Immigrant patients' experiences and reflections pertaining to the consultation: a study on patients from Chile, Iran and Turkey in primary health care in Stockholm, Sweden.

Our knowledge of the immigrant patient's experiences and reflections regarding consultations in primary health care where interpreters are used is limited. Thus, the primary aim was to explore these experiences and reflections. The second aim was to study whether demographic and migration-related factors are associated with the patient's satisfaction with the consultation and feeling of consolation given by the general practitioner (GP).

The effect of having an affected parent or sibling on invasive and in situ skin cancer risk in Sweden.

Studies suggest that skin cancer aggregates within families; however, the risk of skin cancer associated with having an affected sibling or parent by subtype, tumor site, and age at diagnosis has not been established. The 2006 update of the Swedish Family-Cancer Database was used to calculate standardized incidence ratios (SIRs), representing the ratio of cancer risk among individuals with affected parents or siblings to the general population. Risk of invasive squamous cell skin cancer for individuals with an affected sibling or parent was increased between two- and three-fold compared with that in the general population.

The association between BMI value and long-term mortality.

Objectives: To study total mortality in different categories of BMI values, with adjustments for important covariates in a population-based 26-year mortality follow-up. Special interest will be given to gender differences and low BMI values.

Methods: From a stratified sample in 1969 of 32 185 individuals aged 18-64 years from Stockholm County, 2422 underwent a health examination, with complete data obtained for 1020 subjects.

Cancer risk in hospitalized sarcoidosis patients: a follow-up study in Sweden.

Background: Sarcoidosis patients show dysregulated immune function, which may be related to subsequent cancer. We examined here the overall and specific cancer risks among Swedish subjects who had been hospitalized for sarcoidosis.

Methods: A sarcoidosis research database was created by identifying hospitalized sarcoidosis patients from the Swedish Hospital Discharge Register and by linking them with the Cancer Registry.

Familial risks of psychotic disorders and schizophrenia among siblings based on hospitalizations in Sweden.

Familial risks of psychotic disorders and schizophrenia have been assessed in previous studies. However, the degree of familial clustering in large population datasets remains to be established. We conducted a study on familial risks of psychotic disorders and schizophrenia by linking the Multigeneration Register to the nationwide Swedish Hospital Discharge Register.

Cancer risk in hospitalised asthma patients.

Asthma is an increasingly common disorder, affecting 5-10% of the population. It involves a dysregulated immune function, which may predispose to subsequent cancer. We examined cancer risk among Swedish subjects who had hospital admission once or multiple times for asthma.

Subacute and chronic, non-specific back and neck pain: cognitive-behavioural rehabilitation versus primary care. A randomized controlled trial.

Background: In the industrial world, non-specific back and neck pain (BNP) is the largest diagnostic group underlying sick-listing. For patients with subacute and chronic (= full-time sick-listed for 43 - 84 and 85 - 730 days, respectively) BNP, cognitive-behavioural rehabilitation was compared with primary care. The specific aim was to answer the question: within an 18-month follow-up, will the outcomes differ in respect of sick-listing and number of health-care visits?

Methods: After stratification by age (< or = 44/> or = 45 years) and subacute/chronic BNP, 125 Swedish primary-care patients were randomly allocated to cognitive-behavioural rehabilitation (rehabilitation group) or continued primary care (primary-care group).

Educational level and occupation as risk factors for inflammatory bowel diseases: A nationwide study based on hospitalizations in Sweden.

Background: The aim of this study was to investigate possible associations between educational level, occupation, and hospitalization for inflammatory bowel disease.

Methods: A nationwide database was constructed by linking the Swedish Census to the Hospital Discharge Register in order to obtain data on all first hospitalizations for Crohn's disease (CD) and ulcerative colitis (UC) in Sweden during the study period (1970-2004). Standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) were calculated by educational level and occupation for men and women >or=30 years.

Prevalence of hypertension in immigrants and Swedish-born individuals, a cross-sectional study of 60-year-old men and women in Sweden.

Objective: To estimate the prevalence of hypertension, defined as systolic or diastolic blood pressure or both of at least 140/90 mmHg measured on one occasion or being treated for hypertension or both, in 60-year-old men and women in groups of immigrants compared to Swedish-born.

Design And Method: A population-based, cross-sectional study in Stockholm County including 4228 participants (77% participation rate), of whom 19% were immigrants. Outcome measures were prevalence of hypertension in immigrants compared to Swedish-born men and women with adjustments for various metabolic, lifestyle and socio-economic characteristics.

Different types of exposure to the 2004 tsunami are associated with different levels of psychological distress and posttraumatic stress.

The impact of traumatic exposure on psychological distress and posttraumatic stress was investigated at 14 months through self-report in 1,505 Swedish tourists who survived the 2004 Indian Ocean Tsunami. Exposure, differentiated in single and multiple types, was associated with different levels of impaired mental health measured by General Health Questionnaire (GHQ) and Impact of Event Scale-Revised (IES-R). Additionally, having sole exposure to subjective life threat brought about specific psychological effects.

Improving fast and frugal modeling in relation to regression analysis: test of 3 models for medical decision making.

Background: Data from 2 previous studies were reanalyzed, one on judgments regarding drug treatment of hyperlipidemia and the other on diagnosing heart failure. The original MH model and the extended MH model were compared with logistic regression (LR) in terms of fit to actual judgments, number of cues, and the extent to which the cues were consistent with clinical guidelines.

Results: There was a slightly better fit with LR compared with MH.

The influence of age at migration and length of residence on self-rated health among Swedish immigrants: a cross-sectional study.

Objective: Increasing global migration has led to profound demographic changes in most industrialised countries. A growing body of research has investigated various health aspects among immigrant groups and found that some immigrant groups have poorer health than the majority population. It has been suggested that poor acculturation in the host country could lie behind the increased risk of worsened health among certain immigrant groups.

Physical activity, exercise and self-rated health: a population-based study from Sweden.

Background: In order to screen for the most inactive individuals in the population and target health-related interventions where they are most needed it is important to assess different forms of physical activity in population-based studies. The aims were (1) to identify the most inactive individuals in the population by assessing two dimensions of physical activity, (2) to investigate the correlation between exercise and total physical activity and (3) to investigate the association between exercise, total physical activity and good self-rated health.

Methods: A simple random sample of the Swedish population aged 25-64 years were interviewed about their living conditions, health and lifestyle in a survey performed by Statitics Sweden.

The impact of ethnicity and self-reported health on psychological well-being: a comparative study of Kurdish-born and Swedish-born people.

Unlabelled: Although immigrants generally have poorer health and higher psychological distress than the native population, information on Kurdish immigrants' psychological well-being is limited. The aims of the study were to examine the association between ethnicity and poor psychological well-being, and to assess the relationships between socio-demographic characteristics, self-reported health, somatic pain, gastrointestinal complaints and poor psychological well-being.

Methods: Immigrants with self-reported Kurdish ethnicity (men, n=111; women, n=86) in Sweden from the national sample of immigrants aged 27-60 and 1407 Swedes (1996) were studied.

District nurses' involvement in pain care: a theoretical model.

Aim: To explore district nurses care of chronic pain sufferers and to create a theoretical model that can explain the variation in district nurses experiences when caring for these patients.

Background: Many people suffer from chronic pain, which greatly affects their wellbeing and causes physical suffering and psychosocial limitations. District nurses frequently meet patients who suffer from chronic pain and consequent problems.

Arranging appropriate activities immigrant women's ideas of enabling exercise.

Objective: Several studies have reported low levels of physical activity among immigrant women. However, few studies have attempted to explore possible causes underlying this phenomenon. This study intended to explore immigrant women's attitudes and experiences of physical activity and exercise.

Migration and self-rated health: a comparison between Finns living in Sweden and Finns living in Finland.

Aims: There is a lack of studies comparing health among immigrant groups with health among the population in their country of origin. This study compared the prevalence of self-rated poor health between Finns living in Sweden and Finns living in Finland.

Methods: Data were obtained from the Swedish Annual Level of Living Survey between 1996 and 2003 and the Finnish national survey "Health 2000''.

High prevalence of diabetes among immigrants from non-European countries in Sweden.

Patients with diabetes aged 35-64 years from four primary health care centres in Stockholm County were identified from electronic patient records (EPRs): diabetes prevalence occurred 414 of 15,317 men, and 250 of 15,388 women. The age- and sex-standardized prevalence of diabetes was as follows: Non-European immigrants, 5.82% (95% CI 5.

Survival in ovarian cancer patients by histology and family history.

Introduction: Earlier studies suggest that histology has no prognostic significance in patients with invasive ovarian tumors. Studies about the effect of family history on survival have given conflicting results, which we try to clarify in this study. As an additional question, we examined whether family members share survival experience.

Implementing a clinical decision-support system in practice: a qualitative analysis of influencing attitudes and characteristics among general practitioners.

In order to obtain a better understanding of barriers to the implementation of clinical decision-support systems (CDSSs) in primary health care, we explored general practitioners' (GPs) handling of a CDSS during the implementation process. An Internet-based application for the management of chronic heart failure was used that was an adaptation of established clinical guidelines for computer use. The whole implementation process was followed closely, using a combination of different methods for data collection: repeated interviews with the five participating GPs, observations of patient visits, patient interviews, and detection of usage.

Age-specific familial risks of anxiety. A nation-wide epidemiological study from Sweden.

Objective: Familial risks of anxiety have been assessed in small case-control studies, usually based on reported, but not medically verified, anxiety in family members; thus the degree of familial clustering of these diseases remains to be established.

Methods: The Multigeneration Register, in which all men (sons) and women (daughters) born in Sweden from 1932 onward are registered together with their parents, was linked to hospital admission data. Standardized incidence ratios (SIRs) were calculated as the ratio of the observed to the expected number of cases of men and women with mothers and/or fathers affected by anxiety, compared with men and women whose mothers and/or fathers were not affected by anxiety.

Gender differences in self-rated health, quality of life, quality of care, and metabolic control in patients with diabetes.

Background: Because the projected increase in the number of diabetic patients is expected to strain the capabilities of health care providers worldwide, we are challenged to find ways of reducing the burden of diabetes. Maintaining and improving health-related quality of life (QoL) for diabetic patients may be viewed as public health goals.

Objective: The aim of this cross-sectional study was to compare different aspects of health, QoL, and quality of care (QoC) between men and women with diabetes as a basis for planning and managing diabees care.

Regional, socioeconomic and occupational groups and risk of hospital admission for multiple sclerosis: a cohort study in Sweden.

Objective: The aim of this study was to investigate possible associations between hospitalization for multiple sclerosis (MS) and region, socioeconomic status and occupation.

Methods: A nationwide database was constructed by linking Swedish Census data to the Hospital Discharge Register (1987-2001). The hospital diagnoses of MS were based on the International Classification of Diseases.

Screening and diagnosing depression in women visiting GPs' drop in clinic in Primary Health Care.

Background: Only half of all depressions are diagnosed in Primary Health Care (PHC). Depression can remain undetected for a long time and entail high costs for care and low quality of life for the individuals. Drop in clinic is a common form of organizing health care; however the visits are short and focus on solving the most urgent problems.

Obstructive sleep apnea syndrome in siblings: an 8-year Swedish follow-up study.

Background: Understanding the genetic transmission of obstructive sleep apnea syndrome (OSAS) will help clinicians identify patients at risk and offer opportunities for intervention and treatment at specialist clinics.

Objective: To estimate familial risk of hospitalization for OSAS in the adult population of Sweden, and to determine if there are any differences by age and sex.

Design, Setting, And Participants: Using the MigMed database at the Karolinska Institute, we divided the population of Sweden into sibling groups based on a shared mother and father and ascertained the presence or absence of a primary hospital diagnosis of OSAS in each individual during the follow-up period, 1997 to 2004.