liu.seSearch for publications in DiVA
Change search
Refine search result
1 - 50 of 50
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Rows per page
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sort
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
Select
The maximal number of hits you can export is 250. When you want to export more records please use the 'Create feeds' function.
  • 1.
    Ahlner, Johan
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Health Sciences.
    Holmgren, Anita
    National Board for Forensic Medicine, Linkoping, Sweden .
    Jones, A Wayne
    Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Health Sciences.
    Prevalence of alcohol and other drugs and the concentrations in blood of drivers killed in road traffic crashes in Sweden2014In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 42, no 2, 177-183 p.Article in journal (Refereed)
    Abstract [en]

    Background: Drunk or drug-impaired drivers represent a major public health and societal problem worldwide. Because over 95% of drivers killed on the roads in Sweden are autopsied, reliable information is available about the use of alcohol and/or other drug before the crash. Methods: This retrospective 4-year study (2008-2011) used a forensic toxicology database (TOXBASE) to evaluate the concentrations of alcohol and other drugs in blood samples from drivers killed in road-traffic crashes. Results: The mean age of all victims (N = 895) was 48 +/- 20 years, and the majority were male (86%). In 504 drivers (56%), the results of toxicological analysis were negative and these victims were older; mean age (+/- SD) 47 +/- 20 years, than alcohol positive cases (35 +/- 14 years) and illicit drug users (34 +/- 15 years). In 21% of fatalities, blood-alcohol concentration (BAC) was above the statutory limit for driving (0.2 g/L), although the median BAC was appreciably higher (1.72 g/L). Illicit drugs (mainly amphetamine and cannabis) were identified in similar to 7% of victims, either alone (2.5%), together with alcohol (1.8%) or a prescription drug (2%). The psychoactive prescription drugs identified were mainly benzodiazepines, z-hypnotics and tramadol, which were found in the blood of 7.6% of crash victims. Conclusions: The high median BAC in fatally-injured drivers speaks strongly towards alcohol-induced impairment as being responsible for the crash. Compared with alcohol, the prevalence of illicit and psychoactive prescription drugs was fairly low despite a dramatic increase in the number of drug-impaired drivers arrested by the police after a zero-tolerance law was introduced in 1999.

  • 2.
    Annerbäck, Eva-Maria
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Centre for Clinical Research in Sörmland, Uppsala University, Sweden .
    Sahlqvist, Lota
    Centre for Clinical Research in Sörmland, Uppsala University, Sweden .
    Wingren, Gun
    Linköping University, Department of Clinical and Experimental Medicine, Division of Inflammation Medicine. Linköping University, Faculty of Health Sciences.
    A cross-sectional study of victimisation of bullying among schoolchildren in Sweden: Background factors and self-reported health complaints2014In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 42, no 3, 270-277 p.Article in journal (Refereed)
    Abstract [en]

    AIM:

    To examine background factors for bullying and associations between bullying victimisation and health problems.

    METHODS:

    A cross-sectional study on all pupils in grades 7 and 9 in a Swedish county was conducted in 2011 (n=5248). Data have been analysed with bi- and multivariate models.

    RESULTS:

    14% of the children reported that they had been bullied during the past 2 months. Background factors for bullying were: gender (girls more often); age (younger students more often); disability/disease; high body mass index, and having parents born abroad. There were strong associations between being bullied and poor health and self-harm. Associations with poor general health for boys and girls and mental health problems for girls showed stronger associations with higher frequency of bullying than with lower. For boys, physical bullying had stronger correlations with poor general health than written-verbal bullying.

    CONCLUSIONS:

    Bullying is a serious public health problem among young people and healthcare professionals have an important task in identifying exposed children. Children who are "different" are more exposed to bullying, which implies that school personnel, parents, and other adults in these children's social networks can play an important role in paying attention to and preventing the risk of bullying.

    .

  • 3.
    Aronsson, Mattias
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences.
    Husberg, Magnus
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences.
    Kalkan, Almina
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences.
    Eckard, Nathalie
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences.
    Alwin, Jenny
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences.
    Differences between hypothetical and experience-based value sets for EQ-5D used in Sweden: Implications for decision makers2015In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 43, no 8, 848-854 p.Article in journal (Refereed)
    Abstract [en]

    Aims: A number of value sets are available today for converting EQ-5D questionnaire responses to quality-adjusted life year-weights used in health economic evaluations. The aim of this study is to analyse the differences between the commonly used hypothetical UK value set and the newly introduced Swedish experience-based value set and to evaluate health economic implications of such differences on policy decisions. Methods: Differences between the two value sets were studied using two methods: a comparison of health states and improvements as well as an empirical comparison. In the comparison of health states and improvements, the valuations of all EQ-5D states and all pure improvements were compared. In the empirical study, a database of 23,925 individuals was used to identify patient groups that could be affected by the implementation of the Swedish experience-based value set. Results: The comparison of health states and possible improvements showed that only three health states were assigned a lower quality-adjusted life year-weight and most improvements were given smaller absolute values if the experience-based value set was used. The empirical comparison showed that severe conditions were assigned higher values when using the experience-based value set. Conclusions: The Swedish experience-based value set seems to render a higher estimated level of health-related quality of life in virtually all health conditions compared to the hypothetical UK value set. In extension, health-related quality of life enhancing interventions are likely to be given higher priority in decision-making situations where hypothetical values are used to construct quality-adjusted life year-weights. In situations where experience-based quality-adjusted life year-weights are used, life-prolonging interventions would be prioritised.

  • 4.
    Aspberg, Sara
    et al.
    Karolinska Institute, Sweden .
    Stenestrand, Ulf
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Koster, Max
    National Board Health and Welf, Sweden .
    Kahan, Thomas
    Karolinska Institute, Sweden .
    Large differences between patients with acute myocardial infarction included in two Swedish health registers2013In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 41, no 6, 637-643 p.Article in journal (Refereed)
    Abstract [en]

    Background: Acute myocardial infarction (MI) is a leading cause for morbidity and mortality in Sweden. We aimed to compare patients with an acute MI included in the Register of information and knowledge about Swedish heart intensive care admissions (RIKS-HIA, now included in the register Swedeheart) and in the Swedish statistics of acute myocardial infarctions (S-AMI). Methods: Population based register study including RIKS-HIA, S-AMI, the National patient register and the Cause of death register. Odds ratios were determined by logistic regression analysis. Results: From 2001 to 2007, 114,311 cases in RIKS-HIA and 198,693 cases in S-AMI were included with a discharge diagnosis of an acute MI. Linkage was possible for 110,958 cases. These cases were younger, more often males, had fewer concomitant diseases and were more often treated with invasive coronary artery procedures than patients included in S-AMI only. There were substantial regional differences in proportions of patients reported to RIKS-HIA. Conclusions: Approximately half of all patients with an acute MI were included in RIKS-HIA. They represented a relatively more healthy population than patients included in S-AMI only. S-AMI covered almost all patients with an acute MI but had limited information about the patients. Used in combination, these two registers can give better prerequisites for improved quality of care of all patients with acute coronary syndromes.

  • 5.
    Berggren, Fredrik
    et al.
    Department of Community Medicine Malmö universitetssjukhus, Lunds universitet.
    Nystedt, Paul
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Management and Economics, Economics and Economic History.
    Changes in alcohol consumption: An analysis of self-reported use of alcohol in a Swedish national sample 1988-89 and 1996-972006In: Scandinavian Journal of Public Health, ISSN 1403-4948, Vol. 34, no 3, 304-311 p.Article in journal (Refereed)
    Abstract [en]

    Aim: To analyse factors associated with alcohol consumption, and how these changed over the period 1988-97, a period during which Sweden entered the European Union. Methods: Data were used from two waves (1988-89 and 1996-97) of the representative longitudinal micro-level ULF survey in Sweden to estimate a two-part model of consumption. Results: Experiencing financial stress, monthly salary, and not being married were all correlated with alcohol consumption, especially for males in 1988-89. In 1996-97 these correlations were much weaker, revealing a levelling-out trend towards conformity. The pattern was less clear for females. Further, the youngest age group (16-29 years) increased its consumption significantly more than the older age groups. Conclusion: There were significant changes in alcohol behaviour, especially for males, coinciding with Sweden joining the EU and preceding the very substantial general increase in consumption levels since 1998. This underlying process should be kept in mind when analysing the more recent trends. The results support the contention that alcohol policy should be a combination of measures targeting the whole population (e.g. via public health campaigns) with specific measures directed towards more vulnerable groups (e.g. young people). © 2006 Taylor & Francis.

  • 6.
    Bergh, AL
    et al.
    Univ Gothenburg, Dept Hlth Sci, Gothenburg, Sweden Sahlgrens Univ Hosp, Dept Internal Med, Ctr Diabet, S-41345 Gothenburg, Sweden.
    Persson, LO
    Univ Gothenburg, Dept Hlth Sci, Gothenburg, Sweden Sahlgrens Univ Hosp, Dept Internal Med, Ctr Diabet, S-41345 Gothenburg, Sweden.
    Attvall, S
    Univ Gothenburg, Dept Hlth Sci, Gothenburg, Sweden Sahlgrens Univ Hosp, Dept Internal Med, Ctr Diabet, S-41345 Gothenburg, Sweden.
    Psychometric properties of the Swedish version of the Well-Being Questionnaire in a sample of patients with diabetes type 12000In: Scandinavian Journal of Public Health, ISSN 1403-4948, Vol. 28, no 2, 137-145 p.Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of the present investigation was to further test the psychometric properties of a Swedish version of the Well-Being Questionnaire (WBQ) in order to determine whether it could be suitable for measuring health-related quality of life among type 1 diabetic patients. Methods: In total, 94 patients who fulfilled the inclusion criteria were selected for the study and of these 85% participated. Reliability was tested with Cronbach's alpha coefficient and the internal validity by means of principal component analysis and multitrait analysis. To test the external validity, comparisons were made with two other questionnaires, the Short form-36 and a Swedish Mood Adjective Check List. Results: The results show that, above all, the Swedish version of the WBQ measures psychological well-being, and thus must also be complemented with scales that measure other consequences of the illness and/or treatment, i.e. physical symptoms. The questionnaire has low discriminatory validity between subscales, which casts doubt on the appropriateness of using the four subscales as separate measures. The two scales measuring anxiety and depression are not sensitive enough for use among type 1 diabetics without complications and high or normal levels of psychological well-being. Conclusions: The Well-Being Questionnaire alone does not give any more information about subjective health status among type 1 diabetic patients than, for example, the generic SF-36.

  • 7.
    Bernfort, Lars
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Health Sciences.
    Eckard, Nathalie
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Health Sciences.
    Husberg, Magnus
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Health Sciences.
    Alwin, Jenny
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Health Sciences.
    A case of community-based fall prevention: Survey of organization and content of minor home help services in Swedish municipalities2014In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 42, no 7, 643-8 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The aim of this study was to survey minor home help services provided by Swedish municipalities with the main purpose to prevent fall injuries.

    METHODS: If minor home help services were presented on the homepage of a municipality, an initial telephone contact was taken. Thereafter a questionnaire was administered, including questions about target groups, aim with the services, tasks included, costs and restrictions for users, budget, and experienced gains with the services. Municipalities not providing minor home help services were asked about the reason therefore and if the municipality had previously provided the services Results: The questionnaire response rate was 92%. In 191 of Sweden's 290 municipalities services were provided by, or in cooperation with, the municipality. Reasons for not providing the services were mainly financial and lack of demand. Services were more often provided in larger cities and in municipalities located in populous regions. In some municipalities services were performed by persons with functional disabilities or unemployed persons. CONCLUSIONS: BOTH PROVIDERS AND USERS EXPRESSED SATISFACTION WITH THE SERVICES ASPECTS EXPRESSED WERE THAT SERVICES LEAD TO GREATER SENSE OF SAFETY AND SOCIAL GAINS THE EFFECT OF THE SERVICES IN TERMS OF FALL PREVENTION IS YET TO BE PROVED WITH ONLY A SMALL FALL-PREVENTIVE EFFECT SERVICES ARE PROBABLY COST-EFFECTIVE IMPROVED QUALITY OF LIFE, SENSE OF SAFETY, AND BEING ABLE TO OFFER MEANINGFUL WORK TO OTHERWISE UNEMPLOYED PERSONS ARE IMPORTANT ASPECTS THAT MIGHT IN THEMSELVES MOTIVATE THE PROVISION OF MINOR HOME HELP SERVICES.

  • 8.
    Bygren, Magnus
    et al.
    Linköping University, Department of Management and Engineering, The Institute for Analytical Sociology, IAS. Linköping University, Faculty of Arts and Sciences. Stockholm University, Sweden.
    Szulkin, Ryszard
    Stockholm University, Sweden.
    Using register data to estimate causal effects of interventions: An ex post synthetic control-group approach2017In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 45, 50-55 p.Article in journal (Refereed)
    Abstract [en]

    Aims: It is common in the context of evaluations that participants have not been selected on the basis of transparent participation criteria, and researchers and evaluators many times have to make do with observational data to estimate effects of job training programs and similar interventions. The techniques developed by researchers in such endeavours are useful not only to researchers narrowly focused on evaluations, but also to social and population science more generally, as observational data overwhelmingly are the norm, and the endogeneity challenges encountered in the estimation of causal effects with such data are not trivial. The aim of this article is to illustrate how register data can be used strategically to evaluate programs and interventions and to estimate causal effects of participation in these. Methods: We use propensity score matching on pretreatment-period variables to derive a synthetic control group, and we use this group as a comparison to estimate the employment-treatment effect of participation in a large job-training program. Results: We find the effect of treatment to be small and positive but transient. Conclusions: Our method reveals a strong regression to the mean effect, extremely easy to interpret as a treatment effect had a less advanced design been used (e.g. a within-subjects panel data analysis), and illustrates one of the unique advantages of using population register data for research purposes.

  • 9.
    Carlsson, Per
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    Priority setting in health care: Swedish efforts and experiences2010In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 38, no 6, 561-564 p.Article in journal (Other academic)
  • 10. Carlsten, A
    et al.
    Waern, M
    Holmgren, Per
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Pharmacology.
    Allebeck, P
    The role of benzodiazepines in elderly suicides2003In: Scandinavian Journal of Public Health, ISSN 1403-4948, Vol. 31, no 3, 224-228 p.Article in journal (Refereed)
    Abstract [en]

    Aims: In Sweden, suicides by drug poisoning have decreased in the population at large during the past two decades. However, drug poisoning suicides increased among the elderly during this period. Suicides by benzodiazepine poisoning increased in this age group despite a reduction in prescription sales of these drugs. This study aims therefore to determine the role of benzodiazepines in suicide late in life. Methods: Information concerning all definite suicides and deaths due to "undetermined" causes recorded among Swedish citizens aged 65 and above during 1992-96 was obtained from the Cause-of-Death Register. Death certificates were scrutinized to determine the type of drug employed in drug-related suicides. Results of the post mortem screening for drugs and alcohol were then examined. Results: A benzodiazepine was implicated in 216/548 (39%) of the drug poisoning suicides recorded among the elderly. Death certificates revealed that a benzodiazepine was the sole agent in 72% of these cases. Flunitrazepam or nitrazepam were implicated in 90% of the single benzodiazepine suicides. In addition to the suicides classified as drug poisonings, 82 cases were found in which a drug may have contributed to the cause of death. Benzodiazepines predominated. The terminal cause of death was drowning, often in the victim's own bathtub, in three-quarters of these cases. The annual fatality ratios for the newer benzodiazepine-like hypnotics zopiclone and zolpidem appear to be on the rise. Conclusion: Benzodiazepines, especially the hypnotics flunitrazepam and nitrazepam, are common in drug poisoning suicides in the elderly and should be prescribed with caution for this age group.

  • 11.
    Ekerstad, Niklas
    et al.
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    Löfmark, Rurik
    Stockholm Centre for Healthcare Ethics, LIME, Karolinska Institutet, Stockholm.
    Andersson, David
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    Carlsson, Per
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    A Tentative Consensus-Based Model for Priority Setting : An Example from Elderly Patients with Myocardial Infarction and Multi-morbidity2011In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 39, no 4, 345-353 p.Article in journal (Refereed)
    Abstract [en]

    Background: In most Western countries the growing gap between available resources and greater potential for medical treatment has brought evidence-based guidelines into focus. However, such guidelines are difficult to use when the evidence base is weak. Priority setting for frail elderly patients with heart disease illustrates this problem. We have outlined a tentative model for priority setting regarding frail elderly heart patients. The model takes cardiovascular risk, frailty, and comorbidity into account. Objective: Our aim is to validate the model’s components. We want to evaluate the inter-rater reliability of the study experts’ rankings regarding each of the model’s categories. Methods: A confidential questionnaire study consisting of 15 authentic and validated cases was conducted to assess the views of purposefully selected cardiology experts (n = 58). They were asked to rank the cases regarding the need for coronary angiography using their individual clinical experience. The response rate was 71%. Responses were analysed with frequencies and descriptive statistics. The inter-rater reliability regarding the experts’ rankings of the cases was estimated via an intra-class correlation test (ICC). Results: The cardiologists considered the clinical cases to be realistic. The intra-class correlation (two-way random, consistency, average measure) was 0.978 (95% CI 0.958–0.991), which denotes a very good inter-rater reliability on the group level. The model’s components were considered relevant regarding complex cases of non-ST elevation myocardial infarction. Comorbidity was considered to be the most relevant component, frailty the second most relevant, followed by cardiovascular risk.

    Conclusions: A framework taking comorbidity, frailty, and cardiovascular risk into account could constitute a foundation for consensus-based guidelines for frail elderly heart patients. From a priority setting perspective, it is reasonable to believe that the framework is applicable to other groups of elderly patients with acute disease and complex needs.

  • 12.
    Ekerstad, Niklas
    et al.
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    Löfmark, Rurik
    Department of Medical Ethics, Karolinska Institutet.
    Carlsson, Per
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    Elderly people with multi-morbidity and acute coronary syndrome: Doctors' views on decision-making2010In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 38, no 3, 325-331 p.Article in journal (Refereed)
    Abstract [en]

    Background: In most Western countries the growing gap between available resources and greater potential for medical treatment has brought evidence-based guidelines into focus. However, problems exist in areas where the evidence base is weak, e.g. elderly patients with heart disease and multiple co-morbidities. Objective: Our aim is to evaluate the views of Swedish cardiologists on decision-making for elderly people with multiple co-morbidities and acute coronary syndrome without ST-elevation (NSTE ACS), and to generate some hypotheses for testing. Methods: A confidential questionnaire study was conducted to assess the views of cardiologists/internists (n = 370). The response rate was 69%. Responses were analyzed with frequencies and descriptive statistics. When appropriate, differences in proportions were assessed by a chi-square test. A content analysis was used to process the answers to the open-ended questions. Results: 81% of the respondents reported extensive use of national quidelines for care of heart disease in their clinical decision-making. However, when making decisions for multiple-diseased elderly patients, the individual physician's own clinical experience and the patient's views of treatment choice were used to an evidently greater extent than national guidelines. Approximately 50% estimated that they treated multiple-diseased elderly patients with NSTE ACS every day. Preferred measures for improving decision-making were: (a) carrying out treatment studies including elderly patients with multiple co-morbidities, and (b) preparing specific national guidelines for multiple-diseased elderly patients. Conclusions: In the future, national guidelines for heart disease should be adapted in order to be applicable for elderly patients with multiple co-morbidities.

  • 13.
    Garpenholt, Ö
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment.
    Fredlund, Hans
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment.
    Timpka, Toomas
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Östergötlands Läns Landsting, Centre for Public Health Sciences, Centre for Public Health Sciences.
    Immunization against Haemophilus influenzae type b in Sweden - A study of the introduction process2001In: Scandinavian Journal of Public Health, ISSN 1403-4948, Vol. 29, no 4, 271-278 p.Article in journal (Refereed)
    Abstract [en]

    Aims: To study the introduction of Haemophilus influenzae type b (Hib) vaccination in Sweden, and to identify factors promoting and inhibiting the process. Methods. The introduction of general childhood vaccination against Hib in Sweden in 1992-93 was studied using the Cultural Historical Activity Theory as a theoretical framework. Results: Five activity systems were found to be involved in the introduction process, the systems of vaccine production, government administration, news distribution, science, and disease prevention. The critical factors for introduction of the programme were found to be the vaccine product, conception of the disease, government economy and public decision-making. Conclusions: The results show that a broad range of non-biomedical aspects must be considered when a public health intervention such as a general vaccination programme is introduced.

  • 14.
    Granström, Fredrik
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Uppsala University, Sweden.
    Molarius, Anu
    Vastmanland County Council, Sweden.
    Garvin, Peter
    Region Östergötland, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care. Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Elo, Sirkka
    Örebro County Council, Sweden.
    Feldman, Inna
    Uppsala County Council, Sweden; Uppsala University, Sweden.
    Kristenson, Margareta
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Exploring trends in and determinants of educational inequalities in self-rated health2015In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 43, no 7, 677-686 p.Article in journal (Refereed)
    Abstract [en]

    Aims: Educational inequalities in self-rated health (SRH) in European welfare countries are documented, but recent trends in these inequalities are less well understood. We examined educational inequalities in SRH in different age groups, and the contribution of selected material, behavioural and psychosocial determinants from 2000 to 2008. Methods: Data were derived from cross-sectional surveys conducted in 2000, 2004 and 2008 including 37,478, 34,876 and 32,982 respondents, respectively, aged 25-75 in mid-Sweden. Inequalities were analysed by age-standardized and age-stratified rate ratios of poor SRH and age-standardized prevalence of determinants, and contribution of determinants by age-adjusted logistic regression. Results: Relative educational inequalities in SRH increased among women from 2000 (rate ratio (RR) 1.70, 95% CI 1.55-1.85) to 2008 (RR 2.07, 95% CI 1.90-2.26), but were unchanged among men (RR 1.91-2.01). The increase among women was mainly due to growing inequalities in the age group 25-34 years. In 2008, significant age differences emerged with larger inequalities in the youngest compared with the oldest age group in both genders. All determinants were more prevalent in low educational groups; the most prominent were lack of a financial buffer, smoking and low optimism. Educational differences were unchanged over the years for most determinants. In all three surveys, examined determinants together explained a substantial part of the educational inequalities in SRH. Conclusions: Increased relative educational health inequalities among women, and persisting inequalities among men, were paralleled by unchanged, large differences in material/structural, behavioural and psychosocial factors. Interventions to reduce these inequalities need to focus on early mid-life.

  • 15.
    Gustafsson, Klas
    et al.
    Karolinska Institute.
    Backenroth-Ohsako, Gunnel
    Karolinska Institute.
    Rosenhall, Ulf
    Karolinska Institute.
    Ternevall-Kjerulf, Elisabeth
    Karolinska Institute.
    Ulfendahl, Mats
    Karolinska Institute.
    Alexanderson, Kristina
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Future risk for disability pension among people with sickness absence due to otoaudiological diagnoses: a population-based cohort study with a 12-year follow-up2011In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 39, no 5, 501-507 p.Article in journal (Refereed)
    Abstract [en]

    Hearing difficulties is a growing public health problem and more knowledge of consequences of those difficulties in working life is warranted. Aims: To study the future risk of being granted a disability pension (DP) among people with sickness absence with an otoaudiological diagnoses (OAD) compared to other sickness absentees. Methods: A population-based prospective cohort study of all 40,786 people in a Swedish county who in 1985 were aged 16-64 and had a new sick-leave spell greater than 7 days. Those were followed for 12 years with regard to DP. Hazard ratios (HR) + 95% confidence intervals (CI) of being granted DP was calculated among those with sick leave due to OAD compared to people with sickness absence with other diagnoses. Results: In 1985, 515 people had a new sick-leave spell with an OAD. Twelve years later, 36% of those had been granted DP, compared to 24% of all other sickness absentees. Their HR for DP was 1.42 (95% CI 1.23-1.64) adjusting for gender and age. Compared to men, women with an OAD had a HR of DP of 1.24 (95% CI 0.90-1.71), when adjusted for age. The HR for DP regarding those aged greater than 45 years and sickness absent with OAD was 2.63 (95% CI 1.95-3.55) compared to the sickness absentees with OAD below 45 years of age, adjusted for gender. Conclusions: The risk for future DP was more than 40% higher among those initially on sickness absence due to OAD than among other sickness absentees.

  • 16.
    Hansdotter, Frida I.
    et al.
    Public Health Agency Sweden, Sweden.
    Magnusson, Måns
    Linköping University, Department of Computer and Information Science, Statistics. Linköping University, Faculty of Science & Engineering.
    Kuhlmann-Berenzon, Sharon
    Public Health Agency Sweden, Sweden.
    Hulth, Anette
    Public Health Agency Sweden, Sweden.
    Sundstrom, Kristian
    Lund University, Sweden.
    Hedlund, Kjell-Olof
    Swedish Institute Communicable Disease Control, Linkoping, Sweden.
    Andersson, Yvonne
    Swedish Institute Communicable Disease Control, Linkoping, Sweden.
    The incidence of acute gastrointestinal illness in Sweden2015In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 43, no 5, 540-547 p.Article in journal (Refereed)
    Abstract [en]

    Aims: The aim of this study was to estimate the self-reported domestic incidence of acute gastrointestinal illness in the Swedish population irrespective of route of transmission or type of pathogen causing the disease. Previous studies in Sweden have primarily focused on incidence of acute gastrointestinal illness related to consumption of contaminated food and drinking water. Methods: In May 2009, we sent a questionnaire to 4000 randomly selected persons aged 0-85 years, asking about the number of episodes of stomach disease during the last 12 months. To validate the data on symptoms, we compared the study results with anonymous queries submitted to a Swedish medical website. Results: The response rate was 64%. We estimated that a total number of 2744,778 acute gastrointestinal illness episodes (95% confidence intervals 2475,641-3013,915) occurred between 1 May 2008 and 30 April 2009. Comparing the number of reported episodes with web queries indicated that the low number of episodes during the first 6 months was an effect of seasonality rather than recall bias. Further, the result of the recall bias analysis suggested that the survey captured approximately 65% of the true number of episodes among the respondents. Conclusions: The estimated number of Swedish acute gastrointestinal illness cases in this study is about five times higher than previous estimates. This study provides valuable information on the incidence of gastrointestinal symptoms in Sweden, irrespective of route of transmission, indicating a high burden of acute gastrointestinal illness, especially among children, and large societal costs, primarily due to production losses.

  • 17.
    Jansson, Fredrik
    Linköping University, Department of Social and Welfare Studies, The Institute for Analytical Sociology, IAS. Linköping University, Faculty of Arts and Sciences. Stockholm University, Sweden; Malardalen University, Sweden.
    Using register data to deduce patterns of social exchange2017In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 45, 56-61 p.Article in journal (Refereed)
    Abstract [en]

    This paper presents a novel method for deducting propensities for social exchange between individuals based on the choices they make, and based on factors such as country of origin, sex, school grades and socioeconomic background. The objective here is to disentangle the effect of social ties from the other factors, in order to find patterns of social exchange. This is done through a control-treatment design on analysing available data, where the treatment is similarity of choices between socially connected individuals, and the control is similarity of choices between non-connected individuals. Structural dependencies are controlled for and effects from different classes are pooled through a mix of methods from network and meta-analysis. The method is demonstrated and tested on Swedish register data on students at upper secondary school. The results show that having similar grades is a predictor of social exchange. Also, previous results from Norwegian data are replicated, showing that students cluster based on country of origin.

  • 18.
    Jarvis, Benjamin
    et al.
    Linköping University, Department of Management and Engineering, The Institute for Analytical Sociology, IAS. Linköping University, Faculty of Arts and Sciences.
    Kawalerowicz, Juta
    Linköping University, Department of Management and Engineering, The Institute for Analytical Sociology, IAS. Linköping University, Faculty of Arts and Sciences.
    Valdez, Sarah
    Linköping University, Department of Management and Engineering, The Institute for Analytical Sociology, IAS. Linköping University, Faculty of Arts and Sciences.
    Impact of ancestry categorisations on residential segregation measures using Swedish register data2017In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 45, 62-65 p.Article in journal (Refereed)
    Abstract [en]

    Aim: Country-of-birth data contained in registers are often aggregated to create broad ancestry group categories. We examine how measures of residential segregation vary according to levels of aggregation. Method: We use Swedish register data to calculate pairwise dissimilarity indices from 1990 to 2012 for ancestry groups defined at four nested levels of aggregation: (1) micro-groups containing 50 categories, (2) meso-groups containing 16 categories, (3) macro-groups containing six categories and (4) a broad Western/non-Western binary. Results: We find variation in segregation levels between ancestry groups that is obscured by data aggregation. Conclusions: This study demonstrates that the practice of aggregating country-of-birth statistics in register data can hinder the ability to identify highly segregated groups and therefore design effective policy to remedy both intergroup and intergenerational inequalities.

  • 19.
    Kalnina, Liga
    et al.
    State Sports Medical Centre, Latvia; Latvian University, Latvia.
    Sauka, Melita
    State Sports Medical Centre, Latvia.
    Timpka, Toomas
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Health and Developmental Care, Center for Public Health.
    Dahlström, Örjan
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Nylander, Eva
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Clinical Physiology in Linköping. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Selga, Guntars
    State Sports Medical Centre, Latvia; Riga Stradins University, Latvia.
    Ligere, Renate
    Latvian University, Latvia.
    Karklina, Helena
    Latvian University, Latvia.
    Priedite, Ilga S.
    State Sports Medical Centre, Latvia.
    Larins, Viesturs
    Latvian Academic Sports Educ, Latvia.
    Body fat in children and adolescents participating in organized sports: Descriptive epidemiological study of 6048 Latvian athletes2015In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 43, no 6, 615-622 p.Article in journal (Refereed)
    Abstract [en]

    Background: Pressure among young athletes to meet body composition goals may lead to poor nutrition and affect growth. Aims: To examine the proportion of body fat (%BF), measured by bioimpedance analysis, among Latvian children and adolescents participating in organized sports. Methods: Our study had a nationally representative sample of 6048 young athletes, aged 10-17 years. Their %BF was measured using a multifrequency, 8-pole, bioelectrical impedance leg-to-hand analyzer. Results: About 19.2% (CI 14.4-20.0) of boys and 15.1% (CI 14.0-16.3) of girls had a %BF value below the recommended levels. The %BF in young female athletes participating in aesthetic sports was lower than among their peers participating in other sports. Young male athletes participating in aesthetic sports had lower %BF levels at 10 and 12 years of age, compared with participants in weight-class sports; and lower levels of %BF from age 10-14 years, compared with participants in non-weight-sensitive sports. Conclusions: Almost every fifth child and adolescent participating in organized sports displayed critically low body fat levels. Body fat needs to be assessed regularly in young athletes, to prevent negative consequences on health.

  • 20.
    Karlsson, Nadine
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Carstensen, John
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Department of Health and Society, Tema Health and Society.
    Gjesdal, Sturla
    Personskadeprevention Karolinska Institutet.
    Alexanderson, Kristina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science.
    Mortality in relation to disability pension: findings from a 12-year prospective population-based cohort study in Sweden.2007In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 35, no 4, 341-347 p.Article in journal (Refereed)
  • 21.
    Karlén, Jerker
    et al.
    Linköping University, Department of Medical and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences.
    Faresjö, Tomas
    Linköping University, Department of Medical and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences.
    Ludvigsson, Johnny
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Could the social environment trigger the induction of diabetes related autoantibodies in young children?2012In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 40, no 2, 177-182 p.Article in journal (Refereed)
    Abstract [en]

    Aims: The onset and progression of the autoimmune process leading to type 1 diabetes is partly dependent on genetic predisposition and partly on environmental factors. We have implemented a study design where 1-year-old children, from two equally sized, neighbouring but socioeconomically different cities, were compared for the induction of beta-cell autoantibodies. Methods: This study comprises 2448 newborn infants, all living in the urban parts of the twin cities, followed prospectively with regular biological samples and questionnaires in a major population-based study. Of these, a random sample of 1497 children were tested for tyrosine phosphatase (IA-2A) and 1409 children for glutamic acid decarboxylase (GADA). Other documented risk factors of beta-cell autoimmunity and type 1 diabetes, such as family characteristics, dietary factors, and psychosocial factors were also included in the analysis. Results: The risk for diabetes-related autoantibodies, both against GADA and IA-2A (andgt; 95% cut off), was significantly higher (p andlt; 0.0001) among children from the blue-collar than from the white-collar city. This difference persisted still after adjustment for other previously documented risk factors. Some of these previously known risk factors remained significant in the multivariate analysis as independent explanatory factors, in addition to living in a blue-collar city. Conclusions:Factors in the social environment could trigger the induction of diabetes-related autoantibodies in 1-year-old children. These results point out that our present knowledge of factors influencing the autoimmune process might be widen to also include factors in the social environment of the community.

  • 22.
    Kristenson, Margareta
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment.
    Kucinskiene, Zita
    Vilnius, Lithuania.
    Bergdahl, Björn
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Orth-Gomér, Kristina
    Karoliska inst Stockholm.
    Risk factors for coronary heart disease in different socioeconomic groups of Lithuania and Sweden - The LiVicordia study2001In: Scandinavian Journal of Public Health, ISSN 1403-4948, Vol. 29, no 2, 140-150 p.Article in journal (Refereed)
    Abstract [en]

    Aims: Lithuanian middle-aged men have a fourfold higher risk for coronary heart disease (CHD) mortality compared with Swedish men. In Sweden, CHD mortality is twice as high in blue- compared with white-collar workers. Whether the same risk factors that characterized Lithuanian men, compared with Swedish men, could be found in low socioeconomic groups within the cities was investigated. Methods: The LiVicordia study compared both traditional and new possible risk factors for CHD among 150 50-year-old men in Link÷ping, Sweden and Vilnius, Lithuania. A comparison was made of the prevalence of these risk factors in high and low socioeconomic groups within the cities and, after controlling for the city, variations across socioeconomic groups in the total sample. Results: Small differences were found in traditional risk factors between cities. However, Vilnius men were shorter, had lower serum levels of antioxidant vitamins, more psychosocial strain, and lower cortisol response to a standardized laboratory stress test. These characteristics were also found among men in low social classes in both cities. In linear regression models, short stature, low serum ▀-carotene, low social integration, coping and self-esteem, high vital exhaustion, high baseline and low cortisol response to stress were related to low social class. Conclusions: The same set of risk factors, mainly relating to oxidative and psychosocial stress, that characterized Vilnius men was also found in men in low social classes within the cities. The results suggest that a common set of risk factors may help to explain health differences both between and within countries. ⌐ Taylor & Francis 2001.

  • 23.
    Kristenson, Margareta
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Lundberg, Johanna
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Garvin, Peter
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Socioeconomic differences in outpatient healthcare utilisation are mainly seen for musculoskeletal problems in groups with poor self-rated health2011In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 39, no 8, 805-812 p.Article in journal (Refereed)
    Abstract [en]

    Aim: To assess whether there are socioeconomic (SES) differences in outpatient visits within groups of comparable morbidity (medical disease and self-rated health) and whether psychosocial factors can explain these differences. Methods: Baseline data for SES, presence of disease, self-rated health (SRH), and psychosocial factors were collected during 2003-04 from 923 men and women aged 45-69 years in southeast Sweden. Outcome data were all registered outpatient healthcare visits to physicians during 2004-08. Cumulative incidences and standardised rate ratios (SSR) were calculated for strata of comparable morbidity for all visits, for visits due to cardiovascular disorders (CVD)/diabetes and for musculoskeletal problems. Results: Low SES was associated with more outpatient visits due to musculoskeletal problems (SRR for education 1.52, 95% CI 1.35-1.73; for occupation 1.40, 95% CI 1.26-1.56) and accentuated in groups with poor SRH. The SES effect was significant for visits to primary care and to hospitals, for men and women, and independent of present disease, SRH, and psychosocial factors. Low SES was significantly associated with more total outpatient visits at primary healthcare centres. In contrast, for outpatient visits due to CVD/diabetes, high SES was related to more visits to hospitals among people with good SRH at baseline. Conclusions: We found a consistent pattern for outpatient visits related to musculoskeletal problems where people with low SES counted more visits and this was most prominent in groups of poor SRH. The results demonstrate the need to apply different morbidity measures when studying inequalities in healthcare utilisation.

  • 24.
    Kullberg, Agneta
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Nordqvist, Cecilia
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Timpka, Toomas
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Public Health Sciences.
    Lindqvist, Kent
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Residents’ perspectives on safety support needs in different types of housing areas2011In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 39, no 6, 590-597 p.Article in journal (Refereed)
    Abstract [en]

    Background: Knowledge about conditions that are understood to support safety is important for planning residential safety promotion in interactions with residents. How residents themselves perceive and reason about their own safety needs has seldom been investigated in Scandinavia. Aim: To identify factors perceived to be necessary to feel safe by residents in areas with blocks of flats and detached houses.

    Methods: Residents in a Swedish municipality were asked an open-ended question on the research topic by a mail survey; 787 residents provided narrative data that were fed into a summative qualitative and quantitative content analysis.

    Results: A stable social structure in the housing area was perceived to be the central factor in a safety-supportive residential environment. Whereas maintenance of good and reassuring relations was emphasized in detached housing areas, support for management of poor or even fear-provoking neighbour relations was requested from areas with blocks of flats. This finding emphasizes the need to reduce the differential exposure to safety-related factors in the living environment.

    Conclusions: The results of our study encourage the continued use of a setting-orientated safety promotion approach in which residents and other stakeholders are involved. The policy recommendation that can be drawn from the study is that both the subjective and objective dimensions of safety should be identified and considered when developing local safety promotion interventions in community contexts.

  • 25.
    Leander, Karen
    et al.
    Karolinska Institute, Sweden .
    Berlin, Marie
    Swedish National Board Health and Welf, Sweden .
    Eriksson, Annika
    National Council Crime Prevent, Sweden .
    Gillander Gadin, Katja
    Mid Sweden University, Sweden .
    Hensing, Gunnel
    Gothenburg University, Sweden .
    Krantz, Gunilla
    Gothenburg University, Sweden .
    Swahnberg, Katarina
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Danielsson, Maria
    Swedish National Board Health and Welf, Sweden .
    Violence Health in Sweden: The National Public Health Report 20122012In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 40, no 9, 229-254 p.Article in journal (Refereed)
    Abstract [en]

    In Sweden and in other countries, it has become increasingly common to view violence from a public health perspective. This chapter presents a description of interpersonal violence with an emphasis on violence in close relations, particularly in partner relationships. According to the Swedish Crime Survey 2010, approximately one in ten inhabitants was exposed to violence, threats or harassment of some kind in 2009. Young people and single mothers with small children are particularly vulnerable to violence. According to Statistics Sweden's ULF surveys (Survey on Living Conditions) for 2004-2005, 17 per cent of men and 12 per cent of women aged 16-24 years reported having been subjected to violence or serious threats at some time in the previous 12 months. Boys and men are more frequently subjected to lethal violence and to violence resulting in hospitalisation than girls and women. Similarly, men also make up a majority of the victims of assaults reported to the police. On the other hand, domestic violence and work-related violence more often involve women than men, and sexual violence is chiefly directed at girls and women. Most women and children who are subjected to assault are acquainted with the perpetrator, while this only applies to a minority of male victims. Women are four to five times as likely to be killed by a partner as men. Partner assaults against women, rapes, and gross violations of a woman's integrity account for a fifth of all reported crimes of violence (against women and men combined). Violence in partner relationships has significant consequences for physical and mental health; between 12,000 and 14,000 women seek outpatient care each year as a result of violence committed by a partner. Violence can also have serious social repercussions: isolation, financial difficulties, sick leave from work, unemployment, etc., and women subjected to this form of violence can be prevented from seeking medical or other assistance. Children are often involved. Approximately 10 per cent of all children have experienced violence in the home and 5 per cent have experienced it frequently. Many children who witness violence are also beaten themselves. In 2006, the Swedish National Board of Health and Welfare estimated the annual socioeconomic cost of violence against women to be between SEK 2.7 and 3.3 billion, SEK 38 million of which were direct medical costs. Factors affecting the risk of violence in partner relationships are related both to the social structure and individual character of the perpetrator. Trends in violence have moved in different directions. Today, more people in all age groups, with the exception of the most elderly (aged 65-84), report that they have been exposed to threats or violence than in the 1980s. In recent years, however, the increase has halted; there has even been a decline among young people aged 16-24. Crimes of violence reported to the police are growing in number, and the number of reports of work-related violence, for example, has more than doubled since the mid 1970s. The number of rapes reported to the police has also risen significantly in recent year, and the victims are on average becoming younger. Furthermore, rape and gross violation of a woman's integrity (combined) are now almost as common as robbery. This increase is probably due to a combination of greater willingness to report crimes, a lower tolerance threshold for violence, legislative changes and an increase in the number of violent acts committed. The rise in violence represented by crime statistics is not reflected in the proportion of people who have suffered serious physical injuries as a result of violence. Over the past ten years, the number of deaths resulting from violence has declined among women and men. Hospital statistics also show that although the percentage of people receiving treatment has remained relatively stable, more people are now seeking hospital treatment following a sexual assault.

  • 26.
    Leijon, Margareta
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Hensing, Gunnel
    Linköping University, Faculty of Health Sciences.
    Alexanderson, Kristina
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Sickness absence due to musculoskeletal diagnoses: association with occupational gender segregation2004In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 32, no 2, 94-101 p.Article in journal (Refereed)
    Abstract [en]

    Background: Musculoskeletal disorders represent a considerable public health problem and the most common diagnoses behind sickness absence and disability pensions. However, little is known about how sickness absence with these diagnoses varies with the strong gender segregation of the labour market.

    Aims: A study was undertaken to investigate the association between musculoskeletal-related sickness absence and occupational gender segregation.

    Methods: The study was population based, and included all new sick-leave spells exceeding seven days due to musculoskeletal diagnoses, comprising neck/ shoulder pain, low back pain, and osteoarthritis in Östergötland county, Sweden, which has 393,000 inhabitants (5% of the national population). The participants were all sick-leave insured employed persons in Östergötland (n=182,663) in 1985.

    Results: Cumulative incidence of musculoskeletal-related sickness absence (>7 days) was higher for women (7.5%, 95% confidence interval [C.I.] 7.3-7.7) than for men, (5.8%, C.I. 5.6-5.9), and the same was true for the mean number of sick-leave days (women 81, C.I. 78-83; men 65, C.I. 63-68). Grouping occupations according to degree of numerical gender segregation revealed the highest incidence and duration of sickness absence for women in male-dominated occupations. For both genders, the lowest cumulative incidence and duration occurred in gender-integrated occupations.

    Conclusions: Our results indicate a strong association between occupational gender segregation and musculoskeletal-related sickness absence. Further studies are needed to elucidate gender segregation of the labour market in relation to health and rehabilitation measures.

  • 27.
    Lindmark, Ulrika
    et al.
    Jönköping University.
    Stenström, Ulf
    Växjö University.
    Wärnberg-Gerdin, Elisabeth
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Hugoson, Anders
    Jönköping University.
    The distribution of ‘‘sense of coherence’’ among Swedish adults: A quantitative cross-sectional population study2010In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 38, no 1, 1-8 p.Article in journal (Refereed)
    Abstract [en]

    Background: Antonovskys concept of "sense of coherence (SOC) has been shown to be related to health. The aim of this study was to describe the distribution of SOC scores and their components in an adult Swedish population aged 20-80 years. Methods: A random sample of 910 individuals from Jonkoping, Sweden, aged 20, 30, 40, 50, 60, 70 and 80 years, of which 589 agreed to participate in an oral health examination. The participants answered Antonovskys 13-item version of "the life orientation questionnaire scale. The response to the items and the distribution of the three components of comprehensibility, manageability and meaningfulness were analyzed for different age groups and genders using mean values and standard deviations, Students t-test and ANOVA. Results: A total of 526 individuals, 263 men and 263 women, answered all 13 questions and constituted the final material for the study (response rate 89%). The individual SOC score increased with age. The 20 year olds had a statistically significantly lower SOC score compared with the other age groups and 55% of them had a low SOC (andlt;= 66 points) compared with 17% of the 80 year olds. Men in the 60 and 70 year age groups had a statistically significantly higher SOC score compared with women of the same age. Conclusions: The individual distribution of SOC varied with age and gender. Twenty year olds had a significantly lower SOC score compared with elderly age groups. Elderly men had a statistically significantly higher SOC score compared with women of the same age.

  • 28.
    Liss, Per-Erik
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Medicine and Health Sciences, Health and Society.
    Hard choices in public health: The allocation of scarce resources2003In: Scandinavian Journal of Public Health, ISSN 1403-4948, Vol. 31, no 2, 156-157 p.Article, review/survey (Refereed)
    Abstract [en]

    [No abstract available]

  • 29.
    Nilsing, Emma
    et al.
    Linköping University, Department of Medical and Health Sciences, Physiotherapy. Linköping University, Faculty of Health Sciences.
    Söderberg, Elsy
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Normelli, Helena
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Öberg, Birgitta
    Linköping University, Department of Medical and Health Sciences, Physiotherapy. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Public Health Sciences.
    Description of functioning in sickness certificates2011In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 39, no 5, 508-516 p.Article in journal (Refereed)
    Abstract [en]

    Aims: Sickness certificates are to provide information on a disease and its consequences on the patients functioning. This information has implications for the patients rights to sickness benefits and return-to-work measures. The objective of this study was to investigate the description of functioning in sickness certificates according to WHOs International Classification of Functioning, Disability, and Health (ICF), and to describe the influence of patients age, gender, diagnostic group, and affiliation of certifying physician. Method: A content analysis of written statements regarding how the disease limits the patients functioning with ICF as a framework was performed in 475 sickness certificates, consecutively collected in Ostergotland County, Sweden. Results: Musculoskeletal diseases (MSD) were the largest diagnostic group, followed by mental disorders (MD). Certificates were mainly issued from physicians at hospitals and in primary health care (PHC). ICF was applicable for classifying statements regarding functioning in 311 certificates (65%). The distribution of components was 58% body functions, 26% activity, and 7% participation. The descriptions were primarily restricted to the use of at least one component; namely, body functions. Subgroup analysis showed that descriptions of activity and participation were more common in certificates for MD and MSD, or those issued by PHC physicians. A multiple regression analysis with the activity component as dependent variable confirmed the results by showing that activity was related to both diagnosis and affiliation. Conclusions: In a consecutive sample of sickness certificates, it was shown that information on functioning is scarce. When functioning was described, it was mainly body oriented.

  • 30.
    Nordlund, Lars Anders
    et al.
    Linköping University, Department of Medical and Health Sciences, Health and Society. Linköping University, Faculty of Health Sciences.
    Carstensen, John
    Linköping University, Department of Medical and Health Sciences, Health and Society. Linköping University, Faculty of Health Sciences.
    Pershagen, Göran
    Karolinska institutet, Stockholm.
    Are male and female smokers at equal risk of smoking-related cancer: evidence from a Swedish prospective study1999In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 27, no 1, 56-62 p.Article in journal (Refereed)
    Abstract [en]

    This study examines sex differences in the relative risks of lung cancer and other smoking-related cancers (i.e. cancers of the upper respiratory tract, oesophagus, pancreas, bladder, and renal pelvis). Data on smoking habits in 1963 from a random sample of 56,000 men and women were linked with information on new cases of cancer for 1964-89. Compared with people who have never smoked, the relative risks of lung cancer at different levels of pack-years completed in 1963 (>5, 6-15, 16-25 and 25 + pack-years) were 1.6, 4.4, 14.2, and 17.9 for men, and 2.1, 6.3, 10.3, and 16.5 for women. The corresponding relative risks of other smoking-related cancers were 1.8, 3.0 5.4, and 6.4 for men, and 2.0, 3.1, 5.0, and 6.5 for women. These results suggest that men and women have similar relative risks of smoking-related cancers at different levels of smoking.

  • 31.
    Ockander, Marlene
    et al.
    Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Timpka, Toomas
    Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Women's experiences of long term sickness absence: implications for rehabilitation practice and theory2003In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 31, no 2, 143-148 p.Article in journal (Refereed)
    Abstract [en]

    Background: In most European countries, spells of long-term absence contribute the largest number of days that are reimbursed as a result of sickness absence. This group is growing and it is constituted mainly of women.

    Aim: The present study seeks further knowledge about what happens then and there, i.e. how women on long-term sickness absence handle and explain, for themselves and others, this interruption in their daily life.

    Methods: Semi-structured interviews were performed with 82 middle-aged women with personal experience of long-term sickness absence.

    Results: The women's accounts of sickness absence contained interpretations of what had happened to them, how things were at present, and what they thought the future would bring. Three different accounts could be distinguished: crisis, breakpoint, and migration. The perception of their own situation and especially what they thought about their future was associated with their feeling of power to take the initiative, and their well-being.

    Conclusion: From this study the authors have found implications for central topics of importance: time elapse, sense of coherence, reorientation/adaptation, vital goals, and gender.

  • 32.
    Oldfors Engström, Lena
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Physiotherapy.
    Öberg, Birgitta
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Physiotherapy. Östergötlands Läns Landsting, Centre for Public Health Sciences, Centre for Public Health Sciences.
    Patient adherence in an individualized rehabilitation programme: A clinical follow-up2005In: Scandinavian Journal of Public Health, ISSN 1403-4948, Vol. 33, no 1, 11-18 p.Article in journal (Refereed)
    Abstract [en]

    Aims: This investigation aims to describe patients with longstanding pain who did not complete their participation and/or participated infrequently in physiotherapy (PT) treatment based on their own activity and responsibility, and in addition to understand the phenomenon of adherence from a behavioural theoretical perspective. Methods: The phenomenon compliance/adherence was studied in relation to health locus of control (HLC) factors and health belief (HB) variables. Outcome measures were based on a questionnaire answered by all patients before the beginning of treatment. Definitions of adherence were completed treatment period and exercise frequency respectively. Patients completing treatment were compared with those who did not. Exercise frequencies of those completing treatment were also studied. Results: Those who did not complete treatment reported higher pain intensity, higher Oswestry score, and worse general health than those completing treatment. Results also showed that those who exercised once a week or less often valued the significance of healthcare treatment less, perceived higher pain intensity, presented a higher Oswestry score, worse general health, more pain locations, lower expectations, were younger and almost solely women, than those who exercised more often. Conclusions: Individuals exercising irregularly were above all women. This fact needs further investigation. Individuals' belief in treatment effects is of significance to adherence. Adherence is a comprehensive concept and depending on how we look at it we find different populations. © 2005 Taylor & Francis Ltd.

  • 33.
    Omar, Faisal
    et al.
    Linköping University, Department of Medical and Health Sciences, Health and Society. Linköping University, Faculty of Health Sciences.
    Tinghög, Gustav
    Linköping University, Department of Management and Engineering, Economics. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Health Sciences.
    Carlsson, Per
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Health Sciences.
    Omnell Persson, Marie
    Department of Nephrology and Transplantation, Skåne University Hospital (Malmö), Lund University, Malmö, Sweden.
    Welin, Stellan
    Linköping University, Department of Medical and Health Sciences, Health and Society. Linköping University, Faculty of Health Sciences.
    Priority setting in kidney transplantation: A qualitative study evaluating Swedish practices2013In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 41, no 2, 206-215 p.Article in journal (Refereed)
    Abstract [en]

    Background: Kidney transplantation is the established treatment of choice for end-stage renal disease; it increases survival, and quality of life, while being more cost effective than dialysis. It is, however, limited by the scarcity of kidneys. The aim of this paper is to investigate the fairness of the priority setting process underpinning Swedish kidney transplantation in reference to the Accountability for Reasonableness (A4R) framework. To achieve this, two significant stages of the process influencing access to transplantation are examined: assessment for transplant candidacy, and allocation of kidneys from deceased donors.

    Methods: Semi-structured interviews were the main source of data collection. Fifteen Interviewees included transplant surgeons, nephrologists, and transplant coordinators representing centers nationwide. Thematic analysis was used to analyze interviews, with the Accountability for Reasonableness framework serving as an analytical lens.

    Results: Decision-making both in the assessment and allocation stages are based on clusters of factors that belong to one of three levels: patient, professional, and the institutional levels. The factors appeal to values such as maximizing benefit, priority to the worst off, and equal treatment which are traded off.

    Discussion and Conclusions: The factors described in this paper and the values on which they rest on the most part satisfy the relevance condition of the accountability for reasonableness framework. There are however two potential sources for unequal treatment which we have identified: clinical judgment and institutional policies relating both to assessment and allocation. The appeals mechanisms are well developed and supported nationally which help to offset differences between centers. There is room for improvement in the areas of publicity and enforcement. The development of explicit national guidelines for assessing transplant candidacy and the creation of a central kidney allocation system would contribute to standardize practices across centers; and in the process help to better meet the conditions of fairness in reference to the A4R. The benefits of these policy proposals in the Swedish kidney transplant system merit serious consideration.

  • 34.
    Omar, Faisal
    et al.
    Linköping University, Department of Medical and Health Sciences, Health and Society. Linköping University, Faculty of Arts and Sciences.
    Tinghög, Gustav
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    Tinghög, Petter
    Linköping University, Department of Medical and Health Sciences, Health and Society. Linköping University, Faculty of Arts and Sciences.
    Carlsson, Per
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    Attitudes towards priority-setting and rationing in healthcare - an exploratory survey of Swedish medical students2009In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 37, no 2, 122-130 p.Article in journal (Refereed)
    Abstract [en]

    Background: Healthcare priority-setting is inextricably linked to the challenge of providing publicly funded healthcare within a limited budget, which may result in difficult and potentially controversial rationing decisions. Despite priority-settings increasing prominence in policy and academic discussion, it is still unclear what the level of understanding and acceptance of priority-setting is at different levels of health care. Aims: The aim of this study is threefold. First we wish to explore the level of familiarity with different aspects of priority-setting among graduating medical students. Secondly, to gauge their acceptance of both established and proposed Swedish priority-setting principles. Finally to elucidate their attitudes towards healthcare rationing and the role of different actors in decision making, with a particular interest in comparing the attitudes of medical students with data from the literature examining the attitudes among primary care patients in Sweden. Methods: A cross-sectional survey containing 14 multiple choice items about priority-setting in healthcare was distributed to the graduating medical class at Linkoping University. The response rate was 92% (43/47). Results: Less than half of respondents have encountered the notion of open priority-setting, and the majority believed it to be somewhat or very unclear. There is a high degree of awareness and agreement with the established ethical principles for priority-setting in Swedish health care; however respondents are inconsistent in their application of the cost-effectiveness principle. A larger proportion of respondents were more favourable to physicians and other health personnel being responsible for rationing decisions as opposed to politicians. Conclusions: Future discussion about priority-setting in medical education should be contextualized within an explicit and open process. There is a need to adequately clarify the role of the cost-effectiveness principle in priority-setting. Medical students seem to acknowledge the need for rationing in healthcare to a greater extent when compared with previous results from Swedish primary care patients.

  • 35.
    Omar, Faisal
    et al.
    Linköping University, Department of Medical and Health Sciences, Health and Society. Linköping University, Faculty of Health Sciences.
    Tinghög, Gustav
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    Welin, Stellan
    Linköping University, Department of Medical and Health Sciences, Health and Society. Linköping University, Faculty of Health Sciences.
    Incentivizing deceased organ donation: A Swedish priority-setting perspective.2011In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 39, no 2, 156-163 p.Article in journal (Refereed)
    Abstract [en]

    AIMS: The established deceased organ donation models in many countries, relying chiefly on altruism, have failed to motivate a sufficient number of donors. As a consequence organs that could save lives are routinely missed leading to a growing gap between demand and supply. The aim of this paper is twofold; firstly to develop a proposal for compensated deceased organ donation that could potentially address the organ shortage; secondly to examine the compatibility of the proposal with the ethical values of the Swedish healthcare system.

    METHODS: The proposal for compensating deceased donation is grounded in behavioural agency theory and combines extrinsic, intrinsic and signalling incentives in order to increase prosocial behaviour. Furthermore the compatibility of our proposal with the values of the Swedish healthcare system is evaluated in reference to the principles of human dignity, needs and solidarity, and cost effectiveness.

    RESULTS: Extrinsic incentives in the form of a €5,000 compensation towards funeral expenses paid to the estate of the deceased or family is proposed. Intrinsic and signalling incentives are incorporated by allowing all or part of the compensation to be diverted as a donation to a reputable charity. The decision for organ donation must not be against the explicit will of the donor.

    CONCLUSIONS: We find that our proposal for compensated deceased donation is compatible with the values of the Swedish healthcare system, and therefore merits serious consideration. It is however important to acknowledge issues relating to coercion, commodification and loss of public trust and the ethical challenges that they might pose.

  • 36.
    Petersson, Ulla
    et al.
    Linköping University, Department of Medicine and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences.
    Östgren, Carl Johan
    Linköping University, Department of Medicine and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Primary Health Care Centres.
    Brudin, Lars
    Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Linköping University, Faculty of Health Sciences.
    Ovhed, Ingvar
    Blekinge Institute for R&D, Karlshamn, Sweden.
    Nilsson, Peter M
    Department of Clinical Sciences Medicine, University Hospital, Malmö, Sweden.
    Predictors of successful, self-reported lifestyle changes in a defined middle-aged population: the Soderakra Cardiovascular Risk Factor Study, Sweden2008In: Scandinavian Journal of Public Health, ISSN 1403-4948, Vol. 36, no 4, 389-396 p.Article in journal (Refereed)
    Abstract [en]

    Aims: It is well established that the main cause of the development of cardiovascular disease can be found in unhealthy lifestyle habits. In our study, we wanted to explore the long-term predictors of self-reported lifestyle changes in a middle-aged population after screening for cardiovascular risk factors 10 years earlier.

    Methods: We conducted a 10-year follow-up telephone interview on self-reported lifestyle changes in a rural population in south-eastern Sweden, after a cardiovascular screening programme. The population comprised 90% of all inhabitants (n=705) aged 40-59 years at baseline, and 90% of these (n=629) were reached for the telephone interview.

    Results: When multivariate logistic regression was used, a higher success rate for lifestyle changes was independently associated with female gender (odds ratio (OR)=1.56, 95% confidence interval (CI) 1.11-2.18). When stratified for gender, significant predictors for success in men were prevalent cardiovascular risk conditions (OR=4.77, 95% CI 2.18-10.5; p<0.001) and previous myocardial infarction (OR=22.8, 95% CI 4.73-110; p<0.001) at baseline. For women, elevated blood pressure (> or = 160 and/or > or = 90 mmHg) measured at baseline (OR=1.84, 95% CI 1.12-3.02; p=0.016) was significantly associated with successful lifestyle changes. Smoking at baseline was also associated with significant success: OR=3.36 (95% CI:2.05-5.51; p<0.001) and OR=1.81 (95% CI 1.11-2.95; p=0.017) for men and women, respectively.

    Conclusions: Female gender was associated with significant improvements in self-reported lifestyle changes. Furthermore, smoking, a medical history of diabetes, hypertension, angina pectoris or myocardial infarction at baseline predicted success in lifestyle change in this 10-year follow-up study.

  • 37.
    Rahmqvist, Mikael
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Center for Medical Technology Assessment.
    Bara, Ana-Claudia
    National School of Public Health and Health Services Management, Romania.
    Patients retrieving additional information via the Internet: A trend analysis in a Swedish population, 2000-20052007In: Scandinavian Journal of Public Health, ISSN 1403-4948, Vol. 35, no 5, 533-539 p.Article in journal (Refereed)
    Abstract [en]

        

  • 38.
    Sachs, Lisbeth
    Linköping University, Faculty of Arts and Sciences. Linköping University, The Tema Institute.
    The new age of the molecular family. An anthropological view on the medicalisation of kinship2004In: Scandinavian Journal of Public Health, ISSN 1403-4948, Vol. 32, no 1, 24-29 p.Article in journal (Refereed)
    Abstract [en]

    Now that genetic inheritance is featuring more and more as an explanation of disease and human behaviour in general, a question that needs to be asked is how such explanations affect people's perceptions of family and kinship and to what extent genetic explanations conflict with broader social developments. Ideas about the genetic inheritance of disease place the family and kin group in the spotlight, requiring all its members to be scrutinised. Research on inheritable diseases entails a medicalisation of kinship that reflects and promotes a view of family relationships at odds with the ongoing changes in the structure of families. At a time when family structures are more fluid and less determined by "blood" relationships than ever before we have an increasing emphasis on genetic inheritance as the transmitter of both human behaviour and kinship. Embedded in concepts of genetic inheritance is thus the notion that family and kin are the medium through which inheritance flows. Two cases from an anthropological study will illustrate how genetic mapping leads to the medicalisation of kinship. © Taylor & Francis 2004.

  • 39.
    Sandman, Lars
    Högskolan i Borås, Sweden.
    Invited commentary to the discussion paper Ethics dilemmas of early detection of obesity2016In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 44, no 6, 546-548 p.Article in journal (Other academic)
    Abstract [en]

    n/a

  • 40.
    Sjögren, Elaine
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Sjögren, Elaine
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Kristenson, Margareta
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Östergötlands Läns Landsting, Centre for Public Health Sciences, Centre for Public Health Sciences.
    Kristenson, Margareta
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Östergötlands Läns Landsting, Centre for Public Health Sciences, Centre for Public Health Sciences.
    Tondel, Martin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Occupational and Environmental Medicine. Östergötlands Läns Landsting, Pain and Occupational Centre, Occupational and Environmental Medicine Centre.
    Ståhlbom, Bengt
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Occupational and Environmental Medicine. Östergötlands Läns Landsting, Pain and Occupational Centre, Occupational and Environmental Medicine Centre.
    Can gender differences in psychosocial factors be explained by socioeconomic status?2006In: Scandinavian Journal of Public Health, ISSN 1403-4948, Vol. 34, 59-68 p.Article in journal (Refereed)
  • 41.
    Stalsby Lundborg, Cecilia
    et al.
    Karolinska Institute, Sweden.
    Gyllensten, Hanna
    Karolinska Institute, Sweden.
    Hedna, Khadidja
    Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Medicine and Health Sciences.
    Hakkarainen, Katja M.
    Nordic School Public Health NHV, Sweden.
    Lesen, Eva
    Nordic Health Econ, Sweden.
    Andersson Sundell, Karolina
    University of Gothenburg, Sweden.
    Pharmacoepidemiology at Nordic School of Public Health NHV: Examples from 1999 to 20142015In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 43, 73-80 p.Article in journal (Refereed)
    Abstract [en]

    Background: Pharmacoepidemiology is a branch of public health and had a place at the Nordic School of Public Health. Courses, Masters theses and Doctorates of Public Health (DrPH) in Pharmacoepidemiology were a relatively minor, but still important part of the schools activities. Methods: This paper gives a short background, followed by some snapshots of the activities at NHV, and then some illustrative case-studies. These case-studies list their own responsible co-authors and have separate reference lists. Results: In the Nordic context, NHV was a unique provider of training and research in pharmacoepidemiology, with single courses to complete DrPH training, as well as implementation of externally-funded research projects. Conclusions: With the closure of NHV at the end of 2014, it is unclear if such a comprehensive approach towards pharmacoepidemiology will be found elsewhere in the Nordic countries.

  • 42.
    Swahnberg, Katarina
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Davidsson-Simmons, Johanna
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine.
    Hearn, Jeff
    Linköping University, The Tema Institute, The Department of Gender Studies. Linköping University, Faculty of Arts and Sciences.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Men's experiences of emotional, physical, and sexual abuse and abuse in health care: A cross-sectional study of a Swedish random male population sample2012In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 40, no 2, 191-202 p.Article in journal (Refereed)
    Abstract [en]

    Aims: This article addresses the under-researched area ofmen’s experiences of abuse. The aims were to estimate prevalence ofemotional, physical, and sexual abuse and abuse in health care in a random sample of Swedish adult men, to compare these estimates with previously collected prevalence rates in a male clinical sample to see if prevalence rates were dependant on response rate and sampling method. We also wanted to contribute to a more general analysis of men’s experiences ofvictimisation.

    Methods: Cross-sectional study design. The NorVold Abuse Questionnaire that measures the prevalence of four kinds of abuse was sent to 6000 men selected at random from the population of Östergötland, Sweden.

    Results: The responserate was 50% (n=2924). Lifetime experiences of emotional abuse were reported by 16.7%, physical abuse by 48.9%, sexualabuse by 4.5%, and abuse in health care by 7.3%. The proportion ofmen who currently suffered fromabusive experiences washighest for emotional abuse and abuse in health care. No difference in prevalence was seen between the random populationsample and the clinical sample despite significant differences regarding response rate and background characteristics.

    Conclusions: Abuse against men is prevalent and men are victimised as patients in health care. Response rateand sampling method did not influence prevalence rates of abuse. Men’s victimisation from emotional abuseand abuse in health care was associated with low income and being born outside of the Nordic countries and hence needs to be analysed in the intersections of gender, class, and ethnicity.

  • 43.
    Swahnberg, Katarina
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine .
    Wijma, Klaas
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine .
    Validation of the Abuse Screening Inventory (ASI)2007In: Scandinavian Journal of Public Health, ISSN 1403-4948, Vol. 35, no 3, 330-334 p.Article in journal (Refereed)
    Abstract [en]

    Aims: To assess the test-retest reliability and concurrent validity of the Abuse Screening Inventory (ASI) in a female sample. Method: The ASI comprises 16 items concerning four kinds of abuse: psychological, physical, and sexual abuse, and abuse in healthcare. A randomized sample of 699 women answered the ASI once. Six months later 53 of them answered the ASI again and were interviewed. To assess concurrent validity, answers in the interviews were considered as the gold standard and the ASI as the diagnostic test. Results: The ASI presented good overall test-retest reliability ranging from 81% to 96% for separate items. The ASI separated very well abused from non-abused women. No false positive answers were found. Sensitivity ranged from 72% to 82% for items concerning abuse. Conclusion: The ASI is a short abuse screening questionnaire that had acceptable validity and test-retest reliability in a random female Swedish sample.

  • 44.
    Söderberg, Elsy
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Alexanderson, Kristina
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Sickness certificates as a basis for decisions regarding entitlement to sickness insurance benefits2005In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 33, no 4, 314-320 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    The sickness certificate is a major instrument for establishing contact and conveying information between two authorities that have a substantial impact on the life situation and work situation of the patients, as well as on the economic costs of the society.

    AIM:

    A study was undertaken to assess the quality of physicians' sickness certificates as a basis for social insurance officers' decisions regarding entitlement to sickness benefits.

    METHOD:

    Information on all 2,449 sickness certificates for sick-leave periods exceeding 28 days' sick leave period received at the social insurance offices in one Swedish county during one week in 2002 was coded and analysed.

    RESULTS:

    Information provided in the certificates was often not sufficient to allow social insurance officers to determine eligibility for sickness benefits. Qualitative analyses of certificates from general practitioners (GPs) revealed that 21% contained ambiguous statements about the medical disorder, 30% were unclear regarding the assessment of functional capacity, and 22% required additional information on both those aspects. Sickness certificates issued by GPs and physicians under specialist training, as compared with other categories of physicians, more often provided essential data, for example concerning the patient's occupational tasks and type of employment.

    CONCLUSIONS:

    Physicians often fail to contribute required information concerning functional capacity and other important aspects when issuing sickness certificates. This limits the use of these documents as a basis for decisions regarding sickness insurance benefits. The practical consequences of incomplete certificates might be delayed payment of benefits and delayed initiation of return to work measures.

  • 45.
    Söderberg, Elsy
    et al.
    Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Alexanderson, Kristina
    Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Sickness certification practices of physicians: a review of the literature2003In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 31, no 6, 460-474 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: In most Western countries the responsibilities of physicians include assessing work ability and issuing certificates for sickness absence and disability pension. These tasks often have a substantial impact on the lives of patients and constitute a financial burden on employers, insurance companies, and communities.

    AIM: The aim was to review scientific studies on sickness certification practices of physicians published in English, Danish, Norwegian, or Swedish.

    METHOD: Analyses were carried out of studies searched for through literature databases, reference lists, and personal contacts.

    RESULTS: Twenty-six publications fulfilled the inclusion criteria. Most of these were published in the last decade. The studies focused on physicians, and occasionally on physicians and patients, but never on interaction between them. Data had generally been collected using questionnaires, some including case vignettes. There was a large variation in how long different physicians sickness-certified similar patients. Three comprehensive categories of studies were identified dealing with the following: (1). how physicians certify sickness; (2). factors that might affect the certification process; (i.e. elements related to the patient, to the physician, or to restrictions in insurance legislation); and (3). studies concerning attitudes. No studies were found that took into account the work conditions of the hospital or health-care organization in which the physician works.

    CONCLUSIONS: The research problems were seldom medical in nature but were instead carried out within the realm of behavioural science and should preferably be conducted using theories from behavioural, social, and public health scientific theories. Furthermore, factors such as gender, ethnicity, and power should be taken into consideration in studies on this complex phenomenon.

  • 46.
    Theobald, Holger
    et al.
    Karolinska institutet, Stockholm.
    Bygren, Lars Olov
    Umeå universitet.
    Carstensen, John
    Linköping University, Department of Medical and Health Sciences, Health and Society. Linköping University, Faculty of Arts and Sciences.
    Engfeldt, Peter
    Karolinska institutet, Stockholm.
    Validity of two questions of alcohol use in a health survey questionnaire1999In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 27, no 1, 73-77 p.Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate whether consumers of high and low levels of alcohol could be identified by two questions about alcohol use in a postal questionnaire survey. A sample of 2,300 persons aged 18 64 years from Stockholm county were sent a masked postal questionnaire comprising 30 questions about their health and functioning. Two questions concerned their alcohol consumption. One year later the subjects underwent a psychiatric health examination, which included an assessment of their alcohol use. The two questions about alcohol consumption identified high alcohol consumers with a relatively high sensitivity and specificity, of 64% and 87%, respectively, and thus are useful for identifying high alcohol consumers in health surveys using questionnaires.

  • 47.
    Tinghög, Gustav
    et al.
    Linköping University, Department of Management and Engineering, Economics. Linköping University, The Institute of Technology. Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    Carlsson, Per
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    Individual responsibility for healthcare financing: application of an analytical framework exploring the suitability of private financing of assistive devices2012In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 40, no 8, 784-794 p.Article in journal (Refereed)
    Abstract [en]

    Objective: To operationalise and apply a conceptual framework for exploring when health services contain characteristics that facilitate individuals’ ability to take individual responsibility for health care through out-of-pocket payment. In addition, we investigate if the levels of out-of-pocket payment for assistive devices (ADs) in Sweden are in line with the proposed framework. Method: Focus groups were used to operationalise the core concepts of sufficient knowledge, individual autonomy, positive externalities, sufficient demand, affordability, and lifestyle enhancement into a measurable and replicable rationing tool. A selection of 28 ADs were graded separately as having high, medium, or low suitability for private financing according to the measurement scale provided through the operationalised framework. To investigate the actual level of private financing, a questionnaire about the level of out-of-pocket payment for the specific ADs was administered to county councils in Sweden. Results: Concepts were operationalised into three levels indicating possible suitability for private financing. Responses to the questionnaire indicate that financing of ADs in Sweden varies across county councils as regards co-payment, full payment, discretionary payment for certain healthcare consumer groups, and full reimbursement. According to the framework, ADs commonly funded privately were generally considered to be more suitable for private financing. Conclusions: Sufficient knowledge, individual autonomy, and sufficient demand did not appear to influence why certain ADs were financed out-of-pocket. The level of positive externalities, affordability, and lifestyle enhancement appeared to be somewhat higher for ADs that were financed out-of-pocket, but the differences were small. Affordability seemed to be the most influential concept.

  • 48.
    Upmark, Marianne
    et al.
    Section of Personal Injury Prevention, Department of Clinical Neuroscience, Karolinska Instituter, Stockholm, .
    Borg (Festin), Karin
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Alexanderson, Kristina
    Section of Personal Injury Prevention, Department of Clinical Neuroscience, Karolinska Instituter, Stockholm, .
    Gender differences in experiencing negative encounters with healthcare: a study of long-term sickness absentees.2007In: Scandinavian Journal of Public Health, ISSN 1403-4948, Vol. 35, no 6, 577-584 p.Article in journal (Refereed)
    Abstract [en]

    AIM: In most countries there are gender differences in sickness absence and in absentees' return to work (RTW). According to different theories sick-listed persons' experiences of encounters with healthcare professionals can influence self-esteem and RTW. The aim was to analyse gender differences in sickness absentees' experiences of negative encounters with healthcare professionals. METHODS: A questionnaire, comprising numerous questions on experiences of positive and negative encounters with professionals, was constructed and sent to 10,100 individuals who had been on sick leave for the last 6-8 months. The response rate was 58% (n = 5,802). RESULTS: Almost one-third (32%) of the female respondents and one-quarter of the male (24%), respectively, had experienced negative encounters. The most common of such experiences among both women and men were: that they were treated with indifference, with disrespect, that the professional did not take his/her time, did not listen, did not believe in, or doubted complaints. In regression analyses the women had higher significant crude odds ratios, ranging from 1.29 to 1.71, for agreeing to the separate statements on negative encounters. When adjusting for age, ethnicity, and level of education the gender differences were still significant for 14 of the 23 the statements. CONCLUSION: Women's high rate of sickness absence is considered a problem in most countries. The subjective experiences of women are an important factor to consider in efforts aiming at reducing the sick-leave rates. One important endeavour among professionals in healthcare could be to shift the focus towards a more empowering professional role.

  • 49.
    Östlund, G
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Cedersund, E
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment.
    Alexanderson, Kristina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Hensing, Gunnel
    It was really nice to have someone: Lay people with musculoskeletal disorders request supportive relationships in rehabilitation2001In: Scandinavian Journal of Public Health, ISSN 1403-4948, Vol. 29, no 4, 285-291 p.Article in journal (Refereed)
    Abstract [en]

    Aims : To explore the lay person's perspective on the rehabilitation process. Methods : A total of 20 interviews were conducted with women and men who had recent or more distant experience of sickness absence with musculoskeletal diagnoses. Grounded theory was used, which includes an inductive approach and theoretical sampling. The interviews focused on the individuals' own stories and experiences of factors that promoted or hindered the rehabilitation process. Results : The interviewees emphasized how and by whom they had been treated rather than what type of rehabilitation programmes they had attended. They focused on the importance of supportive relationships from the private, occupational, and health care arenas. The relationship with rehabilitation agents (professionals who implemented rehabilitation) was described as having either supportive or non-supportive qualities. Based on the interviewees' descriptions, a model was developed on the socioemotional qualities of the rehabilitation agent. The most promoting factor in the rehabilitation process was to have a professional mentor that is a rehabilitation agent who combines a supportive approach with individually chosen rehabilitation measures and goals. Conclusions : The lay person's perspective gave additional knowledge regarding rehabilitation and recovery from musculoskeletal disorders. The socioemotional qualities of the rehabilitation agents were emphasized by the interviewees and a model regarding these qualities was developed. This model needs to be tested further. A clinical implication of the present study is the need for rehabilitation agents to develop their communication skills further.

  • 50.
    Östlund, Gunnel
    et al.
    Linköping University, Department of Social and Welfare Studies, Society, Diversity, Identity . Linköping University, Faculty of Arts and Sciences.
    Borg, Karin
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Wide, Peter
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Hensing, Gunnel
    Department of Social Medicine, Sahlgrenska Academy, University of Göteborg, Sweden.
    Alexandersson, Kristina
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Client’s perceptions of contacts with professionals within health care and social insurance offices2003In: Scandinavian Journal of Public Health, ISSN 1403-4948, Vol. 31, no 4, 275-282 p.Article in journal (Refereed)
    Abstract [en]

    Aims: An increasing number of people interact with professionals within healthcare and social insurance offices during periods of sick leave due to musculoskeletal disorders. Knowledge of clients' perceptions of such contact is scarce. This study analysed clients' perceptions of their contact with professionals within healthcare and social insurance offices.

    Methods: A cohort study was conducted in the municipality of Linköping, Sweden. Participants were all citizens who in 1985 were aged 25 - 34 years and had at least one new sick-leave spell due to back, neck, or shoulder diagnoses exceeding 28 days (n=213). In 1996, 11 years after inclusion, a questionnaire about perception of contact with professionals, self-perceived health, and mental health was administered. Register data on sickness absence and disability pension from 1985 - 96 were also obtained.

    Results: Factor analysis indicated the existence of three dimensions of contact with professionals: supportive treatment, distant treatment, and empowering treatment. Women perceived their contact with both social insurance officers and healthcare professionals as more supportive than did the men. Respondents with disability pensions perceived their contact with social insurance officers as more supportive and empowering than persons without disability pensions. Respondents with mental health problems perceived their contact with both types of professionals as more distant. Respondents with neck/shoulder diagnoses perceived their contact with healthcare professionals as more empowering than respondents with low back diagnoses.

    Conclusion: There was a relationship between clients' perceptions of contact with professionals and the sex, disability pension, diagnosis, and mental health of clients.

1 - 50 of 50
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf