| 21. |
- Gustavsson, Anders, et al.
(författare)
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Cost of disorders of the brain in Europe 2010.
- 2011
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Ingår i: European Neuropsychopharmacology. - Amsterdam : Elsevier BV. - 0924-977X .- 1873-7862. ; 21:10, s. 718-79
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The spectrum of disorders of the brain is large, covering hundreds of disorders that are listed in either the mental or neurological disorder chapters of the established international diagnostic classification systems. These disorders have a high prevalence as well as short- and long-term impairments and disabilities. Therefore they are an emotional, financial and social burden to the patients, their families and their social network. In a 2005 landmark study, we estimated for the first time the annual cost of 12 major groups of disorders of the brain in Europe and gave a conservative estimate of €386 billion for the year 2004. This estimate was limited in scope and conservative due to the lack of sufficiently comprehensive epidemiological and/or economic data on several important diagnostic groups. We are now in a position to substantially improve and revise the 2004 estimates. In the present report we cover 19 major groups of disorders, 7 more than previously, of an increased range of age groups and more cost items. We therefore present much improved cost estimates. Our revised estimates also now include the new EU member states, and hence a population of 514 million people.AIMS: To estimate the number of persons with defined disorders of the brain in Europe in 2010, the total cost per person related to each disease in terms of direct and indirect costs, and an estimate of the total cost per disorder and country.METHODS: The best available estimates of the prevalence and cost per person for 19 groups of disorders of the brain (covering well over 100 specific disorders) were identified via a systematic review of the published literature. Together with the twelve disorders included in 2004, the following range of mental and neurologic groups of disorders is covered: addictive disorders, affective disorders, anxiety disorders, brain tumor, childhood and adolescent disorders (developmental disorders), dementia, eating disorders, epilepsy, mental retardation, migraine, multiple sclerosis, neuromuscular disorders, Parkinson's disease, personality disorders, psychotic disorders, sleep disorders, somatoform disorders, stroke, and traumatic brain injury. Epidemiologic panels were charged to complete the literature review for each disorder in order to estimate the 12-month prevalence, and health economic panels were charged to estimate best cost-estimates. A cost model was developed to combine the epidemiologic and economic data and estimate the total cost of each disorder in each of 30 European countries (EU27+Iceland, Norway and Switzerland). The cost model was populated with national statistics from Eurostat to adjust all costs to 2010 values, converting all local currencies to Euro, imputing costs for countries where no data were available, and aggregating country estimates to purchasing power parity adjusted estimates for the total cost of disorders of the brain in Europe 2010.RESULTS: The total cost of disorders of the brain was estimated at €798 billion in 2010. Direct costs constitute the majority of costs (37% direct healthcare costs and 23% direct non-medical costs) whereas the remaining 40% were indirect costs associated with patients' production losses. On average, the estimated cost per person with a disorder of the brain in Europe ranged between €285 for headache and €30,000 for neuromuscular disorders. The European per capita cost of disorders of the brain was €1550 on average but varied by country. The cost (in billion €PPP 2010) of the disorders of the brain included in this study was as follows: addiction: €65.7; anxiety disorders: €74.4; brain tumor: €5.2; child/adolescent disorders: €21.3; dementia: €105.2; eating disorders: €0.8; epilepsy: €13.8; headache: €43.5; mental retardation: €43.3; mood disorders: €113.4; multiple sclerosis: €14.6; neuromuscular disorders: €7.7; Parkinson's disease: €13.9; personality disorders: €27.3; psychotic disorders: €93.9; sleep disorders: €35.4; somatoform disorder: €21.2; stroke: €64.1; traumatic brain injury: €33.0. It should be noted that the revised estimate of those disorders included in the previous 2004 report constituted €477 billion, by and large confirming our previous study results after considering the inflation and population increase since 2004. Further, our results were consistent with administrative data on the health care expenditure in Europe, and comparable to previous studies on the cost of specific disorders in Europe. Our estimates were lower than comparable estimates from the US.DISCUSSION: This study was based on the best currently available data in Europe and our model enabled extrapolation to countries where no data could be found. Still, the scarcity of data is an important source of uncertainty in our estimates and may imply over- or underestimations in some disorders and countries. Even though this review included many disorders, diagnoses, age groups and cost items that were omitted in 2004, there are still remaining disorders that could not be included due to limitations in the available data. We therefore consider our estimate of the total cost of the disorders of the brain in Europe to be conservative. In terms of the health economic burden outlined in this report, disorders of the brain likely constitute the number one economic challenge for European health care, now and in the future. Data presented in this report should be considered by all stakeholder groups, including policy makers, industry and patient advocacy groups, to reconsider the current science, research and public health agenda and define a coordinated plan of action of various levels to address the associated challenges.RECOMMENDATIONS: Political action is required in light of the present high cost of disorders of the brain. Funding of brain research must be increased; care for patients with brain disorders as well as teaching at medical schools and other health related educations must be quantitatively and qualitatively improved, including psychological treatments. The current move of the pharmaceutical industry away from brain related indications must be halted and reversed. Continued research into the cost of the many disorders not included in the present study is warranted. It is essential that not only the EU but also the national governments forcefully support these initiatives.
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| 22. |
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| 23. |
- Göransson, Kerstin, et al.
(författare)
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Speciella yrken? Specialpedagogers och speciallärares arbete och utbildning : En enkätstudie
- 2015
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Forskningsprojektet ”Speciella yrken? Ett projekt om speciallärares och specialpedagogers arbete och utbildning” är finansierat av Vetenskapsrådet. I den här rapporten redovisas resultat från delprojekt 1. Syftet med rapporten är att ge en övergripande och representativ bild av specialpedagogers och speciallärares yrkesroll. Det empiriska materialet utgörs av data från en enkätundersökning som omfattar alla som tagit specialpedagog- eller speciallärarexamen från och med 2001 års examensordning (4252 personer, svarsfrekvens 75%). I rapporten redovisas vilka kunskaper och värderingar yrkesgrupperna bedömer att deras utbildning har resulterat i, vilka arbetsuppgifter de menar kännetecknar deras praktiserande av yrkesrollen, och även vilka förutsättningar yrkesgrupperna har att hävda en specifik expertis vad gäller att identifiera och arbeta med skolproblem. Rapporten riktar sig i främsta hand till praktiskt verksamma inom skolverksamheten på olika nivåer, lärarutbildare och blivande specialpedagoger och speciallärare.
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| 24. |
- Lundmark, Linda, et al.
(författare)
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Vilka är ute i naturen? Delresultat från en nationell enkät om friluftsliv och naturturism i Sverige
- 2008
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Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
- Detta är en av fyra rapporter som ger en översiktlig bild av resultaten från en nationell enkätundersökning om friluftsliv och naturturism i Sverige. Studien är genomförd av forskningsprogrammet Friluftsliv i förändring. Resultaten som presenteras här fokuserar bl a på vilka som är ute i naturen och vilka aktiviteter man ägnar sig åt. Nästan alla uppfattar skogar, fjäll, sjöar och hav som ”natur” men det är inte alls lika självklart med t.ex. badstränder, trädgårdar och elljusspår. Mer än hälften av de svarande är ute i naturen ganska ofta, eller mycket ofta, under vardagar. Under längre ledigheter ökar denna andel till 89 %. Naturen är också en central miljö för barns uppväxt och t.ex. har hela 94 % av de svarande ofta, eller mycket ofta, tillbringat lov och semestrar i naturen. Nöjes- och motionspromenader är vanligast att ha ägnat sig åt åtminstone en gång under en 12- månadersperiod (nästan 95 % av de svarande), följt av strövat i skog och mark (90 %), arbetat i trädgården (84 %), solbadat (81 %), och haft picknick eller grillat i naturen (80 %). Även om vi ser till de aktiviteter som är vanligast att ägna sig åt ofta (mer än 60 gånger per år) så toppas listan av nöjes- och motionspromenader (ca 32 %), följt av cykla på vägar, arbeta i trädgården, ströva i skog och mark och promenera med hund. Vi har också gjort en fördjupad analys när det gäller de tio vanligaste aktiviteterna som de svarande angett att de utövat mer än 20 gånger under en 12-månadersperiod (ca 1-2 gånger per månad). Det visar sig då att kvinnorna generellt är mer aktiva. Jogging/terränglöpning, jakt och fiske är mer vanligt bland män medan solbad, picknick och stavgång är mer representerat hos kvinnor. Gruppen under 30 år skiljer ut sig något genom att promenera med hund är vanligare och arbete i trädgården mindre vanligt, jämfört med övriga grupper. Joggning/terränglöpning tycks också vara en aktivitet främst hos yngre och medelålders, medan det omvända gäller för stavgång. Föräldrarnas uppväxtland tycks inte ha så stor betydelse för vilka aktiviteter man väljer, men svarande med svenska föräldrar utövar aktiviteterna i större utsträckning jämfört med personer vars föräldrar vuxit upp utomlands. Ett undantag finns emellertid för picknick eller att grilla i naturen vilket är vanligare hos svarande med utländska föräldrar.
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| 25. |
- Olsson, Helén, 1961-, et al.
(författare)
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Decreased risk for violence in patients admitted to forensic care, measured with the HCR-20
- 2013
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Ingår i: Archives of Psychiatric Nursing. - : Saunders Elsevier. - 0883-9417 .- 1532-8228. ; 27:4, s. 191-197
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim of this study was to explore if patients admitted to forensic psychiatric care decreased their assessed risk for violence over time, to identify patients who decreased their assessed risk for violence exceptionally well (30% or more) on the clinical (C) and risk management (R) scales in the (HCR-20), and to compare them in terms of demographic data.METHODS: The HCR-20 risk assessment instrument was used to assess the risk for violence in 267 patients admitted to a Swedish forensic psychiatric clinic between 1997 and 2010. Their assessments at admission were compared with a second, and most recent, risk assessment.RESULTS: The risk for violence decreased over time. Demographic criteria had no impact on differences on decreased risk. Only two factors, namely gender and psychopathy showed a difference. Risk factors associated with stress and lack of personal support were the items that turned out to be the most difficult to reduce.CONCLUSION: The results show that risk prevention in forensic care does work and it is important to continue to work with risk management. The study highlights the importance of a careful analysis of the patient's risk for violence in order to work with the patient's specific risk factors to reduce the risk.
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| 26. |
- Olsson, Helén, 1961-, et al.
(författare)
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Reducing or increasing violence in forensic care : A qualitative study of inpatient experiences
- 2015
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Ingår i: Archives of Psychiatric Nursing. - Maryland Heights, USA : Elsevier BV. - 0883-9417 .- 1532-8228. ; 29:6, s. 393-400
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Tidskriftsartikel (refereegranskat)abstract
- Semi-structured interviews with 13 forensic psychiatric inpatients that had decreased their assessed risk of violence were analyzed using interpretive description. The main contribution from this study is a detailed description of patients' own strategies to avoid violence. Participants described having an ongoing inner dialog in which they encouraged themselves, thereby increasing their self-esteem and trying to accept their current situation. An unsafe and overcrowded ward with uninterested and nonchalant staff increased the risk of aggressive behavior. In the process of decreasing violence, the patients and the forensic psychiatric nursing staff interacted to create and maintain a safe environment.
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| 27. |
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| 28. |
- Paulsson, Gun, et al.
(författare)
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Comparison of oral health assessments between nursing staff and patients on medical wards
- 2008
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Ingår i: European Journal of Cancer Care. - Oxford : Blackwell Publishing. - 0961-5423 .- 1365-2354. ; 17:1, s. 49-55
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Tidskriftsartikel (refereegranskat)abstract
- The maintenance of good oral health is essential for nutrition, recovery and well-being. This requires the involvement of the nursing staff, especially in cases where oral care and any necessary dental treatment are vital to ensure medical treatment. The aim of this study was to evaluate the validity of oral assessments performed by nursing staff using the revised oral assessment guide (ROAG), using comparisons with patients' self-assessment of oral problems. When a comparison was made of how the staff and patients assessed their oral status, a high level of agreement was found. In these assessments, with the exception of oral mucosa and teeth, the percentage agreement was >80. The kappa coefficient revealed slight to moderate agreement. When there was a disagreement, the staff assessed the oral health as being significantly poorer than the patients did. In the present study, it was shown that few oral assessments performed by the nursing staff and patient disagreed. The ROAG may therefore be useful for the nursing staff to make the patients' oral health problems visible. © 2007 The Authors; Journal compilation © 2007 Blackwell Publishing Ltd.
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| 29. |
- Forsman, Henrietta, et al.
(författare)
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Clusters of competence: Relationship between self-reported professional competence and achievement on a national examination among graduating nursing students
- 2020
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Ingår i: Journal of Advanced Nursing. - Hoboken, NJ : John Wiley & Sons. - 0309-2402 .- 1365-2648. ; 76:1, s. 199-208
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Tidskriftsartikel (refereegranskat)abstract
- AimsTo identify clusters based on graduating nursing students’ self‐reported professional competence and their achievement on a national examination. Furthermore, to describe and compare the identified clusters regarding sample characteristics, students’ perceptions of overall quality of the nursing programme and students’ general self‐efficacy.DesignA cross‐sectional study combining survey data and results from a national examination.MethodsData were collected at two universities and one university college in Sweden in January 2017, including 179 students in the final term of the nursing programme. The study was based on the Nurse Professional Competence Scale, the General Self‐Efficacy scale and results from the National Clinical Final Examination. A Two‐Step Cluster Analysis was used to identify competence profiles, followed by comparative analyses between clusters.ResultsThree clusters were identified illustrating students’ different competence profiles. Students in Cluster 1 and 2 passed the examination, but differed in their self‐assessments of competence, rating themselves under and above the overall median value respectively. Students in Cluster 3 failed the examination but rated themselves at the overall median level or higher.ConclusionThe study illustrates how nursing students’ self‐assessed competence might differ from competency assessed by examination, which is challenging for nursing education. Self‐evaluation is a key learning outcome and is, in the long run, essential to patient safety.ImpactThe study has identified clusters of students where some overestimate and others underestimate their competence. Students who assessed their competence low but passed the exam assessed their general self‐efficacy lower than other students. The findings illuminate the need for student‐centered strategies in nursing education, including elements of self‐assessment in relation to examination to make the students more aware of their clinical competence.
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| 30. |
- Johles, Lis, et al.
(författare)
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Is a Brief Body Scan Helpful for Adolescent Athletes' Sleep Problems and Anxiety Symptoms?
- 2023
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Ingår i: Mindfulness. - : Springer. - 1868-8527 .- 1868-8535. ; 14:6, s. 1522-1530
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesThe aim of the studywas to compare the effects of a brief body scan with relaxation as an active control group to better understand their respective contributions to the reduction of sleep problems and anxiety symptoms among adolescent athletes.MethodTwo hundred and six adolescent athletes were recruited during the school year 2016/2017 and randomized into four arms: 4 weeks body scan, 8 weeks body scan, 4 weeks relaxation, and 8 weeks relaxation. Sleep problems and anxiety were measured at baseline and 4, 8, and 16 weeks after baseline. Time trends in sleep problems and anxiety were estimated using linear repeated measures models and compared between the four groups.ResultsOverall, there were beneficial time changes for sleep problems and anxiety symptoms in all four intervention groups, but significantly so only for anxiety symptoms. Specifically, the reduction of anxiety symptoms varied between - 11% per month for 8 weeks body scan, - 12% per month for 8 weeks relaxation, - 13% per month for 4 weeks relaxation, and - 16% per month for 4 weeks body scan. However, the time trends did not differ by intervention type or duration.ConclusionsBoth types of interventions had beneficial effects on anxiety independent of length of intervention, suggesting that a brief body scan as well as a brief relaxation could be part of a daily recovery practice for adolescent athletes.PreregistrationThis study was not preregistered.
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