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  • 1.
    Lallukka, Tea
    et al.
    Finnish Institute of Occupational Health, Helsinki, Finland Department of Public Health, University of Helsinki, Finland .
    Ervasti, Jenni
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Mittendorfer-Rutz, Ellenor
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet.
    Tinghög, Petter
    The Swedish Red Cross University College, Department of Public Health and Medicine. Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet.
    Kjeldgård, Linnea
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet.
    Pentti, Jaana
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Virtanen, Marianna
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Alexanderson, Kristina
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet.
    The joint contribution of diabetes and work disability to premature death during working age: a population-based study in Sweden.2016In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 44, no 6, p. 580-586Article in journal (Refereed)
    Abstract [en]

    AIMS: We aimed to examine how newly diagnosed diabetes and work disability jointly predict death during working age.

    METHODS: We used prospective population-based register data of 25-59-year-old adults who had lived in Sweden since 2002. All those with onset of diabetes recorded in 2006 were included (n=14266). A 2% random sample (n=78598) was drawn from the general population, comprising people with no indication of diabetes during 2003-2010. Net days of sickness absence and disability pension in 2005-2006 were examined; the follow-up time for mortality was 2007-2010. Cox regression models were fitted (hazard ratios, HR, 95% confidence interval, CI) adjusting for sociodemographics and time-dependent health conditions.

    RESULTS: Individuals with diabetes and work disability for over 6 months were at a higher risk of premature death (HR=14.2, 95% CI 12.0-16.8) than their counterparts without diabetes and work disability. A high risk was also observed among people without diabetes but equally prolonged work disability (HR=6.4, 95% CI 5.4-7.6). Diabetes was associated with premature death even without work disability (HR=3.5, 95% CI 2.8-4.4). The associations were particularly attenuated after adjustment for health conditions assessed over the follow-up.

    CONCLUSIONS: DIABETES AND WORK DISABILITY JOINTLY INCREASE THE RISK OF DEATH DURING WORKING AGE DIABETES WITH LONG-TERM WORK DISABILITY IS ASSOCIATED WITH THE HIGHEST RISK OF PREMATURE DEATH, WHICH HIGHLIGHTS THE IMPORTANCE OF THEIR PREVENTION AND EARLY DETECTION.

  • 2.
    Omar, Faisal
    et al.
    Department of Medical and Health Sciences, Linköping University.
    Tinghög, Gustav
    Department of Medical and Health Sciences, Linköping University.
    Tinghög, Petter
    Department of Medical and Health Sciences, Linköping University.
    Carlsson, Per
    Department of Medical and Health Sciences, Linköping University.
    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, p. 122-130Article 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-setting's 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 Linkoöping 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.

  • 3.
    Stjernberg, Louise
    et al.
    School of Health Science, Blekinge Institute of Technology; Department of Community Medicine, Lund University.
    Berglund, Johan
    School of Health Science, Blekinge Institute of Technology; Department of Community Medicine, Lund University.
    Tick prevention in a population living in a highly endemic area2005In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 33, no 6, p. 432-8Article in journal (Refereed)
    Abstract [en]

    Aims: To describe environmental and personal tick preventive measures and their predictors, taken by a population living in a highly tick-endemic area. Methods: Due to the recent confirmation of human tick-borne encephalitis cases, vaccination against tick borne encephalitis was offered to the population living in the endemic area through the use of leaflets and media campaigns. At the time for the initial dose, information and enrollment to this cohort study was carried out. Participants´ characteristics, frequency of tick-bites and preventive measures were included in questionnaires. Logistic analysis was used to determine behavioural differences in activities taken in order to prevent tick-bites. Conclusion: In total, 70% of the permanent residents had themselves vaccinated before the next tick-season. Of the studied participants 356/517 (69%) regularly took preventive measures in their environment and/or personally. Women in particular, and those previously treated for a tick-borne disease took significantly more preventive measures. When analysing all variables together, spending less time in tick-endemic area and being tick-bitten the latest tick-season significantly increased the probability of taking preventive measures. After being tick-bitten, men were more inclined to start taking preventive measures than women. Awareness of the risks caused by living in a high endemic area to ticks influenced the participant’s daily life through preventive activities. Public health action should be considered thus encouraging out-of-door activities for the population, without anxiety for risks for contracting tick-borne disease after being tick-bitten.

  • 4.
    Thern, Emelie
    et al.
    Department of Public Health Sciences, Karolinska Institute.
    Sjögren Forss, Katarina
    Department of Health, Blekinge Institute of Technology.
    Jogreus, Claes
    Department of Mathematics and Science, Blekinge Institute of Technology.
    Stjernberg, Louise
    Department of Health, Blekinge Institute of Technology.
    Factors associated with active commuting among parents-to-be in Karlskrona, Sweden2015In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 43, no 1, p. 59-65Article in journal (Refereed)
    Abstract [en]

    Aim: The purpose of the present study is to examine the prevalence of active commuting and factors associated with participation in active commuting in the municipality of Karlskrona, Sweden. Active commuting is defined here as walking or cycling to and from school/work for at least 15 min one-way. Method: A cross-sectional study was carried out, which included baseline data from parents-to-be. Pregnant females and their partners were invited to participate in the study when they contacted either of the municipality’s two antenatal clinics. Data collection ran from March 2008 to February 2009. When completing the questionnaire, the participants were asked to reflect on their situation one month before the female became pregnant. The final sample consisted of 432 participants (response rate 51.9% for females and 85.0% for males). Results: The main mode of commuting was motor vehicle (63.0%), with active commuters forming a minority (8.3%). The main facilitating factor for active commuting was living in an urban as opposed to a rural area. Regular participation in outdoor recreational physical activity was significantly positively associated with active commuting. Being Swedish and being surrounded by a green space environment were significantly negatively associated with active commuting. Conclusions: This study found that the number of people who are active commuters is modest and other modes of transportation are preferred. Several facilitating and impeding factors associated with active commuting were also found, indicating the importance of applying a broad health-promoting approach to encouraging active commuting.

  • 5.
    Zander, Viktoria
    et al.
    Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden .
    Müllersdorf, Maria
    School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna/Västerås, Sweden.
    Christensson, Kyllike
    Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden.
    Eriksson, Henrik
    Red Cross University College of Nursing. Mälardalen University.
    Struggling for sense of control: Everyday life with chronic pain for women of the Iraqi diaspora in Sweden2013In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 41, no 8, p. 799-807Article in journal (Refereed)
    Abstract [en]

    Background: As dispersed ethnic populations in Swedish society expand, the healthcare system need to adapt rehabilitation services according to their needs. The experiences of trauma and forced resettlement have a continuing impact on health and musculoskeletal pain, as well as the intersecting structures that prerequisite the possibilities in the new country. To understand the specific needs of women from the Iraqi diaspora in Sweden, there is a need to elucidate the effects of pain on their everyday life. Aims: To elucidate everyday life with chronic pain from the perspective of women from the Iraqi diaspora in Sweden. Methods: Qualitative interview study according to Glaser’s grounded theory. Results: The results from 11 interviews suggest that pain was associated with dependency on society as well as on family. It resulted in a struggle for sense of control, framed by faith in God, influenced by the healthcare system, and with support from family. The women’s testimony of lack of continuity of care, resulting in recollection of lived traumas in every visit, is a vital sign of the unconscious power relations within health care and how representatives from health care, instead of being the ones who help the women forward, become the ones who hold them back. Conclusions: The results show the importance of challenging the normative assumptions embedded in health care and treatment for patients with chronic pain and of including the voice of “others”.

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