| 1. |
- von Celsing, Anna-Sophia, et al.
(författare)
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Determinants for return to work among sickness certified patients in general practice
- 2012
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 12:1, s. 1077-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Long-term sickness absence is one of the main risk factors for permanent exit out of the labour market. Early identification of the condition is essential to facilitate return to work. The aim of this study was to analyse possible determinants of return to work and their relative impact.METHODS:All 943 subjects aged 18 to 63 years, sickness certified at a Primary Health Care Centre in Sweden from 1 January until 31 August 2004, were followed up for three years. Baseline information on sex, age, sick leave diagnosis, employment status, extent of sick leave, and sickness absence during the year before baseline was obtained, as was information on all compensated days of sick leave, disability pension and death during follow-up.RESULTS:Slightly more than half the subjects were women, mean age was 39 years. Half of the study population returned to work within 14 days after baseline, and after three years only 15 subjects were still on sick leave. In multivariate proportional hazards regression analysis the extent of previous sick leave, age, being on part-time sick leave, and having a psychiatric, musculoskeletal, cardiovascular, nervous disease, digestive system, or injury or poisoning diagnosis decreased the return to work rate, while being employed increased it. Marital status, sex, being born in Sweden, citizenship, and annual salary had no influence. In logistic regression analyses across follow-up time these variables altogether explained 88-90% of return to work variation.CONCLUSIONS:Return to work was positively or negatively associated by a number of variables easily accessible in the GP's office. Track record data in the form of previous sick leave was the most influential variable.
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| 2. |
- Bröms, Kristina, 1954-
(författare)
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A Nationwide Study of Asthma and Allergy in Swedish Preschool Children : with Special Reference to Environment, Daycare, Prevalence, Co-ocurrence and Incidence
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim: The aim of this project was to study the age and sex specific occurrence of atopic and non-atopic asthma and other atopic manifestations in a nationwide sample of Swedish pre-school children. Methods: All 70 allergen avoidance day-care centres (AADC) with 84 sections and 140 matched ordinary day-care centres with 440 sections in 62 municipalities across Sweden were sampled. In 2000 the staff at each section responded to a questionnaire on indoor and outdoor environment at the section. In 2002 parents of 5,886 children attending the AADCs and ODCs responded to a postal questionnaire regarding symptoms indicating prevalent asthma, allergic rhinitis, eczema, and food, furred pet and pollen allergy and other data in their children. In 2007, parents of 4255 children responded to an almost identical follow-up questionnaire. Results: The AADCs had far more strict rules than ODCs on furred pets and smoking at home and on perfume use, and the indoor environment was better, owing to better cleaning. The age specific asthma prevalence was curvilinear with a peak at age 3 of 11.4% among boys and 9.8% among girls. In addition the prevalence increased by municipality population density, a proxy for degree of urbanisation. There was a highly significant co-occurrence between all asthma-atopic manifestations, but there was no evidence of ordered sequence of manifestation onset. The asthma incidence was highly dependent on presence or absence of co-occurrence variables. Given the variable mix in the present study population, the annual asthma incidence ranged from 0.6% to 1.2%. Conclusions: AADCs had more strict rules and a better indoor environment than ODCs. The asthma prevalence was affected by age, sex and degree of urbanisation. There was close co-occurrence between all asthma and atopic manifestations but no evidence of ordered sequence of onsets. The annual asthma incidence was strongly dependent of co-occurrence conditions.
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| 3. |
- Bröms, Kristina, et al.
(författare)
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A nationwide study of asthma incidence rate and its determinants in Swedish pre-school children
- 2012
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Ingår i: European Journal of Epidemiology. - : Springer Science and Business Media LLC. - 0393-2990 .- 1573-7284. ; 27:9, s. 695-703
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Tidskriftsartikel (refereegranskat)abstract
- While many studies on asthma prevalence have been published, the number of studies on asthma incidence in pre-school children is limited. In this project, a nationwide sample of pre-school children was followed with the aim of estimating cumulative 5-year asthma incidence and its determinants. Parents of 5,886 children 1-6 years of age, sampled from day-care centres in 62 municipalities all over Sweden, responded in 2002 to a baseline postal questionnaire with questions regarding symptoms indicating possible asthma or atopic conditions, and a number of other variables. In 2007, parents of 4,255 children responded to an almost identical follow-up questionnaire. Of these, the 3,715 children who were free from asthma at baseline constitute the study population for this report. A large number of potential baseline determinants for cumulative 5-year asthma incidence were identified. Of these, food allergy, rhinitis, incomplete asthma diagnosis criteria (wheezing last 12 months, and ever had asthma but no current symptoms), parental rhinitis, parental asthma, age, and eczema, in ranking order of importance, remained significant in multivariate logistic regression analysis. The asthma incidence rate was highly dependent on presence or absence of these variables, the average annual rate ranging from 2/1,000/year in 6-year-olds with no determinants to154/1,000/year in 1-year-olds with all determinants, corresponding to 11/1,000/year based on the whole study population.
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| 4. |
- Bröms, Kristina, et al.
(författare)
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Prevalence and co-occurrence of parentally reported possible asthma and allergic manifestations in pre-school children
- 2013
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 13, s. 764-
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of this study was to make an in-depth analysis of the prevalence and co-occurrence in pre-school children of possible asthma and atopic manifestations. Methods: In Sweden 74%-84% of preschool children, depending on age, attend municipality organised day-care centres. Parents of 5,886 children 1-6 years of age, sampled from day-care centres in 62 municipalities all over Sweden, responded to a postal questionnaire regarding symptoms indicating prevalent possible asthma, allergic rhinitis, eczema, and food, furred pet and pollen allergy and other data in their children. Possible asthma was defined as any of the four criteria wheezing four times or more during the last year, physician diagnosis and current wheezing, ever had asthma and current wheezing, and current use of inhalation steroids, all based on questionnaire responses. Results: The overall prevalence of possible asthma was 8.9%, of eczema 21.7%, of rhinitis 8.1%, and of food allergy 6.6%. There was a highly significant co-occurrence between possible asthma and all atopic manifestations, 35.7% having any of the manifestations. Presence of pet allergy was the manifestation showing the closest co-occurrence with presence of possible asthma, presence of pollen allergy with presence of rhinitis, and presence of food allergy with presence of eczema. Assessed from plots of age-specific prevalence of possible asthma, rhinitis, eczema and food allergy, the prevalence of all manifestations increased from one to three years of age and then decreased, except for rhinitis where the prevalence increased until six years of age, indicating no specific ordered sequence. Conclusions: Parentally reported possible asthma, eczema and food allergy had a curvilinear prevalence course across age with a maximum at age 3, while rhinitis prevalence increased consistently with age. Co-occurrence between possible asthma and atopic manifestations was common, and some combinations were more common than others, but there was no evidence of a specific ordered onset sequence.
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| 5. |
- Eriksson, Margaretha
(författare)
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Observations on Practical Information Security Issues and Life Cycle Management in IT Systems - a Case Study
- 2010
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Ingår i: The Security Conference Europe August 15-17, 2010 in Örebro, Sweden.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Abstract. This paper presents three case studies related to practical information security issues during the Life Cycle of IT systems in (1) a big, global organisation, (2) a medium sized governmental agency, and (3) a small sales and production enterprise. The maturity of the processes used during systems development, as well as the organisation are taken into consideration, and methods of communication of information security, follow-up and feedback is described. Security related processes and procedures, or the lack thereof, are described and their effect discussed. Efficient communication of the security policy, fast feedback on actions and follow-up on security related procedures seems to increase the level of information security and can be expressed in terms of the Quality of Service delivered from the organisation to its customers or clients.
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| 6. |
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| 7. |
- Peterson, Magnus, 1966-, et al.
(författare)
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A randomized controlled trial of eccentric vs. concentric graded exercise in chronic tennis elbow (lateral elbow tendinopathy)
- 2014
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Ingår i: Clinical Rehabilitation. - : Sage Publications. - 0269-2155 .- 1477-0873. ; 28:9, s. 862-872
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To analyse treatment effects of eccentric vs. concentric graded exercise in chronic tennis elbow.Design: Randomized controlled trial.Setting: Primary care in Uppsala County, Sweden.Subjects: A total of 120 subjects with tennis elbow lasting more than three months were recruited from primary care and by advertisement.Intervention: Eccentric (n = 60) or concentric exercise (n = 60), by lowering or lifting a weight, at home daily, for three months with gradually increasing load.Main measures: Pain during muscle contraction and muscle elongation, as well as strength, was assessed at baseline and after one, two, three, six, and 12 months. Function and quality of life was assessed at baseline and after three, six and 12 months.Results: The eccentric exercise group had faster regression of pain, with an average of 10% higher responder rate at all levels of pain reduction, both during muscle contraction and elongation, (p < 0.0001 and p = 0.006, respectively). Significant differences were found in Cox's analysis from two months onwards (HR 0.78, 95% confidence interval (CI) 0.63-0.96, p < 0.02). This represents an absolute pain reduction of 10% in the eccentric vs. the concentric group and a number-needed-to-treat of 10. The eccentric group also had a greater increase of muscle strength than the concentric (p < 0.02). The differences persisted throughout the follow-up period. There were no significant differences between the groups regarding function or quality of life measures.Conclusion: Eccentric graded exercise reduced pain and increased muscle strength in chronic tennis elbow more effectively than concentric graded exercise.
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| 8. |
- Peterson, Magnus, 1966-, et al.
(författare)
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A randomized controlled trial of exercise versus wait list in chronic tennis elbow (lateral epicondylosis)
- 2011
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Ingår i: Upsala Journal of Medical Sciences. - : Uppsala Medical Society. - 0300-9734 .- 2000-1967. ; 116:4, s. 269-279
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Tidskriftsartikel (refereegranskat)abstract
- Background. Chronic tennis elbow (lateral epicondylosis) is a common disorder. Like other chronic soft tissue pain conditions it is often difficult to treat successfully. The effects of exercise have been discussed but no convincing evidence has been put forward so far, and a simple protocol for exercise is lacking. Aims of the study. This study is a randomized, controlled, clinical trial of the effect of exercise versus expectation (wait-list) on pain, muscle strength, function, and quality of life in patients with longstanding lateral epicondylosis. Methods. Eighty-one subjects with tennis elbow lasting for more than three months were randomly allocated to an exercise group (n=40) or a reference group (n=41). The exercise group performed daily exercise, with weekly load increase, for three months. The reference group was wait listed, but otherwise followed in the same way. Outcome measures were pain during maximum voluntary muscle contraction (Cozen´s test) and pain during maximum muscle elongation with a load (modified Empty-can-test), muscle strength measured with a Chatillon MSE 100 hand-held dynamometer, and the Disability of the Arm, Shoulder and Hand (DASH) and the Gothenburg Quality of Life questionnaires. Results .The exercise group had greater and faster regression of pain, both during muscle contraction and muscle elongation, than the reference group (p=0.0005 and p=0.0016, respectively). There was a non-significant muscle strength difference between the groups, but no differences regarding DASH scores or quality of life measures. Conclusions .Exercise appears to be superior to expectation in reducing pain in chronic lateral epicondylosis.
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| 9. |
- Peterson, Magnus, 1966-
(författare)
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Chronic Tennis Elbow : Aspects on Pathogenesis and Treatment in a Soft Tissue Pain Condition
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Objectives: To study the treatment practice of chronic tennis elbow (TE) among general practitioners (GPs) and physiotherapists (PTs), the effects of a simple, graded home exercise regime versus expectation, the effects of eccentric versus concentric exercise, and the involvement of the substance P – NK1 receptor system in the peripheral, painful tissue of chronic TE patients by positron emission tomography (PET).Materials and methods: A postal survey regarding therapeutic methods used in patients with chronic TE was sent to 129 GPs and 77 PTs, 81 subjects with chronic TE were randomly and blindly assigned to either an exercise group or a wait list group, 120 subjects were randomly assigned to either eccentric or concentric exercise and ten subjects were examined by PET and the NK1 specific radioligand [11C]GR205171.Results: High proportions of GPs and PTs used ergonomic counselling and stretching in the treatment of chronic TE. The majority of GPs prescribed passive anti-inflammatory measures such as sick leave and anti-inflammatory medication. Many PTs prescribed dynamic, particularly eccentric, exercise. Graded dynamic exercise according to a simple low-cost protocol, has better effect on pain than a wait-and-see attitude. Adjusted for outcome affecting variables, eccentric graded exercise has quicker effect than concentric graded exercise. During PET scan with the NK1 specific radioligand [11C]GR205171, voxel volume and signal intensity of this volume was significantly higher in the affected than the unaffected arm in subjects with unilateral chronic TE.Conclusions: GPs and PTs used many treatments to a similar extent but differed regarding the use of exercise. Chronic TE responds favourably to graded dynamic exercise aimed specifically at the painful tissue. The exercise should stress the eccentric work phase. The substance P – NK1 receptor system seems to play a part in the peripheral, painful tissue of a chronic, soft tissue pain condition such as chronic TE.
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| 10. |
- Sluys, Kerstin, 1956-, et al.
(författare)
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Outcomes in Pediatric Trauma Care in the Stockholm Region
- 2010
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Ingår i: European Journal of Trauma and Emergency Surgery. - Berlin : Springer Berlin/Heidelberg. - 1863-9933 .- 1863-9941. ; 36:4, s. 308-317
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Tidskriftsartikel (refereegranskat)abstract
- Background:Although trauma is a leading cause of pediatric mortality and morbidity in Sweden, few studies have examined the outcome of pediatric trauma.Objective:Here, we describe the age and gender distribution, injury mechanisms, injury severity, and outcome of pediatric trauma in the Stockholm region.Methods:This retrospective study comprises all trauma patients (age ≤ 15 years) admitted to a regional pediatric trauma center and all pediatric deaths due to trauma in Stockholm in 2002. Data from the trauma registry database were verified by comparison with medical records and autopsy reports. Outcome was measured by mortality and length of stay in a pediatric intensive care unit (PICU) and acute care hospital.Results:In all, 432 injured children were included. The median age was 10 years and 59% were males. The median injury severity score was 4 (interquartile range [IQR] 1–9) and 50% sustained head injuries. Mortality was low (1%) and the median length of hospital stay was 2 days (IQR 1–3); 19% stayed in a PICU and, of those, 89% stayed for one day. Comparison with medical records showed that much information in the trauma registry database was either incorrect or missing.Conclusions:Many injuries were minor and half of the children were discharged home from the emergency department. Head injuries were the most common injury in all age groups. The most severe head injuries were seen in the youngest group and were caused by falls. Trauma team activation criteria should be improved to avoid overutilization. The quality and completeness of data in the trauma registry must be enhanced.
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