This paper reports register data concerning somatic and psychiatric hospital care on 117 battered women who were identified in a surgical emergency department and offered a treatment program. Data were collected during a period of 10 years before to 5 years after the battering in question. It was concluded that the battered woman seeks hospital care much more than the average woman of the same age. It is, however, not only traumatic injuries that bring her to the hospital, but also medical, gynecological, psychiatric, and unspecified disorders and suicide attempts. In this study it was hypothesized that this overuse of hospital care reflects the situation at home characterized by ongoing battering and other psychosocial problems. During the 5 years following the battering, the women did not show any signs of reducing their use of hospital care. It is alarming that this high use of medical care continues over years, and doctors should consider battering as one possible explanation for this phenomenon.
The third chapter by Dr. Ketil Lenert Hansen analyses the major health issues confronting Sami peoples in Norway, Finland, Sweden and Russia and the Inuit in Greenland. The chapter includes an analysis of the unique challenges faced by the indigenous peoples living in the far north due to their specific socioenvironmental location with an increased risk of health problems compared with the average national statistics. Dr. Ketil Lenert Hansen specifies the major constraints to delivering good quality health care in the North and at the same time outlines how traditional healing is being integrated within health services for indigenous peoples.
The true incidence of acute otitis media appears to be on the increase. According to the findings of a number of studies, acute otitis affects 40 per cent of all children during the first years of life. In the article are discussed the prevalence, diagnosis, treatment, follow-up and prevention of acute otitis media in children.
Acute splenic sequestration in children with sickle cell disease - an overview Acute splenic sequestration (ASS) is a life-threatening complication of sickle cell disease (SCD). The condition is important to recognize due to the fact that it can occur with previously unknown disease. ASS is one of the most common causes of death in children with SCD and is the result of blood suddenly getting congested in the spleen, resulting in splenomegaly, acute anemia, and hypovolemic shock. Timely and appropriate treatment is essential in preventing death. Episodes of ASS before one year of age are associated with a higher risk of recurrence. There is no established effective treatment for recurrent ASS; however, there is evidence that all children with SCD should be treated with hydroxyurea. In Sweden, our recommendation is to evaluate the indications for splenectomy after the first episode of ASS. Allogeneic hematopoietic stem cell transplantation (HSCT) is the only curative treatment, and all children with SCD should be evaluated with regard to the potential success of HSCT. This article presents an overview of the condition with Swedish recommendations.
AIMS: To identify characteristics of the public health policies of four Nordic countries concerning how they present the causes of ill health, the best ways to deal with these causes, and where to place responsibility; additionally, to investigate whether there is a common Nordic policy.
METHODS: Analyses of recent public health programs in Denmark, Finland, Norway, and Sweden.
RESULTS: Focus is on either, or both, individual behavior and living conditions as causes of ill health; the remedies are classical liberal as well as social democratic policies. None of the programs is consistent with either ideological strand; each has its peculiar combination of interpretations and policies. The Danish program is the most liberal focusing on behaviors and individual's choices; the Norwegian program is the most social democratic or social liberal focusing mostly on the social and physical environment and the politicians' responsibility to improve the population's health. The Swedish and the Finnish programs lie between those of Denmark and Norway. The Finnish and Norwegian governments stress their responsibility for the health of the population.
CONCLUSIONS: No common Nordic political approach to public health exists. All programs contain contradictory policies and ideological statements with differences regarding the emphasis on individual behavior versus choice and living conditions and political responsibility. The policies are not entirely predictable from the political stance of the government; national differences seem to play a role.
AIMS/HYPOTHESIS: Dietary fatty acids may affect insulin sensitivity. Adipose tissue fatty acid composition partly reflects long-term dietary intake, but data from large studies regarding relationships with insulin sensitivity are lacking. We aimed to determine the association between adipose tissue fatty acids and insulin sensitivity in elderly Swedish men. METHODS: In a cross-sectional analysis of the community-based Uppsala Longitudinal Study of Adult Men (n = 795, mean age 71 years), adipose tissue biopsies were obtained and fatty acid composition was determined by gas-liquid chromatography. Insulin sensitivity was measured directly by a euglycaemic clamp. RESULTS: Palmitic acid (16:0), the major saturated fatty acid (SFA) in the diet and in adipose tissue, was negatively correlated with insulin sensitivity (r = -0.14), as were 16:1 n-7 (r = -0.15), 20:3 n-6 (r = -0.31), 20:4 n-6 (r = -0.38), 22:4 n-6 (r = -0.37) and 22:5 n-3 (r = -0.24; p