| 1. |
- Baigi, A, et al.
(författare)
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Causes of death between 1911-1950 in a Swedish province with a population characterized by longevity: Effects on life expectancy
- 2003
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 31:6, s. 418-427
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Life expectancy in Sweden is among the highest in the world, and the province of Halland has the highest life expectancy in Sweden today. In an earlier paper the authors reported that life expectancy in the province of Halland in the south-west of the country was approx. 3.5 years above the national average between 1911 and 1950. The aim of this study was to explore the influence of different causes of death on life expectancy in Sweden and the distribution of these causes of death in Halland compared with Sweden as a whole during the same period of time. Method: Causes of death between 1911 and 1950 in the whole of Sweden and in Halland were obtained from the archives of Statistics Sweden. A trend analysis was performed on the impact of the various causes of death on life expectancy in Sweden. Calendar year, age, and sex were controlled for in a Poisson model. The distribution and incidence of the most frequent causes of death were compared between Halland and Sweden as a whole. Results: The decreasing mortality risk due to infectious diseases and the simultaneous increase in the risk of mortality from tumours and circulatory diseases contributed most to the change in life expectancy in Sweden. In Halland there was a lower mortality risk in the seven most important causes of death, which accounted for approx 80% of all deaths during the study period. Conclusions: The lower mortality risk from infectious diseases mostly favoured the improvement in life expectancy in Halland up to the mid-1930s. Thereafter, a low mortality risk from tumours and particularly circulatory diseases gained increasing importance although there was always a difference in favour of Halland from the beginning of the study period. Thus, the positive trend in life expectancy that favours Halland today seems to have existed for a long period of time.
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| 2. |
- Jawad, M., et al.
(författare)
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Swedish surgical outcomes study (SweSOS) An observational study on 30-day and 1-year mortality after surgery
- 2016
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Ingår i: European Journal of Anaesthesiology. - : Ovid Technologies (Wolters Kluwer Health). - 0265-0215. ; 33:5, s. 317-325
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUNDThe European Surgical Outcomes Study (EuSOS) revealed large variations in outcomes among countries. In-hospital mortality and ICU admission rates in Sweden were low, going against the assumption that access to ICU improves outcome. Long-term mortality was not reported in EuSOS and is generally poorly described in the current literature.OBJECTIVETo describe the characteristics of the Swedish subset of EuSOS and identify predictors of short and long-term mortality after surgery.DESIGNAn observational cohort study.SETTINGSix universities and two regional hospitals in Sweden.PATIENTSA cohort of 1314 adult patients scheduled for surgery between 4 April and 11 April 2011.MAIN OUTCOME MEASURES30-day and 1-year mortality.RESULTSA total of 303 patients were lost to follow-up, leaving 1011 for analysis; 69% of patients were classified as American Society of Anesthesiologists' physical status 1 or 2, and 68% of surgical procedures were elective. The median length of stay in postanaesthesia care units (PACUs) was 175min (interquartile range 110-270); 6.6% of patients had PACU length of stay of more than 12h and 3.6% of patients were admitted to the ICU postoperatively. Thirty-day mortality rate was 1.8% [95% confidence interval (CI) 1.0-2.6] and 8.5% (CI 6.8-10.2) at 1 year (n=18 and 86). The risk of death was higher than in an age and sex-matched population after 30 days (standardised mortality ratio 10.0, CI 5.9-15.8), and remained high after 1 year (standardised mortality ratio 3.9, CI 3.1-4.8). Factors predictive of 30-day mortality were age, American Society of Anesthesiologists' physical status, number of comorbidities, urgency of surgery and ICU admission. For 1-year mortality, age, number of comorbidities and urgency of surgery were independently predictive. ICU admission and long stay in PACU were not significant predictors of long-term mortality.CONCLUSIONMortality rate increased almost five-fold at 1 year compared with 30-day mortality after surgery, demonstrating a significantly sustained long-term risk of death in this surgical population. In Sweden, factors associated with long-term postoperative mortality were age, number of comorbidities and surgical urgency.
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| 3. |
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| 4. |
- Strömberg, Ulf, 1964, et al.
(författare)
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Disease mapping of early- and late-stage cancer to monitor inequalities in early detection: a study of cutaneous malignant melanoma
- 2020
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Ingår i: European Journal of Epidemiology. - : Springer Science and Business Media LLC. - 0393-2990 .- 1573-7284.
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Tidskriftsartikel (refereegranskat)abstract
- We consider disease mapping of early- and late-stage cancer, in order to identify and monitor inequalities in early detection. Our method is demonstrated by mapping cancer incidence at high geographical resolution using data on 10,302 cutaneous malignant melanoma (CMM) cases within the 3.7 million population of South-West Sweden. The cases were geocoded into small-areas, each with a population size between 600 and 2600 and accessible socio-demographic data. Using the disease mapping application Rapid Inquiry Facility (RIF) 4.0, we produced regional maps to visualise spatial variations in stage I, II and III-IV CMM incidences, complemented by local maps to explore the variations within two urban areas. Pronounced spatial disparities in stage I CMM incidence were revealed by the regional and local maps. Stage I CMM incidence was markedly higher in wealthier small-areas, in particular within each urban area. A twofold higher stage I incidence was observed, on average, in the wealthiest small-areas (upper quintile) than in the poorest small-areas (lower quintile). We identified in the regional map of stage III-IV CMM two clusters of higher or lower than expected late-stage incidences which were quite distinct from those identified for stage I. In conclusion, our analysis of CMM incidences supported the use of this method of cancer stage incidence mapping for revealing geographical and socio-demographic disparities in cancer detection.
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| 5. |
- Abelsson, Tobias, et al.
(författare)
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Evidence-based practice in primary healthcare from the managerial point of view - a national survey
- 2021
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background The vast availability of and demand for evidence in modern primary healthcare force clinical decisions to be made based on condensed evidence in the form of policies and guidelines. Primary healthcare managers play a key role in implementing these governing documents. Thus, the aim of this article is to investigate the use and availability of evidence-based practice resources from the perspective of first-line primary healthcare managers. Methods The study is based on a national survey of primary healthcare managers, consisting of 186 respondents, recruited nationally from Sweden. The data was analysed using empirically constructed concepts and validated using factor analysis. A chi-square test was utilized to determine the statistical significance of comparisons. Associations between variables were calculated using Spearman's correlation coefficients. All tests were two-sided, and the significance level was set to 0.05. Results A majority (97 %) of managers stated that guidelines and policy documents impacted primary healthcare; 84 % of managers observed a direct effect on daily practices. Most of the managers (70 %) stated that some adaptation was needed when new evidence was introduced. The managers emphasized the importance of keeping themselves updated and open to new information about work routines (96 %). Conclusions The study illustrates a nearly unanimous response about the influence of clinical evidence on daily practice. The emphasis on the importance of all staff members keeping their professional knowledge up to date is viewed as a direct result of this effect on daily practice. An information-dense organization such as a primary healthcare organization would have much to gain from increased cooperation with regional information resources such as clinical libraries.
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| 6. |
- Almerud Österberg, S, et al.
(författare)
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Knowledge of heart disease risk in patients declining rehabilitation
- 2010
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Ingår i: British Journal of Nursing. ; 19:5, s. 288-293
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Tidskriftsartikel (refereegranskat)abstract
- Background: Participation in cardiac rehabilitation programmes (CRPs) allows patients to increase their knowledge of the importance of established risk factors to help them maintain healthy lifestyle changes after coronary heart disease (CHD).Aim: To explore perceived importance and knowledge of known risk factors for CHD among non-attendees in CRPs.Method: Consecutive non-attendees in CRPs (n=106) answered a questionnaire focusing on patients' attitudes towards risk factors and cardiac rehabilitation.Results: The non-attendees lacked knowledge of non-physical characteristics such as depression and social isolation. They also had poor knowledge about biological causes and hereditary factors. However, those who said they knew enough about CHD to prevent recurrent illness did have sufficient knowledge about the established risk factors.Conclusion: There is a lack of knowledge about social isolation and depression and their importance in the development of CHD among the non-attendees. They show greater knowledge about biological risk factors than the importance of companionship, joy and happiness. CHD and loneliness are intimately correlated, so creating a sense of belonging must not be underestimated as a measure to prevent CHD.
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| 8. |
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| 9. |
- Baigi, Amir, et al.
(författare)
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Cardiovascular mortality focusing on socio-economic influence : the low-risk population of Halland compared to the population of Sweden as a whole
- 2002
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Ingår i: Public Health. - Amsterdam : Elsevier. - 0033-3506 .- 1476-5616. ; 116:5, s. 285-288
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to investigate the relationship between mortality from cardiovascular diseases (CVD) and socioeconomic status (SES) in Sweden and to estimate to what extent the difference between a province with low mortality and the rest of Sweden was dependent on socio-economic factors. A population-based retrospective study with a historical prospective approach was performed covering a 10-y period in the province of Halland, Sweden, as well as Sweden as a whole. Altogether 1654 744 men and 1592 467 women were included, of whom 45 394 men and 43 403 women were from Halland, distributed according to SES. Multivariate analysis with Poisson regression was used. Relative risks with 95% confidence intervals were calculated. Both men and women with a low SES showed a significantly higher risk of death from CVD in Sweden as a whole. The risk was 23% higher for male blue-collar workers and 44% higher for female blue-collar workers when compared to their white-collar counterparts. The level of mortality in Halland was 14% lower compared to the country as a whole when only age was taken into account. When the socio-economic variable was also included, this figure was 8%. The results show the substantial significance of social differences with respect to CVD mortality. The effect of SES seems to be more important than that of geographical conditions when the latter are isolated from socio-economic influence.
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| 10. |
- Baigi, Amir, et al.
(författare)
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Life expectancy in the province of Halland, Sweden, 1911-50: the progress of public health in a long-living population
- 2002
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 30:3, s. 231-237
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Tidskriftsartikel (refereegranskat)abstract
- Background: Life expectancy in Sweden is currently one of the longest in the world. The population of Halland has the longest life expectancy in Sweden. Aim: Life expectancy in the province of Halland and Sweden as a whole during 1911-50 was studied and the findings are discussed in the light of local historical data. Method: A trend analysis of risk ratio of death and life expectancy for Halland and Sweden was done for the period 1911-50 with regard to calendar year, age, and sex using a Poisson model. Results: The risk ratio between Halland and Sweden was 0.83 for 1911 and 0.76 for 1950. The risk ratio of death for women was lower compared with men and this difference increased over time. At the start of the study period life expectancy for men and women was higher in Halland (58.5 and 60.1 years, respectively) compared with Sweden (54.7 and 56.4 years, respectively) with a difference of approximately 3.8 years. At the end of the study period this difference in life expectancy for men and women in Halland (71.3 and 72.3 years, respectively) and the nation ( 68.0 and 69.2 years, respectively) had decreased to approximately 3.3 years. Conclusion: The long life expectancy seen in Halland today can be traced back to the early twentieth century. The starting point for this development seems to be a lower infant mortality in Halland compared with Sweden as a nation during the 1880-90. The basis for this might have been a greater increase of food production during the whole nineteenth century as well as other socioeconomic characteristics of Halland compared with the rest of the country.
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