Screening for preventive geriatric health-care has become common in many Norwegian municipalities. Different methods are used to screen for unreported need of intervention. There is little information available about which is the most costeffective method. This article describes a comparison of two screening models. The first screening was conducted by means of a personal interview held at a health clinic and the second by a postal questionnaire. The results show that a postal questionnaire study was more cost-effective than the health-clinic consultation. It demanded no more resources than the health-clinic model, but had a wider effect because it covered a broader spectrum with regard to response, proportion of the total population and the proportion of respondents for whom an intervention was implemented.
We report a comparison of fibrinolytic variables between 10 Caucasians on a predominantly European diet and 10 Greenland Eskimos on a traditional Inuit diet containing a substantial amount of fish and sea animals. We studied the diurnal variation in tissue type plasminogen activator (t-PA) and plasminogen activator inhibitor (PAI) antigens and activities during a 24-h period. Blood samples were taken every 4 h. The variations of the sinusoidal curves were evaluated by the Friedman chi 2 test. t-PA and PAI-1 antigen in plasma fluctuated significantly during the 24 h (Eskimos p less than 0.00007 and p less than 0.0007; Caucasians p less than 0.00003 and p less than 0.02), with a peak in the early morning and a nadir in the afternoon. This also held true for PAI activity (Eskimos p less than 0.0008; Caucasians p less than 0.01), whereas t-PA activity showed an inverse but still significant pattern (Eskimos p less than 0.006; Caucasians p less than 0.0008). Amplitudes, areas underneath, and overall medians of the sinusoidal curves did not deviate between the two groups with respect to t-PA and PAI. In contrast to the significant variation of t-PA and PAI, the plasma concentrations of fibrin degradation products (D-Dimer), a measure of effective fibrinolysis, remained constant during the 24 h, and the absolute differences between groups did not reach statistical significance. These findings suggest that circadian variation of fibrinolytic activators and inhibitors is a basic biologic phenomenon, which is not affected by life-style, dietary habits, or ethnic differences.(ABSTRACT TRUNCATED AT 250 WORDS)
The possible contribution to the total mercury burden by dental amalgam among Greenland Eskimos has been studied in Nanortalik Health District. A total of 40 individuals have been tested, and no significant differences in whole blood mercury have been found between individuals with and without experience of dental amalgam. Higher values than previously reported for South-West Greenland have been found, mercury (Hg) concentrations reaching a median of 53 microgram Hg/l in males and 42.5 microgram Hg/l in females. A tendency towards covariation with the relative amount of local food items in the diet did not reach significance at a 5% level.
Greenland Inuit are a population with a low risk of cardiovascular disease. Recently, we stated that frequencies of potentially high risk alleles of the apolipoproteins, fibrinogen, factor V, glycoprotein IIIa and factor VII (FVII) genes have different allele frequencies in the Inuit when compared with Caucasian populations. We have extended this study and evaluated whether or not this was also true for the genetic polymorphisms of tissue-type plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1), angiotensin-converting enzyme (ACE) and angiotensinogen in a group of 133 Greenland Inuit, aged 30-34 gamma. In addition, we compared the plasma levels of these factors and those of C-reactive protein (CRP) and D-Dimer in Inuit and in Danes, comparable for age and gender. Frequencies (f) were assessed of the alleles that are known as the potential high risk alleles in Caucasians. In the Inuit, the f(insertion allele) of the t-PA intron8ins311 polymorphism was 0.37 (CI 0.32-0.43), the f(4G allele) of the PAI-1 promoter polymorphism was 0.88 (CI 0.83-0.91), the f(deletion allele) of the ACE intron16ins287 polymorphism was 0.40 (CI 0.33-0.47) and the f(M-allele) of the angiotensinogen M/T353 polymorphism was 0.30(CI 0.25-0.38). As for fibrinogen and FVII polymorphisms, these frequencies are all significantly different from what is reported for Caucasian populations. In the Inuit, plasma levels of fibrinogen and D-Dimer were higher than in the Danes, the PAI-1 levels were lower and FVII, t-PA and CRP levels were comparable. The observed allele frequencies of the polymorphisms of t-PA, fibrinogen, FVII, ACE, angiotensinogen and the plasma levels of PAI-1 and D-Dimer were in accordance with the low CVD risk in the Inuit, considering the observed associations between these measures and CVD risk in Caucasian populations, but for other measures this was not the case (allele frequencies of the PAI-1 polymorphism, and plasma levels of fibrinogen, FVII and t-PA). In conclusion there are clear differences in genetic background and plasma levels of risk factors in Greenland Inuit compared with Caucasian populations, and these differences were sometimes, but not always, in accordance with the observed low cardiovascular disease risk of the Inuit population.
Geriatric screening at health clinics has become a regular feature of the health-care services offered in some Norwegian municipalities. Normally there is good participation in such screening programmes, but there are always some non-attenders. There is little published material showing the intervention needs among non-respondents. In a municipality in the middle parts of Norway, screening was offered to the municipality's elderly inhabitants at the local health clinic. Those who did not attend were offered a domiciliary visit. The findings indicate that there is a category of people among those who do not attend for screening at the health clinic who have less need of a medical examination and socioeconomic support than those who do attend the screening. There is also a category in need of community nursing, technical aids and health care because of senile dementia, depression and unsought social isolation.
Previously it has been reported that Greenland Inuit (Eskimos) from the Uummannaq district display low levels of plasma cholesterol and triglycerides and relatively high levels of high density lipoprotein (HDL) when compared with healthy Danish control subjects (Lancet 1971;1:1143-1146). Here we present data obtained in 1989 that show the following. In a group of 133 healthy adult Greenland Inuit from Nanortalik, the levels of plasma cholesterol and low density lipoprotein (LDL) cholesterol (6.39 and 4.39 mmol/l, respectively) were slightly higher than "normal" values found in western societies, whereas the HDL cholesterol level was markedly higher (1.64 mmol/l). Compared with most Caucasian populations, the Inuit population we studied exhibits a high apolipoprotein (APO)E*4 allele frequency (0.229), whereas the APOE*2 allele frequency was extremely low (0.015). In contrast to Caucasian populations, in the Inuit population the apoE polymorphism showed only a minor influence on the plasma lipid and (apo)lipoprotein levels, as evaluated by multiple regression analysis, with the exception of apoE levels. This absence of an effect could be explained by the low very low density lipoprotein (VLDL) plus intermediate density lipoprotein (IDL) cholesterol levels. The contributions of eicosapentaenoic acid and linoleic acid to the total amount of fatty acids in plasma cholesterol esters differed markedly from those reported in 1971 for another Greenland Inuit population (3.2% versus 15.8% and 49.5% versus 20.4%, respectively), thereby resembling values now found in the average western population. Even in those Inuit who reported exclusive consumption of the traditional Inuit diet (13% of the population), the fatty acid composition of the plasma cholesterol esters closely resembled the values measured in western populations.(ABSTRACT TRUNCATED AT 250 WORDS)