| 1. |
- Carlsson, Anna, et al.
(författare)
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Precautions taken by mothers to prevent burn and scald injuries to young children at home : An intervention study
- 2011
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Ingår i: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 39:5, s. 471-478
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim of this study was to investigate to what extent individual-based extended information given to mothers from city parts of low education can improve precautions taken by them to prevent burn and scald injuries involving young children in the home and further to compare the results with a group of mothers who had not received extended information. METHODS: This intervention study, with a comparison group, has a quasi-experimental design. Individual-based information, with an empowerment approach, was given to a group of mothers living in two separate areas of a city in southern Sweden with a low level of education. In total, 99 mothers of children under the age of 7 months participated. The mothers were selected through the local child healthcare authorities. Observations were made and bivariate analyses were established. RESULTS: The results showed that the intervention had a significant impact on improving the precautions the participating mothers introduced to protect their children against burn and scald injuries in the home and further, in relation to a comparison group. CONCLUSIONS: Through empowerment, workshops, and home visits aimed to increase their consciousness and knowledge, the participating mothers' precautions taken against child injuries in the home improved. It is of great importance that a framework for considering the problem of burn and scald injuries to children is presented from a preventive perspective which, in combination with evidence-based interventions, may enable the creation of injury prevention programmes for implementation by the community health care.
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| 2. |
- Højgaard, B, et al.
(författare)
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The potential of smoking cessation programmes and a smoking ban in public places: comparing gain in life ex-pectancy and cost effectiveness.
- 2011
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 39:8, s. 785-796
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Interventions aimed at reducing the number of smokers are generally believed to be cost effective. However as the cost of the interventions should be paid up front whereas the gains in life years only appear in the future--the budgetary consequences might be a barrier to implementing such interventions. AIMS: The aim of the present paper was to assess the long-term cost effectiveness as well as the short-term (10 years) budget consequences of cessation programmes and a smoking ban in enclosed public places. METHODS: We develop a population-based Markov model capable of analyzing both interventions and assess long-term costs effectiveness as well as short-term budgetary consequences and outcome gains. The smoking cessation programme model was based on data from the Danish National Smoking Cessation Database (SCDB), while the model of the smoking ban was based on effect estimates found in the literature. RESULTS: On a population level the effect of a smoking ban has the largest potential compared with the effect of smoking cessation programmes. Our results suggest that smoking cessation programmes are cost saving and generate life-years, whereas the costs per life-year gained by a smoking ban are 40,645 to 64,462 DKK (100 DKK = €13.4). These results are conservative as they do not include the healthcare cost saving related to reduced passive smoking. CONCLUSIONS: Our results indicate that smoking cessation programmes and a smoking ban in enclosed public places both in the short term and the long term are cost-effective strategies compared with the status quo.
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| 3. |
- Lazarus, Jeffrey V., et al.
(författare)
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Improving African health research capacity
- 2010
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 38:6, s. 670-671
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Tidskriftsartikel (refereegranskat)abstract
- The issue of strengthening local research capacity in Africa is again high on the health and development agenda. The latest initiative comes from the Wellcome Trust. But when it comes to capacity development, one of the chief obstacles that health sectors in the region must confront is the migration of health professionals to countries that offer more lucrative opportunities, like those in western Europe. To combat this "brain drain", already back in 1984, the Swedish International Development Cooperation Agency (Sida) created a training programme in which healthcare professionals from Africa conducted the bulk of their research in their own countries. However, the model was only partly successful. Several years ago, we assessed the preconditions for the renewal of Sida support for research and research training activities in the region. Based on our work to develop a critical mass of beneficial research capacity in the countries of sub-Saharan Africa, this article suggests several recommendations to both donors and governments that have broad application for general health research issues in the region.
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| 4. |
- Lindström, Martin
(författare)
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Social capital, political trust, and health locus of control: A population-based study.
- 2011
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; Okt, s. 3-9
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate the association between political trust in the Riksdag and lack of belief in the possibility to influence one's own health (external locus of control), taking horizontal trust into account. Design/setting/participants/measurements: The 2008 public health survey in Skåne is a cross-sectional postal questionnaire study with a 55% participation rate. A random sample of 28,198 persons aged 18-80 years participated. Logistic regression models were used to investigate the associations between political trust in the Riksdag (an aspect of vertical trust) and lack of belief in the possibility to influence one's own health (external locus of control). The multiple regression analyses included age, country of birth, education, and horizontal trust in other people. RESULTS: A 33.7% of all men and 31.8% of all women lack internal locus of control. Low (external) health locus of control is more common in higher age groups, among people born outside Sweden, with lower education, low horizontal trust, low political trust, and no opinion concerning political trust. Respondents with not particularly strong political trust, no political trust at all and no opinion have significantly higher odds ratios of external locus of control throughout the multiple regression analyses. CONCLUSIONS: Low political trust in the Riksdag seems to be independently associated with external health locus of control.
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| 5. |
- Nordyke, Katrina, et al.
(författare)
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How do children experience participating in a coeliac disease screening? A qualitative study based on childrens written narratives
- 2010
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Ingår i: SCANDINAVIAN JOURNAL OF PUBLIC HEALTH. - : Sage. - 1403-4948 .- 1651-1905. ; 38:4, s. 351-358
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To explore how 12-year-old Swedish children experienced being involved in a coeliac disease (CD) screening. Methods: A qualitative approach was used to analyse short narratives written by children who had taken part in a school-based CD screening. Narratives were written after blood sampling, but prior to learning of the test results. Through an oscillation between the texts, codes, subcategories and four categories, a theme was generated describing the childrens experience. Results: The theme "A Journey towards Confidence" captures the overall experience of the screening. It illustrates that, although some children faced fear or anxiety, overall they had or were provided tools allowing them to cope well and experience a journey towards confidence. The categories describe conditions that contributed to the experience. The first, being involved, reflects the importance of involvement in receiving information and deciding to participate. Being a "good citizen" refers to feeling a duty to help and a trust to be treated fairly. Being able to cope with the screening was influenced by the childrens ability to manage sensations and support received. The last category, being able to balance risk, illustrates that the children were able to balance the risks of screening when they had a realistic understanding of the disease and their vulnerability and had tamed their anxiety. Conclusions: This study increases the understanding of how 12-year-old Swedish children experienced participating in a CD screening and describes conditions important for a positive experience. We show that, although some children faced anxiety, they had, or were provided with, tools allowing them to cope well and gain confidence.
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| 6. |
- Romé, Åsa, et al.
(författare)
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Willingness to pay for health improvements of physical activity on prescription.
- 2010
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 38, s. 151-159
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Tidskriftsartikel (refereegranskat)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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| 7. |
- Rosvall, Maria, et al.
(författare)
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Auditing patient registration in the Swedish quality register for acute coronary syndrome.
- 2010
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; May 4, s. 533-540
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Tidskriftsartikel (refereegranskat)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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| 8. |
- Stenberg, Berndt, 1948-, et al.
(författare)
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Dermatology in public health - a model for surveillance of common skin diseases
- 2010
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 38:4, s. 368-374
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The aim was to establish a baseline prevalence of skin conditions of public health importance in the general population and taking the validity of the questions into account. Our model is intended for future surveillance of skin conditions. Methods: The suggested questions have for the first time been used in Swedish population surveys. A random sample was taken from the general population aged 16 to 84 years of the participating areas. Results: During the past 12 months, hand eczema was reported by 9.4%, childhood eczema by 15.7% and nickel allergy by 13.7% of the population. Hand and childhood eczema questions have previously been validated. Taking the validity into account, the actual population prevalence of hand eczema (11.7%) is underestimated, and the prevalence of atopic childhood eczema (10.0%) is overestimated based on the results of the questionnaire. In addition to presenting prevalence, population survey results can be used for risk analyses. A 10-fold risk of hand eczema in individuals with childhood eczema and self-reported nickel sensitivity is shown in our study. Conclusions: Questionnaires can be used for epidemiologic surveillance so long as the questions are validated and that the validity is taken into account when estimating the occurrence of the conditions. Public health surveys such as this one lay the basis for future epidemiological surveillance of skin conditions that can be subject to interventions. We propose that these, or similar, questions should be used regularly in population surveys and supplemented by questions on skin exposure.
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| 9. |
- Sundell, Susanne, et al.
(författare)
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Health information for migrants : The role of educational level in prevention of overweight
- 2011
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 39:2, s. 172-178
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Modifiable risk factors for cardiovascular disease include overweight, which is prevented by healthy diet and physical activity. Recently settled migrants may have varying levels of exposure to health information. Therefore, the objectives of this study were to explore the associations between self-reported information on healthy diet and on physical activity and overweight and the possible modification of this association by educational level among recently settled Iraqi migrants in Sweden. Methods: Cross-sectional data were collected through a postal questionnaire in Arabic and analysed by means of logistic regression. Dummy variables were created in order to assess the possible modification by educational level on the association between health information and overweight. Results: After adjustments for potential confounders, associations were found between overweight and not having received information on healthy diet (OR 1.56, 95% CI 1.07-2.27) and physical exercise (OR 1.58, 95% CI 1.07-2.32). Educational level modified these associations, so that the impact on overweight by information was much more evident among those with a high level of education. Conclusions: The findings showed that overweight was associated to perceived lack of health information among recently settled Iraqi migrants. It may be easier for migrants with high education to seek, receive, and understand health-related information. Migrants with low education may be more traditional in, for example, their diet and therefore less likely to be overweight. Culturally adapted information may therefore not be relevant for them. The broader context of the social determinants of health needs to be considered when planning interventions for migrants.
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| 10. |
- Werntoft, Elisabet, et al.
(författare)
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Lack of support structures in prioritization decision making concerning patients and resources : interviews with Swedish physicians
- 2011
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications Ltd. - 1403-4948 .- 1651-1905. ; 39:6, s. 627-633
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To investigate physicians' experiences in relation to prioritization and financing in health care in order to gain a deeper understanding of the reasons behind their standpoints. Methods: Eighteen physicians, seven women and eleven men, aged 30 to 69 years were interviewed and the text was analyzed using an inductive approach, also described as conventional qualitative content analysis. Results: Experience of setting healthcare priorities and difficult decision making differed widely among the physicians and seemed to be related to the number of years in professional practice. Their view of how resources should be allocated between disciplines/patients showed that they wanted politicians to make the decisions, with support from medical professions. The overwhelming impression of their reasoning showed that they lacked support structures for their decision making and could be understood under the following categories: Prioritisation, easier in theory than in practice, and Increasing costs threaten the Swedish welfare model. Conclusions: The findings of this study highlight the importance of practical national guidelines concerning vertical prioritization, also as an important measure to make prioritization more distinct and transparent. The physicians further had a need for tools to increase patients' awareness of their health. The findings of this study also showed that an awareness of the actual costs involved might increase the responsibility among both physicians and patients. The physicians' lack of support structures implies an urgent need for practical national guidelines, especially concerning vertical prioritization. This will also make prioritization appear clear and transparent for citizens.
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