| 1. |
- Eriksson Tinghög, Mimmi, 1973-, et al.
(author)
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Preventing alcohol problems and improving drinking habits among employees : An evaluation of an alcohol education
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Journal article (peer-reviewed)abstract
- Aim: To investigate whether a day-long alcohol education provided to all employed by a Swedish municipality had an effect on alcohol consumption among all employees and among employees with lowand higher levels of consumption respectively.Methods: A quasi-experimental evaluation using pre- and post-test questionnaires was performed. The municipality’s employees were divided in one intervention group (n:124) and one control group (n:139). ANOVA with repeated measures was performed on AUDIT-score and on three separate AUDIT-items; frequency of drinking, frequency of binge drinking and typical amount consumed per drinking occasion.Results: No significant effect on alcohol consumption was identified for the intervention group as a whole. Stratified analyses showed that the intervention had a significant effect on reducing the frequency of binge drinking among those with the highest consumption.Conclusions: Compared to many other studies on alcohol educations some results on behaviour were found when performing stratified analyses. The employees with the highest alcohol consumption, although not labelled high consumers, reduced their frequency of binge drinking. It is though difficult to speculate in whether these results can be generalized to other working populations. The results also have to be valued and compared with other more direct methods of reaching risk consumers, such as screening and brief interventions.To know more about alcohol and associated risk might facilitate thewillingness to seek help sooner.
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| 2. |
- Eriksson Tinghög, Mimmi, et al.
(author)
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Preventing alcohol problems and improving drinking habits among employees : An evaluation of alcohol education
- 2016
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In: Work. - 1051-9815 .- 1875-9270. ; 53:2, s. 421-428
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Journal article (peer-reviewed)abstract
- BACKGROUND: In a municipality in Sweden there was a concern about the high alcohol consumption among its residents. An alcohol education program was provided to all those employed by the municipality. OBJECTIVE: To investigate whether a day-long alcohol education program provided to all employed by a Swedish municipality had an effect on alcohol consumption among employees and specifically among employees with low and higher levels of consumption respectively. METHODS: A quasi-experimental evaluation using pre-test and post-test questionnaires was performed. The municipality's employees were divided in one intervention group (n: 124) and one control group (n: 139). ANOVA with repeated measures was performed on AUDIT-score and on three separate AUDIT-items: frequency of drinking, frequency of binge drinking, and typical amount consumed per drinking occasion. RESULTS: No significant effect on alcohol consumption was identified for the intervention group as a whole. Stratified analyses showed the intervention had a significant effect on reducing the frequency of binge drinking among those with the highest consumption. CONCLUSIONS: Compared to many other studies on alcohol education, some results on behaviour were found when performing stratified analyses. The employees with the highest alcohol consumption, although not labelled high consumers, reduced the frequency of binge drinking. It is difficult to speculate whether these results can be generalized to other working populations. The results have to be compared with more direct methods of reaching risk consumers, such as screening and brief interventions. Knowledge about alcohol and the associated risks of alcohol consumption might facilitate the willingness to seek help sooner.
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| 3. |
- Omar, Faisal, et al.
(author)
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Attitudes towards priority-setting and rationing in healthcare - an exploratory survey of Swedish medical students
- 2009
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In: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 37:2, s. 122-130
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Journal article (peer-reviewed)abstract
- Background: Healthcare priority-setting is inextricably linked to the challenge of providing publicly funded healthcare within a limited budget, which may result in difficult and potentially controversial rationing decisions. Despite priority-settings increasing prominence in policy and academic discussion, it is still unclear what the level of understanding and acceptance of priority-setting is at different levels of health care. Aims: The aim of this study is threefold. First we wish to explore the level of familiarity with different aspects of priority-setting among graduating medical students. Secondly, to gauge their acceptance of both established and proposed Swedish priority-setting principles. Finally to elucidate their attitudes towards healthcare rationing and the role of different actors in decision making, with a particular interest in comparing the attitudes of medical students with data from the literature examining the attitudes among primary care patients in Sweden. Methods: A cross-sectional survey containing 14 multiple choice items about priority-setting in healthcare was distributed to the graduating medical class at Linkoping University. The response rate was 92% (43/47). Results: Less than half of respondents have encountered the notion of open priority-setting, and the majority believed it to be somewhat or very unclear. There is a high degree of awareness and agreement with the established ethical principles for priority-setting in Swedish health care; however respondents are inconsistent in their application of the cost-effectiveness principle. A larger proportion of respondents were more favourable to physicians and other health personnel being responsible for rationing decisions as opposed to politicians. Conclusions: Future discussion about priority-setting in medical education should be contextualized within an explicit and open process. There is a need to adequately clarify the role of the cost-effectiveness principle in priority-setting. Medical students seem to acknowledge the need for rationing in healthcare to a greater extent when compared with previous results from Swedish primary care patients.
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| 4. |
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| 5. |
- Omar, Faisal, et al.
(author)
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Transplant tourism and compensated kidney donation : A survey of opinions amongst Swedish medical students
- 2010
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In: International Journal of Health Promotion & Education. - 1463-5240. ; 48:4, s. 106-112
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Journal article (peer-reviewed)abstract
- Objective: Transplant tourism and proposals for regulated compensated donation are reactions to the global scarcity in kidneys. These areas raise unique ethical challenges in medical education and clinical practice. We aimed to elucidate the opinions of soon-to-be physicians on transplant tourism, and compensated donation. We investigated how these opinions are formed, if they are interrelated, and their impact on encounters with patients. Design and Methods: a 14 item survey was developed using cognitive interviewing techniques, and distributed to the graduating class at Linköping Medical University. Spearman's correlation coefficient and Pearson's chi-square test were employed to investigate significant associations. Results: The response rate was 43/47 (92%). The majority were strongly (64%), or somewhat (29%) against transplant tourism. Those with strong negative positions on transplant tourism were significantly (p<0.05) more likely to dissuade patients from pursuing it. More students expressed support for regulated compensation from a clinical perspective (34%) as compared with support from an ethical perspective (15%). Conclusions: The opinions of young physicians on transplant tourism are a significant indicator for their clinical approach. Young physicians balance competing ethical responsibilities such as respect for autonomy against concerns for kidney vendors in the developing world. Clinical and policy scenarios, similar to those used in this survey are useful tools for students to explore challenging ethical issues within their medical education, to provide appropriate guidance for patients and empower them through health education.
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| 6. |
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| 7. |
- Tinghög, Gustav, 1979-, et al.
(author)
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Horizontal Inequality in Rationing by Waiting Lists
- 2014
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In: International Journal of Health Services. - : Baywood Publishing Company, Inc.. - 0020-7314 .- 1541-4469. ; 44:1, s. 169-184
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Journal article (peer-reviewed)abstract
- The objective of this article was to investigate the existence of horizontal inequality in access to care for six categories of elective surgery in a publicly funded system, when care is rationed through waiting lists. Administrative waiting time data on all elective surgeries (n = 4,634) performed in Östergötland, Sweden, in 2007 were linked to national registers containing variables on socioeconomic indicators. Using multiple regression, we tested five hypotheses reflecting that more resourceful groups receive priority when rationing by waiting lists. Low disposable household income predicted longer waiting times for orthopedic surgery (27%, p < 0.01) and general surgery (34%,p < 0.05). However, no significant differences on the basis of ethnicity and gender were detected. A particularly noteworthy finding was that disposable household income appeared to be an increasingly influential factor when the waiting times were longer. Our findings reveal horizontal inequalities in access to elective surgeries, but only to a limited extent. Whether this is good or bad depends on one's moral inclination. From a policymaker's perspective, it is nevertheless important to recognize that horizontal inequalities arise even though care is not rationed through ability to pay.
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| 8. |
- Alexandersson, Kristina, et al.
(author)
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Att uppmärksamma barn till svårt sjuka patienter på en neurologisk klinik - utvärdering av implementering av rutiner och arbetssätt
- 2017
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In: Socialmedicinsk Tidskrift. - 0037-833X. ; 94:4, s. 485-495
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Journal article (peer-reviewed)abstract
- Barn till allvarligt somatiskt sjuka föräldrar löper en förhöjd risk för egen psykisk ohälsa. Här presenteras resultat från utvärderingen av implementering av rutiner och arbetssätt som syftade till att förbättra arbetet med att identifiera, informera samt stödja minderåriga barn till patienter på en neurologisk klinik. Fyra delstudier genomfördes. Resultaten indikerar att trots betydande insatser för att säkerställa att kliniken lever upp till sina lagstadgade uppgifter, fanns en stor förbättringspotential. Hela 80% av patienter med minderåriga barn hade inte fått information om sina barns rätt till stöd och 40% hade inte tillräckligt stöd för att utöva sin föräldraroll. Samtidigt noterades en tydlig ökning i andelen personal på kliniken som hade kunskap om sin skyldighet att erbjuda information, råd och stöd.
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| 9. |
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| 10. |
- Amin, R., et al.
(author)
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Does country of resettlement influence the risk of suicide in refugees? : A case-control study in Sweden and Norway
- 2021
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In: Epidemiology and Psychiatric Sciences. - : Cambridge University Press. - 2045-7960 .- 2045-7979. ; 30
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Journal article (peer-reviewed)abstract
- Aims Little is known regarding how the risk of suicide in refugees relates to their host country. Specifically, to what extent inter-country differences in structural factors between the host countries may explain the association between refugee status and subsequent suicide is lacking in previous literature. We aimed to investigate (1) the risk of suicide in refugees resident in Sweden and Norway, in general, and according to their sex, age, region/country of birth and duration of residence, compared with the risk of suicide in the respective majority host population; (2) if factors related to socio-demographics, labour market marginalisation (LMM) and healthcare use might explain the risk of suicide in refugees differently in host countries. Methods Using a nested case-control design, each case who died by suicide between the age of 18 and 64 years during 1998 and 2018 (17 572 and 9443 cases in Sweden and Norway, respectively) was matched with up to 20 controls from the general population, by sex and age. Multivariate-adjusted conditional logistic regression models yielding adjusted odds ratios (aORs) with 95% confidence intervals (95% CI) were used to test the association between refugee status and suicide. Separate models were controlled for factors related to socio-demographics, previous LMM and healthcare use. Analyses were also stratified by sex and age groups, by refugees' region/country of birth and duration of residence in the host country. Results The aORs for suicide in refugees in Sweden and Norway were 0.5 (95% CI 0.5-0.6) and 0.3 (95% CI 0.3-0.4), compared with the Swedish-born and Norwegian-born individuals, respectively. Stratification by region/country of birth showed similar statistically significant lower odds for most refugee groups in both host countries except for refugees from Eritrea (aOR 1.0, 95% CI 0.7-1.6) in Sweden. The risk of suicide did not vary much across refugee groups by their duration of residence, sex and age except for younger refugees aged 18-24 who did not have a statistically significant relative difference in suicide risk than their respective host country peers. Factors related to socio-demographics, LMM and healthcare use had only a marginal influence on the studied associations in both countries. Conclusions Refugees in Sweden and Norway had almost similar suicide mortality advantages compared with the Swedish-born and Norwegian-born population, respectively. These findings may suggest that resiliency and culture/religion-bound attitudes towards suicidal behaviour in refugees could be more influential for their suicide risk after resettlement than other post-migration environmental and structural factors in the host country.
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