibiotic. Oral penicillin was especially prescribed in the northern countries of Europe and parenteral penicillin in southern Europe. For almost all countries the mean number of days with fever was between 2 or 3 days. The mean number of days with illness differed greatly (F = 62.12; P = 0.0000). Turkey had the lowest mean (2.56), while Poland had the highest mean (8.23).

Adolescent↗

PubMed1988

t-Specific DNA polymorphisms among wild mice from Israel and Spain.

Lehrach and his coworkers have isolated a series of DNA probes that specifically hybridize with different regions of mouse chromosome 17 within the t complex. The probes display restriction fragment length polymorphisms, RFLPs, which are specific for the t haplotypes in all laboratory mouse strains tested thus far. Some of these probes have been used to test wild mice populations for these t-associated DNA forms. It is demonstrated that populations from Germany, Switzerland, Italy, Greece, Yugoslavia, Australia, Costa Rica, and Venezuela contain chromosomes in which all the tested DNA loci display the t-specific polymorphisms. The frequency of mice carrying these chromosomes is as high as 31%. Wild mice from Israel and Spain, on the other hand, carry chromosomes displaying t-specific DNA forms only at one or two of the probed loci, while the other loci carry the wild-type (+) forms. These chromosomes thus resemble the partial t haplotypes known from the study of laboratory mice. One possible interpretation of these findings is that these DNA polymorphisms contributed to the assembly of the complete t haplotypes and that these haplotypes may have originated in the Middle East.

Animals↗

PubMed1984

Differences and comparative declines in ischaemic heart disease mortality among subpopulations in Australia, 1969-1978.

Mortality rates from ischaemic heart disease (IHD) in Australia for the period 1969-78 have been analysed by place of residence, occupation and country of birth. Large variations were found among subpopulations. Throughout the period IHD mortality was lowest among professional and farming occupations and highest among workers in mining, transport and communications. Geographically, mortality from IHD was highest on the east coast and lowest in Western Australia. Mortality among immigrants was lower than among people born in Australia, with death rates for those born in Greece, Italy and Yugoslavia about half the average rates. Mortality from IHD in Australia has declined by about 25% over the last decade. However, the decline has not occurred uniformly. By occupation, the professional, technical and related workers showed the largest decline, while administrative, executive and managerial workers experienced the smallest decline. By place of residence in Australia, the largest declines occurred in the Hunter and Geelong regions, although the Hunter region still has the highest rate. Western Australia, excluding Perth, and rural Victoria did not show any marked decline. The remaining regions particularly the capital cities all experienced similar declines. When analysed by country of birth, Australian born residents showed a greater decline, while men born in Greece and Italy may have had an increase in IHD mortality. There is every indication that the decline will continue. Even those subpopulations with low initial IHD mortality experienced the decline, thus Perth and Adelaide (with low rates) had similar declines to Brisbane and Sydney (with high rates) and the professional occupation group which had the lowest rate also experienced the greatest decline.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗