| 51. |
- Omar, Faisal, et al.
(author)
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Incentivizing deceased organ donation : A Swedish priority-setting perspective.
- 2011
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In: Scandinavian Journal of Public Health. - : SAGE. - 1403-4948 .- 1651-1905. ; 39:2, s. 156-163
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Journal article (peer-reviewed)abstract
- 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.
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| 52. |
- Osman, Fatumo, et al.
(author)
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Perceptions of the use of khat among Somali immigrants living in Swedish society
- 2011
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In: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 39, s. 212-219
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Journal article (peer-reviewed)abstract
- Aims: The aim of this study was to gain a better understanding of Somali immigrants’ perceptions of the use of khat living in Swedish society. Using khat is illegal in SwedenMethods: A phenomenographic design was used to capture different perception of using khat. Fourteen interviews were conducted with both men and women. The information was subjected to phenomenographic analysis.Findings: Perceptions of the habit of chewing khat among Somalis living in Sweden vary. The use of khat is perceived as a kind of food or as a drug. To use khat is perceived as having a physical impact on individual health, as well as an impact on social and family life. Using khat also has an impact on people’s time, because time is needed to indulge the habit. Furthermore, using khat is perceived as a medium for cultural and community cohesiveness. The Somalis prefered preventive measures in place to counter the use of khat in SwedenConclusions: The use of a phenomenographic design which captured the variation in perceptions of the habit of using khat among Somali immigrants’ living in Swedish society is helpful in guiding individual strategies in health promotion activities.
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| 53. |
- Ostberg, Anna-Lena, et al.
(author)
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Group treatment of obesity in primary care practice : A qualitative study of patients' perspectives
- 2011
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In: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 39:1, s. 98-105
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Journal article (peer-reviewed)abstract
- Aims: To explore patients' experiences of very low calorie diet (VLCD) and subsequent corset treatment of obesity in a primary care setting, and to explore their perceptions of factors influencing weight control. Methods: In western Sweden, five focus group sessions were carried out. The main themes for the discussions were the informants' perceptions of the treatment they had received and their experiences of living with obesity. The analysis was based on the Grounded Theory methodology. Results: The outcomes reflect obese individuals' struggle to handle the demands of their life situation and to recognize their own resources. The core category generated was labelled "Achieving a balance in life and adjusting one's identity". Three categories related to the process of weight reduction were identified: living with obesity, reducing weight and developing self-management. The group treatment with VLCD was positively perceived by the participants, but the corset treatment was considered to be of less value. Conclusions: Maintenance after weight reduction was demanding and the findings indicate a need for extended support. For some individuals the corset treatment could be a psychological support. Follow-up after weight reduction programmes should focus on long-term self-help strategies.
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| 54. |
- Reine, Ieva, 1972-, et al.
(author)
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Is participation in labour market programmes related to mental health? : results from a 14-year follow-up of the Northern Swedish cohort
- 2011
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In: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 39:1, s. 26-34
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Journal article (peer-reviewed)abstract
- Aims: There is a lack of empirical studies assessing the possible impact of active labour market programmes (ALMP) on health. The aim of this study was to analyze whether participation in ALMP, in contrast to being unemployed and not participating in ALMP (UNALMP), was related to mental health at different ages. Methods: The study was carried out in a medium-sized industrial town in the north of Sweden. The cohort, consisting of all 1,083 pupils who attended or should have attended the last year of compulsory school in 1981, was followed up at the ages of 16, 18, 21 and 30. Data on 381 individuals at age 21, and 281 at age 30 were used in the study. The main health measurement was psychological symptoms among participants of ALMP in contrast to UNALMP at ages 21 and 30, and was analyzed by propensity score matching method (PSM) and multivariate logistic regression. Results: Generally, ALMP had higher scores of psychological symptoms than UNALMP. Nevertheless, participation in ALMP was not related to mental health. Due to methodological shortages our results have to be interpreted with caution. Adjustment for either all background selection variables or the propensity score in multivariate logistic regression showed similar associations, suggesting that propensity score could be used to adjust for background selection variables. Conclusions: There is a need for more well-designed studies, using a theoretical framework, within the field, that are based on larger samples.
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| 55. |
- Romé, Åsa, et al.
(author)
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Willingness to pay for health improvements of physical activity on prescription.
- 2010
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In: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 38, s. 151-159
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Journal article (peer-reviewed)abstract
- AIMS: To estimate the willingness to pay for health improvements among participants in the programme "Physical Activity on Prescription". The objective was also to examine predictors such as income, education level, health status, activity level and BMI, differences for long- and short-term health effects of physical activity and differences between a high- and low-intensity activity group. METHODS: Willingness to pay (WTP) data were collected alongside a randomized, controlled trial in Sweden 2007, and 128 sedentary individuals, 20-80 years old (intervention/high-intensity group n = 71, control/low-intensity group n = 57), with lifestyle-related health problems answered open-ended questions in this contingent valuation study. RESULTS: The highest mean WTP (euro59/SEK 552) was stated for an immediate health improvement, but no significant differences compared with long-term health improvements. The high-intensity group showed higher WTP-values for all health improvements, but without significant differences compared with a low-intensity group. Regression analyses show strong associations between a higher level of education and the WTP for improved well-being and improved health, and also between income and the WTP for improved well-being. There are significant correlations between the WTP and the variables BMI, income and education level, as expected from economic theories. CONCLUSIONS: The willingness to pay for the health improvements of exercise is influenced by a higher education level, income and BMI. The highest WTP for a health outcome of physical activity is for an immediate health improvement. The results of this randomized controlled trial in primary health care may be of interest to decision makers when evaluating different approaches to promoting physical activity among people who are sedentary.
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| 56. |
- Ropponen, A, et al.
(author)
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Association between hand grip/body weight ratio and disability pension due to musculoskeletal disorders: a population-based cohort study of 1 million Swedish men
- 2011
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In: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 39:8, s. 830-838
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Journal article (peer-reviewed)abstract
- Aims: To investigate the predictive value of hand grip/body weight ratio and hand grip strength in early adulthood for obtaining a disability pension (DP) due to musculoskeletal disorders in later life. Methods: A nationwide population-based sample of men born 1951–76 ( n = 1,387,166) in Sweden and anthropometric and strength indicators from their conscription examination. Register data on the date and diagnoses of granted DP between the years 1971–2006. Cox proportional hazards regression was used to estimate hazard ratios (HR) with 95% confidence intervals (95% CI). Results: The lowest quintile of hand grip/body weight ratio predicted a greatly increased risk (HR 2.51, 95% CI 2.40–2.63) for DP due to musculoskeletal disorders compared to the mid-quintile. The highest quintile of hand grip/body weight ratio predicted a decreased risk (HR 0.80, 95% CI 0.75–0.84). Stratification of the hand grip/body weight ratio with body mass index confirmed the results. However, the highest quintiles of hand grip strength adjusted for height and weight predicted a somewhat increased risk for DP due to musculoskeletal disorders (HR 1.25, 95% CI 1.18–1.32). Conclusions: This study indicates that the hand grip/body weight ratio in young adulthood is strongly and inversely associated with men's risk of obtaining a disability pension due to musculoskeletal disorders in later life. However, the risk seems to be mediated through the body weight. The properties of hand grip/body weight ratio should be further evaluated before it can be recommended for use in clinical and epidemiological studies.
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| 57. |
- Ropponen, A, et al.
(author)
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Health-related risk factors for disability pensions due to musculoskeletal diagnoses: a 30-year Finnish twin cohort study
- 2011
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In: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 39:8, s. 839-848
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Journal article (peer-reviewed)abstract
- Aims: There is a need to better understand work incapacity due to musculoskeletal disorders (MSD) and the factors that contribute to being granted disability pension (DP) with such disorders. A twin cohort study would serve a powerful tool responding to this knowledge gap by providing information on factors affecting DP when controlling for family background. The purpose was to investigate the incidence of and risk factors for DP due to any MSD ( n = 1,819) and specifically due to osteoarthritis (OA, n = 677) in a twin cohort of 24,043 people over a 30-year follow-up. Methods: Data on twin pairs from a mailed questionnaire during the baseline year of 1975 were followed up with register data regarding DP, emigration, old-age pension, and death. For statistical analysis, univariate and multivariate Cox proportional hazard ratios were estimated. Results: Baseline musculoskeletal pain, frequency of use of analgesics, body mass index, and chronic diseases, as well as education and social class were significant risk factors for DP due to MSD at follow-up in both sexes. These factors were also the significant predictors of DP due to OA in men. In women, DP due to OA was best predicted by baseline musculoskeletal pain and lower social class. Conclusions: The risk of DP due to MSD and OA seemed to be influenced by comorbidities, educational level and social class. Analyses of twin pairs discordant for DP confirmed the results. Accumulated health problems and chronic conditions during the life course may lead to permanent work incapacity.
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| 58. |
- Rosvall, Maria, et al.
(author)
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Auditing patient registration in the Swedish quality register for acute coronary syndrome.
- 2010
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In: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; May 4, s. 533-540
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Journal article (peer-reviewed)abstract
- AIMS: The present study aims to quantify non-participation in the RIKS-HIA register during 2005 and to compare acute myocardial infarction (AMI) patients registered and not registered in RIKS-HIA, in relation to sociodemographic factors, prevalent disease, and 7-day and 30-day survival. METHODS: We linked information on sociodemographic characteristics, treatments, morbidity, and mortality from the LOMAS (Longitudinal Multilevel Analysis in Scania) database with the RIKS-HIA register. The study population consisted of individuals younger than 85 years living in Scania by 31 December 2004 who had one or more AMI during 2005 (n = 2968). RESULTS: The 70% of the AMI patients included in the register were generally younger, more often men, generally more healthy, more often had AMI as the main diagnosis, and more often underwent revascularisation procedures than AMI patients not included. Among both men (ORadjusted = 0.19; 95% CI 0.14-0.27) and women (ORadjusted = 0.30; 95% CI 0.20-0.44), registered patients had a lower 30-day mortality than patients not registered in RIKS-HIA. CONCLUSIONS: Even though RIKS-HIA conveys a clear quality improvement for the care of patients with acute coronary syndrome in Sweden, it is important to be aware that the register does not include the entire AMI population, but rather a selected and healthier population of AMI patients. This circumstance decreases the external validity of the information obtained from the RIKS-HIA register. Such an effect might be reduced over time and data from 2006 shows an inclusion rate of 76% among AMI patients aged less than 80 years.
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| 59. |
- Sahlberg, Bo, et al.
(author)
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Sick building syndrome in relation to domestic exposure in Sweden : A cohort study from 1991 to 2001
- 2010
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In: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 38:3, s. 232-238
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Journal article (peer-reviewed)abstract
- BACKGROUND: Most studies on sick building syndrome (SBS) are cross-sectional and have dealt with symptoms among office workers. There are very few longitudinal cohort studies and few studies on SBS in relation to domestic exposures. The aim of this study was to investigate changes in SBS symptoms during the follow-up period and also to investigate changes in different types of indoor exposures at home and relate them to SBS symptoms in a population sample of adults from Sweden. We also wanted to investigate if there was any seasonal or regional variation in associations between exposure and SBS. METHODS: A random sample of 1,000 people of the general population in Sweden (1991) was sent a self administered questionnaire. A follow-up questionnaire was sent in 2001. RESULTS: An increased risk for onset of any skin symptoms (risk ratio (RR) 2.32, 1.37-3.93), mucosal symptoms (RR 3.17, 1.69-5.95) or general symptoms (RR 2.18, 1.29-3.70) was found for those who had dampness or moulds in the dwelling during follow-up. In addition people living in damp dwellings had a lower remission of general symptoms and skin symptoms. CONCLUSIONS: Dampness in the dwelling is a risk factor for new onset of SBS symptoms. Focus on indoor environment improvements in dwellings can be beneficial both for the inhabitants and the general population. Reducing dampness in buildings is an important factor for reducing SBS symptoms in the general population.
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| 60. |
- Sandmark, Helene
(author)
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Health, sleep, and professional career in female white-collar workers back to work after long-term sick-listing due to minor mental disorders
- 2011
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In: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 39:8, s. 823-829
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Journal article (peer-reviewed)abstract
- Aims: This study is a 3-year follow up of female white-collar workers, who were on long-term sick leave in 2004 due to stress-related and minor mental disorders. The aim is to show what promotes return-to-work (RTW) and the impact of a long period of sickness absence on professional career. Methods: The study includes a cohort of 233 women who were currently on medically certified sick leave lasting >= 90 days in 2004. A postal questionnaire was sent out after 34 months, regarding self-rated health, quality of sleep, sick-listing status, occupational status, etc. Results: After 34 months, 69% of the women had fully returned to working life. One of the most salient findings is that almost half of those had changed jobs and more than a third were in a new profession. Those who were back in working life rated less negative consequences of the long-term sick-listing on their professional career and their quality of sleep was better (OR 2.90, 95% CI 1.50-5.60 "sleeping all night"). Self-rated health did not show significant association with RTW (OR 2.83, 95% CI 0.91-8.77). Those who had returned to working life reported more control over their lives (OR 1.98, 95% CI 1.01-3.88). Conclusions: The findings imply that, in work health promotion and rehabilitation and efforts to prevent sickness absence due to stress-related disorders, important factors to be considered are job mobility, changes in present work, improved sleep, and control over one's own life.
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