| 11. |
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| 12. |
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| 13. |
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| 14. |
- Belfrage, Henrik, 1955-
(författare)
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Psykiskt störda brottslingar : En studie av begreppet "jämställd med sinnessjukdom" - dess historiska bakgrund och praktiska tillämpning
- 1989
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The main objective of this thesis is to study the concept of "equivalent to insanity", its historical background and practical application.Based on a legal historical presentation I show that the term "equivalent to insanity" has one content under the 1864 Penal Statutes, and an entirely different one under the 1962 Criminal Code.The empirical findings are, that those persons in my material who were assessed to be "equivalent to insane" (298 persons), display similar characteristics as corresponding clientele in previous studies. They are, apart from being mentally disordered, also severely socially handicapped.After having examined the concept "equivalent to insanity" and described the persons which were deemed "equivalent", I then concentrate on the question of the reliability of these assessments. The findings are that there is good accordance between different assessments of the same criminal case.To answer the question whether this special category of offenders is treatable, I have used a control group consisting of offenders who where assessed not to be "equivalent to insane" (256 persons). My criterion for "treatability" is recidivism into crime in a three-year period. The results are, that psychiatric treatment has apositive crime preventive effect on some categories of offenders (especially offenders sentenced for assault), but none of significance on others (especially property offenders). It is therefore erroneous to pose the question: Does psychiatric treatment have more crime preventive effect than a prison sentence? The question is far too general. One must take into consideration the crime category dominating the study groups. But it is probable that even further ambiguities are concealed in the question. It is therefore cruicial that further research be aimed at seeking crime preventive factors of psychiatric treatment of mentally disordered offenders.
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| 15. |
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| 16. |
- Brodin, Håkan, 1946-
(författare)
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Regional variations in pharmaceutical consumption in Sweden
- 1987
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Secondary, non-sample data, mainly from official statistics from 259 municipalities in Sweden, are used to investigate systematic variations in the consumptian of pharmaceuticals on the county and municipality level.The theoretical framework is taken from health economics. The utilization of health care, and consequently the consumptian of pharmaceuticals, is determined simultaneausly by the demand for health care, derived from a demand for health, and the supply of health care. The model is exploratory, aiming at the identification of important factors for further study. In particular the importance of the economic budget restriction is examined.An analysis of variance shows that there is no reason to assume systematic differences in the consumptian of pharmaceuticals caused by actions on the county level. The existing variation more likely stems from differences in characteristics of the municipalities, thus reflecting intovariations on the county level.The impact of a number of explanatory variables on drug consumptian is measured by means of multiple regression analyses. The variables included are sick-leave, disability pension, unemployment, age, alcohol consumption, religiousness, occupational structure, commuting, physician density, rural population, presence of a hospital or a regional hospital and income.The regression results indicate that age structure, the number of doctars and commuting explain approximately one third of the variation. Detailed regression studies of the consumption of 19 pharmaceutical subgroups show a more diversified result, but the main pattern remains.Using predictians from the 19 subregressions, a case study is performed for Gotland, known as a divergent municipality with respect to drug consumption. Two pharmaceutical groups, cardiovasculars and analgesics, were identified as particularly divergent campared to the general consumptian behaviour of the municipalities of Sweden.An analysis using the LISREL technique is performed in order to study the relative importance of the latent, unmeasured variables 'morbidity', 'life style', 'availability' and 'economy', grouped from the measured variables. The analysis indicates that 'availability' is the most important factor underlying pharmaceutical consumptian and that 'econorny' is more important than 'morbidity' and 'life style'. The analysis also shows, that low income is associated with high consumption of drugs. Whether this relationship on the municipality leve! also holds on the individual levelis not known.
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| 17. |
- Carlsson, Per, 1951-
(författare)
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Spridning och ekonomiska effekter av medicinsk teknologi vid behandling av magsår, prostataförstoring och gallsten
- 1987
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The general aim of the study is to analyse the economic consequences of diffusion and changed utilization of medical technology. The intention is to widen the empirical basis prospects for assessing the future consequences of technologies other than those studied within the scope of this project. The investigation consists of case studies of three common technologies in medical care. These are cimetidine, a pharmaceutical for treating peptic ulcer, transurethral resection (TURP) for treating benign prostatic hyperplasia and open operation (cholecystectomy) for gallstone treatment.The studies of cimetidine and TURP illustrate a common trend in medical care where the introduction of new medical technology leads both to a reduced risk for the patient and a reduction in the cost per treatment.The lower risk in combination with increased expectations on the part of the patient and the medical profession leads to increased utilization, the overall result being an increase in the costs of medical care.Certain effects on the indirect costs which arise outside medical care have been analysed. The results show that the increased utilization of cimetidine has until 1983 been profitable in terms of social economics. This is in addition to the gains achieved in the form of less pain and discomfort. The increased utilization of TURP has probably not led to any relative reductions in indirect costs. One reason for this is that the average age of patients with benign prostatic hyperplasia is high. Since most patients are over 65, faster rehabilitation has a low valuation in economic terms. Fewer gallstone operations mean a larger reduction in cost both for medical care and society as a whole through reduced sick leave.In the study, a number of hypotheses have been formulated regarding important factors for the diffusion and utilization of medical technology. Further research remains to be done in order to determine these relationships with certainty.The study also shows that the utilization of a technology can rapidly change and that it can begin to be utilized in other situations than those demonstrated to be effective in scientific studies. Extended indicationsfor utilizing the technology may lead to increased costs of medical care. The total effect on health of an increased utilization is often unknown.
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| 18. |
- Daléus, Erika, 1942-
(författare)
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Resource management in traditional farming : A case study in the dry zone of Sri Lanka
- 1988
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The potential of the traditional small irrigation systems in Sri Lanka has to a great extent been overlooked in the efforts to satisfy increasing food requirements and to bring about social development in rural communities. The aim of this study was to arrive at an improved understanding of the resource management ofthe traditional farming system in the Dry Zone of Sri Lanka. Irrigation through small village tanks plays a significant role in this context.A farming system approach was used. It implies that the coordination of activities within a farm setting, and the farmers' reliance on the different parts of the system, can be properly dealt with. Different geographical and temporal perspectives facilitated the analyses of the interactions anddependencies between man and his environment. The information and data forming the basis of the analyses were collected between 1984-1986. The small irrigation system under study is located in a mini-catchment in the north-central part of Sri Lanka.For paddy cultivation in the lowlands, water is an obvious constraint. Water scarcity adversely affected both yield and cultivation intensity. Within a single paddy tract yield variation was considerable. Apart from water scarcity the variation was closely related to distance from the watersource. With sufficient water it seems that the explanations to variations in yield should be sought for in terms of management factors and incidental problems like damage by wild animals.A declining ratio of tank capacity to potential acreage for paddy cultivation has since the 1930's been a contributing factor to a single annual crop of paddy. The increasing population pressure and the reduced intensity of paddy cultivation has led to changes in reliance on the various parts of the farming system. This has led to a shortening of the cultivation cycle in the highlands. In the lowlands the better-off farmers were the early adapters of the 'green revolution package'. Currently however, it is within the highlands that most of the changes occur and it is the poor farmer who seems to be the main agent of change.On a village level the system's resilience to an environmental hazard was demonstrated. A breach of a tank bund disrupted the possibility for cultivation during two consecutive seasons. The crops lost were compensated for by various traditional practices such as share cropping.Coordination of land and water use was evident on a village level whereas no such arrangements exist between the villages within the catchment. There arc indications of conflicts both between the villages and between cultivators with individually and communally operated land within a village. For an optimal utilization of water and land resources it is essential to comprehend and deal with the conflicts which threaten the management of the system.
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| 19. |
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| 20. |
- Faresjö, Tomas, 1954-
(författare)
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Social skiktning och ohälsa i Studien 1913 års män
- 1989
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The main objective of this thesis is to elucidate the relationship between social stratification and a broad spectrum of health problems covering subjective ill-health, serious illness and mortality. Against the background of a social-epidemiological frame of reference, special attention is alsopaid to other social factors that are related to occupation and stratification and its effect on health.The empirical material used is data from the Study of Men Born in 1913, a clinical-epidemiological prospective population study that begun in 1963 with a sample of 50-year old men from the general population of Gothenburg, Sweden. These men have been followed up by repeated health-examinations and records. In the present study, which is a type of secondary analysis of the Gothenburg material, the men are followed between the ages of 50 and 71.In a modern welfare society such as that of Sweden, with comprehensive public health care, one should not expect to find any appreciable differences between the social strata with regard to ill-health. The study indicates that differences are most in evidence with regard to perceivedhealth and being on the sick-list. In both these respects the lower social strata are worse off then the higher. The differences concerning perceived ailments tend to even out after retirement. When it comes to serious illness and mortality there is a certain tendency of differences concerningmyocardial infarction and survival after it. The lower social strata appear to be rather more at risk than the higher, but apart from this the differences were small.Constituting a main group of social-epidemiological factors that are both conceptually and empirically related to social stratification arc various circumstances to do with occupation. It is evident from the study that such factors- which can be designated life-events and which comprise first and foremost unemployment, change of occupation and change in earnings- indicate increased risk of suffering myocardial infarction and death. There are also a number of connections between on the one hand various indicators of ill-health, and on the other hand social phenomena such as status incongruence and social mobility across the generations.Many of the social factors that are of interest from the social epidemiological point of view prove to be strongly intercorrelated and form very complex patterns. 1t is a challenge to sqcialepidemiologicalresearch (which in-many respects is still in its initial stage) to elucidate the complex connections between ill-health and various social conditions, life-style and physiological factors.
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