Scandinavian Journal of Public Health

Some factors influencing the comfort of old people (mean age 73 years) in a modern home for the aged were studied. Most (76%) of the old persons were satisfied with their living conditions. Only one-fourth (24%) of the inmates were dissatisfied. The most important factors causing dissatisfaction were discomfort due to illnesses, and disagreement with other residents. On the whole, the old people were more satisfied with their life at the home for the aged than is often supposed.

Only 32% of the category “seriously injured” in road traffic accidents were correctly registered as such in the official road traffic accident statistics. Furthermore, 25% were registered, though wrongly, as “slightly injured”. Consequently almost one-half of the seriously injured were not registered at all, and they constituted a drop-out which contributes a bias to the statistics obtained. False registration is primarily associated with short-term hospitalization and absence of surgical operations during the hospital stay, i.e. slight injuries, and low age. The material analysed was comprised of 2 689 individuals from hospital or road traffic accident statistics covering the Uppsala hospital region during 1966.

The results of a combined dermatological and surgical treatment of varicose ulcers was studied in 100 patients. This chronic disease, often persisting for decades, was halted in 90% of legs operated upon. Even when the general outcome of the treatment was favourable, it was found that, for 5 out of the 12 ulcers which were the same or larger in size at follow-up than before operation, the patient assessed the result as good or even excellent. This finding deserves further study. It indicates that patients and physicians sometimes use different standards by which to measure therapeutic success.

The mental health center movement represents a new mode of care for the mentally ill. People are treated on an out-patient basis rather than in institutions. The therapeutic work is mainly carried out by so-called para-professionals who seem to be well qualified for the job. However, when organizing such a treatment system there appear to be several important factors which need to be taken into account: (1) the therapist's need to work individually and independently, (2) the therapist's need for personal training, (3) the therapists' need to be heard when they channel information from the community to the service system, (4) the need for open and direct communication in the system to ensure that the therapists work within the frame of accepted therapeutic procedures, (5) the importance of the therapists' being represented at the highest decision-making level in the system in order to ensure that their needs are met. The author stresses this as an inevitable necessity in order to give the therapists the appropriate working-background.

A proband group was selected, consisting of 71 female alcoholics subjected to compulsory treatment by the Temperance Board in Malmö. For the period beginning 20 years before, up to, and including a maximum of 9 years after the first compulsory treatment, less than one conviction was expected, according to a calendar year-and age-specific risk table for Swedish women. During that period, 44 of the probands had been convicted for a total of 219 drunkenness offences. Before then, no offences were recorded. In relation to the expected incidence, the observed was not particularly high at the beginning of the period. From the 11th to the 2nd year before the first compulsory treatment, it increased to an extremely high level, where it remained. The ratio of offences per offender and year was constant during the observation period. The average age at the first offence was high: 35.5 years. Gonorrhoea, recorded criminal offence, and receipt of public assistance appeared much earlier. Drunkenness was more common on Fridays and Mondays among the least complicated cases. A more even distribution on week-days seems to be characteristic for the most advanced alcoholics.

The incidence of gonorrhoea among 71 female alcoholics was studied from the twentieth year before, to the ninth year after the first compulsory treatment by the Temperance Board of Malmö. Twenty-five probands had, at some time, had gonorrhoea. The mean age at the first infection was high, over 28 years. None the less, the onset of gonorrhoea was an early “symptom”. Recorded criminal offence, receipt of public assistance, and conviction for drunkenness usually appeared later. Each individual's risk of contracting gonorrhoea was assessed from tabulated data concerning the gonorrhoea incidence among Malmö women in general, specified by calendar year and age. A total of 53 infections was observed, as against 6.9 expected. The ratio of observed to expected gonorrhoea was not particularly high in the early period of observation. From the twelfth year before, up to one year before, the first compulsory treatment, the ratio increased to roughly fifteen to one. This high ratio remained during the subsequent years. Syphilis was diagnosed in five probands.

A computer system is described for cytological report and registration routines in gynecological practice. The sociomedical advantages of the integration of such a computer system with a previously described computer system for organized gynecological health control are pointed out.

A follow-up examination of 1 143 Greenlanders operated on for pulmonary tuberculosis in the years 1954–66 is reported. The main group consists of 785 resected patients. At follow-up 2–12 years after operation all patients were traced. One hundred and four (9%) had died; the remaining 1 039 had all been restored to health. Ninety percent of the ex-patients were fully or partially fit and 1% unfit for work. Length of observation, time of resumption of work, reasons for change (if any) of occupation, work capacity in relation to the nature of the surgical interventions, and the patient's general condition as well as housing situation are discussed. National assistance in Greenland is mentioned in brief.