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Mortality differentials between three populations--residents of Scandinavia, Scandinavian immigrants to Canada and Canadian-born residents of Canada, 1979-1985.

The study compares the mortality of Canadian residents born in Canada and Scandinavia (Finland, Sweden, Norway, Denmark) to the mortality of the four Scandinavian countries. The study focuses on the mortality experience of anyone who was 35-74 years old during the period 1979-85. Swedish and Norwegian populations both in Scandinavia as well as immigrants to Canada had relatively low mortality from all causes of death. On the other hand, populations in Finland and Denmark had comparatively higher mortality from certain causes of death. Finnish excess mortality from cardiovascular diseases and from external causes of death was present in Finnish living in Scandinavia as well as in Finnish immigrants to Canada. This contrasted with the excess mortality from non-cardiovascular disease in the population of Denmark which was not reflected in the mortality of Danish immigrants to Canada. Finally, the cardiovascular mortality of all Scandinavian-born immigrants to Canada was found to be lower than in their respective countries of origin. The article includes a discussion of possible explanations for these results.

Adult

Nephropathia epidemica (hemorrhagic fever with renal syndrome) in Scandinavia.

Nephropathia epidemica (NE) in Scandinavia is a zoonosis caused by Puumala virus. The main animal reservoir is the bank vole. NE predominantly affects men. Its annual incidence varies in a cyclic fashion, with peaks occurring every third to fourth year. The clinical picture of NE in Scandinavia is similar to that of hemorrhagic fever with renal syndrome in other parts of the world, although NE generally has a milder course. The case-fatality rate is approximately 0.2%. The most common clinical findings in NE are an acute onset of symptoms, fever (greater than or equal to 38 degrees C), oliguria, headache, back pain, and polyuria. Hemorrhagic manifestations are seen in about one-third of cases, and up to 5% of patients have gastrointestinal bleeding or disseminated intravascular coagulation. Thrombocytopenia occurs in a majority of patients. In the acute phase, the glomerular filtration rate is markedly decreased and tubular dysfunction is evident. Most patients with NE recover within 6 months.

Animals

Orthopedic research and education in Scandinavia.

Based upon an enquiry conducted in 1988 and 1989, data on the resources for orthopedic research in Scandinavia are presented, supplemented with a survey of the number of scientific papers published from Scandinavia in major orthopedic journals. The postgraduate training programs for orthopedic surgeons in the Scandinavian countries are outlined.

Education, Medical, Graduate

[Prediction of cancer mortality in Scandinavia in 2005. Effect of various interventions].

Approximate estimates have been made of the effect by the year 2005 of various preventive measures to reduce cancer mortality in Scandinavia. Figures have been calculated for changes in smoking, diet and exposure to sunlight (primary prevention), for earlier diagnosis (secondary prevention), and improved survival as a result of improved treatment (tertiary prevention). The calculations have been performed with the American program CAN TROL, the effect being expressed as the percentage reduction in cancer mortality by the year 2005. The results give promise of a substantial overall reduction in cancer mortality in Scandinavia.

Diet

On the epidemiology of human toxoplasmosis in Scandinavia especially in children.

A random sample representing approx. one-third of pre-school children and approx. 95% of school children in age groups 8, 11, 13, and 15 years in a suburb of Stockholm were examined for antibodies to Toxoplasma. Antibodies were uncommon in small children. They gradually appeared throughout childhood but especially in adolescence and adult life. Antibodies were more common in females than in males. Even small girls were more often infected than boys of corresponding age. The difference becomes marked in puberty and is significant in adults. A family study revealed evidence of familial aggregation of the infection albeit with borderline significance. No correlation was found between occurrence of antibodies and the presence of cats in the families or reported consumption of raw meat. The majority of representative samples of Lapps and Skolt Lapps in northern Scandinavia lacked antibodies to Toxoplasma.

Adolescent

The changed epidemiology of hepatitis A infection in Scandinavia.

The prevalence of antibodies against hepatitis A virus (anti-HAV) was studied in a Swedish city population. A great difference was observed in different age groups. Anti-HAV was not found in the serum of young individuals while the prevalence was high in older ages (87% in individuals 60 years or older). This pattern of hepatitis A exposure is quite different from that reported for instance from the Mediterranean area and may indicate a very low frequency of hepatitis A exposure in Scandinavia today. The high prevalence of anti-HAV in older Swedes possibly reflects hepatitis A exposure in childhood during World War I and II when hepatitis A was more common.

Adolescent

[Assessment of radiologists workload in Scandinavia(author's transl)].

Experience in Sweden, Norway and Finland (University Clinic, Oulu) indicates that the points system instituted by the Scandinavian Association of Radiologists provides a satisfactory means of measuring radiologists' workload. A similar system for assessing radiographic technicians' workload is desirable.

Humans

PCDD and PCDF in human milk from Scandinavia, with special emphasis on Norway.

Levels of polychlorinated dibenzo-p-dioxins (PCDD) and polychlorinated dibenzofurans (PCDF) were measured in human milk in a collaborative Scandinavian study with 10 samples from each of 7 locations in Norway and Sweden (total 70 samples) and 10 samples from Denmark. Four locations represented areas with different PCDD and PCDF sources and three background areas. Norwegian results are presented and related to the Danish and Swedish values. No geographical differences were found in total dioxins expressed as Nordic TCDD equivalents. Mean equivalent values (pg/g fat basis) were 15-18 in Norway and Denmark and 20-24 in Sweden, lower than those reported from parts of Western Europe but higher than in the undeveloped countries. When looking at the individual compounds, the highest values of PCDD congeners were observed in industrialized areas of Sweden, while the highest PCDF values were found in a Norwegian area known for dioxin contamination from a magnesium-producing factory.

Adult

Present functions of forensic psychiatry in Scandinavia.

An attempt is made to give a description of the functions of forensic psychiatry in the Scandinavian countries, including some statistical information on activities and persons involved. Definitions are given. Organizational differences in preparing psychiatric reports to the court in the five countries are outlined, as are the ways in which psychiatrists participate at the post-trial level. Some problems and divergent trends are mentioned. It is concluded that a demand for psychiatric evaluation and treatment of offenders who are psychotic or moderately and more severely mentally retarded will continue to exist, whereas it seems unclear how psychiatrists should deal with the psychiatric problems of offenders with other mental abnormalities. Forensic psychiatric research should include analysis of the functions of this discipline (frequency studies, studies of content, organization and effect).

Ambulatory Care

The situation in Scandinavia.

The history of legislation controlling the treatment of venereal infections and undergraduate and postgraduate training in venereology is outlined. Arrangements for research into these infections and the advantages of centralized facilities for serum antibody tests are described. Syphilis, gonorrhoea, chancroid, and lymphogranuloma venereum are notifiable. One present problem is the difficulty of collecting information on non-gonococcal urethritis. There is a high incidence of infection in Greenland and further research should be undertaken there.

Denmark