Sociodemographic predictors of self-rated health in patients with diabetes of short duration.

Aims: To examine the impact of gender and socioeconomic factors on health-related quality of life (HRQoL) one year and eight years after diabetes diagnosis.

Methods: Two national incidence cohorts who contracted diabetes between the ages of 15 and 34 years (n=554) and matched control groups from the general population of Sweden (n=1,029) were surveyed. Data on HRQoL, diabetes treatment, marital status, education, social class, and employment were collected via a questionnaire mailed to the younger cohort (aged 16-35) one year after diagnosis and to the older cohort (aged 23-42) eight years after diagnosis.

Gender equity in health care: the case of Swedish diabetes care.

To explore the issue of gender equity in diabetes care in Sweden and to develop strategies for monitoring gender equity in health care, population-based studies and statistics published since 1990 were reviewed that contained gender-specific data on health care utilization, glycemic control, patient satisfaction, health-related quality of life, and mortality from diabetes. The review shows that diabetic women in Sweden report more frequent outpatient contacts, less patient satisfaction, and a lower health-related quality of life than diabetic men. No gender differences were found in the level of glycemic control.

Diabetes mellitus and health service utilization: a case-control study of outpatient visits 8 years after diagnosis.

All incident cases of diabetes mellitus in the age group 15 to 34 years have been prospectively registered in Sweden since January 1983. To analyse the utilization of outpatient services 8 years after disease onset, we selected the cases registered in 1983 and two controls per case from the general population, matched by age, gender, and county of residence. In 1991, retrospective data about utilization patterns during a 3-month period were collected via a mailed questionnaire, returned by 317 (72%) patients with diabetes and 586 (68%) controls.

The effect of routine hospital care on the health of hypothermic newborn infants in Zambia.

A prospective cohort study was carried out at the University Teaching Hospital, Lusaka, Zambia, to investigate the prevalence of neonatal hypothermia, type of infant care and incidence of mortality. Two-hundred-and-sixty-one infants, aged 0-7 days, admitted to the pediatric unit during the 'warm' season were recruited to the study. Forty-four per cent of the infants were hypothermic (< 36 degrees C) on admission, and admission hypothermia correlated to admission weight and home delivery in the youngest age group (0-24 hours).

Effects of "group detailing" on the prescribing of lipid-lowering drugs: a randomized controlled trial in Swedish primary care.

The objective was to study the effect of "academic group detailing" on the prescribing of lipid-lowering drugs in Swedish primary care. A randomized controlled trial was conducted, randomization being by group. Groups of doctors at 134 community health centres were randomly allocated to an intervention and a control group.

What future WHO?

New actors on the international health scene have emerged, challenging WHO's leadership in global health. The role and functions of WHO have been questioned. Changes in financing have eroded the influence of the governing bodies.

Randomization by group in studying the effect of drug information in primary care.

Drug information is a technology which is rarely evaluated. Practical and ethical considerations limit the use of a classical experimental method (a randomized controlled trial) in studying the effect of drug information in primary care. An alternative approach, randomization by group, is preferable for several reasons: it avoids contamination of the control group; the effect of information can be evaluated in the natural working environment; and the impact of information is increased via diffusion.

Drug use and the role of patients and prescribers.

In order to move towards rational drug use in any national or local setting the methods of inquiry have to be expanded. Both the public and private sector have to be addressed. In the latter the pharmacists might be studied using a tracer, fictitious client.

Assessment of midwifery routines. Toward a north/south collaborative effort.

Cooperation in midwifery research between Zambia and Sweden is ongoing. Joint studies on gastric suctioning and maternity routines are used as examples, and breastfeeding is discussed from a global perspective. The midwife, who also interprets responses from mothers, is an important member of an assessment team.

Maternity care routines in a teaching hospital in Zambia.

At the University Teaching Hospital, Lusaka, Zambia, 59 uncomplicated, vaginally delivered mothers, were studied with regard to maternity care during the antenatal period and delivery. Information was collected from antenatal cards, labour records, observations during delivery and interviews with mothers. The average of more than five antenatal visits indicates that there was a sufficient demand for health care.

Anthropometry and subsequent mortality in groups of children aged 6-59 months in Guinea-Bissau.

To assess the importance of nutritional status for subsequent survival, 2228 children aged 6-59 mo were followed for 8-12 mo in four different areas of Guinea-Bissau. The overall death rate was 0.62/100 child-months of follow-up (126 deaths) and 0.

Acute illnesses in young children and family response.

Swedish speaking parents of 446 children, all around one year of age and living in the suburbs of Stockholm, participated in a three-week diary study. The aim was to describe the pattern of illnesses in children and the measures taken in the family and to correlate the findings with the socio-economic conditions of the family. A health complaint, most frequently running or blocked nose or a cough, was recorded for about 1/3 of the days of observation.

Health problems and care in young families--load of illness and patterns of illness behaviour.

During a winter month 185 young suburban families reported in a diary on perceived health problems and measures taken in response to these problems. Information on socio-economical factors, medical experience and structure of the social network was obtained from a mailed questionnaire. As a mean every fourth individual-day a health problem was recorded.

Self-prescribing by way of pharmacies in three Asian developing countries.

The pattern of advice given and drugs dispensed at 75 Asian pharmacies in response to the presentation of a fictitious infant with diarrhoea were studied. Only 16 of the 75 pharmacies gave the appropriate advice--oral rehydration or consultation with a health worker. 19 of 25 pharmacies in Bangladesh, 16 of 25 in Sri Lanka, and 24 of 25 in Yemen Arab Republic dispensed drugs, with or without oral rehydration solution.

Determinants of microangiopathy in growth-onset diabetes. With special reference to retinopathy and glycaemic control.

In a quasi-experiment all diabetic children in a defined area were exposed either to an intense clinical treatment or served as a constructed control. The cohort of 146 diabetics was observed prospectively for at least 15 years as to diabetic control, mainly glycosuria, and cross-sectionally examined for microangiopathy on four occasions. Data on family background, social situation, smoking, blood pressure, biochemical status, anthropometry, HLA factors and mortality were also gathered.

Utilization of emergency care by pre-school children in Stockholm suburbs.

The number of emergency visits (i.e. visits on the same day as the first contact for the problem in question was taken) by a defined population of pre-school children in Stockholm was studied during three months in 1977 and 1982.

The epidemiology of diabetes in Swedish children 0-14 years--a six-year prospective study.

Since 1 July 1977, all newly diagnosed diabetic children in Sweden aged 0-14 years have been reported to a central register. During the first 6 years, 2300 newly diagnosed diabetic children out of a population of 1.6 million children were registered.

Health problems and care in young families--an evaluation of survey procedures.

This report compares the value of a diary, and telephone interviews covering either the previous 24 hours or the previous week as methods of collecting data from young families on perceived health problems and the measures taken to deal with them. The population of 310 families was randomly divided into three groups. The study design allowed the evaluation of both qualitative and quantitative aspects of the different methods.

The incidence of diabetes mellitus in Swedish children 0-14 years of age. A prospective study 1977-1980.

This is a prospective study of the incidence of insulin-dependent diabetes mellitus (IDDM) in children 0-14 years of age, including all newly diagnosed cases in the whole of Sweden from July 1, 1977 until June 30, 1980. All 45 Swedish departments of paediatrics participated. During the three-year-period studied, 1108 Swedish children, 0-14 years of age had their onset of diabetes.

Personality changes and social adjustment during the first three years of diabetes in children.

Two groups of 64 diabetic and 30 carefully selected and matched non-diabetic control children 4-17 years old were studied with regard to psychological and social adaptation. Four sets of psycho-social methods were used: (a) psychiatric assessment of the mental state, (b) evaluation of the social situation, (c) measurement of the intellectual capacity, and (d) a Rorschach test. A base-line study was done within 5 months after the onset of diabetes and a follow-up 3 years later with the same methods.