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| 2. |
- Michaelson, Peter, et al.
(författare)
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Factors predicting pain reduction in chronic back and neck pain after multimodal treatment.
- 2004
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Ingår i: The Clinical Journal of Pain. - : Ovid Technologies (Wolters Kluwer Health). - 0749-8047 .- 1536-5409. ; 20:6, s. 447-454
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To determine whether treatment related pain reduction on the short- and long-term is predicted by different baseline variables, and with different accuracy, in patients with chronic low back pain as compared with those with chronic neck pain. DESIGN AND METHODS: A single blinded prospective cohort study based on patients with chronic musculoskeletal pain in the lower back (N = 167) or the neck (N = 136) who completed a 4-week multimodal rehabilitation program. At admission, each patient was evaluated on 17 potential predictors, including pain characteristics and physical, sociodemographic, and psychosocial-behavioral variables. Changes in self-reported pain intensity in the lower back or the neck between the pretreatment evaluation and those performed immediately after, and 12 months after the rehabilitation program, were assessed. RESULTS: Logistic regression models revealed that change in pain intensity could be predicted with good specificity but with poor sensitivity both for patients with chronic low back pain and chronic neck pain. Significant predictors among the neck pain patients were high endurance, low age, high pain intensity, few other symptoms, low need of being social, to do things with others, and to be helped, along with optimistic attitudes on how the pain will interfere with daily life. Among the low back pain patients, high pain intensity, low levels of pain severity, and high affective distress were important predictors. Variables such as sex, sick leave history, working status, accident, pain duration, and depressive symptoms demonstrated no predictive value. Short- and long-term pain outcome was equally predictable and predicted by almost the same variables. CONCLUSIONS: Patients who reported unchanged or increased pain after multimodal treatment could be predicted with good accuracy, whereas those who reported decreased pain were more difficult to identify. Treatment-related pain alteration in chronic low back pain seems to be predicted by partly different variables than in chronic neck pain.
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| 3. |
- Sjölander, Per, et al.
(författare)
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Stroke and acute myocardial infarction in the Swedish Sami population : incidence and mortality in relation to income and level of education
- 2008
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Ingår i: Scandinavian Journal of Public Health. - : SAGE. - 1403-4948 .- 1651-1905. ; 36:1, s. 84-91
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Tidskriftsartikel (refereegranskat)abstract
- Background: Gender differences in cardiovascular diseases (CVD) among the Sami have been reported previously. The aim of the present study was to investigate the incidence of and mortality from stroke, subarachnoid haemorrhage (SAH), and acute myocardial infarction (AMI) in the Swedish Sami population between 1985 and 2002, and to analyse the potential impact of income and level of education on cardiovascular morbidity and mortality. Methods: A Sami cohort of 15,914 persons (4,465 reindeer herding and 11,449 non-herding Sami) were followed up from 1985 to 2002 with regard to incidence and mortality rates of AMI, stroke, and SAH. Incidence and mortality ratios were calculated using a demographically matched non-Sami control population (DMC) as the standard (71,550 persons). Results: There was no elevated risk of developing AMI among the Sami compared with the DMC. However, the mortality ratio of AMI was significantly higher for Sami women. Higher incidence rates of stroke and SAH for both Sami men and women was observed, but no differences in mortality rates. Apart from the reindeer-herding men who demonstrated lower levels of income and education, the income and education levels among Sami were similar to the DMC. Conclusions: High mortality rates from AMI rather than stroke explain the excess mortality for CVD previously shown among Sami women. The results suggest that the differences in incidence of stroke between herding and non-herding Sami men, and between Sami women and non-Sami women, are caused by behavioural and psychosocial risk factors rather than by traditional socioeconomic ones.
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| 4. |
- Daerga, Laila, et al.
(författare)
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Work-related musculoskeletal pain among reindeer herding Sami in Sweden : a pilot study on causes and prevention
- 2004
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Ingår i: International Journal of Circumpolar Health. - 1239-9736 .- 2242-3982. ; 63 Suppl 2, s. 343-348
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To investigate the prevalence and to identify causes of musculoskeletal pain (MSP) among reindeer herding Sami, and to evaluate the impact on the MSP symptoms elicited by an intervention-pre- vention programme (lP programme). Study Design. A prospective cohort study in which alterations in MSP symptoms were documented over a two-year period. Methods. Data were collected from 51 rein- deer herders (26 men, 25 w omen) before and af ter a two-year lP programme. Information on MSP cha- racteristics (affected body regions, pain duration and pain intensity) and exposure to a number of phy- sical and psychosocial risk factors were collected as part of comprehensive health examinations. Cli- nical examinations and interviews complemented self-reported data collected through questionnaires. Results. MSP symptoms were prevalent, both among w omen and men. High exposure to physical risk factors, to a large extent related to extensive use of snowmobiles and motorcycles, was the main cau- se of MSP among men, while psychosocial risk factors were suggested to be more important among wo- men. About one-third of the reindeer herders reported fewer MSP symptoms as a resull of the lP programme. Conclusions. This pilot study suggests that it is possible to reduce the number and the se- verity of the MSP symptoms among reindeer herders by implementing suitably tailored intervention- prevention measures.
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| 5. |
- Edin-Liljegren, A, et al.
(författare)
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Risk factors for cardiovascular diseases among Swedish Sami : a controlled cohort study
- 2004
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Ingår i: International Journal of Circumpolar Health. - 1239-9736 .- 2242-3982. ; 63:Suppl 2, s. 292-297
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate the occurrence of clinical, psychosocial and behavioural risk factors for cardiovascular diseases (CVD) among reindeer herding (RS) and non-reindeer herding Sami (NRS). STUDY DESIGN: A retrospective cohort study, comparing risk factors behind CVD between Sami and non-Sami, RS and NRS, and Sami men and women. METHODS: A cohort of 611 Swedish Sami (276 men and 335 women) was constructed from national population registers. A twice as large control cohort of non-Sami was created, matched by age, gender and area of residence. Information on risk factors was obtained from a database containing clinical and psychosocial-behavioural data from a regional CVD preventive programme for the period 1990-2001. RESULTS: The Sami and the non-Sami showed similar risk factor patterns. The main differences were related to working conditions and lifestyle factors of the RS. The RS men had lower blood pressure, were more physically active and had higher job demand and decision latitude. The RS women showed more negative scores on the indices of the job strain model. CONCLUSIONS: Previously reported differences in CVD mortality between Sami and non-Sami, and Sami men and women, can only partly be explained by different exposure to the psychosocial and behaviour risk factors investigated in this study.
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| 6. |
- Hassler, Sven, et al.
(författare)
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Causes of death in the Sami population of Sweden, 1961-2000.
- 2005
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Ingår i: International Journal of Epidemiology. - : Oxford University Press (OUP). - 0300-5771 .- 1464-3685. ; 34:3, s. 623-629
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Indigenous people often have a pattern of mortality that is disadvantageous in comparison with the general population. The knowledge on causes of death among the Sami, the natives of northern Scandinavia, is limited. The aim of the present study was to compare gender and cause specific mortality patterns for reindeer herding Sami, non-herding Sami, and non-Sami between 1961 and 2000. METHODS: A Sami cohort was constructed departing from a group of index-Sami identified as either reindeer herding Sami or Sami eligible to vote for the Sami parliament. Relatives of index-Sami were identified in the National Kinship Register and added to the cohort. The cohort contained a total of 41 721 people (7482 reindeer herding Sami and 34 239 non-herding Sami). A demographically matched non-Sami reference population four times as large, was compiled in the same way. Relative mortality risks were analysed by calculating standardized mortality ratios (SMRs). RESULTS: The differences in overall mortality and life expectancy of the Sami, both reindeer herding and non-herding, compared with the reference population were relatively small. However, Sami men showed significantly lower SMR for cancers but higher for external causes of injury. For Sami women, significantly higher SMR was found for diseases of the circulatory system and diseases of the respiratory system. An increased risk of dying from subarachnoid haemorrhage was observed among both Sami men and women. CONCLUSIONS: The similarities in mortality patterns are probably a result of centuries of close interaction between the Sami and the non-Sami, while the observed differences might be due to lifestyle, psychosocial and/or genetic factors.
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| 7. |
- Hassler, Sven, et al.
(författare)
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Fatal accidents and suicide among reindeer-herding Sami in Sweden
- 2004
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Ingår i: International Journal of Circumpolar Health. - 1239-9736 .- 2242-3982. ; 63 Suppl 2, s. 384-388
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Tidskriftsartikel (refereegranskat)abstract
- Objective. Over the last decades, reindeer-herding management has experienced drarnatic changes, e.g. increased motorization and socio-econornic pressure. The airn of the present study was to investigate whether these changes have increased the risk of fatal, work-related accidents and suicide between 1961 and 2000. Study design and methods. A c oh ort containing 7,482 members of reindeer-herding Sami families was extracted from national population registers. Information on fatal accidents and suicide was obtained from the Swedish Causes of Death Register, and compared to the expected number of deaths in a dernographica11y matched control population of non-Sami. Results. The ffiale reindeer her- ding Sami showed a significantly increased risk of dying from accidents such as vehicle accidents and poisoning. No significant increased risk of suicide was observed. A comparison between the periods of 1961-1980 and 1981- 2000 showed non-significant differences in risk, although a trend towards incre- ased risks was observed for most types of external causes of death except suicide. Conclusions. It is suggested that the increased socio-econornic pressure and the extensive use of terrain vehicles have increased the risk for fatal accidents arnong Swedish reindeer herders, and that commercial reindeer ma- nagement is one of the most dangerous occupations in Sweden
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| 8. |
- Ineland, Lisa, et al.
(författare)
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Attitudes towards mental disorders and psychiatric treatment : changes over time in a Swedish population
- 2008
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Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 62:3, s. 192-197
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Tidskriftsartikel (refereegranskat)abstract
- Over the years a lot of research of attitudes towards mental disorders, towards people with mental illness and towards psychiatric services and treatment have shown a persistent negative attitude. There are, however, few studies on changes over time. The aim of this study was to compare responses to a questionnaire on attitudes towards mental disorders and psychiatric patients and the perception of psychiatric treatment in a community in northern Sweden in 1976 and 2003. In 1976 a random sample of 391 persons 18-70 years of age were asked and in 2003 a new sample of 500 persons from the same community were approached with the same questions. There are considerable changes over time. In 2003, almost 90% agree to the statement that mental illness harms the reputation more than physical illness, compared with 50% in 1976. In 2003, 51% agreed to the statement "Most people with mental disorders commit violent acts more than others" compared with 24% in 1976. There is an apparent ambivalence towards psychiatric treatment. Whilst 88% would advice a person with mental problems to contact a psychiatrist, still 26% would not like themselves to be referred to a psychiatrist. We argue that improving treatment methods is as important as changing attitudes through accurate information.
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| 9. |
- Åsell, Malin, et al.
(författare)
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Are lumbar repositioning errors larger among patients with chronic low back pain compared with asymptomatic subjects?
- 2006
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Ingår i: Archives of Physical Medicine and Rehabilitation. - : Elsevier BV. - 0003-9993 .- 1532-821X. ; 87:9, s. 1170-1176
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To resolve the debate over whether lumbar repositioning acuity is reduced in patients with chronic low back pain (CLBP) by using a study design and methodology to minimize the effects of potential confounders. DESIGN: A single-blinded, controlled, multigroup comparative study.SETTING: Vocational rehabilitation center.PARTICIPANTS: Ninety-two patients with CLBP, divided into subgroups based on severity of symptoms and diagnostic characteristics. An age- and sex-matched group (n=31) of healthy subjects were the control. INTERVENTIONS: Not applicable.MAIN OUTCOME MEASURES: We measured repositioning errors (variable, constant) at 3 positions of the lumbar spine. Subjects were guided to a sitting target posture and asked to perform lumbar flexion before reproducing the target posture. Self-assessed pain, self-efficacy, and functional ability were addressed through questionnaires.RESULTS: There were no differences in repositioning errors between the patients with CLBP or the subgroups of patients and the control group. We found only weak correlations between the repositioning errors and the self-reported data on functional disability, self-efficacy, and pain.CONCLUSIONS: We suggest that sensorimotor dysfunctions in CLBP should be evaluated with methods other than repositioning tests in order to generate data relevant to the development of rational diagnostic methods and rehabilitation programs.
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