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STUDY OBJECTIVE: To assess the impact of mechanical exposure and work related psychosocial factors on shoulder and neck pain. DESIGN: A prospective cohort study. PARTICIPANTS: 4919 randomly chosen, vocationally active men and women ages 45-65 residing in a Swedish city. Neck and shoulder pain were determined by the standardised Nordic questionnaire. Mechanical exposure was assessed by an index based on 11 items designed and evaluated for shoulder and neck disorders. Work related psychosocial factors were measured by the Karasek and Theorell demand-control instrument. MAIN RESULTS: High mechanical exposure was associated with heightened risk for shoulder and neck pain among men and women during follow up. Age adjusted odds ratios (OR) were 2.17 (95% confidence intervals (CI): 1.65, 2.85) and 1.59 (95% CI: 1.22, 2.06), respectively. In women, job strain (high psychological job demands and low job decision latitude) correlated with heightened risk (OR = 1.73, 95% CI: 1.29, 2.31). These risk estimates remained statistically significant when controlled for high mechanical exposure regarding job strain (and vice versa), and for sociodemographic factors. Testing for effect modification between high mechanical exposure and job strain showed them acting synergistically only in women. CONCLUSION: Job related mechanical exposure in both sexes, and psychosocial factors in women, seem independently of each other to play a part for development of shoulder and neck pain in vocationally active people. The effect of psychosocial factors was more prominent in women, which could be the result of biological factors as well as gender issues. These results suggest that interventions aiming at reducing the occurrence of shoulder and neck pain should include both mechanical and psychosocial factors. [ABSTRACT FROM AUTHOR]

Background: The motives, objectives and design of a multicentre prospective study on job stress, absenteeism and coronary heart disease in Europe (the JACE study) is presented in this paper. Some specific gaps in the reviewed literature are explicitly tapped into by the JACE study. Its objectives are i) to compare the distributions of the Karasek job stress scales for the same broad categories of occupations in different European countries (in males and females), ii) to study the predictive power of the job stress scales and the job strain model for one year of sickness absence (in males and females) and iii) to study the predictive power of the job stress scales and the job strain model for a three year incidence of coronary heart disease (in males only). Methods: In answering these questions, relations are studied controlling for gender, age, level of education, company size, physical work risks and shift work, as well as traditional risk factors for CHD (i.e. serum cholesterol, serum HDL cholesterol, smoking habits and blood pressure). The JACE study is a Biomed 1 concerted action. The JACE group consists of eight participating centres from six countries, i.e. from Belgium and Sweden (two centres), France, Italy, Spain, Sweden and The Netherlands (each one centre). The coordination of the group is in Brussels. The participating centres brought in over 15,000 European workers to test the hypotheses. [ABSTRACT FROM AUTHOR]

Base line data together with data in public registers and a structured phone interview of 94 of the 121 non-attenders was used for an assessment of factors influencing participation in the prospective population study 'Men born in 1914' in Malmö, Sweden. The overall attendance rate was 80.5% but varied among areas in the city from 27% to 100%. The lower participation rate among single men remained, when correcting for social class, significant only for single men in social class III. Men who did not feel well and/or had been admitted to hospital during the last 12 months had a lower participation rate. A negative attitude towards health surveys in general was the most common reason for non-participation. The phone interview turned out to be a feasible method to reach non-attenders to assess whether the sample was representative of the population and to learn more about reasons for non-participation. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To investigate differences in different aspects of social participation and social capital among baseline daily smokers that had remained daily smokers, become intermittent smokers, or stopped smoking at one year follow up. Design/setting/participants/measurements: 12 507 individuals, aged 45-69 years, interviewed at baseline between 1992 and 1994 and at a one year follow up were investigated in this longitudinal study. The three groups of baseline daily smokers were compared to the reference population (baseline intermittent smokers and non-smokers) according to different aspects of social participation and social capital. A multivariate logistic regression model was used to assess differences in different aspects of social participation and social capital. RESULTS: The baseline daily smokers that remained daily smokers at the one year follow up had significantly increased odds ratios of non-participation in study circles in other places than at work, meeting of organisations other than unions, theatre/cinema, arts exhibition, church, sports events, large gatherings of relatives, and private parties compared to the reference population. The baseline daily smokers that had become intermittent smokers at the one year follow up had significantly increased odds ratios of non-participation in church services. The baseline daily smokers that had stopped smoking had increased odds ratios of non-participation in having attended a meeting of organisations other than labour unions during the past year, having been to a theatre or cinema, and of having visited an arts exhibition during the past year. All three categories of baseline daily smokers had significantly decreased odds ratios of non-participation in night club/entertainment. CONCLUSIONS: The baseline daily smokers that had remained daily smokers at the one year follow up had particularly high rates of non-participation compared to the reference population in both activities specifically related to social capital, such as other study circles, meetings of organisations other than labour unions, and church attendance and cultural activities such as theatre/cinema and arts exhibition, although significantly lower participation in cultural activities and meetings of other organisations was also observed among daily smokers that had stopped smoking. All three baseline daily smoker groups had higher rates of having visited a night club during the past year. [ABSTRACT FROM AUTHOR]

During the past 10 years, researchers on both sides of The Sound in the so-called Oresund region have worked together to analyze the causes of the observed differences in life expectancy between Denmark and Sweden. The region includes Copenhagen and North Zealand and the county of Scania in southern Sweden, with Malmö as its largest city. Both Denmark and Sweden held top rankings among OECD-countries in 1970 regarding life expectancy at birth. In 1990 Denmark had fallen to a bottom ranking, while Sweden was still at the top. At a scientific meeting in Malmö on January 26-27, 2000, some 60 presentations were made concerning differences and similarities in health measures on the two sides of the sound which divides the two countries. On the Swedish side, life expectancy is 3-4 years longer than on the Danish side. Paramount among explanations are higher mortality figures due to smoking and alcohol-related diseases on the Danish side, both in men and women (most pronounced). Minor contributions to the differences are suicides and traffic accidents. Historically, Denmark and Sweden have much in common. Until 1658, Scania, the Swedish county to the east of The Sound was part of Denmark. During the past 150 years rather impressive cultural differences have developed. Smoking prevalence and alcohol consumption are more than twice as high on the Danish side of the sound. In coming years, researchers, representatives for the health service systems and others will work together in order to prevent disease and promote health in the Oresund region. The conference was arranged by the Medicon Valley Academy, an EU-supported enterprise seeking to stimulate research and development within the health sector in the Oresund region (also known as Medicon Valley).

In prospective cohort studies, person-time time is calculated from baseline until the first definite event occurs or until censoring. A way to correctly identify and date definite events when only routine registers are available is to retrieve all hospital discharge notes and death certificates with a diagnosis of probable event and perform a consecutive revision. It is important to detect all possible hospital stays as they may contain useful information for the revision study. Furthermore, loss to follow-up can be avoided by extending the retrieval outside the specific geographical area where the cohort was defined. The aims of this study were (i) to describe a comprehensive retrieval of probable myocardial infarctions (diagnosis with International Classification of Diseases 8th and 9th revisions codes 410-414) or stroke (codes 430-438), (ii) to quantify the relative efficiency of different local and national routine registers or their combination compared with the use of all available registers together, and (iii) to audit local and national registers by comparing their outcome at the county level. The study was performed in two prospective cohorts studies i.e., 'Men-born-1914' (n = 500) from Skåne (period 1982-1993), and Skara-1 (n = 683) from Skaraborg (period 1988-1994.). All available routine registers were linked to the cohorts. The use of all available routine registers improved retrieval of both individual and hospital stays with a discharge diagnosis of probable event and gave an enhanced basis for a future validation study. Local registers were not completely covered by the national register, but the accessible combination of national inpatient and mortality registers was an efficient alternative.

The cross-sectional study entitled Health Profile of Skaraborg County, 1977 (HPS 77), forms part of an evaluation of a care programme for persons suffering from high blood pressure. Concurrently with the implementation of the study, epidemiological data were collected concerning the health profile of an entire county, with the aim of facilitating comparisons between the municipalities in the county. This paper describes how the study was implemented and gives an analysis of non-participation and validity. A comparison is made between participants and non-participants with regard to record data obtained from the National Health Insurance Fund, hospital records and the register of the Temperance Board. The non-participants differ in most respects from the participants, who have a more marked pattern of disorders in their case histories. In a longitudinal non-participants analysis, participants are compared with non-participants with respect to mortality during the following four-year period. In this study the non-participants differed, in having a higher mortality rate. The validity of the questionnaire is discussed on the basis of three different analyses. The validity varied considerably, depending on the questions studied. For example, 53% of those with myocardial infarction in the questionnaire were confirmed in hospital records. This was also true for 62% of those with stroke and 49% of those with angina pectoris in a follow-up interview. Medication for hypertension was confirmed in 94%. Ten of twelve participants who reported three or more symptoms of mental disorders were confirmed at interview with a physician. Studies like HPS 77 could be useful when planning preventive as well as curative measures. Thus it is important to describe not only the implementation of the study, but also its validity and the importance of non-participation for the results presented.