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A 10 year asthma programme in Finland: major change for the better.

https://arctichealth.org/en/permalink/ahliterature168103
Source
Thorax. 2006 Aug;61(8):663-70
Publication Type
Article
Date
Aug-2006
Author
T. Haahtela
L E Tuomisto
A. Pietinalho
T. Klaukka
M. Erhola
M. Kaila
M M Nieminen
E. Kontula
L A Laitinen
Author Affiliation
Skin and Allergy Hospital, Helsinki University Central Hospital, P O Box 160, FIN-00029 HUS, Finland. tari.haahtela@hus.fi
Source
Thorax. 2006 Aug;61(8):663-70
Date
Aug-2006
Language
English
Publication Type
Article
Keywords
Adult
Anti-Asthmatic Agents - therapeutic use
Asthma - economics - epidemiology - therapy
Child
Communication
Cost of Illness
Disabled Persons
Emergency Treatment - statistics & numerical data
Finland - epidemiology
Health Promotion - economics - organization & administration - trends
Hospitalization - statistics & numerical data
Humans
Incidence
Insurance, Disability - economics
Interprofessional Relations
National Health Programs - economics - trends
Pharmaceutical Services - standards
Primary Health Care
Program Evaluation
Smoking - epidemiology
Abstract
A National Asthma Programme was undertaken in Finland from 1994 to 2004 to improve asthma care and prevent an increase in costs. The main goal was to lessen the burden of asthma to individuals and society.
The action programme focused on implementation of new knowledge, especially for primary care. The main premise underpinning the campaign was that asthma is an inflammatory disease and requires anti-inflammatory treatment from the outset. The key for implementation was an effective network of asthma-responsible professionals and development of a post hoc evaluation strategy. In 1997 Finnish pharmacies were included in the Pharmacy Programme and in 2002 a Childhood Asthma mini-Programme was launched.
The incidence of asthma is still increasing, but the burden of asthma has decreased considerably. The number of hospital days has fallen by 54% from 110 000 in 1993 to 51 000 in 2003, 69% in relation to the number of asthmatics (n = 135 363 and 207 757, respectively), with the trend still downwards. In 1993, 7212 patients of working age (9% of 80 133 asthmatics) received a disability pension from the Social Insurance Institution compared with 1741 in 2003 (1.5% of 116 067 asthmatics). The absolute decrease was 76%, and 83% in relation to the number of asthmatics. The increase in the cost of asthma (compensation for disability, drugs, hospital care, and outpatient doctor visits) ended: in 1993 the costs were 218 million euro which had fallen to 213.5 million euro in 2003. Costs per patient per year have decreased 36% (from 1611 euro to 1031 euro).
It is possible to reduce the morbidity of asthma and its impact on individuals as well as on society. Improvements would have taken place without the programme, but not of this magnitude.
Notes
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PubMed ID
16877690 View in PubMed
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A 10-year incidence of acute whiplash injuries after road traffic crashes in a defined population in northern Sweden.

https://arctichealth.org/en/permalink/ahliterature122426
Source
PM R. 2012 Oct;4(10):739-47
Publication Type
Article
Date
Oct-2012
Author
Johan Styrke
Britt-Marie Stålnacke
Per-Olof Bylund
Peter Sojka
Ulf Björnstig
Author Affiliation
Division of Surgery, Department of Surgical and Perioperative Sciences, Umeå University, 901 85 Umeå, Sweden. johan.styrke@surgery.umu.se
Source
PM R. 2012 Oct;4(10):739-47
Date
Oct-2012
Language
English
Publication Type
Article
Keywords
Accidents, Traffic - statistics & numerical data - trends
Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Automobiles
Bicycling
Catchment Area (Health)
Child
Child, Preschool
Emergency Service, Hospital
Female
Humans
Incidence
Insurance Claim Reporting - statistics & numerical data - trends
Male
Middle Aged
Questionnaires
Sex Distribution
Sweden - epidemiology
Trauma Centers
Whiplash Injuries - epidemiology
Young Adult
Abstract
To examine the annual incidence of acute whiplash injuries after road traffic crashes in a geographic catchment area in Northern Sweden during the period 2000-2009.
Descriptive epidemiology determined by prospectively collected data from a defined population.
The study was conducted at a public hospital in Sweden.
The population of the hospital's catchment area (136,600 inhabitants in 1999 and 144,500 in 2009).
At the emergency department, all injured persons (approximately 11,000 per year) were asked to answer a questionnaire about the injury incident. Data from the medical records also were analyzed. From 2000-2009, 15,506 persons were injured in vehicle crashes. Persons who were subject to an acute neck injury within whiplash-associated disorder grades 1-3 were included. The overall and annual incidences were calculated as incidence. Age, gender, type of injury event, and direction of impact were described. The incidences were compared with national statistics on insurance claims from 2003, 2007, and 2008 to detect changes in the proportions of claims.
The annual incidence of acute whiplash injuries. Secondary outcome measures were types of injury events, age and gender distribution, changes in the proportion of rear-end crashes during 2000-2009, and changes in the proportion of insurance claims during 2003-2008.
During 2000-2009, 3297 cases of acute whiplash injury were encountered. The overall incidence was 235/100,000/year. The average yearly increase in incidence was 1.0%. Women comprised 51.9% and men 48.1% of the injured. Car occupants (86.4%) and bicycle riders (6.1%) were most frequently injured. The proportion of rear-end crashes decreased from 55% to 45% from 2000-2009. The proportion of insurance claims significantly decreased between 2003 and 2008 (P
PubMed ID
22819305 View in PubMed
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[A crisis intervention service in an outpatient psychiatric clinic of a general hospital: function and clientele].

https://arctichealth.org/en/permalink/ahliterature221532
Source
Can J Psychiatry. 1993 Mar;38(2):96-100
Publication Type
Article
Date
Mar-1993
Author
J P Fournier
F. Gagnon
Author Affiliation
Centre hospitalier de l'Université Laval, Ste-Foy, Québec.
Source
Can J Psychiatry. 1993 Mar;38(2):96-100
Date
Mar-1993
Language
French
Publication Type
Article
Keywords
Adolescent
Adult
Crisis Intervention
Cross-Sectional Studies
Emergency Services, Psychiatric - utilization
Female
Hospitals, General - utilization
Humans
Incidence
Male
Mental Disorders - diagnosis - epidemiology - rehabilitation
Middle Aged
Outpatient Clinics, Hospital - utilization
Patient Care Team - utilization
Psychiatric Status Rating Scales
Quebec - epidemiology
Risk factors
Suicide - prevention & control - statistics & numerical data
Abstract
The authors describe an external crisis intervention service in a general hospital. This service is intended for a clientele presenting acute mental health problems, referred, in the majority of cases, from the emergency department. They present demographic data, diagnostic data, data on the factors precipitating the crises and data which can be used to qualify and quantify the clientele. In addition, they describe the therapeutic approach and the treatment philosophy, the number of follow-up sessions, and the guidance provided to the clientele after follow-up. Finally, the authors suggest prerequisites considered essential to the effective operation of a crisis intervention module in an external psychiatric clinic.
PubMed ID
8467450 View in PubMed
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[Acute coronary syndrome: regional experience of rendering urgent aid at prehospital stage in Khanty-Mansi Autonomous Okrug--Yugra].

https://arctichealth.org/en/permalink/ahliterature117732
Source
Kardiologiia. 2013;53(11):17-20
Publication Type
Article
Date
2013
Author
I A Urvantseva
L V Salamatina
I A Andreeva
E V Milovanova
S I Mamedova
O R Ibragimov
A A Seitov
Source
Kardiologiia. 2013;53(11):17-20
Date
2013
Language
Russian
Publication Type
Article
Keywords
Acute Coronary Syndrome - epidemiology - therapy
Ambulatory Care - methods
Electrocardiography
Emergency Medical Services - methods
Female
Fibrinolytic Agents - therapeutic use
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Prognosis
Retrospective Studies
Russia - epidemiology
Survival Rate - trends
Thrombolytic Therapy - methods
Time Factors
Abstract
Aim of the study was assessment of efficacy of rendering urgent aid to patients with acute coronary syndrome (ACS) at prehospital stage on the territory of Khanty-Mansi Autonomous Okrug (KhMAO). The analysis showed that yearly about 5000 inhabitants of KhMAO-Yugra received prehospital medical care (30% because of acute myocardial infarction, 70% because of unstable angina). Over 3 years portion of persons requesting medical aid during first 3 hours after onset of pain attack increased 6.1%. Rate of prehospital fibrinolysis did not exceed 6.5%. Alteplase was used most often (79.7%). Late patient's appeal was among causes of rare application of thrombolytic therapy (41.8%). Most physicians responsible for prehospital care considered it necessary to refer patients with ACS directly to centers of interventional cardiology. The data obtained would promote improvement of quality of medical aid to ACS patients at prehospital stage.
PubMed ID
24654430 View in PubMed
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Acute epiglottitis in northern Finland today--still a potential emergency situation.

https://arctichealth.org/en/permalink/ahliterature33007
Source
Int J Circumpolar Health. 1999 Oct;58(4):226-33
Publication Type
Article
Date
Oct-1999
Author
O P Alho
K. Jokinen
T. Pirilä
A. Ilo
P. Koivunen
Author Affiliation
Department of Otorhinolaryngology, University of Oulu, Finland. opalho@cc.oulu.fi
Source
Int J Circumpolar Health. 1999 Oct;58(4):226-33
Date
Oct-1999
Language
English
Publication Type
Article
Keywords
Acute Disease
Adolescent
Adult
Aged
Child
Child, Preschool
Emergency Treatment - adverse effects - methods
Epiglottitis - epidemiology - etiology - therapy
Female
Finland - epidemiology
Haemophilus Infections - complications
Haemophilus influenzae type b
Humans
Incidence
Infant
Infant, Newborn
Intubation, Intratracheal - adverse effects - methods
Male
Middle Aged
Population Surveillance
Registries
Risk factors
Tracheotomy - adverse effects - methods
Treatment Outcome
Abstract
To examine patient characteristics related to airway intervention in acute epiglottitis and how the intervention affected the further course of the disease, 46 pediatric and 49 adult cases were retrospectively evaluated. All three airway management approaches, namely observation, nasotracheal intubation and tracheotomy were needed in both the children and adults. Five out of every six children needed an artificial airway, while observation was sufficient in three out of every five adults. H influenzae type b bacteremia in children, a short duration of the symptoms in adults and most important, respiratory distress in both were the best predictors of the need for an artificial airway. Nasotracheal intubation may be a successful means of implementing an artificial airway, but it is a technically demanding procedure and complications are frequent. Despite the recent changes in the occurrence of acute epiglottitis it remains a potential emergency situation both in children and adults.
PubMed ID
10615827 View in PubMed
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[Acute myocardial infarction among Icelanders forty years old and younger 2005-2009. Comparison with a study carried out 1980-1984].

https://arctichealth.org/en/permalink/ahliterature283430
Source
Laeknabladid. 2017 Januar;103(1):11-15
Publication Type
Article
Author
Bjorn Jakob Magnusson
Uggi Agnarsson
Thorarinn Guðnason
Gudmundur Ã?orgeirsson
Source
Laeknabladid. 2017 Januar;103(1):11-15
Language
Icelandic
Publication Type
Article
Keywords
Adult
Age of Onset
Cause of Death
Chi-Square Distribution
Comorbidity
Emergency medical services
Female
Genetic Predisposition to Disease
Hospital Mortality
Hospitals, University
Humans
Hypertension - epidemiology
Iceland - epidemiology
Incidence
Male
Myocardial Infarction - diagnosis - epidemiology - genetics - microbiology
Obesity - epidemiology
Pedigree
Risk assessment
Risk factors
Sex Factors
Smoking - adverse effects - epidemiology
Time Factors
Young Adult
Abstract
While acute myocardial infarction  (AMI) mostly is a disease of the elderly it also affects younger individuals, often with serious consequenses. In 1980-1984 a study was carried out on the incidence, risk factors, infarct location and distribution of atherosclerosis among Icelanders forty years and younger with AMI. Here we present the results of a similar study carried out for the five year period 2005-2009.
Medical and autopsy records of all individuals, forty years and younger, diagnosed with AMI (I21 in ICD-10) at Landspitali, National University Hospital 2005-2009, or suffering sudden cardiac death in Iceland during the same period were reviewed. Blood tests, electrocardiograms, echocardiograms, coronary angiograms and autopsy results were reviewed with respect to AMI-criteria. Statistical comparisons of ratios and means were carried out using Chi-square test and T-test, respectively.
38 individuals 40 years and younger, 32 males and 6 females, fulfilled the diagnostic criteria of AMI. Calculated incidence for the population at risk was 10/100.000/year (14/100.000/year in 1980-1984) and the mean age ±S.D. was 36.7±3.9. Three (7.9%) died suddenly before reaching hospital but of the 35 hospitalised patients 30 day mortality was zero, compared to nine (23.7%) pre-hospital deaths and two (6.9%) hospital deaths in 1980-1984. Thus, combined pre-hospital and in-hospital (30 day) mortality was 28.9% and 7.9% in the previous and recent time periods, respectively (p=0.02). In 2005-2009, 77.1% had a smoking history and 31.4% were hypertensive compared to 97% and 6.9% in 1980-85 (p=0.026 and p=0.015, respectively). Body mass index (BMI) was higher in the later period, 28.6±4,8 kg/m2 compared to 26.1±3.6 (mean±S.D.; p=0.04) but s-cholesterol was lower, 5.1±1.4 mmol/L compared to 6.3±1.16 ( mean±S.D.; p
PubMed ID
28497765 View in PubMed
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Acute poisonings in Iceland: a prospective nationwide study.

https://arctichealth.org/en/permalink/ahliterature86765
Source
Clin Toxicol (Phila). 2008 Feb;46(2):126-32
Publication Type
Article
Date
Feb-2008
Author
Kristinsson Jakob
Palsson Runolfur
Gudjonsdottir Gudborg A
Blondal Margret
Gudmundsson Sigurdur
Snook Curtis P
Author Affiliation
Institute of Pharmacy, Pharmacology and Toxicology, University of Iceland, Reykjavik, Iceland.
Source
Clin Toxicol (Phila). 2008 Feb;46(2):126-32
Date
Feb-2008
Language
English
Publication Type
Article
Keywords
Acute Disease
Adolescent
Adult
Age Factors
Alcoholic Beverages - poisoning
Child
Child, Preschool
Circadian Rhythm
Counseling - methods
Data Collection - methods - statistics & numerical data
Emergency Service, Hospital - statistics & numerical data
Female
Hazardous Substances - classification - poisoning
Humans
Iceland - epidemiology
Incidence
Male
Middle Aged
Patient Admission - statistics & numerical data
Poison Control Centers - utilization
Poisoning - epidemiology - prevention & control
Prospective Studies
Rural Health Services - statistics & numerical data
Sex Factors
Suicide, Attempted - statistics & numerical data
Abstract
INTRODUCTION: Poisoning is a common cause of emergency visits and hospital admission in Western countries. The purpose of this study was to assess the incidence and type of toxic exposures presenting to emergency medical facilities in Iceland. MATERIALS AND METHODS: The study was prospective and included all patients with confirmed or suspected poisoning presenting to hospitals and rural medical centers providing emergency services in Iceland during the twelve-month period from April 2001 until March 2002. RESULTS: A total of 1,121 toxic exposures were documented representing an incidence of 3.91 cases per 1,000 inhabitants per year. The female to male ratio was 1.23. The majority of exposures (56.7%) occurred in the patient's home, 60% were deliberate, 72% had drugs and/or alcohol as their main cause, and 11% involved illicit drugs. Exposures to chemicals other than drugs were usually unintentional. CONCLUSION: Toxic exposures requiring emergency medical care are common in Iceland. Self-poisonings by ingestion of prescription drugs and/or alcohol accounted for the majority of cases.
PubMed ID
18259960 View in PubMed
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Aetiology, epidemiology and management strategies for blunt scrotal trauma.

https://arctichealth.org/en/permalink/ahliterature279682
Source
Surgeon. 2016 Feb;14(1):18-21
Publication Type
Article
Date
Feb-2016
Author
D M Dalton
N F Davis
D C O'Neill
C M Brady
E A Kiely
M F O'Brien
Source
Surgeon. 2016 Feb;14(1):18-21
Date
Feb-2016
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Child
Diagnostic Imaging - methods
Disease Management
Emergency Service, Hospital
Humans
Iceland - epidemiology
Incidence
Male
Middle Aged
Practice Guidelines as Topic
Prognosis
Retrospective Studies
Scrotum - injuries
Wounds, Nonpenetrating - epidemiology - etiology - therapy
Young Adult
Abstract
To describe our experience of all patients presenting to a tertiary referral centre over a 3 year time period with blunt scrotal trauma and to describe a methodical approach for managing this group of patients.
A retrospective analysis was performed on all patients presenting to the Emergency Department (ED) of a level 1 trauma centre with blunt scrotal trauma from 2010 to 2013 inclusive. Inclusion criteria included a recent history of blunt scrotal trauma with associated pain and/or swelling of the affected testis on clinical examination.
Twenty-seven male patients with a median age of 19 (range 8-65) years were included and all but 1 patient underwent scrotal ultrasonography upon presentation. Sixteen patients (59%) presented with scrotal trauma secondary to a sports related injury. Fifteen patients were managed conservatively and of the 12 who underwent urgent exploration 9 had a testicular rupture, including 1 who had an emergency orchidectomy due to a completely shattered testis. Four patients had >30% of the testis replaced by necrotic tissue/haematoma; of which 2 ultimately underwent orchidectomy and insertion of testicular prosthesis.
Our findings demonstrate that the necessity for scrotal protection in sports that predispose to scrotal trauma should be reviewed. We also demonstrate the importance of scrotal ultrasonography for determining an appropriate management strategy (i.e., conservative versus surgical treatment) in this young patient cohort.
PubMed ID
25151340 View in PubMed
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Air pollution and pneumonia: the "old man" has a new "friend".

https://arctichealth.org/en/permalink/ahliterature146569
Source
Am J Respir Crit Care Med. 2010 Jan 1;181(1):5-6
Publication Type
Article
Date
Jan-1-2010

An exact test to detect geographic aggregations of events.

https://arctichealth.org/en/permalink/ahliterature143029
Source
Int J Health Geogr. 2010;9:28
Publication Type
Article
Date
2010
Author
Rhonda J Rosychuk
Jason L Stuber
Author Affiliation
Department of Pediatrics, 11402 University Avenue NW, Edmonton, Alberta, Canada. rhonda.rosychuk@ualberta.ca
Source
Int J Health Geogr. 2010;9:28
Date
2010
Language
English
Publication Type
Article
Keywords
Adolescent
Age Distribution
Alberta - epidemiology
Cluster analysis
Databases, Factual
Demography
Emergency Service, Hospital - utilization
Female
Humans
Incidence
Male
Poisson Distribution
Risk assessment
Sampling Studies
Self-Injurious Behavior - diagnosis - epidemiology
Sensitivity and specificity
Sex Distribution
Abstract
Traditional approaches to statistical disease cluster detection focus on the identification of geographic areas with high numbers of incident or prevalent cases of disease. Events related to disease may be more appropriate for analysis than disease cases in some contexts. Multiple events related to disease may be possible for each disease case and the repeated nature of events needs to be incorporated in cluster detection tests.
We provide a new approach for the detection of aggregations of events by testing individual administrative areas that may be combined with their nearest neighbours. This approach is based on the exact probabilities for the numbers of events in a tested geographic area. The test is analogous to the cluster detection test given by Besag and Newell and does not require the distributional assumptions of a similar test proposed by Rosychuk et al. Our method incorporates diverse population sizes and population distributions that can differ by important strata. Monte Carlo simulations help assess the overall number of clusters identified. The population and events for each area as well as a nearest neighbour spatial relationship are required. We also provide an alternative test applicable to situations when only the aggregate number of events, and not the number of events per individual, are known. The methodology is illustrated on administrative data of presentations to emergency departments.
We provide a new method for the detection of aggregations of events that does not rely on distributional assumptions and performs well.
Notes
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PubMed ID
20529286 View in PubMed
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240 records – page 1 of 24.