scholarly journals How do individuals with alcohol problems use social and healthcare services in Finland? Comparison of service use patterns between two high-need patient groups

2021 ◽  
pp. 145507252110185
Author(s):  
Elina Rautiainen ◽  
Olli-Pekka Ryynänen ◽  
Päivi Rautiainen ◽  
Tiina Laatikainena
Keyword(s):  
Service Use ◽  
Healthcare Services ◽  
Alcohol Problems ◽  
Continuous Contact ◽  
Organisation Of Care ◽  
Risk Of Death ◽  
The North ◽  
Doctor Visits ◽  
Icd 10 ◽  
And Gender

Aims: Alcohol use disorders (AUDs) are associated with high risk of comorbidities and excess use of social and healthcare services. We examined health service use (HSU) frequencies of patients with AUD in comparison to those with type 2 diabetes mellitus (T2DM). Design: A random sample of individuals with AUD ( n = 396) were identified based on ICD-10 codes and HSU patterns, morbidity and mortality were compared with age- and gender-matched T2DM controls ( n = 792) using logistic regression analysis. Six years (2011–2016) of electronic health record (EHR) data from the North Karelia district in Finland were used. Results: Similarities in comorbidity patterns existed, although mental health comorbidity (odds ratio [ OR] 1.86) was more prevalent in the AUD group. The average annual HSU varied according to the groups: T2DM patients had more continuous contact with public health nurses in primary care, whereas AUD patients were more likely to experience somatic specialised care hospitalisations ( OR 11.30) and have frequent somatic primary healthcare doctor visits ( OR 3.30) and frequent emergency room doctor visits in specialised care ( OR 8.89). Furthermore, patients with AUD had a 7.5 times higher risk of death compared with T2DM patients. Conclusions: This study identified rather similar comorbidity status for the AUD and T2DM patients, but their HSU patterns differed noticeably. AUD patients had higher frequencies of hospitalisation periods and emergency service use and were at a higher risk of death compared with T2DM patients, indicating greater challenges in the organisation of care for AUD patients compared with those having T2DM.

Healthcare System in the Arctic Zone of Russia. Known and Emerging Issues and Solutions to Them

2019 ◽  
pp. 3-20
Author(s):  
V.N. Leksin
Keyword(s):  
Metallurgical Industry ◽  
Healthcare Services ◽  
The Arctic ◽  
Russian Arctic ◽  
Arctic Zone ◽  
Shift Workers ◽  
The North ◽  
Medical Institutions ◽  
Emerging Issues ◽  
The Impact

The impact on healthcare organization on the territory of Russian Arctic of unique natural and climatic, demographic, ethnic, settlement and professional factors of influencing the health of population, constantly or temporarily living on this territory is studied. The necessity is substantiated of various forms and resource provision with healthcare services such real and potential patients of Arctic medical institutions, as representatives of indigenous small peoples of the North, workers of mining and metallurgical industry, military personnel, sailors and shift workers. In this connection a correction of a number of All-Russian normative acts is proposed.

N, P and K Fertilizers Alter Plant Growth, Essential Oil Yield and Gender of Sweet Gale (Myrica gale L)

2014 ◽  
Vol 8 (1) ◽  
pp. 9-17
Author(s):  
X. Chang ◽  
P. Martin
Keyword(s):  
Plant Growth ◽  
Field Trials ◽  
Oil Yield ◽  
Oil Composition ◽  
Myrica Gale ◽  
The North ◽  
Oil Concentration ◽  
N Treatment ◽  
And Gender ◽  
Essential Oil Yield

To investigate whether the fertilizers N, P or K individually affect plant growth, oil content and the gender of sweet gale, two trials, pot and field trials, were carried out at Orkney College UHI in Scotland. A pot trial was established with eight soils which were collected from different sweet gale trial sites in the north of Scotland. Although neither shoot yield nor oil concentration in shoots was affected by soil, there were significant differences in shoot yields as a result of fertilizer treatments (nitrogen (N), phosphorus (P), potassium (K) or none (control)). The best yield was obtained from the N treatment which was double to that of the control and P treatments. N, P or K fertilizers did not consistently affect shoot oil concentration in two seasons; however, oil yield was significantly affected, and N treatment produced two-three fold oil yield increases compared with the control or P treatment. In the N treatment, the increase in shoot yield was positively correlated with total nitrogen or nitrate nitrogen in the soil, suggesting the occurrence of a nitrogen priming effect. Data suggested that as shoot yield increased the oil concentration in shoots decreased. Neither soil nor N, P or K fertilizers had a significant effect on oil composition. Amongst fertilizer treatments, P resulted in the largest number of plants changing gender from female to male. A field N trial confirmed that nitrogen significantly enhanced the shoot yield of young plants.

scholarly journals Comparison of data sources on alcohol problems: An exploratory exercise using surveys vs. national healthcare registers

2020 ◽  
pp. 145507252096802
Author(s):  
Pia Mäkelä ◽  
Kristiina Kuussaari ◽  
Airi Partanen ◽  
Elina Rautiainen
Keyword(s):  
Health Care ◽  
Substance Abuse ◽  
Healthcare Service ◽  
Service Use ◽  
Basic Education ◽  
Alcohol Problems ◽  
Register Data ◽  
Data Sources ◽  
National Healthcare ◽  
Healthcare Service Use

Aims: Both survey and healthcare register data struggle as data sources to capture the phenomenon of alcohol problems. We study a large group of people for whom survey data and two types of register data are available, and examine the overlaps of similar or related measures in the different data sources to learn about potential weaknesses in each. We also examine how register-based data on the prevalence of alcohol problems change depending on which register data are used. Design: We use data from the Regional Health and Wellbeing Study (ATH) of the adult Finnish population collected in 2013 and 2014 ( n = 69,441), individually linked with data on two national healthcare registers (Care Register for Health Care; Register of Primary Health Care visits) for the survey year and previous year. Results: The prevalence of substance-abuse-related healthcare was almost two-fold if data on outpatient primary care visits were included in addition to hospitalisations. Forty-six per cent of the survey respondents self-reporting substance-abuse-related healthcare service use were identified in the registers, and 22% of all respondents with such service use according to registers reported this in the survey. Records of substance-abuse-related healthcare service use, controlled for self-reported alcohol use and self-reported substance-abuse-related service use, were found more often for men, the middle-aged, people with basic education only, and the non-employed. Conclusions: The results are suggestive of underreporting in both data sources. There is an evident need to develop recording practices in the healthcare registers regarding substance use disorders.

Complex transformation of divorce in Vietnam under the forces of modernization and individualism

2021 ◽  
pp. 1-21
Author(s):  
Tran Thi Minh Thi
Keyword(s):  
Statistical Data ◽  
Marriage And Family ◽  
Male And Female ◽  
Rural Districts ◽  
The North ◽  
Complex Transformation ◽  
The Family ◽  
Social And Economic Development ◽  
Annual Population ◽  
And Gender

Abstract After more than four decades since its reunification since 1975, Vietnam has achieved remarkable results in social and economic development. With the rapid speed of recent modernization, society has loosened numerous old values related to the family and promoted individual freedoms. Marriage and family affairs, including divorce, have modernized with liberal characteristics. The paper examines the trends of divorce and reasons for divorce using statistical data from the Vietnam People's Supreme Court and from the government's annual population statistics. The analysis compiled and analysed a database of every divorce case at six urban and rural districts in Can Tho province. The analysis highlights changes in the reasons for divorce in the South in comparison with previous divorce studies in the North of Vietnam, discussed in relation to modernization, individualism and gender equality. The analysis is supported by interview data with thirty male and female divorcees.

scholarly journals Inequalities in psychiatric service use and mortality by migrant status following a first diagnosis of psychotic disorder: a Swedish cohort study of 1.3m people

2021 ◽  
Author(s):  
Dafni Katsampa ◽  
Syeda F Akther ◽  
Anna-Clara Hollander ◽  
Henrik Dal ◽  
Christina Dalman ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Psychotic Disorder ◽  
Service Use ◽  
Psychiatric Service ◽  
Mental Healthcare ◽  
Migrant Status ◽  
Region Of Origin ◽  
Icd 10 ◽  
Sub Saharan ◽  
First Diagnosis

Abstract It is unclear whether inequalities in mental healthcare and mortality following the onset of psychosis exist by migrant status and region-of-origin. We investigated whether (i) mortality (including by major causes of death); (ii) admission type (in- or out-patient), and; (iii) in-patient length of stay at first diagnosis for psychotic disorder presentation, and; (iv) time-to-readmission for psychotic disorder differed for refugees, non-refugee migrants and by region-of-origin. We established a cohort of 1,335,192 people born 1984-1997 and living in Sweden from 1st January 1998, followed from their 14 th birthday or arrival to Sweden, until death, emigration, or 31 December 2016.People with ICD-10 psychotic disorder (F20-33; N=9,399) were 6.7 (95%CI: 5.9-7.6) times more likely to die than the general population, but this did not vary by migrant status (p=0.15) or region-of-origin (p=0.31). This mortality gap was most pronounced for suicide (adjusted hazard ratio [aHR]: 12.2; 95% CI: 10.4-14.4), but persisted for deaths from other external (aHR: 5.1; 95%CI: 4.0-6.4) and natural causes (aHR: 2.3; 95%CI: 1.6-3.3). Non-refugee (adjusted odds ratio [aOR]: 1.4, 95%CI: 1.2-1.6) and refugee migrants (aOR: 1.4, 95%CI: 1.1-1.8) were more likely to receive inpatient care at first diagnosis. No differences in inpatient length of stay at first diagnosis were observed. Sub-Saharan African migrants with psychotic disorder were readmitted more quickly than their Swedish-born counterparts (adjusted sub-HR: 1.2; 95%CI: 1.1-1.4). Our findings highlight the need to understand the drivers of disparities in psychosis treatment and the mortality gap experienced by all people with disorder, irrespective of migrant status or region-of-origin.

The course of depression in the elderly: a longitudinal community-based study in Australia

1997 ◽  
Vol 27 (1) ◽  
pp. 119-129 ◽  
Author(s):  
A. S. HENDERSON ◽  
A. E. KORTEN ◽  
P. A. JACOMB ◽  
A. J. MACKINNON ◽  
A. F. JORM ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Cognitive Decline ◽  
Service Use ◽  
Community Sample ◽  
The Elderly ◽  
Activity Levels ◽  
Sample Attrition ◽  
Poor Social Support ◽  
Icd 10 ◽  
Depressive States

Background. We report the outcome of depressive states after 3-4 years in a community sample of the elderly.Methods. A sample of 1045 persons aged 70+ years in 1990–1 was re-interviewed after 3·6 years.Results. Mortality (21·7%) and refusal or non-availability (10·4%) were higher in those who initially had had a diagnosis or symptoms of depression. Of those with an ICD-10 depressive episode in 1990–1, 13% retained that diagnosis. Of those who were not depressed initially only 2·5% had become cases. Depression was unrelated to age or apolipoprotein E genotype. The best predictors of the number of depressive symptoms at follow-up was the number at Wave 1, followed by deterioration in health and in activities of daily living, high neuroticism, poor current health, poor social support, low current activity levels and high service use. Depressive symptoms at Wave 1 did not predict subsequent cognitive decline or dementia.Conclusions. Non-random sample attrition is unavoidable. ICD-10 criteria yield more cases than other systems, while continuous measures of symptoms confer analytical advantages. Risk factors for depressive states in the elderly have been further identified. The prognosis for these states is favourable. At the community level, depressive symptoms do not seem to predict cognitive decline, as they do in referred series.

AGE-RELATED FEATURES OF THE DYNAMICS OF MORBIDITY AND MORTALITY, LOCALIZATION AND HISTOLOGICAL STRUCTURES OF RECTAL CANCER (POPULATION STUDY)

2021 ◽  
pp. 900-907
Author(s):  
В. М. Мерабишвили ◽  
Д. М. Дубовиченко ◽  
М. Ю. Вальков ◽  
А. М. Щербаков ◽  
Э. Н. Мерабишвили
Keyword(s):  
Rectal Cancer ◽  
Malignant Tumors ◽  
Federal District ◽  
Distal Colon ◽  
Morbidity And Mortality ◽  
The North ◽  
Leading Role ◽  
Age Related ◽  
Icd 10 ◽  
North Western

Рак прямой кишки (РПК) - это злокачественная опухоль дистального отдела толстой кишки эпителиального происхождения. Ежегодно в России регистрируется более 30 тыс. (30 969 в 2018 г.) новых случаев РПК и 16 тыс. (16 151) случаев смерти. Индекс достоверности учета (отношение числа умерших к заболевшим) составляет 0,52 %. РПК относится к локализациям со средним уровнем летальности. В Северо-Западном Федеральном округе зарегистрировано более 3 тыс. первичных случаев РПК (3 285 в 2018 г.). Государственная статистика РПК представляет данные о заболеваемости и смертности населения по трем рубрикам МКБ-10 вместе (С19-21). Детальная разработка данных не только отдельно по каждой рубрике МКБ-10, но и по четвертому знаку возможна только по материалам баз данных раковых регистров. Созданный нами Популяционный раковый регистр Северо-Западного Федерального округа насчитывал на 01.01.2019 г. более 1 млн (1 067 661) случаев злокачественных новообразований (ЗНО), в том числе РПК - 50 745 случаев, или 4,8 %. Удельный вес РПК близок к среднероссийскому - 4,9 %. В работе представлена детальная структура онкологической патологии по РПК. Ведущая роль из трех указанных рубрик принадлежит ЗНО прямой кишки (С20) - 75,4 %; 19,8 % приходится на ЗНО ректосигмоидного отдела (С19) и только 4,7 % на С21 - ЗНО ануса и анального канала. По всем этим рубрикам представлена динамика структуры, которая оказалась достаточно устойчивой. Rectal cancer is a malignant tumor of the distal colon of epithelial origin. Every year, more than 30,000 (30 969 - 2018) new cases of Rectal cancer and 16,000 deaths (16 151) are registered in Russia. The index of reliability of accounting (the ratio of the number of dead to sick) is 0,52 %. Rectal cancer refers to localities with an average mortality rate. In the North-Western Federal district, more than 3 thousand primary cases of Rectal cancer were registered (3285 - 2018). The state statistics of the Rectal cancer provides data on morbidity and mortality in three categories of ICD-10 together (C19-21). Detailed development of data not only separately for each category of ICD-10, but also for the fourth sign is possible only from the data bases of cancer registers. As of 01.01.2019, the Population cancer register of the North-Western Federal district created by us totaled more than 1 million cases of malignant tumors (1 067 661), including Rectal cancer - 50 745 cases, or 4,8 %. The share of the Rectal cancer is close to the national average - 4,9 %. The article presents a detailed structure of cancer pathology in Rectal cancer. The leading role of the 3 specified categories belongs to the rectal malignant tumors (C20) - 75,4 %, 19,8 % falls on the malignant tumors of the rectosigmoid department (C19) and only 4,7 % on the C21 - malignant tumors of the anus and anal canal. For all these categories, the dynamics of the structure is presented, which proved to be quite stable.

A Mixed-Methods Comparison of a National and State Opioid Overdose Surveillance Definition

2021 ◽  
Vol 136 (1_suppl) ◽  
pp. 31S-39S
Author(s):  
Danielle M. Brathwaite ◽  
Catherine S. Wolff ◽  
Amy I. Ising ◽  
Scott K. Proescholdbell ◽  
Anna E. Waller
Keyword(s):  
North Carolina ◽  
False Positive ◽  
False Positive Rate ◽  
International Classification Of Diseases ◽  
Opioid Overdose ◽  
The North ◽  
Classification Of Diseases ◽  
Positive Rate ◽  
Icd 10 ◽  
Ed Visits

Objectives We assessed the differences between the first version of the Centers for Disease Control and Prevention (CDC) opioid surveillance definition for suspected nonfatal opioid overdoses (hereinafter, CDC definition) and the North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT) surveillance definition to determine whether the North Carolina definition should include additional International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes and/or chief complaint keywords. Methods Two independent reviewers retrospectively reviewed data on North Carolina emergency department (ED) visits generated by components of the CDC definition not included in the NC DETECT definition from January 1 through July 31, 2018. Clinical reviewers identified false positives as any ED visit in which available evidence supported an alternative explanation for patient presentation deemed more likely than an opioid overdose. After individual assessment, reviewers reconciled disagreements. Results We identified 2296 ED visits under the CDC definition that were not identified under the NC DETECT definition during the study period. False-positive rates ranged from 2.6% to 41.4% for codes and keywords uniquely identifying ≥10 ED visits. Based on uniquely identifying ≥10 ED visits and a false-positive rate ≤10.0%, 4 of 16 ICD-10-CM codes evaluated were identified for NC DETECT definition inclusion. Only 2 of 25 keywords evaluated, “OD” and “overdose,” met inclusion criteria to be considered a meaningful addition to the NC DETECT definition. Practice Implications Quantitative and qualitative trends in coding and keyword use identified in this analysis may prove helpful for future evaluations of surveillance definitions.

scholarly journals Trends in diagnostic patterns and mortality in emergency ambulance service patients in 2007−2014: a population-based cohort study from the North Denmark Region

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e014508 ◽  
Author(s):  
Erika Frischknecht Christensen ◽  
Mette Dahl Bendtsen ◽  
Thomas Mulvad Larsen ◽  
Flemming Bøgh Jensen ◽  
Tim Alex Lindskou ◽  
...  
Keyword(s):  
Cohort Study ◽  
Relative Risk ◽  
Population Based ◽  
Ambulance Service ◽  
Annual Number ◽  
Adjusted Relative Risk ◽  
Risk Of Death ◽  
The North ◽  
Emergency Ambulance ◽  
Age And Sex

ObjectiveDemand for ambulances is growing. Nevertheless, knowledge is limited regarding diagnoses and outcomes in patients receiving emergency ambulances. This study aims to examine time trends in diagnoses and mortality among patients transported with emergency ambulance to hospital.DesignPopulation-based cohort study with linkage of Danish national registries.SettingThe North Denmark Region in 2007–2014.ParticipantsCohort of 148 757 patients transported to hospital by ambulance after calling emergency services.Main outcome measuresThe number of emergency ambulance service patients, distribution of their age, sex, hospital diagnoses, comorbidity, and 1-day and 30-day mortality were assessed by calendar year. Poisson regression with robust variance estimation was used to estimate both age-and sex-adjusted relative risk of death and prevalence ratios for Charlson Comorbidity Index (CCI) to allow comparison by year, with 2007 as reference year.ResultsThe annual number of emergency ambulance service patients increased from 24.3 in 2007 to 40.2 in 2014 per 1000 inhabitants. The proportions of women increased from 43.1% to 46.4% and of patients aged 60+ years from 39.9% to 48.6%, respectively. The proportion of injuries gradually declined, non-specific diagnoses increased, especially the last year. Proportion of patients with high comorbidity (CCI≥3) increased from 6.4% in 2007 to 9.4% in 2014, corresponding to an age- and sex-adjusted prevalence ratio of 1.27 (95% CI 1.16 to 1.39). The 1-day and 30 day mortality decreased from 2.40% to 1.21% and from 5.01% to 4.36%, respectively, from 2007 to 2014, corresponding to age-adjusted and sex-adjusted relative risk of 0.43 (95% CI 0.37 to 0.50) and 0.72 (95% CI 0.66 to 0.79), respectively.ConclusionDuring the 8-year period, the incidence of emergency ambulance service patients, the proportion of women, elderly, and non-specific diagnoses increased. The level of comorbidity increased substantially, whereas the 1-day and 30-day mortality decreased.

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