| 1. |
- Deogan, Charlotte L., et al.
(författare)
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A cost-effectiveness analysis of the Chlamydia Monday A community-based intervention to decrease the prevalence of chlamydia in Sweden
- 2010
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Ingår i: Scandinavian Journal of Public Health. - : SAGE PUBLICATIONS LTD. - 1403-4948 .- 1651-1905. ; 38:2, s. 141-150
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The study was undertaken to assess the cost-effectiveness of the Chlamydia Monday, 2007. This is a community-based intervention aimed at reducing the prevalence of chlamydia by information and increased availability of testing, treatment and contact tracing in Stockholm. The aim was to analyze the cost-effectiveness by estimating costs, savings and effects on health associated with the intervention, and to determine if cost-effectiveness varies between men and women. Methods: A societal perspective was adopted, meaning all significant costs and consequences were taken into consideration, regardless of who experienced them. A cost-effectiveness model was constructed including costs of the intervention, savings due to avoiding potential costs associated with medical sequels of chlamydia infection, and health gains measured as quality adjusted life years (QALY). Sensitivity analyses were done to explore model and result uncertainty. Results: Total costs were calculated to be (sic)66,787.21; total savings to (sic)30,370.14; and total health gains to 9.852324 QALYs (undiscounted figures). The discounted cost per QALY was (sic)8,346.05 ((sic)10,810.77/QALY for women and (sic)6,085.35/QALY for men). Sensitivity analyses included changes in effectiveness, variation of prevalence, reduced risk of sequel progression, inclusion of prevented future production loss and shortened duration for chronic conditions. The cost per QALY was consistently less than (sic)50,000, which is often regarded as cost-effective in a Swedish context. Conclusions: The Chlamydia Monday has been demonstrated by this study to be a cost-effective intervention and should be considered a wise use of society's resources.
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| 2. |
- Gusdal, Annelie K, 1963-, et al.
(författare)
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District nurses' use for an assessment tool in their daily work with elderly patients' medication management
- 2011
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 39:4, s. 354-360
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To explore the capability of the Safe Medication Assessment (SMA) tool in identifying factors highly related to unsafe medication management among elderly patients and to investigate the district nurses' (DNs) opinions of the SMA's usefulness as a tool in their daily primary healthcare practice. Introduction: Elderly patients who experience many medical conditions often use multiple drugs. As well as the combined decline in physical and cognitive functions, the elderly are at high risk for medication-related problems. It is essential to develop a screening procedure to distinguish elderly at risk of an unsafe medication management.METHODS: An explorative study. During a 3-6-month period, 25 voluntary DNs used SMA with 160 patients (consecutively chosen and meeting four specified criteria) in their daily practice. Furthermore, DNs responded to questions regarding SMA's usefulness.RESULTS: The result showed that SMA had the capability to identify factors highly related to unsafe medication management among the elderly included in the study. In 64% of assessments DNs identified areas of new information and in 23% of the assessments DNs intervened. They found SMA to be satisfactory regarding its level of simplicity, relevance, completeness, intelligibility, and time for implementation.CONCLUSIONS: SMA alerted the DNs to patients' attitudes about medication and empowered them in identifying elderly patients who had unsafe medication management. SMA was also perceived as a useful assessment tool by the DNs.
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| 3. |
- Johansson, Pia, et al.
(författare)
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Financing intersectoral health promotion programmes : some reasons why collaborators are collaborating as indicated by cost-effectiveness analyses
- 2011
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 39, s. 26-32
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Intersectoral collaboration is an important part of many health promotion programmes. The reasons for the local organisations to collaborate, i.e. to finance programmes, are presumably based on benefits they derive from the collaboration. The aim of this study is to discuss whether subsector financial analyses based on data from cost-effectiveness analyses reflect incentives of collaborating organisations in two intersectoral health promotion programmes. Methods: Within economics, financial incentives are important reasons for actions. The financial incentives of collaborators are exemplified with two subsector financial analyses containing avoided disease-related costs as estimated in two cost-effectiveness analyses, on an elderly safety promotion programme (Safe Seniors in Sundbyberg) and on a diabetes prevention programme (Stockholm Diabetes Prevention Program, SDPP) from Stockholm, Sweden. Results: The subsector financial analyses indicate that there are financial incentives for the key local community organisation, i.e. the local authority, to collaborate in one of the programmes but not the other. There are no financial benefits for other important community organisations, such as non-governmental organisations. Conclusions: The reasons for collaborating organisations to collaborate within intersectoral health promotion programmes extend beyond financial benefits from averted disease. Thus, the reported subsector financial analyses are only partial reflections of the incentives of collaborators, but they might be used as a starting point for discussions on cost sharing among potential intersectoral collaborators.
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| 4. |
- Müllersdorf, Maria, et al.
(författare)
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Aspects of health, physical/leisure activities, work and socio-demographics associated with pet ownership in Sweden
- 2010
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 38:1, s. 53-63
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The aim of the work presented here was to explore differences between pet owners and non-pet-owners concerning aspects of health, physical/leisure activities, work and socio-demographics. Methods: The study was based on nationally representative data from the Swedish population (n = 43,589). Associations between pet ownership and background variables were investigated using logistic regression analysis. Results: A total of 39,995 respondents were included in the analysis (non-pet-owners 25,006; pet owners 14,989). Pet ownership was associated with both positive and negative aspects of health, physical/leisure activities and socio-demographics. Pet owners had better general health but suffered more from mental health problems than non-pet-owners. Their leisure activities involved a greater interest in nature life and/or gardening than those of non-pet-owners. The logistic regression analysis showed that people who were self-employed, in the age range 35 to 49, of female sex, and suffering from pain in the head, neck and shoulders were more likely to own a pet than others. People physically active at a level sufficient to have a positive effect on their health more often owned a pet than people who were less active. Conclusions: Pet owners differ from non-pet-owners in aspects of socio-demographics, health, physical/leisure activities and work situation. This study, based on a general regional population in Sweden, showed differences of both a positive and a negative kind between non-pet-owners and pet owners concerning aspects of health, physical and leisure activities, and work situation.
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| 5. |
- Osman, Fatumo, et al.
(författare)
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Perceptions of the use of khat among Somali immigrants living in Swedish society
- 2011
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 39, s. 212-219
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Tidskriftsartikel (refereegranskat)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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| 6. |
- Sandmark, Helene, 1951-
(författare)
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Health, sleep and professional career in female white-collar workers returning to work after long-term sick-listing due to minor mental disorders
- 2011
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Ingår i: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 39:8, s. 823-829
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Tidskriftsartikel (refereegranskat)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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| 7. |
- Toivanen, Susanna, 1961-
(författare)
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Income differences in stroke mortality : a 12-year follow-up study of the Swedish working population.
- 2011
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 39:8, s. 797-804
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: This study explored the association between income and stroke mortality in the total working population in Sweden and examined whether the associations differ by gender or for stroke subtypes intracerebral haemorrhage (ICH) or brain infarction (BI).METHODS: This was a register-based study among nearly 3 million working women and men (30-64 years in 1990) with a 12-year follow up (1991-2002) for mortality from stroke (4886 deaths). Income was measured as annual registered income from work in 1990. Gender-specific Cox regressions were applied with adjustments for sociodemographic covariates.RESULTS: The age-adjusted hazard ratio (95% confidence interval) of lowest versus highest income quartile was 1.80 (1.48-2.19) for any stroke, 1.68 (1.29-2.17) for ICH and 2.23 (1.53-3.22) for BI in women, and the corresponding figures for men were 2.12 (1.92-2.34), 2.02 (1.77-2.31), and 2.09 (1.77-2.46). Adjustment for covariates attenuated these associations to 1.69 (1.33-2.15) for any stroke and 1.56 (1.14-2.14) for ICH in women and to 1.98 (1.74-2.24) for any stroke and 1.77 (1.44-2.19) for BI in men. In contrast, adjustment for covariates amplified the estimates to 2.36 (1.52-3.66) for BI in women and to 2.05 (1.73-2.44) for ICH in men.CONCLUSIONS: Risk of stroke mortality was highest in the lowest income group, with a gradient for the intermediate groups, in both women and men. The risk of mortality from BI was highest in women with the lowest income and the risk of ICH was highest in men with the lowest income.
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| 8. |
- Wamala, Sarah, et al.
(författare)
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Can the Millennium Development Goals database be used to measure the effects of globalisation on women's health in Sub-Saharan Africa? : A critical analysis
- 2010
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Ingår i: Scandinavian Journal of Public Health. - : SAGE PUBLICATIONS LTD. - 1403-4948 .- 1651-1905. ; 38, s. 18-28
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Tidskriftsartikel (refereegranskat)abstract
- Background: Africa has had poor returns from integration with world markets in globalisation, has experienced worsening poverty and malnutrition and has high burdens of HIV and communicable disease, with particular burdens on women. It is therefore essential to describe the impact of globalisation on women's health. Indicators such as the Millennium Development Goals (MDGs) are presented as having a major role in measuring this impact, but an assessment of the adequacy of aggregate national indicators used in monitoring the MDGs for this purpose is lacking. Methods: The Millennium Development Goals' panel database 2000 to 2006 was used to investigate the association between globalisation and women's health in Sub-Saharan Africa based on various determinants of heath. Out of the 148 countries classified as developing countries, 48 were in Sub-Saharan Africa. Results: Results suggest that developing countries are becoming more integrated with world markets through some lowering of trade barriers. At the same time, women's occupational roles are changing, which could affect their health status. However, it is difficult to measure the impact of globalisation on women's health from the MDG database. First, data on trade liberalization is aggregated at the regional level and does not hold any information on individual countries. Second, too few indicators in the MDG database are disaggregated by sex, making it difficult to separate the effects on women from those on men. Conclusions: The MDG database is not adequate to assess the effects of globalisation on women's health in Sub-Saharan Africa. We recommend that researchers aim to address this research question to find other data sources or turn to case studies. We hope that results from this study will stimulate research on globalisation and health using reliable sources.
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| 9. |
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