| 1. |
- Bäckryd, Emmanuel, et al.
(författare)
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The new chronic pain mg30 category and diagnostic specificity in quality registries : problems and suggested solutions with special reference to Swedish quality registry for pain rehabilitation (SQRP)
- 2024
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Ingår i: Frontiers in Pain Research. - : MDPI. - 2673-561X. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- The Swedish Quality Registry for Pain rehabilitation (SQRP) is a well-established clinical registry for adult patients with complex chronic pain conditions. SQRP registers patient-reported outcome measures from a majority of specialist chronic pain units/departments in Sweden. Up to four International Classification of Diseases version 10 (ICD-10) diagnoses can be registered in SQRP. The aim of the paper is to describe how we envision the new chronic pain category MG30 in ICD-11 can be used in SQRP. We envision that the first diagnosis in SQRP shall always be a MG30 diagnosis, which will ensure broad implementation of ICD-11 in Swedish pain care. However, at first glance, there seems to be specificity problems with ICD-11 codes that might impair their useability in SQRP or other registries. But ICD-11 offers more than meets the eye. First, the entries at the level of the so-called foundational layer have unique resource identifiers (URI) that can be used to enhance specificity. Second, ICD-11 contains numerous extension codes that can be combined with the MG30 codes – for instance, concerning the anatomical location of pain. Third, to enrich the description of the clinical concept at hand, it is possible to create clusters of stem codes. These three options are briefly discussed. We conclude that the full potential of the MG30 category can be better exploited in registries such as SQRP if foundational codes, extension codes, and/or clustering of stem codes are used to enhance diagnostic specificity.
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| 2. |
- Djekic, Demir, 1989-, et al.
(författare)
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Metabolomics in atherosclerosis
- 2015
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Ingår i: International Journal of Cardiology Metabolic & Endocrine. - : Elsevier. - 2214-7624. ; 8, s. 26-30
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Forskningsöversikt (refereegranskat)abstract
- It is well established that atherosclerotic cardiovascular disease (ACD) is a leading cause of death in the West. There are several predisposing factors for ACD, which can be divided into two groups: firstly modifiable risk factors, including hypertension, dyslipidaemia, type 2 diabetes mellitus, obesity, smoking and a sedentary lifestyle and secondly the unmodifiable risk factors such as age, gender and heredity. Since single biomarkers are unable to provide sufficient information about the biochemical pathways responsible for the disease, there is a need for a holistic approach technology, e.g. metabolomics, that provide sufficiently detailed information about the metabolic status and assay results will be able to guide food, drug and lifestyle optimisation. Rather than investigating a single pathway, metabolomics deal with the integrated identification of biological and pathological molecular pathways. Mass spectrometry (MS) and nuclear magnetic resonance (NMR) spectroscopy are the two most commonly used techniques for metabolite profiling. This detailed review concluded that metabolomics investigations seem to have great potential in identifying small groups of disturbed metabolites which if put together should draw various metabolic routs that lead to the common track pathophysiology. The current evidence in using metabolomics in atherosclerotic cardiovascular disease is also limited and morewell designed studies remain to be established, which might significantly improve the comprehension of atherosclerosis pathophysiology and consequently management.
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| 3. |
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| 4. |
- Molander, Peter, et al.
(författare)
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Ehlers-Danlos Syndrome and Hypermobility Syndrome Compared with Other Common Chronic Pain Diagnoses-A Study from the Swedish Quality Registry for Pain Rehabilitation
- 2020
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Ingår i: Journal of Clinical Medicine. - : MDPI. - 2077-0383. ; 9:7
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Tidskriftsartikel (refereegranskat)abstract
- Although chronic pain is common in patients with Ehlers-Danlos syndrome (EDS) and hypermobility syndromes (HMS), little is known about the clinical characteristics of these groups. The main aim was to compare EDS/HMS with common local and generalized pain conditions with respect to Patient Reported Outcome Measures (PROMs). Data from the Swedish Quality Register for Chronic Pain (SQRP) from 2007 to 2016 (n= 40,518) were used, including patients with EDS/HMS (n= 795), fibromyalgia (n= 5791), spinal pain (n= 6693), and whiplash associated disorders (WAD) (n= 1229). No important differences in the PROMs were found between EDS and HMS. Women were represented in > 90% of EDS/HMS cases and fibromyalgia cases, and in about 64% of the other groups. The EDS/HMS group was significantly younger than the others but had a longer pain duration. The pain intensity in EDS/HMS was like those found in spinal pain and WAD; fibromyalgia had the highest pain intensity. Depressive and anxiety symptoms were very similar in the four groups. Vitality-a proxy for fatigue-was low both in EDS/HMS and fibromyalgia. The physical health was lower in EDS/HMS and fibromyalgia than in the two other groups. Patients with EDS/HMS were younger, more often female, and suffered from pain for the longest time compared with patients who had localized/regional pain conditions. Health-care clinicians must be aware of these issues related to EDS/HMS both when assessing the clinical presentations and planning treatment and rehabilitation interventions.
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| 5. |
- Molander, Peter, et al.
(författare)
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Interdisciplinary pain rehabilitation for patients with Ehlers-Danlos syndrome and hypermobility spectrum disorders
- 2024
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Ingår i: Journal of Rehabilitation Medicine. - : Foundation for Rehabilitation Information. - 1650-1977 .- 1651-2081. ; 56
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Chronic pain is a common manifestation of Ehlers-Danlos syndrome and hypermobility spectrum disorders; thus it is often suggested that patients undergo generic interdisciplinary pain rehabilitation, despite there being little evidence to support this decision. The aim of this study is to examine the effectiveness of standard rehabilitation programmes for chronic pain on patients with Ehlers-Danlos syndrome and hypermobility spectrum disorders, compared with patients with other chronic pain disorders.SUBJECTS: Data, collected between 2008 and 2016, were extracted from a Swedish national registry. The patient data comprised of 406 cases with Ehlers-Danlos syndrome or hypermobility spectrum disorders, 784 cases with a whiplash-related diagnosis, 3713 cases with diagnoses relating to spinal pain, and 2880 cases of fibromyalgia.METHODS: The differences between groups on key outcome measures from pre- to 1-year follow-up after interdisciplinary pain rehabilitation were analysed using linear mixed effects models. Sensitivity analysis in the form of pattern-mixture modelling was conducted to discern the impact of missing data. RESULTS: No significant differences were found in improvements from pre- to 1-year follow-up for patients with Ehlers-Danlos syndrome or hypermobility spectrum disorder compared with other diagnostic groups regarding measures of health-related quality of life, mental health, or fatigue. At follow-up, differences in pain interference (d = -0.34 (95% confidence interval [95% CI] -0.5 to -0.18)), average pain (d = 0.22 (95% CI 0.11-0.62)) and physical functioning (d = 2.19 (95% CI 1.61-2.77)) were detected for the group with spinal-related diagnoses in relation to those with EDS/HSD, largely due to pre-treatment group differences. Sensitivity analysis found little evidence for missing data influencing the results.CONCLUSION: This study suggests that patients with Ehlers-Danlos syndrome/hypermobility spectrum disorders may benefit from inclusion in an interdisciplinary pain rehabilitation programme.
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| 6. |
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| 7. |
- Nyberg, Vanja E, 1941-, et al.
(författare)
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Can registry data be used as predictive factors for effective pain rehabilitation?
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Purpose: The aim of this study were: a) using registry data to analyse which patients with disability from chronic pain that were offered participation in the rehabilitation programme after assessment in interdisciplinary teams, and b) to analyse if there were registry data features which could already before the programme predict a positive outcome, i.e. less sick leave. Method: An observational study of data derived from 8509 patients, 2588 men and 5951, collected from the Swedish Quality Register for Pain Rehabilitation. Results: Being a woman, having higher education and being on full time sick leave increased, whereas being unemployed or being of non-Swedish origin decreased the chance to be offered a rehabilitation programme. Patients with shorter time outside work had higher probability to be offered a programme. On the other hand, the strongest predictive factors for a return to work were not being on full time sick leave and employment situation as well as patients’ own beliefs and expectations. Conclusion: It seemed that variables that measured pain and its health consequences were of less importance for the future sick leave situation. It is possible that contextual factors not covered by the registry may play a crucial role here. Key words: Chronic pain, sick leave benefits, pain rehabilitation, register study.
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| 8. |
- Nyberg, Vanja E., et al.
(författare)
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Changes in multidimensional pain inventory profile after a pain rehabilitation programme indicate the risk of receiving sick leave benefits one year later
- 2014
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 46:10, s. 1006-1013
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To determine whether coping profile changes after rehabilitation, assessed with the Multidimensional Pain Inventory (MPI), can predict which persons disabled by chronic musculoskeletal pain will be in receipt of sick leave benefits in the long term. Methods: Study of MPI data from 2,784 patients (709 men and 2,075 women) collected from the Swedish Quality Register for Pain Rehabilitation (SQRP) before and at the end of rehabilitation and compared with independent sick leave data for 1 year later. Results: After rehabilitation there was a significantly decreased share of Dysfunctional profiles (DYS) among both men (44% before, 31% after) and women (39% before, 26% after), but an increased share of Adaptive Coper profiles (men 15% before, 24% after, women 14% before, 24% after). The number of patients on full-time sick leave decreased significantly among men (from 57% to 46%) and women (from 57% to 50%). Persons with a DYS profile after rehabilitation had a low probability of having no or part-time sick leave. Conclusion: The number of persons with DYS profiles decreased after rehabilitation. Those with other profiles had less full-time sick leave one year later than those with DYS profiles, indicating that leaving the DYS profile is a positive prognostic sign long-term. Furthermore, the gender differences observed suggest the need to tailor rehabilitative strategies differently for men and women.
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| 9. |
- Nyberg, Vanja E, 1941-, et al.
(författare)
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Do multidimensional pain inventory scale score changes indicate risk of receiving sick leave benefits 1 year after a pain rehabilitation programme?
- 2011
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Ingår i: Disability and Rehabilitation. - London : Taylor & Francis. - 0963-8288 .- 1464-5165. ; 33:17-18, s. 1548-1556
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To study whether scale score changes in the Multidimensional Pain Inventory (MPI) can predict which persons disabled by pain will receive sick leave benefits 1 year after completing a pain rehabilitation programme.Method: An observational study of MPI data derived from 1468 patients, 388 men and 1080 women, who had participated in multidisciplinary cognitive-behavioural oriented pain rehabilitation programmes in Sweden, collected from the Swedish Quality Register for Pain Rehabilitation, before, at the end and 1 year after the programme.Results: Most MPI scale scores showed improvements after completing a pain rehabilitation programme and this improvement was sustained after 1 year. Moreover, we found that a decrease in MPI scales scores for Pain severity and Interference immediately after the pain rehabilitation programme decreased the risk of being on full-time sick leave 1 year later [OR 0.85, (95% CI 0.73–0.99) and OR 0.73, (95% CI 0.61–0.87), respectively]. The Interference scale, which may be considered to include ICF components of both activities and participation, might represent the core of suffering among persons disabled with pain.Conclusions: A rehabilitation intervention directed to combating the consequences of pain in activities and participation rather than against pain per se might lead to improved working capacity.
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| 10. |
- Nyberg, Vanja, 1941-, et al.
(författare)
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MPI profile changes after a pain rehabilitation programme indicate risk of receiving sick leave benefits one year later
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Purpose: to study whether changes of coping profiles derived from the Multidimensional Pain Inventory MPI can predict which persons disabled by chronic pain will receive sick leave benefits 1 year after completing a pain rehabilitation programme.Method: An observational study of MPI data derived from 2784 patients, 709 men and 2075 women, who had participated in interdisciplinary cognitive-behavioural oriented pain rehabilitation programmes in Sweden, collected from the Swedish Quality Register for Pain Rehabilitation, before and at the end of the programme.Results: After a pain rehabilitation programme, there was a significantly decreased share of dysfunctional profile among both men (44 % before compared to 31% after), and women (39% to 26%) as well as an increased share of Adaptive coper profiles (men 15% to 24% and women 14% to 24%). The number of those with full-time sick leave decreased significantly (p<0.001) both among men (from 57% to 46%) and women (57% and 50% respectively). At the same time level of women who had part-time sick leave increased from 20% to 30%. Persons staying with or moving into a dysfunctional profile after a rehabilitation programme had a low probability of having no or part-time sick leave.Conclusion: Persons with dysfunctional profiles have higher levels of sick-leave compared to adaptive coper and interpersonally distressed. The presently used cognitive behavioural pain rehabilitation programmes in Sweden, decreased the levels of full-time sick leave one year later. Our findings suggest also the need to tailor rehabilitative strategies differently for men and womenKeywords: Chronic pain, sick leave benefits, pain rehabilitation, Multidimensional Pain Inventory
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| 11. |
- Nyberg, Vanja, 1941-
(författare)
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Pain rehabilitation in Sweden : a quality registry study
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Chronic pain, defined as non-malignant pain emanating from the musculoskeletal system, may limit everyday activities, social functioning and the quality of social and working life for individuals, creating disability as well as incurring high economic and public costs for society. Controlled studies show that cognitive-behavioural interdisciplinary rehabilitation has a positive effect on functioning in patients who have been disabled by chronic non-malignant pain conditions. Positive outcomes described include lower pain intensity, less preoccupation with pain, greater independence and lower consumption of healthcare. On the other hand, the return to work rate varies. To facilitate comparisons on the national level and to enable audit spirals for single programmes as part of the ongoing quality assurance in healthcare the Swedish Quality Registry for Pain Rehabilitation (SQRP) has aggregated data since 1998 on all patients referred to the majority of Swedish rehabilitation units. The aim of this dissertation was to improve the knowledge base of pain rehabilitation in Sweden using the validated self-reported instruments of pain and its consequences included in the SQRP. Methods: The SQRP data were collected before, at the end and 1 year after the intervention for all individuals included, and concerns self-reported demographic variables, pain intensity, activities, thought patterns, impact of pain on daily life and life satisfaction. Individual sick leave data were collected from the Swedish Social Insurance after 1 year. Data collected from 19833 patients (6002 men and 13831 women) of which 7289 participate in work ability improving programmes, were used. Results: The results of four studies included in this thesis showed that the SQRP provided a basis for scientific works since it use the validated self-report instruments of pain and its consequences and contain a large amount of patient’s data. However, a lack of follow-up data from some units influenced the opportunity of to analyse long-term outcomes. Nevertheless, the SQRP was a useful tool to audit and evaluate as well as to propose optimising of pain rehabilitation. It seemed that contextual factors such as patients’ own beliefs and expectations, education, gender, actual sick leave and employment situation had more importance for the effect of rehabilitation programme than pain characteristics, depression or activity limitation. The Multidimensional Pain Inventory (MPI) scale scores and MPI coping profiles might be used for assessing the outcomes of treatment interventions. A reduction of MPI scale scores for Pain severity and Interference decreased the risk of being on full-time sick leave. On the other hand, the MPI coping profiles Dysfunctional, among both men and women, and Interpersonally distressed, among women, were associated with higher odds of being on full-time sick leave. Conclusions: Attending cognitive-behavioural interdisciplinary pain rehabilitation programmes in Sweden resulted in improvements of the MPI scales after completing a pain rehabilitation programme and this improvement was sustained after 1 year. Moreover, these programmes decreased the levels of full-time sick leave 1 year after completed programme. The findings suggest also the need to tailor rehabilitative strategies differently for men and women as well as for different pain coping profiles.
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| 12. |
- Reine, Ieva, 1972-, et al.
(författare)
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Does the association between ill health and unemployment differ between young people and adults? : results from a 14-year follow-up study with a focus on psychological health and smoking
- 2004
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Ingår i: Public Health. - : Elsevier. - 0033-3506 .- 1476-5616. ; 118:5, s. 337-345
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. Research has given a comprehensive picture of the negative health consequences of unemployment without offering sufficient comparison between different age groups. The aim of this study was to analyse whether the associations between ill health, particularly poor psychological health and smoking, and unemployment differ between young and adult men and women. Study design. A 14-year follow-up study of graduates of compulsory school in an industrial town in northern Sweden was undertaken. The subjects were analysed at ages 16, 21 and 30 years. Complete data on the cohort were collected for 1044 individuals with the aid of a comprehensive questionnaire. The response rate was 96.4%. Methods. The main health measurements used in this study were poor psychological health and smoking, analysed by multivariate logistic regression. Results. After controlling for several background variables, associations between long-term unemployment and poor psychological health were found in young men and women, and adult men. Long-term unemployment was only associated with smoking inyoung people. Conclusions. The association between long-term unemployment and psychological health, as well as smoking, seemed to be stronger in young people than adults.
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| 13. |
- Reine, Ieva, 1972-, et al.
(författare)
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Does transition from an unstable labour market position to permanent employment protect mental health? : results from a 14-year follow-up of school-leavers
- 2008
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Ingår i: BMC Public Health. - : BioMed Central. - 1471-2458. ; 8:159
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Tidskriftsartikel (refereegranskat)abstract
- Background: Having secure employment, in contrast to being unemployed, is regarded as an important determinant of health. Research and theories about the negative health consequences of unemployment indicated that transition from unemployment to a paid job could lead to improved health. The objective of this study was to test the hypothesis that obtaining permanent employment after being in an unstable labour market position protects mental health. Methods: A 14-year follow-up of all graduates from compulsory school in an industrial town in northern Sweden was performed at ages 16, 18, 21 and 30 years. Complete data on the cohort were collected for 1044 individuals with the aid of a comprehensive questionnaire. The response rate was 96.4%. The health measurement used in this study was the psychological symptoms analysed by multivariate logistic regression. Those who obtained permanent employment were the focus of the analysis. This group consisted of people who were in an unstable labour market position for a year or more between the ages of 25 and 29, and who had acquired a permanent job one year before and at the time of the investigation. Results: After controlling for gender as well as for an indicator of health-related selection, possible confounders and mediators, an association was found between the lower probability of psychological symptoms and obtaining permanent employment (OR = 0.35, 95% CI 0.19–0.63) as well as having permanent employment (OR = 0.22, 95% CI 0.10–0.51). Conclusion: Our findings suggest that transition from an unstable labour market position topermanent employment could be health-promoting, even after controlling for possible confounders and mediators, as well as for an indicator of health-related selection. However, as there are few studies in the field, there is a need for more longitudinal studies in order to further analyse the relationship and to examine possible explanations. The policy implication of our study is that the transformation of unstable labour market positions into permanent employment could contribute to better public health.
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| 14. |
- Reine, Ieva, 1972-
(författare)
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From young to adult : health consequences of unemployment from a gender perspective
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background The point of departure in this thesis is that unemployment is a recognised determinant of health, which may vary between different ages and among men and women. Despite governmental policies to tackle unemployment and ease its effects on health, unemployment continues to bea growing public health problem. Aim The objective of the thesis was to analyse, from a gender perspective, the relationships between ill health and unemployment as well as other unstable labour market positions in the transition from youth to adulthood. The aim of each paper was: I. Does the association between ill health and unemployment differ between young people and adults? II. Is the transition from an unstable labour market position to permanent paid job health-protective? III. Is participation in labour market programmes related to mental health? IV. What is the association between ill health among men and women and how could it be analysed with a relational theory of gender? Methods The longitudinal study was carried out in Luleå - a medium-sized industrial town in the Northern Sweden. The cohort, consisting of all 1083 pupils (506 girls and 577 boys) aged 16 who attended the last year of compulsory school in 1981, was followed up at the ages of 16, 18, 21 and 30. The response rates were high e.g. 96.4% at 14 years follow-up. The cohort was followed with extensive and well-validated questionnaires. Multivariate logistic regression was used in all papers, while propensity score matchingwas used in Paper III. Results Paper I. Health effects of long-term unemployment differed between young people and adults. Long-term unemployment was more related to psychological ill health and smoking in young people than in adults. Paper II. The results indicated that after controlling for gender as well as for an indicator of health-related selection, possible confounders and mediators transition from an unstable labour market position to permanent employment could be health-promoting. Paper III. No association was found between participation in active labour market programmes and psychological symptoms. Due to methodological shortages the 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. Paper IV. A strong association between unemployment and suboptimal self-rated health among women and high alcohol consumption among men was found and a theory of structural relations was used to discuss the gendered patterns for ill health. Conclusion The thesis indicated gendered patterns of relations between unemployment and the health outcomes, in the transition from youth to adulthood. The policy implications of my thesis are that full employment policies should be promoted to reduce the health inequalities associated with unemployment.
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| 15. |
- Reine, Ieva, 1972-, et al.
(författare)
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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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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 39:1, s. 26-34
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Tidskriftsartikel (refereegranskat)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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| 16. |
- Reine, Ieva, 1972-, et al.
(författare)
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Unemployment and ill health - a gender analysis : results from a 14-year follow-up of the Northern Swedish cohort
- 2013
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Ingår i: Public Health. - : Saunders Elsevier. - 0033-3506 .- 1476-5616. ; 127:3, s. 214-222
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. To investigate the experience of suicidal expressions (death wishes, life weariness, ideation, plans and attempts) in young Swedish Sami, their attitudes toward suicide (ATTS), and experience of suicidal expressions and completed suicide in significant others and to compare with Swedes in general. Methods. A cross-sectional study comprising 516 Swedish Sami, 18-28 years of age together with an age and geographically matched reference group (n = 218). Parts of the ATTS questionnaire have been used to cover different aspects of the suicidal complex. Data were analysed with regard to gender, occupation, counties and experience of negative societal treatment due to Sami background. Results. Both young Sami and young Swedes reported suicidal ideation, life weariness, and death wishes in a high degree (30-50%), but it was more common among the Sami. Having had plans to commit suicide showed a significant gender difference only in the Sami. The prevalence of suicide attempts did not differ significantly between Sami and Swedes. Subgroups of the Sami reported a higher degree of suicidal behaviour, Sami women and reindeer herders reported a 3, 5-fold higher odds of suicide attempts and a 2-fold higher odds having had plans committing suicide. Sami living in Vasterbotten/Jamtland/Vasternorrland and Sami with experience of ethnicity related bad treatment 2-fold higher odds of suicidal plans compared to those living in other counties. Conclusion. An increased occurrence of suicidal ideation/death wishes/life weariness in young Sami compared to young majority Swedes was found, but not an increased prevalence of suicide attempts and positive attitudes together with an increased awareness to handle suicide problems could be a contributing factor. Severe circumstances and experience of ethnicity-related bad treatment seems to contribute to increased levels of suicidal plans and attempts in subgroups of Sami.
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| 17. |
- Strandh, Mattias, 1970-, et al.
(författare)
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Mental health among the unemployed and the unemployment rate in the municipality
- 2011
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Ingår i: European Journal of Public Health. - Oxford : Oxford Journals - Oxford University Press. - 1101-1262 .- 1464-360X. ; 21:6, s. 799-805
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Tidskriftsartikel (refereegranskat)abstract
- Background: Previous research has shown that unemployment experiences increase the risk of poor mental health and that this effect differs depending on individual characteristics. Relatively little is known, however, about how the unemployment rate and labour market conditions impact the relationship. This study investigates how municipal unemployment rates and vacancy rates affect mental health in a nationally representative longitudinal survey of initially unemployed Swedish respondents.Methods: The study uses a nationally representative longitudinal survey of currently and recently unemployed people in Sweden, in which respondents were re-interviewed one year after the initial interview. Mental health was measured using the GHQ-12. The present article uses multilevel models (hierarchical linear models) to combine municipal-level information on unemployment levels and vacancy rates with individual-level control variables.Results: Higher municipal vacancy rates improved mental health among the unemployed. However, no coherent effect of municipal unemployment rate on the relationship between unemployment and mental health was found.Conclusions: The effect of municipal vacancy rates can be understood in terms of the impact of perceived opportunity on the sense of life-course predictability. That there was no effect of municipal unemployment rate indicates that high local unemployment levels do not reduce the sense of shame and perceived stigma among the unemployed. Taken together, our findings would seem to present a rather bleak picture of the current dramatic labour market situation. The unemployed will be negatively affected by the extremely low demand for labour, while they will not be able to take comfort from their growing numbers.Background: Previous research has shown that unemployment experiences increase the risk of poormental health and that this effect differs depending on individual characteristics. Relatively little is known, however, about how the unemployment rate and labour market conditions impact the relationship. This study investigates how municipal unemployment rates and vacancy rates affect mental health in a nationally representative longitudinal survey of initially unemployed Swedish respondents.Methods: The study uses a nationally representative longitudinal survey of currently and recently unemployed people in Sweden, in which respondents were re-interviewed one year after the initial interview. Mental health was measured using the GHQ-12. The present article uses multilevel models (hierarchical linear models) to combine municipal-level information on unemployment levels and vacancy rates with individual-level control variables.Results: Higher municipal vacancy rates improved mental health among the unemployed. However, no coherent effect of municipal unemployment rate on the relationship between unemployment and mental health was found.Conclusions: The effect of municipal vacancy rates can be understood in terms of the impact of perceived opportunity on the sense of life-course predictability. That there was no effect of municipal unemployment rate indicates that high local unemployment levels do not reduce the sense of shame and perceived stigma among the unemployed. Taken together, our findings would seem to present a rather bleak picture of the current dramatic labour market situation. The unemployed will be negatively affected by the extremely low demand for labour, while they will not be able to take comfort from their growing numbers.
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| 18. |
- Stålnacke, Britt-Marie, et al.
(författare)
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Smärtanalys och diagnossättning vid kroniska smärtor inom specialiserad smärtvård
- 2014
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Vi har som modifiering av SoS diagnosriktlinje föreslagit att smärtdiagnostiken ska använda två system parallellt d.v.s. både ICD10 systemet som det föreslagits av Socialstyrelsen för den specialiserade smärtvården (exklusiveR52.2A-C och F45.4) (Bilaga 1) och en utvidgad smärtmekanistisk klassificering. Vid tillämpningen av det förra används lämpligen den lathund som har utarbetats av diagnosgruppen inom NRS (Bilaga 2). För den senare används kategorierna definierade i detta dokument (dvs. neuropatisk, nociceptiv, generaliserad, psykogen och/eller idiopatisk) tillsammans med ställningstagande till smärtkänslighet.Härigenom skapas mer enhetlig diagnossättning vilket är en förutsättning för kliniska riktlinjer, kliniska jämförelser och intensifierad forskning involverande diagnosaspekter.
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| 19. |
- Yekkalam, Negin, 1981-, et al.
(författare)
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Risk factors associated with symptoms of temporomandibular disorders among women with hypermobile Ehlers–Danlos syndrome : questionnaire‐based study in Finland and Sweden
- 2024
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842. ; 51:8, s. 1390-1400
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Tidskriftsartikel (refereegranskat)abstract
- Background: Generalized joint hypermobility as a characteristic feature of Ehlers–Danlos syndromes (EDS) is among the factors contributing to temporomandibular disorders (TMD).Objective: To evaluate the prevalence of TMD symptoms and their risk factors among women born in Sweden or Finland who were 27- to 78-year-olds with diagnosed hypermobile EDS (hEDS).Methods: A cohort of women with confirmed hEDS (n = 185) was constructed from the members of the National EDS Associations in both countries. Based on questionnaire data, frequency of independent variables in terms of socio-demographic, general health and oral health-related factors, comorbid symptoms and psychological distress for self-reported TMD symptoms as the dependent variables, were calculated first. Prevalence ratios (PR) and their 95% confidence interval (95% CI) were estimated for the association between independent and dependent variables.Results: Nearly all participants reported TMD symptoms (98%) with TMD pain (95%), TMJ clicking (90%) and jaw fatigue (80%) as the most common symptoms and TMJ crepitation (63%) and luxation (44%) as the least common symptoms. Risk factors for TMD among 27- to 50-year-olds participants were Finland as a country of birth, living alone and self-reported worst pain in the body (not the joints). The respective risk factors among the 51- to 78-year-olds were Finland as a country of birth, family history of EDS, tinnitus and regularly taking contraceptives.Conclusions: Among adult women with confirmed hEDS, socio-demographic and health-related factors and comorbid symptoms were significantly associated with TMD but with differences regarding age group. Therefore, management of TMD requires a multidisciplinary approach among the affected.
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- Yekkalam, Negin, 1981-, et al.
(författare)
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Treatments related to temporomandibular disorders among patients with prevalent types of Ehlers-Danlos syndrome in Sweden
- 2024
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Ingår i: Cranio. - : Taylor & Francis. - 0886-9634 .- 2151-0903.
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to assess the received TMD treatment modalities and the perceived outcome among the frequent types of EDS. A digital questionnaire was sent to the member of the National Swedish EDS Association during January-March 2022. The subsamples of hypermobile and classical EDS were constructed. Almost 90% reported TMD symptoms. Bite splint therapy, counselling, jaw training and occlusal adjustment were reported as the most common treatments with no statistically significant difference in terms of good effect between the two subsamples. Hypermobile and classical EDS might consider as an entity with regards to TMD.
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