Evaluation of an Educational Programme for Telephone Advisers in Primary Health Care

Marklund B, Silfverhielm B and Bengtsson C. Evaluation of aneducational programme for telephone advisers in primary healthcare. Family Practice 1989; 6: 263–267. Telephone advisers, usually registered nurses, have a very importantrole in the Swedish primary health care service. In order toimprove this service, a special educational programme has beenworked out for registered nurses working at a Swedish healthcentre. The purpose of this paper is to evaluate this educationalprogramme at one of the health centres. The quality of the telephoneadvice was evaluated by a blind observer. After the educationalprogramme the quality of advice was improved. Among the participatingnurses, the confidence and the satisfaction with the work increasedafter the educational programme.     

Erythropoietin and Renin Substrate in Cerebellar Haemangioblastoma

ABSTRACT. We examined eight cerebellar haemangioblastoma tumours from eight patients, aged 16–63 years, 5 females and 3 males. Preoperative haemoglobin values exceeded 180 g/1 in four patients, and 150 g/1 in four. All high Hb values were normalized upon surgical removal of the tumours. All tumours contained scattered cells which stained positively with antisera against pure human urinary erythropoietin and plasma renin substrate. We conclude that cerebellar haemangioblastomas produce immunoreactive erythropoietin, which shares common antigenic determinants with renin substrate.     

Interrelation between potential risk factors for cardiovascular disease in men aged 33-42 years with special reference to life-style factors: A study from Habo in the County of Skaraborg, Sweden

A population study was carried out in the community of Haboin southwestern Sweden, to which all men living in the communityaged 33–42 years were invited. Altogether 652 participated,the participation rate being 86.1%. Special reference was givento potential risk factors for coronary heart disease. Therewere significant correlations between the life-style factors(physical inactivity, smoking, alcohol intake, self-experiencedmental stress) and probable biological markers of life-stylefactors such as anthropometric data, blood pressure and serumlipids. Physical inactivity was the life-style factor whichwas most strongly associated with anthropometric measurementsand to a lower degree with serum lipid concentrations and arterialblood pressure. Of the biological markers studied, the waistto hip circumference ratio was most strongly associated withlife-style factors. The observations further emphasize the needfor a murtifactorial view on risk factors.     

Morbidity and Mortality in Relation to Blood Pressure and Antihypertensive Treatment

ABSTRACT Morbidity and mortality in cardiovascular and cerebrovascular diseases and total mortality have been studied in a longitudinal population study initially comprising 1462 women representative of the general female population. When related to the initial blood pressure (BP) levels of women not on antihypertensive drugs (hypertensives and non-hypertensives), the distributions of women with myocardial infarction (MI) and stroke during the 12-year follow-up period seemed to be U-shaped, with the highest incidences in women with the lowest and the highest BP levels. Women recognized as untreated hypertensives in the initial study were offered regular control by the study team during the whole 12-year period and were treated when treatment was considered indicated. They were found to be similar to the non-hypertensives with regard to the incidence of MI and stroke and total mortality. Our encouraging results may be explained by continuity of medical care, the antihypertensive treatment per se or the types of antihypertensive drugs administered.     

Thirty‐six‐year secular trends in sleep duration and sleep satisfaction,and associations with mental stress and socioeconomic factors – results of the Population Study of Women in Gothenburg,Sweden

Several European studies have reported sleeping problems in 20–40% of the population. We used data from the Population Study of Women in Gothenburg, based on medical examinations of three different representative cohorts of 38‐ and 50‐year‐old women in 1968–1969, 1980–1981 and 2004–2005 to study secular trends in sleep‐related factors. The average reported sleep duration declined by about 15 min in the 38‐year‐old women during the 36 years of observation. No corresponding change in sleep duration was observed among 50‐year‐old women. During the same period, the proportion of women complaining of sleeping problems almost doubled in both age groups: from 17.7% in 1968 to 31.7% in 2004 in 38‐year‐old women, and from 21.6% to 41.8% in 50‐year‐old women. The prevalence of insomnia was higher in 50‐year olds than in 38‐year olds in all investigated cohorts. The use of sleeping medications remained unchanged since 1968. There were significant associations between perceived sleeping problems and reported lower satisfaction concerning economic, social and family situations, as well as with medical retirement and mental stress. There was, however, no association between alcohol consumption and sleeping problems. Regular leisure time physical activity was not, in most cases, associated with less perceived sleeping problems. Our study indicates that the physician should take socio‐economic and family situations into consideration when examining female patients complaining of sleeping problems. Improvements on society level rather than on the individual level could be expected to be more efficient in improving women’s sleep.     

Blood Glucose,Glucose Tolerance and Manifest Diabetes in Relation to Cardiovascular Disease and Death in Women: A 12-Year Follow-up of Participants in the Population Study of Women in Gothenburg,Sweden

ABSTRACT. A longitudinal population study of 1462 women, aged 38–60, was carried out in Gothenburg, Sweden in 1968–69. Women with initially manifest diabetes mellitus had significantly increased 12-year incidence of myocardial infarction and increased mortality while no increased incidence of angina pectoris, ECG changes indicating ischaemic heart disease or stroke was observed. The association to myocardial infarction remained in multivariate analyses and was independent of age, body fat distribution, smoking, serum cholesterol and systolic blood pressure. The association to mortality was independent of these factors and also of serum triglycerides. Women who were diagnosed as “new diabetics” during the 12-year follow-up had a significantly increased 12-year incidence of myocardial infarction but no significant increase was observed for any of the other end-points studied. When women with initially manifest diabetes mellitus were excluded, no association was found between initial fasting blood glucose concentration and the end-points studied. A negative significant association was found between initial fasting blood glucose concentration and smoking.